No abstract available.
Blood Platelets* ; Platelet Activating Factor* ; Progesterone*

Sodium azide (NaN3) is a white to colorless, crystalline powder that is highly water soluble, tasteless, and odorless. It is used mainly as a preservative in aqueous laboratory reagents and biologic fluids and also as an automobile airbag gas generant. Although it has caused deaths for decades, the toxic properties and effects of sodium azide in humans remains unknown. A 31-year-old comatose female was transported to the emergency department with an empty bottle labeled sodium azide. She developed cardiac arrest 15 minutes after arrival and expired in spite of 30 minutes of resuscitative effort. Subsequently, resuscitation team members incidentally suffered from sodium azide's exposure and developed eye discomfort, skin rashes parasthesias, pruritus, sore throat, and headache.
Adult ; Air Bags ; Automobiles ; Coma ; Crystallins ; Eating ; Emergencies ; Exanthema ; Eye ; Female ; Headache ; Heart Arrest ; Humans ; Indicators and Reagents ; Pharyngitis ; Pruritus ; Resuscitation ; Sodium ; Sodium Azide

Epinephrine is frequently used to control local bleeding during surgery. However, it may be associated with complications, such as pulmonary edema, reversible cardiomyopathy, and cardiac arrest. We encountered a case of stress induced cardiomyopathy (SIC) after local epinephrine instillation. The SIC is manifested with typical left ventricular apical ballooning and clinical symptoms of a myocardial infarction without coronary stenosis. Although its prognosis is more favorable than a myocardial infarction, anesthesiologists need to be aware of the possible adverse effects of local epinephrine infiltration.
Cardiomyopathies ; Coronary Stenosis ; Epinephrine ; Heart Arrest ; Hemorrhage ; Myocardial Infarction ; Prognosis ; Pulmonary Edema

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Echocardiography* ; Exercise Tolerance* ; Humans ; Tetralogy of Fallot*

Background: Squamous cell carcinomas (SqCCs) of the lung are known to arise more often in a central area but reports of peripheral SqCCs have increased, with a pathogenesis that is obscured. In this study, the clinicopathologic characteristics of peripheral lung SqCCs were studied and compared with those of the central type. Methods: This study included 63 peripheral lung SqCCs and 48 randomly selected central cases; hematoxylin and eosin-stained slides of surgically resected specimens were reviewed in conjunction with radiologic images and clinical history. Cytokeratin-7 immunohistochemical staining of key slides and epidermal growth factor receptor (EGFR)/KRAS mutations tested by DNA sequencing were also included. Results: Stages of peripheral SqCCs were significantly lower than central SqCCs (p=.016). Cystic change of the mass (p=.007), presence of interstitial fibrosis (p=0.007), and anthracosis (p=.049) in the background lung were significantly associated with the peripheral type. Cytokeratin-7 positivity was also higher in peripheral SqCCs with cutoffs of both 10% and 50% (p=.011). Pathogenic mutations in EGFR and KRAS were observed in only one case out of the 72 evaluated. The Cox proportional hazard model indicated a significantly better disease-free survival (p=.009) and the tendency of better overall survival (p=.106) in the peripheral type. Conclusions In peripheral type, lower stage is a favorable factor for survival but more frequent interstitial fibrosis and older age are unfavorable factors. Multivariate Cox analysis revealed that peripheral type is associated with better disease-free survival. The pathogenesis of peripheral lung SqCCs needs further investigation, together with consideration of the background lung conditions.

BACKGROUND: A decrease in the number of tissue eosinophils is known to reflect the malignancy potential of neoplastic lesions and even prognosis. Increased levels of the chemokines CCL11 and CCL24 in serum and tissue are also known to have diagnostic value as serum tumor markers or prognostic factors. The aim of this study was to evaluate the correlation between the degree of tissue eosinophilia and the expression of these chemokines in the glandular and stromal cells of colorectal neoplastic lesions ranging from benign to malignant tumors. METHODS: We counted the number of infiltrating eosinophils in neoplastic lesion tissue and we evaluated the expression of CCL11 and CCL24 in glandular cells and stromal cells by immunohistochemical staining. RESULTS: The results showed that the number of eosinophils decreased significantly and the expression of CCL11 and CCL24 in glandular cells decreased with tumor progression, whereas the stromal expression of CCL11 and CCL24 appeared to increase. CONCLUSIONS: The discrepancy in CCL11 and CCL24 expression between glandular cells and stromal cells might shed light on how colorectal cancer evades the immune system, which would enable further development of immunotherapies that target these chemokines. Further research on eosinophil biology and the expression pattern of chemokines in tumor cells is needed.
Biology ; Chemokines ; Colorectal Neoplasms* ; Eosinophilia ; Eosinophils* ; Immune System ; Immunotherapy ; Prognosis ; Stromal Cells ; Biomarkers, Tumor

No abstract available.
Diagnosis, Differential ; Doxycycline/therapeutic use ; Female ; Guillain-Barre Syndrome/*diagnosis/pathology ; Humans ; Immunoglobulins/therapeutic use ; Male ; Middle Aged ; Respiration, Artificial ; Respiratory Insufficiency/*diagnosis/pathology ; Scrub Typhus/*diagnosis/pathology

OBJECTIVES: Alpha1-antitrypsin (AAT) is the main inhibitor of human neutrophil elastase, and plays a role in counteracting the tissue damage caused by elastase in local inflammatory conditions. The study evaluated the involvement of AAT in nasal allergic inflammation. METHODS: Forty subjects with mono-sensitization to Dermatophagoides pteronyssinus (Dpt) were enrolled. Twenty allergic rhinitis patients frequently complained of nasal symptoms such as rhinorrhea, stuffiness, sneezing, and showed positive responses to the nasal provocation test (NPT) with Dpt (Group I). The other 20 asymptomatic patients showed sensitization to Dpt but negative NPT (Group II). The levels of AAT, eosinophil cationic protein (ECP), and Dpt-specific IgA antibodies were measured in the nasal lavage fluids (NLFs), collected at baseline, 10 minutes, 30 minutes, 3 hours, and 6 hours after the NPT. Nasal mucosa AAT expression was evaluated with immunohistochemical staining from Group I and Group II. RESULTS: At baseline, only the Dpt-specific IgA level was significantly increased in the NLFs of Group I compared with Group II, while ECP and AAT levels were not significantly different between two groups. After Dpt provocation, AAT, ECP, and Dpt-specific IgA levels were significantly increased in the NLFs of Group I during the early and late responses. The protein expression level of AAT was mostly found in the infiltrating inflammatory cells of the nasal mucosa, which was significantly increased in Group I compared to Group II. CONCLUSION: The increment of AAT showed a close relationship with the activation of eosinophils induced by allergen-specific IgA in the NLFs of patients with allergic rhinitis after allergen stimulation. These findings implicate AAT in allergen-induced nasal inflammation.
Antibodies ; Dermatophagoides pteronyssinus ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Immunoglobulin A ; Inflammation ; Leukocyte Elastase ; Nasal Lavage Fluid ; Nasal Mucosa ; Nasal Provocation Tests ; Pancreatic Elastase ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sneezing

OBJECTIVES: Alpha1-antitrypsin (AAT) is the main inhibitor of human neutrophil elastase, and plays a role in counteracting the tissue damage caused by elastase in local inflammatory conditions. The study evaluated the involvement of AAT in nasal allergic inflammation. METHODS: Forty subjects with mono-sensitization to Dermatophagoides pteronyssinus (Dpt) were enrolled. Twenty allergic rhinitis patients frequently complained of nasal symptoms such as rhinorrhea, stuffiness, sneezing, and showed positive responses to the nasal provocation test (NPT) with Dpt (Group I). The other 20 asymptomatic patients showed sensitization to Dpt but negative NPT (Group II). The levels of AAT, eosinophil cationic protein (ECP), and Dpt-specific IgA antibodies were measured in the nasal lavage fluids (NLFs), collected at baseline, 10 minutes, 30 minutes, 3 hours, and 6 hours after the NPT. Nasal mucosa AAT expression was evaluated with immunohistochemical staining from Group I and Group II. RESULTS: At baseline, only the Dpt-specific IgA level was significantly increased in the NLFs of Group I compared with Group II, while ECP and AAT levels were not significantly different between two groups. After Dpt provocation, AAT, ECP, and Dpt-specific IgA levels were significantly increased in the NLFs of Group I during the early and late responses. The protein expression level of AAT was mostly found in the infiltrating inflammatory cells of the nasal mucosa, which was significantly increased in Group I compared to Group II. CONCLUSION: The increment of AAT showed a close relationship with the activation of eosinophils induced by allergen-specific IgA in the NLFs of patients with allergic rhinitis after allergen stimulation. These findings implicate AAT in allergen-induced nasal inflammation.
Antibodies ; Dermatophagoides pteronyssinus ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Immunoglobulin A ; Inflammation ; Leukocyte Elastase ; Nasal Lavage Fluid ; Nasal Mucosa ; Nasal Provocation Tests ; Pancreatic Elastase ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sneezing

PURPOSE: CPR Anytime(R), a self-instructional video program, has gained popularity amongst CPR instructors for training non-healthcare providers. This instructional kit enables second-tier instruction. The purpose of this study is to determine the status of second-tier instruction CPR by CPR Anytime(R) trainees. METHODS: Questionnaires were sent to 606 CPR Anytime(R) trainees from 12 BLS training sites. The training period was from October 2006 to July 2007. Questionnaires included provider's basic information, post-course self exercise, amount of second-tier instruction, and multiplier status. RESULTS: The response rate of the questionnaire was 53.6%(325). The mean age was 20.4+/-10.3 years old. The professions of respondents were as follows: students (76.3%), office workers(13.2%), teachers(4.4%), and service providers(1.9%). The post-course self exercise rate was 49% with three fourths of those completing the exercises using both the DVD and MiniAnne(R). Second-tier instruction tools use rates(48%) were as follows: DVD and manikin(35%), manikin only(9%), verbal only(2%), and DVD only(1%). The total multiplier effect was 1.77(575/ 325) with the multiplier effect of teachers significantly higher than others. CONCLUSION: This study found that 48% of CPR Anytime(R) providers perform second-tier instruction to family and friends. Amongst them, the total multiplier effect was 1.77 (575/325).
Cardiopulmonary Resuscitation ; Surveys and Questionnaires ; Exercise ; Friends ; Humans ; Manikins