Purpose: This study aimed to identify the factors that influence the wellness of bus drivers by examining the relationships between job stress, physical activity, subjective happiness, and wellness. Methods: Self-report questionnaires were distributed during October 2017. Results: Based on a multiple regression analysis, the significant factors found to affect the wellness of bus drivers were physical activity (β=.48,p<.001), subjective happiness (β=.25, p=.001), and job stress (β=-.17, p=.025). The total explanatory power of the study variables for wellness was 45.7% (F=33.04, p<.001). Conclusion These findings highlight a need to develop workplace wellness programs to reduce job stress and improve physical activity and subjective happiness among bus drivers.

The nasal ala is a challenging area for surgical reconstruction, with thick sebaceous skin, the lack of an ample tissue reservoir, and an adjacent free margin. Numerous flaps have been reported for the repair of alae defects. A 71-year-old woman with simultaneous basal cell carcinomas involving both nasal alae was treated by Mohs micrographic surgery. The surgical defects measured 1.5x1.5 cm on the center of the right nasal ala and 1.0x1.0 cm on the left nasal ala, including the alar crease and rim. The right nasal ala was used as a nasolabial transposition flap and the left nasal ala was reconstructed by an island pedicle flap. The final shape and texture were satisfactory. The flaps survived and nasal symmetry was preserved. Combined nasolabial transposition and island pedicle flaps thus offer a superior esthetic and functional result owing to minimized tension. This may be a valuable reconstructive option in the repair of bilateral nasal alae defects.
Aged ; Carcinoma, Basal Cell ; Female ; Humans ; Mohs Surgery ; Skin ; Succinates

BACKGROUND: Anesthesia induction time is related to speed of injection, injected volume, and Keo. In the case of target controlled infusion, induction time can be controlled by adjusting the induction time mode. The aim of this study was to estimate the effect of induction time mode on variable parameters and vital signs during anesthesia induction with propofol using a target controlled infusion (TCI). METHODS: Sixty unpremedicated adult patients (ASA class I or II, 18 55 yrs) scheduled for elective surgery were randomly allocated to four groups according to induction mode. Group 1 was assigned a flash induction mode, and groups 2, 3 and 4 were assigned 2, 3 and 4min respectively. The end point of anesthesia induction was loss of eyelash reflex. Various parameters including induction time, infused volume, current/effect concentration at induction, and vital signs were compared. RESULTS: As the induction time mode was prolonged, induction time was delayed, but there was no difference in infused volume. Also, the current concentration decreased gradually, but the effect concentration did not show any difference. The vital signs were more stable in groups 3 and 4 compared with groups 1 and 2. CONCLUSIONS: For anesthesia induction, a rapid induction mode showed more rapid induction and low current concentration, but vital signs were relatively unstable and the effect concentration at induction showed no difference. For critically ill patients or patients with unstable hemodynamics, a more gradual induction mode for anesthesia induction in propofol TCI is recommended.
Adult ; Anesthesia* ; Critical Illness ; Hemodynamics ; Humans ; Propofol* ; Reflex ; Vital Signs*

Sirtuins (SIRTs) are involved in multiple cellular processes. And they are involved in cellular pathways related aging, cancer, and a variety of cellular functions including cell cycle, DNA repair and proliferation. Also they modulate life span. Stem cells have the ability to self-renew for unlimited proliferation and differentiate into various cell types. It has been a little known that the mutation of undifferentiated stem cells in tissue may result in the development of cancer cells by genotoxic carcinogens. Therefore, this study investigated whether some carcinogenic compounds can modulate the expression of sirtuin mRNA on human adipose-derived stem cells. Adipose-derived stem cells (ADSC) were exposed to genotoxic carcinogenic compound (2-nitrofluorene, 2NF) and non-genotoxic carcinogenic compound (clonidine, CND) for 24 hours, 48 hours, 72 hours and 96 hours. The expression of SIRT1 mRNA increased on 72 hours. Expressions of SIRT2 and SIRT7 mRNA increased robustly on 48 hours. But all of SIRTs decreased to a level before a treatment of genotoxic compound on adipose-derived stem cells. These results demonstrated that a treatment of genotoxic compound induced the expression of SIRT mRNA only in the short time. But their level returned to untreated cells on 96 hours. They suggest that the possibility that the sirtuins can retard the carcinogenesis of adipose derived stem cells.
Aging ; Carcinogenesis ; Carcinogens ; Cell Cycle ; Clonidine* ; DNA Repair ; Humans ; RNA, Messenger* ; Sirtuins ; Stem Cells*

Sirtuins (SIRTs) are involved in multiple cellular processes including those related to aging, cancer, and a variety of cellular functions including cell cycle progression, DNA repair, and cellular proliferation. SIRTs have been shown to extend the yeast life span, although there is presently little known about SIRT expression in the organs of mice. In the present study, we were especially interested in identifying differences in SIRT expression between young mice and aged mice. Specifically, we investigated the expression of SIRT1 and SIRT3 in the kidney, lung, skin, adipose tissue, and spleens of 6-month-old and 24-month-old mice using immunohistochemical staining. Compared with that in younger mice, the expression of SIRT1 in 24-month-old rats was increased in kidney, lung, and spleen tissue, while that of SIRT3 was decreased in adipose, kidney, and lung tissue. The results of our study suggest that aging is associated with altered patterns of expression of SIRT1 and SIRT3. In addition, we noted that the expression patterns of SIRT1 and SIRT3 varied by organ. Taken together, the results of this study suggest the possibility that SIRTs may be involved in diseases associated with aging.
Adipose Tissue ; Aging ; Animals ; Cell Cycle ; Cell Proliferation ; Child, Preschool ; DNA Repair ; Humans ; Immunohistochemistry ; Infant ; Kidney ; Lung ; Mice* ; Rats ; Sirtuins ; Skin ; Spleen ; Yeasts

BACKGROUND: Bispectral index (BIS) has been designed to measure objectively the degree of sedation and hypnosis for several anesthetics. It is predicted that sedation and hypnosis during nitrous oxide inhalation affect BIS in an unusual manner due to a different mechanism compared to usual hypnotics. The aim of this study was to evaluate the effect of different concentration of nitrous oxide inhalation on BIS and sedation score. METHODS: Forty unpremedicated ASA physical status I or II patients scheduled for lower extremity surgery were studied. After performing epidural anesthesia, patients inhaled gradually increasing concentrations of nitrous oxide from 0 to 67% (15 minutes for each concentration) via a tightly sealed face mask. At the end of each inhalation, BIS and OAA/S scale (Observers's Assessment of Alertness/ Sedation scale) were assessed. RESULTS: The increasing concentrations of inhaled nitrous oxide resulted in significant reduction of the OAA/S scale but in no change of BIS. Concentrations of nitrous oxide exceeding 50% affected behavior or emotion of the patients. CONCLUSIONS: Following increasing concentrations of inhaled nitrous oxide, sedation score was reduced significantly but BIS was not affected.
Anesthesia, Epidural ; Anesthetics ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Inhalation ; Lower Extremity ; Masks ; Nitrous Oxide*

Nicolau syndrome or embolia cutis medicamentosa is an acute necrotic condition of skin that follows intramuscular injection of drugs. A 36-year-old man developed a painful, purpuric and erythematous patch on his left buttock following an intramuscular injection of diclofenac sodium. Histologically, the patch lesion displayed epidermal necrosis, dermal degeneration, and vascular thrombosis. We report a rare case of Nicolau syndrome following intramuscular injection of diclofenac sodium. In our case, the patient was successfully treated by surgical excision with primary closure.
Adult ; Buttocks ; Diclofenac ; Humans ; Injections, Intramuscular ; Necrosis ; Skin ; Thrombosis

Churg-Strauss syndrome is an uncommon disorder characterized by bronchial asthma or allergic rhinitis, peripheral eosinophilia, systemic necrotizing vasculitis, and extravascular granuloma formation. It commonly affects the lungs, skin, gastrointestinal tract, peripheral nerve, kidneys and the heart. Gastrointestinal symptoms of Churg-Strauss syndrome are common, mainly shown in abdominal pain, diarrhea, or bleeding. Ulceration, perforation, stenosis can occurr with ischemia induced by vasculitis. Gastrointestinal perforation by Churg-Strauss syndrome has been reported rarely, and was recently discovered to have a close correlation to systemic steroid treatment. Nearly one third of patients infected with a gastrointestinal perforation die. This report covers the interesting case of a 54 year-old woman who was being treated for asthma, and was diagnosed as Churg-Strauss syndrome by multiple polyneuropathy and ulcerative macules. Small intestine perforation was generated 4 days after high dose systemic steroid intravenous injection.
Abdominal Pain ; Asthma ; Churg-Strauss Syndrome ; Constriction, Pathologic ; Diarrhea ; Eosinophilia ; Female ; Gastrointestinal Tract ; Granuloma ; Heart ; Hemorrhage ; Humans ; Injections, Intravenous ; Intestine, Small ; Ischemia ; Kidney ; Lung ; Peripheral Nerves ; Polyneuropathies ; Rhinitis ; Rhinitis, Allergic, Perennial ; Skin ; Ulcer ; Vasculitis

The cutaneous diseases associated with progesterone are autoimmune progesterone dermatitis, erythema multiforme- like eruption, drug-induced progesterone dermatitis and solar urticaria. Estrogen and progesterone are widely used in oral contraceptives and hormone replacement therapies, and they are rarely known to cause a photosensitive reaction. The mechanism of contraceptive-induced photosensitivity is uncertain. Estrogen, rather than progesterone, in the combined oral contraceptive pill has been most frequently implicated in the induction of photosensitivity. A 32-year-old woman presented with an erythematous patch with an itching sensation on the centrofacial area of a residual vitiligious lesion. She had a history of being previously treated with narrow band UVB for 1 year. Her skin lesions had mostly subsided, but some lesions continued. She underwent an in vitro fertilization-embryo transfer 3 months previously, and she then took synthetic progesterone for 3 weeks starting at the 4th week of pregnancy. She was in good health with neither a family history of photosensitivity nor a personal history of any other drug ingestion or topical agent such as sunscreen in association with the beginning of her lesions. Phototesting revealed her to be markedly photosensitive in the UVB and UVA ranges. The intradermal skin reactions to progesterone combined with irradiation with UVA or UVB were positive. We report here on an unusual case of photosensitivity that was localized in a vitiliginous lesion, and this was associated with the intramuscular injections of synthetic progesterone that she had received during an in vitro fertilization-embryo transfer.
Adult ; Autoimmune Diseases ; Contraceptives, Oral ; Dermatitis ; Eating ; Erythema ; Estrogens ; Female ; Hormone Replacement Therapy ; Humans ; Injections, Intramuscular ; Pregnancy ; Progesterone ; Pruritus ; Sensation ; Skin ; Urticaria

Lichen planus is a chronic papulosquamous disease chracterized by various clinical manifestations of the skin and mucous membrane. Although its etiology is not fully understood, lichen planus has been associated with viral infection, autoimmune disease, psychologic factors, and medications. Both antigen-specific and non-specific mechanisms may be involved in the pathogenesis of lichen planus. The former includes antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing by CD8+ cytotoxic T cells, the latter includes mast cell degranulation and matrix metalloproteinase activation. A large variety of topical and systemic therapies are available for the treatment of lichen planus. Also, topical pimecrolimus (Elidel(R) 0.1% cream) may be used because of its inhibitory effect on activated T cells and mast cell degranulation. Recently, it has been shown to be effective in the treatment of oral and genital lichen planus. But, its effect in cutaneous lichen planus has not been reported to date. We report on the successful use of topical pimecrolimus in the management of a generalized lichen planus patient.
Antigen Presentation ; Autoimmune Diseases ; Homicide ; Humans ; Keratinocytes ; Lichen Planus* ; Lichens* ; Mast Cells ; Mucous Membrane ; Skin ; T-Lymphocytes