Direct Release Research Articles

Transient Vasodilation in Mouse 4T1 Tumors after Intragastric and Intravenous Administration of Gold Nanoparticles.

Gold nanoparticles (AuNPs) are foreseen as a promising tool in nanomedicine, both as drug carriers and radiosensitizers. They have been also proposed as a potential anticancer drug due to the anti-angiogenic effect in tumor tissue. In this work we investigated the effect of citrate-coated AuNPs of nominal diameter 20 nm on the growth and metastatic potential of 4T1 cells originated from a mouse mammary gland tumor inoculated into the mammary fat pad of Balb/ccmdb mice. To evaluate whether AuNPs can prevent the tumor growth, one group of inoculated mice was intragastrically (i.g.) administered with 1 mg/kg of AuNPs daily from day 1 to day 14 after cancer cell implantation. To evaluate whether AuNPs can attenuate the tumor growth, the second group was intravenously (i.v.) administered with 1 or 5 mg/kg of AuNPs, twice on day 5 and day 14 after inoculation. We did not observe any anticancer activity of i.v. nor i.g. administered AuNPs, as they did not affect neither the primary tumor growth rate nor the number of lung metastases. Unexpectedly, both AuNP treatment regimens caused a marked vasodilating effect in the tumor tissue. As no change of potential angiogenic genes (Fgf2, Vegfa) nor inducible nitric oxygenase (Nos2) was observed, we proposed that the vasodilation was caused by AuNP-dependent decomposition of nitrosothiols and direct release of nitric oxide in the tumor tissue.

Energy Distribution Law of Dynamic Failure of Coal-Rock Combined Body

The rock burst must be generated by energy. In order to explore the distribution law of energy in coal-rock system, based on the structural characteristics of coal and rock and the mechanical characteristics analysis of coal-rock combined body model, the calculation formula of energy distribution was given before the damage of same diameter coal-rock combine body and nonsame-diameter coal-rock combined body; the uniaxial compression experiments were carried out on the combined body, and the energy distribution before the failure of the combined body was calculated by using the energy distribution calculation formula. The results show that the greater the difference in hardness between the components of the combined body, the stronger the outburst proneness; the energy mainly accumulates on the weak component before the combined body is destroyed, and the hard components act as a clamping device. When the soft layers and the hard rock layers are interbedded, the energy accumulation ability of the soft rock layer is stronger than that of the hard rock layer, and the weak rock layer is the main carrier of energy accumulation. According to this, from the perspective of energy accumulation layer, for the energy-bearing structure, direct release energy and indirect release energy two kinds of rock burst prevention and control concepts and corresponding antiburst measures were proposed. At the same time, engineering practice, microseismic monitoring, and on-site measurement were conducted in Junde Coal Mine. The results show that the blasting pressure relief for the weak coal seam and the hard roof destroys the energy-bearing structure formed by the fine sandstone-coal-fine sandstone and effectively releases the energy and has a remarkable antiscour effect.

Investigating the chronological reduction potential of a urease inhibitor in respiration chambers

Ammonia emissions have wide-ranging negative consequences for human, animal and environmental health. Regulations including EU Directive 2016/2284 require European Union member states to reduce emissions. Dairy farming has one of the highest levels of ammonia emissions. Most dairy barns in Germany are naturally ventilated to meet higher animal welfare standards. However, these housing systems allow an uncontrolled direct release of emissions into the atmosphere. A novel mitigation method could be the use of a urease inhibitor. Although previous studies have noted the reduction potential of the inhibitor type K, the chronological course of the reduction is still unknown. This study investigates the inhibitory reaction by dividing the experiment into time slots to examine the chronological reduction in emissions. The inhibitor was found to reduce ammonia emissions by up to 37% at the 12-h time slot. This supports the assumption that the reduction potential of the inhibitor evolves over time. • First direct ammonia measurement of a urease inhibitor inside respiration chambers. • First calculation of a reduction potential by testing a urease inhibitor. • Urease inhibitor reduction potential ranged between 3% and 37%. • First information of the chronological development could be provided. • Indications of the inhibitor application process could be achieved.

Circulatory collapse during wound closure in spine surgery with an unknown cause: a possible adverse effect of topical application of vancomycin?

BackgroundVancomycin (VCM) is effective in fighting Gram-positive bacteria related severe infections, and topical application of VCM powder is widely used in orthopedic surgery to prevent wound infection. However, VCM could lead to infusion rate-dependent antibody-and complement-independent anaphylaxis reaction by inducing direct release of histamine.Case presentationWe retrospectively analyzed seven cases of severe hypotension and shock during wound closure or immediately after orthopedic surgery with unidentifiable reasons. We found that these cases were all associated with local application of VCM powder during wound closure process. Two patients experienced sudden cardiac arrest. Most of the cases (6/7) with circulatory collapse were discharged without severe sequelae. While one case with application of 3 g VCM developed cardiac arrest and remained in a coma due to hypoxic-hypoxic encephalopathy. The clinical presentations and the time of the shock onset were considered to be related with a VCM induced anaphylaxis reaction. However, as this was a retrospective study, and there was no laboratory examination performed, the conclusion was made upon differential diagnosis based on clinical manifestations and the timing of the shock.ConclusionsLocal application of VCM may not be as safe as was once believed and may lead to a related anaphylaxis. As VCM induced infusion-rate dependent, non-IgE mediated anaphylaxis is characterized by delayed occurrence, severe hypotension and even circulatory collapse, surgeons and anesthesiologists should be extra vigilant during and after VCM application.

Nutrient sensing and cAMP signaling in yeast: G-protein coupled receptor versus transceptor activation of PKA.

A major signal transduction pathway regulating cell growth and many associated physiological properties as a function of nutrient availability in the yeast Saccharomyces cerevisiae is the protein kinase A (PKA) pathway. Glucose activation of PKA is mediated by G-protein coupled receptor (GPCR) Gpr1, and secondary messenger cAMP. Other nutrients, including nitrogen, phosphate and sulfate, activate PKA in accordingly-starved cells through nutrient transceptors, but apparently without cAMP signaling. We have now used an optimized EPAC-based fluorescence resonance energy transfer (FRET) sensor to precisely monitor in vivo cAMP levels after nutrient addition. We show that GPCR-mediated glucose activation of PKA is correlated with a rapid transient increase in the cAMP level in vivo, whereas nutrient transceptor-mediated activation by nitrogen, phosphate or sulfate, is not associated with any significant increase in cAMP in vivo. We also demonstrate direct physical interaction between the Gap1 amino acid transceptor and the catalytic subunits of PKA, Tpk1, 2 and 3. In addition, we reveal a conserved consensus motif in the nutrient transceptors that is also present in Bcy1, the regulatory subunit of PKA. This suggests that nutrient transceptor activation of PKA may be mediated by direct release of bound PKA catalytic subunits, triggered by the conformational changes occurring during transport of the substrate by the transceptor. Our results support a model in which nutrient transceptors are evolutionary ancestors of GPCRs, employing a more primitive direct signaling mechanism compared to the indirect cAMP second-messenger signaling mechanism used by GPCRs for activation of PKA.

Ecological effects and causal synthesis of oil sands activity impacts on river ecosystems: water synthesis review

Oil sands development in the lower Athabasca River watershed has raised considerable public and scientific concerns regarding perceived effects on environmental health. To address this issue for tributaries and the mainstem of the Athabasca River in the Athabasca Oil Sands Region, the Water Component of the Joint Oil Sands Monitoring (JOSM) plan produced monitoring assessments for seven integrated themes: atmospheric deposition, tributary water quality, river mainstem water quality, groundwater quality and quantity, water quality and quantity modelling, benthic invertebrate condition, and fish health. Our review integrates and synthesizes the large and diverse datasets assembled in the seven JOSM theme assessments to (i) evaluate possible environmental effects based on known sources and candidate proximal causes and (ii) determine the importance of cause-and-effect pathways related to contaminant, sediment, and nutrient inputs. Although JOSM research identified ecological effects that appear to be associated with contaminant exposure, the source of this exposure is confounded by co-location of, and inability to differentiate between, oil sands operations (principally released by atmospheric emission) and inputs from the natural bitumen outcrops (e.g., erosional material transported by surface and groundwater flows). Nutrient enrichment from treated municipal sewage effluent was the dominant ecological effect observed for the mainstem Athabasca River, associated with increased fish size and changes in invertebrate assemblages, likely because this pollution source is discharged directly into the river. If the direct release of treated oil sands process water occurs in the future, then the potential ecological impact of these direct industry releases will need to be evaluated carefully. The ecological causal assessment method proved to be a useful tool for better understanding how stressor sources relate to ecological effects through candidate proximate causes. Factors that confound our ability to assess the ecological effects of oil sands development focus on our inability to adequately differentiate between contaminants supplied from natural and anthropogenic contaminant sources. Our causal synthesis identifies options for changes in future monitoring to better anticipate and detect degradation in the ecosystem health of the lower Athabasca River and its tributaries.

Genetic analysis for some top crosses of yellow maize

Twenty elite yellow maize inbred lines were crossed as female parents with three different testers as male parents, i.e. Gem. Pop. (Broad genetic base), Single cross 101(Narrow genetic base) and Inbred line 100 (Narrow genetic base) at the Experiment Research Station of Moshtohor, Benha University, Egypt during 2014 growing summer season. The resulting 60 crosses with three commercial check hybrids i.e. SC 155, SC Pioneer 3080 and TWC 352 were evaluated in a yield trial in two sowing dates during 2015 growing summer season. The results showed that, sowing dates, crosses, lines, testers and line x testers mean squares were significant for all traits. The seven parental inbred lines (L-4, L-5, L-10, L-12, L-13, L-14 and L-19) possessed high GCA effects for grain yield and six lines (L-1, L-7, L-10, L-13, L-16 and L-18) possessed high GCA effects for earliness. These lines can be utilized as promising inbred lines in a hybridization program to develop high yielding and early maturity maize hybrids. The seven crosses (T-1 × L-7, T-1 × L-13, T-1 × L-17, T-2 × L-4, T-2 × L-5, T-2 × L-10 and T-2 × L-12) which had out-yielded significantly the best check SC. 3080 could be utilized for future breeding work as well as for direct release after confirming the stability of their performances observed in the current study. Hence, the information from this study may possibly be useful for researchers who would like to develop high yielding hybrids of maize.

The mechanism of immunity in tbc.

Experimental studies of V. A. Lyubarsky, N. L. Zhivago and A. F. Korzhinskaya (Arch. Exp. Biol. And Med., 1925, No. 1) convinced these authors that bacteriolysis (lipolysis) of tbc bacilli in immune the body does not occur - the immunity to tbc is of a cellular nature, namely, in the immune body, tbc bacilli are fixed in order to isolate them from the body, which is achieved by the formation of tubercles with all their subsequent transformations. Along with this, there is a direct release of tbc rods from the body, which occurs through the bile and intestines. The specified mechanism of immunity is the same regardless of whether we are dealing with virulent or low-virulent bacilli. The same is the mechanism of immunity in relation to acid-resistant saprophytes.

The Environmental Impact of a Complex Hydrogeological System on Hydrocarbon-Pollutants’ Natural Attenuation: The Case of the Coastal Aquifers in Eleusis, West Attica, Greece

The study area is the Thriassion Plain, an important area, in antiquity, surrounding the famous ancient town of Eleusis, 20 km west of Athens. The modern town and port and the entire area were heavily industrialized (1965–1995) coupled with unregulated urban and agricultural development. The presence of two crude oil refineries and other oil-related industries have strongly impacted the entire environment, including soils, waters and sediments of the broader area. The purpose of this work is to better understand how a multi-layered groundwater system affects the potential underground spread of certain fuel volatile compounds, namely the BTEX (benzene, toluene, ethylbenzene and total xylenes) as well as their attenuation after their direct or indirect release into the aquifer system. The spatial distribution of BTEX in groundwaters show that they were concentrated mainly in four rather restricted locations. Three of them were spotted, as expected, in the close vicinity of known pollution sources (a military airfield and two crude oil refineries). The other one corresponds to an abandoned site with no outstanding pollution sources where wells exist, eventually used for illegal dumping of oily wastes. It is important that the concentrations decrease significantly from autumn to spring. This decline could be characterized as natural attenuation, related to natural dilution phenomena and a flushing out of pollutants discharging through underwater springs to the sea during the rainy period (October to April). This, in turn, could be associated to the specific geological conditions affecting the hydrology, such as the unconsolidated non-permeable deposits and the multi layered formations of the area’s aquifers.

Immediate effects of a direct myofascial release technique on hip and cervical flexibility in inactive females with hamstring shortening: A randomized controlled trial

BackgroundCurrently, greater background is required about the effectiveness of myofascial release (MFR) on muscle flexibility. ObjectiveOur goal was to determine the immediate effect of a direct MFR technique on hip and cervical flexibility in inactive females with hamstring shortening. MethodThe sample group included 68 female university students, randomly divided into a control group (n = 34) and an experimental group (n = 34). A placebo technique was used with the control group, and direct MFR on the posterior thigh region was used with the experimental group. ResultsThe mixed factorial ANOVA did not show significant intergroup differences (p > 0.05). In the experimental group, Bonferroni post hoc test showed significant intragroup differences between pre-test and post-test 1, as well as between pre-test and post-test 2 for the three ischiotibial muscle flexibility tests (p < 0.001). Cervical flexion range of motion showed significant differences between pre-test and post-test 1 (p < 0.001). ConclusionsWe conclude that the protocol based on a single direct MFR intervention was no more effective than the placebo in improving flexibility both locally at the hamstring level and remotely at the level of the cervical extensor muscles. Future research should consider different MFR techniques on the immediate increase in muscle flexibility and the long-term effect of MFR, as well as consider different intervention groups.

Methoxyeugenol regulates the p53/p21 pathway and suppresses human endometrial cancer cell proliferation

Ethnopharmacological relevancePlant-derived compounds are a reservoir of natural chemicals and can act as drug precursors or prototypes and pharmacological probes. Methoxyeugenol is a natural compound found in plant extracts, such as nutmeg (Myristica fragrans), and it presents anthelmintic, antimicrobial, anti-inflammatory activities. Recently, interest in the anticancer activity of plant extracts is increasing and the therapeutic activity of methoxyeugenol against cancer has not yet been explored. Aim of the studyThe present study aimed to evaluate the cancer-suppressive role and the molecular signaling pathways of methoxyeugenol in human endometrial cancer (Ishikawa) cell line. Materials and methodsProliferation, viability, and cell toxicity were assessed by direct counting, MTT assay, and LDH enzyme release assay, respectively. Antiproliferative effect were evaluated by nuclear morphological changes along with the cellular mechanisms of apoptosis and senescence by flow cytometry. The underlying molecular and cellular mechanisms were investigated by RT-qPCR, reactive oxygen species (ROS) levels, mitochondrial dysfunction, and proliferative capacity. Results and conclusionsMethoxyeugenol treatment significantly inhibited the proliferation and viability of Ishikawa cells. Probably triggered by the higher ROS levels and mitochondrial dysfunction, the gene expression of p53 and p21 increased and the gene expression of CDK4/6 decreased in response to the methoxyeugenol treatment. The rise in nuclear size and acidic vesicular organelles corroborate with the initial senescence-inducing signals in Ishikawa cells treated with methoxyeugenol. The antiproliferative effect was not related to cytotoxicity and proved to effectively reduce the proliferative capacity of endometrial cancer cells even after treatment withdrawal. These results demonstrated that methoxyeugenol has a promising anticancer effect against endometrial cancer by rising ROS levels, triggering mitochondrial instability, and modulating cell signaling pathways leading to an inhibition of cell proliferation.

Nanoparticle Exposure and Workplace Measurements During Processes Related to 3D Printing of a Metal Object.

Metal 3D printing has many potential uses within prototyping and manufacturing. Selective laser melting (SLM) is a process that uses metal powders in the micrometer range as printing material. The particle release from the entire SLM printing process is not well-studied. While the 3D printing itself often occurs in a sealed chamber, activities related to the process can potentially release harmful metal particles to the indoor working environment through resuspension of the printing powder or via incident nanoparticles generated during printing. The objective of this study was to improve the understanding of particle exposure in work processes associated with 3D printing and potential needs for interventions by a case study conducted in a 3D printing facility. In this setting, direct release and dispersion of particles throughout the workspace from processes related to metal 3D printing was investigated. The release from five activities were studied in detail. The activities included post-printing cleaning, object annealing, and preparation of new base substrate for the next printing was. Three of the five measured activities caused particles number concentrations in the working environment to increase above background levels which were found to be 8·102 cm−3. Concentrations during chamber emptying and the open powder removal system (PRS) cleaning processes increased to 104 and 5·103 cm−3, respectively, whereas grinding activity increased number concentrations to 2.5·105 cm−3. Size distributions showed that particles were mainly smaller than 200 nm. Respirable mass concentrations were 50.4 μg m−3, collected on filters. This was corroborated by respirable mass measured with a DustTrak of 58.4 μg m−3. Respirable mass concentrations were below the occupational exposure limits in Denmark for an 8 h time-weighted average.

Sustainability consolidation via employment of biomimetic ecomaterials with an accentuated photo-catalytic potential: emerging progressions

Abstract Environmental pollution produced due to direct and untreated release of toxic organic pollutants such as dyes from the textile industries is not only effect the human life but also contaminates the ecosystem through different transferal modes. Green nanomaterials synthesized by using biological reducing agents offer sustainable, economically viable, facile, rapid and eco-friendly approach with photocatalytic degradation efficiencies &gt;90% for organic dyes over the other traditional technologies. Current review has for the first time comprehensively abridged the suitability of green nanoparticles over chemogenic nanoparticles, the remediative role of these biogenic nanoparticles with major emphasis on the recent progressions in the photocatalysis of different toxic dyes and pollutants. Unlike physicochemically processed nanoparticles, biogenic nanoparticles has profound contribution to the sustainable development goals due to their cleaner and economical synthesis in addition to their detoxifying role. Meticulous review of the publications are strongly suggestive of the adoptability of biogenic nanoparticles at an implementation scale for their auspicious remediative role in addition to facile fabrication, natural reducing agents based synthetic mode, toxicity free and sustainable nature. However, the studies are also indicative of the need for utilization of biogenic synthesis at practical scale to derive maximum sustainability and ecological benefits.

Temperature of metal wires for nanosecond and microsecond electrical explosions in vacuum

Experiments show an inverse correlation between temperature and heating time for the electrical explosion of thin metal wires in vacuum. Faster heating of the wire results in higher energy release in a short time, while slow heating lasts longer but releases less energy before breakdown. Breakdown is a natural barrier to the direct release of Joule energy and an increase in the metal temperature to an abnormally high value. An increase in the current rate from 0.07 to 170 A/ns leads to a decrease in the heating time from 5 μs to 5 ns and an increase in the wire temperature from 450 K to 4000 K before the voltage breakdown. This inverse correlation between the heating time and the temperature of the wire in a vacuum can be explained by the inertia of evaporation of the hydrocarbon impurity from the surface of the hot metal.

Toxicological effects and bioaccumulation of fullerene C60 (FC60) in the marine bivalve Ruditapes philippinarum

Fullerene C60 (FC60), with its unique physical properties, has been used in many applications in recent decades. The increased likelihood of direct release into the environment has raised interest in understanding the biological effects of FC60 to aquatic organisms. Nowadays, only few studies have analysed FC60 effects and bioaccumulation in marine organisms following in vivo exposure. To provide new data about FC60 toxicity, Ruditapes philippinarum was selected as target species to assess potential adverse effects of the contaminant. Clams were exposed for 1, 3 and 7 days to predicted environmental concentrations of FC60 (1 and 10 μg/L) and cellular and biochemical responses were evaluated in clams’ gills, digestive gland and haemolymph. The FC60 content in gills and digestive gland was determined in all experimental conditions after 7 days of exposure. Results showed an increase in oxidative stress. In particular, a significant modulation in antioxidant enzyme activities, and changes in glutathione S-transferase activity were observed in gills. Moreover, damage to lipids and proteins was detected in FC60-treated (10 µg/L) clams. In digestive gland, slighter variations in antioxidant enzyme activities and damage to molecules were detected. CAT activity was significantly affected throughout the exposure, whereas damage to lipids was evident only at the end of exposure. FC60 accumulation was revealed in both gills and digestive gland, with values up to twelve-fold higher in the latter. Interestingly, haemolymph parameters were slightly affected by FC60 compared to the other tissues investigated. Indeed, only Single Cell Gel Electrophoresis and Neutral Red uptake assays showed increased values in FC60-exposed clams. Moreover, volume and diameter of haemocytes, haemocyte proliferation, and micronucleus assay highlighted significant variations in treated clams, but only in the first phases of exposure, and no changes were detected after 7 days. Our results suggested clam gills as the target tissue for FC60 toxicity under the exposure conditions tested: the high damage detected to lipids and proteins could contribute to long-term problems for the organism.

Hydrogeochemical Characteristics and Impact of Arsenic Released from a Gold Deposit in Tibet

High arsenic concentrations are common in the water and soils in Tibet. In this study, arsenic concentrations were found to be below detection limits in natural river water, although the high background concentrations of HCO3− and the pH all favor arsenic release. Lake water had the highest arsenic concentrations due to intense evaporation. The impact of mining on arsenic release was assessed using a mixing model composed of three end-members: KS02 (a post-mining sample), R07 (a river water sample), and S12 (spring water that contains arsenic). The results indicated that mining operations are likely responsible for a small proportion (2.0%) of direct release of arsenic from deep thermal water, and that most arsenic was released by desorption from Fe oxyhydroxides. The mixing model also revealed that so far, mining operations have accelerated carbonate dissolution, but have not led to arsenopyrite oxidation. Therefore, HCO3− concentrations increased during mining, which along with the pH (> 7.0), led to desorption of arsenic from Fe oxyhydroxide.

Trophic levels of Tidal and Non-Tidal Marshes of Southern Mesopotamia

Carlson’s Trophic State Index (CTSI) was applied to assess the trophic status of two kind of southern Mesopotima marshes. Six stations were selected, three in non-tidal Chebiyesh marshes and other three in tidal East Hammer marsh. The results indicated that the values of CTSI of the six stations fluctuated between 47.59 - 61.96 ranged from mesotrophic to Eutrophic. The increase of salinity during 2018 drastically affect CTSI values in East Hammer marsh. In general, both tidal and non-tidal marshes were eutrophic mainly due to direct release of untreated domestic swage and agricultural drainage waters. Trophic status of southern Iraqi marshes potentially impacted by transparency of the marsh, chlorophyll a and phospharus concentrations.

Isotope ratio mass spectrometry and spectroscopic techniques for microplastics characterization

Micro- and nano-scale plastic particles in the environment result from their direct release and degradation of larger plastic debris. Relative to macro-sized plastics, these small particles are of special concern due to their potential impact on marine, freshwater, and terrestrial systems. While microplastic (MP) pollution has been widely studied in geographic regions globally, many questions remain about its origins. It is assumed that urban environments are the main contributors but systematic studies are lacking. The absence of standard methods to characterize and quantify MPs and smaller particles in environmental and biological matrices has hindered progress in understanding their geographic origins and sources, distribution, and impact. Hence, the development and standardization of methods is needed to establish the potential environmental and human health risks. In this study, we investigated stable carbon isotope ratio mass spectrometry (IRMS), attenuated total reflectance - Fourier transform infrared (ATR-FTIR) spectroscopy, and micro-Raman spectroscopy (μ-Raman) as complementary techniques for characterization of common plastics. Plastic items selected for comparative analysis included food packaging, containers, straws, and polymer pellets. The ability of IRMS to distinguish weathered samples was also investigated using the simulated weathering conditions of ultraviolet (UV) light and heat. Our IRMS results show a difference between the δ13C values for plant-derived and petroleum-based polymers. We also found differences between plastic items composed of the same polymer but from different countries, and between some recycled and nonrecycled plastics. Furthermore, increasing δ13C values were observed after exposure to UV light. The results of the three techniques, and their advantages and limitations, are discussed.

An analysis on the steam generator tube rupture events with core damage

This paper investigates risk significance of Steam Generator Tube Rupture (SGTR) events accompanying a core damage and a direct release of radionuclides into the atmosphere bypassing the containment. Analyses on a spontaneous steam generator tube rupture (S-SGTR) event leading to a core damage and a consequential steam generator tube rupture (C-SGTR) event caused by a station black out (SBO) event are performed for APR1400 using MELCOR 2.2. Both events led to a direct radiological release to the atmosphere. The amount of radiological release was more than that of the Chernobyl and the Fukushima accident.Operator actions to mitigate the radiological releases are investigated. For the S-SGTR scenario, recovery of either auxiliary feed water (AFW) or safety injection alone was not able to prevent significant radiological releases. Combined action of opening of atmospheric dump valve (ADV) and supply of AFW to the steam generators (SGs) resulted in an aggressive depressurization of the primary system and an actuation of safety injection tank. Recovery of liquid inventory and minimizing the U-tube leakage prevented core damage. For C-SGTR scenario, delayed operator action until the time of U-tube creep rupture was not able to prevent significant radiological releases. C-SGTR had to be prevented by a supply of AFW to SGs or rapidly depressurizing the reactor coolant system before an occurrence of U-tube creep rupture.

UNUSUAL PRESENTATION OF DISSEMINATED LEGIONELLA WITH HYPERTRIGLYCERIDEMIA AND MASSIVE RHABDOMYOLYSIS

SESSION TITLE: Medical Student/Resident Chest Infections Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Legionella most commonly presents as pneumonia but can involve multiple organ systems. We present a case of a patient with pneumonia, rhabdomyolysis, renal failure, hypertriglyceridemia, pancreatitis, and cutaneous involvement. CASE PRESENTATION: A 41-year-old black male presented with shortness of breath requiring intubation. Pertinent labs showed elevated white blood cell count, creatinine, and CK. Chest radiograph (fig 1) showed right lower lobe airspace opacity. He was started on broad spectrum antibiotics and admitted to the intensive care unit. Despite aggressive IV fluids, his CK level peaked at 780,000. Kidney function continued to decline, ultimately requiring dialysis. Urine legionella antigen was positive otherwise work up negative. Antibiotics were switched to Levaquin. He was noted to have triglyceride level of 1800, with associated lipase elevation and imaging consistent with pancreatitis. This was managed with fluids and insulin infusion but eventually needed plasma exchange. He also had a 1cm superficial ulcer in the left groin (fig 2) and biopsy revealed a dermal microabscess favoring an underlying infectious process (fig 3). After 2 weeks of levaquin, he clinically improved, however required long-term dialysis. DISCUSSION: Legionella infection typically presents as pneumonia. Rarely, it can present as extra-pulmonary disease involving gastrointestinal, neurological, cardiac, renal, and musculoskeletal systems, and skin and soft tissues. A rare triad of pneumonia, rhabdomyolysis and renal failure has been associated with worse and sometimes fatal outcomes [1]. Our patient’s course is unique as he had severe rhabdomyolysis, renal failure, hypertriglyceridemia, pancreatitis, and cutaneous lesion associated with his legionella infection. To our knowledge this is the first case report of hypertriglyceridemia associated with legionella infection in humans. There have been reports of elevated triglyceride levels in guinea-pigs with legionella [2]. It is likely his pancreatitis was from hypertriglyceridemia, however may be from pancreatic injury due to direct cell infection, toxin release, or cytokine induced inflammation. His skin lesion was very similar to the cutaneous manifestations of legionnaire disease reported in the literature [4]. The biopsy results strongly favored an underlying infectious process and no other infection was identified with tissue stains and culture. Few case reports have described rhabdomyolysis in Legionnaires’ disease. The highest reported CK level was 165,600 [2], our patient peaked at 780,000. The mechanism of action is unclear; direct bacterial invasion into the muscle and the release of endotoxin leading to muscle damage have been postulated [3]. CONCLUSIONS: This case highlights the breath of involvement legionella can have, including the new manifestation of hypertriglyceridemia and severe rhabdomyolysis that has never been reported previously. Reference #1: T. Koufakis, I. Gabranis, M. Chatzopoulou, A. Margaritis, M. Tsiakalou. Severe Legionnaires' disease complicated by rhabdomyolysis and clinically resistant to moxifloxacin in a splenectomised patient: too much of a coincidence? Case Rep. Infect. Dis., 2015 (2015), pp. 1-4 Reference #2: Hambleton P, Bailey NE, Fitzgeorge RB, Baskerville A. Clinical chemical responses to experimental airborne legionellosis in the guinea-pig. Br J Exp Pathol. 1985;66(2):173-183. Reference #3: Johnson DA, Etter HS. Legionnaires' disease with rhabdomyolysis and acute reversible myoglobinuric renal failure. South Med J. 1984;77(6):777-779. doi:10.1097/00007611-198406000-00032 DISCLOSURES: No relevant relationships by Hadi Hatoum, source=Web Response No relevant relationships by Hamel Patel, source=Web Response No relevant relationships by Patrisha Shelley, source=Web Response