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

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

No abstract available.
Hypertension*

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

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

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

PURPOSE: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. MATERIALS AND METHODS: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. RESULTS: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean 16.8degrees, 13.5 mm to 4.2degrees, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. CONCLUSION: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.
Ankle* ; Athletes* ; Follow-Up Studies ; Foot ; Gait ; Humans ; Jogging ; Leg ; Ligaments ; Prospective Studies ; Range of Motion, Articular ; Running ; Sports ; Suture Anchors ; Sutures* ; Walking ; Surveys and Questionnaires

PURPOSE: Although influenza is one of the most important causes of acute respiratory tract infections in children, effective antiviral therapies are not common and there are only a few clinical studies on treatment of influenza in children. We evaluated the efficacy of oseltamivir in the treatment of naturally aquired influenza in children during the first half of 2004 in Busan. METHODS: From January 2004 to June 2004, throat swabs and nasal washes were performed and cultured for the isolation of influenza virus and tested by rapid antigen detection test (QuickVue influenza test) in children with suspected influenza infections. The children who responded positively to the QuickVue influenza test, we divided into two groups: an oseltamivir treatment group and a control group. We compared their clinical symptoms (including fever duration) and diagnosis. The medical records of patients with influenza virus infection were reviewed retrospectively. RESULTS: A total of 621 individuals were suspected of influenza infection. Influenza viruses were isolated in 79 (17.2 percent) out of 621 patients examined. QuickVue influenza tests were positive in 181 cases. The treatment group (83 individuals) received oseltamivir twice daily for 5 days, and the control group (99 individuals) were administered only symptom relief medicine. There was no differences between the two groups in clinical diagnosis and symptoms. Oseltamivir treatment reduced the fever duration and other respiratory symptoms. There were no adverse events associated with oseltamivir treatment. CONCLUSION: Our data suggest that oral oseltamivir treatment reduces the fever duration and other respiratory symptoms of acute influenza without side effects in children.
Busan* ; Child* ; Diagnosis ; Fever ; Humans ; Influenza, Human* ; Medical Records ; Orthomyxoviridae ; Oseltamivir* ; Pharynx ; Respiratory Tract Infections ; Retrospective Studies