Effects of hydrocortisone-presensitized sugammadex on recovery from neuromuscular blockade induced by rocuronium: a rodent in vivo study

Choi Hey-Ran,Yang Hong Seuk,Choi Jae-Moon,Park Chungon,인준용,김용범 대한마취통증의학회 2022 Anesthesia and pain medicine Vol.17 No.2

Background: Sugammadex is a specific antagonist of aminosteroidal neuromuscular blocking agents with 1:1 binding to guest molecules. Sugammadex can also bind to other drugs having a steroid component in its chemical structure. In this in vivo experiment, we investigated the differences in the recovery of rocuronium-induced neuromuscular blockade using sugammadex pre-exposed with two different concentrations of hydrocortisone.Methods: The sciatic nerves and tibialis anterior muscles of 30 adult Sprague–Dawley rats were prepared for the experiment. The sciatic nerves were stimulated using a train-of-four (TOF) pattern with indirect supramaximal stimulation at 20 s intervals. After 15 min of stabilization, a 250 μg loading dose and 125 μg booster doses of rocuronium were serially administered until > 95% depression of the first twitch tension of TOF stimulation (T1) was confirmed. The study drugs were prepared by mixing sugamadex with the same volume of three different stock solutions (0.9% normal saline, 10 mg/ml hydrocortisone, and 100 mg/ml hydrocortisone). The recovery of rats from neuromuscular blockade was monitored by assessing T1 and the TOF ratio (TOFR) simultaneously until T1 was recovered to > 95% and TOFR to > 0.9.Results: In the group injected with sugammadex premixed with a high concentration of hydrocortisone, statistically significant intergroup differences were observed in the recovery progression of T1 and TOFR (P < 0.050).Conclusions: When sugammadex was pre-exposed to a high dose of hydrocortisone only, recovery from neuromuscular blockade was delayed. Delayed recovery from neuromuscular blockade is not always plausible when sugammadex is pre-exposed to steroidal drugs.

3′ Splice Site Sequences of Spinal Muscular Atrophy Related SMN2 Pre-mRNA Include Enhancers for Nearby Exons

Cho, Sunghee,Moon, Heegyum,Loh, Tiing Jen,Oh, Hyun Kyung,Kim, Hey-Ran,Shin, Myung-Geun,Liao, D. Joshua,Zhou, Jianhua,Zheng, Xuexiu,Shen, Haihong Hindawi Publishing Corporation 2014 The Scientific World Journal Vol.2014 No.-

<P>Spinal muscular atrophy (SMA) is a human genetic disease which occurs because of the deletion or mutation of SMN1 gene. SMN1 gene encodes the SMN protein which plays a key role in spliceosome assembly. Although human patients contain SMN2, a duplicate of SMN1, splicing of SMN2 produces predominantly exon 7 skipped isoform. In order to understand the functions of splice site sequences on exon 7 and 8, we analyzed the effects of conserved splice site sequences on exon 7 skipping of SMN2 and SMN1 pre-mRNA. We show here that conserved 5′ splice site sequence of exon 7 promoted splicing of nearby exons and subsequently reduced splicing of distant exons. However, to our surprise, conserved 3′ splice site sequence of exon 7 and 8 did not promote splicing of nearby exons. By contrast, the mutation inhibited splicing of nearby exons and subsequently promoted splicing of distant exons. Our study shows that 3′ splice sites of exon 7 and 8 contain enhancer for their splice site selection, in addition to providing cleavage sites.</P>

CD44 alternative splicing and hnRNP A1 expression are associated with the metastasis of breast cancer.

Loh, Tiing Jen,Moon, Heegyum,Cho, Sunghee,Jang, Hana,Liu, Yong Chao,Tai, Hongmei,Jung, Da-Woon,Williams, Darren R,Kim, Hey-Ran,Shin, Myung-Geun,Liao, D Joshua,Zhou, Jianhua,Shi, Wei,Zheng, Xuexiu,Shen National Hellenic Research Foundation 2015 ONCOLOGY REPORTS Vol.34 No.3

<P>CD44 is a transmembrane receptor for hyaluronic acid. CD44 pre-mRNA contains 19?exons, 9?of which are alternatively spliced. Among the CD44 spliced variants, the v4-7 variant, one of the v6?exon-containing isoforms that contains variable exon?4, 5, 6 and?7, confers metastatic potential to non-metastatic cells. Splicing of CD44 and the function of CD44 isoforms are different in breast cancer cells. hnRNP?A1 is a ubiquitously expressed protein with an inhibitory function in pre-mRNA splicing. We showed that CD44v6 isoform, which includes all of the v6-containing mRNA isoforms, had the highest expression level in non-metatatic breast cancer cells (MCF7) when compared to the level in metastatic breast cancer cells (MDA-MB-231) and normal breast cells (MCF10A). Furthermore we showed that hnRNP?A1 knockdown regulated splicing of CD44 differently in breast cancer cells. We showed here that CD44 isoform expression is completely different in MDA-MB-231 cells than that in MCF7 and MCF10A cells, whereas MCF7 and MCF10A cells had a similar expression pattern of CD44 isoforms. RT-PCR analysis of CD44v6 showed that MCF7 and MCF10A cells predominantly expressed the c5v6v7v8v9v10c6 isoform. However, in addition to this isoform, MDA-MB-231 cells also expressed the c5v6v8v9v10c6 and c5v6c6 isoforms. We also found that knockdown of hnRNP?A1 significantly reduced the expression of c5v6v7v8v9v10c6 and c5v6v8v9v10c6, and promoted the expression of c5v6c6. hnRNP?A1 knockdown significantly induced cell death. In addition, hnRNP?A1 knockdown induced a decrease in cell invasion in the MDA-MB-231 cells. Our results indicate that the knockdown of hnRNP A1 has a specific function on the splicing of CD44 in breast cancer cells.</P>

α-2,3 Sialylation on Neural Cell Surface N-Glycans Increases during Glucose Deprivation

Ha Na Choi,Yoon Hee Lee,Doo Jin Choi,Hey Ran Moon,Young-Kug Choo,Su-Il Do,Yong Il Park 한국당과학회 2010 한국당과학회 학술대회 Vol.2010 No.1

Sialic acids are typically found as terminal monosaccharides attached to the cell surface glycoconjugates and play important roles in many physiological and pathological processes, including microbe binding that leads to infections, regulation of the immune response, the progression and spread of human malignancies, differentiation, development, canceration, and degenerative diseases (1-3). UDP-GlcNAc is a metabolic precursor of sialic acids. Thus, glucose metabolism and regulation of metabolic flux of UDT-GlcNAc critically affect the expression of cell surface sialic acid and nervous system function (4,5). Here, we investigated the expression of sialic acid in human neuroblastoma cell, SK-N-SH, in response to glucose deprivation. When subjected to a glucose-free environment for 24 h, SK-N-SH cells showed severe defects in neurite development and eventually died. During glucose limitation, the expression level of sialic acid of total cellular proteins was examined by lectin blotting using Maackia amunrensis(MAA) lectin and Sambucus nigra(SNA) lectin, which are specific for α-2,3 sialic acid and α-2,6 sialic acid, respectively. Glucose deprivation caused increase in MAA binding to several major proteins (especially, 45 and 75 kDa), suggesting an increased α-2,3 sialylation on these proteins. Lectin histochemistry using MAA lectin also showed a significant increase in surface α,2-3 sialylation upon glucose deprivation. In addition, glucose deprivation resulted in a dose-dependant increase in the mRNA level of ST3GAL4 sialyltransferase by 2.3 folds comparing to that cultured in 2 mg/ml glucose medium, whereas expressions of other sialyltransferases (ST3GAL3, ST3GAL6, and ST6GAL1) were not significantly influenced. These results suggest that glucose deprivation upregulates the α,2-3 sialylation on several cell surface glycoproteins and this phenomenon may be involved in neural cell death by glucose deprivation.

Sufficient explanation of management affects patient satisfaction and the practice of post-treatment management in spinal pain, a multicenter study of 1007 patients

( Jae Yun Kim ),( Jae Hang Shim ),( Sung Jun Hong ),( Jong Yeun Yang ),( Hey Ran Choi ),( Yun Hee Lim ),( Ho Sik Moon ),( Jaemoon Lee ),( Jae Hun Kim ) 대한통증학회 2017 The Korean Journal of Pain Vol.30 No.2

Background: Spinal pain is most common symptom in pain clinic. In most cases, before the treatment of spinal pain, physician explains the patient`s disease and treatment. We investigated patient`s satisfaction and physician`s explanation related to treatments in spinal pain patients by questionnaires.Methods: Anonymous questionnaires about physician`s explanation and patient`s satisfaction in each treatment and post-treatment management were asked to individuals suffering from spinal pain. Patients who have spinal pain were participated in our survey of nationwide university hospitals in Korea. The relationships between patient`s satisfaction and other factors were analyzed.Results: Between June 2016 and August 2016, 1007 patients in 37 university hospitals completed the questionnaire. In the statistical analysis, patient`s satisfaction of treatment increased when pain severity was low or received sufficient preceding explanation about nerve block and medication (P < 0.01). Sufficient explanation increased patient`s necessity of a post-treatment management and patients` performance rate of post-treatment management (P < 0.01).Conclusions: These results show that sufficient explanation increased patients` satisfaction after nerve block and medication. Sufficient explanation also increased the practice of patients` post-treatment management. (Korean J Pain 2017; 30: 116-25)

A survey of patients’ perspectives of steroid injection (ppyeojusa) in Korea

Bo-Mi Shin,홍성준,Yun Hee Lim,Jae Hun Jeong,Ho Sik Moon,Hey Ran Choi,Sun Kyung Park,Richard Jin Woo Han,Jae Hun Kim 대한통증학회 2019 The Korean Journal of Pain Vol.32 No.3

Background: Steroid injections are commonly used in pain clinics to relieve pain and treat inflammation. In Korea, these steroid injections are well known as ‘ppyeojusa’, which means to inject into the bone in Korean. Some patients often have a negative perception of this treatment method due to inaccurate information about the treatment and side effects of steroids. The purpose of this study is to investigate patients’ perception and knowledge of ppyeojusa.Methods: A questionnaire about ppyeojusa was completed by patients who visited one of the pain clinics in nine university hospitals, from August 1 to September 10, 2017.Results: Three-hundred seventy-four patients completed the survey. Eighty-five percent of patients had had ppyeojusa, and 74% of the respondents had heard of ppyeojusa from the mass media, friends or relatives. Only 39% of the patients answered that this injection was safe without side effects if properly spaced. Of the patients surveyed, 21% responded that ppyeojusa are “injections into the bone”; while 15% responded that ppyeojusa are “terrible injections that melted ‘the bone if used a lot’”. Half of the patients did not know what the active constituent is in ppyeojusa. If steroid injections are advised by the pain specialists, 89% of the patients would consent.Conclusions: Most pain clinic patients have heard of ppyeojusa. Most patients obtained information about ppyeojusa from mass media, rather than their physicians. Therefore, it is likely that most patients have inaccurate knowledge.

A survey of patients' perspectives of steroid injection (ppyeojusa) in Korea

Shin, Bo-Mi,Hong, Sung Jun,Lim, Yun Hee,Jeong, Jae Hun,Moon, Ho Sik,Choi, Hey Ran,Park, Sun Kyung,Han, Richard Jin Woo,Kim, Jae Hun The Korean Pain Society 2019 The Korean Journal of Pain Vol.32 No.3

Background: Steroid injections are commonly used in pain clinics to relieve pain and treat inflammation. In Korea, these steroid injections are well known as 'ppyeojusa', which means to inject into the bone in Korean. Some patients often have a negative perception of this treatment method due to inaccurate information about the treatment and side effects of steroids. The purpose of this study is to investigate patients' perception and knowledge of ppyeojusa. Methods: A questionnaire about ppyeojusa was completed by patients who visited one of the pain clinics in nine university hospitals, from August 1 to September 10, 2017. Results: Three-hundred seventy-four patients completed the survey. Eighty-five percent of patients had had ppyeojusa, and 74% of the respondents had heard of ppyeojusa from the mass media, friends or relatives. Only 39% of the patients answered that this injection was safe without side effects if properly spaced. Of the patients surveyed, 21% responded that ppyeojusa are "injections into the bone"; while 15% responded that ppyeojusa are "terrible injections that melted 'the bone if used a lot'". Half of the patients did not know what the active constituent is in ppyeojusa. If steroid injections are advised by the pain specialists, 89% of the patients would consent. Conclusions: Most pain clinic patients have heard of ppyeojusa. Most patients obtained information about ppyeojusa from mass media, rather than their physicians. Therefore, it is likely that most patients have inaccurate knowledge.

스트리밍 서비스 품질 보장을 위한 멀티캐스트 트리 구성 기법

이태우(Tae-Woo Lee),김남중(Nam-Joong Kim),문혜란(Hey-Ran Moon) 한국엔터테인먼트산업학회 2014 한국엔터테인먼트산업학회논문지 Vol.8 No.2

본 논문에서는 실시간 스트리밍 서비스에 적합한 QoS(Quality of Service)를 보장하는 효율적인 멀티캐스트 트리 구성 기법을 제안한다. 멀티캐스트 트리 구성 시 하위 호스트에서 루트 노드로 전송되는 호스트에 대한 정보를 기반으로 트리 구성 지연시간을 감소시켜 스트리밍 서비스의 품질을 높일 수 있다. 제안하는 기법에서 루트노드는 새로운 호스트를 추가할 때, 자신의 자식 노드로 수용할 수 있는 호스트들의 정보를 분석하여 목록을 구성한다. 신규 호스트의 서비스 요청 또는 호스트 탈퇴 및 이탈로 인한 트리 재구성 시 해당 목록을 전송하여 기존의 방법보다 빠르게 트리를 구성할 수 있다. 이는 트리의 구성 및 재구성 시 부모 노드 탐색에 걸리는 시간을 단축시켜 스트리밍 서비스처럼 지연시간에 민감한 서비스에 적합하도록 구현하였다. 실험결과 그룹크기에 따라 트리 구성 시 소요되는 시간이 최소 24%, 최대 37% 절약되는 것을 확인하였다. In this paper, we propose a multi-case tree constitution method to require the quality of service in streaming service. When the multi-case tree constitution time is reduced based on the information about the host transmitted to the root node in the tree constitution from the subordinate host and the quality of the streaming service can be enhanced. The root node analyze the information of the hosts whom it can accommodate as its own child node when adding the new host and comprises the list. The relevant list is transmitted in the tree recomposition because of the service request of the new host or the host secession and secession and the tri can be rapidly comprised than the existing method. When reconstructing with the organization of the tri, this shortened the time required for the corresponding parent node search and in order to be suitable for the service susceptible to delay time, it implemented like the streaming service. In experimental result, time of the multi-cast tree constitution was reduced at least 24%, up to 37% based on sized of the group.

Patients’ perception about opioids and addiction in South Korea

( Cho Long Kim ),( Sung Jun Hong ),( Yun Hee Lim ),( Jae Hun Jeong ),( Ho Sik Moon ),( Hey Ran Choi ),( Sun Kyung Park ),( Jung Eun Kim ),( Hakjong You ),( Jae Hun Kim ) 대한통증학회 2020 The Korean Journal of Pain Vol.33 No.3

Background: Chronic pain affects approximately 22% of the world’s population. Opioids can be useful in chronic pain management. However, some patients have negative perception of opioids. The purpose of this research was to evaluate patients’ perception about opioids and investigate problems associated with prescribing and taking opioids in South Korea. Methods: Patients who visited a pain clinic in 14 university hospitals of South Korea from September through October 2018 were asked to complete anonymous questionnaires about taking opioids. Results: Of the 368 patients that were surveyed (female 53.3%, male 46.7%), 56.8% were prescribed opioids. In the opioid group, 92.8% patients had heard of opioids from their doctor and 72.6% of them had a positive perception about opioids. The side effects associated with opioid use were constipation (35.4%), dizziness (24.6%), nausea and vomiting (17.4%), dysuria (6.2%), and addiction (2.0%). In the no opioid group, the primary sources of information about opioids were doctors (49.2%), mass media (30.8%), and the internet (16.2%). The main reasons why 39.0% patients did not take opioids were fear of addiction (57.7%) and side effects (38.5%). There were 71.5% and 60.9% patients in the opioid and no opioid group, respectively, who wished to take opioids when their numeric rating scale pain score was ≥ 7. Conclusions: Perception of opioids among patients who take them was either neutral or positive. However, 39.0% patients who have not been prescribed opioids did not want an opioid prescription, citing fear of addiction and side effects as the primary reasons.