Industrial exposure to toxic agent may produce a wide variety of respiratory damage. Acetic acid is a colorless liquid with a pungent vingar-like odor. It is a rare case that acute lung injury is caused by inhalation of acetic acid. Acetic acid is miscible with water, and may directly produce damage to mucosa of respiratory tract due to its irritant quality. The outcome of the reaction is dependent on the intensity and duration of exposure and varies from death or pulmonary edema in acute phase to resolution or bronchiolitis obliterans or bronchiectasis. We experienced a rose of acute lung injury due to accidental inhalation of acetic acid. The patient was a 31-year-old male who had developed progressive chest discomfort, chilling sense, and mild dyspnea after accidental inhalation of acetic acid. He had severe hypoxemia and chest radiograph showed diane bilateral alveolar edema. He responded to conservative treatment with oxygen inhalation and was discharged with improved condition on the 7th hospital day.
Acetic Acid* ; Acute Lung Injury* ; Adult ; Anoxia ; Bronchiectasis ; Bronchiolitis Obliterans ; Dyspnea ; Edema ; Humans ; Inhalation* ; Male ; Mucous Membrane ; Odors ; Oxygen ; Pulmonary Edema ; Radiography, Thoracic ; Respiratory System ; Thorax ; Water

BACKGROUND: The proliferation of vascular smooth muscle cell(VSMC) is a part of the major pathogenic mechanism for atheroscle- rosis. It has been reported that L-type calcium channel plays a role in the VSMC proliferation in diabetic rats. But there is a little study results about the association between L-type calcium channel and VSMC proliferation by glucose concentrations in culture media. So we examined the association between voltage-dependent L-type calcium channel of VSMCs and the proliferative activity of vascular smooth muscle cells. METHODS: Rat aortic VSMCs were isolated from the aorta of OLETF rat by enzyme method. VSMCs were cultured in various concentrations of glucose(5.5, 25 mM). The VSMCs(1x104 cells in 24-well plates) were incubated in the presence of Bay K 8644 (10-6M) with/without verapamil(10-6M) for 48 hours. Then the proliferation was assessed by MTT(methylthiazole tetrazolium) assay and expression of L-type calcium channel mRNA was measured by RT-PCR. RESULTS: The proliferative ability and the expression of L-type calcium channel of cultured VSMCs were increased dose-dependently by the glucose concentrations(p<0.05). Bay K 8644 enhanced the proliferation of VSMC and verapamil blocked the incremental effects induced by Bay K 8644. CONCLUSION: These results suggest that L-type calcium channel may play a role in VSMC proliferation of OLETF rat.
3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Animals ; Aorta ; Calcium Channels, L-Type* ; Cell Proliferation* ; Culture Media ; Glucose* ; Muscle, Smooth, Vascular* ; Rats ; Rats, Inbred OLETF* ; RNA, Messenger* ; Verapamil

The Dichloromethane(methylene chloride) is a highly volatile liquid used as a solvent, extraction medium, and paint remover. The most significant route of intoxication to dichloromethane is generally inhalation at work site or home, but ingestion is rare. The main toxicological harvard insults from in vivo conversion of dichloromethane to carbon monoxide. We present a case of dichloromethane intoxication following ingestion. A 71 years old male patient ingested 60-70cc of dichloromethane was brought to emergency department after stomach washout via nasogastric tube at other hospital. On arrival at emergency department(approximately 19 hours after ingestion), he was stuporous with a blood pressure 140/90mmHg, heart rate of 92 beats/min, dyspneic, respiratory rate of 24/min and body temperature 36.8 degrees C. His Pupils were isocoric, miotic, and sluggishly reactive. There were mucosal bums and significant secretion in oral cavity. On auscultation, breathing sound was coarse without role on both lung field. The COHb levels were 6.3%at 32 hours after ingestion and normalized to 0.6%at 44 hours after ingestion. Patient was transfered to intensive care unit and supportive care was started with 100% oxygen. On ingestion 4th day, chest X-ray showed pulmonary edema and acute respiratory distress syndrome developed. Patient regained the consciousness on the 11th day. On the 30th day, respiratory function improved and the ventilator was removed. Alveolitis and mild pulmonary fibrosis developed and mild dyspnea was continued. On the 36th day, gastroscopic examinations showed ulceration of esophagus and stomach. On the 76th day, patient was discharged after pulmonary rehabilitation.
Aged ; Auscultation ; Blood Pressure ; Body Temperature ; Carbon Monoxide ; Consciousness ; Dyspnea ; Eating* ; Emergencies ; Emergency Service, Hospital ; Esophagus ; Heart Rate ; Humans ; Inhalation ; Intensive Care Units ; Lung ; Male ; Methylene Chloride* ; Mouth ; Oxygen ; Paint ; Pulmonary Edema ; Pulmonary Fibrosis ; Pupil ; Rehabilitation ; Respiratory Distress Syndrome, Adult ; Respiratory Rate ; Respiratory Sounds ; Stomach ; Stupor ; Thorax ; Ulcer ; Ventilators, Mechanical ; Workplace

A case of disseminated superficial actinic poroLeratosis affecting 47 years old, house wife, who has been suffering from multiple dark-brownish keratotic papules on the sun-light exposed parts especially face, forearm and dorsa of the both hands with mild itching sensation, is presented. The skin lesions developed about two years ago insidiously and increased size and numberes of the lesion. Her family background suggests autosomal dominant inheritance.
Actins ; Forearm ; Hand ; Humans ; Middle Aged ; Porokeratosis* ; Pruritus ; Sensation ; Skin ; Spouses ; Wills

No abstract available.

Due to the great deal of effort that has gone into the study of osteoclastic differentiation and activation over the last few decades, the mechanisms of these two events have been discovered gradually. Nitric oxide(NO-), which is produced from arginine by a nitric oxide synthase, opened up a new area of biological research. Recently, it has been reported that NO- is produced by osteoblasts stimulated by lipopolysaccharide and several other cytokines. In this study, the effect of sodium nitroprusside(SNP), a donor of nitric oxide(NO-), on osteoclast-like cell formation and on mature osteoclast function was examined. To determine the mechanism of the inhibitory effects of SNP decreased not only the basal 45Ca release but also thee bone resorption induced by PTH and l,25-dihydroxyvitamin D3 (I ,25[OH]2D3). The inhibitory effect of SNP on bone resorption induced by PTH appeared 2 days after treatment, whereas SNP effect on inhibiting bone resorption induced by l,25[OH]2D3 appeared at the third days. When chicken and rat osteoclasts were cultured on dentin slices, treatment of 300micronM SNP resulted in a significant decrease in dentin resorption by osteoclasts in terms of total resorption area and average individual area. We also examined the effect of SNP on formation of osteoclast-like cells that is TRAP-positive multinucleated cells from chicken and rat bone marrow cells in the presence or absence of 10(-8)M l,25[OH]2D3. The addition of 300 micronM SNP inhibited the formation of TRAP-positive multinucleated cells. The present data suggest that SNP, possibly as a NO- donor, inhibits the osteoclastic differentiation and osteoclastic activity.
Animals ; Arginine ; Bone Marrow Cells ; Bone Resorption ; Chickens ; Cytokines ; Dentin ; Humans ; Nitric Oxide Synthase ; Nitroprusside* ; Osteoblasts ; Osteoclasts* ; Rats ; Sodium* ; Tissue Donors

No abstract available.
Femur*

No abstract available.
Knee* ; Ligaments*

The tracheostomy is increasingly being performed. In most cases, the tracheostomy sites are left to heal by secondary intention, so it leaves a depressed and wide scar that is cosmetically disfigured. Another problem os that the scar is also attached directly to the trachea itself and will move vertically with the trachea during the act of swallowing. Even though the tracheostomy scar is cosmetically acceptable, the mobility and retraction of the scar is a continual nuisance to the patient. We performed a retrospective study on 9 patients who had undergone revision of the depressed thracheostomy scar by the Renner Method from June, 1997 to February, 1999. The method includes transverse fusiform incision of the original scar and excision of the depressed portion of the scar to the level of the trachea itself. To prevent attachment of the skin and trachea, a bilateral subcutaneous flap and muscle flap were simply advanced to the midline and overlapped. Then the rest of scar that was not depressed was deepithelized and flipped to augment the soft tissue volume in the central depressed area. Satisfactory results were achieved in all patients without hematoma, infection, hypertrophic scar, and keloid formation. We believe this simple Renner method is one of the best ways of performing posttracheostomy scar revision.
Cicatrix* ; Cicatrix, Hypertrophic ; Deglutition ; Hematoma ; Humans ; Intention ; Keloid ; Retrospective Studies ; Skin ; Trachea ; Tracheostomy

The main purpose of this study was to develop and evaluate the effectiveness of the standardized patient method in teaching catherization skills, communication skills and students' learning motivation in undergraduate nursing students. The study employed a quasi-experimental method using a non-equivalent control group post-test design. Data were collected over 2 years from August 2000 to September 2001 with 75 sophomore student nurses in one baccaleureate program. The results are summarized as follows; The scores in catheterization skills and communication skills were statistically significantly higher in the experimental group than the control group. Learning motivation score were also statistically significantly higher in the experimental group than the control group. In conclusion, this study suggests that a standardized patients managed instruction which emphasize authenticity and contex- tualization is very effective in teaching nursing students, the mastery and application of nursing skills, and the utilizing therapeutic communication skills. It is recommended that more standardized patients cases be developed for wider areas of nursing education and this study be replicated with more students using a longitudinal design.
Catheterization ; Catheters ; Education, Nursing ; Humans ; Learning* ; Motivation* ; Nursing ; Students, Nursing ; Urinary Catheterization*