Inflammation is a common link in the pathophysiology of many neurological illnesses, including Alzheimer’s disease. Activated glial cells contribute to neuroinflammation by producing pro-inflammatory mediators. Naproxen and ibuprofen are nonsteroidal anti-inflammatory drugs with 2-aryl(s) propionic acid as a common pharmacophore. Here we designed a small series of naproxen and ibuprofen amide dimers and tested their effects on the expression of inducible nitric oxide synthase (iNOS), a neuroinflammatory enzyme in lipopolysaccharide (LPS)-stimulated BV2 mouse microglial cells. Of note, treatment with CNU 019, 020, 021, 023, 024, and 027 at 10 M markedly inhibited the LPS-induced iNOS expression in BV2 cells. CNU 024 was tested further at different concentrations to regulate the LPS-induced iNOS expression in BV2 cells. Treatment with CNU 024 at 5, 10, or 20 M dose-dependently suppressed the LPS-induced iNOS protein and mRNA expression levels in BV2 cells, in which maximal inhibition was seen at 20 M. CNU 024 treatment at doses tested further led to a concentration-dependent inhibition of the LPS-induced phosphorylation (activation) of p38 mitogen-activated protein kinase (MAPK) without influencing its total protein expression in BV2 cells, but it did not affect the LPS-induced activation of c-jun N-terminal kinase-1/2 and extracellular signal-regulated kinases-1/2 in these cells. In summary, our results demonstrate that CNU 024 inhibits the LPS-induced iNOS expression in BV2 cells, partly mediated by the inhibition of p38 MAPK. This work shows that CNU 024 could be a valuable ligand for further development as a potential drug candidate for treating neuroinflammatory pathologies.

Background: The number of aging physicians is increasing as the global population ages. With aging, anesthesiologists would be expected to experience changes in their professional position. Therefore, we aimed to investigate the current professional status of Korean anesthesiologists aged over 60 years. Methods: Registered anesthesiologists aged over 60 years in Korea were invited for a survey. The questionnaire addressed 10 subjects with 40 questions that focused on demographics, practical activities, work conditions, difficulties experienced due to physical changes caused by aging, and economic status. Results: In total, 122 anesthesiologists responded to the survey (response rate: 15.7%). Of them, 30.3% were working in honorary and advisory positions at tertiary hospitals, while 19.7% were working as pain physicians. Majority of the respondents were working for 5 days a week (41.8%) and 6–8 hours/day (48.4%). Majority of them (79.5%) were generally satisfied with their present life. Conclusions Majority of the senior anesthesiologists were working at general hospitals and they reported being “satisfied” with the current status of their life. However, the clinical practice and retirement strategies of senior anesthesiologists need to be evaluated systematically to prepare for the continuing gradual increase in the number of senior anesthesiologists.

Background: The number of aging physicians is increasing as the global population ages. With aging, anesthesiologists would be expected to experience changes in their professional position. Therefore, we aimed to investigate the current professional status of Korean anesthesiologists aged over 60 years. Methods: Registered anesthesiologists aged over 60 years in Korea were invited for a survey. The questionnaire addressed 10 subjects with 40 questions that focused on demographics, practical activities, work conditions, difficulties experienced due to physical changes caused by aging, and economic status. Results: In total, 122 anesthesiologists responded to the survey (response rate: 15.7%). Of them, 30.3% were working in honorary and advisory positions at tertiary hospitals, while 19.7% were working as pain physicians. Majority of the respondents were working for 5 days a week (41.8%) and 6–8 hours/day (48.4%). Majority of them (79.5%) were generally satisfied with their present life. Conclusions Majority of the senior anesthesiologists were working at general hospitals and they reported being “satisfied” with the current status of their life. However, the clinical practice and retirement strategies of senior anesthesiologists need to be evaluated systematically to prepare for the continuing gradual increase in the number of senior anesthesiologists.

BACKGROUNDS: Insufficient intermaxillary space is caused by non-restoration following tooth extraction in the past, and this involves eruption of the opposing teeth and changes of the arch structure. Such cases are difficult just by a simple prosthetic approach, and diversified treatment plans should be established. Among these, posterior maxillary segmental osteotomy (PMSO) is an efficient treatment option than extraction of opposing teeth as it surgically repositions multiple erupted teeth and alveolar bone. PMSO can preserve the natural teeth; therefore, it is being regarded as a treatment method which can improve insufficient intermaxillary space significantly. CASE PRESENTATION: In this case report, the first patient received PMSO in order to place an implant in the mandibular edentulous space after decreased vertical dimension is restored, and the second patient received PMSO along with orthodontic treatment to obtain the intermaxillary space and balance the interarch molar width. CONCLUSION: PMSO is the treatment of choice when occlusion is compromised in the presence of decreased vertical dimension or arch length discrepancy.
Humans ; Methods ; Molar ; Orthognathic Surgery ; Osteotomy* ; Tooth ; Tooth Extraction ; Vertical Dimension

PURPOSE: This study examined the effectiveness of a hand massage combined with analgesics on pain control in hospice patients with terminal cancer. METHODS: This study is a quasi-experimental study with a single group time series design. The study included 25 terminal cancer patients who were admitted to a hospice ward. Each patient’s pain level was measured after analgesics use only (control group). When patients complained of pain again, the pain level was assessed after administering a combination of hand massage and analgesics (experimental group). As for the experimental treatment, the participants were provided with oil hand massage on each hand for 5 minutes. RESULTS: The experimental group and the control group showed no significant differences in the changes of pain score (F=0.74, P=0.3939). CONCLUSION: Although the pain level of the experimental group did not significantly improve compared with the control group, their pain levels tended to be low to begin with. Thus, a complementary utility value of hand massage cannot be completely excluded in terminal cancer patients. Since the pain level significantly changed according to the dosage of analgesic, nurses need more education and research on analgesic drug therapy for terminal cancer patients.
Analgesics* ; Drug Therapy ; Education ; Hand* ; Hospice Care ; Hospices ; Humans ; Massage* ; Non-Randomized Controlled Trials as Topic

BACKGROUND: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. METHODS: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. RESULTS: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. CONCLUSION: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.
Classification ; Drug Therapy* ; Fee-for-Service Plans ; Fees and Charges ; Health Care Costs ; Hospitals, General ; Humans ; Information Systems ; Insurance ; Insurance Claim Review ; Insurance, Health ; Outpatients* ; Product Packaging ; Prospective Payment System ; Referral and Consultation

BACKGROUND: Although patients with a ruptured abdominal aortic aneurysm (RAAA) often reach the hospital alive, the perioperative mortality is still very high. We retrospectively reviewed thirty patients who underwent repair of RAAA to identify the factors affecting postoperative mortality in a single hospital. MATERIALS AND METHODS: Between September 2007 and May 2011, thirty patients with RAAA underwent emergent surgery (n=27) or endovascular aneurysm repair (n=3). Their medical records were retrospectively reviewed regarding three categories: 1) preoperative patient status: age, gender, vital signs, serum creatinine, blood urea nitrogen, hematocrit, and hemoglobin level: 2) aneurysmal status: size, type, and rupture status; and 3) operative factors: interval time to operating room, operative duration, and amount of perioperative transfusion. RESULTS: The 30-day postoperative mortality rate was 13.3% (4/30); later mortality was 3.3% (1/30). On multivariate analysis, the initial diastolic blood pressure (BP), interval time to operating room and amount of preoperative packed cell transfusion were statistically significantly linked with postoperative mortality (p<0.05). CONCLUSION: In this study, preoperative diastolic BP, preoperative packed cell transfusion amount and interval time between arrival and entry to operating room were significantly associated with postoperative mortality. It is important to prevent hemorrhage as quickly as possible.
Aneurysm ; Aortic Aneurysm, Abdominal ; Blood Pressure ; Blood Transfusion ; Blood Urea Nitrogen ; Creatinine ; Hematocrit ; Hemoglobins ; Hemorrhage ; Humans ; Medical Records ; Multivariate Analysis ; Operating Rooms ; Retrospective Studies ; Rupture ; Vital Signs

Intermediate filaments, including nestin and glial fibrillary acidic protein (GFAP), are important for the brain to accommodate neural activities and changes during development. The present study examined the temporal changes of nestin and GFAP protein levels in the postnatal development of the mouse hippocampus. Mouse hippocampi were sampled on postnatal day (PND) 1, 3, 6, 18, and 48. Western blot analysis showed that nestin expression was high at PND 1 and markedly decreased until PND 18. Conversely, GFAP expression was acutely increased in the early phase of postnatal development. Nestin immunoreactivity was localized mainly in the processes of ramified cells at PND 1, but expression subsequently decreased. In contrast, GFAP was evident mainly in the marginal cells of the hippocampus at PND 1, but immunoreactivity revealed satellite, radial, or ramified shapes of the cells from PND 6-48. This study demonstrates that the opposing pattern of nestin and GFAP expressions in mouse hippocampus during postnatal development occur in the early development stage (PND 1-18), suggesting that the opposing change of nestin and GFAP in early postnatal development is important for neural differentiation and positioning in the mouse hippocampus.
*Aging ; Animals ; Blotting, Western ; Brain/cytology/growth & development ; Female ; *Gene Expression Regulation, Developmental ; Glial Fibrillary Acidic Protein/genetics/*metabolism ; Hippocampus/cytology/*growth & development/*metabolism ; Immunohistochemistry ; Intermediate Filament Proteins/genetics/*metabolism ; Male ; Mice ; Mice, Inbred ICR ; Nerve Tissue Proteins/genetics/*metabolism ; Neurons/metabolism

BACKGROUND: Recently the cases of varicose veins are increasing because the patients with latent disease have come to realize that they want a positive treatment. Accordingly, the purpose of this study is to compare and analyze two methods the conventional phlebectomy (CP) and transiliuminated powered phlebectomy (TIPP). MATERIAL NAD METHOD: From March 2001 to December 2004, 114 patients (167 legs) with varicose vein were operated in Pusan National University Hospital. A retrospective review was performed on the clinical records. We analyzed age, sex, duration of illness, chief complaints, duplex doppler findings, number of skin incisions, operative time, length of hospitalization, complications, and remnant lesions. RESULT: Operative time was significantly shorter in the TIPP group than CP group (for one leg 108.4+/-27.6 min vs 83.4+/-24.4 min, for both legs 184.7+/-28.4 min vs 137.8+/-24.4 min). There was significant statistical difference in average number of skin incisions per leg between the CP group and the TIPP group (5.9+/-2.2 vs 4.2+/-1.6). Mean duration of hospitalization was significantly shorter in the TIPP group than CP group (4.4+/-1.0 days vs 5.8+/-1.9 days). Complications were pain (15.9%), remnant lesion (9.5%), and ecchymosis (4.8%) in the CP group and ecchymosis (19.6%), pain (7.8%), and remnant lesion (7.8%) in TIPP group. Sclerotherapy or reopertaion was done for the patients who had remnant lesions. CONCLUSION: Transilluminated powered phlebectomy in varicose vein could reduce operative time and number of skin incisions, and almost completely removed the multiple lesions. Although there were postoperative complications such as ecclymosis, they were absorbed within 2 months and patients were satisfied. Therefore, TIPP is a more effective operative technique than conventional phlebectomy in varicose veins.

A femoral artery aneurysm (FAA) is a rare disease with the symptoms of nerve and vein compression, lower extremity ischemia, local pain, pulsating mass, and rupture. Compression of the femoral vein may cause the symptoms of lower extremity venous insufficiency, which accounts for nearly 10% of FAA patients. (Case) A 55 year-old female was hospitalized, suffering from swelling, heaviness and venous ectasia of the left lower extremity. Preoperative CT angiography revealed a 3 cm-sized FAA and compression of the femoral vein due to the aneurysm in her left inguinal area. The aneurysm extended from the distal external iliac artery (EIA) to both the proximal superficial femoral artery (SFA) and profunda femoris artery (PFA). After an aneurysmectomy, interposition grafting from the EIA to the SFA with reimplantation of PFA was done. Immediately after the operation, the symptoms dramatically disappeared, and the follow-up CT revealed the decompressed femoral vein.
Aneurysm* ; Angiography ; Arteries ; Dilatation, Pathologic ; Female ; Femoral Artery* ; Femoral Vein ; Follow-Up Studies ; Humans ; Iliac Artery ; Ischemia ; Leg* ; Lower Extremity ; Middle Aged ; Rare Diseases ; Replantation ; Rupture ; Transplants ; Veins ; Venous Insufficiency