Dexmedetomidine and LPS co-treatment attenuates inflammatory response on WISH cells via inhibition of p38/NF-kB signaling pathway

Background@#Inflammatory dental diseases that occur during pregnancy can cause preterm labor and/or intrauterine growth restriction. Therefore, proactive treatment of dental diseases is necessary during pregnancy. Dexmedetomidine (DEX) is a widely used sedative in the dental field, but research on the effect of DEX on pregnancy is currently insufficient. In this study, we investigated the effects of co-treatment with DEX and lipopolysaccharide (LPS) on inflammatory responses in human amnion-derived WISH cells. @*Methods@#Human amnion-derived WISH cells were treated with 0.001, 0.01, 0.1, and 1 μg/mL DEX with 1 μg/mL LPS for 24 h. Cytotoxicity of WISH cells was evaluated by 3-(4,5-)-2,5-diphenyltetrazolium bromide (MTT) assay. The protein expression of cyclooxygenase-2 (COX-2), prostaglandin E 2 (PGE 2 ), p38, and nuclear factor kappa B (NF-κB) was examined by western blot analysis. The mRNA expression of pro-inflammatory cytokines such as interleukin (IL)-1β and tumor necrosis factor (TNF)-α was analyzed by real-time quantitative polymerase chain reaction. @*Results@#Co-treatment with DEX and LPS showed no cytotoxicity in the WISH cells. The mRNA expression of IL-1β and TNF-α decreased after co-treatment with DEX and LPS. DEX and LPS co-treatment decreased the protein expression of COX-2, PGE 2 , phospho-p38, and phospho-NF-κB in WISH cells. @*Conclusion@#Co-treatment with DEX and LPS suppressed the expression of COX-2 and PGE 2 , as well as pro-inflammatory cytokines such as IL-1β and TNF-α in WISH cells. In addition, the anti-inflammatory effect of DEX and LPS co-treatment was mediated by the inhibition of p38/NF-κB activation.

Optimal effect-site concentration of remifentanil to prevent hemodynamic changes during nasotracheal intubation using a video laryngoscope

Background@#Nasotracheal intubation is the most commonly used method to secure the field of view when performing surgery on the oral cavity or neck. Like orotracheal intubation, nasotracheal intubation uses a laryngoscope. Hemodynamic change occurs due to the stimulation of the sympathetic nervous system. Recently, video laryngoscope with a camera attached to the end of the direct laryngoscope blade has been used to minimize this change. In this study, we investigated the optimal effect-site concentration (Ce) of remifentanil for minimizing hemodynamic responses during nasotracheal intubation with a video laryngoscope. @*Methods@#Twenty-one patients, aged between 19 and 60 years old, scheduled for elective surgery were included in this study. Anesthesia was induced by slowly injecting propofol. At the same time, remifentanil infusion was initiated at 3.0 ng/ml via target-controlled infusion (TCI). When remifentanil attained the preset Ce, nasotracheal intubation was performed using a video laryngoscope. The patient's blood pressure and heart rate were checked pre-induction, right before and after intubation, and 1 min after intubation. Hemodynamic stability was defined as an increase in systolic blood pressure and heart rate by 20% before and after nasotracheal intubation. The response of each patient determined the Ce of remifentanil for the next patient at an interval of 0.3 ng/ml. @*Results@#The Ce of remifentanil administered ranged from 2.4 to 3.6 ng/ml for the patients evaluated. The estimated optimal effective effect-site concentrations of remifentanil were 3.22 and 4.25 ng/ml, that were associated with a 50% and 95% probability of maintaining hemodynamic stability, respectively. @*Conclusion@#Nasotracheal intubation using a video laryngoscope can be successfully performed in a hemodynamically stable state by using the optimal remifentanil effect-site concentration (Ce50 , 3.22 ng/ml; Ce95 , 4.25 ng/ml).

Anti-inflammatory effect of remifentanil in lipopolysaccharide–stimulated amniotic epithelial cells

BACKGROUND: Sometimes general anesthesia is required for dental surgery in pregnant women. Facial bone fractures or neck abscess should be treated immediately. Dental surgery, however, creates a stressful situation that can cause inflammation. Inflammatory responses are a well-known major cause of preterm labor and preterm birth. Here we demonstrate the effects of remifentanil on the factors related to preterm labor and its mechanism of action on amniotic-derived epithelial cells (WISH cells). METHODS: WISH cells were exposed to lipopolysaccharide (LPS) for 24 h and co-treated with various concentrations of remifentanil. MTT assays were performed to measure cell viability. To explain the effects of remifentanil on the factors related to inflammation in WISH cells, activation of nuclear factor kappa B (NF-κB) and p38 and the expression of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, cyclooxygenase (COX)2, and prostaglandin E (PGE)2 were quantified using western blotting and RT-PCR, respectively. RESULTS: Remifentanil did not affect WISH cell viability. In western blot analysis, co-treatment with remifentanil resulted in decreased phosphorylation of NF-κB, and expression of COX2 and PGE2 in LPS-induced inflammation, but the results were statistically significant only at low concentrations. Reduction of IL-1β and TNF-α expression was also observed with RT-PCR. CONCLUSION: Co-treatment with remifentanil does not affect the viability of WISH cells, but reduces the expression of the factors related to inflammation, which can induce uterine contraction and preterm labor. These findings provide evidence that remifentanil may inhibit uterine contraction and preterm labor in clinical settings.

Propofol Suppresses LPS-Induced Inflammation in Amnion Cells via Inhibition of NF-κB Activation

BACKGROUND: Preterm labor is a leading risk factor for neonatal death and long-term impairment and linked closely with inflammation. Non-obstetric surgery is occasionally needed during pregnancy and the anesthetic drugs or surgery itself can give rise to inflammation. Here, we examined the influence of propofol pretreatment on the expression of cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) after lipopolysaccharide (LPS) stimulation. In addition, we evaluated the expression of pro-inflammatory cytokines and nuclear factor kappa B (NF-κB). METHODS: Human amnion-derived WISH cells were used to investigate the effect of propofol on the LPS-induced expression of inflammatory substances involved in preterm labor. For the experiment, WISH cells were pretreated with various concentrations propofol (0.01–10 µg/ml) for 1 h and then treated with LPS (1 µg/ml) for 24 h. Cytotoxicity was evaluated using MTT assay. PGE2 concentration was assessed by ELISA. Protein expressions of COX-2, PGE2 and NF-κB were analyzed by western blotting analysis. RT-PCR was used for analysis of mRNA expression of COX-2, PGE2, interlukin (IL)-1β and tumor necrosis factor (TNF)-α. RESULTS: Propofol showed no cytotoxicity on the WISH cells. LPS-induced PGE2 production and COX-2 and PGE2 expression were decreased after propofol pretreatment. Propofol also attenuated the LPS-induced mRNA expression of IL-1β and TNF-α. Moreover, the activation of NF-jB was inhibited by propofol pretreatment on LPS-stimulated WISH cells. CONCLUSION: We demonstrated that propofol suppresses the expression of inflammatory substances enhanced by LPS stimulation. Furthermore, this inhibitory effect of propofol on the inflammatory substance expression is mediated by suppression of NF-κB activation.

The Influence of Health Status and Type of Health Management on Depression in Middle-Aged Women / 한국간호교육학회지

PURPOSE: This study aimed to investigate the influence of health status and types of health management on depression in middle-aged women. METHODS: A convenience sample of 188 participants was recruited from health centers in S city. Using a structured questionnaire, data was collected and analyzed by t-test, ANOVA, Pearson's correlation, and linear regression using SPSS/WIN 23 program. RESULTS: Results of the regression analysis showed that perceived current health status (β=−0.55, p < .001), no caregiver (β=0.47, p < .001), chronic diseases lasting more than three months (β=0.36, p < .001), perceived health status compared to peer group (β=0.32, p < .001), walking for health (β=−0.20, p=.002), caregiver except family (β=0.18, p=.001), and gastrointestinal disease (β=0.10, p=.022) influenced depression in middle-aged women. Overall, approximately 69.7% of total variance explained this model (adjusted R2=0.678, F=57.21, p < .001). CONCLUSION: This study suggests that it is more important to understand the level of perceived health status in middle-aged women. Furthermore, it is necessary to develop programs that include various health management methods and strengthen the health care with the help of families and neighbors in order to manage depression in middle-aged women.

Analysis of Workplace Health Education Performed by Occupational Health Managers in Korea

PURPOSE: To evaluate workplace health education as practiced by occupational health managers based on standardized job tasks and suggest priority tasks and areas to be trained. METHODS: The study was conducted between November 10, 2013 and April 30, 2014. The tool used in this study was standardized job tasks of workplace health education for occupational health managers which was developed through methodological steps. It was evaluated by 233 worksite occupational health managers. Data were analyzed using SPSS 21.0. RESULTS: Predicting variables of workplace health education performance were the "analysis and planning" factor, type of enterprise, and form of management. Healthcare professionals and occupational health managers who managed the nonmanufacturing industry showed high importance and low performance level in "analysis and planning" factor. CONCLUSIONS: "Analysis and planning" skill is priority training area for healthcare professionals and occupational health managers who managed nonmanufacturing industry. It is necessary to develop a training curriculum for occupational health managers that include improving analysis of worksites and plans for a health education program.

Effects of Health Status and Health Management on Activities of Daily Living among Urban-Dwelling Older Koreans / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify the effects of health status and health management on activities of daily living (ADL) in older, urban-dwelling Koreans. METHODS: A total of 206 subjects were recruited from one senior welfare center, six senior citizen centers, and subjects' home in two cities. Data was collected with self-reported questionnaires in order to measure health management, health status, and ADL. Data was analyzed by t-test, ANOVA, and stepwise multiple linear regression using SPSS/WIN 22.0. RESULTS: ADL in this subject were different depending on their age, education, marital status, type of family, and average monthly living expenses. Multivariate analysis showed that age (beta=-0.35, p<.001), exercise ability (beta=0.20, p<.001), diabetes (beta =-0.17, p<.001), osteoarthritis (beta=-0.15, p<.001), caregiver (beta=0.14, p=.005), frequency of health management (beta =-0.13, p=.006), smoking (beta=-0.11, p=.019), hypertension (beta=-0.10, p=.027), and type of family (beta=-0.10, p=.036) were significantly associated with ADL. Overall, approximately 60.2% of total variability in ADL could be explained by the 11 variables in this model (R2=0.602, F=32.06, p<.001). CONCLUSION: This study suggests that individualized health care should be continued for older, community-dwelling Koreans in order to improve their ADL. Moreover, we need to develop self-care programs and encourage them to participate in those programs.

Occupational Stress and Emotional Intelligence in Hospice Volunteers / 한국호스피스완화의료학회지

PURPOSE: The purpose of this study was to explore the level of occupational stress and emotional intelligence in hospice volunteers. METHODS: Participants were 158 hospice volunteers at hospitals in B city. Occupational stress, emotional intelligence, and general characteristics of hospice volunteers were measured. The data were analyzed with descriptive statistics, t-tests, ANOVA, and Pearson's correlation coefficients. RESULTS: The mean score for occupational stress was 2.16 points out of 4 and 4.65 out of 7 for emotional intelligence. The scores for occupational stress and emotional intelligence were significantly different by educational level and monthly income in hospice volunteers. Occupational stress was negatively correlated with emotional intelligence (r=-0.196, P=0.013). CONCLUSION: A continuous educational program is needed to offer volunteers with new hospice-related trends. To ensure quality care for patients and their families, it should be helpful to encourage hospice volunteers to build a social network to enhance their emotional intelligence.

Perceived Confidence in Practice of Core Basic Nursing Skills of New Graduate Nurses / 한국간호교육학회지

PURPOSE: This study was to measure and identify the differences of perceived confidence in practice of core basic nursing skills performed by new graduate nurses in Korea. METHODS: The tool used in this study was a questionnaire for measuring the confidence in 20 items of core basic nursing skills which was structured based on Korean Accreditation Board of Nursing Education tool. 231 new graduate nurses participated in this study. The reliability of this questionnaire had Cronbach's alpha .918. RESULTS: Subjects who experienced simulation education and standard patient education were 86.6% and 35.9%, respectively. Item enema intervention, tracheostomy care, and blood transfusion showed low practice confidence level. These items showed significant differences on whether the subjects experienced simulation and clinical practicum or not. CONCLUSION: Developing and managing clinical education program under deep cooperation between practicum agency and clinical instructor are needed. Simulation practicum will complement insufficient core basic nursing skills between newly graduated nurses before they allocate at the clinical department.

Development of an Educational Program for Parents of Children with Epilepsy / 기본간호학회지

PURPOSE: The purpose of this study was to develop an educational program for parents of children with epilepsy. METHOD: The first step was to survey the need for information and social support for these parents. The second step was to design the educational program based on the survey results, literature review, and the theory of chronic sorrow that provided a framework for understanding and working with people suffering a loss of health. RESULT: The information which these parents were most anxiously seeking was information on the causes of seizures, appropriate steps deal with seizures, and appropriate and supportive parental role for their children. The educational program for parents of children with epilepsy included understanding the responses to loss, increasing the parents' knowledge about how to care for their children, managing their stress, enhancing the psychosocial adaptation of children, and encouraging the participation of the family. CONCLUSION: The educational program developed by the researcher can used with parents of children with epilepsy, and is expected to enhance the psychosocial adaptation of these children.