Concomitant Occurrence of Acute Motor Axonal Neuropathy in Systemic Lupus Erythematosus.

ABSTRACT: Few case reports exist on the association of acute motor axonal neuropathy, a subtype of the Guillain-Barré syndrome (GBS), with systemic lupus erythematosus. Standard therapeutic guidelines for concomitant acute motor axonal neuropathy and systemic lupus erythematosus in the acute phase are not established, and no studies have reported physical medicine and rehabilitation perspective management in the plateau and recovery phases. A 50-yr-old woman with systemic lupus erythematosus presented with upper and lower limb weakness that progressed to an inability to walk. Neurological examination, radiologic evaluation, serologic analysis, and electrodiagnostic study were conducted, and she was diagnosed with acute motor axonal neuropathy. Subsequently, intravenous immunoglobulin therapy was administered. She complained of residual upper and lower extremity weakness and an inability to walk 3 mos after symptom onset. She underwent an intensive inpatient rehabilitation program for 6 wks and showed remarkable recovery in muscle strength and functional status (Berg Balance Scale, modified Barthel index, and Guillain-Barré syndrome disability scale). To our knowledge, this is the first reported case that focused on the functional outcomes after the rehabilitation program in acute motor axonal neuropathy with a history of systemic lupus erythematosus. This case report emphasizes the need for rehabilitation intervention for functional recovery in the plateau and recovery phases.

Clinical impact and benefits of a simultaneous cardio-pulmonary rehabilitation in a COVID-19-infected patient following cardiac arrest: A case report.

Since the advent of the pandemic, cardio-pulmonary rehabilitation (CR) has been shown to be an effective treatment. However, there are no studies showing data to substantiate its simultaneous application. A 62-year-old man was resuscitated for asystole during the work-up after presenting with a 2-day history of difficulty breathing. PCR test was positive for COVID-19. He was intubated and admitted to a negative pressure zone. Symptoms improved in response to acute treatment. Following extubation, respiratory distress persisted, and CR was implemented. Clinical indicators of cardiopulmonary function improved resulting in a successful return to community participation. The decline in cardiopulmonary function has been on the rise among COVID-19 survivors. The simultaneous application of CR treatment in our patient resulted in improved clinical indicators of cardiopulmonary function. The patient regained full function for independent community participation.

Synthesis and formation mechanism of bone mineral, whitlockite nanocrystals in tri-solvent system.

Whitlockite (WH, Ca18Mg2(HPO4)2(PO4)12) is the second most abundant bone mineral and has attracted attention as one of the novel bone regenerative materials. It has proven to enhance growth and promote osteogenesis of stem cells. However, investigating the mechanism of formation of pure phase WH nanocrystals remains a challenge. In this study, we introduced an interesting synthesis approach of WH nanocrystals using a tri-solvent system for the solid-liquid-solution (SLS) process. The ratio of precursor and reaction solvent composition was optimized to generate WH nanocrystals with tunable size, morphology (nanoplates, nanospheres), and surface properties (hydrophobic, hydrophilic), which is impossible to achieve using the traditional precipitation method. Molecular dynamics (MD) simulations revealed that the growth direction of nanoplates is highly related to the surfactant and its binding affinity. Finite element method (FEM) simulations elucidated that the ratio of ethanol/water plays an important role in defining the crystallinity and morphology of WH. In this study, we demonstrated that the cell proliferation of human bone marrow-derived mesenchymal stem cells (hBMSCs) is enhanced upon treatment with WH. The results of quantitative real-time polymerase chain reaction (qPCR) revealed that WH can positively accelerate the osteogenic differentiation in hBMSCs. The as-synthesized WH has a great potential in the future to be used in osteogenic tissue engineering. This study opens a new horizon for the synthesis and application of WH.

Validation of the Nurses' Involvement in Dying Patients and Family Care-Korean Version.

Purpose: The purpose of this study was to test the validity of the Korean version of the Nurses' Involvement in Dying Patients and Family Care (NIDPFC) instrument. Methods: Data were collected from 410 registered nurses at a university hospital, general hospitals, and a convalescent hospital. Data were collected from June 23 to July 17, 2020. Internal consistency reliability, construct validity, and criterion validity were examined using the SPSS and AMOS software. Results: Of the 35 preliminary items of the instrument, 24 items were finally selected after evaluating the content validity, analyzing the items, and assessing construct validity. The following four factors were derived "burden" (seven items), "deep involvement" (eight items), "resilience" (five items), and "empathy" (four items), with a cumulative explanatory variance of 55.2%. For criterion validity, a significant positive relationship was found between the NIDPFC and attitudes toward caring for the dying. For internal consistency reliability, the Cronbach's α was 0.82. Conclusion: The validity and reliability of the NIDPFC were verified. Therefore, the NIDPFC is an effective instrument to use in further studies.

Effects of Progesterone and 17ß-Estradiol under Presence or Absence of FBS on Plasminogen Activators Activity in Porcine Uterine Epithelial Cells.

The present study was conducted to investigate the regulatory mechanism of plasminogen activators (PAs) activation by 17ß-estradiol (E2) and progesterone (P4) in porcine uterine epithelial cells (pUECs). pUECs were collected from porcine uterine horn and cultured at 80% confluence. Then, 0.1% (v/v) DMSO, 20 ng/mL E2, and P4 with or without fetal bovine serum (FBS) treated to cultured cells for 24 hours. The supernatants were used for measurement of PAs activity and expression of urokinase-type PA (uPA), tissue-type PA (tPA), uPA specific receptor (uPAR), and type-1 PA inhibitor (PAI-1) mRNA were analyzed by real-time PCR. The expression of PAs-related genes was not affect by steroid hormones in both of serum treatment groups. However, PAs activity was increased by treatment of E2 compared to 0.1% DMSO treatment in serum-free group (p<0.05). Then, E2 and P4 were diluted with 0.002% (v/v) DMSO for reduction of its effect and treated to cultured cells without FBS. Only tPA mRNA was significantly increased by E2 treatment (p<0.05). PAs activity was enhanced in E2 treated group compared to control groups (p<0.05). These results indicate that serum-free condition is more proper to evaluate effect of steroid hormones and activation of PAs in pUECs was mainly regulated by estrogen. These regulation of PAs activation may be associated with uterine remodeling during pre-ovulatory phase in pigs, however, further studies are needed to investigate precise regulatory mechanism.