ABSTRACT
The histopathology of airway inflammation in rare cases of sudden asphyxic asthma death (SAAD) is unclear. This study examines, for the first time, the relative disposition of lymphocyte and macrophage subsets and eosinophils in proximal and distal tissues of such cases. Multiple resection specimens from five cases of SAAD were studied. Tissue blocks were obtained at necroscopy and immediately frozen in liquid nitrogen within 18 hours of death (death occurring within 1 h of the onset of an unprovoked asphyxic asthma attack). After immunohistological staining, frozen sections underwent semi-quantitative analysis (cell counts per unit area) for T-cells, macrophages and eosinophils using computerized imaging systems. Subsets of T-cells and macrophages were estimated using double immunofluorescence techniques. Variability within samples, between samples and between cases was compared. These cases of fatal asthma showed infiltrates of T-cells, macrophages and eosinophils within peribronchial tissues. Distinct from stable asthma, a CD8+ T-cell dominance was found. A high proportion of eosinophils were activated (EG2+), whereas the relative proportion of antigen-presenting cells (RFD1+) did not seem to be abnormal, although numbers of these cells were high. These features were seen both in proximal and distal tissues. The variability of these parameters within an individual was 9.4-15.2%, however, the variability between individual cases was greater. Sudden asphyxic asthma is associated with inflammatory infiltrates both of proximal and distal lung tissues. In contrast to stable asthma, this infiltrate contains large numbers of CD8+ T-cells, suggesting distinct qualitative as well as quantitative characteristics in the immunopathology of sudden asthma death.
Subject(s)
Asthma/pathology , Death, Sudden/pathology , Lung/pathology , Acute Disease , Adult , Antigen-Presenting Cells/pathology , Asphyxia/etiology , Asphyxia/pathology , Asthma/complications , Bronchi/pathology , Death, Sudden/etiology , Eosinophils/pathology , Female , Fluorescent Antibody Technique , Humans , Immunohistochemistry , Inflammation/pathology , Lymphocytes/pathology , Macrophages/pathology , Male , Middle Aged , Prospective Studies , T-Lymphocyte SubsetsABSTRACT
The following study was undertaken to evaluate the level of slef-care activities of severely disabled patients discharged from the G. F. Strong Rehabilitation Centre to extended care units (FCU). The results may offer significant information with regard to the ongoing rehabilitation program at the Centre, and could have implications in terms of total management for severely disabled patients in the future.
Subject(s)
Activities of Daily Living , Outcome and Process Assessment, Health Care , British Columbia , Continuity of Patient Care , Humans , Rehabilitation Centers , Skilled Nursing FacilitiesABSTRACT
In this study of techniques for the operation of environmental control aids for disabled persons, 12 programmed input modes were investigated in a uniform typing task. A microprocessor-based electronic aid (MECON) developed for this project was operated in 1 mode at a time by the disabled subject using a joystick and/or switch. Fourteen severely handicapped subjects with a wide variety of disabling conditions participated in the investigation. In the results, various input modes were ranked in order of speed. The fit and stability of the transducer were found to be important to the subjects' performance, and there were a number of indications that the availability of multiple input modes for an aid is highly desirable.
