Objective To assess the clinical significance of detecting the immune markers in idiopathic thrombocytopenic purpura (ITP). Methods The frequencies of circulating B cells secreting platelet-specific antibody, platelet-specific antibody, the percentage of T lymphocyte subsets, the percentage of reticulated platelet and the level of thrombopoietin in 64 ITP patients and 31 healthy controls were measured with enzyme-linked immunospot assay (ELISPOT),modified monoclonal antibody immunobilization of platelet antigens assay (MAIPA), flow cytometry and sandwich enzyme-linked innnunosorbent assay respectively. Results Compared with the controls[1.3 ± 0. 5/105 peripheral blood mononuclear cell (PBMC), (0.33±0.06,0.41±0.03), (22.08±4.54)% and (8.19±2.46)%], the frequencies of circulating B cells secreting platelet-specific antibody (7.6±4.6/105 PBMC in acute ITP group, 5.3±3.0/105 PBMC in chronic ITP group), platelet-specific antibody (including the anti-GP Ⅱ b/Ⅲa antibody, anti-GP Ⅰ b/X antibody) (0.51 ±0.11, 0.48±0.06 in acute ITP group; 0.49±0.10,0.46±0.09 in chronic ITP group), the percentage of CD8+ T Lymphocyte (27.09±9.86 ) %, the percentage of reticulated platelet in ITP patients[the megakaryocyte cytosis group (24. 85 ± 19. 18)%, the normal megakaryocyte group (23.89±18.90)%]were significantly increased ( all P＜0.05).The frequencies of circulating B cells secreting platelet-specific antibody in acute ITP patients were notably increased (P＜0.05) compared to the chronic ITP patients. In T lymphocyte subsets, the percentage of CD3+T lymphocyte and CD4+ T lymphocyte and the ratio of CD4+/CD8+ in the patients with ITP[(60.88±14.59)%, (28.41±10.55)%, 1.18±0.59]were notably decreased than those in the healthy controls [(69.89±6.43)%, (35.38±5.05) %, 1.64±0.29, P＜0.05]. There was no apparent difference of the level of thrombopoietin between ITP patients with megakaryocyte cytosis (72. 09 ± 41.64 ) and health controls (75.37± 26. 32, P ＞ 0. 05 ), however, the level of thrombopoietin of ITP patients with normal megakaryocyte apparently increased (118.60±70.72, P＜0.05). Conclusion Detecting the frequencies of circulating B cells secreting platelet-specific antibody, platelet-specific antibody, the percentage of T lymphocyte subsets, the percentage of reticulated platelet and the level of thrombepoietin in the patients with ITP may improve the diagnosis and guide clinical therapy.

Aim To study the effect of Tongxinluo on the polarization of macrophages to type M2 and M1, and on Notch signaling pathway.Methods THP-1 was respectively induced by PMA and IL-4 or LPS to M2 and M1 type polarized macrophages, and treated by Tongxinluo.The expressions of marker molecules IL-10, TNF-α, IL-6 and protein of Notch signaling pathway were detected.Results The level of IL-10 increased in M2 group and there was no statistical difference on the level of IL-6 and TNF-α;the level of IL-10 decreased and IL-6, TNF-α increased in M1 group;the level of IL-10 increased and IL-6,TNF-α decreased in TXL group.There was no statistical difference in the expression of active Notch-1, DLL4 and Hes-1 between control group and M2 group;the expression of active Notch-1, DLL4 and HES-1 increased significantly in M1 group;the expression of active Notch-1, DLL4 and HES-1 decreased significantly in TXL group;there was no significant difference in the expression of Notch-1 protein in each group.Conclusion The polarization of macrophages to M1 type can be inhibited by Tongxinluo, and its mechanism may be related to the inhibition of activation of Notch-1 signaling pathway.

Endovascular aneurysm repair (EVAR) of combined abdominal and iliac aneurysm requires exclusion of the hypogastric artery for prevention of endoleak. However, exclusion of the hypogastric artery is often associated with significant ischemic complications such as hip or buttock claudication, gluteal necrosis and bowel ischemia. Several techniques have been introduced to preserve the flow of the hypogastric artery. We report a successful case of external iliac artery-to-hypogastric artery bypass with artificial graft combined with EVAR.
Aneurysm ; Aortic Aneurysm, Abdominal ; Arteries ; Buttocks ; Endoleak ; Hip ; Humans ; Iliac Aneurysm ; Ischemia ; Necrosis ; Transplants

Background: Although numerous studies have indicated that lower levels of physical activity correlate with a higher risk of depression, an association between the type of physical activity and depression has not been identified in Korea. This study aimed to examine whether the type and intensity of physical activity are associated with depression in Korean adults. Methods: This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (KNHANES). A total of 11,679 individuals were analyzed using multiple logistic regression analyses to identify any association between the type of physical activity and depressive disorders in the sample subjects. Results: Measured weekly in units of energy expenditure, known as metabolic equivalents (METs), the amount of work-related physical activity was higher in individuals with depression according to the Patient Health Questionnaire- 9 than the participants without depression (386.7 vs. 206.7 MET-min/wk, P=0.01). Those diagnosed with depression tended to engage in less recreational activity per week (143.7 vs. 316.3 MET-min/wk, P<0.001) than those without depression. After controlling for covariates, the risk of depression among all participants was 1.012 times higher with a 100-unit increase in total work-related activity measured in METs (95% confidence interval [CI], 1.006–1.017; P<0.001) and 0.962 times lower with a 100-unit increase in total leisure activity measured in METs (95% CI, 0.937–0.987; P=0.003). Conclusion Different types of physical activity were shown to be differently associated with depressive disorders in Korean adults. This study might guide in reducing work-related physical activity and increasing leisure activity to prevent the occurrence of depression.

Background: Information about the factors involved in the progress of both high distressed and low distressed victims in the early days after a sexual assault are needed to provide effective intervention for victims of sexual assault. In this study, we examined the relationship among posttraumatic stress disorder (PTSD) symptoms, assault-related factors and trauma-related cognitions in Korean female victims of sexual assault. Methods: For this study, we retrospectively investigated the records of 94 female victims from the Sunflower Center for Women and Children Victims of Violence at the Ajou University Hospital in Korea. Demographic characteristics and the features of the sexual assault, post-traumatic stress symptoms, and trauma-related cognition were obtained from data recorded at the initial assessment. One month after the initial assessment, victims were contacted by telephone and their PTSD symptom severity was re-evaluated. The sample of 94 participants were divided into two groups depending on the PTSD symptom scale scores at initial assessment: High-distress group and Low-distress group. Results: Repeated-measured analyses of variance revealed that the high-distress group showed a decrease in PTSD symptom severity over the month, while the low-distress group did not show significant change of PTSD symptom severity. In correlation analysis, negative thoughts and beliefs about the assault were strongly correlated with PTSD symptom severity one month later in both the low-distress and high-distress groups. Conclusion Our results suggest that trauma-related cognitions seem to play an important role in the maintenance of PTSD both of high-distress and low-distress groups, and that effective intervention will need to address these cognitive factors.

The global older adult population is rapidly growing, intensifying the burden of elderly care. To alleviate this challenge of an aging society, interventions utilizing artificial intelligence (AI) technology are becoming widespread. This review aimed to examine the effects of AI robot interventions on the psychological outcomes of community-dwelling older adults through a systematic literature review. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was employed to identify and select relevant studies. Seven electronic databases were thoroughly searched for eligible studies from June 1st to 30th, 2023. Methodological quality was assessed using RoB 2.0 or RoBANS 2. Results: Thirteen studies (five randomized controlled trials and eight quasi-experimental studies) were selected in the systematic review. Among the selected studies, eight provided AI robot interventions individually, whereas five used a group format, primarily addressing older adults with cognitive impairment or dementia. Depression was the most frequently addressed psychological outcome, with six of ten studies reporting significant effects. Additionally, five studies each highlighted significant effects on emotions, such as positive expressiveness and enjoyment. However, quality of life, anxiety, and loneliness revealed divergent results. Conclusion: AI robots show potential in alleviating psychological challenges for older adults. However, due to the scarcity of high-quality studies, the review recommends conducting more randomized controlled trials with rigorous designs. This review is expected to provide valuable insights for planning and executing AI robot interventions to improve psychological outcomes for community-dwelling older adults in future research.

Malignant peripheral nerve sheath tumor (MPNST) is rare, soft tissue, spindle cell sarcoma of an ectomesenchymal origin. MPNSTs frequently occur in the extremities and trunk, whereas there has been only one previous report of MPNST originated from the pancreas. A 55-yr-old previously healthy man was admitted for a pancreas head mass, which was detected during a routine health inspection. Fine needle aspiration biopsy showed atypical cells that were suspicious for malignancy. On open exploration, a 2.6cm sized hypervascular well capsulated mass was seen between the duodenal first portion and the pancreas head, and so enucleation was performed. The tumor was composed with spindle cells without a typical storiform pattern and the cells were positive for mesenchymal antigen, S-100 and vimentin, whereas they were negative for epithelial membrane antigen and cytokeratin. It was concluded that the tumor was a MPNST with perineural cell differentiation. Primary MPNST of the pancreas is extremely rare and performing immunohistochemical staining is necessary for making its diagnosis.
Biopsy ; Biopsy, Fine-Needle ; Cell Differentiation ; Extremities ; Head ; Keratins ; Mucin-1 ; Nerve Sheath Neoplasms ; Pancreas ; Peripheral Nerves ; Sarcoma ; Vimentin

PURPOSE: The rectus abdominis myocutaneous flap is currently the most commonly used donor site of immediate and delayed breast reconstruction surgery, for its versatility and ease of handling, as well as sufficient blood supply. Despite many advantages of rectus abdominis flap, morbidity of donor site is considered as inevitable shortcoming. The authors recently faced a devastating complication, small bowel obstruction that led to strangulation, after delayed breast reconstruction with free transverses rectus abdominis myocutaneous (TRAM) flap. And we would like to report it, because abdominal pain after TRAM flap is a common symptom and can be overlooked easily. METHODS: A 56-year-old female patient who had history of receiving total abdominal hysterectomy 20 years ago underwent delayed breast reconstruction with TRAM flap transfer. She complained abdominal discomfort and pain from third postoperative day, postoperative small bowel obstruction that arose from strangulated bowel and prompt emergency operation was done. RESULTS: After resection of the strangulated bowel and reanastomosis, quickly her symptoms were relieved, and there were no further problems during her hospital stay. 7 days after her emergency operation she was discharged. CONCLUSION: In patients with previous abdominal surgical history, prolonged ileus can lead to bowel strangulation, so surgeons should always consider the possibility, and must be aware of abdominal symptoms in patients who receive free TRAM flap operations.
Abdominal Pain ; Breast ; Emergencies ; Female ; Handling (Psychology) ; Humans ; Hysterectomy ; Ileus ; Length of Stay ; Mammaplasty ; Middle Aged ; Rectus Abdominis ; Tissue Donors

Minor ginsenosides Rh1 and Rg2 were isolated from Korean red ginseng and reported to have various biological effects on anti-inflammatory and anti-stress activities. However, the effects of Rh1 and Rg2 on antioxidant activity and their regulatory effects on the antioxidant enzymes have not been studied. Since oxidative stress is one of the major toxic inflammatory responses stimulated by lipopolysaccharides (LPS), the present study investigated the role of minor ginsenosides Rh1 and Rg2 on antioxidant effects in LPS-treated RAW 264.7 cells. In this study, we found that treatment with ginsenosides Rh1 and Rg2 strongly inhibited LPS-stimulated intracellular ROS production in cells. Luciferase assay showed that treatment with LPS reduced antioxidant response element (ARE) encoding the pARE-luc promoter activity, while ginsenosides inhibited the pARE-luc promoter activity. Moreover, ginsenosides Rh1 and Rg2 exhibited anti-oxidative activity in LPS-induced cells by upregulating antioxidant enzymes including superoxide dismutase, catalase, and glutathione peroxidase. Our results suggest that minor ginsenosides Rh1 and Rg2 may be potential bio-active compounds for antioxidative effects by inhibiting the generation of ROS in RAW 264.7 cells.
Antioxidant Response Elements ; Antioxidants ; Catalase ; Ginsenosides* ; Glutathione Peroxidase ; Lipopolysaccharides ; Luciferases ; Oxidative Stress* ; Panax ; RAW 264.7 Cells* ; Reactive Oxygen Species ; Superoxide Dismutase