Predictors of High Peak Serum CK Levels in Doxylamine Intoxication

BACKGROUND: Because doxylamine succinate (DS) is an over-the-counter medicine, it can be obtained easily and is frequently used in suicidal attempts. Patients usually recover without serious complications, but occasionally rhabdomyolysis and even death can occur in DS intoxication. In this study, the authors tried to find out the independent predictors of high peak serum CK levels, i.e. probable rhabdomyolysis in DS intoxication. METHODS: The medical records of 41 patients who visited a hospital for DS intoxication from January 1, 2002 to April 30, 2003, were reviewed retrospectively. RESULTS: In the group of DS only, initial occult blood of urine (P=0.003), initial WBC count (P=0.003) and confusion (P=0.007) were the best predictors of the peak serum CK level (2=0.724). In the group of DS with other drugs intoxication, initial creatinine level (P=0.003) and initial occult blood of urine (P=0.007) were the best predictors of the peak serum CK level (r2=0.784). In the cases of rhabdomyolysis patients, the time taken for the CK level to be increased over 1,000 IU/L was 1.9level to be increased over 1,000 IU/L was 1.9+/-0.6 days. CONCLUSION: In DS only intoxication, occult blood in initial urine analysis, initial high WBC count and confusion can be thought of as useful clinical predictors for high peak serum CK level case. In DS with other drugs intoxication, initial creatinine level and initial occult blood of urine can be considered as the best predictors. More than 2 days will be needed for the observation of serious complications in DS intoxication.

bcl-2 and MIB-1 Expression in Basal Cell Carcinoma / 대한피부과학회지

BACKGROUND: bcl-2 is a newly characterized proto-oncogen that has been shown to suppress programmed cell death(apoptosis), which is involved in tumorigenesis, and its expression has been demonstrated within tumor cells in a variety of neoplasms. OBJECTIVE: We examined whether there are differences in bcl-2 expression in basal cell carcinoma and several epidermal keratinocytic tumors. In addition, we evaluated bcl-2 expression according to histological types of basal cell carcinoma as well as the interaction of expression of bcl-2 and MIB-1 protein in BCC subtypes. METHODS: Routine paraffin sections of formalin-fixed sixty tissues(20 BCC, 10 Bowen disease, 10 keratoacanthoma, and 20 SCC) were labelled with anti-bcl-2 monoclonal antibody and MIB-1 using a labelled streptavidin-biotin complex. RESULTS: 1. Twenty cases of basal cell carcinoma were examined and all expressed cytoplasmic bcl-2. Three out of 20 cases of squamous cell carcinoma were focally positive. None of the 10 Bowen disease cases and the 10 keratoacanthoma cases expressed bcl-2. 2. In BCC, bcl-2 immunoreactivity was great in the superficical subtypes which had an indolent growth variant, moderate in the circumscribed types, and weak in the infiltrative types which had aggressive growth variants. 3. Evaluation of the distribution of bcl-2 immunoreactive categories and MIB-1 grades revealed a negative correlation tendency, but no statistical significance. CONCLUSION: Our results suggest the presence of a protection mechanism from apoptosis mediated by bcl-2 protein involved in the neoplastic growth mechanism of BCC. In addition, the observed findings in the expression pattern of bcl-2 and MIB-1 in the BCC subtypes may be due to interaction between bcl-2 and other apoptotic-related oncogens.