ABSTRACT
In adults with acute epiglottitis, transient noncardiogenic pulmonary edema may follow relief of upper airway obstruction, but typically does not progress to more severe pulmonary derangements. We describe a patient with post-obstructive pulmonary edema whose course was complicated by ARDS, multiorgan failure, and death. Recognition of UAO and expedient treatment depends heavily on the judgment and skills of the clinician and the available resources of the institution. Physicians caring for patients with AE should be aware of the potential for delayed morbidity and mortality following upper airway obstruction, even after establishing an adequate artificial airway. This case provides additional justification for aggressive airway management and intensive care support of patients with AE in order to avoid serious complications.
Subject(s)
Airway Obstruction/complications , Multiple Organ Failure/mortality , Respiratory Distress Syndrome/mortality , Acute Disease , Airway Obstruction/surgery , Epiglottitis/complications , Humans , Male , Middle Aged , Multiple Organ Failure/etiology , Pulmonary Edema/etiology , Respiratory Distress Syndrome/etiology , TracheostomyABSTRACT
Glycosidases, which cleave sugar molecules from complex glycopolymers, have been previously quantified in normal human cornea in our laboratory. Data quantifying glycosidases in macular corneal dystrophy are lacking. Tissue obtained at keratoplasty from patients with macular dystrophy and normal corneas obtained from eye bank eyes were used to determine levels of glycosidase activity. A fluorometric technique was employed using 4-methyl-umbelliferyl-glycosides as substrates. The corneal tissues were homogenized, centrifuged, and the supernatants assayed for enzyme activity. Specific activities (mumol/mg protein/hour) were determined and Km and Vmax values were obtained for all but one enzyme. Activity of alpha-galactosidase was significantly lower in cornea tissue and keratocytes from macular corneal dystrophy compared to normal.
