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*

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

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

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

Objectives: ：The purpose of this study was to investigate the relationship between serum vitamin D concentration and resilience in patients hospitalized with bipolar disorder. Methods: ：Serum vitamin D levels were measured on day 1 of hospitalization in 64 patients with bipolar disorder, who were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. The ConnorDavidson Resilience Scale and the Korean version of the Inventory for Depressive Symptomatology (KIDS) were administered to these patients, and symptoms of mania were evaluated using the Young Mania Rating Scale (YMRS). Patients were then categorized into vitamin D sufficient and deficient groups based on a serum vitamin D cut-off of 20 ng/ mL. Analysis of covariance (ANCOVA) was performed to compare the resilience between the two groups, and multiple linear regression was performed to determine the association between serum vitamin D levels and resilience. Results: ：The vitamin D deficiency group had more depressive episodes than the sufficient group (p<0.05). ANCOVA showed that the vitamin D deficient group had significantly lower resilience scores than the sufficient group (p= 0.034). Moreover, multiple regression analyses conducted by controlling age, sex, body mass index, season of blood sampling, KIDS scores, and YMRS scores, showed a significant association between serum vitamin D concentration and resilience in patients with bipolar disorder (p=0.001). Conclusions ：This study suggested that vitamin D deficiency is associated with resilience as a protective factor against stress and trauma in patients with bipolar disorder. Further research is warranted to determine the causal relationship between vitamin D levels and resilience.

Objectives: Adolescent suicide is a serious social problem. Adolescent alcohol use is one of the most important risk factors for adolescent suicide. This study aimed to identify the relationship between drinking habits and suicide among Korean adolescents. Methods: Data from the 14th and 15th Korean Youth Risk Behavior Web-based Survey, conducted in 2018 and 2019, were used for analysis. Multiple logistic regression analysis was used to identify the relationship between drinking habits—including the age of drinking initiation, frequency of drinking, average drinking amount, frequency of drunkenness—and suicidal ideation, plans, and attempts. Results: Even after adjusting for age, sex, school grade, academic achievement, socioeconomic status, depression, stress, and drinking habits, the frequencies of drinking and drunkenness increased the risk of suicide attempts. Suicide attempts were associated with the frequency of drinking in girls and middle school students, and with the frequency of drunkenness in boys and high school students. Conclusion This study identified associations between drinking habits (the age of drinking initiation, frequency of drinking, average amount of drinking, frequency of drunkenness) and suicidal behavior in adolescents. Our findings suggest that to prevent adolescent suicide, it might be necessary to investigate drinking habits, including the frequencies of drinking and drunkenness. Moreover, considering the differences in sex and school grade, it is important to include the individual group characteristics when evaluating drinking habits.