Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.
Blood Transfusion ; Death, Sudden, Cardiac ; Erythrocyte Transfusion ; Erythrocytes ; Extracorporeal Membrane Oxygenation* ; Heart Arrest* ; Humans ; Hyperkalemia* ; Infant* ; Infant, Newborn ; Potassium

Purpose: To introduce a method of correcting lower eyelid epiblepharon with severe epicanthal fold combined with minimal incision of medial epicanthoplasty (Hiraga method) and to report its clinical outcomes. Methods: We retrospectively reviewed the medical records of patients who underwent surgery for lower eyelid epiblepharon and minimal incision of medial epicanthus from January 2015 and January 2019. Seventy-eight eyes of 39 patients were analyzed for surgical outcomes, subjective symptoms, recurrence, and complications for more than six months of the follow-up period. Results: A total of 39 patients (14 male, 25 female) were included in the analysis. The mean patient age was 8.4 ± 4.3 years, and the mean postoperative follow-up was 14 ± 5.2 months. Eyelid shape and function were well maintained in 39 patients (100%), with no recurrence during follow-up. Conclusions For patients with lower eyelid epiblepharon with severe medial epicanthal fold, lower eyelid epiblepharon with a minimal incision of medial epicanthoplasty (Hiraga method) is a simple surgical technique to prevent recurrence of medial cilia touch, showing successful results without complications.

Purpose: This study aimed to explore the influence of teamwork and grit on job adaptation and intention to remain among advanced beginner nurses. Methods: A cross-sectional descriptive research design employing a survey method was used. The study involved 203 advanced beginner nurses with 13~36 months of experience working at a tertiary hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis. Results: Job adaptation positively correlated with teamwork (r=.58, p<.001) and grit (r=.65, p<.001). Intention to remain was also positively correlated with teamwork (r=.32, p<.001) and grit (r=.59, p<.001). A hierarchical multiple regression model including control variables, teamwork, and grit accounted for 64% of the factors influencing job adaptation. Another hierarchical multiple regression model, incorporating control variables, teamwork, and grit, explained 44% of the factors influencing the intention to remain. Among the related factors, grit emerged as the most influential in regarding job adaption and intention to remain. Conclusion These findings underscore the importance of establishing a support system to bolster grit, enhancing adaptation to the job and fostering intention to remain among advanced beginner nurses.

Purpose: This study aimed to explore the influence of teamwork and grit on job adaptation and intention to remain among advanced beginner nurses. Methods: A cross-sectional descriptive research design employing a survey method was used. The study involved 203 advanced beginner nurses with 13~36 months of experience working at a tertiary hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis. Results: Job adaptation positively correlated with teamwork (r=.58, p<.001) and grit (r=.65, p<.001). Intention to remain was also positively correlated with teamwork (r=.32, p<.001) and grit (r=.59, p<.001). A hierarchical multiple regression model including control variables, teamwork, and grit accounted for 64% of the factors influencing job adaptation. Another hierarchical multiple regression model, incorporating control variables, teamwork, and grit, explained 44% of the factors influencing the intention to remain. Among the related factors, grit emerged as the most influential in regarding job adaption and intention to remain. Conclusion These findings underscore the importance of establishing a support system to bolster grit, enhancing adaptation to the job and fostering intention to remain among advanced beginner nurses.

Purpose: This study aimed to explore the influence of teamwork and grit on job adaptation and intention to remain among advanced beginner nurses. Methods: A cross-sectional descriptive research design employing a survey method was used. The study involved 203 advanced beginner nurses with 13~36 months of experience working at a tertiary hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis. Results: Job adaptation positively correlated with teamwork (r=.58, p<.001) and grit (r=.65, p<.001). Intention to remain was also positively correlated with teamwork (r=.32, p<.001) and grit (r=.59, p<.001). A hierarchical multiple regression model including control variables, teamwork, and grit accounted for 64% of the factors influencing job adaptation. Another hierarchical multiple regression model, incorporating control variables, teamwork, and grit, explained 44% of the factors influencing the intention to remain. Among the related factors, grit emerged as the most influential in regarding job adaption and intention to remain. Conclusion These findings underscore the importance of establishing a support system to bolster grit, enhancing adaptation to the job and fostering intention to remain among advanced beginner nurses.

Purpose: This study aimed to explore the influence of teamwork and grit on job adaptation and intention to remain among advanced beginner nurses. Methods: A cross-sectional descriptive research design employing a survey method was used. The study involved 203 advanced beginner nurses with 13~36 months of experience working at a tertiary hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis. Results: Job adaptation positively correlated with teamwork (r=.58, p<.001) and grit (r=.65, p<.001). Intention to remain was also positively correlated with teamwork (r=.32, p<.001) and grit (r=.59, p<.001). A hierarchical multiple regression model including control variables, teamwork, and grit accounted for 64% of the factors influencing job adaptation. Another hierarchical multiple regression model, incorporating control variables, teamwork, and grit, explained 44% of the factors influencing the intention to remain. Among the related factors, grit emerged as the most influential in regarding job adaption and intention to remain. Conclusion These findings underscore the importance of establishing a support system to bolster grit, enhancing adaptation to the job and fostering intention to remain among advanced beginner nurses.

BACKGROUND: Particulate matter may be toxic to human tissue. Ambient air particulate matter < or =10micrometer in aerodynamic size (PM10), which changes under different environmental conditions, is a complex mixture of organic and inorganic compounds. The Asian dust event caused by meteorological phenomena can also spread unique particulate matter in affected areas. We evaluated production of ROS, TGF-beta, fibronectin, and NF kappa B by exposing normal epithelial cells to Asian dust particulate matter. METHODS: Bronchial epithelial cells were exposed to 0, 50, 100microgramg/ml of a suspension of PM10 for 24 h. ROS were detected by measurement of DCF release from DCF-DA by FACScan. TGF-beta, fibronectin, and NF kappa B were detected by western blotting. RESULTS: PM10 exposure increased the expression of TGF-beta, fibronectin, and NF kappa B. ROS production and TGF-betalevels were significantly higher with 50 or 100microgram/ml PM10. Fibronectin and NF kappa B production were significantly higher after 100microgram/ml of PM10. CONCLUSION: PM10 from Asian dust particles might have fibrotic potential in bronchial epithelial cells via ROS induction after PM10 exposure.
Asian Continental Ancestry Group ; Blotting, Western ; Dust ; Epithelial Cells ; Fibronectins ; Humans ; NF-kappa B ; Particulate Matter ; Pulmonary Fibrosis ; Reactive Oxygen Species ; Transforming Growth Factor beta

The anti-inflammatory effects of an ethanol extract of Angelica gigas (EAG) were investigated in vitro and in vivo using croton oil-induced inflammation models. Croton oil (20 microgram/mL) up-regulated mRNA expression of cyclooxygenase (COX)-I and COX-II in the macrophage cell line, RAW 264.7, resulting in the release of high concentrations of prostaglandin E2 (PGE2). EAG (1~10 microgram/mL) markedly suppressed croton oil-induced COX-II mRNA expression and PGE2 production. Application of croton oil (5% in acetone) to mouse ears caused severe local erythema, edema and vascular leakage, which were significantly attenuated by oral pre-treatment with EAG (50~500 mg/kg). Croton oil dramatically increased blood levels of interleukin (IL)-6 and PGE2 without affecting tumor-necrosis factor (TNF)-alpha and nitric oxide (NO) levels. EAG pre-treatment remarkably lowered IL-6 and PGE2, but did not alter TNF-alpha or NO concentrations. These results indicate that EAG attenuates inflammatory responses in part by blocking the COX-PGE2 pathway. Therefore, EAG could be a promising candidate for the treatment of inflammatory diseases.
Angelica/*immunology ; Animals ; Cell Line ; Cyclooxygenase 1/genetics/*immunology ; Cyclooxygenase 2/genetics/*immunology ; Dinoprostone/genetics/immunology ; Inflammation/drug therapy/enzymology/*immunology ; Interleukin-6/blood ; Macrophages ; Male ; Mice ; Mice, Inbred ICR ; Nitric Oxide/blood ; Phytotherapy/*methods ; Plant Extracts/*pharmacology/therapeutic use ; Plant Roots/immunology ; RNA, Messenger/chemistry/genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha/blood

Femoral artery pseudoaneurysm, a very uncommon disease, is usually reported trauma, iatrogenic vascular intervention, and nail fixation in the treatment of fracture. The femoral artery is a major vessel for blood supply to the lower extremities. If the femoral artery is injured, the patient will experience cardiovascular collapse and hypovolemic shock due to massive hemorrhage. We report on the case of a 49-year-old male patient who had been diagnosed with systemic lupus erythematosus (SLE), who was admitted to our hospital with progressive swelling of the right thigh without any trauma history. A computed tomographic scan with arterial enhancement showed a large pseudoaneurysm of the right femoral artery, which was then treated successfully with great saphenous vein graft surgery.
Aneurysm ; Aneurysm, False* ; Femoral Artery* ; Hemorrhage ; Humans ; Lower Extremity ; Lupus Erythematosus, Systemic* ; Male ; Middle Aged ; Rupture* ; Saphenous Vein ; Shock ; Thigh ; Transplants

Epigenetic silencing is considered to be a major mechanism for loss of activity in tumor suppressors. Reversal of epigenetic silencing by using inhibitors of DNA methyltransferase (DNMT) or histone deacetylases (HDACs) such as 5-Aza-CdR and FK228 has shown to enhance cytotoxic activities of several anticancer agents. This study aims to assess the combinatorial effects of gene-silencing reversal agents (5-Aza-CdR and FK228) and oxaliplatin in gastric cancer cells, i.e., Epstein-Barr virus (EBV)-negative SNU-638 and EBV-positive SNU-719 cells. The doublet combinatorial treatment of 5-Aza-CdR and FK228 exhibited synergistic effects in both cell lines, and this was further corroborated by Zta expression induction in SNU-719 cells. Three drug combinations as 5-Aza-CdR/FK228 followed by oxaliplatin, however, resulted in antagonistic effects in both cell lines. Simultaneous treatment with FK228 and oxaliplatin induced synergistic and additive effects in SNU-638 and SNU-719 cells, respectively. Three drug combinations as 5-Aza-CdR prior to FK228/oxaliplatin, however, again resulted in antagonistic effects in both cell lines. This work demonstrated that efficacy of doublet synergistic combination using DNMT or HDACs inhibitors can be compromised by adding the third drug in pre- or post-treatment approach in gastric cancer cells. This implies that the development of clinical trial protocols for triplet combinations using gene-silencing reversal agents should be carefully evaluated in light of their potential antagonistic effects.
Antineoplastic Agents ; Cell Line ; DNA ; Drug Combinations ; Epigenomics* ; Herpesvirus 4, Human ; Histone Deacetylases ; Humans* ; Stomach Neoplasms* ; Triplets