Radiocontrast media-induced acute severe thrombocytopenia is a very rare complication and potentially life-threatening. Here, we report the case of a 63-year-old male patient with severe acute thrombocytopenia following first exposure to intravenous non-ionic contrast media without immediate allergic reactions. His platelet count dropped from 107000/µL to 2000/µL after six hours of radiocontrast infusion. After administration of corticosteroid and transfusion of platelet concentrates, the platelet count returned gradually to normal within 5 days. To the best of our knowledge, non-ionic contrast media-induced isolated acute severe thrombocytopenia following no signs or symptoms of immediate allergic reaction has never been described.
Acute Disease ; Administration, Intravenous ; Contrast Media/administration & dosage ; Contrast Media/adverse effects ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Platelet Count ; Thrombocytopenia/etiology

Purpose: The purpose of this study was to analyze the nursing activities of registered nurses working in rehabilitation units, and to investigate the application of the health insurance fee for each nursing practice. Methods: Using the Delphi survey method, nursing activities were analyzed as job-task-task elements. Then, the status of the application of health insurance fees was investigated for the task elements according to National Health Insurance Benefit. Results: 15 jobs, 61 tasks, and 290 task elements were derived as nursing activities in rehabilitation units.According to the opinion by the expert panel, Among the 290 task elements, 166 (57.2%) out of 290 take elements should be accepted as insurance fees (fee agreement CVR≥0.56). However, the health insurance was applied to only 40 items (24.1%) for nursing management fees, 25 items for nursing care (15.1%), and 26 items for other rehabilitation related medical fees (15.7%). 82 items (49.4%) were not covered by insurance, and most educational interventions were not covered. Conclusion To provide high-quality nursing services in rehabilitation units, it is essential to apply an appropriate level of health insurance coverage. Further research to expand the application of medical fees related to rehabilitation and institutional arrangements to obtain recognition of the fees for nursing services are necessary.

Oral squamous cell carcinoma (OSCC) is mostly diagnosed at an advanced stage, with local and/or distal metastasis. Thus, locoregional and/or local control of the primary tumor is crucial for a better prognosis in patients with OSCC. Platelets have long been considered major players in cancer metastasis. Traditional antiplatelet agents, such as aspirin, are thought to be potential chemotherapeutics, but they need to be used with caution because of the increased bleeding risk. Podoplanin (PDPN)-expressing cancer cells can activate platelets and promote OSCC metastasis. However, the reciprocal effect of platelets on PDPN expression in OSCC has not been investigated. In this study, we found that direct contact with platelets upregulated PDPN and integrin β1 at the protein level and promoted invasiveness of human OSCC Ca9.22 cells that express low levels of PDPN. In another human OSCC HSC3 cell line that express PDPN at an abundant level, silencing of the PDPN gene reduced cell invasiveness. Analysis of the public database further supported the co-expression of PDPN and integrin β1 and their increased expression in metastatic tissues compared to normal and tumor tissues of the oral cavity. Taken together, these data suggest that PDPN is a potential target to regulate platelet-tumor interaction and metastasis for OSCC treatment, which can overcome the limitations of traditional antiplatelet drugs.