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

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

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

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.

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

BACKGROUND: We performed a prospective, double blind study to compare the clinical effect of vertical infraclavicular brachial plexus block produced by 0.5% levobupivacaine and 0.5% ropivacaine for upper limb surgery. METHODS: We included 60 patients receiving upper limb surgery under infraclavicular brachial plexus block. The infraclavicular brachial plexus block was performed via the vertical technique with 30 ml of 0.5% levobupivacaine or 0.5% ropivacaine. We observed which nerve type was stimulated and scored the sensory and motor block. The quality of block was assessed intraoperatively. The duration of sensory and motor block and complications were assessed. RESULTS: There were no significant differences in frequencies of stimulated nerve type, evolution of sensory and motor block quality, or success of block. There were no significant difference in duration of sensory block, but duration of motor block was prolonged after 0.5% levobupivacaine. There were no complications. CONCLUSIONS: Both 0.5% levobupivacaine and 0.5% ropivacaine had similar effects in the vertical infraclavicular brachial plexus block.
Amides ; Brachial Plexus ; Bupivacaine ; Double-Blind Method ; Humans ; Prospective Studies ; Upper Extremity

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: The aim of this study was to investigate the existence of TNF-alpha polymorphisms in Korean children with Crohn's disease (CD), ulcerative colitis (UC), as compared to healthy controls. METHODS: Blood samples were obtained from 40 patients with CD, 14 patients with UC, and 30 healthy controls. Genotyping for 5 TNF-alpha polymorphisms (G238A, G308A, C857T, C863A, and T1031C) was performed. The allele frequencies for the inflammatory bowel diseases, CD and UC, were measured in patients with these disease and in healthy controls, and these allele frequencies were compared between the 3 groups. We examined the significant association between polymorphism and disease phenotype, such as location, behavior, perianal disease, and pediatric Crohn's activity index (PCDAI) in CD. RESULTS: Based on our findings, the TNF-alpha allele frequencies of G238A, G308A, C857T, C863A, and T1031C were 3.3, 8.3, 16.7, 16.7, 21.7% in healthy control, 2.5%, 7.5%, 18.8%, 20.0%, 22.5% in CD, 7.1%, 7.1%, 7.1%, 21.4%, 28.6% in UC. They were no statistically significant differences between the 3 groups. There were no associations between genotypes and phenotypes in CD, except a statistically significant higher allele frequency of G238A in ileal type (L1) disease (p=0.010). CONCLUSION: Our results indicate that 5 TNF-alpha polymorphisms do not seem to be associated with susceptibility to inflammatory bowel disease in Korean pediatric patients even though young patients were anticipated to have a stronger genetic affiliation for these diseases than adult patients. We think that further studies are needed to find those genes associated with susceptibility to CD and UC in Korean pediatric patients with inflammatory bowel disease.
Adult ; Child ; Colitis, Ulcerative ; Crohn Disease ; Gene Frequency ; Genotype ; Humans ; Inflammatory Bowel Diseases ; Phenotype ; Tumor Necrosis Factor-alpha