The mammalian target of rapamycin (mTOR) plays a role in various cellular phenomena, including autophagy, cell proliferation, and differentiation. Although recent studies have reported its involvement in nociceptive responses in several pain models, whether mTOR is involved in orofacial pain processing is currently unexplored. This study determined whether rapamycin, an mTOR inhibitor, reduces nociceptive responses and the number of Fos-immunoreactive (Fos-ir) cells in the trigeminal nucleus caudalis (TNC) in a mouse orofacial formalin model. We also examined whether the glial cell expression and phosphorylated p38 (p-p38) mitogen-activated protein kinases (MAPKs) in the TNC are affected by rapamycin. Mice were intraperitoneally given rapamycin (0.1, 0.3, or 1.0 mg/kg); then, 30 min after, 5% formalin (10 l) was subcutaneously injected into the right upper lip. The rubbing responses with the ipsilateral forepaw or hindpaw were counted for 45 min. High-dose rapamycin (1.0 mg/kg) produced significant antinociceptive effects in both the first and second phases of formalin test. The number of Fos-ir cells in the ipsilateral TNC was also reduced by high-dose rapamycin compared with vehicle-treated animals. Furthermore, the number of p-p38-ir cells the in ipsilateral TNC was significantly decreased in animals treated with high-dose rapamycin; p-p38 expression was co-localized in microglia, but not neurons and astrocytes. Therefore, the mTOR inhibitor, rapamycin, reduces orofacial nociception and Fos expression in the TNC, and its antinociceptive action on orofacial pain may be associated with the inhibition of p-p38 MAPK in the microglia.

The mammalian target of rapamycin (mTOR) plays a role in various cellular phenomena, including autophagy, cell proliferation, and differentiation. Although recent studies have reported its involvement in nociceptive responses in several pain models, whether mTOR is involved in orofacial pain processing is currently unexplored. This study determined whether rapamycin, an mTOR inhibitor, reduces nociceptive responses and the number of Fos-immunoreactive (Fos-ir) cells in the trigeminal nucleus caudalis (TNC) in a mouse orofacial formalin model. We also examined whether the glial cell expression and phosphorylated p38 (p-p38) mitogen-activated protein kinases (MAPKs) in the TNC are affected by rapamycin. Mice were intraperitoneally given rapamycin (0.1, 0.3, or 1.0 mg/kg); then, 30 min after, 5% formalin (10 l) was subcutaneously injected into the right upper lip. The rubbing responses with the ipsilateral forepaw or hindpaw were counted for 45 min. High-dose rapamycin (1.0 mg/kg) produced significant antinociceptive effects in both the first and second phases of formalin test. The number of Fos-ir cells in the ipsilateral TNC was also reduced by high-dose rapamycin compared with vehicle-treated animals. Furthermore, the number of p-p38-ir cells the in ipsilateral TNC was significantly decreased in animals treated with high-dose rapamycin; p-p38 expression was co-localized in microglia, but not neurons and astrocytes. Therefore, the mTOR inhibitor, rapamycin, reduces orofacial nociception and Fos expression in the TNC, and its antinociceptive action on orofacial pain may be associated with the inhibition of p-p38 MAPK in the microglia.

Purpose: This study aimed to identify the risk factors for peripheral intravenous catheter-related phlebitis in hospitalized neurosurgery patients. Methods: This study involved 443 neurosurgery patients who were admitted to a general hospital in Seoul. The analysis included 982 intravenous lines. Data were retrospectively extracted from electronic medical records for the period between November 1, 2022, and May 31, 2023. Data were analyzed using descriptive statistics, independent t-test, x 2 test, and logistic regression. Results: The incidence rate of phlebitis was 13.6%, with the majority of cases classified as grade 2. Gender, present diseases, length of hospital stay, needle gauge size, and cardiovascular drugs were identified as risk factors for phlebitis in neurosurgery patients. Conclusion This study is significant as it provides basic data for the prevention and management of peripheral phlebitis in hospitalized neurosurgery patients. The risk factors identified in this study should be incorporated into nursing education to implement a systematic peripheral intravenous management program, and appropriate peripheral intravenous catheter-related nursing interventions are necessary based on the characteristics of each patient.

Purpose: This study aimed to identify the risk factors for peripheral intravenous catheter-related phlebitis in hospitalized neurosurgery patients. Methods: This study involved 443 neurosurgery patients who were admitted to a general hospital in Seoul. The analysis included 982 intravenous lines. Data were retrospectively extracted from electronic medical records for the period between November 1, 2022, and May 31, 2023. Data were analyzed using descriptive statistics, independent t-test, x 2 test, and logistic regression. Results: The incidence rate of phlebitis was 13.6%, with the majority of cases classified as grade 2. Gender, present diseases, length of hospital stay, needle gauge size, and cardiovascular drugs were identified as risk factors for phlebitis in neurosurgery patients. Conclusion This study is significant as it provides basic data for the prevention and management of peripheral phlebitis in hospitalized neurosurgery patients. The risk factors identified in this study should be incorporated into nursing education to implement a systematic peripheral intravenous management program, and appropriate peripheral intravenous catheter-related nursing interventions are necessary based on the characteristics of each patient.

Purpose: This study aimed to identify the risk factors for peripheral intravenous catheter-related phlebitis in hospitalized neurosurgery patients. Methods: This study involved 443 neurosurgery patients who were admitted to a general hospital in Seoul. The analysis included 982 intravenous lines. Data were retrospectively extracted from electronic medical records for the period between November 1, 2022, and May 31, 2023. Data were analyzed using descriptive statistics, independent t-test, x 2 test, and logistic regression. Results: The incidence rate of phlebitis was 13.6%, with the majority of cases classified as grade 2. Gender, present diseases, length of hospital stay, needle gauge size, and cardiovascular drugs were identified as risk factors for phlebitis in neurosurgery patients. Conclusion This study is significant as it provides basic data for the prevention and management of peripheral phlebitis in hospitalized neurosurgery patients. The risk factors identified in this study should be incorporated into nursing education to implement a systematic peripheral intravenous management program, and appropriate peripheral intravenous catheter-related nursing interventions are necessary based on the characteristics of each patient.

Purpose: This study aimed to identify the risk factors for peripheral intravenous catheter-related phlebitis in hospitalized neurosurgery patients. Methods: This study involved 443 neurosurgery patients who were admitted to a general hospital in Seoul. The analysis included 982 intravenous lines. Data were retrospectively extracted from electronic medical records for the period between November 1, 2022, and May 31, 2023. Data were analyzed using descriptive statistics, independent t-test, x 2 test, and logistic regression. Results: The incidence rate of phlebitis was 13.6%, with the majority of cases classified as grade 2. Gender, present diseases, length of hospital stay, needle gauge size, and cardiovascular drugs were identified as risk factors for phlebitis in neurosurgery patients. Conclusion This study is significant as it provides basic data for the prevention and management of peripheral phlebitis in hospitalized neurosurgery patients. The risk factors identified in this study should be incorporated into nursing education to implement a systematic peripheral intravenous management program, and appropriate peripheral intravenous catheter-related nursing interventions are necessary based on the characteristics of each patient.

BACKGROUND: B-type natriuretic peptide (BNP) levels are elevated in various conditions unrelated to heart failure, such as acute coronary syndrome, and cardiac troponin (cTn) levels may also be elevated in several non-ischemic conditions. This study aimed to evaluate the clinical usefulness of combined cardiac marker testing (BNP and cTnI) with point-of-care devices in patients who presented to the emergency department (ED). METHODS: Two thousand six hundred and seventy-four consecutive patients who visited the ED from March to August 2013 were included in this study. Cardiac marker testing was performed using the Triage Cardio3 panel (Alere, USA). Electronic medical records were collected on August 2014. RESULTS: We found that 22.2% patients had elevated BNP and/or cTnI (12.8% with only elevated BNP, 4.4% with only elevated cTnI, and 5.0% with both elevations). Patients with elevations in both marker levels showed significantly higher admission rate (78.5% vs. 62.7%, P=0.006) and longer length of hospital stay (11 vs. 6 days, P=0.001) than those with only elevated cTnI. Patients with elevations in both marker levels also showed higher admission rate (78.5% vs. 67.3%, P=0.016) and higher BNP levels (430 vs. 194 pg/mL, P<0.001) than those with only elevated BNP. CONCLUSIONS: Concurrent elevation of BNP and cTnI may be associated with inferior clinical outcome and combined testing of cTnI and BNP levels with high sensitivity would provide important information for assisting management decisions at the ED.
Acute Coronary Syndrome ; Electronic Health Records ; Emergencies* ; Emergency Service, Hospital* ; Heart Failure ; Humans ; Length of Stay ; Natriuretic Peptide, Brain ; Point-of-Care Systems* ; Triage ; Troponin ; Troponin I

BACKGROUND: Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are increasingly important in immunocompromised patients. Nucleic acid extraction methods could affect the results of viral nucleic acid amplification tests. We compared two automated nucleic acid extraction systems for detecting CMV and EBV using real-time PCR assays. METHODS: One hundred and fifty-three whole blood (WB) samples were tested for CMV detection, and 117 WB samples were tested for EBV detection. Viral nucleic acid was extracted in parallel by using QIAsymphony RGQ and QIAcube (Qiagen GmbH, Germany), and real-time PCR assays for CMV and EBV were performed with a Rotor-Gene Q real-time PCR cycler (Qiagen). Detection rates for CMV and EBV were compared, and agreements between the two systems were analyzed. RESULTS: The detection rate of CMV and EBV differed significantly between the QIAsymphony RGQ and QIAcube systems (CMV, 59.5% [91/153] vs 43.8% [67/153], P=0.0005; EBV, 59.0% [69/117] vs 42.7% [50/117], P=0.0008). The two systems showed moderate agreement for CMV and EBV detection (kappa=0.43 and 0.52, respectively). QIAsymphony RGQ showed a negligible correlation with QIAcube for quantitative EBV detection. QIAcube exhibited EBV PCR inhibition in 23.9% (28/117) of samples. CONCLUSIONS: Automated nucleic acid extraction systems have different performances and significantly affect the detection of viral pathogens. The QIAsymphony RGQ system appears to be superior to the QIAcube system for detecting CMV and EBV. A suitable sample preparation system should be considered for optimized nucleic acid amplification in clinical laboratories.
Automation ; Cytomegalovirus/*genetics/isolation & purification ; Cytomegalovirus Infections/diagnosis/*virology ; DNA, Viral/*blood/isolation & purification/metabolism ; Herpesvirus 4, Human/*genetics/isolation & purification ; Humans ; Reagent Kits, Diagnostic ; Real-Time Polymerase Chain Reaction

BACKGROUND: Soluble ST2 (sST2) has emerged as a biomarker of heart failure. Previous studies indicated 35 ng/mL of sST2 as the clinically prognostic cut-off value. This study aims to establish reference intervals in a Korean population using an sST2 assay and to evaluate the applicability of the cut-off value. METHODS: From March to May 2014, sST2 levels were assayed in serum samples of 255 cardio-healthy Koreans (128 men and 127 women) using the Presage ST2 ELISA kit (Critical Diagnostics, USA). The reference interval for sST2 was defined using the nonparametric percentile method according to the CLSI EP28-A3c guideline. RESULTS: The median sST2 concentrations were 23.8 ng/mL (interquartile range (IQR), 19.0-28.7), 26.6 ng/mL (IQR, 21.0-30.9), and 21.9 ng/mL (IQR, 17.3-26.5) for the entire cohort, men, and women, respectively. sST2 levels were significantly higher in men than in women (P<0.0001). The 97.5th percentile upper reference limits for sST2 were 43.8 ng/mL, 49.6 ng/mL, and 35.4 ng/mL for the cohort, men, and women, respectively. Gender-specific upper reference limits were similar to limits reported by other studies. CONCLUSIONS: We suggest that gender-specific reference intervals should be used for the Korean population, as application of a single cut-off value of 35 ng/mL may be overcautious of the possibility of false positivity, especially in men.
Cohort Studies ; Enzyme-Linked Immunosorbent Assay ; Female ; Heart Failure ; Humans ; Male ; Methods

Isoniazid is one of the most commonly used antituberculosis drug. Acute into xication is characterized by repetitious convulsions, high anion gap metabolic a cidosis and coma. The basis of theraphy consists of parental pyridoxine admi nistration in a dose equivalent to that of isoniazid ingested. Here we present a case of seizure and metabolic acidosis due to only renal adjustment dosage of Isoniazid in an elderly woman.
Acid-Base Equilibrium ; Acidosis* ; Aged* ; Coma ; Female ; Humans ; Isoniazid* ; Parents ; Pyridoxine ; Seizures*