Hydrofluoric acid (HFA) is an extremely corrosive fluid and should be handled very carefully. It penetrates tissue more quickly than typical acids, and has the systemic toxicity that can occur via dermal, ocular, inhalation, and oral routes. Furthermore, it interferes with nerve function, thus burns may not initially be painful but may become gradually painful. If the treatment is delayed, the extent and seriousness of injury and toxicity will be much more severe; HFA will be absorbed into the blood stream, react with serum calcium, and may cause arrhythmia or cardiac arrest. As the chemical industry grows, the frequency of HFA use is increasing, leading to increased incidences of HFA dermal burn. Yet, reports of HFA inhalation injury are rare. Presently, we treated one patient with HFA inhalation injury sustained during work at a cosmetic factory. The male presented an acutely ill appearance, shortness of breath, and cold sweating. At once, oxygen, IV antibiotics, and IV 20% calcium gluconate were administered, and the patient was closely monitored. The patient was admitted to the intensive care unit. Successful management led to discharge without any significant complications.
Anti-Bacterial Agents ; Arrhythmias, Cardiac ; Burns ; Calcium ; Calcium Gluconate ; Chemical Industry ; Cold Temperature ; Cosmetics ; Dyspnea ; Gluconates ; Heart Arrest ; Humans ; Hydrofluoric Acid ; Incidence ; Inhalation ; Intensive Care Units ; Male ; Oxygen ; Rivers ; Sweat ; Sweating

Hydrofluoric acid (HFA) is an extremely corrosive fluid and should be handled very carefully. It penetrates tissue more quickly than typical acids, and has the systemic toxicity that can occur via dermal, ocular, inhalation, and oral routes. Furthermore, it interferes with nerve function, thus burns may not initially be painful but may become gradually painful. If the treatment is delayed, the extent and seriousness of injury and toxicity will be much more severe; HFA will be absorbed into the blood stream, react with serum calcium, and may cause arrhythmia or cardiac arrest. As the chemical industry grows, the frequency of HFA use is increasing, leading to increased incidences of HFA dermal burn. Yet, reports of HFA inhalation injury are rare. Presently, we treated one patient with HFA inhalation injury sustained during work at a cosmetic factory. The male presented an acutely ill appearance, shortness of breath, and cold sweating. At once, oxygen, IV antibiotics, and IV 20% calcium gluconate were administered, and the patient was closely monitored. The patient was admitted to the intensive care unit. Successful management led to discharge without any significant complications.
Anti-Bacterial Agents ; Arrhythmias, Cardiac ; Burns ; Calcium ; Calcium Gluconate ; Chemical Industry ; Cold Temperature ; Cosmetics ; Dyspnea ; Gluconates ; Heart Arrest ; Humans ; Hydrofluoric Acid ; Incidence ; Inhalation ; Intensive Care Units ; Male ; Oxygen ; Rivers ; Sweat ; Sweating

BACKGROUND: Recently, there are many reports about the association of Diffusion Weighted Imaging (DWI) and the prognosis of hypoglycemic encephalopathy (HE), but those relationships have not yet been completely determined. As such, we researched for prognosis, according to a variety of clinical data, and the lesion's distribution on DWI. METHODS: We retrospectively reviewed 19 patients who were diagnosed as HE. In addition, those prognoses were analyzed by a variety of clinical data and characteristics of lesion's distribution, which were evaluated on DWI and Apparent Diffusion Coefficient (ADC) maps. Three months later, those prognoses were determined by each Modified Rankin Scale. Further, the time-dependent average Glasgow Coma Scale (GCS), among the groups according to the characteristics of lesion's distributions in the initial DWI, was estimated. RESULTS: In this study, the difference of prognosis was not shown, according to all the clinical data, such as the severity or duration of the hypoglycemic state, but the group that did not have any pathologic lesion on the initial DWI demonstrated a better prognosis, in comparison with the groups-that exhibited any positive lesion on the initial DWI (p = 0.006). The group that had a focal pathologic lesion on the initial DWI showed a better prognosis than the diffuse lesion's group (p = 0.045). The groups with no lesion or focal lesion showed a faster recovery of GCS than the other groups with a positive lesion or diffuse lesion within the initial 1 week. CONCLUSIONS: We can identify that the characteristics of the lesion's distribution of DWI can be more helpful to predict of prognosis in HE than a variety of clinical data, such as the severity or duration of the hypoglycemic state.
Diffusion ; Glasgow Coma Scale ; Humans ; Hypoglycemia ; Prognosis ; Retrospective Studies

Takayasu's arteritis is an arteritis of undetermined etiology, which affects the aorta and the proximal portions of its major branches. But aortic regurgitation and coronary artery involvement were unusual manifestations in this disease. We experienced a patient of Takayasu's arteritis who represented these unusual manifestations. Aortogram revealed grade IV aortic regurgitation and proximal segment narrowing of left main coronary artery. A case of Takayasu's arteritis associated with aortic regurgitation and left main coronary artery involvement is reported with a review of literatures.
Aorta ; Aortic Valve Insufficiency* ; Arteritis ; Coronary Vessels* ; Humans ; Takayasu Arteritis*

The expression pattern of immunoproteasomes in human thymus has not been analyzed but may have important consequences during thymic selection. Here we examined the expression patterns of immunoproteasome subunits in fetal and adult thymic tissues by immunohistochemistry and found that all three subunits are expressed in both cortical and medullary stromal cells. These data suggest that thymic selection in human can be affected by peptide repertoires generated by immunoproteasomes.
Adult ; Humans ; Immunohistochemistry ; Stromal Cells ; Thymus Gland

42 patients with the clinical evidences of endocarditis were examined by echocardiography. In 28 of 42 cases(66.7%) vegetation was present, whereas in 14(33.3%) vegetation was not visualized. Alpha-hemolytic streptococcus was the most common infecting organism(47.6%) and rheumatic heart disease was the most common predisposing heart disease(47.6%). Patients with echocardiographically demonstrable vegetation had a higher incidence of congestive heart failure compared to the patients without vegetation(75.0% vs. 21.4% p<0.05). But major embolism was not significantly different in the two groups. Mortality was higher in the patients with vegetation than in the patients without it(39.3% vs. 0%, p<0.05). Among vegetation positive patients, mortality was highest in aortic valve patients.(58.3%) So patietns with aortic valve vegetation should be regarded as high risk group and early surgical intervention should be considered if indicated. The causes of mortality were congestive heart failure(45.5%), cerebral embolism(36.4%), myocardial infarction(9.1%) and ventricular tachycardia(9.1%) in decreasing frequency.
Aortic Valve ; Echocardiography* ; Embolism ; Endocarditis ; Endocarditis, Bacterial* ; Estrogens, Conjugated (USP) ; Heart ; Heart Failure ; Humans ; Incidence ; Mortality ; Rheumatic Heart Disease ; Streptococcus

Primary papillary serous carcinoma of the peritoneum(PPSCP) is vere rare. It has been suggested that PPSCP derives from embryonal coelomic epithelium with m llerian ducts potential. PPSCP can develop from a single or multicentric focus. The clinical and histologic disease entities are similar to those of primary papillary serous carcinoma of the ovary, but PPSCP involves the ovarian surface only minimally(microscopic disease) or spares the ovaries entirely. We have experienced a case of primary papillary serous carcinoma of the peritoneum and report this case with brief review of the concerned literature.
Epithelium ; Female ; Ovary ; Peritoneum*

Supine exercise test was done with bicycle ergometer and echocardiography in 28 patients with chronic aortic regurgitation. Ejection fraction was measured before and immediately after exercise from echocardiography, wall stress and radius/thickness ratio was calculated from echocardiography and systolic blood pressure. 1. There was no difference in left ventricular end systolic and diastolic dimension, ejection fraction at rest, radius/thickness ratio, wall stress between NYHA functional class I, II, III. But work capacity was greater in NYHA class I than in class II, III(39712+/-10778 watt-sec, 23766+/-14280 watt-sec, 11968+/-6052 watt-sec respectively). Ejection fraction after exercise was significantly increased in class I(66.3+/-8.9% at rast vs 71.3+/-10.7% after exercise). 2. Ejection fraction was increased more than 5% in 12 patients(group I) and increased less than 5% or decreased in 16 patients(group II). There was no difference in basal E.F., Ded, Des and postexercise heart rate-blod pressure product between group I and II. But between group I and II, there was significant difference in diastolic redius/thickness ratio(2.55+/-0.30 vs 3.00+/-0.51), mean radius/thickness ratio(1.86+/-0.23 vs 2.18+/-0.30), systolic wall stress(192.3+/-38.6mmHg vs 240.2+/-57.7mmHg), mean wall stress(265.8mmHg vs 334.8+/-68.7mmHg) and work capacity(33848+/-12682 watt-sec vs 19210+/-12342 watt-sce). 3. Work capacity was more than 23800 watt-sec in 16 patients(group A), and less than 23800 watt-sec in 12 patients(group B). There was no difference in ejection fraction at rest, radius/thickness ratio, wall stress, and left ventricular dimension. But ejection fraction after exercise was significantly different between group A and B(68.6+/-14.6% vs 55.8+/-14.2%). 4. In nine patients with end systolic dimension greater than 50 mm ejection fraction was decreased or increased less than 5% in 7 patients. So mean ejection fraction was significantly decreased after exercise(56.8+/-7.5% at rest, 51.0+/-16.3% after exercise).
Aortic Valve Insufficiency* ; Blood Pressure ; Echocardiography* ; Exercise Test ; Heart ; Humans

BACKGROUND: Down regulation of major histocompatibility complex class II transactivator (CIITA) has been identified as a major factor of immunosuppression in sepsis and the level of CIITA expression inversely correlates with the degree of severity. However, it has not been fully elucidated whether the lower expression of CIITA is a cause of disease process or a just associated sign. Here we determined whether the CIITA deficiency decreased survival rate using murine sepsis model. METHODS: Major histocompatibility complex class II (MHC-II) deficient, CIITA deficient and wild type B6 mice were subjected to cecal ligation puncture (CLP) surgery. CIITA and recombination activation gene (RAG)-1 double deficient mice were generated to test the role of lymphocytes in CIITA-associated sepsis progression. RESULTS: Sepsis mortality was enhanced in CIITA deficient mice, not by impaired bacterial clearance resulted from CD4 T cell depletion, but hyper-inflammatory response such as excessive release of a pro-inflammatory cytokine, high-mobility group box 1 (HMGB1). CONCLUSION: Our results demonstrate that CIITA deficiency affects the course of sepsis via the unexpected function of CIITA, regulation of cytokine release.
Animals ; Cytokines ; Down-Regulation ; HMGB1 Protein ; Immunosuppression ; Inflammation ; Ligation ; Lymphocytes ; Major Histocompatibility Complex ; Mice ; Nuclear Proteins ; Punctures ; Recombination, Genetic ; Sepsis ; Shock ; Survival Rate ; Trans-Activators

The tuberculous peritonitis, especially in pregnancy, is very rare and difficult to diagnose since there is no diagnostic clue and limitation of diagnostic means. The clinical features may vary such as fever, chill, tachycardia, abdominal tenderness or rebound tenderness which are not controlled easily with antibiotics. It is possible to diagnose by AFB culture and biopsy through exploro-laparotomy which is done due to uncontrolled symptoms even to unstable vital signs. It's clinical symptoms and signs are dramatically improved with antituberculotic therapy. Recently we have experienced a case of tubeculous peritonitis at 29 weeks gestation which was diagnosed through exploro-laparotomy including cesarean section. So we report this case with a brief review of literature
Anti-Bacterial Agents ; Biopsy ; Cesarean Section ; Female ; Fever ; Peritonitis ; Peritonitis, Tuberculous* ; Pregnancy* ; Tachycardia ; Vital Signs