Successful extracorporeal life support after potentially fatal pulmonary oedema caused by inhalation of nitric and hydrofluoric acid fumes

Two patients presented with potentially fatal pulmonary oedema after accidental exposure to nitric and hydrofluoric acid fumes during electroplating. Despite aggressive respiratory support, one succumbed to respiratory failure 3.5h after inhalation. The other patient also rapidly progressed to respiratory failure. Extracorporeal life support (ECLS) was started 5h after exposure at the ED. During ECLS, hypoxia improved, but pulmonary oedema shown by chest radiography became aggravated. N-Acetyl cysteine and calcium gluconate were given i.v. on the first day of admission and nebulised for 48 h after exposure. Pulmonary secretions were significantly reduced 24 h after the nebulising therapy began. Ultimately, the patient was discharged without serious pulmonary or neurological complications after 28 days of hospitalisation. In this case, early ECLS, nebulised antioxidant and antidote were available to treat potentially fatal pulmonary oedema after exposure to nitric and hydrofluoric acid fumes.     

Interleukin 6 gene polymorphism in patients with degenerative lumbar scoliosis: a cohort study

Purpose

Low bone mass and a female gender increase susceptibility to the development of degenerative lumbar scoliosis (DLS), which suggests the potential involvement of an osteoporosis-related gene in the pathogenesis of DLS. In the present study, the authors studied the relations between polymorphisms of interleukin 6 (IL-6) gene and DLS in a patient cohort.

Methods

In 184 patients with a diagnosis of DLS, the authors determined the presence of the -597 G/A, -572 G/C, and -174 G/C polymorphisms, measured bone mineral densities at the lumbar spine (LSBMD) and femoral neck (FNBMD), assessed radiological findings including lumbar scoliosis and lateral listhesis, investigated biochemical markers of bone turnover, and compared these results obtained with those of 220 healthy normal controls.

Results

Genotype frequencies in the DLS patients and controls revealed a significant difference for the IL6-572 G/C polymorphism (P = 0.0168). Mean LSBMD was lower in DLS patients than in controls, but no significant difference was found between these two groups with respect to FNBMD, biochemical markers, or radiological findings. A significant association was found between the IL6-572 G/C polymorphism and LSBMD. LSBMD in DLS with the CC genotype was found to be significantly higher than in DLS with the GC (P < 0.05) or GG (P < 0.05) genotypes.

Conclusion

The results of this study suggest that the IL6-572 G/C polymorphism influences LSBMD in Korean DLS patients and the prevalence of the disease.