The Effect of Neuromuscular Blockade Reversal Agents on Postoperative Pulmonary Complications in Patients undergoing Femur Fracture Repair Surgery: A Retrospective Observational Study

Background Femoral fracture repair surgery under general anesthesia is associated with postoperative pulmonary complications (PPCs). However, information on PPCs caused by residual neuromuscular blockade following perioperative use of neuromuscular blockers is limited. This study aimed to identify the differences in the incidence of PPCs according to the type of neuromuscular blockade reversal agent used in femoral fracture repair surgery, as well as the risk factors for PPCs. Methods We retrospectively analyzed the electronic medical records of 604 patients aged >18 years who underwent general anesthesia for femoral fracture repair surgery at a single university hospital between March 2017 and March 2022. Patients in whom sugammadex or anticholinesterase was used to reverse the neuromuscular block were subjected to propensity score matching. Multivariate logistic regression analysis was performed to identify risk factors for PPCs. Results Among the 604 patients, 108 were matched in each group. The incidence rates of PPCs overall and in the anticholinesterase and sugammadex groups were 7.0%, 8.3%, and 5.6%, respectively, with no significant differences between the groups. Older age, higher ASA (American Society of Anesthesiologists) physical status, and lower preoperative oxygen saturation were risk factors, whereas emergency surgery was a preventive factor. Conclusions Our results demonstrated that the incidence of PPC did not differ significantly between sugammadex and anticholinesterase in patients undergoing femur fracture repair under general anesthesia. Identifying the risk factors and confirming complete recovery from neuromuscular blockade might be more important

Comparison of the effects of intraoperative remifentanil and sufentanil infusion on postoperative pain management in robotic gynecological surgery: a retrospective cohort study

Background Remifentanil and sufentanil are potent short-acting synthetic opioid analgesics. The administration of remifentanil has been associated with the incidence of opioid-induced hyperalgesia. Opioid-induced hyperalgesia may be alleviated when opioids, such as morphine, are switched to sufentanil. Therefore, this retrospective observational study aimed to compare the effects of remifentanil and sufentanil on postoperative pain in patients undergoing robotic gynecological surgery. Methods We retrospectively analyzed the electronic medical records of patients who underwent elective robotic gynecological surgery between January 2016 and February 2021. The patients were classified into sufentanil (n = 159) or remifentanil (n = 359) groups according to the opioids administered continuously during anesthesia. The primary outcome assessed in this study was the postoperative pain score measured using the numeric rating scale (NRS). The secondary outcomes assessed included the recovery time (from discontinuation of opioid infusion to extubation) and frequency of rescue analgesic administration in the post-anesthesia care unit (PACU). Results The recovery time did not differ significantly between the two groups. The NRS score for pain (median [1Q, 3Q]) in the PACU was significantly lower in the sufentanil group than in the remifentanil group (2 [2, 3] vs. 4 [3, 7], P < 0.001). The frequency of rescue analgesic administration in the PACU was 6.3% and 35.4% in the sufentanil and remifentanil groups, respectively (P < 0.001). Conclusions Sufentanil, as an adjunct to sevoflurane anesthesia is more advantageous than remifentanil in terms of postoperative pain control during robotic gynecological surgery

Lattice-patterned LC-polymer composites containing various nanoparticles as additives

In this study, we show the effect of various nanoparticle additives on phase separation behavior of a lattice-patterned liquid crystal [LC]-polymer composite system and on interfacial properties between the LC and polymer. Lattice-patterned LC-polymer composites were fabricated by exposing to UV light a mixture of a prepolymer, an LC, and SiO2 nanoparticles positioned under a patterned photomask. This resulted in the formation of an LC and prepolymer region through phase separation. We found that the incorporation of SiO2 nanoparticles significantly affected the electro-optical properties of the lattice-patterned LC-polymer composites. This effect is a fundamental characteristic of flexible displays. The electro-optical properties depend on the size and surface functional groups of the SiO2 nanoparticles. Compared with untreated pristine SiO2 nanoparticles, which adversely affect the performance of LC molecules surrounded by polymer walls, SiO2 nanoparticles with surface functional groups were found to improve the electro-optical properties of the lattice-patterned LC-polymer composites by increasing the quantity of SiO2 nanoparticles. The surface functional groups of the SiO2 nanoparticles were closely related to the distribution of SiO2 nanoparticles in the LC-polymer composites, and they influenced the electro-optical properties of the LC molecules. It is clear from our work that the introduction of nanoparticles into a lattice-patterned LC-polymer composite provides a method for controlling and improving the composite's electro-optical properties. This technique can be used to produce flexible substrates for various flexible electronic devices

Neo-Marxian social class inequalities in self-rated health among the employed in South Korea: the role of material, behavioral, psychosocial, and workplace environmental factors

Background The aim of this study was to examine the pattern of social inequality in self-rated health among the employed using the Wrights social class location indicator, and to assess the roles of material, behavioral, psychosocial, and workplace environmental factors as mediating factors in explaining the social class inequality in self-rated health in South Korea. Methods This study used data from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Study subjects included the employed population of 4392 men and 3309 women aged 19–64 years. Subjects were classified into twelve social class positions based on the Wrights social class map. The health outcome was self-rated health. Material, psychosocial, behavioral, and workplace environmental factors were considered as potential mediators in explaining social class health inequality. We calculated prevalence ratios of poor self-rated health according to social class, adjusted for age and mediating factors using Poisson regression models. Results Nonskilled workers and petty bourgeoisie reported worse self-rated health than other social classes among men. The age-adjusted prevalence of petty bourgeoisie and nonskilled workers were about four-fold greater than that of managers. Expert supervisors in the contradictory class location had a greater prevalence of poor self-rated health than experts in men. In women, the prevalence of poor self-rated health was greater in most social classes than their male counterparts, while the differences among social classes within women were not statistically significant. Workplace environmental factors explained the social class inequality by from 24 to 31% in nonskilled and skilled workers and nonskilled supervisors, respectively, and material factors showed an explanatory ability of about 8% for both nonskilled workers and petty bourgeoisie in men. Conclusions We showed the inequality in self-rated health according to the Wrights social class in an industrialized Asian country. Policy efforts to improve workplace environments in nonskilled and skilled workers and nonskilled supervisors would have a moderate effect on reducing the magnitude of social class inequality in self-rated health. Furthermore, the means to improve power relations in the workplace should be devised to further reduce the social class inequalities in health

Bioavailability of the amino acid-attached prodrug as a new anti-HIV agent in rats

The primary objective of this study was to compare the pharmacokinetics of a new anti-human immunodeficiency virus agent 1-(2-amino-pyridin-4-ylmethyl)-6-(3,5-dimethyl-benzoyl)-5-isopropyl-1H-pyrimidine-2,4-dione (VP-0502) with its amino acid prodrug alanine amide of VP-0502 (VP-0502AL), following intravenous and oral administrations to rats. The plasma concentrations of both analytes were analyzed via high-performance liquid chromatography coupled with photodiode-array detection (HPLC-DAD). When VP-0502 was intravenously administered at 20 mg/kg, the analyte appeared in low levels with an AUC of 0.3 µg · h/ml, and C0 of 0.2 µg/ml in plasma. However, both the prodrug VP-0502AL and its metabolite VP-0502 appeared at comparatively higher levels following intravenous injection of VP-0502AL at the same dose. VP-0502AL's pharmacokinetic parameters were Vd: 4.6 l/kg; AUC: 3 µg · h/ml; t1/2: 0.5 h; C0: 6 µg/ml; CLtot: 7 l/h/kg; and MRT: 0.6 h. Following oral administration of VP-0502 (100 mg/kg), it was not detectable in plasma (<50 ng/ml), while after the oral administration of VP-0502AL, VP-0502 was quantitatively detected as an active metabolite for the first 7 h, with a maximum plasma concentration (Cmax) of 0.8 µg/ml, and an area under the concentration-time curve (AUC) of 2 µg · h/ml. The oral pharmaco-kinetic parameters of VP-0502AL were calculated to be: maximum concentration time (tmax) 2.7 h; Cmax 0.2 µg/ml; elimination half-life (t1/2): 0.8 h; and AUC 0.5 µg · h/ml. Overall the findings indicate that VP-0502AL has a favorable pharmacokinetic profile as a prodrug with rapid transformation into the active metabolite, and that the attachment of the amino acid alanine to VP-0502 is an effective approach to improve its oral bioavailability. VP-0502AL is predicted to become a new highly bioavailable anti-AIDS drug candidate and/or lead compound

Sulforaphane Increases Cyclin-Dependent Kinase Inhibitor, p21 Protein in Human Oral Carcinoma Cells and Nude Mouse Animal Model to Induce G2/M Cell Cycle Arrest

Previously, our group reported that sulforaphane (SFN), a naturally occurring chemopreventive agent from cruciferous vegetables, effectively inhibits the proliferation of KB and YD-10B human oral squamous carcinoma cells by causing apoptosis. In this study, treatment of 20 and 40 µM of SFN for 12 h caused a cell cycle arrest in the G2/M phase. Cell cycle arrest induced by SFN was associated with a significant increase in the p21 protein level and a decrease in cyclin B expression, but there was no change in the cyclin A protein level. In addition, SFN increased the p21 promoter activity significantly. Furthermore, SFN induced p21 protein expression in a nude mouse xenograft model suggesting that SFN is a potent inducer of the p21 protein in human oral squamous carcinoma cells. These findings show that SFN is a promising candidate for molecular-targeting chemotherapy against human oral squamous cell carcinoma