Cigarette Smoking-Induced Acute Eosinophilic Pneumonia: A Case Report Including a Provocation Test

The mechanism and cause of acute eosinophilic pneumonia are largely unknown. Many factors including the smoking of cigarettes have been suggested, but none have been proven to directly cause acute eosinophilic pneumonia. The authors report a case of acute eosinophilic pneumonia in a young Asian male who recently started smoking. The diagnosis was made based on his clinical course and results of chest radiography, lung spirometry, bronchoalveolar lavage, and transbronchial lung biopsies. After administration of methylprednisolone, his clinical course rapidly improved. A provocation test was designed to establish a connection between cigarette smoking and the development of acute eosinophilic pneumonia. After the provocation test, the patient showed identical symptoms, increase in sputum eosinophils, and worsening of pulmonary function. The results of the provocation test suggest that smoking may directly cause acute eosinophilic pneumonia, and support previous reports of cigarette smoking-induced acute eosinophilic pneumonia

Incidentally Detected Inguinoscrotal Bladder Hernia

The bladder is involved in less than 4% of inguinal hernias. Inguinoscrotal bladder hernias are difficult to diagnose, and less than 7% are diagnosed preoperatively. Inguinoscrotal bladder hernias are usually asymptomatic. However, they can result in significant complications, such as bladder necrosis or acute renal failure. Accurate diagnosis is crucial to avoid bladder injury during surgery and other complications. Here we report the case of a 64-year-old man who presented with a scrotal mass. Ultrasonography of the scrotal mass showed a nonspecific cystic mass. During surgery, the mass was revealed to be a herniated bladder

Pyruvate Dehydrogenase Kinase 4 Promotes Vascular Calcification via SMAD1/5/8 Phosphorylation

Vascular calcification, a pathologic response to defective calcium and phosphate homeostasis, is strongly associated with cardiovascular mortality and morbidity. In this study, we have observed that pyruvate dehydrogenase kinase 4 (PDK4) is upregulated and pyruvate dehydrogenase complex phosphorylation is increased in calcifying vascular smooth muscle cells (VSMCs) and in calcified vessels of patients with atherosclerosis, suggesting that PDK4 plays an important role in vascular calcification. Both genetic and pharmacological inhibition of PDK4 ameliorated the calcification in phosphate-treated VSMCs and aortic rings and in vitamin D3-treated mice. PDK4 augmented the osteogenic differentiation of VSMCs by phosphorylating SMAD1/5/8 via direct interaction, which enhances BMP2 signaling. Furthermore, increased expression of PDK4 in phosphate-treated VSMCs induced mitochondrial dysfunction followed by apoptosis. Taken together, our results show that upregulation of PDK4 promotes vascular calcification by increasing osteogenic markers with no adverse effect on bone formation, demonstrating that PDK4 is a therapeutic target for vascular calcification

Intra-host competition and interactions between Soybean mosaic virus (SMV) strains in mixed-infected soybean

Abstract Over the past two decades, the dominant Soybean mosaic virus (SMV) strain in South Korea has changed from G5 to G7H. To examine the dominance of G7H, intra-host competition between G7H and G5 was evaluated in soybean plants infected with a mixture of SMV strains. The distribution patterns of the two SMV strains in soybean plants inoculated with G7H, G5 and G7H/G5 were investigated at designated time points by RT-PCR/RFLP analysis, which enables the specific differentiation of low concentrations of SMV strains and the detection of mixed infection at any given time. When leaves of 'Kwangankong' and 'Tawonkong' were infected with both strains, the upper leaves had only the G7H strain in simultaneous infections. In sequential inoculations, the leaves exhibited mosaic symptoms caused by G7H, and the G5 strain was not detected in plants pre-inoculated with the G7H strain before inoculation with the G5 strain. In the reverse treatment, both G5 and G7H were present at every vegetative stage. In addition, interactions between the virulence and dominance of G7H, G5, and G1, a less virulent strain, were investigated. Three landrace soybeans were co-inoculated with G7H/G5, G7H/G1, G5/G1, and G7H/G5/G1 sets. There was no significant difference between virulence and dominance. These results demonstrate the dominance of G7H in mixed infections and could explain the prevalence of G7H in South Korea