PURPOSE: The purpose of this study was to compare the working status and Standard Shiftwork Index (SSI) between night shift-fixed nurses and rotating shift nurses. METHODS: Participants were 367 nurses working as registered nurses at 7 different medical institutions. The data were collected from August 8, 2016 to September 30, 2016. RESULTS: Night shift fixed nurses were more satisfied with work schedule than rotating shift nurses. Rotating shift nurses reported higher SSI scores, such as chronic fatigue, musculoskeletal problems, than night shift fixed nurses. In SSI's sub-items, rotating shift nurses reported higher scores, such as the amount of sleep, feeling well after sleep, heartburn or stomach-ache and heartbeat irregularities, than night shift fixed nurses. CONCLUSION: The results indicated that night shift fixed system might be an effective method to improve nurses' work satisfaction. It is necessary to figure out any suitable night shift fixed system based on the characteristics of each nursing organization. The SSImight be an useful tool tomeasure the nurses' satisfaction in reference to their work shift.
Appointments and Schedules ; Fatigue ; Heartburn ; Humans ; Job Satisfaction ; Methods ; Nurses ; Nursing

PURPOSE: The purpose of this study was to investigate the welfare status of nurses and the status of fixed night shifts and flexible work arrangements in both general hospitals and advanced general hospitals in Korea. METHODS: A total of 167 hospitals participated in this study, done from April to October 2018. RESULTS: There were 103 hospitals utilizing the fixed night shift system, 22 in the two-shift system, 3 in the fixed holiday shift, 79 in the fixed shift system, and 39 in the short-time working system. The average welfare benefits for nurses increased to 33.02 million won on average. However, welfare services for the nurses were poor: 41.8% of the respondents had a nurses' lounge, 81.7% were given dormitory space at their place of employment, 41.8% had access to welfare facilities, and 56.4% were provided with welfare support countermeasures. CONCLUSION: The results show an increasing trend of hospitals to utilize fixed night shift and flexible work arrangements. An institutional strategy at the national policy level should be established to implement flexible work arrangements including the fixed night shift system, which has a poor level of welfare.
Employment ; Holidays ; Hospitals, General ; Korea ; Surveys and Questionnaires

Coronary artery fistula (CAF) is a rare form of congenital anomalies of the coronary arteries, and this is usually discovered by chance during coronary angiography. However, this type of fistula can cause important coronary morbidity and mortality leading to angina, syncope, congestive heart failure, myocardial infarction and sudden death. Bilateral CAFs are even rarer, and especially when combined with valvular heart disease. The coincidence of CAF with aortic regurgitation is relatively rare and this might sometimes cause myocardial ischemia. We present here a case of bilateral coronary-pulmonary artery fistulas that arose from the first diagonal branch of the left anterior descending artery and the conal branch of the right coronary artery combined with severe aortic regurgitation, and this all caused myocardial ischemia.
Aortic Valve Insufficiency ; Arteries ; Arteriovenous Fistula ; Coronary Angiography ; Coronary Vessels ; Death, Sudden ; Fistula ; Heart Failure ; Heart Valve Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Pulmonary Artery ; Syncope

BACKGROUND:With the application of early reperfusion by thrombolysis after acute MI, the importance of nontransmural infarction is increasing. We evaluated 1) the changes of LV dimension, LV fibrosis and transforming growth factor-beta1 (TGF-beta1) mRNA expression in a rat model of nontransmural infarction and 2) effects of angiotensin converting enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ATRB) treatment after nontransmural infarction. METHOD AND RESULTS: Female Sprague-Dawley rats were subjected to 45 minutes of coronary occlusion followed by reperfusion, and at 5 days after the operation, animals were randomized to untreated (MI-vehicle, n=19), captopril-treated (MI-captopril, n=15) and losartan-treated (MI-losartan, n=14) groups. LV dimension, measured by transthoracic echocardiography, was significantly increased at 26 days after MI, and both captopril and losartan treatment inhibited LV cavity dilatation (LV end-diastolic dimension (mm): MI-vehicle, MI-captopril, MI-losartan; 8.6 +/- 0.2, 7.8 +/- 0.2, 8.0 +/- 0.2, p<0.05 vs. MI-vehicle each). Interstitial fibrosis was reduced with both captopril and losartan treatment (p<0.05 vs. MI-vehicle). TGF-beta1 mRNA increased 2.6 fold at 10 days (p<0.05 vs. pre-MI), and normalized at 26 days after nontransmural MI. Captopril and losartan treatment blocked the induction of TGF-beta1 expression after nontransmural MI (p=S vs. pre-MI). CONCLUSION: After large nontransmural MI, ACEI and ATRB treatments attenuate LV remodeling and decrease interstitial fibrosis, at least partly by blocking the acute induction of TGF-beta1 mRNA expression.
Angiotensins* ; Animals ; Captopril ; Coronary Occlusion ; Dilatation ; Echocardiography ; Female ; Fibrosis ; Humans ; Infarction ; Losartan ; Models, Animal ; Peptidyl-Dipeptidase A* ; Rats, Sprague-Dawley ; Receptors, Angiotensin ; Reperfusion ; RNA, Messenger ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; Ventricular Remodeling*

Post-tonsillectomy hemorrhage (PTH) is the most frequent complication of tonsillectomy, and occasionally results in a lethal outcome. A 21-year-old man (height 180 cm, weight 95 kg) was scheduled for a bilateral tonsillectomy and uvulopalatopharyngoplasty for treatment of obstructive sleep apnea. He required 5 rounds of general anesthesia due to recurrent PTH. The anesthesiologist used sugammadex a total of 3 times to achieve the successful reversal of the deep neuromuscular blockade (NMB) induced by rocuronium. After sugammadex 2 mg/kg was administered, the NMB was reversed in 2 minutes each time. Re-administration of rocuronium within a short time interval after sugammadex may result in unpredictable effects of neuromuscular blocking agents. Sugammadex made it possible to perform a rapid, complete reverse when the residual block was maintained by an incomplete reversal of anticholinesterase.
Anesthesia, General ; Hemorrhage* ; Humans ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Postoperative Hemorrhage ; Sleep Apnea, Obstructive ; Tonsillectomy ; Young Adult

Hypersensitivity to mosquito bites is a disorder characterized by necrotic skin reactions and systemic generalized symptoms subsequent to mosquito bites. This disease has been reported mostly in Japanese patients in their first two decades of life. Recent studies have revealed that hypersensitivity to mosquito bites is frequently associated with chronic Epstein-Barr virus infection and natural killer cell leukemia/lymphoma. We describe here a Korean male adolescent who had hypersensitivity to mosquito bites accompanied by chronic Epstein-Barr virus infection and atypical lymphocytosis.
Adolescent ; Asian Continental Ancestry Group ; Culicidae* ; Herpesvirus 4, Human* ; Humans ; Hypersensitivity* ; Killer Cells, Natural ; Lymphocytosis* ; Skin

No abstract available.

Legionella bacterium, an intracellular pathogen of mononuclear phagocytes, causes acute fatal pneumonia, especially in patients with impaired cellular immune responses. Until recently, however, the toll-like receptor (TLR) engagement of bacterial proteins derived from Legionella is uncertain. We previously showed that a 19-kDa highly conserved peptidoglycan-associated lipoprotein (PAL) of Legionella pneumophila induced the PAL-specific B cell and T cell responses in mice. In this study, we observed that the rPAL antigen of L. pneumophila, as an effector molecule, activated murine macrophages via TLR2 and produced proinflammatory cytokines such as IL-6 and TNF-alpha. In both BALB/c and TLR4-deficient C3H/HeJ mice, pretreatment of macrophages with anti-TLR2 mAb showed severely impaired cytokine production in response to the rPAL. In addition, in vitro the rPAL treatment increased the cell surface expression of CD40, CD80, CD86 and MHC I/II molecules. We further showed that the synthetic CpG-oligodeoxynucleotides (CpG ODN) coadministered with the rPAL enhanced IL-12 and IL-6 production and expression of CD40, CD80 and MHC II compared to the rPAL treatment alone. In conclusions, these results indicate that Legionella PAL might activate macrophages via a TLR2-dependent mechanism which thus induce cytokine production and expression of costimulatory and MHC molecules.
Animals ; Antigens, CD/immunology/metabolism ; Bacterial Outer Membrane Proteins/*pharmacology ; Cells, Cultured ; Female ; Histocompatibility Antigens Class II/immunology/metabolism ; Host-Pathogen Interactions ; Interleukin-12/biosynthesis ; Interleukin-6/biosynthesis ; Legionella pneumophila/*immunology/metabolism ; Legionnaires' Disease/immunology/metabolism ; Lipoproteins/*pharmacology ; Macrophage Activation/drug effects/immunology ; Macrophages, Peritoneal/drug effects/immunology/*metabolism ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C3H ; Mice, Inbred C57BL ; Toll-Like Receptor 2/*metabolism ; Tumor Necrosis Factor-alpha/biosynthesis

Stress-induced cardiomyopathy is a relatively rare, unique entity that has only recently been widely appreciated. It characterized by transient left ventricular regional wall motion abnormalities (with a peculiar apical ballooning appearance), chest pain or dyspnea, ST-segment elevation and/or T wave inversion and minor elevations of the cardiac enzyme levels. The patients in the previous series were usually women over 50 years of age and a triggering event was identified in most cases; these included severe emotional distress or an acute medical illness. Although reports of single episodes of stress-induced cardiomyopathy are not infrequent in the recent medical literature, we report here on a case of stress-induced cardiomyopathy in a young women, and this was related with the post-partum period as a stressful condition.
Cardiomyopathies* ; Chest Pain ; Dyspnea ; Female ; Humans ; Postpartum Period*

PURPOSE: Oxidative stress has been implicated in the pathogenesis of various diseases. Catalase is one of the main defense mechanisms against oxidative stress. To examine the possible relationship between oxidative stress, and gastric and hepatocellular carcinomas, HinfI restriction length polymorphism (RFLP) in the human catalase gene was assessed. MATERIALS AND METHODS: The genotype and allele frequencies in the promoter region of the catalase gene were studied by PCR-RFLP in 108 Korean controls, 80 Korean gastric carcinoma (GC) and 106 Korean hepatocellular carcinoma (HCC) patients. RESULTS: No statistically significant differences were found in the genotypic distribution and allelic frequencies between the controls and both types of carcinoma patient. CONCLUSION: To address the possible contribution of oxidative stresses to the pathogenesis of gastric and hepatocellular carcinomas, the associations between the catalase gene polymorphism and GC and HCC susceptibilities were studied. As a result, the catalase gene polymorphism was found not to be determinant of GC and HCC susceptibilities. Further studies are required on various other oxidative stress related genes to elucidate the mechanisms of GC and HCC.
Carcinoma, Hepatocellular* ; Catalase* ; Defense Mechanisms ; Gene Frequency ; Genotype ; Humans ; Oxidative Stress ; Promoter Regions, Genetic