No abstract available.
Disaster Medicine* ; Disasters* ; Railroads*

No abstract available.
Emergencies* ; Humans ; Pulmonary Disease, Chronic Obstructive*

No abstract available.
Lung* ; Tracheoesophageal Fistula*

The acute respiratory distress syndrome (ARDS) is a disorder of diffuse lung injury secondary to a wide variety of clinical insults including sepsis. It is manifested by impaired oxygenation, pulmonary edema, decreased static and dynamic compliance of lung, and increased airway resistance. Reduced lung compliance together with increased airway resistance is a hallmark of the syndrome and has generally been considered as the primary abnormality of lung mechanics. The study was designed to reproduce an ARDS condition in an animal model with acute lung injury and to determine whether these changes are reversed by inhalation of aerosolized bronchodilator such as salbutamol or nicorandil. Six adult mongrel dogs were exposed to intravenous oleic acid (0.08 ml/kg) mixed into a same amount of pure enthanol. We defined a condition of PaO2 less than 60 mmHg in FiO2 0.6 as an acute diffuse lung injury. Lung mechanics were deteriorated after oleic acid injection, from 27.33+/-2.73 to 17.50+/-.47 cmH2O/l/sec in compliance and from 14.55+/-.46 to 26.33+/-.02 ml/cmH2O in airway resistance. Salbutamol or Nicorandil inhalation significantly improved lung compliance to 30.57+/-11.30 or 36.33+/-.00 cmH2O/l/sec and airway resistance to 16.77+/-.47 or 19.55+/-.45 ml/cmH2O. From above data, we carefully concluded that compromized lung mechanics in adult respiratory distress syndrome could be effectively managed by inhalation of aerolized bronchodilator.
Acute Lung Injury ; Adult* ; Airway Resistance ; Albuterol ; Animals ; Compliance ; Dogs ; Humans ; Inhalation* ; Lung Compliance ; Lung Injury ; Lung* ; Mechanics* ; Models, Animal ; Nicorandil ; Oleic Acid ; Oxygen ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult ; Sepsis

BACKGROUND: Brief episode of coronary artery occlusion (i.e., ischemic preconditioning) makes the heart more resistant to injury from a subsequent ischemic insult. Although a great deal of effort has been made in studying ischemic preconditioning, the underlying mechanism of ischemic preconditioning and its effect on hypothermic insult has not been elucidated. This study was performed to see whether ischemic preconditioning protects against the depression of cardiac contractility induced by hypothermic cardioplegic arrest/reperfusion. And recently, adenosine was known to have some correlation with the mechanism of preconditioning. If so, does this effect remain after the blockade of adenosine receptor by 8-phenyl theophylline? METHOD: Twenty-four Sprague-Dawley rat weighed 250-350g were used and divided into three groups. Rat hearts were removed rapidly, and each isolated heart paced with a rate of 180/min was perused by modified Krebs-Hensleit buffer(KHB) solution on a Langendorff apparatus far an hour. After obtaining baseline data including left ventricular pressure(LVP), dp/dt, and coronary flow, cardiac arrest was induced by perfusion of 0degrees C crystalloid cardioplegic(St Thomas) solution. After that, all hearts were stored in the same St Thomas solution at salute temperature far 2 hours. In group I (control group), the hear was reperfused by KHB solution. In group II(preconditioning group), the heart was subjected to two 2-minute episode of global ischemia followed by 5 minute reperfusion with KHB solution(preconditioning) before cardiac arrest. In group III(phenyl theophylline group), the heart was subjected to preconditioning procedure and 8-phenyl theophylline at 10muM in concentration was added to KHB solution at time of reperfusion. Observing parameter was obtained in each group at 10, 20, 40 and 60 minutes after starting reperfusion and compared statistically by use of one way ANOVA test(STASTICA, release 4.5). P-value less than 0.05 was considered significant. RESULTS: Although depressed LVP, dp/dt, and Coronary flow were seen in all groups during the reperfusion period, the preconditioned group showed more effective recovery of LVP than that of the control group, especially at 10, 20 and 40 minutes(p<.05). We failed to demonstrate the difference between the phenyl theophylline group and the control group(p=NS). CONCLUSION: These results suggest that ischemic preconditioning has protective effect on recovery state of hypothermic cardioplegic arrest/reperfusion. Its protective effect was limited during early reperfusion stage and was blocked by adenosine blocker.
Adenosine ; Animals ; Coronary Vessels ; Depression ; Heart Arrest ; Heart* ; Ischemia ; Ischemic Preconditioning* ; Myocardium* ; Perfusion ; Rats ; Rats, Sprague-Dawley ; Receptors, Purinergic P1 ; Reperfusion ; Theophylline

Aortic transection or interruption is a rare condition which developed after an acute deceleration injury. Its occurrence depends on the location and direction of the force applied and is usually from motor vehicle accident or falling down. The exact incidence of aortic transection in trauma is not known but, when develops, only about 10-15% of the victims can furtive and be transported to the hospital. Even in the survivors, majority of them will be fatal within a few days if a prompt diagnosis and surgical treatments are not made. Aggressive diagnostic work-up is recommended for the patients with high suspicious index, which would salvage the victims with this fatal condition. We report the experience of two cases of aortic transection or interruption following motor vehicle accidents.
Deceleration ; Diagnosis ; Early Diagnosis* ; Humans ; Incidence ; Motor Vehicles ; Survivors ; Thorax* ; Wounds and Injuries*

Traditionally, the Rhododendron species has been used in gastrointestinal disorder or hypertension. Grayanotoxin exists in honey, flowers, pollen, and the nectar of the Rhododendron species. We experienced 3 cases of Grayanotoxin intoxication. The symptoms of intoxication were nausea, vomiting, hypotension, bradycardia, diplopia, dizziness, and chest discomfort. Generally, the treatment for Grayanotoxin intoxication is fluid resuscitation and injection of atropine sulfate. The patients who were intoxicated with Grayanotoxin were discharged without complication after supportive care.
Atropine ; Bradycardia ; Diplopia ; Dizziness ; Flowers ; Honey ; Humans ; Hypertension ; Hypotension ; Nausea ; Plant Nectar ; Pollen ; Resuscitation ; Rhododendron ; Thorax ; Vomiting

No abstract available.
Emergencies* ; Emergency Medicine* ; Humans

PURPOSE: Respiratory syncytial virus is the primary cause of pneumonia and bronchiloitis in young children and infants. RSV infection is also known to be very important to asthma patient, because previous RSV infection increases the frequency of the asthma development and RSV infection may cause airway hyperresponsiveness. Natural RSV infection does not provide complete immunity and reinfection occurs throughout life. Several strategies have recently been used in RSV vaccine development, including the generation of formalin inactivated RSV(FI-RSV), peptides, recombinant vaccine viruses (rVV), and DNA based vaccines. Previous studies in mice primed with RSV G protein enhanced lung pathology resulted from a Th2 host immune response against the viral G protein. We studied for the evaluation of protective immunity, effect on airway hyperesponsiveness, and influence on lung pathology after pND G immunization. METHODS: BALB/c mice were injected with pND G(50g in 1 g/l PBS), pND G-HA (50 g), pND(50 g) FI-RSV(10 6PFU) i.d.at 0, 2, 4 weeks. Four weeks later, mice were challenged with RSV(10 6PFU). Mice were sacrificed on postchallenge day 4 and their lungs were removed for RT-PCR and viral titration. The other mice were sacrificed on postchallenge day 6 for bronchoalveolar lavage, serum and histologic examination. Airway responsiveness was assessed by using a single chamber whole body plethysmography on post challenge day 5. RESULTS: 1) Vaccination with pND-G reduced the Mch(methacholine) induced airway hyperresponsiveness after RSV infection(P<0.05). 2) Viral titers are decreased in pND-G group and FI-RSV group(P<0.05) and complete protection from RSV infection was 9/12(75%) in pND-G group. 3) Serum anti-G IgG antibody is more increased in pND-G group than RSV group(P<0.05). 4) IFN-/IL-5 ratio is increased in pND-G group(0.59) and decreased in FI-RSV group(P<0.036). 5) Inflammatory response in BAL after RSV infection was decreased by pND-G vaccination(P>0.05). CONCLUSION: In this study, immunization with pND encoding G protein induced decrease in airway hyperresponsiveness, and protection against RSV infection of the lower respiratory tract infection and also induced virus neutralizing antibody and decrease in lymphocytic inflammation. pND G immunization elicited balanced pulmonary Th1/Th2 cytokine response without atypical pulmonary inflammatory responses.
Animals ; Antibodies, Neutralizing ; Asthma ; Bronchoalveolar Lavage ; Child ; DNA* ; Formaldehyde ; GTP-Binding Proteins ; Humans ; Immunization* ; Immunoglobulin G ; Infant ; Inflammation ; Lung ; Mice ; Pathology ; Peptides ; Plethysmography, Whole Body ; Pneumonia ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections ; Vaccination ; Vaccines

Traumatic asphyxia is a clinical symptom complex characterized by craniofacial cyanosis, subconjunctival hemorrhage, and head and neck vascular engorgement due to sudden compressive injury on the thoracic cage. It is occasionally combined with mental deterioration, lung contusion, and edema. It is considered due to increased intrathoracic pressure in state of closed epiglottis. Recently, we had experienced three cases of traumatic asphyxia of which clinical courses were somewhat different. The first case developed by a compression between a elevator and the ground while the victim did not realized the accident happening, and the patient showed nonspecific facial edema and ecchymosis but mental deterioration and ultimate respiratory failure. The second case by a compression between cars, while the impending accident was noticed by the victim, showed full-blown asphyxia without mental or respiratory symptoms. The last case by forceful coughing and vomiting showed facial edema and ecchymosis without any other symptoms. Hospital courses of all cases were uneventful. We believe that 'fear response' or 'closure of the epiglottis' might be an important mechanism on developing symptom of traumatic asphyxia.
Asphyxia* ; Contusions ; Cough ; Cyanosis ; Ecchymosis ; Edema ; Elevators and Escalators ; Epiglottis ; Head ; Hemorrhage ; Humans ; Lung ; Neck ; Respiratory Insufficiency ; Vomiting