RÉSUMÉ
OBJECTIVES: Following a volcanic eruption in 2000, high concentrations of ambient sulfur dioxide (SO2) are still observed on Miyakejima, Japan despite the reversal 2 years ago of the ban on residents living on the island. This study examines the association between current levels of volcanic SO2 and the incidence of acute subjective symptoms in volunteers on Miyakejima. METHODS: The authors conducted a follow-up study on 611 healthy volunteers, on a person-hour basis (28 413 person-hours), who visited the island to provide support to residents from February to July 2005. Adverse health symptoms were measured by self-administered diary and exposure was approximated using monitoring data across 14 sites. Associations between incidence rates and increasing SO2 levels (reference (the lowest), very low, low, middle and high) were examined using Poisson regression. RESULTS: Hourly incidence of cough, scratchy throat, sore throat and breathlessness showed clear exposure-response relationships with SO2 concentrations. There were statistically significant risks of those symptoms at relatively low SO2 levels. Thus, rate ratios in the 0.6-2.0 ppm exposure band (vs <0.01 ppm) were: for cough, 3.4 (95% CI 1.8 to 6.6) in men and 9.8 (3.9 to 24.9) in women; for sore throat, 3.2 (1.7 to 6.2) in men and 5.8 (2.0 to 16.5) in women; and for breathlessness, 10.5 (4.2 to 26.6) in men and 18.5 (4.6 to 74.3) in women. Little evidence of SO2 effects on sputum and nasal discharge/congestion was observed in this study. Eye and skin irritations showed inconsistent results between hourly maximal and hourly mean SO2 concentrations. CONCLUSION: The authors observed strong evidence of an exposure-response relationship between volcanic SO2 and subjective acute respiratory symptoms among a healthy population on Miyakejima. The results are consistent with reports that females and non-smokers are more sensitive to irritant gas than males and smokers, respectively.
Sujet(s)
Polluants atmosphériques/toxicité , Maladies de l'appareil respiratoire/induit chimiquement , Dioxyde de soufre/toxicité , Éruptions volcaniques/effets indésirables , Maladie aigüe , Adolescent , Adulte , Sujet âgé , Polluants atmosphériques/analyse , Exposition environnementale/effets indésirables , Exposition environnementale/analyse , Femelle , Recommandations comme sujet , Humains , Incidence , Japon/épidémiologie , Mâle , Adulte d'âge moyen , Maladies de l'appareil respiratoire/épidémiologie , Dioxyde de soufre/analyse , Jeune adulteSujet(s)
Tumeurs des canaux biliaires/imagerie diagnostique , Carcinome hépatocellulaire/imagerie diagnostique , Cholangiopancréatographie rétrograde endoscopique , Calculs biliaires/imagerie diagnostique , Carcinome hépatocellulaire/anatomopathologie , Diagnostic différentiel , Humains , Tumeurs du foie/anatomopathologie , Mâle , Adulte d'âge moyenRÉSUMÉ
In microscopic polyangiitis (MPA), renal manifestations are very common as first symptoms. Here, we report a case of MPA which presented liver dysfunction prior to noted renal manifestations. A 58-year-old woman was hospitalized because of a fever for 8 weeks. A laboratory examination revealed marked elevation of alkaline phosphatase and gamma-glutamyl transpeptidase, while blood urea nitrogen and creatinine levels remained normal. Although apparent renal dysfunction developed in this case soon after hospitalization, physicians should be aware of the variety of clinical manifestations in MPA. Moreover, antineutrophil cytoplasmic autoantibodies were found to be helpful for diagnosing MPA.
Sujet(s)
Maladies du rein/étiologie , Maladies du foie/étiologie , Vascularite/complications , Vascularite/diagnostic , Femelle , Humains , Adulte d'âge moyenSujet(s)
Adénocarcinome papillaire/anatomopathologie , Tumeur du sein de l'homme/anatomopathologie , Carcinome hépatocellulaire/anatomopathologie , Cirrhose du foie/complications , Tumeurs du foie/anatomopathologie , Tumeurs primitives multiples/anatomopathologie , Adénocarcinome papillaire/imagerie diagnostique , Antinéoplasiques/usage thérapeutique , Tumeur du sein de l'homme/imagerie diagnostique , Carcinome hépatocellulaire/imagerie diagnostique , Embolisation thérapeutique , Éthanol/usage thérapeutique , Études de suivi , Humains , Tumeurs du foie/imagerie diagnostique , Mâle , Mastectomie partielle , Adulte d'âge moyen , Tumeurs primitives multiples/imagerie diagnostique , ÉchographieRÉSUMÉ
We report a 75-year-old Japanese man infected with hepatitis C virus (HCV) who died of acute hepatic failure due to the hepatic infiltration of B-cell non-Hodgkin's lymphoma (NHL) cells. He suddenly developed jaundice, fatigue, fever, and hepatosplenomegaly during the course of chronic infection with HCV. Postmortem liver necropsy revealed extensive infiltration of lymphoma cells into the liver. Although the association between HCV infection and NHL has recently become a matter of concern, we believe this to be the first reported case of acute hepatic failure caused by hepatic involvement of non-Hodgkin's lymphoma in an HCV-infected patient.