An evaluation of respiratory effects following exposure to 2.0 ppm formaldehyde in asthmatics: lung function, symptoms, and airway reactivity

Fifteen asthmatic volunteers were exposed in a double-blind, random manner to room air and 2.0 ppm formaldehyde for 40 min in an environmental chamber. These exposures were repeated on a separate day during moderate exercise (450 kpm/min) for 10 min. Ambient and dew point temperatures were 23.0 +/- 0.0 degrees C and 11.5 +/- 1.0 degrees C, respectively. No significant airway obstruction as measured by flow-volume parameters and airway resistance was noted in this group during or immediately after exposure. Furthermore, sequential measurements of peak flow for 24 hr following formaldehyde exposure revealed no delayed airway response. In contrast, in comparison to the baseline methacholine inhalation challenge (MIC) test on the screening day, 8 of 12 asthmatics demonstrated a lower threshold to MIC following 2.0 ppm exposure for 40 min; however, the mean and median decrements of threshold in methacholine concentration of 10.4 mg/ml and 24.3 mg/ml were not significant (p = .12). Bad odor, sore throat, and eye irritation were common during exposure but symptoms were infrequent afterward.     

Synovial chondromatosis of four compartments of the knee: medial and lateral tibiofemoral spaces,patellofemoral joint and proximal tibiofibular joint

A case of synovial chondromatosis of the proximal tibiofibular joint in addition to lateral and medial tibiofemoral spaces and patellofemoral joint has been presented.     

Takayasu disease with prominent pulmonary artery involvement: confusion with pulmonary disease leading to delayed diagnosis

Pulmonary artery involvement as the initial predominant clinical manifestation in Takayasu arteritis (TA) is rare. We describe a young adult female who presented with life-threatening complications of proximal pulmonary arterial involvement of Takayasu arteritis. In our case, atypical presentation of TA with pulmonary symptoms due to pulmonary artery involvement resulted in an erroneous initial diagnosis of sarcoidosis and then tuberculosis. The frequency of such a clinical form could be underestimated given the difficulties involved in its diagnosis and because its features are similar to those of pulmonary disease.     

Reconstruction of defects of the dorsum of the nose with bilateral transposition flaps. Case report.

Transposition flaps are old but are the method of choice in reconstruction of defects of the dorsum of the nose. Eleven consecutive patients with such defects were treated with 22 transposition flaps. The nasal defects resulted from tumour (n = 9), trauma (n = 1), and keratoacanthoma (n = 1). The dissection is rapid, easy and the complication rate is low.     

Physiological-dose steroid therapy in sepsis [ISRCTN36253388

Introduction  

The aim of the study was to assess the prognostic importance of basal cortisol concentrations and cortisol response to corticotropin, and to determine the effects of physiological dose steroid therapy on mortality in patients with sepsis.     

Serum YKL-40 levels in patients with coronary artery disease

Atherosclerosis is considered to be an inflammatory disease in which the initial process is the augmented infiltration of monocytes into the vessel wall and their subsequent differentiation from macrophages into lipid-laden foam cells. Human cartilage glycoprotein-39 (YKL-40) is a new inflammatory marker found to be secreted by lipid-laden macrophages inside human atherosclerotic vessel wall. The aim of this study was to investigate the association of serum YKL-40 levels with the presence and extent of coronary artery disease (CAD) assessed by coronary angiography. We also studied the relation of high-sensitivity C-reactive protein with the presence and angiographic severity of CAD. A total of 200 participants undergoing to coronary angiography was divided into four subgroups: control patients without CAD (n=53), and those with one-vessel disease (n=52), two-vessel disease (n=47), or three-vessel disease (n=48). Serum YKL-40 levels were measured by enzyme-linked immunosorbent assay. Both serum YKL-40 levels and high-sensitivity C-reactive protein concentrations in patients with CAD were significantly higher than in control participants (P<0.001). We also found a significant association between the levels of YKL-40 and the extent of CAD defined by the number of stenosed vessels (P<0.001). The relationship between the serum YKL-40 level and atherosclerosis may represent a new opportunity for the possible utility of serum YKL-40 as an inflammatory marker for coronary artery disease. Moreover, our findings revealed that plasma YKL-40 measurement might also be regarded as a quantitative indicator of disease extent besides being a marker of disease presence.     

Case report of a patient with osteopoikilosis

Osteopoikilosis (OPK) is a benign osteosclerotic dysplasia of unknown origin, which is an inherited autosomal disorder. Males and females are equally affected. It is usually asymptomatic and may only be recognized on radiological examination. In this study we report a 33-year-old woman with fibromyalgia who suffers from back and leg pain and was diagnosed OPK by radiologically and review literature.     

Implant-retained auricular prosthesis

Auricular defects may result from congenital malformations, injuries from motor vehicle crashes, trauma, or tumor resections. An auricular prosthesis was fabricated for a patient who had an injury from a motor vehicle crash. Extraoral implants and bar-and-clip retention for the proper connection of the auricular prosthesis to implant were used. This prosthesis was acceptable to the patient because of excellent support, retentive abilities, and the patient's appearance.     

Coronary artery bypass grafting in a patient with pseudothrombocytopenia: case report

A 53-year-old female patient with coronary arterial disease who had been diagnosed with conventional coronary angiography was scheduled to undergo elective coronary artery bypass grafting surgery. Preoperative routine evaluations of the whole blood count revealed severe thrombocytopenia (6000/mm3). The patient received a consultation by the internal medicine clinic. With an initial diagnosis of pseudothrombocytopenia, the patient's operation was delayed, and she was referred to a hematology clinic for further diagnosis. The thrombocyte count in heparinized whole blood was in the normal range. A smear of a fresh, nonheparinized blood sample revealed thrombocytes in aggregations of 5 to 14, which confirmed the diagnosis. The patient underwent operation with cardiopulmonary bypass with normal heparinization, and no unexpected postoperative complications, including bleeding, occurred in the early postoperative period. She had an uneventful recovery and was discharged from the hospital on the seventh postoperative day. Later routine polyclinic control evaluations showed no complications. We think the possibility of pseudothrombocytopenia should be discussed with patients. With the correct diagnosis, such patients can be safely given the chance of operation with no more than the usual risks of coronary bypass surgery.