Influence of folic acid knowledge on effective folic acid intake in Chinese pregnant women: a cross-sectional study.

PURPOSE: This study aimed to investigate the current status of effective folic acid intake and the level of folic acid knowledge of Chinese pregnant women and to analyze the relationship between effective folic acid intake and folic acid knowledge. METHODS: From November 2021 to May 2022, 140 pregnant women at Yantai Yuhuangding Hospital in the Chinese province of Shandong, answered questions about their general characteristics, folic acid intake, and folic acid knowledge. The data were analyzed using the t-test, chi-square test, and logistic regression analysis, and were presented with frequency with percentage or mean±standard deviation. RESULTS: Only 16.4% of the pregnant women (n=23) took folic acid effectively, using the following four criteria. Of all pregnant women who took folic acid, 72.2% took folic acid starting 1 month before pregnancy, 70.8% took folic acid up to 3 months after pregnancy, 36.8% took 400 µg every time, and 78.6% took folic acid more than 24 days every month. The score for folic acid knowledge was relatively high (5.61±2.18 on a scale of 0-9). A higher folic acid knowledge score correlated with more effective folic acid intake (t=4.10, p<.001). CONCLUSION: Our study shows that the current recommendations to prevent neural tube defects through effective folic acid intake supplementation are not being fully implemented in China. Furthermore, folic acid knowledge was positively correlated with the effectiveness of its intake. Future education related to effective folic acid intake should emphasize the four methods of effective folic acid intake, especially regarding the recommended dose of 400 µg every time.

Fluoroscopic criteria for on-site evaluation of failed intussusception reduction during air enema technique.

Background: There is no reliable fluoroscopic criteria for failed intussusception reduction during air enema technique. Methods: This retrospective case-control study included 373 episodes of ileocolic intussusceptions who had undergone air enema under fluoroscopy. All procedures were initially classified by conventional fluoroscopic criteria: presumptive successful procedures (PSP) vs. presumptive failed procedures (PFP). PFP were divided into true failure, false failure, and undetermined groups. The configuration and size of the residual mass were evaluated on fluoroscopic images. Statistical analyses included Mann-Whitney U-test, Fisher's exact test, receiver operating characteristic (ROC) analysis, logistic regression analyses, and Kruskal-Wallis rank sum test with a post hoc Tukey test. Results: PSP was 264 episodes (71%) and PFP was 109 episodes (29%). The true failure was 40 (37%) and false failure was 48 (44%). The true failure group commonly showed a larger size and round configuration for the residual mass than false failure (P<0.001). Multivariable analysis revealed configuration (P=0.004) and transverse diameter (P=0.007) as significant parameters that differentiated true and false failure. The optimal cut-off value of the transverse diameter of the residual mass was 2.3 cm. The sensitivity and specificity of conventional fluoroscopic criteria for failed reduction was 100% and 85%, respectively. The combination of new fluoroscopic findings and conventional criteria increased the specificity to 100%. Conclusions: Fluoroscopic finding of round-shape and larger size residual mass combined with conventional criteria may be useful for differentiating false failure from truly failed enema reduction in children with intussusception.

Selenium Nanoparticles as Candidates for Antibacterial Substitutes and Supplements against Multidrug-Resistant Bacteria.

In recent years, multidrug-resistant (MDR) bacteria have increased rapidly, representing a major threat to human health. This problem has created an urgent need to identify alternatives for the treatment of MDR bacteria. The aim of this study was to identify the antibacterial activity of selenium nanoparticles (SeNPs) and selenium nanowires (SeNWs) against MDR bacteria and assess the potential synergistic effects when combined with a conventional antibiotic (linezolid). SeNPs and SeNWs were characterized by transmission electron microscopy (TEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), zeta potential, and UV-visible analysis. The antibacterial effects of SeNPs and SeNWs were confirmed by the macro-dilution minimum inhibitory concentration (MIC) test. SeNPs showed MIC values against methicillin-sensitive S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), vancomycin-resistant S. aureus (VRSA), and vancomycin-resistant enterococci (VRE) at concentrations of 20, 80, 320, and >320 µg/mL, respectively. On the other hand, SeNWs showed a MIC value of >320 µg/mL against all tested bacteria. Therefore, MSSA, MRSA, and VRSA were selected for the bacteria to be tested, and SeNPs were selected as the antimicrobial agent for the following experiments. In the time-kill assay, SeNPs at a concentration of 4X MIC (80 and 320 µg/mL) showed bactericidal effects against MSSA and MRSA, respectively. At a concentration of 2X MIC (40 and 160 µg/mL), SeNPs showed bacteriostatic effects against MSSA and bactericidal effects against MRSA, respectively. In the synergy test, SeNPs showed a synergistic effect with linezolid (LZD) through protein degradation against MSSA and MRSA. In conclusion, these results suggest that SeNPs can be candidates for antibacterial substitutes and supplements against MDR bacteria for topical use, such as dressings. However, for use in clinical situations, additional experiments such as toxicity and synergistic mechanism tests of SeNPs are needed.

Status of Four Trace Elements in Elderly Patients with Online Hemodiafiltration.

BACKGROUND: Essential trace elements play key roles in multiple biological systems, and hemodialysis patients are at risk for deficiency of essential trace elements. The aim of the study was to assess the essential element status in end stage renal disease patients undergoing online hemodiafiltration (online HDF) in outpatient dialysis clinic. METHODS: A total of 28 Korean patients with regular online HDF were included. Blood samples were collected before and after one HDF session, and serum concentrations of zinc, copper, selenium, and manganese were simulta-neously measured by inductively coupled plasma mass spectrometry. RESULTS: Selenium, zinc, copper deficiencies were observed in 71.4%, 35.8%, and 21.4%, compared with the reference range. No patients revealed manganese deficiency. After the HDF, the post-HDF level significantly increased in all trace elements, compared with the pre-HDF (11.2% for selenium, 10.7% for copper, and 6.6% for zinc). However, 50% patients were still deficient for selenium at the post-HDF. CONCLUSIONS: Our data suggest that the patients undergoing online HDF are at an increased risk of trace element deficiency, especially for selenium.

Grapefruit Seed Extract as a Natural Derived Antibacterial Substance against Multidrug-Resistant Bacteria.

Multidrug-resistant (MDR) bacteria are increasing due to the abuse and misuse of antibiotics, and nosocomial infections by MDR bacteria are also increasing. The aim of this study was to identify new substances that can target MDR bacteria among 12 plant extracts that are known to have antibacterial effects. The experiments were performed by the disk diffusion test and microdilution minimum inhibitory concentration (MIC) test, as described by the Clinical and Laboratory Standards Institute (CLSI). By screening against methicillin-sensitive Staphylococcus aureus (MSSA), grapefruit seed extract (GSE) was selected from 12 plant extracts for subsequent experiments. GSE showed antibacterial effects against methicillin-resistant S. aureus (MRSA) and vancomycin-resistant S. aureus (VRSA) in the disk diffusion test. Even at the lowest concentration, GSE showed antibacterial activity in the microdilution MIC test. As a result, we can conclude that GSE is a naturally derived antibacterial substance that exhibits a favorable antibacterial effect even at a very low concentration, so it is a good candidate for a natural substance that can be used to prevent or reduce nosocomial infections as coating for materials used in medical contexts or by mixing a small amount with other materials.

Resolution of Pulmonary Cement Embolism After Treatment of Rivaroxaban on Ventilation/Perfusion SPECT Image.

ABSTRACT: A 73-year-old woman took a chest radiography for medical check-up, and pulmonary cement embolism was diagnosed. She had undergone percutaneous vertebroplasty. Ventilation-perfusion imaging revealed V/Q mismatched perfusion defect on the lung. Then, she has taken rivaroxaban (orally active direct factor Xa inhibitor) for 6 months and took follow-up V/Q scan. It revealed the disappearance of previous 2 of 3 moderate V/Q mismatches. There are controversies in the role of anticoagulation in treatment of pulmonary cement embolism, and this case shows functional recovery through the perfusion scan after anticoagulation treatment.

Nanoscale Calcium Salt-Based Formulations As Potential Therapeutics for Osteoporosis.

Osteoporosis causes severe bone damage, posing potential risks to human health, patient quality of life, and society. Calcium has been widely shown to enhance bone density and prevent osteoporosis-related bone fractures. Here, we focused on calcium salt formulations containing natural substances and their possible therapeutic effects on osteoporosis. In particular, we developed a nanoscale calcium salt of natural origin and formulated nanocomposite tablets supplemented with vitamin D (Vit D), herb Rhodiola rosea (R. rosea) and natural mineral Shilajit that are known to be antiosteoporotic. The calcium salt nanocomposites exhibited no toxicity, and particularly the formulation containing R. rosea stimulated osteogenic differentiation. The calcium salt nanocomposites inhibited osteoclastic activity, including RANKL expression, as shown by a decrease in tartrate-resistant acid phosphatase (TRAP)-positive cells. When administered orally to osteoporotic rats for 45 days, the calcium salt nanocomposites reduced bone resorption, as evidenced by the significantly higher bone volume and density, increase in osteoblasts and decrease in osteoclasts compared to those in nontreated control rats. Systemic administration of the nanocomposites caused no severe stomach toxicity or damage over the test period, during which no renal stone growth was observed. On the basis of their significant bilateral effects in stimulating osteoblasts and inhibiting osteoclasts and the resultant efficacy in an osteoporotic model, the nanocomposite tablets composed of a calcium salt and natural products can be considered novel nanotherapeutics for osteoporosis treatment.

Prenatal nursing intervention studies published in Korean nursing journals: a scoping review.

The purpose of this study was to describe prenatal nursing intervention studies on pregnant women and their families published in Korean nursing journals to identify research trends and to analyze the characteristics of intervention studies. This scoping review was conducted using Arksey and O'Malley's framework. We identified a research question and searched six domestic electronic databases for relevant articles. Forty-five references that met the inclusion and exclusion criteria were finally selected. We extracted the data using an analytic framework, and then collated and summarized the characteristics of the intervention studies. The most frequently used research designs were non-randomized controlled trials (91.1%), and only a few studies applied a specific theoretical framework (24.4%). The participants were mainly pregnant women only (64.4%) during the third trimester (35.6%) of pregnancy. Prenatal education was the most common type of intervention (48.9%), followed by complementary therapy (37.8%) and psychosocial support programs (13.3%). The most commonly used outcome variables were drawn from the psychological domain (44.5%), although distinct types of outcome variables-especially from the psychological and physical domains-were used to measure the effectiveness of different types of prenatal interventions. This review suggests that further prenatal nursing intervention studies in Korea should expand the study participants to include pregnant women's family members, high-risk and vulnerable groups, and women throughout entire pregnancy. Furthermore, it is necessary to develop integrative prenatal nursing interventions that promote family support and participation by facilitating partnerships among women, families, and nurses before, during, and after pregnancy.

Label-Free Fluorescent Mesoporous Bioglass for Drug Delivery, Optical Triple-Mode Imaging, and Photothermal/Photodynamic Synergistic Cancer Therapy.

Nanomaterials combined with phototherapy and multimodal imaging are promising for cancer theranostics. Our aim is to develop fluorescent mesoporous bioglass nanoparticles (fBGn) based on carbon dots (CD) with delivery, triple-mode imaging, and photothermal (PTT) properties for cancer theranostics. A direct and label-free approach was used to prepare multicolor fluorescent fBGn with 3-aminopropyl triethoxysilane as the surface-functionalizing agent. The calcination at 400 °C provided fBGn with high fluorescence intensity originating from the CD. In particular, a triple-mode emission [fluorescence imaging, two-photon (TP), and Raman imaging] was observed which depended on CD nature and surface properties such as surface oxidation edge state, amorphous region, nitrogen passivation of surface state, and crystalline region. The fBGn also exhibited phototherapeutic properties such as photodynamic (PDT) and PTT effects. The antitumor effect of the combined PDT/PTT therapy was significantly higher than that of individual (PDT or PTT) therapy. The fBGn, due to the mesoporous structure, the anticancer drug doxorubicin could be loaded and released in a pH-dependent way to show chemotherapy effects on cancer cells. The in vivo imaging and biocompatibility of fBGn were also demonstrated in a nude mouse model. The fBGn, with the combined capacity of anticancer delivery, triple-mode imaging, and PTT/PDT therapy, are considered to be potentially useful for cancer theranostics.

Curcumin in tissue engineering: A traditional remedy for modern medicine.

Curcumin is the principal polyphenolic compound present in turmeric with broad applications in tissue engineering and regenerative medicine. It has some important inherent properties with the potential to facilitate tissue healing, including anti-inflammatory, anti-oxidant, and antibacterial activities. Therefore, curcumin has been used for the treatment of various damaged tissues, especially wound injuries. There are different forms of curcumin, among which nano-formulations are of a great importance in regenerative medicine. It is also important to design sophisticated delivery systems for controlled/localized delivery of curcumin to the target tissues and organs. Although there are many reports on the advantages of this compound, further research is required to fully explore its clinical usage. The review describes the physicochemical and biological properties of curcumin and the current state of the evidence on its applications in tissue engineering. © 2018 BioFactors, 45(2):135-151, 2019.

Inhibitory effect of traditional Korean medicine on the recurrent endometriosis after laparoscopic excision: a case report.

Endometriosis is a common benign gynecologic tumor, and it can destroy a patient's life. Surgery and hormone therapy are established therapies for endometriosis. However, there are many cases of recurrent endometriosis after conventional therapies. This report presents a case of a patient who has repetitive recurrence of endometriosis after laparoscopic excision and hormone therapy. A 32-years-old female patient first had laparoscopic surgery to remove endometriosis in 2011. The disease recurred two more times after the first excision. Hormone therapy by dienogest and two more laparoscopic surgeries were done in 2012 and 2014. With acupuncture, moxibustion, fumigation therapy, and herbal medicine therapy, endometriosis didn't recur during treatment and observation period of 34 months. Menstrual pain numeric rating scales (NRS) decreased from 2 to none. Shortened menstrual cycle (24 days) after second surgery became longer (26.63 ± 2.28 days) after traditional Korean medicine therapy. This case presents the therapeutic potential of TKM for inhibitory effect on the recurrent endometriosis after laparoscopic excision and hormone therapy.

A Systematic Review on Sasang Constitutional Type-Associated Susceptibility to Disorders in Korea.

BACKGROUND/OBJECTIVE: Sasang constitutional medicine is a component of traditional Korean medicine that classifies individuals into four Sasang constitutional types (SCTs) by their physical and psychological traits. Each SCT is known to show different susceptibilities to disorders. This systematic review investigated the effect of SCT as a risk factor for various disorders. METHODS: A systematic literature survey was conducted by searching seven databases for all articles on the prevalence rates of disorders according to SCT and sex. RESULTS: From 14,272 relevant articles, 15 studies (13 disorders) were ultimately identified to verify different prevalence rates by SCT. Of the 13 disorders, 6 (prehypertension, general obesity, abdominal obesity, metabolic syndrome, diabetes mellitus, and irritable bowel syndrome [IBS]) had a significantly different prevalence by SCT. Metabolic syndrome and its associated disorders showed the highest prevalence in Taeumin-type individuals, whereas IBS was most prevalent in Soeumin-type individuals. In general, these findings were consistent with the results obtained in an analysis of male and female participants. CONCLUSIONS: This study revealed that susceptibility to disorders was affected by SCT to some extent. Further studies are needed to determine the concrete features of SCT-related susceptibility, which may be helpful in preventive medicine with Sasang constitutional practice.

Systematic review on herb-induced liver injury in Korea.

Herbal drugs are generally regarded as safe due to their extensive clinical use especially in East Asian countries. However, the potential toxicity of herbal drugs has become an important medical issue recently, resulting in numerous reports of drug-induced liver injury (DILI). Here, we performed a systematic review of herbal medicines with the potential to cause hepatotoxicity in Korea. A literature search of six databases, including PubMed and five Korean electronic databases, was performed to identify cases of herb-induced liver injury (HILI) in Korea, yielding 31 unique reports, including 21 single herb and 10 multi-herb preparations. From these reports, we identified 97 cases of HILI (47 males, 49 females, and 1 unknown sex) consisting of 74.7% hepatocellular-type injury, 10.8% cholestatic-type injury, and 14.5% mixed-type injury. Causative agents included 21 unique herbal preparations, including 11 single species and 10 multispecies, with Polygoni Multiflori (39.2%) and Dictamnus dasycarpus (37.1%) as the most frequent agents. These analyses presented a feature of HILI, and produced a comprehensive list of herbs with a higher risk of hepatotoxicity in Korea. Further studies will be necessary to ascertain the mechanisms by which these herbs induce HILI and to determine whether these effects are specific to the Korean population.

Enabling consistency in pluripotent stem cell-derived products for research and development and clinical applications through material standards.

There is a need for physical standards (reference materials) to ensure both reproducibility and consistency in the production of somatic cell types from human pluripotent stem cell (hPSC) sources. We have outlined the need for reference materials (RMs) in relation to the unique properties and concerns surrounding hPSC-derived products and suggest in-house approaches to RM generation relevant to basic research, drug screening, and therapeutic applications. hPSCs have an unparalleled potential as a source of somatic cells for drug screening, disease modeling, and therapeutic application. Undefined variation and product variability after differentiation to the lineage or cell type of interest impede efficient translation and can obscure the evaluation of clinical safety and efficacy. Moreover, in the absence of a consistent population, data generated from in vitro studies could be unreliable and irreproducible. Efforts to devise approaches and tools that facilitate improved consistency of hPSC-derived products, both as development tools and therapeutic products, will aid translation. Standards exist in both written and physical form; however, because many unknown factors persist in the field, premature written standards could inhibit rather than promote innovation and translation. We focused on the derivation of physical standard RMs. We outline the need for RMs and assess the approaches to in-house RM generation for hPSC-derived products, a critical tool for the analysis and control of product variation that can be applied by researchers and developers. We then explore potential routes for the generation of RMs, including both cellular and noncellular materials and novel methods that might provide valuable tools to measure and account for variation. Multiparametric techniques to identify "signatures" for therapeutically relevant cell types, such as neurons and cardiomyocytes that can be derived from hPSCs, would be of significant utility, although physical RMs will be required for clinical purposes.

Angiogenesis in bone regeneration: tailored calcium release in hybrid fibrous scaffolds.

In bone regeneration, silicon-based calcium phosphate glasses (Bioglasses) have been widely used since the 1970s. However, they dissolve very slowly because of their high amount of Si (SiO2 > 45%). Recently, our group has found that calcium ions released by the degradation of glasses in which the job of silicon is done by just 5% of TiO2 are effective angiogenic promoters, because of their stimulation of a cell-membrane calcium sensing receptor (CaSR). Based on this, other focused tests on angiogenesis have found that Bioglasses also have the potential to be angiogenic promoters even with high contents of silicon (80%); however, their slow degradation is still a problem, as the levels of silicon cannot be decreased any lower than 45%. In this work, we propose a new generation of hybrid organically modified glasses, ormoglasses, that enable the levels of silicon to be reduced, therefore speeding up the degradation process. Using electrospinning as a faithful way to mimic the extracellular matrix (ECM), we successfully produced hybrid fibrous mats with three different contents of Si (40, 52, and 70%), and thus three different calcium ion release rates, using an ormoglass-polycaprolactone blend approach. These mats offered a good platform to evaluate different calcium release rates as osteogenic promoters in an in vivo subcutaneous environment. Complementary data were collected to complement Ca(2+) release analysis, such as stiffness evaluation by AFM, ζ-potential, morphology evaluation by FESEM, proliferation and differentiation analysis, as well as in vivo subcutaneous implantations. Material and biological characterization suggested that compositions of organic/inorganic hybrid materials with a Si content equivalent to 40%, which were also those that released more calcium, were osteogenic. They also showed a greater ability to form blood vessels. These results suggest that Si-based ormoglasses can be considered an efficient tool for calcium release modulation, which could play a key role in the angiogenic promoting process.

Effect of parotid gland massage on parotid gland Tc-99m pertechnetate uptake.

BACKGROUND: Salivary dysfunction is the most common side effect associated with (131)I therapy in patients with differentiated thyroid cancer. The purpose of this study was to evaluate the effect of parotid gland (PG) massage on radioisotope accumulation in the salivary gland. METHODS: Sixty patients were included in this study. Using Tc-99m pertechnetate, two salivary scans were performed in all patients. In 30 patients, PG massage was performed between the two salivary gland scans, whereas in the other 30 patients no massage was performed between the two scans. Total counts of both PGs and accumulation ratios were calculated. RESULTS: In the patients who received massage, no difference was observed between the mean PG counts of first and second images (8556.9±3333.4 count vs. 8598.3±3341.3 count, p=0.39). In the patients who did not receive massage, the mean PG count on second images was significantly higher than that on first images (8581.2±3618.0 count vs. 9096.4±3654.0 count, p<0.01). Mean accumulation ratio in the patients who received massage was significantly lower than in the patients who did not receive massage (0.5%±3.3% vs. 6.8%±3.8%, p<0.01). Further, among the patients who received massage there was a higher percentage of patients with a negative accumulation ratio than among the patients who did not receive massage (43.3% vs. 0%, p<0.01). CONCLUSIONS: PG massage can reduce Tc-99m pertechnetate accumulation in the PG, and thus, should be helpful to prevent salivary damage associated with (131)I therapy.

Nanofiber of ultra-structured aluminum and zirconium oxide hybrid.

An internally ultrastructured Al- and Zr-oxide hybrid was developed into a nanofiber. As a precursor for the generation of nanofiber, a hybridized sol was prepared using the Pechini-type sol-gel process, whereby the Al- and Zr-metallic ions were to be efficiently distributed and stabilized within the polymeric network. The hybridized sol was subsequently electrospun and heat treated to a nanofiber with diameters of tens to hundreds of nanometers. The internal structure of the nanofiber was organized at the molecular level, with the Al- and Zr-oxide regions being interspaced at distances of less than ten nanometers. This ultrastructured Al- and Zr-oxide hybrid nanofiber is considered to be potentially applicable in numerous fields.

Improvement in biocompatibility of ZrO2-Al2O3 nano-composite by addition of HA.

The biocompatibility of zirconia-alumina (ZA) nano-composites in load-bearing applications such as dental/orthopedic implants was significantly enhanced by the addition of bioactive HA. The ZA matrix was composed of nano-composite powder obtained from the Pechini process and had higher flexural strength than conventionally mixed zirconia-alumina composite. Because the ZA nano-composite powder effectively decreased the contact area between HA and zirconia for their reaction during the sintering process, the HA-added ZA nano-composites contained biphasic calcium phosphates (BCP) of HA/TCP and had higher flexural strength than conventionally mixed ZA-HA composite. From the in vitro test with osteoblastic cell-lines, the proliferation and the differentiation (as expressed by the alkaline phosphatase activity) of the cellular response on the HA-added ZA nano-composites gradually increased as the amount of HA added increased. From the mechanical and biological evaluations of the HA-added ZA nano-composites, 30HA (30 vol% HA + 70 vol% ZA) was found to be the optimal composition for load-bearing biological applications.

Effects of methyl methacrylate on Ca2+ uptake of cardiac sarcoplasmic reticulum.

In isolated cardiac sarcoplasmic reticulum (SR) vesicles, methyl methacrylate (2.5-100mM) directly inhibited initial rates of Ca2+ uptake as well as the maximal uptake. Inhibition of SR Ca2+ uptake by methyl methacrylate was concentration-dependent, and the highest concentration of methyl methacrylate (100mM) almost completely inhibited the SR Ca2+ uptake. EC(50) of methyl methacrylate in percent inhibition of SR Ca2+ uptake was 16.1, 31.9, and 53.4mM at pCa 7.0, 6.6, and 6.0, respectively. At low Ca2+ concentrations (0.1-1 microM), SR vesicles treated with 20mM methyl methacrylate showed the decreased Ca2+ uptake rates. However, further increase of Ca2+ concentration to pCa 5.5 abolished the inhibitory effect of methyl methacrylate on SR Ca2+ uptake, showing no difference between the control and the methyl methacrylate-treated SR vesicles. From these results we could conclude that methyl methacrylate exerts a direct inhibition of cardiac SR Ca2+ uptake. This mechanism, at least in part, might contribute to the profound hypotension induced by methyl methacrylate. Supplementation of calcium ion appears to reduce the methyl methacrylate-induced cardiovascular disturbances efficiently.