The authors in this article explore the experiences of eight South Korean nurses during an outbreak of the Middle East Respiratory Syndrome (MERS), which took place in the fall of 2015. These nurses were mandated to remain in isolation in an intensive care unit (ICU) dedicated to the treatment of the patients with the MERS virus for 7 days. Parse's humanbecoming theory was used to frame the discussion. Three themes found in the nurse's stories are discussed: feeling hopeless and cut off, feeling shame and overworked, and feeling pride in fulfilling a duty. The nurses discuss how they overcame the difficulties of their situation, which ultimately reinforced their identities as nurses.
In this study, we elucidated the inhibitory effect of fucoidan from marine brown algae on the lipid accumulation in differentiated 3T3-L1 adipocytes and its mechanism. The treatment of fucoidan in a dose-dependent manner was examined on lipid inhibition in 3T3-L1 cells by using Oil Red O staining. Fucoidan showed high lipid inhibition activity at 200 μg/mL concentration (P < 0.001). Lipolytic activity in adipocytes is highly dependent on hormone sensitive lipase (HSL), which is one of the most important targets of lipolytic regulation. Here, we examined the biological response of fucoidan on the protein level of lipolysis pathway. The expressed protein levels of total hormone sensitive lipase (HSL) and its activated form, phosphorylated-HSL were significantly increased at concentration of 200 μg/mL fucoidan. Furthermore, insulin-induced 2-deoxy-d-[3H] glucose uptake was decreased up to 51% in fucoidan-treated cells as compared to control. Since increase of HSL and p-HSL expression and decrease of glucose uptake into adipocytes are known to lead to stimulation of lipolysis, our results suggest that fucoidan reduces lipid accumulation by stimulating lipolysis. Therefore, these results suggest that fucoidan can be useful for the prevention or treatment of obesity due to its stimulatory lipolysis.
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BackgroundBased on the fact that B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) have a regulatory role in B cell biology, excessive levels of these cytokines can promote autoimmune pathogenesis. However, the expression and implication remain unresolved in cases of membranous nephropathy (MN).ResultsThe plasma BAFF levels of the primary MN patients were higher than those of healthy controls but lower than those of secondary MN patients, whereas the APRIL levels were similar between the MN patients and healthy controls. The BAFF levels were higher in relapse cases, whereas the APRIL levels were higher in the patients who did not experience remission compared with the counterpart patients. The ectopic expression of BAFF and APRIL was observed in the glomeruli or circulating B cells of MN patients, and this high expression trend was similar to that of lupus patients.ConclusionsExpression profile of BAFF and APRIL in MN is similar to that of other autoimmune disease, which affects the kidney outcomes.MethodsPlasma BAFF and APRIL levels were measured upon kidney biopsy in patients with primary (n = 89) and secondary MN (n = 13), and the results were compared with the levels in healthy controls (n = 111). The kidney outcomes (e.g., remission and relapse) were traced for the median of 3 years. Aberrant expression of the cytokines was evaluated in the kidney and circulating B cells using immunohistochemistry and flow cytometry analyses, respectively.
We have attempted to reduce blood use during the perioperative period to avoid complications associated with blood transfusions in pediatric patients undergoing open-heart surgery. We retrospectively reviewed clinical data of patients who underwent open-heart surgery (age < 15 years, body weight ≤ 30 kg) from January 2012 to October 2013. Our strategy to reduce transfusion volume included: (1) shortening the length of cardiopulmonary bypass (CPB) circuit, and adding red blood cells (RBC) to CPB circuit priming solution when preoperative hematocrit was ≤30%; (2) routine modified ultrafiltration in all patients; and (3) restricting RBC transfusions during postoperative period, given when hematocrit was ≤25%. In total, 349 cases were enrolled. The median age of patients was 7 months (1 day-168 months), and body weight was 7 kg (2.3-30 kg). We did not use blood products in 81 (23.2%) cases and did not add RBCs to CPB priming solution in 119 (34.1%) cases. Patients who did not require a transfusion showed a shorter intensive care unit (ICU) stays (0.97 ± 0.5 days) than patients who required a transfusion (4.1 ± 5.5 days, p = 0.003). Larger volume transfusion correlated with longer intubation durations, ICU and hospital stays, higher peak C-reactive protein levels, and an increased blood urea nitrogen/creatinine ratio. No significant problems were observed in patients with relatively lower hematocrit levels. Our strategy to reduce transfusion volume resulted in shorter ventilator support, ICU stay, hospitalization, reduced inflammatory reaction, and less kidney insult during the postoperative course in pediatric patients.
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