| dc.description.abstract | Insects are the most species and number of animals on the earth, and there must have both harmful or beneficial interactions between the two species. Hymenoptera is a large order of insects, and the Vespidae and Formicidae stings are the most common and serious causes of animal injuries met in the emergency department (ED). Allergic reactions are the most common problem for most insect injuries met in ED, and the most severe allergic reaction is anaphylaxis. The overall objective of this dissertation was to study{title}. Chapter One was aimed to study difference of clinical presentations, managements, and outcomes between Formicidae sting and Vespidae sting patients in Taiwan. The results indicated clinical comparison on Vespidae stings and Formicidae stings, and they were the two major causes of ED visits due to insect attacks. Formicidae sting patients presented with a higher rate of allergic reaction and spend more time in ED than Vespidae sting patients. But, Vespidae sting patients had higher complications and higher rates of admission, especially with an anaphylactic reaction. Both groups have positively correlated with temperature and had a higher rate on weekend days. Chapter Two was to evaluate the clinical management of patients with severe allergic reactions(anaphylaxis) in ED. Underuse of epinephrine in anaphylaxis patients may not a serious problem in ED. ED physicians tend to use epinephrine in severe symptoms of anaphylaxis, and the deicing factors to use epinephrine were sent via ambulance, hypotension, airway compromise, and conscious change. Among those severe presentations, hypotension was the most tolerating situation. Emergent care focuses first on the airway, breathing, and circulation may also compensate for the under usage of epinephrine. The importance of epinephrine use on anaphylaxis is still should be emphasized especially not in ED. Chapter Three was to examine the effect of bee propolis-derived caffeic acid phenethyl ester (CAPE) on angiotensin II-induced abdominal aortic aneurysm. The results indicated that CAPE could reduce the expansion of the aortic diameter and that CAPE attenuated Ang II-induced cell growth and inflammation of human aortic smooth muscle. Western blot analysis indicated that CAPE inhibited the Ang II-induced increasing the phosphorylation s of ERK, p38, and P65 proteins. However, CAPE treated alone did not alter the phosphorylations of these proteins. These results suggest that CAPE attenuates Ang II-induced cell growth and inflammation possibly through the ERK, p38, and p65 pathways and that CAPE may have the potential to prevent the formation of AAA. | en_US |