Carotid artery stenting (CAS) is considered for patients with symptomatic carotid stenosis of 50% or greater. Following CAS, hemodynamic changes can alter the cerebral perfusion status. Furthermore, hypotension and bradycardia may occur due to the stimulation of carotid sinus baroreceptors. A more meticulous approach to these hemodynamic changes is required, especially in patients with bilateral carotid artery stenosis and concurrent multiple cerebrovascular stenoses. This report presents a case of posterior cerebral artery territory infarction that occurred after bilateral CAS.

Background: Identifying the risks related to the complications of electrical cardioversion (ECV) can alert the determinaton of rhythm control in patients with atrial fibrillation (AF). Methods: We retrospectively reviewed 1,058 patients who underwent ECV for persistent or long-standing persistent AF/atrial flutter (AFL) from multiple centers. Patients were classified into the no-complication (1,023 patients) and complication (35 patients) groups based on the following major complications: stroke and/or systemic embolism (SSE), myocardial infarction, major bleeding, implantation of cardiac implantable electronic devices, ventricular tachycardia/fibrillation, and death at 1 year follow-up after ECV. Results: Compared with the no-complication group, the complication group exhibited a higher proportion of female patients (37% vs. 22%), as well as a higher proportion of patients with older age (67 ± 11 vs. 61 ± 10 years), diabetes mellitus (DM) (49% vs. 24%), heart failure (HF) (49% vs. 30%), SSE (23% vs. 9%), high CHA 2 DS 2 -VASc (CV) score (3.6 ± 1.8 vs.2.2 ± 1.4), low left ventricular ejection fraction (LVEF) (50 ± 16% vs. 58 ± 21%), and high left atrial volume index (LAVI) (51 ± 26 vs. 40 ± 20 mL/m 2 ). Class I and III antiarrhythmics were less prescribed in the complication group than in the no-complication group (57% vs.76%). Univariate analysis for complications revealed age (≥ 65 years), female sex, DM, HF, SSE, LVEF (< 50%), LAVI (≥ 40 mL/m 2 ), CV score (≥ 3), bradycardia on Holter (< 60/min), and no antiarrhythmics as risk factors. Among these, multivariate analysis revealed clinical significance of female sex and SSE. Conclusion Female sex and a history of SSE were the most important risk factors of complications in patients with persistent or long-standing persistent AF/AFL who underwent ECV.

Purpose: Chemo-port insertion is performed by a radiologist or surgeon in an interventional radiology (IR) suite or an operating room (OR). The complication rate is approximately 3%–4%. However, there is still a lack of data for comparison when it is performed in different conditions such as IR suite and OR. Methods: This study is for the safety of adult cancer patients after chemo-port implantation by comparing postoperative complication types and rates in different places. Among 375 patients who underwent chemo-port implantation, 203 patients underwent chemo-port implantation by radiologists in an IR suite, and 172 patients underwent the procedure by general surgeons in an OR. In both groups, early and late mortality were investigated. Early and late complication types and rates were also compared, and our study results were compared to the literature. Results: Patients’ characteristics showed no differences. Mortality after the procedure was 39 in OR vs. 72 in IR (P < 0.01).Early mortality at 7 days was 1 in IR, no patient in OR (P = 0.36). Catheter problems did not show a statistical difference in these 2 groups (1.16% vs. 0.49%, P = 0.47). Venous thrombosis happened in 4 and 7 (2.33% vs. 3.45%, P = 0.13), and the central line bloodstream infection was in 5 patients and 6 patients (2.91% vs. 2.96 %, P = 0.98), respectively. Skin problems were 6 and 7 (3.49% vs. 3.45 %, P = 0.98). Port site infection happened in 6 patients in each group (3.49% vs. 2.96 %, P = 0.77). Conclusion Chemo-port implantation can be performed in OR or IR without difference in complication rates.

Phenylketonuria (PKU), an autosomal recessive genetic disorder, has been documented to exhibit over 950 distinct mutations. This condition primarily affects the metabolism of phenylalanine, which is affected by a deficiency in the hepatic enzyme phenylalanine hydroxylase. The optimal treatment for PKU disease remains to be determined, necessitating further research. The severity of the disease and the most effective treatment method vary depending on the specific mutation, which necessitates the development of personalized treatment strategies. In this study, we successfully established induced pluripotent stem cell (iPSC) lines from the blood of a PKU patient with the R243Q mutation via Sendai virus-based reprogramming (R243Q-iPSCs). The established R243Q-iPSCs exhibited characteristics of pluripotency, as confirmed through quantitative reverse transcription polymerase chain reaction, western blot, immunocytochemistry, and karyotype analysis. Furthermore, these iPSCs not only successfully differentiated into hepatocytes but also exhibited a complete PKU disease phenotype. These results provide a valuable foundation for PKU disease research, including physiological studies of PKU, gene therapy, drug screening, and the development of platforms for novel cell therapy approaches.

Purpose: Intensive cytotoxic chemotherapy increases the risk of infection in patients with cancer by inducing bone marrow suppression and mucosal injury. Febrile neutropenia (FN) is the most important clinical adverse event in patients with cancer receiving cytotoxic chemotherapy. To prevent FN, standard precautions including hand and respiratory hygiene are generally recommended, but the exact effect of non-pharmacologic intervention has not been clearly proven in the clinical setting. We aimed to compare the incidence of FN between the pre-coronavirus disease 19 (COVID-19) era vs. the postCOVID-19 era. Methods: We retrospectively enrolled patients with breast cancer who received an adriamycin and cyclophosphamide (AC) regimen containing adjuvant chemotherapy at Jeju National University Hospital. We compared the incidence of FN between the pre- and post-COVID-19 period and analyzed characteristics of the event and other clinical risk factors. Results: In total, 149 patients were enrolled, including 94 who received AC chemotherapy in the pre-COVID-19 era and 55 who received it in the post-COVID-19 era. Sixteen patients (10.7%) experienced FN. Fourteen (14.9%) and 2 events (3.6%) occurred in pre-COVID-19 and post-COVID-19 eras, respectively. The post-COVID-19 era was the only risk factor for FN (P = 0.032). Conclusion We found an association between FN occurrence and the COVID-19 outbreak, providing indirect evidence of the importance of non-pharmacological measures to reduce FN risk in patients with breast cancer. Further research is required to confirm the standard precautions for FN prevention in patients with cancer.

As in type 1 diabetes, the loss of pancreatic β-cells leads to insulin deficiency and the subsequent development of hyperglycemia. Exercise has been proposed as a viable remedy for hyperglycemia. Lithium, which has been used as a treatment for bipolar disorder, has also been shown to improve glucose homeostasis under the conditions of obesity and type 2 diabetes by enhancing the effects of exercise on the skeletal muscles. In this study, we demonstrated that unlike in obesity and type 2 diabetic conditions, under the condition of insulin-deficient type 1 diabetes, lithium administration attenuated pancreatic a-cell mass without altering insulin-secreting β-cell mass, implying a selective impact on glucagon production.Additionally, we also documented that lithium downregulated the hepatic gluconeogenic program by decreasing G6Pase protein levels and upregulating AMPK activity.These findings suggest that lithium’s effect on glucose metabolism in type 1 diabetes is mediated through a different mechanism than those associated with exerciseinduced metabolic changes in the muscle. Therefore, our research presents the novel therapeutic potential of lithium in the treatment of type 1 diabetes, which can be utilized along with insulin and independently of exercise.

Purpose: This scoping review aims to provide established basic data on the characteristics and the effects of rehabilitation nursing interventions for improving the daily living ability and motor functions of stroke patients with hemiplegia to suggest the future direction of rehabilitation nursing interventions. Methods: The study population, concept and context were as of the following: ‘patients with hemiplegia’, ‘improvement of daily living abilities and motor functions’, and ‘published literature on the effects of rehabilitation nursing interventions’. Databases including PubMed, Embase, CINAHL, Cochrane Library, and DBpia were searched. Results: A total of 14 articles published within the past 5 years were identified. This review summarizes 1) the general characteristics of the reviewed literature (authors, year of publication, research method, research subjects), 2) the characteristics of the identified rehabilitation nursing interventions (interventionist, intervention type, period, measurement tool), 3) the effects of the rehabilitation nursing interventions, and the academic and clinical implications. Conclusion This scoping review provides theoretical basis for the future development of rehabilitation nursing interventions for stroke patients with hemiplegia.

Ischemic stroke is a medical emergency that requires precise diagnosis and prompt treatment. Nonetheless, it is essential to evaluate alternative conditions, such as seizure, peripheral neuropathy and malignancy, with special attention to lymphoma due to its variable clinical manifestations, imaging features, and prognosis. In this report, we present a case of a patient who initially exhibited symptoms and radiological findings considered as lacunar stroke but was ultimately diagnosed with diffuse large B cell lymphoma.

Background: Brugada syndrome (BrS) and arrhythmogenic cardiomyopathy (ACM) are inherited cardiac diseases that may predispose to ventricular arrhythmia. Although overlapping features between BrS and ACM have been demonstrated previously, it remains to be determined whether genetic testing for ACM-related genes is needed in BrS probands.MethodBased on a single-center, retrospective registry of BrS, we aimed to verify genetic profiles of BrS using a next-generation sequencing panel, and further analyzed genetic testing of ACM-related variants in Brugada phenotypes. Results: Among a total of 119 Brugada phenotypes, 114 patients (95.8%) were male and the mean age of onset was 43.6 years. Genetic variants were identified in 25 of the 42 patients who underwent genetic testing. Fifteen patients had BrS-related genotypes, including SCN5A in 6 patients, and non-SCN5A genes in 9 patients (SCN10A, HCN4, SCN3B, and KCNE3). Nineteen patients underwent additional genetic testing with cardiomyopathy panel, which revealed ACM-related genotypes (2 PKP2, 1 DSG2, 1 TMEM43, 1 JUP, and 1 DSP) present in 6 patients (31.5%). None of the patients had structural or electrocardiographic features that fulfilled the diagnostic criteria for ACM. Conclusions In clinical setting, ACM-related genes were identified in a significant proportion of Brugada phenotypes, supporting the argument that genetic testing of ACM overlapping is needed. Follow-up imaging studies should be considered to monitor if the disease progresses to ACM.