Population pharmacokinetics of intravenous sufentanil in critically ill patients supported with extracorporeal membrane oxygenation therapy.

Background: Sufentanil is commonly used for analgesia and sedation during extracorporeal membrane oxygenation (ECMO). Both ECMO and the pathophysiological changes derived from critical illness have significant effects on the pharmacokinetics (PK) of drugs, yet reports of ECMO and sufentanil PK are scarce. Here, we aimed to develop a population PK model of sufentanil in ECMO patients and to suggest dosing recommendations.

FEL performance achieved at PAL-XFEL using a three-chicane bunch compression scheme.

PAL-XFEL utilizes a three-chicane bunch compression (3-BC) scheme (the very first of its kind in operation) for free-electron laser (FEL) operation. The addition of a third bunch compressor allows for more effective mitigation of coherent synchrotron radiation during bunch compression and an increased flexibility of system configuration. Start-to-end simulations of the effects of radiofrequency jitter on the electron beam performance show that using the 3-BC scheme leads to better performance compared with the two-chicane bunch compression scheme.

Hard X-ray self-seeding commissioning at PAL-XFEL.

A wake monochromator based on a large-area diamond single crystal for hard X-ray self-seeding has been successfully installed and commissioned in the hard X-ray free-electron laser (FEL) at the Pohang Accelerator Laboratory with international collaboration. For this commissioning, the self-seeding was demonstrated with a low bunch charge (40 pC) and the nominal bunch charge (180 pC) of self-amplified spontaneous emission (SASE) operation. The FEL pulse lengths were estimated as 7 fs and 29.

Chronic Pain: Structural and Functional Changes in Brain Structures and Associated Negative Affective States.

Chronic pain is a condition in which pain progresses from an acute to chronic state and persists beyond the healing process. Chronic pain impairs function and decreases patients' quality of life. In recent years, efforts have been made to deepen our understanding of chronic pain and to develop better treatments to alleviate chronic pain.

Development and clinical applications of the dried blood spot method for therapeutic drug monitoring of anti-epileptic drugs.

Anti-epileptic drugs (AEDs) have various pharmacokinetic profiles, inter-individual variabilities, high possibilities of drug-drug interactions and narrow therapeutic indices. To provide optimal treatment for patients, therapeutic drug monitoring (TDM) is necessary. However, TDM requires sufficient quantities of blood samples to measure drug concentrations.

Comparison of acute kidney injury and clinical prognosis of vancomycin monotherapy and combination therapy with beta-lactams in the intensive care unit.

Antibiotics induced acute kidney injury (AKI) risk in critically ill patients is not well known. This study aimed to evaluate the AKI development and clinical outcomes in critically ill adult patients treated with vancomycin (VAN) or combined with piperacillin-tazobactam (TZP) or meropenem (MEM). This was a retrospective study on critically ill adult patients who were given VAN, TZP or MEM and maintained for at least 48 h.

Management of neuropathic pain induced by cubital tunnel syndrome using pulsed radiofrequency: Two case reports.

Rationale: Recently, pulsed radiofrequency (PRF) has been applied to alleviate neuropathic pain caused by various peripheral nerve pathologies. This report describes and discusses the cases of 2 patients with cubital tunnel syndrome who responded well to PRF for the management of neuropathic pain.

Patient Concerns: Patients 1 and 2 presented with numeric rating scale (NRS) scores of 4 and 3 for neuropathic pain due to right cubital tunnel syndrome, respectively.

Crystal structure of the multifunctional SAM-dependent enzyme LepI provides insights into its catalytic mechanism.

Pericyclic reactions are among the most powerful synthetic transformations widely applied in the synthesis of multiple regioselective and stereoselective carbon-carbon bonds. LepI is a recently identified S-adenosyl-l-methionine (SAM)-dependent enzyme, which could catalyze dehydration, Diels-Alder reaction, and the retro-Claisen rearrangement reactions. However, the mechanism underlying these reactions by LepI remains elusive.

Development and validation of the Korean version of the medication regimen complexity index.

The medication regimen complexity index (MRCI), originally developed in English, is a reliable and valid tool to assess the complexity of pharmacotherapy. This study aimed to validate the Korean version of MRCI (MRCI-K). A cross-cultural methodological study comprising 335 discharged patients of a tertiary hospital in Korea was conducted.

Laser systems for time-resolved experiments at the Pohang Accelerator Laboratory X-ray Free-Electron Laser beamlines.

Optical laser systems for ultrafast X-ray sciences have been established at the Pohang Accelerator Laboratory X-ray Free-Electron Laser (PAL-XFEL) beamlines. Three Ti:sapphire regenerative amplifier systems are synchronized to the XFEL with femtosecond precision, and the low temporal jitter of the PAL-XFEL results in an experimental time resolution below 150 fs (full width at half-maximum). A fundamental wave and its harmonics are currently provided for all beamlines, and tunable sources from ultraviolet to near-infrared are available for one beamline.

Clobazam as an adjunctive treatment for infantile spasms.

Infantile spasms constitute a catastrophic epileptic condition. Seizures in approximately half of children with infantile spasms fail to improve with initial treatment attempts; at present, data regarding alternative treatments are limited. We assessed the efficacy of clobazam as an adjunctive therapy in patients whose seizures failed to respond to initial regimens of standard treatment for infantile spasms.

Nociceptin impairs acquisition of novel object recognition memory in perirhinal cortex.

Nociceptin/Orphanin FQ (N/OFQ) plays an important role in the regulation of spatial, fear and recognition memories. N/OFQ receptors are highly distributed in the perirhinal cortex, which is a key brain area involved in modulating novel object recognition (NOR) memory. However, the role of N/OFQ in NOR memory in the perirhinal cortex was still unknown.

Deterioration of Brain Neural Tracts in Elderly Women with Sarcopenia.

Objectives: Sarcopenia is known to be associated with increased stiffness in brain arteries, which causes deterioration in brain structure and function. In this study, the authors evaluated the deterioration of neural tracts using diffusion tensor tractography (DTT) in elderly women with sarcopenia and investigated whether deterioration of neural tracts is consistent with clinical findings.

Methods: Twenty elderly women with sarcopenia were recruited.

Effects of Diabetes on Motor Recovery After Cerebral Infarct: A Diffusion Tensor Imaging Study.

Objective: Little is known about the effects of diabetes on motor recovery after cerebral infarct. To address this question, we recruited patients with corona radiata infarct and controlled for the integrity of the corticospinal tract (CST) as determined by diffusion tensor tractography (DTT).

Design: One hundred patients were recruited, and DTT was performed within 7 to 30 days of infarct onset.

Takotsubo cardiomyopathy associated with serotonin syndrome in a patient with stroke: A case report.

Rationale: Takotsubo cardiomyopathy (TC) is characterized by transient left ventricular dysfunction. We describe a patient with stroke who presented with TC caused by serotonin syndrome (SS) following the administration of serotonergic and dopaminergic agents.

Patient Concerns: A 55-year-old man with stroke was administered venlafaxine, tianeptine, ropinirole, carbidopa/levodopa, bromocriptine, and methylphenidate during rehabilitation.

Bacterial meningitis and cauda equina syndrome after trans-sacral epiduroscopic laser decompression: A case report.

Rationale: Trans-sacral epiduroscopic laser decompression (SELD) is a noninvasive pain-relieving procedure for treatment of herniated lumbar disc (HLD), and is known to have positive effects in alleviating lower back pain or radicular leg pain after HLD. However, little is known about the possible complications of SELD.

Patient Concerns: A 51-year-old woman received SELD with a holmium:yttrium-aluminum-garnet laser for controlling radicular pain due to HLD on L5-S1.

Utilization patterns of insulin for patients with type 2 diabetes from national health insurance claims data in South Korea.

Type 2 diabetes mellitus (T2DM) is a chronic disease that requires long-term therapy and regular check-ups to prevent complications. In this study, insurance claim data from the National Health Insurance Service (NHIS) of Korea were used to investigate insulin use in T2DM patients according to the economic status of patients and their access to primary physicians, operationally defined as the frequently used medical care providers at the time of T2DM diagnosis. A total of 91,810 participants were included from the NHIS claims database for the period between 2002 and 2013.

Early treadmill exercise increases macrophage migration inhibitory factor expression after cerebral ischemia/reperfusion.

The neuroprotective function of macrophage migration inhibitory factor (MIF) in ischemic stroke was rarely evaluated. This study aimed to investigate the effects of early treadmill exercise on recovery from ischemic stroke and to determine whether these effects are associated with the expression levels of MIF and brain-derived neurotrophic factor (BDNF) in the ischemic area. A total of 40 male Sprague-Dawley rats were randomly assigned to the ischemia and exercise group [middle cerebral artery occlusion (MCAO)-Ex, n = 10), ischemia and sedentary group (MCAO-St, n = 10), sham-surgery and exercise group (Sham-Ex, n = 10), or sham-surgery and sedentary group (Sham-St, n = 10).

Clinical Outcomes of Zone 2 Flexor Tendon Repairs Using the Modified Lim/Tsai Technique.

Background: The single looped suture modified Lim/Tsai technique is widely used for flexor tendon repairs. It has been shown to possess better biomechanical properties and require less repair time per tendon as compared to the double looped suture original Lim/Tsai technique. However, there is no clinical data on the modified technique.

Acute ulnar nerve compression associated with pisiform fracture - a case report and literature review.

We evaluated a case of pisiform fracture with ulnar nerve compression managed with pisiformectomy. At 11 months' follow-up, the patient regained range of motion of the wrist and grip strength with no subjective loss of function and normal nerve conduction study. We compared other treatment modalities and reviewed their outcomes.

A review of cyclic testing protocols for flexor tendon repairs.

Background: Cyclic testing of flexor tendons aims to simulate post-operative rehabilitation and is more rigorous than static testing. However, there are many different protocols, making comparisons difficult. We reviewed these protocols and suggested two protocols that simulate passive and active mobilization.

Oral ixazomib maintenance following autologous stem cell transplantation (TOURMALINE-MM3): a double-blind, randomised, placebo-controlled phase 3 trial.

Background: Maintenance therapy following autologous stem cell transplantation (ASCT) can delay disease progression and prolong survival in patients with multiple myeloma. Ixazomib is ideally suited for maintenance therapy given its convenient once-weekly oral dosing and low toxicity profile. In this study, we aimed to determine the safety and efficacy of ixazomib as maintenance therapy following ASCT.