Particulate matter air pollution stimulates monocyte release from the bone marrow

Particulate air pollution (PM(10)) stimulates alveolar macrophages (AMs) to release immature granulocytes from the bone marrow (BM) into the circulation. This study was designed to determine the effect of PM(10) (ambient EHC-93 or inert carbon [CC]) instillation exposure on the monocyte release from the BM and the role of AM in this response. Monocyte precursors were labeled in the BM of rabbits in vivo by an intravenous injection of 5'-bromo-2'-deoxyuridine, and the effects of PM(10) were determined by instillation either particles or supernatants of AM exposed to particles into the lungs. Instillation of EHC-93 (500 microg/ml) or supernatants from AM incubated with EHC-93 (100 microg/ml) increased circulating band cell counts (p < 0.05) and shortened the transit time of monocytes through the BM (35.5 +/- 2.2 to 25.0 +/- 1.5 hours or 36.2 +/- 2.6 to 25.7 +/- 1.8 hours, p < 0.05) compared with the control subject. CC (1%) instillation also shortened the monocyte BM transit time to 28.4 +/- 1.9 hours (p < 0.05), but supernatants of AM incubated with CC did not. We conclude that exposure to atmospheric PM(10) stimulates the production of mediators by AM, and these cytokines accelerate the monocyte release from the BM.     

Urticarial reaction caused by ethanol.

BACKGROUND: We report a case of an urticarial reaction after drinking alcohol beverages. The patient was a 47-year-old man suffering urticarial and anaphylactoid reaction to alcohol for two years. These reactions were observed at every alcohol beverages intake. CASE SUMMARY: We performed a prick test with diluted ethanol, alcohol beverages and their metabolites (acetaldehyde, acetic acid). Only acetic acid showed a positive result. Oral challenge test with diluted-ethanol caused pruritus and swelling of his lips. An oral challenge test with 8% diluted Shochu (Japanese distilled alcohol from rice or wheat) caused wheals on his upper back. DISCUSSION: Only acetic acid, a metabolite of alcohol, induced a positive prick test in the patient with alcohol-induced urticaria. This result was not observed in normal volunteers. An oral challenge test with diluted-alcohol or Shochu showed a positive wheal reaction in a dose dependent-manner which suggests that urticaria seen in this patient might be induced by alcohol-intolerance. However possible allergic reaction to acetaldehyde could not be excluded.     

Renal vein measurement using ultrasonography in patients with cirrhotic ascites and congestive heart failure

Journal of Medical Ultrasonics - Ascites can cause compression of the inferior vena cava (IVC), leading to increased renal venous pressure and renal congestion. Previously, the left renal vein...     

Postoperative whole pelvic radiotherapy plus concurrent chemotherapy versus extended-field irradiation for early-stage cervical cancer patients with multiple pelvic lymph node metastases

Objectives

The aim of this study was to compare the efficacy of postoperative pelvic radiotherapy plus concurrent chemotherapy with that of extended-field irradiation (EFRT) in patients with FIGO Stage IA2-IIb cervical cancer with multiple pelvic lymph node metastases.

Methods

We retrospectively reviewed the medical records of patients with FIGO Stage IA2-IIb cervical cancer who had undergone radical surgery between April 1997 and March 2008. Of these, 55 patients who demonstrated multiple pelvic lymph node metastases were treated postoperatively with pelvic radiotherapy plus concurrent chemotherapy (n = 29) or EFRT (n = 26). Thirty-six patients with single pelvic node metastasis were also treated postoperatively with pelvic radiotherapy plus concurrent chemotherapy. The recurrence rate, progression free survival (PFS), and overall survival (OS) were compared between the treatment groups.

Results

Pelvic radiotherapy plus concurrent chemotherapy was significantly superior to EFRT with regard to recurrence rate (37.9% vs 69.2%, p = 0.0306), PFS (log-rank, p = 0.0236), and OS (log-rank, p = 0.0279). When the patients were treated with pelvic radiotherapy plus concurrent chemotherapy, there was no significant difference in PFS or OS between the patients with multiple lymph node metastases and those with single node metastases. With regards to grade 3-4 acute or late toxicities, no statistically significant difference was observed between the two treatment groups.

Conclusions

Postoperative pelvic radiotherapy plus concurrent chemotherapy is superior to EFRT for treating patients with FIGO Stage IA2-IIb cervical cancer displaying multiple pelvic lymph node metastases.