How to screen the cervix and reduce the risk of spontaneous preterm birth in asymptomatic women without a prior preterm birth

Preterm birth (PTB) is a leading cause of perinatal morbidity and mortality globally. PTB rates have increased in South Korea despite reduction in birth rates. A history of PTB is a strong predictor of subsequent PTB and screening of cervical length between 16 0/7 weeks and 24 0/7 weeks of gestation is recommended in women with a singleton pregnancy and a prior spontaneous PTB. However, the prediction and prevention of spontaneous PTBs in women without a prior PTB remain a matter of debate. The scope of this review article comprises cervical screening and prevention strategies for PTB in asymptomatic women without a prior PTB, based on recent evidence and guidelines

Management of Patients with Ischemic Heart Disease in Spine Surgery

In ischemic heart disease (IHD), the myocardium does not receive enough blood and oxygen. Although the IHD-related mortality rate is decreasing, the risk remains and is a major predictor of cardiac complications following noncardiac surgery. Given the increase in the older population, the number of patients with spinal diseases requiring surgery is increasing. Among these patients, those with underlying IHD or a high risk of cardiac complications before and after surgery are also increasing. Given that cardiac complications following spinal surgery are associated with delayed patient recovery and even death, spinal surgeons should be knowledgeable about overall patient management, including medication therapy in those at high risk of developing perioperative cardiac complications for successful patient care. Before surgery, the underlying medical conditions of patients should be evaluated. Patients with a history of myocardial infarction should be checked for a history of surgical treatments, and the anticoagulant dose should be controlled depending on the surgery type. In addition, the functional status of patients must be examined before surgery. Functional status can be assessed according to the metabolic equivalent of task (MET). More preoperative cardiac examinations are needed for patients who are unable to perform four METs in daily because of the high risk of postoperative cardiac complications. Patients with a history of IHD require appropriate preoperative management and further postoperative evaluation. When considering surgery, spinal surgeons should be knowledgeable about patient care before and after surgery

Correlation between macular ganglion cell-inner plexiform layer thickness and visual acuity after resolution of the macular edema secondary to central retinal vein occlusion

AIM: To examine the thickness of the ganglion cell-inner plexiform layer (GCIPL) in eyes with resolved macular edema (ME) in non-ischemic central retinal vein occlusion (CRVO), applying spectral-domain optical coherence tomography (SD-OCT), and its relationship with visual acuity. METHODS: The retrospective observational case-control study included 30 eyes of non-ischemic CRVO patients with resolved ME (ME eyes) after treatment, and 30 eyes of non-ischemic CRVO patients without ME (non-ME eyes). The macular GCIPL thickness, peripapillary retinal nerve fiber layer (pRNFL) thickness and central macular thickness (CMT) were measured on a SD-OCT scan. Linear regression analyses were performed to determine the correlation between the thickness of each and the visual acuity (VA). RESULTS: No significant difference in average GCIPL thickness, mean pRNFL thickness and CMT were observed between ME group and non-ME group (P=0.296, 0.183, 0.846). But, minimum GCIPL thickness was reduced in ME eyes compared with non-ME eyes (P=0.022). Final VA significantly correlated with the minimum GCIPL thickness in ME eyes (r=-0.482, P=0.007), whereas no correlation was found with average GCIPL thickness, average pRNFL thickness and mean CMT. CONCLUSION: Minimum GCIPL thickness is reduced in ME eyes compared with non-ME eyes, and correlated with the VA in non-ischemic CRVO. These results propose that inner retinal damage occurring in patients with ME secondary to non-ischemic CRVO may lead to permanent visual defect after treatment

Tall-building effects on pedestrian-level flow and pollutant dispersion: Large-eddy simulations

© 2022 Turkish National Committee for Air Pollution Research and ControlThe urban environmental impact of tall buildings has increasingly become an important topic of investigation, with the rapid pace of tall-building constructions around the world. In this study, the effects of a tall building on pedestrian-level flow and pollutant dispersion are investigated using the parallelized large-eddy simulation model (PALM). Numerical simulations are conducted by changing the tall-building height in the configuration of a tall building surrounded by low-rise cubical buildings. As the tall-building height increases, the time- and area-averaged pedestrian-level wind speed and pollutant concentration increases and decreases, respectively. Both the rates of changes in the average wind speed and pollutant concentration decrease with increasing tall-building height. The trend of the average wind speed is attributable to an increasing tendency of oncoming flows to pass by the sides of the tall building rather than going down as the tall-building height increases. The trend of the average pollutant concentration is associated with that of the average wind speed. Instantaneous flow and pollutant dispersion are also analyzed. In the upstream region of the tall building, bulks of polluted air are repeatedly transported from further upstream regions and enter the canyon right in front of the tall building, temporarily increasing the pedestrian-level pollutant concentration near the windward wall of the tall building. In the downstream region of the tall building, at the pedestrian level, two counter-rotating vortices appear in the canyon just behind the tall building. Each of these vortices repeatedly develops at one of the two leeward corners of the tall building, moves downstream while changing its size, and disappears after reaching the windward wall of the neighboring low-rise building. These coherent vortices considerably affect the spatiotemporal variation of pedestrian-level pollutant concentration in the canyon just behind the tall building.N

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ABSTRACT Curcumin and quercetin are natural compounds with a wide spectrum of activities, including antioxidant and anticancer activities. In this study, the combined effect of the 2 compounds was investigated, with special emphasis on the pharmacokinetics of curcumin by the quercetin-induced changes in the albuminbinding of curcumin. We evaluated the effect of quercetin on the binding of curcumin to albumin and on the uptake of curcumin into the cells of the human colon carcinoma cell line WiDr. Additionally, we also investigated the changes in the in vivo pharmacokinetics of curcumin and curcumin sulfate, major metabolite of curcumin by co-administered with quercetin. We found that quercetin inhibited the binding of curcumin to albumin and increased the uptake of curcumin into WiDr cells, the human colon carcinoma cell. The quercetin-induced increased uptake (1.6-fold) of curcumin into WiDr cells was also confirmed by an ex vivo study. The in vivo pharmacokinetics of curcumin showed obvious changes when it was coadministered with quercetin, with the significantly lower plasma concentration and greater biliary excretion of curcumin and curcumin sulfate. The present study suggests that quercetin could enhance the cellular uptake of curcumin and modulate in vivo pharmacokinetics of curcumin and it could be related with albumin binding interaction