Fatal Asthma with Rhabdomyolysis Induced by Hair Dye

Hair dyes have been reported to cause exacerbation of asthma in hairdressers through occupational exposure. We report a 54-year-old housewife who developed a fatal asthma attack following the use of a hair dye at home. She was admitted semiconscious with multiple organ failure. Laboratory findings were indicative of rhabdomyolysis. Skin prick and interdermal tests with hair dyes were performed. Hair dyes can be nonspecific stimuli that cause an asthma attack. But in our case, we cannot deny the possibility that the attack resulted from antigen-antibody reaction by the hair dye. We should warn that hair dyes can cause an asthma attack not only through occupational exposure but also through occasional domestic use

ホイクシ ヨウセイ シセツ ニ オケル ショウガイジ ホイク カモク キョウジュ ホウホウ ノ ヒカク ケントウ

保育士養成課程における、障害児保育で教授するべき内容は、障害の特性や障害のある子どもの保育の方法など非常に幅広いといえる。 障害児保育の教授方法や教授する際の工夫について共通点・差異点を比較検討するため、保育士養成施設を対象としてアンケート調査を実施した。アンケートの結果から、保育士、幼稚園教諭、看護師などの有資格者が、教授の困難さを感じつつ教授していることと、自分の所有資格を生かして、様々な方法で教えていることがわかった。この結果は、障害児保育の演習のあり方や教授方法を今後、具体的に検討していくための事前研究となった。Extensive knowledge is necessary to teach in the class of developmental handicapped child care. We investigated the teaching methods for handicapped child care, and some devices in teaching.It has been turned out, from the questionnaire surveys, that the teachers of various qualifications give lectures having some troubles and that they teach in various ways using their own special qualities

Clinical Analysis of Perforated Intestinal Behcet Disease

Clinical pattern of perforated intestinal Behcet disease was analyzed in the five patients who underwent surgery in terms of preoperative symptoms, the condition of perforation, the extent of resection and recurrence. In the experienced patients, recurrences were included in four of the five patients in spite of treatment. Perforation was based on deep multiple ulcers, characteristic of the punchedout type. It is emphasized that intestinal Behcet disease is more likely to occur as a catastrophic event of perforation which requires an urgent operation, and more extensive resection is mandatory for prevention of recurrence

A retrospective comparative study of recombinant human thrombomodulin and gabexate mesilate in sepsis-induced disseminated intravascular coagulation patients

The novel biological agent recombinant human thrombomodulin (rhTM) has been used clinically in Japan to treat disseminated intravascular coagulation (DIC) since 2008. Previous studies have shown the efficacy of rhTM versus heparin therapy or non-rhTM therapy. We retrospectively evaluated and compared the efficacies of rhTM and gabexate mesilate (GM) in patients diagnosed with sepsis-induced DIC. From September 2010 to October 2012, patients with sepsis-induced DIC who were treated with rhTM (n = 13) or GM (n = 10) at Nagasaki Municipal Hospital were extracted. Patients receiving other anticoagulants in combination were excluded. Clinical information, laboratory data, Sequential Organ Failure Assessment (SOFA) scores, and DIC scores were obtained from the medical records. Mortality at days 7 and 30 after DIC diagnosis and changes in laboratory data and SOFA scores from days 1-7 were evaluated. The groups\u27 clinical characteristics did not differ, except for the relatively higher C-reactive protein (CRP) levels in the rhTM group (P = 0.0508). The survival rates of the rhTM and GM groups on days 7 and 30 were 92.3%, 69.2% and 80%, 70%, respectively, both group indicated similar mortality. However, on day 7, the platelet counts, SOFA scores, and CRP levels significantly improved in the rhTM group; the platelet counts and SOFA scores did not improve significantly in the GM group. The platelet counts of the rhTM group significantly improved compared to the GM group (P = 0.004). Recombinant human thrombomodulin might be more effective for sepsis-induced DIC than GM

Autoimmune pulmonary alveolar proteinosis co-existing with breast cancer: a case report

Introduction. Pulmonary alveolar proteinosis is a rare pulmonary disease characterized by excessive alveolar accumulation of surfactant due to defective alveolar clearance by macrophages. There are only a few published case reports of pulmonary alveolar proteinosis occurring in association with solid cancers. To the best of our knowledge, there are no previously reported cases of pulmonary alveolar proteinosis associated with breast cancer. Case presentation. A 48-year-old Asian woman, a nonsmoker, presented to our institution with a right breast mass. Biopsy examination of the lesion revealed scirrhous carcinoma. A chest computed tomography scan for metastases showed abnormal shadows in both upper lung fields. As a result of flexible fiberscopic bronchoscopy, this patient was diagnosed as having pulmonary alveolar proteinosis. This case was categorized as autoimmune pulmonary alveolar proteinosis due to the positive anti-granulocyte-macrophage colony-stimulating factor antibody. Pulmonary alveolar proteinosis decreased gradually after mastectomy. Conclusions: The present case involved the coincident occurrence of autoimmune pulmonary alveolar proteinosis with breast cancer; breast cancer may be a factor during pulmonary alveolar proteinosis development

An iliopsoas abscess caused by Parvimonas micra: a case report

Abstract Background Parvimonas micra, a Gram-positive anaerobic coccus, is a rare pathogen for psoas abscess. We describe a case of a patient with iliopsoas abscess caused by P. micra. Case presentation An 81-year-old Asian man presented to our department with complaints of fever since the preceding day. Abdominal computed tomography revealed the presence of a low-density mass in the right iliopsoas muscle indicative of a psoas abscess. Computed tomography-guided percutaneous drainage of the psoas abscess was performed. Results of organism cultures of the abscess and blood were positive for P. micra. However, our patient had no known primary focus of infection. On the basis of these findings, a primary psoas abscess caused by P. micra was diagnosed, and treatment with ampicillin/sulbactam 1.5 g, administered intravenously every 8 h, was initiated. By day 7, the patient’s white blood cell count normalized. By day 20, his C-reactive protein level was decreased to 0.35 mg/dl. Conclusion Iliopsoas abscesses caused by anaerobic bacteria are relatively rare, and iliopsoas abscesses caused by P. micra are especially rare. Our patient’s case revealed that P. micra can cause iliopsoas abscess. Therefore, clinicians should be aware of the possibility that P. micra may cause iliopsoas abscess

Miliary tuberculosis with co-existing pulmonary cryptococcosis in non-HIV patient without underlying diseases: a case report

Abstract Background Tuberculosis and cryptococcosis co-infection usually occurs in immunosuppressed patients with impaired cell-mediated immunity. However, there are few reports about such co-infection in non-HIV patients without underlying diseases. Here, we report a case of miliary tuberculosis with co-existing pulmonary cryptococcosis in non-HIV patient without underlying diseases. Case presentation An 84-year-old Asian female presented to our hospital with complaints of a 1-week history of abdominal pain and appetite loss. Chest computed tomography (CT) showed diffuse micronodules in random patterns in both lung fields. Liver, skin and bone marrow biopsies showed epithelioid cell granuloma. Polymerase chain reaction of gastric aspirate was positive for Mycobacterium tuberculosis. According to these findings, miliary tuberculosis was suspected and antimycobacterial therapy was initiated. After a 6-month treatment course, chest radiograph showed new multiple nodules in the right middle lung field. Chest CT showed that a right S6 small nodule was increased and new multiple nodules appeared in the right lower lobe. Flexible fiberoptic bronchoscopy was subsequently perfomed. Cytology of the bronchial lavage showed a small number of Periodic acid-Schiff-positive bodies, suggesting Cryptococcus species. Moreover, serum cryptococcal antigen testing was positive. According to these findings, pulmonary cryptococcosis was diagnosed, although the culture was negative. Oral fluconazole therapy was subsequently initiated. After a 6-month treatment course, chest radiograph showed gradual improvement. Conclusion Although tuberculosis and cryptococcosis co-infection is relatively rare in immunocompromised hosts, such as those with acquired immunodeficiency syndrome, clinicians should be aware that these infections can co-exist even in non-HIV patients without underlying diseases