Axis, Cervical Vertebra ; Dentofacial Deformities ; Malocclusion ; Mandible ; Osteotomy, Sagittal Split Ramus ; Prognathism ; Temporomandibular Joint

A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

No abstract available.
Histiocytosis, Langerhans-Cell* ; Myelodysplastic Syndromes* ; Skin

No abstract available.
Aflatoxin B1* ; Aflatoxins*

No abstract available.
Lithotripsy*

No abstract available.
Narcolepsy*

Basement membrane zone gene expression by fibroblast cultures was examined by molecular hybridizations with human sequence specific cDNAs corresponding to type 1V procollagen and laminin subunit polypeptides. Northern transfer analysis with total RNA revealed the presence of specific mRNA transcripts for al (IV) and a2 (1V) chains of type 1V procollagen as well as Bl and B2 chains of laminin. Laminin A chain mRNAs were not detected using the same RNA preparations. The molecular size of al (1V) and a2 (1V) procollagen mRNA revealed 6.8kb and 6.7kb, respectively. The molecular size of Bl chain of laminin revealed 5.6kb, and B2 chain revealed 8.2 and 5.5kb polymorphic transcripts. In slotblot analysis using densitometer, steady-state levels of type IV procollagen and laminin mRNAs indicated that they were in relatively low abunclance, as compaired with type I procollagen mRNA. Quantitative levels of al (IV) and laminin Bl chaii mRNAs were more abundant than those of a2 (IV) and laminin B2 mRNAs. The mRNA ratio of al (IV)/a2 (lV) and laminin Bl/B2 were 1.9 and 1.5, respectively. These results demonstrate evidence for differential regulation of the expression of different basement membrane zone molecules during the formation of basement membrane.
Basement Membrane ; Collagen Type I ; Collagen Type IV* ; DNA, Complementary ; Fibroblasts* ; Gene Expression ; Humans ; Laminin* ; Peptides ; Procollagen ; RNA ; RNA, Messenger ; Skin*

No abstract available.

No abstract available.
Status Epilepticus*

Nicotine is a water-soluble alkaloid extracted from tobacco plants, and most frequently encountered in snuff, chewing tobacco, cigarettes, cigars and pipe tobacco or in a limited number of pesticides. Nicotine overdose or poisoning might be serious or fatal and lead to death; caused by cardiovascular arrest, respiratory muscle paralysis, and/or central respiratory failure due to its toxic effect. Suicide by nicotine ingestion has been rarely reported due to emetic response. We present a case of suicidal nicotine poisoning. A 56-year-old man was found dead and the postmortem examination revealed no injury or disease. We confirmed a high concentration of nicotine in the toxicological test. Through scene investigation, we determined this case as a suicidal nicotine poisoning.
Autopsy ; Eating ; Humans ; Middle Aged ; Nicotine* ; Pesticides ; Poisoning* ; Respiratory Insufficiency ; Respiratory Paralysis ; Suicide ; Tobacco ; Tobacco Products ; Tobacco, Smokeless