Onion-induced anaphylactic shock rapidly evolving to allergic right ventricular myocardial infarction and subsequent cardiogenic shock

AbstractThe type II variant of Kounis syndrome is defined as a rare allergic myocardial angina or infarction event in patients with preexisting quiescent coronary artery disease. Various causative factors have been implicated in the etiology of Kounis syndrome. However, reports highlighting the importance of recognizing a decreased preload caused by allergic right ventricular (RV) myocardial infarction and subsequent cardiogenic shock from ongoing anaphylactic shock are rare. Here we report the case of a 54-year-old male who initially presented with anaphylactic shock after ingesting onions. His condition silently progressed to RV infarction and cardiogenic shock within 2 hours of symptom onset. Under such instances, it is crucial to promptly identify RV infarction and cardiogenic shock by repeatedly performing electrocardiography at frequent intervals

Developing the Ideal Profile of OCAs and IT Usage in the Foodservice Chain

In recent years, the number of the branches of the foodservice chain rapidly increases, and every branch wants to be successful. Thus, how to use information technology to support Organizational Critical Activities (OCAs) has become an important issue. This research found out ten Organizational Critical Activities (OCAs) of the foodservice chain and three types of information technology usage, Defender Type, Follower Type, and Innovator Type. Furthermore, after the revision of two experts, the ten Organizational Critical Activities (OCAs) are divided into three categories, Internal Management, External Management, and Product Service. The analytical result found out that Defender Type matches Internal Management, External Management matches Innovator Type, and Product Service matches Follower Type. Finally, this study hopes that companies in the foodservice chain can develop appropriate IT strategies according to this research result to enhance their core competitiveness

Understanding the Impact of Service Failure and Recovery Justice on Consumers’ Satisfaction and Repurchase Intention

This research attempts to explore the impacts of different types of justice and their interactions on the satisfaction toward service failure recovery. We attempt to classify justices into hygiene, motivator, or asymmetric variable, based on the concept of asymmetric effect and two factors theory proposed by Herzberg. Specifically, we predict that procedural and distributive justices are hygiene or performance factor and interpersonal justice is motivator. In addition, based on expectancy-disconfirmation theory (EDT), we also attempt to understand the interaction between paired justices by arguing that motivator can generate more effect when hygiene factor or performance factors meet initial expectation. An experiment, with 3x2x2 between-subjects factorial design consisting of three factors to represent different levels of justice provided by online retailer, will be conducted to test the proposed hypotheses. A two-step approach will be used to (1) confirmation the types (hygiene, performance, or motivator) that each justice dimension belongs to, (2) understand the impact of each justice on satisfaction, and (3) test whether motivator will generate more effect when hygiene and performance factor are satisfied

Factors Affecting Daughter Cells' Arrangement during the Early Bacterial Divisions

On agar plates, daughter cells of Escherichia coli mutually slide and align side-by-side in parallel during the first round of binary fission. This phenomenon has been previously attributed to an elastic material that restricts apparently separated bacteria from being in string. We hypothesize that the interaction between bacteria and the underneath substratum may affect the arrangement of the daughter bacteria. To test this hypothesis, bacterial division on hyaluronic acid (HA) gel, as an alternative substratum, was examined. Consistent with our proposition, the HA gel differs from agar by suppressing the typical side-by-side alignments to a rare population. Examination of bacterial surface molecules that may contribute to the daughter cells' arrangement yielded an observation that, with disrupted lpp, the E. coli daughter cells increasingly formed non-typical patterns, i.e. neither sliding side-by-side in parallel nor forming elongated strings. Therefore, our results suggest strongly that the early cell patterning is affected by multiple interaction factors. With oscillatory optical tweezers, we further demonstrated that the interaction force decreased in bacteria without Lpp, a result substantiating our notion that the side-by-side sliding phenomenon directly reflects the strength of in-situ interaction between bacteria and substratum

Production of N-acetyl-D-neuraminic acid using two sequential enzymes overexpressed as double-tagged fusion proteins

<p>Abstract</p> <p>Background</p> <p>Two sequential enzymes in the production of sialic acids, N-acetyl-D-glucosamine 2-epimerase (GlcNAc 2-epimerase) and <it>N</it>-acetyl-D-neuraminic acid aldolase (Neu5Ac aldolase), were overexpressed as double-tagged gene fusions. Both were tagged with glutathione S-transferase (GST) at the N-terminus, but at the C-terminus, one was tagged with five contiguous aspartate residues (5D), and the other with five contiguous arginine residues (5R).</p> <p>Results</p> <p>Both fusion proteins were overexpressed in <it>Escherichia coli </it>and retained enzymatic activity. The fusions were designed so their surfaces were charged under enzyme reaction conditions, which allowed isolation and immobilization in a single step, through a simple capture with either an anionic or a cationic exchanger (Sepharose Q or Sepharose SP) that electrostatically bound the 5D or 5R tag. The introduction of double tags only marginally altered the affinity of the enzymes for their substrates, and the double-tagged proteins were enzymatically active in both soluble and immobilized forms. Combined use of the fusion proteins led to the production of <it>N</it>-acetyl-D-neuraminic acid (Neu5Ac) from <it>N</it>-acetyl-D-glucosamine (GlcNAc).</p> <p>Conclusion</p> <p>Double-tagged gene fusions were overexpressed to yield two enzymes that perform sequential steps in sialic acid synthesis. The proteins were easily immobilized via ionic tags onto ionic exchange resins and could thus be purified by direct capture from crude protein extracts. The immobilized, double-tagged proteins were effective for one-pot enzymatic production of sialic acid.</p

Associations of obesity and malnutrition with cardiac remodeling and cardiovascular outcomes in Asian adults:A cohort study

BackgroundObesity, a known risk factor for cardiovascular disease and heart failure (HF), is associated with adverse cardiac remodeling in the general population. Little is known about how nutritional status modifies the relationship between obesity and outcomes. We aimed to investigate the association of obesity and nutritional status with clinical characteristics, echocardiographic changes, and clinical outcomes in the general community.Methods and findingsWe examined 5,300 consecutive asymptomatic Asian participants who were prospectively recruited in a cardiovascular health screening program (mean age 49.6 ± 11.4 years, 64.8% male) between June 2009 to December 2012. Clinical and echocardiographic characteristics were described in participants, stratified by combined subgroups of obesity and nutritional status. Obesity was indexed by body mass index (BMI) (low, ≤25 kg/m2 [lean]; high, >25 kg/m2 [obese]) (WHO-recommended Asian cutoffs). Nutritional status was defined primarily by serum albumin (SA) concentration (low, ConclusionsIn our cohort study among asymptomatic community-based adults in Taiwan, we found that obese individuals with poor nutritional status have the highest comorbidity burden, the most adverse cardiac remodeling, and the least favorable composite outcome

The Role of Pulmonary Veins in Cancer Progression from a Computed Tomography Viewpoint

Background. We studied the role of pulmonary veins in cancer progression using computed tomography (CT) scans. Methods. We obtained data from 260 patients with pulmonary vein obstruction syndrome (PVOS). We used CT scans to investigate pulmonary lesions in relation to pulmonary veins. We divided the lesions into central and peripheral lesions by their anatomical location: in the lung parenchymal tissue or pulmonary vein; in the superior or inferior pulmonary vein; and by unilateral or bilateral presence in the lungs. Results. Of the 260 PVOS patients, 226 (87%) had central lesions, 231 (89%) had peripheral lesions, and 190 (75%) had mixed central and peripheral lesions. Among the 226 central lesions, 93% had lesions within the superior pulmonary vein, either bilaterally or unilaterally. Among the 231 peripheral lesions, 65% involved bilateral lungs, 70% involved lesions within the inferior pulmonary veins, and 23% had obvious metastatic extensions into the left atrium. All patients exhibited nodules within their pulmonary veins. The predeath status included respiratory failure (40%) and loss of consciousness (60%). Conclusion. CT scans play an important role in following tumor progression within pulmonary veins. Besides respiratory distress, PVOS cancer cells entering centrally can result in cardiac and cerebral events and loss of consciousness or can metastasize peripherally from the pulmonary veins to the lungs

Immune reconstitution inflammatory syndrome of Kaposi’s sarcoma in an HIV-infected patient

We present a case of Kaposi’s sarcoma-related immune reconstitution inflammatory syndrome in an HIV-infected patient who developed fever, worsening pulmonary infiltrates with respiratory distress, and progression of skin tumors at the popliteal region and thigh that resulted in limitation on movement of the right knee joint at 3.5 months following a significant increase of CD4 count after combination antiretroviral therapy