Meclofenamate Suppresses MUC5AC Mucin Gene Expression by Regulating the NF-kB Signaling Pathway in Human Pulmonary Mucoepidermoid NCI-H292 Cells

The current study aimed to reveal the potential effect of meclofenamate, a nonsteroidal anti-inflammatory drug, on the gene expression of airway MUC5AC mucin. Human pulmonary mucoepidermoid NCI-H292 cells were pretreated with meclofenamate for 30 min and stimulated with phorbol 12-myristate 13-acetate (PMA) for 24 h. Thereafter, the effect of meclofenamate on the PMAinduced nuclear factor kappa B (NF-kB) signaling pathway was assessed. Meclofenamate inhibited glycoprotein production and mRNA expression of MUC5AC mucins induced by PMA by inhibiting the degradation of inhibitory kappa Bα (IkBα) and NF-kB p65 nuclear translocation. These results suggest meclofenamate suppresses mucin gene expression by regulating NF-kB signaling pathway in human pulmonary epithelial cells.

Difficult Airway and Failed Tracheal Intubation in a Patient with Mucopolaysaccharidoses Type II: A Case Report

Mucopolysaccharidoses are rare lysosomal storage diseases resulting from defects in lysosomal enzymes involved in degradation of glycosaminoglycans. Different mucopolysaccharidoses are caused by different enzyme deficiencies The anesthetic complications are related to the organs involved. Patients with mucopolysaccharidoses are rare, and few anesthetists encounter such patients. We experienced a case of mucopolysaccharidoses type II. Several endotracheal intubation attempts were tried, but we experienced failed endotracheal intubation. And we decided to proceed with surgery under bag-mask ventilation because of the short operation time. There’s no desaturation time. And the patient’s spontaneous ventilation was recovered and awakened. We have also briefly discussed the pathophysiology, clinical features, and possible airway management options for patients with mucopolysaccharidoses type II.

Anesthetic Management for Spine Surgery in a Patient with Left Internal Carotid Artery Occlusion and Penetrating Aortic Ulcer: A Case Report

A key challenge of anesthesia is to provide patients with safe and optimized anesthetic management to improve prognosis and minimize mortality and morbidity. To this end, the anesthesiologist should comprehensively understand the patient’s physical status through pre-anesthetic assessment and carefully monitor the patient during surgery. Several types of novel patient-monitoring devices may be useful to achieve this purpose. We report a case of anesthetic management in a patient with left internal carotid artery occlusion and penetrating aortic ulcer.

Regional Anesthesia for Abdominal Surgery in a Patient with Severe Chronic Respiratory Failure: A Case Report

General anesthesia is associated with a risk for postoperative pulmonary complications. The risk is even higher in patients with chronic respiratory failure, and postoperative mortality rates are high. Proper perioperative anesthetic management is important in such patients. Therefore, it is essential to optimize the patient’s physical status before anesthesia and to determine the optimal anesthesia technique based on the pre-anesthesia evaluation of the patient’s pulmonary function. We successfully performed abdominal surgery under spinal anesthesia in a patient with severe chronic respiratory failure.

Differences in Associated Factors according to the Time of Occurrence of Pressure Ulcers in Intensive Care Unit Patients / 중환자간호학회지

Purpose@#: This study aimed to present the incidence of pressure ulcers and identify different associated factors according to the time of occurrence of pressure ulcers in intensive care unit (ICU) patients. @*Methods@#: The participants were 313 patients who reported pressure ulcers among 2,908 patients in ICUs at a large tertiary hospital in Gyeonggi-do. Among them, 220 patients (70.3%) had a pressure ulcer before admission, and 93 patients (29.7%) reported newly developed pressure ulcers after admission to the ICU. Data were collected between August 2018 and April 2019. Along with the time of occurrence and characteristics of pressure ulcers, diverse associated factors were gathered through electronic medical records. Data were analyzed using descriptive statistics, independent t-tests, and χ2-tests. @*Results@#: Different risk factors associated with pressure ulcers in ICU patients according to the time of occurrence were main diagnosis, score of acute physiology and chronic health evaluation, score of Richmond agitation sedation scale, level of consciousness, administered sedatives, use of a ventilator, insertion of a feeding tube, and the duration of fasting period. @*Conclusion@#: Based on the results of this study, healthcare providers, especially ICU nurses, should try to detect early signs and symptoms of pressure ulcers, taking into account the derived factors associated with pressure ulcers in ICU patients. Practical intervention programs and strategies considering the factors associated with pressure ulcers must be developed to prevent and alleviate such ulcers in ICU patients in the future.

Comparison of the Effects of Education Only and Exercise Training Combined with Education on Fall Prevention in Adults Aged 70 Years or Older Residing in Elderly Residential Facilities

Purpose@#To compare the effects of education only and exercise training combined with education on fall knowledge, fall efficacy, physical activity, and physical function in adults aged 70 years or older residing in elderly residential facilities. Method: A three-group pre- and posttest design was utilized: education only (EO; n = 23), education and TheraBand (ET; n = 22), and education and walking (EW; n = 22).Fall education was provided for all three groups. In addition, TheraBand exercise training was provided for the ET and a walking exercise for the EW. Data were collected from November 1st, 2017 to February 15th, 2019 and analyzed with χ2 test, paired t-test, and one-way ANOVA using IBM SPSS/WIN ver. 22.0. @*Results@#Compared with the EO, the ET and the EW were more effective in terms of fall efficacy, physical activity, and lower extremity muscle strength. The EW showed higher improvement in walking abilities than the EO and the ET. @*Conclusion@#Exercise training combined with education is more effective in preventing falls among community-dwelling adults aged 70 years or older. When considering fall prevention programs for older adults, both TheraBand and walking exercise training combined with education can be chosen based on the participant’s physical status. Aggressive strategies to improve daily walking are required to maintain walking abilities among community-dwelling adults aged 70 years or older.

Comparison of the Effects of Education Only and Exercise Training Combined with Education on Fall Prevention in Adults Aged 70 Years or Older Residing in Elderly Residential Facilities

Purpose@#To compare the effects of education only and exercise training combined with education on fall knowledge, fall efficacy, physical activity, and physical function in adults aged 70 years or older residing in elderly residential facilities. Method: A three-group pre- and posttest design was utilized: education only (EO; n = 23), education and TheraBand (ET; n = 22), and education and walking (EW; n = 22).Fall education was provided for all three groups. In addition, TheraBand exercise training was provided for the ET and a walking exercise for the EW. Data were collected from November 1st, 2017 to February 15th, 2019 and analyzed with χ2 test, paired t-test, and one-way ANOVA using IBM SPSS/WIN ver. 22.0. @*Results@#Compared with the EO, the ET and the EW were more effective in terms of fall efficacy, physical activity, and lower extremity muscle strength. The EW showed higher improvement in walking abilities than the EO and the ET. @*Conclusion@#Exercise training combined with education is more effective in preventing falls among community-dwelling adults aged 70 years or older. When considering fall prevention programs for older adults, both TheraBand and walking exercise training combined with education can be chosen based on the participant’s physical status. Aggressive strategies to improve daily walking are required to maintain walking abilities among community-dwelling adults aged 70 years or older.

Effects of First Assisted Reproductive Technologies on Anxiety and Depression among InfertileWomen: A Systematic Review and Meta-Analysis

Purpose@#The purpose of this study was to analyze anxiety and depression among infertile women at different time points during the firstIn Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI) treatment through a systematic review and meta-analysis. @*Methods@#Seven out of 3,011 studies were included for meta-analysis. To estimate the effect size, a meta-analysis of the studies was performedusing the RevMan 5.3 program. We compared the measurement outcomes at three time points: before the start of treatment (T0), cancellationof treatment after pregnancy detection (T2), one to six months after treatment (T3). The effect size used was the standardizedmean difference (SMD). @*Results@#In comparing the different time points of the pregnant women from their cycle, significantly lower levelsof depression were found at T2 than at T0. In non-pregnant women, anxiety at T2 and depression at T2 and T3 were significantly higherthan those at T0. At T2 and T3, the non-pregnant women reported higher levels of anxiety and depression compared with the pregnantwomen. @*Conclusion@#Anxiety and depression in infertile women undergoing the first IVF or ICSI are associated with the time points andpregnancy status after treatment. These findings suggest that attention should be paid to helping infertile women prepare for and copewith treatment and treatment failure.

Association between Preoperative Transthoracic Echocardiography and Clinical Outcomes after Scheduled Hip Fracture Surgery in Geriatric Patients

Objective@#Hip fracture is a major problem for elderly patients and is expected to become more common as society ages. Transthoracic echocardiography (TTE) is still widely performed for cardiac risk assessment, while routine echocardiography is not recommended in patients undergoing non-cardiac surgery. Thus, we evaluated the relationship between TTE-related variables and postoperative outcomes in elderly patients with hip fracture. @*Methods@#This study consisted of a single-center, retrospective medical record review including a total of 356 patients. The study population included patients 65 years of age and older who underwent TTE for preoperative assessment within 1 month before the scheduled hip fracture surgery between January 2013 and October 2016. @*Results@#In total, 356 patients were included. Seven patients died within 30 days after surgery. Advanced age (odds ratio [OR], 1.14; 95% confidence interval [CI], 1–1.3; P @*Conclusion@#In elderly patients undergoing hip fracture surgery, preoperative TTE is not a useful predictive factor for postoperative mortality.

A Case of Expiratory Limb Filter Obstruction in Heated Circuit Kit

Antimicrobial filters that prevent cross-contamination through anesthesia equipment are commonly used in operating rooms. Occlusion of this filter leads to the patient’s airway obstruction, which may lead to fatal outcomes. We report a case of the airway obstruction by antimicrobial filter occlusion during general anesthesia, and symptoms recovered immediately after removal of the filter.

Sustained erroneous near-infrared cerebral oxygen saturation in alert icteric patient with vanishing bile duct syndrome during and after liver transplantation: A case report

Monitoring cerebral oxygenation using a near infrared spectroscopy (NIRS) device is useful for estimating cerebral hypoperfusion and is available during liver transplantation (LT). However, high serum bilirubin concentration can interfere with NIRS because bilirubin absorbs near infrared light. We report a patient who underwent LT with a diagnosis of vanishing bile duct syndrome, whose regional cerebral oxygen saturation (rSO₂) remained below 15% even with alert mental status and SpO2₂ value of 99%. The rSO₂ values were almost fixed at the lowest measurable level throughout the intra- and postoperative period. We report a case of erroneously low rSO₂ values during the perioperative period in a liver transplant recipient which might be attributable to skin pigmentation rather than higher serum bilirubin concentration.

Unanticipated Difficult Intubation in Patient with Undiagnosed Posterior Glottic Stenosis

Posterior glottic stenosis (PGS) is frequently caused by prolonged intubation complications, which may limit the movement of the vocal cords and obstruct airway obstruction. Despite of a life-threatening condition, it might be overlooked in asymptomatic individual. A 63-year-old female was scheduled for arthroscopic rotator cuff repair. The patient had experienced 2 times of intubation and organophosphate poisoning for suicide. Both of 7.0- and 6.5-mm inner diameter endotracheal tubes could not be passed vocal cords. After two failed attempts at intubation, adhesion of posterior part of vocal cord was revealed. We stopped the tracheal intubation and called the otolaryngologist, and adhesiolysis was performed under direct laryngosope. Thereafter, endotracheal intubation was performed successfully with 6.5-mm endotracheal tube.

How Does Advance Provision of Emergency Contraceptives Affect Contraceptive Use and Sexual Activity Among Adolescents? Systematic Review and Meta-Analysis

PURPOSE: The purpose of this study was to analyze the effect of emergency contraceptive pill on adolescent sexuality and contraceptive behaviors through a meta - analysis of intervention studies on advance provision of emergency contraceptives. This study aimed to provide objective data on the transition of general medicines to be discussed in relation to the reclassification of emergency contraceptive pills. METHODS: Using electronic database, 1,820 studies written in Korean or English without limitation of the year were reviewed and for analysis, 5 studies were selected, in which emergency contraceptives were provided to adolescents. RESULTS: The advance provision of emergency contraceptives has increased their use and shortened the time it takes to take contraceptive pills after unprotected sex. There was no change in the frequency of engaging in sexual intercourse and unprotected sex or in existing contraceptive behavior, pregnancy rates decreased, but there was no increase in sexually transmitted infection. CONCLUSION: The results of this study provide objective grounds for the reclassification of emergency contraceptive pills and propose effective interventional programs on contraceptive education, such as on efficacy and side effects of the contraceptive drug and its proper use among the youth who engage in sexual activity, to improve their reproductive health.

Diagnosis and Treatment of Abdominal Cutaneous Nerve Entrapment Syndrome Using Ultrasonography

Abdominal cutaneous nerve entrapment syndrome is one of the abdominal wall-origin pain that develops in anterior cutaneous branches of 7th to 12th thoracic nerves passing through fibrous ring in rectus abdominis. Number of this condition has been misdiagnosed to visceral dysfunctions; therefore, delayed diagnosis leads to waste of cost and time. Injection of local anesthetics is a kind of useful technique for the purpose of the confirmed diagnosis with treatment in abdominal wall pain. Recently, the accuracy and safety of local anesthetics injection to muscle or nerve are significantly improved than the past times since ultrasound has been accepted as a substantial device in clinical area. Here, we report a case of abdominal cutaneous nerve syndrome, treated by ultrasound-guided nerve block accompanied with medical treatment.