OBJECTIVES: Shift work is a stressful situation. It is important to know the factors associated with the ability to adapt to a shift work schedule. The aim of the present study was to investigate the association between sleep, as well as personality variables, and the resilience of shift work nurses. METHOD: Self-report questionnaires were administered to 95 nurses who worked in one national university hospital. Connor-Davidson resilience scale, hospital anxiety and depression scale, morningness-eveningness scale, Pittsburgh sleep quality index, other sleep-related questionnaires, and Korean defense style questionnaires were used. RESULTS: Age, shift work duration, off-day oversleep, depression, anxiety, adaptive defense style, and self-suppressive defense style were significantly associated with resilience (p < 0.05). Multiple regression analysis showed that age (beta = 0.34, p < 0.05), depression (beta = -0.25, p < 0.05), adaptive defense style (beta = 0.45, p < 0.001), and self-suppressive defense style (beta = -0.19, p < 0.05) significantly predicted the resilience of shift work nurses. Concerning individual defense mechanisms, resignation (beta = -0.20, p < 0.05), sublimation (beta = 0.19, p < 0.05), omnipotence (beta = 0.19, p < 0.05), and humor (beta = 0.20, p < 0.05) significantly predicted the resiliency. CONCLUSION: The findings indicate that a specific defense style and other mechanisms were associated with the resilience of shift work nurses. A future prospective study with more participants could further clarify the relationship between sleep-related variables, as well as personality factors, and resilience of shift work nurses.
Anxiety ; Appointments and Schedules ; Defense Mechanisms ; Depression ; Surveys and Questionnaires ; Sublimation

OBJECTIVE: This study aimed to examine whether educational stressors and relational stressors are associated with burnout in medical students and to test social support as a moderator between stressors and burnout. METHODS: A total of 263 medical students attending Gyeongsang National University composed the study sample. A standardized questionnaire was used to investigate educational and relational stressors, three dimensions of burnout, and social support of medical students. RESULTS: The findings showed that overall burnout is very high among Korean medical students, with 9.9% totally burned out. Educational and relational stressors were significantly associated with the risk of burnout in medical students after controlling for socio-demographics and health behaviors. Social support moderated educational and relational stressors on personal accomplishment, but did not moderate stressors on emotional exhaustion and depersonalization. CONCLUSION: Burnout level is substantially high among Korean medical students. Educational and relational stressors are significantly associated with burnout risk in Korean medical students. Social support had moderated educational and relational stressors on personal accomplishment. The results suggest that more social support for medical students is needed to buffer stressors on and burnout.
Burns ; Depersonalization ; Health Behavior ; Humans ; Students, Medical*

PURPOSE: This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. METHODS: The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. RESULTS: The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. CONCLUSION: Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.
Adult ; Caregivers ; Child ; Cost of Illness ; Efficiency ; Health Care Costs ; Humans ; Incidence ; Inpatients ; Insurance, Health ; Korea ; Outpatients ; Quality of Life ; Republic of Korea ; Rotavirus ; Rotavirus Infections ; Transportation

PURPOSE: This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. METHODS: The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. RESULTS: The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. CONCLUSION: Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.
Adult ; Caregivers ; Child ; Cost of Illness ; Efficiency ; Health Care Costs ; Humans ; Incidence ; Inpatients ; Insurance, Health ; Korea ; Outpatients ; Quality of Life ; Republic of Korea ; Rotavirus ; Rotavirus Infections ; Transportation

Platelets are derived from the fragments that are formed from the cytoplasm of bone marrow megakaryocytes-small irregularly shaped anuclear cells. Platelets respond to vascular damage, contracts blood vessels, and attaches to the damaged region, thereby stopping bleeding, together with the action of blood coagulation factors. Platelet activation is known to affect genes associated with vascular risk factors, as well as with arteriosclerosis and myocardial infarction. Here, we performed a genome-wide association study with 352,228 single-nucleotide polymorphisms typed in 8,842 subjects of the Korea Association Resource (KARE) project and replicated the results in 7,861 subjects from an independent population. We identified genetic associations between platelet count and common variants nearby chromosome 4p16.1 (p = 1.46 x 10(-10), in the KIAA0232 gene), 6p21 (p = 1.36 x 10(-7), in the BAK1 gene), and 12q24.12 (p = 1.11 x 10(-15), in the SH2B3 gene). Our results illustrate the value of large-scale discovery and a focus for several novel research avenues.
Arteriosclerosis ; Blood Coagulation Factors ; Blood Vessels ; Blood Platelets ; Bone Marrow ; Cytoplasm ; Genome-Wide Association Study* ; Hemorrhage ; Humans ; Korea ; Megakaryocytes ; Myocardial Infarction ; Platelet Activation ; Platelet Count* ; Polymorphism, Single Nucleotide ; Risk Factors

BACKGROUND: The number of patients suffering from acute myocardial infarction is on the increase in Korea due to the westernization of life style. Recent improvement of therapeutic stratigies have shown early mortality benefits in acute myocardial infarction. But we don't have data how many patients died and what's the cause of death in these patients. This study aimed to find out the mortality rate, cause of death and it's relevant prognostic factors of myocardial infarction (MI) patients who admitted alive, and to construct a database which will be used to develop a risk stratification strategy for the implementation of new preventive therapeutic modalities, such as implantable cardioverter-defibrillator (ICD). METHODS: Seven hundred and forty two MI patients admitted to our hospital from March, 1999 to August, 2002 were included in this study. The risk factors and survivals were evaluated by medical record searching and telephone survey in these patients. RESULTS: The average age was 64 years-old and 67% was male. During the mean follow up 20.7+/-15.4 months, total 105 cardiac death (14.2%) was occurred and cumulative mortality rate at 1 year and 2 year was 5.69% and 10.80%, respectively. Of the total 129 death, in-hospital death was 68 (cardiac death 48, non-cardiac death 20) and out of hospital death was 60 (cardiac death 57, non-cardiac death 4). When it comes to cause of death, most common cause of cardiac death was malignant arrhythmia. The proportion of malignant arrhythmia in cardiac death was 81.3% and 72% of in-hospital and out of hospital death, respectively. Multivariate analysis showed that old age, low LV ejection fraction and no percutaneous coronary intervention (PCI) treatment were independent risk factors for cardiac mortality. CONCLUSIONS: Myocardial infarction shows still high mortality rate despite the recent development of therapeutic strategy. As post-MI patients with low LVEF or no PCI shows high mortality, the early reperfusion therapy should be encouraged. Additionally, because malignant arrhythmia was one of the most in cause of cardiac death, ICD therapy to prevent sudden cardiac death should be considered in an active manner.
Arrhythmias, Cardiac ; Cause of Death* ; Death ; Death, Sudden, Cardiac ; Defibrillators, Implantable ; Follow-Up Studies ; Humans ; Korea ; Life Style ; Male ; Medical Records ; Middle Aged ; Mortality* ; Multivariate Analysis ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Reperfusion ; Risk Factors ; Telephone

OBJECTIVE: Restenosis after successful PTCA remains the main limitation of this technique. Restenosis is a response to injury of the vessel wall, platelet aggregation, thrombus formation, liberation of growth factors, cellular hyperplasia involving predominantly smooth muscle proliferation and migration, and intercellular matrix formation. The identification of risk factors for restenosis could help to prevent and reduce the impact of this phenomenon. We undertook this study to evaluate retrospectively the association between risk factors and restenosis after PTCA METHODS: We studied 123 patients and 174 lesions that underwent successful PTCA and the follow-up period (from PTCA to follow-up angiography) was 8.2+/-5.8 months in all patients. They were divided into two groups according to the restenosis. Clinical feature, lesional feature, PTCA procedural feature, and other risk factors were compared. Restenosis was defined as the cutoff point of >50% in diameter stenosis at angiographic follow-up. RESULTS: 1) Restenosis was found in 68 lesions after successful PTCA(39.1%). 2) Clinical features of restenosis group are similar to no restenosis group 3) Thrombus (p=0.002), total occlusion(p=0.001), severity of stenosis in the initial lesion(p=0.013) and residual stenosis(p=0.001) were found to be independently associated with restenosis, whereas other lesional characteristics were not. 4) Balloon inflation duration(p=0.017) and dissection(p=0.002) were found to be independently associated with restenosis, whereas other procedural characteristics were not. CONCLUSION: Thrombus, total occlusion, dissection, severity of stenosis in the initial lesion, balloon inflation time, residual stenosis were found to be associated with restenosis after PTCA in our study.
Angioplasty, Balloon, Coronary* ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Hyperplasia ; Inflation, Economic ; Intercellular Signaling Peptides and Proteins ; Muscle, Smooth ; Platelet Aggregation ; Retrospective Studies ; Risk Factors ; Thrombosis

Sialolithiasis, the most common salivary gland pathology, is caused by calculi in the gland itself and its duct. While patients with small sialoliths can undergo conservative treatment, those with standard-size or larger sialoliths require sialolithotomy. In the present case study, we removed two sialoliths located beneath the mucosa in the posterior and anterior regions of Wharton's duct, respectively. For the posterior calculus, we performed sialolithotomy via an intra-oral approach; thereafter, the small anterior calculus near the duct orifice was removed by hydraulic power. This method has not previously been reported. There were no complications either during the operation or postoperatively, and the salivary function of the gland remained normal.
Calculi* ; Humans ; Methods* ; Mucous Membrane ; Needles* ; Pathology ; Salivary Ducts ; Salivary Gland Calculi ; Salivary Glands ; Submandibular Gland

Human dermal fibroblast is essential in wound healing of the skin through the synthesis of extracellular matrix proteins. With respect to oxidative stress, the effects of remifentanil on human dermal fibroblast have received little attention. Therefore, we investigated the effects of remifentanil on the apoptosis and autophagic reaction of human dermal fibroblasts under oxidative stress. The subjects were divided into the following groups: Control group: cells were incubated at 37℃ in a humidified atmosphere with 5% CO₂. Hydrogen peroxide (H₂O₂) group: cells were exposed to H₂O₂ for 2 h. RPC/H₂O₂ group: cells were pretreated with remifentanil for 2 h and exposed H₂O₂ for 2 h. 3-MA/RPC/H₂O₂ group: cells were pretreated with 3-methyladenine (3-MA) and remifentanil for 1 h and 2 h, respectively. We measured cell viability using MTT assay. Western blot analysis was used to determine the expression levels of proteins associated with apoptosis and autophagy. Quantification of apoptotic cells was performed using flow cytometer analysis, and autophagic vacuoles were observed under a fluorescence microscope. Remifentanil treatment increased the proliferation of human dermal fibroblast and decreased apoptotic cell death, enhancing autophagic activity under oxidative stress. However, 3-MA, the autophagy pathway inhibitor, inhibited the protective effect of remifentanil in oxidative stress. This study demonstrates that remifentanil activated autophagy and decreased apoptotic death of human dermal fibroblasts under oxidative stress. Our results suggest that remifentanil may help in the treatment of oxidative stress.
Apoptosis ; Atmosphere ; Autophagy ; Blotting, Western ; Cell Death ; Cell Survival ; Extracellular Matrix Proteins ; Fibroblasts* ; Fluorescence ; Humans* ; Hydrogen Peroxide ; Oxidative Stress* ; Skin ; Vacuoles ; Wound Healing

Objective: The suicide rate in Korea was the highest among countries in the Organisation for Economic Co-operation and Development in 2019. In a previous study, higher intake of vegetables and fruits was associated with a lower risk of suicidal ideation, and carotene-rich fruits and vegetables lowered the risk of depression. This study aimed to examine the direct relationship between carotene intake and suicidal ideation, adjusting for the effect on depression. Methods: This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2012, 2013, and 2015. Carotene intake was assessed through a food intake frequency survey with a 24-hour recall. Suicidal ideation and depression were assessed using the mental health section of the KNHANES. We applied logistic regression to assess the relationship between carotene intake and suicidal ideation, adjusting for potential confounders. Results: A total of 5,480 females aged 19–64 years were included in this study. Carotene intake was significantly lower in the suicidal ideation group (3,034.5±1,756.4 μg/day) than in the nonsuicidal ideation group (3,225.4±1,795.1 μg/day) (p=0.015). We found a significant inverse association between carotene intake and the risk of suicidal ideation after adjusting for potential confounders (odds ratio=0.934, 95% confidence interval=0.873–0.999). Conclusion These results suggest that carotene intake may be inversely associated with the risk of suicidal ideation. Our findings may inform the development of new nutritional interventions to prevent increases in the risk of suicide worldwide.