A vascular closure device is used for hemostasis after a procedure involving an arterial puncture. The increasing frequency of endovascular arterial interventions has caused these devices to play a more important role in clinical practice. FemoSeal is a popular vascular closure device, and its safety and effectiveness have been verified. However, complications still occur in some cases, including even disastrous complications on occasion. Even with little experience, it is possible to reduce the complication rate by using real-time ultrasonography monitoring during the deployment of this device. Based on our experiences, presented herein, we suggest that complications related to FemoSeal could be reduced by using our method.

BACKGROUND: The sleep quality of subway drivers who work in the dark underground with an rotating shift system is generally poor, which can degrade the quality of a worker's life. This study examined the relationship between the sleep quality of subway worker and shift work by comparing three shift systems (rotating shift system, a three day shift system, and no-shift system). METHOD: Questionnaires including The short form of the Korean Occupational Stress Scale (KOSS), Pittsburgh Sleep Questionnaire (PSQI), the worker's age, gender, job type, accident, near miss and shift system were given to a total of 1010 workers. The results of 759 qualified questionnaires (75.15 %) were analyzed using the SPSS (ver 12.0) program. RESULT: The highest level of job stress was found among those working a rotating shift system followed by three shift system and no-shift system. The mean sleep quality score in the rotating shift workers was 5.1 (SD+/-3.2), which was greater than the sleep symptom score (5). 34.8% of rotating shift workers suffered from sleep symptoms. The sleep quality score by shift-work was significantly different. High job demand, strong external locus control, the experience of a near miss or an accident in the workplace during previous year has an adverse affect on the sleep quality. The sleep quality improved in case of a change into a no-shift system or a strong internal locus control. CONCLUSION: A rotating shift system is more harmful to the quality of sleep in subway workers than a 3 shift system or no-shift system. In addition, job stress, personality, near miss and the experience of an accident affect the sleep quality of subway workers.
Questionnaires ; Railroads

PURPOSE: Scopolamine is a nonselective muscarinic cholinergic receptor antagonist, which induces impairment of learning ability and memory function. Exercise is known to ameliorate brain disturbance induced by brain injuries. In the present study, we investigated the effect of treadmill exercise on short-term memory in relation to acetylcholinesterase (AChE) expression in the hippocampus, using a scopolamine-induced amnesia model in mice. METHODS: To induce amnesia, 1 mg/kg scopolamine hydrobromide was administered intraperitoneally once per day for 14 days. A step-down avoidance test for short-term memory was conducted. AChE histochemistry, immunohistochemistry for collagen IV, and doublecortin were performed. RESULTS: Short-term memory deteriorated in the mice with scopolamine-induced amnesia, concomitant with enhanced AChE expression and suppression of angiogenesis in the hippocampus. Critically, treadmill exercise ameliorated short-term memory impairment, suppressed AChE expression, and enhanced angiogenesis in the mice with scopolamine-induced amnesia. CONCLUSIONS: Overexpression of AChE is implicated in both brain and renal disease. The findings of our study indicate that treadmill exercise may be of therapeutic value in neurodegenerative and renal diseases by suppressing the effects of AChE expression.
Acetylcholinesterase ; Amnesia* ; Animals ; Brain ; Brain Injuries ; Collagen ; Exercise Test ; Hippocampus ; Immunohistochemistry ; Learning ; Memory ; Memory, Short-Term* ; Mice ; Rats* ; Scopolamine Hydrobromide

PURPOSE: Rotenone is the most widely used neurotoxin for the making Parkinson disease (PD) animal model. The neurodegenerative disorder PD shows symptoms, such as slowness of movements, tremor at resting, rigidity, disturbance of gait, and instability of posture. We investigated whether treadmill running improves motor ability using rotenone-caused PD rats. The effect of treadmill running on PD was also assessed in relation with apoptosis of cerebellar Purkinje cells. METHODS: Treadmill running was applied to the rats in the exercise groups for 30 minutes once a day for 4 weeks, starting 4 weeks after birth. We used rota-rod test for the determination of motor coordination and balance. In this experiment, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining, immunohistochemistry for calbindin, glial fibrillary acidic protein (GFAP), Iba-1, and western blot analysis for Bax and Bcl-2 were performed. RESULTS: Treadmill running enhanced motor balance and coordination by preventing the loss of Purkinje cells in the cerebellar vermis. Treadmill running suppressed PD-induced expression of GFAP-positive reactive astrocytes and Iba-1-positive microglia, showing that treadmill running suppressed reactive astrogliosis and microglia activation. Treadmill running suppressed TUNEL-positive cell number and Bax expression and enhanced Bcl-2 expression, demonstrating that treadmill running inhibited the progress of apoptosis in the cerebellum of rotenone-induced PD rats. CONCLUSIONS: Treadmill running improved motor ability of the rotenone-induced PD rats by inhibiting apoptosis in the cerebellum. Apoptosis suppressing effect of treadmill running on rotenone-induced PD was achieved via suppression of reactive astrocyte and inhibition of microglial activation.
Animals ; Apoptosis ; Astrocytes ; Blotting, Western ; Calbindins ; Cell Count ; Cerebellar Vermis ; Cerebellum ; Gait ; Glial Fibrillary Acidic Protein ; Immunohistochemistry ; Microglia ; Models, Animal ; Neurodegenerative Diseases ; Parkinson Disease* ; Parturition ; Posture ; Purkinje Cells* ; Rats* ; Rotenone ; Running ; Tremor

Background/Aims: Idiopathic multicentric Castleman disease (iMCD) comprises approximately 30% of all cases of Castleman disease. It is characterized by constitutional symptoms, enlarged lymph nodes at multiple anatomical sites, and laboratory test abnormalities, which are primarily related to the overproduction of interleukin 6 (IL-6). Siltuximab is a human-mouse chimeric immunoglobulin G1κ monoclonal antibody against human IL-6. In view of the limited treatment options for iMCD, this study aimed to evaluate the efficacy and safety of siltuximab in the management of this condition. Methods: In this real-world retrospective study, we administered siltuximab to 15 patients with iMCD who previously received conventional chemotherapy and/or steroid pulse therapy. The median time to a durable symptomatic response was 22 days (range, 17 to 56). The serum hemoglobin and albumin levels and erythrocyte sedimentation rates significantly normalized after the first 3 months of siltuximab treatment. Lymph node involution, assessed using imaging, was relatively gradual, demonstrating a complete or partial response at 6 months. Results: On an average, the improvements in clinical, laboratory, and radiologic parameters of iMCD in responders were observed after one, three, and eight cycles of siltuximab treatment, respectively. Siltuximab demonstrated a favorable safety profile, and prolonged treatment was well-tolerated. Conclusions Despite the small sample size of the present study, the results are encouraging and demonstrate the potential of siltuximab as the first-line treatment of iMCD. Further large multicenter studies are needed to evaluate the clinical outcomes and adverse events associated with siltuximab.

Background: Arsenic trioxide (ATO) is the standard treatment for relapsed acute promyelocytic leukemia (APL). However, consensus on post-remission therapies is still lacking. Methods: We evaluated 52 patients who experienced relapse following initial treatment of APL between 2000 and 2019 at Catholic Hematology Hospital. Among them, 41 patients received reinduction treatment, 30 with ATO-based regimen, whereas 11 with conventional intensive chemotherapy (IC). Results: The ATO reinduction group showed a significantly higher second molecular complete remission (mCR2) rate, superior neutrophil and platelet recovery, and a lower infection rate than the IC reinduction group. No significant differences were observed in survival outcomes after post-remission treatment among the ATO-based (N=19), autologous (N=12), and allogeneic (N=6) hematopoietic stem cell transplantation (HSCT) groups. In the ATO-based and autologous HSCT groups, among patients with mCR2 after ATO reinduction, nine and five patients experienced a second relapse, respectively (50.7% vs. 41.7%, P =0.878). Among these patients, seven received salvage allogeneic HSCT; six remained alive. The other seven patients received ATO without HSCT. Five died from disease progression, and two survived and have been in mCR2 since. Conclusion Post-remission treatment outcomes of patients with relapsed APL were not significantly different, regardless of the treatment option, suggesting the feasibility of ATO-based treatment without HSCT in mCR2. Allogeneic HSCT may be an effective salvage treatment modality for patients with a second relapse. Owing to a few cases of relapsed APL, multicenter prospective studies may help elucidate the efficacy of each post-remission treatment.

Idiopathic bronchiolitis obliterans with organizing pneumonia (BOOP) is a specific clinicopathologic syndrome characterized by a pneumonia-like illness, with excessive proliferation of granulation tissue within bronchioles, alveolar ducts and alveoli. The changes are most numerous in alveolar ducts. The presence of intraluminal tufts of organizing connective tissue in alveolar ducts and more distal airspaces has been termed organizing pneumonia The radiologic manifestations are distinctive with bilateral, diffuse alveolar opacities predominantly in the subpleural and lower lung zone. Patchy migratory pneumonic foci or solely nodular infiltrates are rarely present in BOOP. BOOP is a diagnosis of importance because of its dramatic response to steroids.
Bronchioles ; Bronchiolitis Obliterans ; Connective Tissue ; Cryptogenic Organizing Pneumonia* ; Diagnosis ; Granulation Tissue ; Lung ; Pneumonia ; Steroids

PURPOSE: The aim of this study was to evaluate whether serum creatinine levels at 3 days after renal transplantation can predict long-term graft survival and its associated clinical aspects. METHODS: Three hundred and seventy six renal transplant recipients who received grafts from living donors were included. Recipients were classified into two groups according to their serum creatinine levels (1.2 mg/dL group) at 3 days after renal transplantations. Demographic characteristics (age, sex, weight, body mass index, donor/recipient body weight ratio, pre-transplant dialysis type, underlying disease and pre-transplant transfusion), transplant variables (immuno-suppressive agents, HLA mismatch and HLA DR mismatch) and post-transplant variables (routine graft biopsy, number of acute rejection episodes within first year after renal transplantation, serum creatinine level and graft survival at each first, second, and fifth years) were assessed. RESULTS: Among total 376 recipients, serum creatinine 1.2 mg/dL groups were 224 (59.6%) recipients. The characteristics of patients with good graft function (serum creatinine 1.2 mg/dL group (first year, 100% vs. 95.7%; fifth year, 96.7% vs. 89.8%; P<0.05). Conclusion: Serum creatinine levels at 3 days after renal transplantation can predict long-term kidney transplant survival. It was associated with immunological (frequency of acute rejection) and non- immunological aspect (match of kidney size and donor's age).
Biopsy ; Body Weight ; Creatinine* ; Dialysis ; Female ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation* ; Living Donors ; Transplantation ; Transplants*