Caregivers' and patients' quality of life are related and both share a community of distress.

The report of a clinical study of 104 electrical accidents which befell 85 men is divided into two parts.Part I enumerates the different types of accidents as flash burn, Joule burn, arc eye, "held on" shock and "not held" shock, physical shock, and death. These are related to the different voltages involved ranging from 240/415 (medium) voltage to 33 kilovolts. There appeared to be no association between voltage and type of injury and no evidence to suggest that any of the voltages are free from hazard. There were 53 cases of flash burn, affecting mostly the face and extensor surface of the hands and arms. The 16 cases of arc eye caused no serious concern. Of the 15 Joule burns all except one occurred at medium voltages in "held on" accidents, the other being associated with an electric shock at 33 kilovolts. The majority of Joule burns affected the flexor surfaces.Part II of the paper deals with the 43 cases of electric shock (passage of current through the body). Thirty of these cases were "held on" to the circuit by the current. It was found that the longer a victim was held on to the circuit the greater appeared to be his chances of developing heart and chest symptoms suggestive of impending asphyxia, and of losing consciousness. Although about half of these men were released by an external agmncy and others struggled off, a number suddenly became free from the circuit without, they claimed, losing consciousness. This is difficult to explain. Artificial respiration was administered in two cases, one of whom was "held on" and was being asphyxiated. The other case received flash burns only and did not in fact receive an electric shock. PART I: GENERAL REVIEW AND NON-SHOCK CASESElectrical accidents receive little attention in British medical literature. In fact, in the electricity supply industry they account for only 1 % of the total number of accidents but they are the commonest cause of accidental death (Hughes and Corney, 1956). In factories, electrical accidents account for less than 0-5 % of all accidents, but more than 5% of these electrical accidents prove fatal (Emerson, 1961). This paper reports a clinical investigation into a series of electrical accidents; detailed consideration of the cases of electric shock (passage of current through the body) is given in Part II of this paper. MethodThe names of all men in an electricity supply undertaking who had sustained an electrical accident during the preceding three years were obtained. Of the total of 114, 107 were still employed by the undertaking. One man was killed; the remainder were contacted and 84 attended for interview. (The majority of those who were not seen worked in one small area and there is no reason to suppose that the nature of their accidents was any different from the whole.) They were all seen by one investigator and were questioned about the electrical and physical circumstances of the accident, about symptoms, and about subsequent medical history.

The transfer of exosomes containing both genetic and protein materials is necessary for the control of the cancer cell microenvironment to promote tumor angiogenesis. The nature and function of proteins found in the exosomal cargo, and the mechanism of their action in membrane transport and related signaling events are not clearly understood. In this study, we demonstrate, in human lung cancer A549 cells, that the exosome release mechanism is closely linked to the multifaceted receptor sortilin (also called neurotensin receptor 3). Sortilin is already known to be important for cancer cell function. Here, we report for the first time its role in the assembly of a tyrosine kinase complex and subsequent exosome release. This new complex (termed the TES complex) is found in exosomes and results in the linkage of the two tyrosine kinase receptors TrkB (also known as NTRK2) and EGFR with sortilin. Using in vitro models, we demonstrate that this sortilin-containing complex exhibits a control on endothelial cells and angiogenesis activation through exosome transfer.

Tyrosine kinase receptors such as the epidermal growth factor receptor (EGFR) transduce information from the microenvironment into the cell and activate homeostatic signaling pathways. Internalization and degradation of EGFR after ligand binding limits the intensity of proliferative signaling, thereby helping to maintain cell integrity. In cancer cells, deregulation of EGFR trafficking has a variety of effects on tumor progression. Here we report that sortilin is a key regulator of EGFR internalization. Loss of sortilin in tumor cells promoted cell proliferation by sustaining EGFR signaling at the cell surface, ultimately accelerating tumor growth. In lung cancer patients, sortilin expression decreased with increased pathologic grade, and expression of sortilin was strongly correlated with survival, especially in patients with high EGFR expression. Sortilin is therefore a regulator of EGFR intracellular trafficking that promotes receptor internalization and limits signaling, which in turn impacts tumor growth.

The subset of patients with active immunological profile is characterized by systemic complications leading to immunosuppressive drug utilization and polyclonal B-cell activation profile.