Argon reduces microglial activation and inflammatory cytokine expression in retinal ischemia/reperfusion injury

We previously found that argon exerts its neuroprotective effect in part by inhibition of the toll-like receptors(TLR)2 and 4.The downstream transcription factors signal transducer and activator of transcription 3(STAT3)and nuclear factor kappa B(NF-κB)are also affected by argon and may play a role in neuroprotection.It also has been demonstrated that argon treatment could mitigate brain damage,reduce excessive microglial activation,and subsequently attenuate brain inflammation.Despite intensive research,the further exact mechanism remains unclear.In this study,human neuroblastoma cells were damaged in vitro with rotenone over a period of 4 hours(to mimic cerebral ischemia and reperfusion damage),followed by a 2-hour post-conditioning with argon(75%).In a separate in vivo experiment,retinal ischemia/reperfusion injury was induced in rats by increasing intraocular pressure for 1 hour.Upon reperfusion,argon was administered by inhalation for 2 hours.Argon reduced the binding of the transcription factors signal transducer and activator of transcription 3,nuclear factor kappa B,activator protein 1,and nuclear factor erythroid 2-related factor 2,which are involved in regulation of neuronal damage.Flow cytometry analysis showed that argon downregulated the Fas ligand.Some transcription factors were regulated by toll-like receptors;therefore,their effects could be eliminated,at least in part,by the TLR2 and TLR4 inhibitor oxidized phospholipid 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphorylcholine(OxPAPC).Argon treatment reduced microglial activation after retinal ischemia/reperfusion injury.Subsequent quantitative polymerase chain reaction analysis revealed a reduction in the pro-inflammatory cytokines interleukin(IL-1α),IL-1β,IL-6,tumor necrosis factorα,and inducible nitric oxide synthase.Our results suggest that argon reduced the extent of inflammation in retinal neurons after ischemia/reperfusion injury by suppression of transcription factors crucial for microglial activation.Argon has no known side effects or narcotic properties;therefore,therapeutic use of this noble gas appears ideal for treatment of patients with neuronal damage in retinal ischemia/reperfusion injury.The animal experiments were approved by the Commission for Animal Care of the University of Freiburg(approval No.35-9185.81/G14-122)on October 19,2012.

Pancreatectomy and splenectomy for a splenic aneurysm associated with segmental arterial mediolysis

Segmental arterial mediolysis(SAM) is characterized by intra-abdominal, retroperitoneal bleeding or bowel ischemia, and the etiology is unknown. A 44-year-old man complaining of abdominal pain was admitted to our hospital. He had been admitted for a left renal infarction three days earlier and had a past medical history of cerebral aneurysm with spontaneous remission. The ruptured site of the splenic arterial aneurysm was clear via a celiac angiography, and we treated it using trans-arterial embolization. Unfortunately, the aneurysm reruptured after two weeks, and we successfully treated it with distal pancreatomy and splenectomy. We recommended a close follow-up and prompt radiological or surgical intervention because SAM can enlarge rapidly and rupture.

Cardiac Tamponade Associated with Blunt Cardiac Injury: Its Definitive Management in the Emergency Department

Cardiac tamponade secondary to blunt cardiac injury is an extremely serious and life-threatening condition that the emergency physician is required to make definitive and appropriate management and resuscitation. Although blunt cardiac injury includes a wide spectrum of pathological conditions, cardiac tamponade due to blunt trauma is rarely seen because most of the patients with cardiac rupture die at the scene or before arrival at the hospital. Definitive surgical repair is commonly necessary following pericardial decompression if the patient is too unstable with impending cardiac arrest. Bringing the patient to definitive surgery as soon as possible is crucial for the chance of survival to the emergency physician. We describe two cases of cardiac tamponade resulting from blunt chest trauma successfully treated with a definitive management and surgical repair.

Serum Albumin Levels in Emergency Patients with Low BMI

A low body mass index (BMI) is often associated with low nutritional status and adverse health outcomes. While the BMI is used in describing “thinness” meaning cachexia, serum albumin levels were also used in assessing patient’s nutritional conditions. Object: A retrospective study was conducted to determine whether the extremes of BMI and/or cachexia increased the morbidity and mortality in our critical emergency department. Methods: A hundred and five cases with low BMI (≤18.5 kg/m2) were chosen from the patients who were admitted to our critical emergency department from Sept 2013 to Aug 2016. The relationship between serum albumin levels on admission and prognosis were analyzed. Results: No significant correlations were observed between body mass index and albumin levels in thin patients. Lower levels of serum albumin (p Conclusions: Even with low BMI, if the albumin value was 3.3 g/dL or more, the prognosis was good in our emergency department. Estimation of albumin level on admission is not only a simple and objective way to assess the nutritional status but also a useful outcome predictor of critically ill patients coming to emergency centers.

To Investigate the Effect of Using Ethanol Containing Wipes in Collecting Blood for the Measurement of Alcohol Concentration

This study was aimed to establish whether the skin preparation using ethanol-containing skin antiseptics causes ethanol contamination through blood collection. Venous blood was collected from 40 healthy volunteers according to the national guidelines for blood sampling, with four sequential procedures as follows: 1) collecting blood immediately (within 5 seconds) after cleaning the skin with an individually packaged type of ethanol-containing wipe, 2) collecting blood 1 minute after cleaning the skin with an individually packaged type of ethanol-containing wipe, 3) collecting immediately (within 5 seconds) after cleaning the skin with a traditional cleaning method (thoroughly ethanol-impregnated wipe, and 4) collecting 1 minute after cleaning the skin with a traditional cleaning method. Each sequential procedure was performed with and without the ethanol-containing wipe used for skin cleaning on the puncture site on their right and left arms at the time the needle was withdrawn, respectively. The collected specimens were subjected to the determination of ethanol by using headspace gas chromatography-mass spectrometry. In every 80 blood specimens obtained from 40 participants, ethanol was undetectable (<0.001 mg/mL). This study demonstrates that disinfection using ethanol-containing skin antiseptics is unlikely to cause ethanol contamination through blood collection regardless of skin preparation technique according to the guidelines for blood sampling. This may have implications in forensic science.

Interactions between the lung microbiome and host immunity in chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory disease and the third leading cause of death worldwide.Developments in next-generation sequencing technology have improved microbiome analysis,which is increasingly recognized as an important component of disease management.Similar to the gut,the lung is a biosphere containing billions of microbial communities.The lung microbiome plays an important role in regulating and maintaining the host immune system.The microbiome composition,metabolites of microorganisms,and the interactions between the lung microbiome and the host immunity profoundly affect the occurrence,development,treatment,and prognosis of COPD.In this review,we drew comparisons between the lung microbiome of healthy individuals and that of patients with COPD.Furthermore,we summarize the intrinsic interactions between the host and the overall lung microbiome,focusing on the underlying mechanisms linking the microbiome to the host innate and adaptive immune response pathways.Finally,we discuss the possibility of using the microbiome as a biomarker to determine the stage and prognosis of COPD and the feasibility of developing a novel,safe,and effective therapeutic target.