Sudden atelectasis and respiratory failure in a neutropenic patient: atypical presentation of pseudomembranous necrotizing bronchial aspergillosis.

Pseudomembranous necrotizing bronchial aspergillosis (PNBA) is a rare form of invasive aspergillosis with a very poor prognosis. The symptoms are non-specific, and the necrotizing plugs cause airway obstruction. Atelectasis and respiratory failure can be the initial manifestations.

Ubiquitous-severance hospital project: implementation and results.

Objectives: The purpose of this study was to review an implementation of u-Severance information system with focus on electronic hospital records (EHR) and to suggest future improvements.

Methods: Clinical Data Repository (CDR) of u-Severance involved implementing electronic medical records (EMR) as the basis of EHR and the management of individual health records. EHR were implemented with service enhancements extending to the clinical decision support system (CDSS) and expanding the knowledge base for research with a repository for clinical data and medical care information.

Unilateral ureteral obstruction caused by Aspergillus, subgenus Nidulantes in a patient on steroid therapy: a case report and review of the literature.

Urinary tract obstructions caused by Aspergillus bezoars has been reported on rare occasions. We describe in this paper an unusual case caused by an isolate of the Aspergillus nidulantes subgenus, and review the literature on 13 additional cases of ureteral obstruction due to renoureteric aspergillosis so as to provide the characteristics of this disease entity. Our case presented with a unilateral ureteral obstruction and acute renal failure due to Aspergillus bezoars.

Asthma-like symptoms are increased in the metabolic syndrome.

Background: The prevalence of obesity and asthma has been increasing during the last several decades. Obesity has been reported to be associated with asthma. Obesity, especially abdominal obesity, is the main component of the metabolic syndrome.

Characteristics of mechanical ventilation employed in intensive care units: a multicenter survey of hospitals.

A 1D point-prevalence study was performed to describe the characteristics of conventional mechanical ventilation in intensive care units (ICUs). In addition, a survey was conducted to determine the characteristics of ICUs. A prospective, multicenter study was performed in ICUs at 24 university hospitals.

Inflammatory and transcriptional roles of poly (ADP-ribose) polymerase in ventilator-induced lung injury.

Introduction: Poly (ADP-ribose) polymerase (PARP) participates in inflammation by cellular necrosis and the nuclear factor-kappa-B (NF-kappaB)-dependent transcription. The purpose of this study was to examine the roles of PARP in ventilator-induced lung injury (VILI) in normal mice lung.

Methods: Male C57BL/6 mice were divided into four groups: sham tracheostomized (sham), lung-protective ventilation (LPV), VILI, and VILI with PARP inhibitor PJ34 pretreatment (PJ34+VILI) groups.

Atypical radiological manifestation of pulmonary metastatic calcification.

Metastatic pulmonary calcification refers to calcium deposition in the normal pulmonary parenchyma and this deposition is secondary to abnormal calcium metabolism. The most common radiologic manifestation consists of poorly-defined nodular opacities that are mainly seen in the upper lung zone. We present here a case of metastatic pulmonary calcification that manifested as atypical, dense, calcium deposition in airspaces within the previously existing consolidation in the bilateral lower lobes, and this process was accelerated by pneumonia-complicated sepsis in a patient with hypercalcemia that was due to hyperparathyroidism.

Potential use of an anticancer drug gefinitib, an EGFR inhibitor, on allergic airway inflammation.

The EGFR plays an essential role in goblet cell hyperplasia and mucus hypersecretion. EGFR has an intrinsic tyrosine kinase activity that, when activated, induces the production of MUC5AC through the signaling kinase cascade in the airway epithelium. We have investigated the effects of an EGFR tyrosine kinase inhibitor, gefitinib, on ovalbumin (OVA)-induced, allergic inflammation in airway epithelia of mice.

Basal serum cortisol levels are not predictive of response to corticotropin but have prognostic significance in patients with septic shock.

Because high levels of cortisol are frequently observed in patients with septic shock, low levels of serum cortisol are considered indicative of relative adrenal insufficiency (RAI). This study was performed to investigate whether pretest clinical characteristics, including basal serum cortisol levels, are predictive of serum cortisol response to corticotropin and whether basal cortisol levels have a prognostic significance in patients with septic shock. We performed a retrospective analysis of 68 patients with septic shock who underwent short corticotropin stimulation testing.

Proteomic analysis of peripheral T-lymphocytes in patients with asthma.

Background: Asthma is chronic airway inflammation that occurs together with reversible airway obstruction. T-lymphocytes play an important role in the pathogenesis of asthma. Proteomic technology has rapidly developed in the postgenomic era, and it is now widely accepted as a complementary technology to genetic profiling.

Prognostic factors in pulmonary tuberculosis requiring mechanical ventilation for acute respiratory failure.

Background And Objective: The prognosis in patients with pulmonary tuberculosis and acute respiratory failure requiring mechanical ventilation is believed to be poor. The aim of this study was to identify factors contributing to in-hospital mortality in these patients.

Methods: The medical records of 32 patients with active pulmonary tuberculosis as a primary cause of acute respiratory failure requiring mechanical ventilation in the medical intensive care unit (ICU) of a tertiary referral hospital over a 10-year period were reviewed retrospectively, and predictors of mortality were assessed.

Diaphragmatic weakness after transcatheter arterial chemoembolization of inferior phrenic artery for treatment of hepatocellular carcinoma.

Purpose: To prospectively assess the diaphragmatic anatomic and functional consequences of transcatheter arterial chemoembolization (TACE) of the inferior phrenic artery in patients with hepatocellular carcinoma.

Materials And Methods: Informed consent and institutional review board approval were obtained. Fifteen patients (13 men, two women; mean age, 52 years; age range, 22-61 years) who underwent TACE of the inferior phrenic artery for treatment of hepatocellular carcinoma were enrolled.

Partial interferon-gamma receptor deficiency and non-tuberculous mycobacterial lung disease.

Interferon-gamma (IFN-gamma) plays a key role in the host defense response against mycobacterial disease, and a complete or partial deficiency in IFN-gamma receptor 1 (IFN-gammaR1) or IFN-gamma receptor 2 (IFN-gammaR2) has been reported to contribute to susceptibility to disseminated infection with non-tuberculous mycobacteria (NTM). However, IFN-gammaR1 and IFN-gammaR2 deficiencies have not yet been studied in adult patients with isolated NTM lung disease. The purpose of the present study was to evaluate whether partial IFN-gammaR1 and IFN-gammaR2 deficiency are associated with human susceptibility to NTM lung disease.

Early intervention can improve clinical outcome of acute interstitial pneumonia.

Study Objectives: To report on our experience with acute interstitial pneumonia (AIP) in which patients underwent early diagnostic procedures and received mechanical ventilation with a "lung-protective" strategy and early institution of immunosuppressive therapy.

Design: A retrospective chart review.

Setting: A tertiary referral hospital.

Recruitment maneuvers attenuate repeated derecruitment-associated lung injury.

Objective: Repeated derecruitments of previously recruited lungs can exacerbate lung injuries during mechanical ventilation. The aim of this study was to assess lung injury associated with repeated derecruitments and to assess whether this type of injury could be attenuated by recruitment maneuvers.

Design: Prospective, randomized, experimental animal study.

Prone positioning improves oxygenation without adverse hemodynamic effects during partial liquid ventilation in a canine model of acute lung injury.

Background: Partial liquid ventilation (PLV) and prone positioning can improve the arterial oxygenation (PaO2) in acute lung injury (ALI). We evaluated the effect of prolonged prone positioning during partial liquid ventilation (PLV) in a canine model of acute lung injury.

Methods: Six mongrel dogs (weighing 17.

Acute respiratory distress syndrome. Computed tomography findings and their applications to mechanical ventilation therapy.

In acute respiratory distress syndrome, computed tomography (CT) typically demonstrates symmetric ground-glass opacity and gravity-dependent consolidation when patients are positioned supine. Moreover, CT findings may vary according to the evolutional stage of the disease over time. The slope of the pressure-volume curve, which is a direct or indirect measure of lung recruitment rather than a measure of the characteristics of the respiratory mechanics of a portion of the aerated lung, indicates the potential for recruitment.