PURPOSE: This study aimed to investigate the incidence of intravenous extravasation and the risk factors associated with the use of peripheral intravenous catheters in adults.METHOD: This prospective observational study included 203 adult patients admitted to the general ward who received non-chemotherapy vesicant drug infusion treatments. Data were analyzed using frequencies, percentage, means, standard deviations, and odds ratios (ORs) from multiple logistic regressions.RESULTS: The incidence of extravasation was 43.3%. Risk factors for intravenous extravasation included continuous injections (OR=5.35, 95% CI [1.38, 20.83]), and parenteral nutrition (OR=3.53, 95% CI [1.43, 8.73]).CONCLUSION: The present findings revealed that gastrointernal medicine problems, continuous injection, and parenteral nutrition were related to intravenous extravasation. Further research is necessary to reduce the incidence of extravasation related to peripheral intravenous catheterization in adults, and to prevent secondary complications. Finally, patients should be provided appropriate and continuous care based on the type of intravenous infusion.
Adult ; Catheterization ; Catheters ; Humans ; Incidence ; Infusions, Intravenous ; Irritants ; Logistic Models ; Methods ; Observational Study ; Odds Ratio ; Parenteral Nutrition ; Patients' Rooms ; Prospective Studies ; Risk Factors ; Veins

Respiratory syncytial virus is the most common cause of lower respiratory infection (bronchiolitis and pneumonia) of infancy and early childhood. We analyzed clinical and radiological features of 76 patients with lower respiratory infections by respiratory syncytial virus, which were diagnosed by indirect immunofluorescent test or culture of nasal aspirate in Hep-2 cell monolayer, during the period of January-December, 1991. There were peaks of incidences in March-May and November-December, accounting for 87% of eases. Sixty-two cases (82%) were under 1 year of age. Fifty cases(66%) had underlying diseases. Major radiographical findings were overaeration (83%), parahilar peribronchial infiltrates(67%), segmental or subsegmental atelectasis(32%), and segmental or lobar consolidation(16%). In 15 cases(20%), overaeration was the only radiological findings. There was no evidence of pleural effusion or hilar lymph node enlargement in all cases. By considerig clinical features(symptoms, age. Underlying diseases, epidemic seasons) in addition to the radiological findings, radiologists would be familiar with lower respiratory infection by respiratory syncytial virus. Air space consolidation, which is generally though to represent bacterial pneumonia, is also observed not infrequently in respiratory syncytial virus infections.
Child* ; Humans ; Incidence ; Infant* ; Lymph Nodes ; Pleural Effusion ; Pneumonia, Bacterial ; Respiratory Syncytial Virus Infections ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections

BACKGROUND: Atopic asthma is characterized by activation of Th2-type T cells in the bronchial mucosa. Several reports have suggested an important role for costimulation through the CD28/CTLA4 (cytotoxic T lymphocyte-associated antigen 4)-B7 (CD80/CD86) pathway in allergen activation of T cells in animal models of allergen-induced asthma, because B7-CD28/ CTLA4 interaction can promote the differentiation and development of the Th2 lymphocyte subset. OBJECTIVE: In the present study, we intended to investigate a potential role of humanized CTLA4-Ig on the inhibition of T and B cell activation by blocking B7/CD28 interactions. METHOD: For this purpose we produced humanized CTLA4-Ig fusion protein by transfection to CHO cell and examined its inhibitory effects for activated T and B cell responses. We evaluated the inhibitory effect of MLR (mixed lymphocyte reaction) and con A-stimulated T cell proliferation. And we assayed wheather B cell was inhibited by stimulation of costimulatory signal in LPS-induced B cell response and PFC assay. RESULT: In vitro assay, humanized CTLA4-Ig fusion protein inhibited T cell-specific immune response in dose-dependent manner: CTLA4-Ig inhibited allogeneic stimulation in murine MLR, and the proliferation of T cell by the stimulation of Con A. But CTLA4-Ig did not inhibit directly the proliferative response of B cell by the stimulation of LPS. In addition, in vivo assay, CTLA4-Ig inhibited the production of antibody from B cell, which was presented by plaque-forming cell (PFC) assay. CONCLUSION: These findings suggest that humanized CTLA4-Ig is effective to inhibit the proliferation of activated T cell directly by blocking B7/CD28 costimulation. And humanized CTLA4-Ig influences antibody-producing capacity of B cell indirectly by regulating T cell.
Abatacept ; Animals ; Antibody Formation* ; Asthma ; Cell Proliferation ; CHO Cells ; Cricetinae ; Humans ; Lymphocyte Subsets ; Lymphocytes ; Models, Animal ; Mucous Membrane ; T-Lymphocytes ; Transfection

No abstract available.
Catheters* ; Humans

Airway problems are easiest to manage when they are anticipated. Difficult intubation might, however, occur in patients with no obvious signs or symptoms suggesting airway obstruction. We describe a case of difficult intubation where the laryngeal inlet was obscured by a large epiglottic cyst that was discovered during rapid-sequence induction of general anesthesia. A 3-year-old male weighing 15 kg was admitted for an emergency appendectomy. After preoxygenation, a rapid-sequence induction was carried out. Direct laryngoscopy (Macintosh 1 blade) revealed a large 2-cm cyst arising from the lingual surface of the epiglottis. The cyst completely obstructed the view of the epiglottis and larynx, and several attempts at endotracheal intubation were unsuccessful. Fortunately, the patient was mask ventilated without difficulty and oxygen saturation was 98 99%. After a second 10 mg dose of succinylcholine, intubation was attempted using the same laryngoscope blade and a styletted 4.5 mm endotracheal tube by another anesthesiologist as cricoid pressure was maintained. By using the tube to push the cyst upward, intubation of the trachea was performed after a brief view of the arytenoid cartilages. Anesthesia and the operation then proceeded uneventfully. Following an appendectomy, an ENT surgeon removed the cyst.
Airway Obstruction ; Anesthesia ; Anesthesia, General ; Appendectomy ; Arytenoid Cartilage ; Bays ; Child, Preschool ; Emergencies ; Epiglottis ; Humans ; Intubation ; Intubation, Intratracheal* ; Laryngoscopes ; Laryngoscopy ; Larynx ; Male ; Masks ; Oxygen ; Succinylcholine ; Trachea

No abstract available.
Hypopigmentation*

Recently physiologically based pharmacokinetic (PB-PK) model has important role in industrial and environmental health. One of problem in application of PB-PK models is that they have uncertainties that is due to different input parameters according to authors. In order to develope a PB-PK model that hag good validity, the effect of several input parameters on simulation results was studies. Chemicals studied were perchloroethylene, toluene and styrene. Simulation of alveolar concentration, blood concentration and urinary metabolites was performed for three solvents, respectively. Input parameters discusses were physiological parameters, metabolic parameters and partition coefficient of chemicals. By comparing simulation results according to several pairs of parameters with experimental data, input parameters that showed best fit were decided.
Environmental Health ; Solvents ; Styrene ; Tetrachloroethylene ; Toluene ; Volatile Organic Compounds*

Antiphospholipid syndrome (APS) is a noninflammatory autoimmune disorder characterized by the association of arterial and/or venous thrombosis, recurrent fetal loss and elevated titres of antiphospholipid antibodies, namely lupus anticoagulant (LAC) and/or anticardiolipin antibodies (aCL). It can either occur as a free-standing condition (primary APS) or be associated with another autoimmune disease (secondary APS), mainly systemic lupus erythematosus. The precise pathogenesis of thrombosis in APS in unknown. For children with unexplainable venous or arterial thrombosis, APS should be considered. The diagnosis of APS in children requires a clinical event including venous or arterial thrombosis or immune thrombocytopenia and a laboratory abnormality including positive LAC test or positive aCL antibody test, moderate or high titer IgG. The laboratory abnormality should persist for at least 2 months. We report a 7-year-old girl who had pulmonary embolism and multiple arterial thrombosis caused by primary APS. The laboratory abnormality was positive LAC and beta2-glycoprotein I. She was treated successfully with low molecualr weight heparin (LMWH). After recovery, she was continuously treated with subcutaneous LMWH for another 3 months and switched to oral warfarin. She was symptom-free through 3 years of follow-up.
Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Autoimmune Diseases ; beta 2-Glycoprotein I ; Child ; Diagnosis ; Female ; Follow-Up Studies ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Immunoglobulin G ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; Pulmonary Embolism ; Pulmonary Infarction* ; Thrombocytopenia ; Thromboembolism* ; Thrombosis ; Venous Thrombosis ; Warfarin

No abstract available.
Adrenocortical Carcinoma*

OBJECTIVES: In this study, the exposure status of the hazardous substances from incinerators, such as polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs), were studied, and the relationship between the exposure of these hazardous substances and their heath effects on the workers and residents near municipal solid waste (MSW) incinerators and an industrial incinerator investigated. METHODS: Between July 2001 and June 2002, 13 workers at two MSW incinerators, 16 residents from the area around the two MSW incinerators, 6 residents from the control area, and further 10 residents near an industrial incinerator, estimated to emit higher levels of hazardous substances, were interviewed. Information, including sociodemographic information, personal habits, and work history, detailed gynecologic and other medical history were collected through interviews. Blood samples were also collected from 45 subjects, and analyzed for PCDD/DFs, by high resolution gas chromatography - high resolution mass spectrometry, using the US EPA 1613 method. In addition to the questionnaire survey, urinary concentrations of 8-hydroxydeoxyguanosine (8-OH-dG) and malondialdehyde (MDA) were measured as oxidative injury biomarkers. The urinary concentrations of 8-OH-dG were determined by in vitro ELISA, and the MDA by HPLC, using an adduct with thiobarbituric acid. RESULTS: The PCDD/DFs concentrations in the residents near the industrial incinerator were higher than those in the controls, workers and residents near the MSW incinerators. The average TEQ (Toxic Equivalencies) concentrations of the PCDD/DFs in residents near the industrial incinerator were 53.4pg I-TEQs/g lipid. The estimated daily intakes were within the tolerable daily intake range (1-4 pg I-TEQ/Kg bw/day) suggested by WHO (1997) in only 30% to the people near the industrial incinerator. Animal studies have already shown that even a low body burden of PCDD/DFs, such as 10ng TEQ/kg bw, can cause oxidative damage in laboratory animals. Our study also showed that the same body burden of PCDD/DFs can cause oxidative damage to humans. CONCLUSIONS: The exposures to PCDD/DFs and the oxidative stress of residents near the industrial incinerator, were higher than those in the controls, workers and residents near the MSW incinerators. Proper protection strategies against these hazardous chemicals are needed. Because a lower body burden of PCDD/Fs, such as 10ng TEQ/kg bw, can cause oxidative damage, the tolerable daily intake range should be restrictedly limited to 1pg I-TEQ/kg bw/day.
Animals ; Animals, Laboratory ; Biomarkers ; Body Burden ; Chromatography, Gas ; Chromatography, High Pressure Liquid ; Enzyme-Linked Immunosorbent Assay ; Hazardous Substances ; Humans ; In Vitro Techniques ; Korea* ; Malondialdehyde ; Mass Spectrometry ; Methods ; No-Observed-Adverse-Effect Level ; Oxidative Stress ; Solid Waste