Systemic inflammatory response syndrome in intravascular lymphomatosis

Intravascular lymphomatosis (IVL) is characterized by an intravascular proliferation of atypical mononuclear cells of haematopoietic origin occluding small blood vessels including venules, capillaries and small arteries, and can affect virtually any organ in the body. Clinically, the most common manifestations are involvement of the skin and central nervous system, although various organ involvement has been described. We report a patient who presented with fever and rash, and succumbed with acute neurological symptoms and systemic inflammatory response syndrome (SIRS) with no evidence of infection. The postmortem revealed disseminated involvement of virtually every organ with IVL, the malignant cells being of T-cell origin, which may secrete cytokines including tumour necrosis factor and interleukin-1, that are believed to be mediators in SIRS. In the absence of evidence of infection on microbiology and pathology, we postulate that the features of SIRS in this patient was due to the disseminated malignancy itself.link_to_subscribed_fulltex

System inflammatory response syndrome in intravascular lymphomatosis.

Intravascular lymphomatosis (IVL) is characterized by an intravascular proliferation of atypical mononuclear cells of haematopoietic origin occluding small blood vessels including venules, capillaries and small arteries, and can affect virtually any organ in the body. Clinically, the most common manifestations are involvement of the skin and central nervous system, although various organ involvement has been described. We report a patient who presented with fever and rash, and succumbed with acute neurological symptoms and systemic inflammatory response syndrome (SIRS) with no evidence of infection. The postmortem revealed disseminated involvement of virtually every organ with IVL, the malignant cells being of T-cell origin, which may secrete cytokines including tumour necrosis factor and interleukin-1, that are believed to be mediators in SIRS. In the absence of evidence of infection on microbiology and pathology, we postulate that the features of SIRS in this patient was due to the disseminated malignancy itself.link_to_subscribed_fulltex

Reliability of automated blood pressure devices used by hypertensive patients

Automated blood pressure (BP) devices are used by many hypertensive patients in Hong Kong, with or without medical advice. At two community clinics, we invited hypertensive patients aged between 40 and 70 years who used such a device to fill in a questionnaire and to have four sets of BP measurements, automated and mercury, at two visits. Of 290 hypertensive patients 120 fulfilled the criteria, and 73 of these agreed to participate. 53 devices measured arm BP, 21 measured forearm BP. The agreement between the mercury sphygmomanometer and the automated devices was poor, with average differences of 9.5 mmHg for systolic and 9.4 mmHg for diastolic and no clear advantage for either site of measurement. As a means of screening for BP >140/ 90 mmHg the sensitivity of the automated devices was 81% and the specificity was 80%. There were large variations in how often and under what circumstances the devices had been used. One-fifth of the devices had been acquired on medical advice but only 11% of the participants were aware of the three important conditions for operating such devices. Discussion of automated devices, their role and proper use, should now be part of routine hypertensive care.link_to_OA_fulltex

Incidence of chest wall paresthesia after video-assisted thoracic surgery for primary spontaneous pneumothorax

Objective: Video-assisted thoracic surgery (VATS) is an established treatment for recurrent or complicated primary spontaneous pneumothorax (PSP). However, a proportion of patients still complains of chronic pain or discomfort after VATS pleurodesis. We aimed to investigate if paresthesia is a distinct component of the post-operative discomfort in patients receiving VATS for PSP. Methods: Telephone interviews were conducted with 52 patients who had received VATS pleurodesis for PSP in our institute during a defined 24 month period. A standardized questionnaire was used to identify paresthetic discomforts which the patients themselves could distinguish from their wound pain. Responses were obtained from 51 patients (42 male, 9 female) with a mean age of 24.1 years (range 14-63 years), giving a response rate of 98.0%. Results: With a median observation time of 19 months (range 2-24 months), 27 patients (52.9%) reported experiencing paresthesia as a post-operative complication distinct from their wound pain. The most commonly described characteristics of the paresthesia were 'pins and needles' (37.0%), 'numbness' (25.9%) or a sensation of abnormal 'swelling' in the chest wall (11.1%). Although only two of the affected patients (7.4%) described the paresthesia as 'severe', consequent functional disturbances in daily life were noted by seven patients (25.9%), and 11 patients (40.7%) actively sought medical or alternative, holistic therapies to relieve the paresthesia. Eight (21.0%) of the 38 patients followed-up for over 12 months after surgery still experienced the paresthesia. Conclusions: Although it should not detract from the proven advantages of VATS, paresthesia in the chest wall represents a distinct but previously overlooked post-VATS complication. It is a potential source of significant post-operative morbidity, and may run a chronic course in some patients. Further study is warranted to elucidate its mechanisms and optimum management. © 2004 Elsevier B.V. All rights reserved.link_to_subscribed_fulltex

Usage of natural chitosan membrane obtained from insect corneal lenses as a drug carrier and its potential for point of care tests

Koç Bilican, Behlül ( Aksaray, Yazar )Chitosan is an indispensable biopolymer for use as a drug carrier thanks to its non-toxic, biodegradable, biocompatible, antimicrobial, and anti-oxidative nature. In previous studies, chitosan was first dissolved into weak acids and formed into gel, then used for carrying pharmaceutically active compounds such as nanoparticles, capsules, composites, and films. Using the produced chitosan gel after dissolving it in weak acids has advantages, such as ease of processing for loading the required amount of active substance and making the desired shape and size. However, dissolved chitosan loses some of its natural properties such as fibrous structure, crystallinity, and thermal stability. In this study, for the first time, three-dimensional chitosan lenses obtained from an insect's (Tabanus bovinus) compound eyes, with the original shape intact, were tested as a drug carrier. A model drug, quercetin, was loaded into chitosan membrane, and its release profile was examined. Also, a point-of-care test was conducted for both chitin and chitosan membranes. Chitin and chitosan membranes obtained from insect corneal lenses were characterized by using FTIR, TGA, elemental analysis, and surface wettability analysis as well as stereo, binocular, and scanning electron microscopies. It was observed that chitosan membrane could be used as a drug carrier material. Both chitin and chitosan membranes will be improved for lateral flow assay, and these membranes can be tested for other bioengineering applications in further studies

Usage of natural chitosan membrane obtained from insect corneal lenses as a drug carrier and its potential for point of care tests

Article no.: 110897Chitosan is an indispensable biopolymer for use as a drug carrier thanks to its non-toxic, biodegradable, biocompatible, antimicrobial, and anti-oxidative nature. In previous studies, chitosan was first dissolved into weak acids and formed into gel, then used for carrying pharmaceutically active compounds such as nanoparticles, capsules, composites, and films. Using the produced chitosan gel after dissolving it in weak acids has advantages, such as ease of processing for loading the required amount of active substance and making the desired shape and size. However, dissolved chitosan loses some of its natural properties such as fibrous structure, crystallinity, and thermal stability. In this study, for the first time, three-dimensional chitosan lenses obtained from an insects (Tabanus bovinus) compound eyes, with the original shape intact, were tested as a drug carrier. A model drug, quercetin, was loaded into chitosan membrane, and its release profile was examined. Also, a point-of-care test was conducted for both chitin and chitosan membranes. Chitin and chitosan membranes obtained from insect corneal lenses were characterized by using FTIR, TGA, elemental analysis, and surface wettability analysis as well as stereo, binocular, and scanning electron microscopies. It was observed that chitosan membrane could be used as a drug carrier material. Both chitin and chitosan membranes will be improved for lateral flow assay, and these membranes can be tested for other bioengineering applications in further studiesAgronomijos fakultetasBiologijos katedraVytauto Didžiojo universiteta