Preeclampsia is a hypertensive disorder involving multiple organs during the late gestational period. It may cause maternal and fetal morbidity and mortality. Preeclampsia parturients have an increased risk of cesarean delivery for several reasons including growth retardation of the intrauterine fetus, fetal distress and termination of pregnancy for treatment of severe preeclampsia. The hemodynamic state of preeclampsia varies depending on the onset, the severity of preeclampsia and the involved organs. Spinal anesthesia is recommended for preeclampsia parturients because of its rapid onset, stable hemodynamics and fewer neurologic complications. Hypotension during spinal anesthesia occurs less in preeclampsia, as compared to healthy pregnant women. Hemodynamic monitoring and planned fluid administration are important to anesthetic management of preeclampsia parturients.
Anesthesia, Spinal ; Female ; Fetal Distress ; Fetus ; Hemodynamics* ; Humans ; Hypotension ; Mortality ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women

PURPOSE: The objective of this study was to analyze the factors affecting the stages of exercise behaviors changes of low back pain patients. METHODS: The participants in this study were 220 low back pain patients who have been treated by therapeutic exercise or had the exercise treatment under the doctor's advice. The tools used for this study were the stages of exercise behavior change, intrinsic motivation questionnaires, and physical activity social support scale (PASS). RESULTS: The group that did exercise (preparation stage, maintenance stage, action stage) was 75.9% but the group that did not exercise (precontemplation stage, contemplation stage) was 24.1%. Social supports from family members and friends and motivation affected the exercise behaviors changes. And 34.6% of the exercise behavior change can be explained by the social support (family, friend) and motivation. CONCLUSION: There were two recommendations for maintaining the exercise behaviors of low back pain patients based on theoretical background. First, we recommended more exercise programs which reinforce social supports from family and friend for constant exercise behaviors of low back pain patients. Second, more exercise programs for the low back pain patients who have similar health goals or problems were needed for motivating them to join the exercise programs.
Friends ; Humans ; Low Back Pain* ; Motivation ; Motor Activity ; Surveys and Questionnaires

Trisomy 22 is closely associated with inv(16) or t(16;16) and could be a marker of cryptic rearrangement of CBFB/MYH11 in acute myeloid leukemia (AML). Trisomy 22 not associated with CBFB/MYH11 rearrangement is a rare event. Here, we report a case diagnosed as refractory anemia with excess blasts-2 (RAEB-2) with sole trisomy 22 in the absence of CBFB/MYH11 rearrangement. The cytogenetic study of bone marrow cells disclosed trisomy 22 in 10% of metaphase cells analyzed. The other chromosomal abnormalities were not found. Fluorescence in situ hybridization (FISH) using CBFB/MYH11 probe to detect cryptic inv(16)(p13q22) showed negative result. We also excluded rearrangements of chromosome 5, 7, 8, 20, and ETV6 by FISH. Sole trisomy 22 not associated with inv(16) is a true entity.
Anemia, Refractory ; Bone Marrow Cells ; Chromosome Aberrations ; Chromosomes, Human, Pair 22 ; Chromosomes, Human, Pair 5 ; Cytogenetics ; Fluorescence ; In Situ Hybridization ; Leukemia, Myeloid, Acute ; Metaphase ; Myelodysplastic Syndromes ; Trisomy

Contrast-induced encephalopathy (CIE) is a rare complication of angiography and endovascular intervention following administration of iodinated intravenous contrast agents. Neuroimaging findings of CIE usually show cerebral edema, leptomeningeal enhancement, and parenchymal signal abnormality on fluid-attenuated inverse recovery (FLAIR). Hyperintense acute reperfusion marker (HARM) generally implies an enhancement of the subarachnoid cerebrospinal fluid space on brain FLAIR imaging in cases of acute ischemic stroke or hyperperfusion syndrome. We report a case of possible CIE following cerebral angiography, accompanied by HARM sign.

The Republic of Korea has been using malaria antibody assays to screen blood donors and reduce the risk of transfusion-transmitted malaria (TTM). This study examined the effectiveness of the current malaria antibody test for screening blood donors and calculated the positive predictive value (PPV) with the real-time polymerase chain reaction (RT-PCR) as the reference. The reactive rate and PPV of the malaria antibody screening assay during particular period from 2020 to 2021 were 0.82% (248/30,309) and 0.40% (1/248), respectively. The low PPV of current malaria antibody screening in blood donors suggests that the effectiveness of this test is limited in terms of balancing blood safety and supply in low-prevalence situations.

The manifestation of behavioral and psychological symptoms of dementia (BPSD) poses a considerable care burden and precipitates adverse health outcomes. Despite the increasing development of digital interventions, their application in the dementia population, specifically regarding their effectiveness in addressing BPSD, remains limited. Therefore, in this study, we aimed to describe a study protocol for evaluating the effectiveness of a mobile app-based individualized non-pharmacological intervention to improve BPSD in community-dwelling older adults. Methods: Employing a randomized control group pretest-posttest design, 36 dyads comprising people living with dementia (PLWD) and their family caregivers will be assigned to either an experimental or control group. The experimental group will engage in a 4-week regimen using a mobile app-based individualized non-pharmacological intervention, which includes recording and predicting BPSD. The control group will use the BPSD record system without accessing the individualized interventions. Both groups will continue with their usual care practices throughout the study period. Subsequently, an evaluation of the effectiveness of the mobile app-based individualized non-pharmacological intervention on BPSD will be conducted, which will serve as the primary outcome. Discussion: We hypothesize that the implementation of the mobile app-based individualized non-pharmacological intervention will alleviate BPSD. However, the research team may encounter several challenges owing to the novelty of digitalized interventions. Nevertheless, the results of this study will provide robust evidence regarding the efficacy of mobile app-based individualized non-pharmacological interventions for community-dwelling older PLWD.Trial registration: This trial has been registered with the Clinical Research Information Service in South Korea (CRIS No. KCT0008713; registered August 18, 2023).

BACKGROUND/OBJECTIVES: Atherosclerosis is associated with increased inflammation in the visceral adipose tissue (VAT). Vitamin D has been reported to modulate the inflammatory responses of stromal vascular cells (SVCs) and adipocytes in adipose tissue, but the role of vitamin D in atherosclerosis biology is unclear. This study examined the effects of in vitro 1,25-dihydroxyvitamin D 3 (1,25[OH] 2 D 3 ) treatment on the inflammatory responses of SVCs and adipocytes from atherosclerotic mice.MATERIALS/METHODS: C57BL/6J (B6) mice were divided randomly into 2 groups and fed a 10% kcal fat control diet (control group, CON) or 41% kcal fat, 0.21% cholesterol (high fat+ cholesterol, HFC) diet (obese group, OB), and B6.129S7-Ldlr tm1Her /J (Ldlr −/− ) mice were fed a HFC diet (obese with atherosclerosis group, OBA) for 16 weeks. SVCs and adipocytes isolated from VAT were pre-incubated with 1,25(OH) 2 D 3 for 24 h and stimulated with lipopolysaccarides for the next 24 h. Proinflammatory cytokine production by adipocytes and SVCs, the immune cell population in SVCs, and the expression of the genes involved in the inflammatory signaling pathway in SVCs were determined. RESULTS: The numbers of total macrophages and SVCs per mouse were higher in OB and OBA groups than the CON group. The in vitro 1,25(OH) 2 D 3 treatment significantly reduced macrophages/SVCs (%) in the OBA group. Consistent with this change, the production of interleukin-6 and monocyte chemoattractant protein 1 (MCP-1) by SVCs from the OBA group was decreased by 1,25(OH) 2 D 3 treatment. The 1,25(OH) 2 D 3 treatment significantly reduced the toll-like receptor 4 and dual-specificity protein phosphatase 1 (also known as mitogenactivated protein kinase phosphatase 1) mRNA levels in SVCs and MCP-1 production by adipocytes from all 3 groups. CONCLUSIONS These findings suggest that vitamin D can attribute to the inhibition of the inflammatory response in VAT from atherosclerotic mice by reducing proinflammatory cytokine production.

BACKGROUND: Alloimmunization of human platelet antigens (HPA) is associated with clinically significant disease, such as platelet refractoriness, neonatal alloimmune thrombocytopenia, or posttransfusion purpura. It is determined by single nucleotide polymorphism of genes for platelet membrane glycoprotein. To date, approximately 27 HPAs have been discovered, and their frequencies differ depending on ethnicity and country. METHODS: We conducted an investigation of prevalence of HPA in the Korean population using a multiplex single-base primer extension reaction (SNaPshot). With 84 specimens from healthy donors, HPA genotyping was performed on 11 different HPAs, including HPA-1, -2, -3, -4, -5, -6, -7, -8, -9, -13, and -15. RESULTS: A total of 90 blood samples were genotyped. The genotype frequencies of HPA were as follows: HPA-1a/1a: 100.0%, -2a/2a: 83.3%, -2a/2b: 14.3%, -2b/2b: 2.4%, -3a/3a: 39.3%, -3a/3b: 52.4%, -3b/3b: 8.3%, -4a/4a: 100.0%, -5a/5a: 95.2%, -5a/5b: 4.8%, -6a/6a: 94.0%, -6a/6b: 6.0%, -7a/7a: 100.0%, -8a/8a: 100.0%, -9a/9a: 97.6%, -9a/9b: 2.4%, -13a/13a: 100.0%, -15a/15a: 23.8%, -15a/15b: 51.2%, and -15b/15b: 25.0%. CONCLUSION: The SNaPshot assay was employed for detection of SNPs in various clinically significant HPA genes. In addition to well-known frequencies of previously reported HPA-1 to -8, this study showed frequencies of HPA-9, -13, and -15 in Koreans for the first time. The SNaPshot technique might be suitable for use in actual clinical testing in patients with platelet alloimmunization.
Antigens, Human Platelet ; Blood Platelets ; Genotype ; Humans ; Membrane Glycoproteins ; Polymorphism, Single Nucleotide ; Prevalence ; Purpura ; Purpura, Thrombocytopenic ; Thrombocytopenia, Neonatal Alloimmune ; Tissue Donors

BACKGROUND: This clinical study was designed to evaluate the effect of midazolam as a premedication on the onset of propofol and rocuronium during propofol target-controlled infusion (TCI). METHODS: Seventy four patients (ASA class I or II) were randomly allocated to receive either no premedication (control group) or premedication with 0.04 mg/kg intravenous midazolam (midazolam group). Anesthesia was induced and maintained with propofol TCI. Time from propofol injection to loss of consciousness (LOC) and estimated effect concentration at LOC were recorded. After LOC, rocuronium (0.6 mg/kg) was injected. We monitored the degree of neuromuscular blockade by acceleromyography. The following parameters were measured and compared between groups: Time from rocuronium injection to depression of twitch height below 25%, time to maximal depression of twitch height (defined as rocuronium onset time). RESULTS: Systolic blood pressure before induction was lower in midazolam group (125 +/- 15 vs 135 +/- 20 mmHg), however, there was no difference in blood pressure at LOC between groups (111 +/- 16 vs 106 +/- 21 mmHg). In midazolam group, time to LOC in propofol TCI was shorter (63 +/- 22 vs. 203 +/- 118 sec) and estimated effect site concentration of propofol was significantly lower than control group (0.9 +/- 0.3 vs. 2.2 +/- 0.4 microl/ml). The onset time of rocuronium was not different between groups (120 +/- 39 vs. 137 +/- 42 sec). CONCLUSIONS: Midazolam pretreatment fastens the onset time of propofol and decreases the propofol requirement for LOC. However, it does not influence the onset of rocuronium.
Androstanols ; Anesthesia ; Blood Pressure ; Depression ; Humans ; Midazolam ; Neuromuscular Blockade ; Premedication ; Propofol ; Unconsciousness

Kennedy's disease is a rare lower motor neuron disease affecting the limbs and bulbar musculature. Regional anesthesia is generally the recommended anesthetic technique in patients with Kennedy's disease because of bulbar involvement and airway clearing disturbance. We administered general anesthesia in a patient with Kennedy's disease who was undergoing a laparoscopic cholecystectomy. We closely monitored the degree of neuromuscular blockade throughout the operation and injected atracurium on demand. There was no exacerbation of neurologic signs or symptoms postoperatively. Therefore, we report the successful administration of general anesthesia for laparoscopic cholecystectomy in a patient with Kennedy's disease.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General ; Atracurium ; Cholecystectomy, Laparoscopic ; Extremities ; Humans ; Motor Neuron Disease ; Neurologic Manifestations ; Neuromuscular Blockade