No abstract available.
Hypertension*

No abstract available.
Echocardiography* ; Emergencies* ; Emergency Service, Hospital* ; Myocardial Ischemia*

Psychological stress including depression and anxiety are independent risk factors for cardiovascular disease morbidity and mortality, especially in women. Emotional regulation plays a mediating role in the development of depression and physical illness, and can alter resting physiologic responses associated with the stress response. Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. MBSR was originally developed for the management of chronic pain, which is now used widely to reduce psychological morbidity associated with chronic illnesses and to treat emotional and behavioral disorders. In cardiovascular disease, MBSR may be helpful for controlling several risk factors for coronary heart disease such as hypertension, type 2 diabetes mellitus, dyslipidemia, oxidative and psychosocial stress, obesity, and smoking, and improvements in submaximal exercise responses and heart rate variability. Although the most effective mode of stress reduction therapy is yet to be established, increasing recognition is being given to MBSR therapy.
Anxiety ; Cardiovascular Diseases* ; Chronic Disease ; Chronic Pain ; Coronary Disease ; Depression ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Female ; Heart Rate ; Heart* ; Humans ; Hypertension ; Meditation ; Mindfulness ; Mortality ; Negotiating ; Obesity ; Relaxation ; Risk Factors ; Smoke ; Smoking ; Stress, Psychological

BACKGROUND AND OBJECTIVES: An association between chronic stress and cardiovascular diseases has been described, but the underlying mechanisms have not been fully elucidated. We investigate the impact of perceived stress on the left ventricular (LV) and endothelial functions in postmenopausal women. SUBJECTS AND METHODS: We investigated 64 consecutive postmenopausal women (mean age 56.7+/-9.7 years) with atypical chest pain and chronic stress. Patients with coronary heart disease were excluded. Global and segmental longitudinal deformation parameters of LV were used as parameters to assess myocardial function and brachial flow-mediated dilatation (FMD) was used to assess the endothelial function, and patients were analyzed by the Symptom Checklist 90 Revised (SCL-90-R) to determine emotional stress. The study participants were divided into two groups, based on global severity index (GSI): > or =50 (group A, n=27) or <50 (group B, n=37). RESULTS: Although there were no significant differences in LV geometry or myocardial performance indices between the groups, global LV strain was significantly reduced in group A compared to group B (-16.6+/-2.7% vs. -19.1+/-1.9%, p=0.001). There were also significant differences in the value of reactive FMD (6.6+/-2.2% vs. 9.5+/-2.9%, p<0.001), and same result was observed for nitroglycerine-induced dilatation (14.6+/-4.7% vs. 18.0+/-5.8%, p=0.016). Multivariate linear regression analysis showed that GSI was the only significant attributor to global LV strain (beta=0.149, p=0.008) and reactive FMD (beta=-0.200, p=0.041). CONCLUSION: Chronic emotional stress may exert negative effects on the LV and endothelial functions, which may be associated with the severity of stress. This study provides a possible mechanism by which stress is associated with an increased risk of cardiovascular dysfunction.
Cardiovascular Diseases ; Checklist ; Chest Pain ; Coronary Disease ; Dilatation ; Echocardiography ; Endothelium ; Female ; Humans ; Linear Models ; Sprains and Strains ; Stress, Psychological

PURPOSE: The purpose of this study was to figure out influences of supervisor's and colleague's supports, nursing work environment, ego-resilience, organizational commitment and burnout on turnover intention of nurses working in general hospitals. METHODS: The data were collected from 379 nurses working in general hospitals with more than 500 beds in S city from July 1 to August 31, 2012. The collected data were analyzed with independent t-test, one-way ANOVA, Pearson's correlation and Hierarchial regression analysis by using SPSS 19.0. RESULTS: In case the subject was young, with work experience of 1~5 years, single, female and position of general nurse, turnover intention was statistically significantly higher. Turnover intention, supervisor's support, nursing work environment, organizational commitment and ego-resilience showed significantly negative correlations, but burnout showed significantly positive correlations. In case of controlling general characteristics, higher correlational variables with turnover intention accounted for 30.2%. CONCLUSION: In order to reduce turnover intention of general nurses who showed higher intention with 1~5 years' work experience, situational variables such as organizational commitment and nursing work environment and interpersonal relation variables such as supervisor's support as well as personal variables such as ego-resilience should all be considered.
Female ; Hospitals, General ; Humans ; Intention* ; Interpersonal Relations* ; Nursing ; Regression Analysis

BACKGROUND: Although carotid intima-media thickness (IMT) is the most commonly used ultrasonic measurement of atherosclerosis, plaque burden can be also assessed by ultrasound (US). We investigated the relationship between IMT, total plaque area (TPA) and total plaque volume (TPV) in patients with coronary artery disease (CAD). METHODS: One hundred and seven patients with suspected CAD and carotid plaques identified by duplex ultrasound underwent 3-dimensional US and coronary angiography. The mean IMT, TPA, and TPV were analyzed for patients with CAD according to the severity of CAD. RESULTS: In the 107 participants, IMT, TPA and TPV averaged 0.90 +/- 0.26 mm, 0.42 +/- 0.39 cm2 and 237.0 +/- 301.2 mm3, respectively. We found significant correlations for mean IMT : TPA, mean IMT : TPV and TPA : TPV of 0.448, 0.587 and 0.873, respectively (all p < 0.005). Although there was no significant association of IMT and the severity of CAD, TPA and TPV showed significant positive correlation with CAD severity (r = 0.340, p = 0.0003 for TPA and r = 0.465, p < 0.0001 for TPV). Multivariate linear regression analysis showed age was the only significant attributor to IMT, TPA, and TPV. Mean IMT was significantly associated only with hypertension. TPA was significantly associated with male sex, hypertension, and low density lipoprotein-cholesterol (LDL-C). TPV was significantly associated with male sex, C-reactive protein, and LDL-C. CONCLUSION: Although there were significant correlations among the various US measures of carotid artery morphology, there seemed to be different biological determinants of IMT, TPA, and TPV. We might need to be selective about the particular measurements for specific applications.
Atherosclerosis ; C-Reactive Protein ; Carotid Arteries ; Carotid Intima-Media Thickness ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Humans ; Hypertension ; Linear Models ; Male ; Ultrasonics

PURPOSE: The purpose of this study was to figure out influences of supervisor's and colleague's supports, nursing work environment, ego-resilience, organizational commitment and burnout on turnover intention of nurses working in general hospitals. METHODS: The data were collected from 379 nurses working in general hospitals with more than 500 beds in S city from July 1 to August 31, 2012. The collected data were analyzed with independent t-test, one-way ANOVA, Pearson's correlation and Hierarchial regression analysis by using SPSS 19.0. RESULTS: In case the subject was young, with work experience of 1~5 years, single, female and position of general nurse, turnover intention was statistically significantly higher. Turnover intention, supervisor's support, nursing work environment, organizational commitment and ego-resilience showed significantly negative correlations, but burnout showed significantly positive correlations. In case of controlling general characteristics, higher correlational variables with turnover intention accounted for 30.2%. CONCLUSION: In order to reduce turnover intention of general nurses who showed higher intention with 1~5 years' work experience, situational variables such as organizational commitment and nursing work environment and interpersonal relation variables such as supervisor's support as well as personal variables such as ego-resilience should all be considered.
Female ; Hospitals, General ; Humans ; Intention ; Interpersonal Relations ; Nursing ; Regression Analysis

BACKGROUND: Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. In this study, we investigate the impact of MBSR on left ventricular (LV) and endothelial function in female patients with microvascular angina. METHODS: A total of 34 female patients (mean age 52.2 ± 13.8 years) diagnosed with microvascular angina underwent a MBSR program with anti-anginal medication for 8 weeks. The global longitudinal strain (GLS) of the LV was used as a parameter to assess myocardial function and reactive brachial flow-mediated dilatation (FMD) was used to assess endothelial function. Symptoms were analyzed by the Symptom Checklist 90 Revised to determine emotional stress. Changes in GLS and FMD between baseline and post-MBSR were analyzed. RESULTS: After 8 weeks of programmed MBSR treatment, stress parameters were significantly decreased. In addition, GLS (−19.5 ± 2.1% vs. −16.6 ± 2.5%, p < 0.001) and reactive FMD significantly improved (8.9 ± 3.0% vs. 6.9 ± 2.6%, p = 0.005) after MBSR compared to baseline. The changes in GLS correlated to changes in FMD (r = 0.120, p = 0.340) and with the changes in most stress parameters. CONCLUSION: MBSR has beneficial impacts on myocardial and endothelial function in female patients with microvascular angina.
Checklist ; Dilatation ; Female* ; Humans ; Meditation ; Microvascular Angina* ; Mindfulness* ; Stress, Psychological

BACKGROUND AND OBJECTIVES: Renin-angiotensin system (RAS) inhibitors are likely to reduce the development of atrial fibrillation (AF) by preventing atrial fibrosis. We attempted to assess the relevance of strain echocardiography for quantitative assessment of the left atrial (LA) status in AF, its modification by RAS inhibitors and changes of biochemical markers during cardiac remodeling in AF. SUBJECTS AND METHODS: Strain echocardiography is performed 2 times (baseline and 12 month) in 60 patients with AF (RAS inhibitors-used group: 30, non-used group: 30). In an apical 4-chamber view, the regional analysis consisted of placing the region of interest cursor at the basal segments of the septal and lateral wall of LA. Mean peak systolic and early diastolic strain/rate are measured with LA end-systolic antero-posterior, longitudinal and transverse dimensions. RESULTS: Six patients of RAS inhibitors-used group (group A, 20%) and three patients of non-used group (group B, 10%) were converted to normal sinus rhythm during the study. LA size, E wave velocity, E/E', strain parameters showed no significant differences between groups at the baseline. There were no significant differences in LA size and E wave velocity between groups at the 12 months, however, peak systolic strain/rate were significantly higher in group A (36.71+/-13.63% and 2.98+/-0.59s(-1), p<0.05, respectively) than group B (27.21+/-10.49% and 2.21+/-0.47s(-1)). In addition, peak early diastolic strain/rate were significantly higher in group A (-1.89+/-3.30% and -2.32 +/-0.77s-1 p<0.05, respectively) than group B (-0.83+/-2.79% and -1.77+/-0.25s(-1)). There were no significant differences in C-reactive protein (CRP) and B-type natriuretic peptide (BNP) at the baseline, but BNP were significantly reduced in group A (822.9+/-798.3 pg/mL, p<0.05) than group B (1481.9+/-209.97 pg/mL) at the 12-month follow-up. CONCLUSION: The increased values of atrial peak systolic and diastolic strain/rate after treatment with RAS inhibitors revealed that passive stretching and shortening of LA wall might improve in some patients with AF even before LA size change possibly because of reduced atrial fibrosis and increased compliance. Our results indicated that strain echocardiography provides clinically useful information of LA function and remodeling and treatment with RAS inhibitors appears to preserve LA reservoir function in AF patients without visible LA structural change.
Atrial Fibrillation ; Atrial Function, Left ; Biomarkers ; C-Reactive Protein ; Compliance ; Echocardiography ; Fibrosis ; Humans ; Muscle Stretching Exercises ; Natriuretic Peptide, Brain ; Prospective Studies ; Renin-Angiotensin System ; Sprains and Strains

PURPOSE: To determine the MR imaging findings of synovial sarcoma, with emphasis on the signal characteristicsof pathologically correlated T2-weighted images. MATERIALS AND METHODS: MR images of 14 cases ofpathologically-proven synovial sarcomas were retrospectively reviewed and correlated with the histopathologicfindings. We analyzed the signal intensity of T1- and T2-weighted images and the incidence of triple signalintensity, and evaluated the frequency of fluid-fluid levels, internal fibrous septa, calcification, the invasionof bone or neurovascular bundles and the involvement of joint capsules, as well as the size, location and marginof the tumors and pattern of contrast enhancement. RESULTS: Necrosis, cystic change or hemorrhage was suggested in11 cases, ten of which showed triple signal intensity, and in all cases, was pathologically confirmed. Fluid-fluidlevels were found in three cases and internal septa in ten. In four cases, maximum diameter was less than 5cm, andin nine, was greater than this. No mass was detected in one case. The tumor was located in the low extremity(n=9),pelvic girdle and hip joint area(n=2), scapular(n=1), shoulder joint area(n=1), and scalp(n=1). Eleven casesshowed a relatively well-defined margin and nine showed lobulation. Except in the area of necrosis and cysticchange, the pattern of contrast enhancement was diffuse and inhomogenous. Bony invasion was detected in two cases,neurovascular encasement in four, calcification in four, and joint capsule invasion in four. CONCLUSION: OnT2-weighted images, synovial sarcoma frequently showed triple signal intensity and internal septa with fluid-fluidlevels ; this was induced by cystic changes due to necrosis and hemorrhage.
Hemorrhage ; Hip Joint ; Incidence ; Joint Capsule ; Magnetic Resonance Imaging* ; Necrosis ; Retrospective Studies ; Sarcoma, Synovial* ; Shoulder Joint