Background: Uncontrolled blood pressure (BP) is relatively common despite treatment with antihypertensive medication. This study aimed to investigate factors associated with uncontrolled systolic BP (SBP) and diastolic BP (DBP) separately in hypertensive patients with high medication adherence in Korea. Methods: This population-based cross-sectional study included 3,236 participants in the Korea National Health and Nutrition Examination Survey from 2013 to 2015. Hypertensive patients with high medication adherence were defined when they stated that they were taking antihypertensive medication daily. “Uncontrolled SBP and DBP” were defined as SBP ≥140 mm Hg and DBP ≥90 mm Hg, respectively. Data were analyzed using logistic regression to determine the association between uncontrolled SBP or DBP and various factors. Results: The prevalence of uncontrolled SBP and uncontrolled DBP was 23.3%, and 9.0%, respectively. In multivariate analysis, uncontrolled SBP was positively associated with older age, female sex, blue-collar occupation or no work (vs. white-collar), presence of a spouse, short sleep duration, frequent heavy alcohol drinking, longer hypertension duration, diabetes, stroke, and missing antihypertensive medication on the examination day, but negatively associated with high stress. Uncontrolled DBP was positively associated with frequent heavy alcohol drinking, but negatively associated with older age, blue-collar occupation or no work (vs. white-collar), and diabetes. Conclusion After excluding low medication adherence, we identified various factors associated with uncontrolled SBP or DBP in Korean adults with treated hypertension. There were differences between factors associated with uncontrolled SBP or DBP. Separate analysis of SBP and DBP may help understand the factors involved in BP control.

In this study, we examined the effect of a combination of fibroblast growth factor-2 (FGF-2) and retinoic acid (RA) on osteoblast and adipocyte lineage commitment and differentiation of human bone marrow mesenchymal stem cells (BMSCs). Pretreatment of human BMSCs with FGF-2 or RA for 5 days followed by osteoblast differentiation induction showed high calcium deposition compared to control. A combination of FGF-2 and RA further induced calcium deposition compared to FGF-2 or RA alone. The enhanced mineral deposition was accompanied with the increased expression of osteoblast differentiation markers, alkaline phosphatase and osteocalcin. On the other hand, FGF-2 pretreatment followed by adipocyte differentiation induction also showed increased formation of lipid droplets in human BMSCs, whereas RA pretreatment suppressed formation of lipid droplets. However, a combination of FGF-2 and RA increased formation of lipid droplets and expression of adipocyte marker genes, including adiponectin, ADIPOQ, FABP4, peroxisome proliferator-activated receptor γ (PPARγ), and C/EBPα. During pretreatment of BMSCs with FGF-2, RA or in combination, the cells expressed similar levels of MSC surface markers such as CD29, CD44, CD90, and CD105, indicating that they maintain stem cell potential. To determine how RA cooperates with FGF-2 in osteoblast and adipocyte lineage commitment, the expression of RA receptors and intracellular lipid-binding proteins was examined. A combination of FGF-2 and RA strongly induced the expression of RA receptor α, β, γ, PPAR β/δ, CRABP-II, and FABP5. Collectively, these results demonstrate that combined pretreatment of human BMSCs with FGF-2 and RA enhances the commitment into osteoblast and adipocyte lineages through modulation of the expression of RA-related genes.
Adipocytes ; Adiponectin ; Alkaline Phosphatase ; Antigens, Differentiation ; Bone Marrow* ; Calcium ; Fibroblast Growth Factor 2* ; Fibroblasts* ; Hand ; Humans ; Lipid Droplets ; Mesenchymal Stromal Cells* ; Miners ; Osteoblasts ; Osteocalcin ; Peroxisome Proliferator-Activated Receptors ; Peroxisomes ; Stem Cells ; Tretinoin*

PURPOSE: The aim of this study was to develop and to analyze the duty and the task of rehabilitation nurse in Korea. METHOD: The definition of rehabilitation nurse and job description was developed based on developing curriculum(DACUM) by panels who have experienced in DACUM analysis and rehabilitation nursing. 228 nurses who were working at rehabilitation centers and rehabilitation unit in general hospitals were participated. The questionnaire included frequency, importance, and difficulty of duties and tasks. The data were collected in March and April 2009, analyzed by descriptive statistics. RESULTS: The job description of rehabilitation nurse in Korea revealed 11 duties, and 61 tasks. On the all 11 duties, the highest duty in frequency and importance was direct nursing care (2.47+/-.31, 2.77+/-.28) and the highest duty in difficulty was self-development (2.39+/-.48). Among the tasks of duties 'direct nursing care' in 'manage medication' (2.87+/-.35) in frequency, the task 'prevent and manage bedsore' (2.91+/-.31) of duty 'direct nursing care' in importance, and 'cope emergency situations' (2.72~.49) of duty direct nursing care in difficulty showed the highest degree. CONCLUSION: The political efforts for the legislation of role and task of rehabilitation nurse were needed.
Emergencies ; Hospitals, General ; Humans ; Job Description ; Korea ; Nurse Practitioners ; Nursing Care ; Surveys and Questionnaires ; Rehabilitation Centers ; Rehabilitation Nursing

Background: Despite the distinctly high risk of suicide among patients with psychiatric disorders, little is known regarding the nationwide rates and risk factors for suicide among individual subgroups of patients with psychiatric disorders. This study aimed to assess differences in suicide rates and identify risk factors for suicide across multiple psychiatric diseases using data from a nationally representative cohort in Korea. Methods: Six groups of incident patients with psychiatric disorders, namely those with drug use disorder (DUD), alcohol use disorder (AUD), schizophrenia (SCZ), bipolar disorder (BD), depressive disorder (DD), or other affective disorders (OADs), were extracted from the National Health Information Database and followed up. Suicide rates and risk factors were then determined for each disease group. Results: Patients with psychiatric disorders had higher suicide rates than did the general population, with standardized mortality ratios (SMRs) ranging from 2.5 to 16.6. In particular, patients with DUD showed markedly higher suicide rate (584.0 per 100,000 person-years [PYs]; SMR, 16.6) than did patients with affective disorders, including DD (119.8 per 100,000 PYs; SMR, 3.1). AUD, DUD, SCZ, and BD showed lower male/female suicide rate ratios (1.1–1.4) than did depressive and OADs (2.2–2.4). Old age increased the risk for suicide among those with DUD and OADs, while medical aid recipients exhibited the lowest suicide risk among those with the AUD and SCZ. Male sex and the presence of multiple psychiatric comorbidities were consistently identified as suicide risk factors across mental illness subgroups. Conclusion The current study observed substantial variations in suicide rates and risk factors across psychiatric disorders and patient characteristics, which have significant implications for suicide prevention strategies.

Objective: To describe the incidence and survival outcomes of uterine cervical cancer during 1999–2018. Methods: Patients who were diagnosed with cervical cancer during 1999–2018 were identified in the Korea Central Cancer Registry. Age-standardized incidence rates (ASRs) and annual percent changes (APCs) were calculated. Survival rates by histology, year of diagnosis (1999–2008 vs. 2009–2018), stage, and age at diagnosis were analyzed. Results: The absolute incidence of cervical cancer decreased over 20 years from 4,488 in 1999 to 3,500 in 2018, with an APC of −3.42% (p<0.0001). While ASR of squamous cell carcinoma (SCCA) more than halved from 13.27 per 100,000 in 1999 to 6.16 in 2018 (APC, −4.04%), adenocarcinoma continued to rise (ASR, 1.30 per 100,000 to 1.92; APC, 1.52%; p<0.0001). Patients with adenocarcinoma were younger than those with SCCA (mean, 49.9±12.7 vs. 52.9 ±14.6 years; p<0.0001). Five-year survival rate of cervical cancer patients overall was 78.0%. Adenocarcinoma had poorer survival than SCCA (5-year survival rate, 76.8% vs. 79.8%; p<0.0001). There was no survival difference between patients who were diagnosed between 1999–2008 and 2009–2018. Earlier-stage disease had better survival (5-year survival rate for localized, regional, and distant disease, 90.0% vs. 69.9% vs. 26.5%; p<0.0001). Younger patients aged <50 years had better survival than those aged ≥50 years (87.1% vs. 69.8%; p<0.0001). Conclusion The incidence of SCCA of the uterine cervix declined while adenocarcinoma continued to increase slowly but significantly from 1999 to 2018 in Korea. Adenocarcinoma was diagnosed at a younger age, but had poorer survival outcome than SCCA.

Objective: Primary peritoneal cancer (PPC), ovarian cancer (OC), and fallopian tube cancer (FTC) are considered as a single disease group. As knowledge of the pathogenesis and clinical presentation of peritoneal, ovarian, and fallopian tube (POFT) cancer grows, the tendencies in OC diagnosis are changing. We investigate the incidence and clinical characteristics of epithelial POFT based on cancer site and histologic type. Methods: Data from the Korea Central Cancer Registry for the period between 1999 and 2016 were analyzed. The incidence rates and annual percent changes (APCs) for each tumor site were reported. Results: Among 27,768 women with cancer, 1,086 (3.91%) had PPC, 25,847 (93.08%) had OC, and 835 (3.01%) had FTC. Age-standardized rates increased from 0.05 to 0.24, 3.51 to 5.48, and 0.04 to 0.28 in PPC, OC, and FTC, respectively. The proportion of PPC and FTC among all the POFT cases increased consistently during the study period (from, respectively, 1.48 and 1.06 in 1999 to 4.52 and 4.76 in 2016). The APC of PPC, OC, and FTC during 1999–2016 was 9.3%, 2.7%, and 8.6%, respectively. The incidence of PPC, OC, and FTC was highest among patients in the 65–69, 50–54, and 55–59 years age group, respectively. Conclusion The overall incidence of PPC, OC, and FTC cancer has steadily increased. The relative increase of PPC and FTC has been significant. In this study, OC incidence had a relatively young peak age, in contrast to FTC and PPC, which had an older peak age.

Objective: To investigate the incidence and survival outcomes of ovarian carcinosarcoma in Korea between 1999 and 2018. Methods: Patients diagnosed with ovarian carcinosarcoma between 1999 and 2018 were identified from the Korea Central Cancer Registry (KCCR) and their information was collected. Age-standardized incidence rates (ASRs), annual percent changes (APC), and relative survival rates of ovarian carcinosarcoma were calculated and compared to those of epithelial ovarian cancer. Results: According to the KCCR, 458 cases of ovarian carcinosarcoma were detected, and accounted for 1.5% (458/30,679) of all epithelial ovarian cancers in Korea between 1999 and 2018. The ASR of ovarian carcinosarcoma between 1999 and 2018 was 0.064 per 100,000 women. The incidence rate of ovarian carcinosarcoma increased during the study period, with an ASR of 0.029 per 100,000 in 1999 and 0.073 per 100,000 in 2018. The APC of ovarian carcinosarcoma during 1999–2018 was 5.86 (p<0.001). The median overall survival (OS) of patients with ovarian carcinosarcoma was 39 months, and the 5-year OS rate was 42.5%.Among ovarian carcinosarcomas, patients with localized stages showed better clinical outcomes than those with regional or distant stages (5-year OS, 60.8%, 57.9%, and 32.8%, respectively; p<0.001). In addition, younger (<50 years) patients showed better OS than older (≥50 years) patients (5-year OS, 52.6% vs. 40.2%; p<0.001). Conclusion Our nationwide registry-based study demonstrated that the incidence of ovarian carcinosarcoma increased from 1999 to 2018 in Korea. Patients with advanced-stage disease and older age (≥50 years) had poorer survival outcomes.

Objective: To investigate the incidence and survival outcomes of ovarian carcinosarcoma in Korea between 1999 and 2018. Methods: Patients diagnosed with ovarian carcinosarcoma between 1999 and 2018 were identified from the Korea Central Cancer Registry (KCCR) and their information was collected. Age-standardized incidence rates (ASRs), annual percent changes (APC), and relative survival rates of ovarian carcinosarcoma were calculated and compared to those of epithelial ovarian cancer. Results: According to the KCCR, 458 cases of ovarian carcinosarcoma were detected, and accounted for 1.5% (458/30,679) of all epithelial ovarian cancers in Korea between 1999 and 2018. The ASR of ovarian carcinosarcoma between 1999 and 2018 was 0.064 per 100,000 women. The incidence rate of ovarian carcinosarcoma increased during the study period, with an ASR of 0.029 per 100,000 in 1999 and 0.073 per 100,000 in 2018. The APC of ovarian carcinosarcoma during 1999–2018 was 5.86 (p<0.001). The median overall survival (OS) of patients with ovarian carcinosarcoma was 39 months, and the 5-year OS rate was 42.5%.Among ovarian carcinosarcomas, patients with localized stages showed better clinical outcomes than those with regional or distant stages (5-year OS, 60.8%, 57.9%, and 32.8%, respectively; p<0.001). In addition, younger (<50 years) patients showed better OS than older (≥50 years) patients (5-year OS, 52.6% vs. 40.2%; p<0.001). Conclusion Our nationwide registry-based study demonstrated that the incidence of ovarian carcinosarcoma increased from 1999 to 2018 in Korea. Patients with advanced-stage disease and older age (≥50 years) had poorer survival outcomes.