Comparative Safety Profiles of Sedatives Commonly Used in Clinical Practice: A 10-Year Nationwide Pharmacovigilance Study in Korea.

This study aims to compare the prevalence and seriousness of adverse events (AEs) among sedatives used in critically ill patients or patients undergoing invasive procedures and to identify factors associated with serious AEs. Retrospective cross-sectional analysis of sedative-related AEs voluntarily reported to the Korea Adverse Event Reporting System from 2008 to 2017 was performed. All AEs were grouped using preferred terms and System Organ Classes per the World Health Organization-Adverse Reaction Terminology. Logistic regression was performed to identify factors associated with serious events. Among 95,188 AEs, including 3132 (3.3%) serious events, the most common etiologic sedative was fentanyl (58.8%), followed by pethidine (25.9%). Gastrointestinal disorders (54.2%) were the most frequent AEs. The most common serious AE was heart rate/rhythm disorders (33.1%). Serious AEs were significantly associated with male sex; pediatrics; etiologic sedative with etomidate at the highest risk, followed by dexmedetomidine, ketamine, and propofol; polypharmacy; combined sedative use; and concurrent use of corticosteroids, aspirin, neuromuscular blockers, and antihistamines (reporting odds ratio > 1, p < 0.001 for all). Sedative-induced AEs are most frequently reported with fentanyl, primarily manifesting as gastrointestinal disorders. Etomidate is associated with the highest risk of serious AEs, with the most common serious events being heart rate/rhythm disorders.

A Nationwide Survey on the Facilities and Personnel for Endoscopic Sedation: Results from 50 Qualified Endoscopy Units of Teaching Hospitals Accredited by the Korean Society of Gastrointestinal Endoscopy (KSGE).

BACKGROUND/AIMS: This study aimed to determine the current status of facilities, equipment, and personnel for endoscopic sedation from endoscopy units of representative hospitals in South Korea. METHODS: A questionnaire survey was conducted on 50 qualified endoscopy units accredited by the Korean Society of Gastrointestinal Endoscopy. RESULTS: All included endoscopy units had regulations and educational programs regarding sedation training for endoscopists and nursing personnel. There present one assisting nurse during endoscopy in 35 units (70%) and at least two nurses in 12 units (24.0%). All endoscopy units had examination rooms equipped with oxygen supply and suction systems. Endoscopist-directed sedation was performed in 48 units (96.0%). Propofol-based sedation was the most used sedation method. All units had a separate recovery bay. The daily number of patients per bed was greater than 10 in 17 units (34.0%). In 26 (52.0%) units, a single nurse cared for ≥10 patients per day. All the units fulfilled the discharge criteria. CONCLUSION: This study presents data regarding endoscopic sedation clinical practice in 50 endoscopy units in South Korea. This study presents the current status of endoscopic sedation clinical practice in 50 qualified endoscopy units accredited by the KSGE, which provide excellent quality management.

Simple transscleral fixation of IOL technique without tying up haptics.

AIM: To introduce a novel technique for transscleral fixation of the posterior chamber intraocular lens (PC-IOL) that requires no sutures on the IOL haptics. METHODS: Instead of suturing polypropylene onto the IOL haptics, the method simply winds the thread on the haptics. Fifteen eyes of 15 patients underwent this technique and were followed up for more than 18mo. Surgical outcomes and post-operative complications were evaluated and compared with those of the conventional transscleral fixation method. RESULTS: Postoperative cylinder was significantly lower in the thread winding group than in the conventional transscleral fixation method group (-1.02±0.46 diopters vs -1.57±0.77 diopters; P=0.01). Further, no postoperative complications, such as optic capture, IOL dislocation, and hyphema, were detected in the thread winding group. CONCLUSION: We believe that our thread winding technique is better than previously reported methods because it is simple, mechanically stable, and free from suture-related complications.

Preparation and Characterization of Nanostructured Manganese Oxide for Supercapacitors.

Nanostructured manganese oxides were synthesized by a sol-gel method using manganese acetate (MnAc2) and citric acid (C6H8O7,) as precursors, and characterized by Brunauer-Emmett-Teller (BET) analysis, Barrett-Joyner-Halenda (BJH), X-ray diffraction (XRD), scanning electron microscopy (SEM), and transmission electron microscopy (TEM) techniques. The nano-rod structure of MnO2 developed gradually when the calcination temperature varied from 380 to 580 degrees C. As the pH increased, the pore size increased, while the specific surface area decreased. The effects of the pH and calcination temperature on the electrochemical properties of the nano-MnO2 electrode, including the supercapacitive behavior, were investigated by cyclic voltammetry (CV) tests. The tests were performed between 0 and 0.8 V versus Ag/AgCl in 1 M Na2SO4 electrolyte at various scan rates (10-200 mVs(-1)). The specific capacitance of the SP-380 sample, prepared at pH 6, was equal to 269.3 Fg(-1). After 300 cycles, approximately a 3.4% increase of the specific capacitance was measured, confirming the excellent cyclability.

Synthesis and Electrochemical Analyses of Manganese Oxides for Super-Capacitors.

δ-Phase and α-phase manganese oxides were prepared using a hydrothermal method and their electrochemical properties were characterized. The influence of calcination temperature on the properties of manganese oxides was studied. Crystallinities were studied by X-ray diffraction, and scanning and transmission electron microscopy were utilized to examine morphologies. Average pore sizes and specific surface areas of samples were analyzed using the Barret-Joyner-Halenda and Brunauer-Emmett-Teller methods, respectively. After calcination in the range 300 degrees C to 600 degrees C, changes in morphology and crystallinity were observed. The flower-like shape of as synthesized samples became nanorod-like and the δ-phase changed to the α-phase. These changes may have been due to the removal of water during calcination. Furthermore, a transition stage in which the two phases coexisted was observed. Synthesized manganese oxides were mixed with carbon by sonification, to increase electric conductivity and to induce a synergistic effect between pseudo-capacitor and electric double layer capacitor (EDLC). Specific capacitances and rate durability of each composite were investigated by cyclic voltammetry in 1 M Na2SO4 electrolyte at different scan rates. MnO2 calcined at 400 degrees C exhibited the highest capacitance, probably due to its high surface area and more porous structure.

Effects of umbilical cord serum eye drops in a mouse model of ocular chemical burn.

PURPOSE: To evaluate the effect of umbilical cord serum (UCS) eye drops on corneal wound healing and haze in a mouse model of ocular chemical burn and compare with that of peripheral blood serum (PBS) eye drops or artificial tears (AT). METHODS: Chemical burn of the ocular surface was induced by 1N NaOH in C57BL/6 mice. Injured mice were topically treated with 20% UCS, 20% PBS, or AT four times daily. The changes of corneal epithelial defects and degree of haze were analyzed at 6 h, 1, 2, 3, 5, and 7 days, and histological examination was performed at 3 and 7 days. The concentration of IL-1ß in the cornea was measured by enzyme-linked immunosorbent assay at 7 days after treatment. RESULTS: The UCS group showed lower epithelial defect parameters compared with the PBS group at 1 and 2 days (p < 0.05), and with the AT group from 1-5 days (p < 0.05). The haze scores were significantly lower in the UCS group than in the PBS group at 2 and 3 days (p < 0.05), and in the AT group from 2-7 days (p < 0.05). Histological examination showed better epithelial integrity and lower stromal inflammation and edema in the UCS group than the other groups. IL-1ß levels were 99.71 ± 85.22 and 230.76 ± 102.67 pg/ml in the UCS and PBS groups, respectively (p = 0.03). CONCLUSIONS: UCS eye drops are more effective in improving corneal wound healing and reducing corneal haze compared with PBS eye drops and AT in experimental chemical burns.

Design and synthesis of 4-O-methylhonokiol analogs as inhibitors of cyclooxygenase-2 (COX-2) and PGF1 production.

A series of novel 4-O-methylhonokiol analogs were synthesized in light of revealing structure-activity relationship for inhibitory effect of COX-2 enzyme. The key strategy of the molecular design was oriented towards modification of the potential metabolic soft spots (e.g., phenol and olefin) or by altering the polar surface area via incorporating heterocycles such as isoxazole and triazole. Most of all exhibited the inhibitory effects on COX-2 and PGF(1) production but not macrophage NO production. Especially, aryl carbamates 10 and 11 exhibited more potent inhibitory activity against COX-2 and PGF(1) production.

Ultrasonographic features of pyonephrosis in dogs.

Pyonephrosis refers an infected hydronephrotic kidney which arise from pyelonephritis followed by exudate accumulation in a dilated renal pelvis or hydronephrosis followed by ascending infection. Pyonephrosis may cause serious systemic complications, making prompt and reliable diagnosis critical. Clinical and ultrasonographic findings are used for the diagnosis of pyonephrosis in humans, but these findings have not been investigated in dogs. We reviewed ultrasonographic features in pyonephrosis in 18 dogs. Ten dogs with hydronephrosis were also evaluated to compare with the pyonephrosis patients. In most dogs with pyonephrosis, hyperechoic contents completely filled the dilated renal pelvis (n = 8) or a fluid-debris level was observed (n = 8). Hyperechoic contents were dispersed in renal pelvis in only two of the 18 dogs. Hyperechoic, edematous mesentery, and peritoneal and retroperitoneal effusion, which represented peritoneal and retroperitoneal inflammation, were observed in the perinephric region in 11 dogs. Compared with pyonephrosis, and as expected, hydronephrosis was characterized by anechoic contents within the urine-filled collecting system and there were no definitive findings to suspect peritonitis. Thus, there is a distinct difference in the sonographic appearance of pyonephrosis vs. hydronephrosis in dogs.

Structure-activity relationship of indoline-2-carboxylic acid N-(substituted)phenylamide derivatives.

Chroman derivatives exhibited potent inhibitory activity of NF-kappaB. For SAR, the chroman scaffold was modified with an indoline moiety. A series of indoline-2-carboxylic acid N-(substituted)phenylamide derivatives were synthesized to explore their inhibitory activities of NF-kappaB and they were also evaluated for cytotoxicity against various cancer cell lines. Since intermediates with Boc showed outstanding results, various substituents in place of the Boc group were introduced additionally and these compounds were also evaluated for SAR.