Pulmonary toxicity of tungsten trioxide nanoparticles in an inhalation study and an intratracheal instillation study.

OBJECTIVES: We conducted inhalation and intratracheal instillation studies in order to examine the effects of tungsten trioxide (WO3 ) nanoparticles on the lung, and evaluated whether or not the nanoparticles would cause persistent lung inflammation. METHODS: In the inhalation study, male 10-week-old Fischer 334 rats were classified into 3 groups. The control, low-dose, and high-dose groups inhaled clean air, 2, and 10 mg/m3 WO3 nanoparticles, respectively, for 6 h each day for 4 weeks. The rats were dissected at 3 days, 1 month, and 3 months after the inhalation, and the bronchoalveolar lavage fluid (BALF) and lung tissue were examined. In the intratracheal instillation study, male 12-week-old Fischer 334 rats were divided into 3 subgroups. The control, low-dose, and high-dose groups were intratracheally instilled 0.4 ml distilled water, 0.2, and 1.0 mg WO3 nanoparticles, respectively, dissolved in 0.4 ml distilled water. The rats were sacrificed at 3 days, 1 week, and 1 month after the intratracheal instillation, and the BALF and lung tissue were analyzed as in the inhalation study. RESULTS: The inhalation and instillation of WO3 nanoparticles caused transient increases in the number and rate of neutrophils, cytokine-induced neutrophil chemoattractant (CINC)-1, and CINC-2 in BALF, but no histopathological changes or upregulation of heme oxygenase (HO)-1 in the lung tissue. CONCLUSION: Our results suggest that WO3 nanoparticles have low toxicity to the lung. According to the results of the inhalation study, we also propose that the no observed adverse effect level (NOAEL) of WO3 nanoparticles is 2 mg/m3 .

Prevertebral abscess associated with meningitis: Double cause of neck stiffness.

While neck stiffness belongs to the classic triad of meningitis symptoms together with fever and altered mental status, it can also be attributed to inflammation from prevertebral space infection. We describe a difficult-to-diagnose case of prevertebral abscess associated with meningitis. Prevertebral space infection, vertebral osteomyelitis, and meningitis are reported to be associated with each other. When a patient presents with an altered mental status due to meningitis, signs and symptoms may be obscured and physicians may be unable to conduct detailed physical examinations or identify symptoms beyond neck stiffness. The threshold for imaging evaluation may need to be lowered for patients at high risk for prevertebral abscess or vertebral osteomyelitis. Physicians need to recognize this clinical entity, as prompt referral to specialists in head and neck surgery is essential for timely drainage.