Redox-regulating molecule, recombinant human thioredoxin (rhTRX) which shows anti-inflammatory, and anti-oxidative effects against lipopolysaccharide (LPS)-stimulated inflammation and regulate protein expression levels. LPS-induced reactive oxygen intermediates (ROI) and NO production were inhibited by exogenous rhTRX. We identified up/downregulated intracellular proteins under the LPS-treated condition in exogenous rhTRX-treated A375 cells compared with non-LPS-treated cells via 2-DE proteomic analysis. Also, we quantitatively measured cytokines of in vivo mouse inflammation models using cytometry bead array. Exogenous rhTRX inhibited LPS-stimulated production of ROI and NO levels. TIP47 and ATP synthase may influence the inflammation-related lipid accumulation by affecting lipid metabolism. The modulation of skin redox environments during inflammation is most likely to prevent alterations in lipid metabolism through upregulation of TIP47 and ATP synthase and downregulation of inflammatory cytokines. Our results demonstrate that exogenous rhTRX has anti-inflammatory properties and intracellular regulatory activity in vivo and in vitro. Monitoring of LPS-stimulated pro-inflammatory conditions treated with rhTRX in A375 cells could be useful for diagnosis and follow-up of inflammation reduction related with candidate proteins. These results have a therapeutic role in skin inflammation therapy.
Animals ; Antioxidants/*pharmacology ; Cell Line, Tumor ; Humans ; Inflammation/metabolism ; *Lipid Metabolism ; Lipopolysaccharides/pharmacology ; Mice ; Mice, Inbred C57BL ; Nitric Oxide/metabolism ; Proteome/genetics/metabolism ; Skin/drug effects/metabolism/pathology ; Thioredoxins/*pharmacology

PURPOSE: This study was done to investigate nurses' knowledge of, and compliance with the multidrug-resistant organism (MDRO) infection control guidelines. METHODS: A survey questionnaire was developed based on the institutional and national guidelines and was administered to a convenience sample of 306 nurses in a university hospital. RESULTS: The mean score for knowledge was 33.87 (percentage of correct answers: 82.61%). The percentages of correct answers for basic concepts, route of transmission, hand washing/protective devices and environment management were 74.27%, 94.29%, 92.90% and 75.54% respectively. The mean compliance score was 4.15 (range: 1-5). The compliance scores for education, communication, contact precaution, disinfection, surveillance culture, and hand washing were 3.29, 4.05, 4.20, 4.50, 4.40 and 4.48 respectively. Nurses indicated "lack of time (30.06%)", "lack of means (10.78%)" and "lack of knowledge (9.48%)" as reasons for noncompliance. CONCLUSION: While most educational programs have focused on hand washing or use of protective devices to prevent transmission of MDRO in acute care settings, hospital nurses' knowledge of the basic concepts of MDRO and environmental management has remained insufficient. Nurses are relatively non-compliant to the guidelines in the areas of education (staff, patient, family) and communication. Comprehensive educational programs are needed to decrease hospital infection rates and to improve the health of patients.
Adult ; Attitude of Health Personnel ; *Drug Resistance, Multiple, Bacterial ; Female ; Guideline Adherence ; *Health Knowledge, Attitudes, Practice ; Hospitals, University ; Humans ; Infection Control/methods/*standards ; Nursing Staff, Hospital/education/*psychology ; Practice Guidelines as Topic ; Questionnaires

The 150 microl and 50 micol was reversed in the labeled line of the insert box in above article, on page 92, Fig. 4. The correct figure is printed below. We apologize for any confusion resulting from this error.

Corrections for Table. 1 in page 125 are needed. We apologize for any inconvenience that this may have caused.

PURPOSE: The clinical efficacy of allergen-immunotherapy is known to be dose dependent. However, optimal maintenance dosage has not yet been determined for sublingual immunotherapy (SLIT). Furthermore, since companies adopt their own units for expression of allergenicity, the allergen concentrations of individual reagents cannot be compared easily. We sought to measure and compare the allergenicities of 3 commercially available house dust mite (HDM) SLIT regents and a subcutaneous immunotherapy reagent. METHODS: We measured the HDM allergenic potency of the maintenance dosages of three SLIT reagents: Staloral(R) (300 index of reactivity [IR] /mL, recommended maintenance dosage [MD]: 120 IR), SLITone(R) (1,000 standard therapeutic unit [STU]/mL, recommended MD: 200 STU), Wolwopharma(R) (100 microg/mL, recommended MD: 20 microg), and subcutaneous immunotherapy regents of Hollister-Stier (10,000 allergy unit [AU] /mL). The allergenic potency was assessed by measuring the total protein concentrations, mite group 1 and 2 allergens using 2-site ELISA, and an inhibition test against IgE specific to Dermatophagoides farinae and Dermatophagoides pteronyssinus. RESULTS: The protein content of the Wolwopharma(R) reagent was 1.5-261.4 times higher than that of the other 2 SLIT reagents. The concentration of group 1 major allergens in Staloral(R) (132.03 microg/mL) was 33- to 44.5-fold higher than in SLITone(R) (4.00 microg/mL) and Wolwopharma(R) (2.97 microg/mL). The concentration of group 2 major allergen was also 8.9- to 10.5-fold higher in Staloral(R) (15.7 microg/mL) than in SLITone(R) (1.8 microg/mL) or Wolwopharma(R) (1.5 microg/mL). An ELISA inhibition study against HDM-specific IgE showed that the allergen potency of Staloral(R) reagent is 8.5-fold and 21-fold higher than that of SLITone(R) or Wolwopharma(R), respectively. The differences between the maintenance dosages are further exaggerated by the differences in the recommended volumes of SLIT reagents. CONCLUSIONS: The allergen potencies of commercially available HDM SLIT reagents are markedly different. Consensus regarding the optimal allergen concentration for SLIT reagents used to treat HDM respiratory allergies is needed.
Allergens ; Consensus ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Enzyme-Linked Immunosorbent Assay ; Hypersensitivity ; Immunoglobulin E ; Immunotherapy ; Indicators and Reagents* ; Mites ; Pyroglyphidae* ; Sublingual Immunotherapy*

A model that provides reproducible, submaximal yet sufficient spinal cord injury is needed to allow experiments leading to development of therapeutic techniques and prediction of clinical outcome to be conducted. This study describes an experimental model for spinal cord injury that uses three different volumes of balloon inflation and durations of compression to create a controlled gradation outcome in adult dogs. Twenty-seven mongrel dogs were used for this study. A 3-french embolectomy catheter was inserted into the epidural space through a left hemilaminectomy hole at the L4 vertebral arch. Balloons were then inflated with 50, 100, or 150 microliter of a contrast agent at the L1 level for 6, 12, or 24 h and spinal canal occlusion (SCO) measured using computed tomography. Olby score was used to evaluate the extent of spinal cord injury and a histopathologic examination was conducted 1 week after surgery. The SCO of the 50, 100, and 150 microliter inflations was 22-46%, 51-70%, and 75-89%, respectively (p < 0.05). Olby scores were diminished significantly by a combination of the level of SCO and duration of inflation in all groups. Olby scores in the groups of 150 microliter-12 h, 150 microliter-24 h, and 100 microliter-24 h were 0.5, 0, and 1.7, respectively. Based on these results, a SCO > 50% for 24 h, and > 75% for 12 h induces paraplegia up to a week after spinal cord injury.
Animals ; Balloon Dilatation/*methods ; *Disease Models, Animal ; *Dogs ; Epidural Space/injuries ; Spinal Cord Compression/*etiology/pathology ; Tomography, X-Ray Computed

BACKGROUND: Continuous epidural block after surgery has been able to get better postoperative analgesic effect than intermittent intravenous (IV) opioids and to decrease the duration of mechanical ventilatory support, endotracheal intubation and ICU stay. The purpose of this study is to observe these effects of continuous epidural block after cardiac surgery. METHODS: 30 patients, undergoing cardiac surgery, were divided into 2 groups. Postoperative analgesia were performed by intermittent IV meperidine 25 mg in group 1 and by continuous epidural block with 1% mepivacaine 100 ml and morphine 4 mg in group 2. Both groups were supplemented, at the patient's request, by IV meperidine 25 mg as needed. Quality of pain relief, total number of IV meperidine and duration of consciousness return, mechanical ventilatory support, endotracheal intubation, ICU stay were compared between 2 groups. RESULTS: Quality of pain relief and total number of IV meperidine were significantly lower in group 2 than group 1, each time interval. Duration of consciousness return, mechanical ventilatory support, endotracheal intubation, ICU stay and time interval between consciousness return & mechanical ventilatory support were significantly shorter in group 2 than group 1. CONCLUSIONS: Continuous epidural block, with 1% mepivacaine 100 ml and morphine 4 mg, for postoperative analgesia decreases the duration of intensive care compaered with intermittent IV meperidine 25 mg, after cardiac surgery.
Analgesia ; Analgesics, Opioid ; Consciousness ; Humans ; Critical Care* ; Intubation, Intratracheal ; Meperidine ; Mepivacaine ; Morphine ; Thoracic Surgery*

Background: Use of opioids for chronic intractable pain is increasing globally, and their proper use can improve patients’ quality of life. In contrast, opioid use disorders, such as abuse or addiction, caused by prescribing opioids, are a worldwide issue. This study aimed to understand current opioid prescribing patterns and pain physicians’ experiences with opioid use in South Korea. Methods: Pain physicians in 42 university hospitals in South Korea were asked to complete anonymous questionnaires regarding opioid prescriptions. Results: A total of 69 surveys were completed. Most pain physicians started prescribing opioids at a pain score of 7/10 and aimed to reduce pain by 50%. Most physicians (73.1%) actively explained the prescribed medications and possible side effects, and 61.2% of physicians preferred the prescription interval of 4 weeks.Immediate-release opioids were the most popular treatment for breakthrough pain (92.6%). The most common side effect encountered by physicians was constipation (43.3%), followed by nausea/vomiting (34.3%). Of the physicians, 56.5% replied that addiction and misuse prevalences were less than 5%. However, the most concerning side effect was addiction (33.0%). Conclusions The survey results showed that the prescribing patterns of pain physicians generally followed Korean guidelines. Physicians were most interested in the safety and effectiveness of opioid prescriptions. They were most concerned about respiratory depression and abuse or addiction. A significant number of physicians agreed that the NHIS regulations needed improvement for patient convenience and safe and effective treatment, though there were pros and cons of the NHIS restrictions on prescription conditions.

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused significant changes. This study aimed to investigate the impact of COVID-19 on patients with chronic pain. Methods: Patients with chronic pain from 23 university hospitals in South Korea participated in this study. The anonymous survey questionnaire consisted of 25 questions regarding the following: demographic data, diagnosis, hospital visit frequency, exercise duration, time outside, sleep duration, weight change, nervousness and anxiety, depression, interest or pleasure, fatigue, daily life difficulties, and self-harm thoughts. Depression severity was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was used to investigate the relationship between increased pain and patient factors. Results: A total of 914 patients completed the survey, 35.9% of whom had decreased their number of visits to the hospital, mostly due to COVID-19. The pain level of 200 patients has worsened since the COVID-19 outbreak, which was more prominent in complex regional pain syndrome (CRPS). Noticeable post-COVID-19 changes such as exercise duration, time spent outside, sleep patterns, mood, and weight affected patients with chronic pain. Depression severity was more significant in patients with CRPS. The total PHQ-9 average score of patients with CRPS was 15.5, corresponding to major depressive orders. The patients’ decreased exercise duration, decreased sleep duration, and increased depression were significantly associated with increased pain. Conclusions COVID-19 has caused several changes in patients with chronic pain.During the pandemic, decreased exercise and sleep duration and increased depression were associated with patients’ increasing pain.

Ganglioneuromas is a rare benign neoplasm that originates from the sympathetic ganglia and the adrenal medulla. It belongs to the group of neurogenic tumors, which also include ganglioneuroblastoma and neuroblastoma. Most of them are asymptomatic and diagnosed by chance, rarely because of their hormonal activity or metaiodobenzylguanidine (MIBG) uptake. We here report a case of adrenal ganglioneuroma secreting catecholamine. A 22-year old male presented with incidentally detected calcifications in the left upper quadrant of the abdomen. Abdominal CT and MRI revealed an about 8-cm adrenal mass with eggshell and punctuate calcifications. Increased urinary catecholamine metabolites and MIBG uptake in the tumor leaded to the preoperative diagnosis of adrenal pheochromocytoma. His blood pressure was normal and the typical symptoms of catecholamine excess were not observed during the admission period. Surgical resection and histologic examination of the tumor confirmed the diagnosis of ganglioneuroma originating from the left adrenal gland. Characteristic radiologic and histologic findings are presented with review of the literature.
3-Iodobenzylguanidine ; Abdomen ; Adrenal Glands ; Adrenal Medulla ; Blood Pressure ; Calcinosis ; Catecholamines* ; Diagnosis ; Ganglia, Sympathetic ; Ganglioneuroblastoma ; Ganglioneuroma* ; Humans ; Magnetic Resonance Imaging ; Male ; Neuroblastoma ; Pheochromocytoma ; Tomography, X-Ray Computed ; Young Adult