OBJECTIVE: This study evaluated the complaint rates of musculoskeletal symptoms and investigated the related factors of musculoskeletal symptoms in the caddies. METHODS: For 316 caddies working at 6 regular golf courses, we used the self-recording questionnaires to examine general characteristics, job stress factors, subjective musculoskeletal symptoms designed by NIOSH, working environments, and working contents. RESULTS: The complaint rates of musculoskeletal symptoms according to the musculoskeletal criteria of NIOSH were 41.8% in the leg/knee/ankle/foot, 35.8% in the shoulder, 35.8% in the upper back/lower back, 28.8% in the neck, and 28.5% in the arm/wrist/fingers. Important factors affecting musculoskeletal symptoms were daily working hours during the high-demand season in all anatomical sites except the arm/wrist/fingers. Other related factors were degrees of winding and inclined in the golf courses, violent language and violence of customers, inability to regulate the velocity and work load control, heavy physical burden, instability of employment, and possibility of unemployment according to the specialty of caddies. As a results of multivariate logistic regression analysis, musculoskeletal symptoms of the neck, shoulders, back/lower back and leg/knee/ankle/foot were significantly influenced by working time over 12 hours in the high-demand season, and symptoms of the arm/wrist/fingers by low decision latitude (P<0.05). CONCLUSIONS: The complaint rates of musculoskeletal symptoms in the caddies were affected by working time over 12 hours and low decision latitude against excessively high psychological job demand.
Employment ; Golf* ; Logistic Models ; National Institute for Occupational Safety and Health (U.S.) ; Neck ; Questionnaires ; Seasons ; Shoulder ; Unemployment ; Violence ; Wind

Improved nutritional intake contributes to maintaining health and quality of life in elderly population and also reducing individual and social medical costs. Most of nutrition assistance programs for elderly, such as congregate or home-delivered meal programs, are not currently serviced in rural communities mainly due to low cost efficiency of program operation. However, the needs and necessity of such programs are presumed to be higher in rural area where the population density of elderly at nutritional risk is relatively high. Therefore, the purpose of this study was to develop a community-based meal program for the rural elderly. In 2007, four rural communities located in Jeon-Nam province were selected and the pilot meal program was applied for three months. Following are key features of the meal program model developed in this study: 1) meal production and service are operated by elderly participants to overcome the voluntary personnel shortage, 2) utilization of locally-produced foods is maximized to reduce the meal cost, 3) traditional cooking methods are applied to adjust the food preference of elderly, and 4) foods are serviced on site to minimize the food safety problem possibly caused by delivery process. The pilot programs resulted in high satisfaction with the programs of participating elderly. The community-based meal program model developed in this study is expected to be used as an effective nutrition and health intervention model for the rural elderly.
Aged ; Cooking ; Food Preferences ; Food Safety ; Humans ; Meals ; Population Density ; Quality of Life ; Rural Population

Intestinal microbiota is involved in the atherosclerotic process by development of an atheromatous core with foam cells in carotid arteries. It has reported that lipopolysaccharide (LPS) from Escherichia coli localizes in human atherosclerotic plaque and causes inflammation via interaction with toll like receptor 4. However, there is no evidence that whether LPS-activated macrophages regulate endothelial cell (EC) function. We evaluated whether LPS-activated macrophage acts as one of the stimulants activating EC and its underlying signaling pathways. Using Western blotting and quantitative reverse transcription-polymerase chain reaction (qRT-PCR), we confirmed that intraperitoneal injection with LPS increases iNOS protein and inflammatory cytokine, TNF-α and IL-6 mRNA expressions. To determine whether LPS-mediated macrophage inflammatory condition affects EC activation and inflammation, human umbilical vein endothelial cells (HUVECs) were incubated with isolated peritoneal macrophages from LPS-injected mice. Interestingly, p90RSK Serine 380 phosphorylation and protein expression were significantly increased by macrophage treatment in EC. Messenger RNA levels of vascular cell adhesion molecule 1 and p90RSK was increased, but endothelial nitric oxide synthase was decreased. In addition, NF-κB promoter activity, which plays an important role in the pathogenesis of inflammation, was strongly enhanced by the macrophage treatment in EC. We further evaluated the effects of LPS on EC function in the mouse aorta using en face staining. In agreement with in vitro result, p90RSK expression was strongly increased in the steady laminar flow region of the mouse aorta in mice injected with LPS. Together, our study demonstrates that p90RSK might be a one of the major therapeutic candidates for the prevention of vascular diseases mediated by LPS.
Animals ; Aorta ; Atherosclerosis ; Blotting, Western ; Carotid Arteries ; Endothelial Cells ; Escherichia coli ; Foam Cells ; Gastrointestinal Microbiome ; Human Umbilical Vein Endothelial Cells ; Humans ; In Vitro Techniques ; Inflammation ; Injections, Intraperitoneal ; Interleukin-6 ; Macrophage Activation* ; Macrophages* ; Macrophages, Peritoneal ; Mice ; Nitric Oxide Synthase Type III ; Phosphorylation ; Plaque, Atherosclerotic ; RNA, Messenger ; Serine ; Toll-Like Receptor 4 ; Vascular Cell Adhesion Molecule-1 ; Vascular Diseases

p90 ribosomal S6 kinase (p90RSK), one of the downstream effectors in ERK1/2 pathways, shows high expression in human breast cancer tissues. However, its role in breast cancer development and drug resistance is not fully understood. Here, we demonstrate that Cis-DDP treatment failed to increase cytotoxicity in MDA-MB-231 cells compared to MCF-7 cells and p90RSK activation was involved in Cis-DDP-resistance to MDA-MB-231 cells. In the study, we found that inhibition of p90RSK expression or activation using a small interfering RNA (siRNA) or dominant-negative kinase mutant (DN-p90RSK) plasmid overexpression increased Cis-DDP-induced cytotoxicity of MDA-MB-231 cells, respectively. Mechanistically, we found that Cis-DDP resistance was associated with up-regulation of epithelial growth factor (EGF) expression and EGF treatment induced cancer survival signaling pathway including activation of ERK1/2, p90RSK, and Akt. We also examined the expression of epithelial-mesenchymal transition (EMT)-associated proteins using a reverse transition-quantitative PCR analysis. Cis-DDP treatment induced EMT by increasing the expression levels of N-cadherin, Snail, and Twist, while decreasing the expression levels of E-cadherin. Furthermore, we examined the epithelial marker, Zonula occludens-1 (ZO-1) using immunofluorescence analysis and found that Cis-DDP-inhibited ZO-1 expression was recovered by p90RSK deactivated condition. Therefore, we conclude that Cis-DDP resistance is involved in EMT via regulating the EGF-mediated p90RSK signaling pathway in MDA-MB-231 cells.
Breast Neoplasms ; Cadherins ; Cisplatin ; Drug Resistance ; Epidermal Growth Factor ; Epithelial-Mesenchymal Transition ; Fluorescent Antibody Technique ; Humans ; MCF-7 Cells ; Phosphotransferases ; Plasmids ; Polymerase Chain Reaction ; Ribosomal Protein S6 Kinases, 90-kDa ; RNA, Small Interfering ; Snails ; Triple Negative Breast Neoplasms ; Up-Regulation

PURPOSE: We explored the relationship between the use of each medical intervention and the length of time between do-not-resuscitate (DNR) consent and death in Korea. MATERIALS AND METHODS: A total of 295 terminal cancer patients participated in this retrospective study. Invasive interventions (e.g., cardiopulmonary resuscitation, intubation, and hemodialysis), less invasive interventions (e.g., transfusion, antibiotic use, inotropic use, and laboratory tests), and the time interval between the DNR order and death were evaluated. The subjects were divided into three groups based on the amount of time between DNR consent and death (G1, time interval ≤ 1 day; G2, time interval > 1 day to ≤ 3 days; and G3, time interval > 3 days). RESULTS: In general, there were fewer transfusions and laboratory tests near death. Invasive interventions tended to be implemented only in the G1 group. There was also less inotrope use and fewer laboratory tests in the G3 group than G1 and G2. Moreover, the G3 group received fewer less invasive interventions than those in G1 (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.03 to 0.84; 3 days before death, and OR, 0.16; 95% CI, 0.04 to 0.59; the day before death). The frequency of less invasive interventions both 1 and 3 days before death was significantly lower for the G3 group than the G1 (p ≤ 0.001) and G2 group compared to G1 (p=0.001). CONCLUSION: Earlier attainment of DNR permission was associated with reduced use of medical intervention. Thus, physicians should discuss death with terminal cancer patients at the earliest practical time to prevent unnecessary and uncomfortable procedures and reduce health care costs.
Cardiopulmonary Resuscitation ; Health Care Costs ; Humans ; Intubation ; Korea* ; Resuscitation Orders ; Retrospective Studies ; Terminal Care

The purpose of this study was to understand the mechanism of cardiovascular disease (CVD) caused by exposure to hazardous chemicals. We investigated changes in the symptoms of metabolic syndrome, which is strongly related to CVD, and in levels of other CVD risk factors, with a special emphasis on the roles of catecholamines and oxidative stress. The results revealed that neither body mass index (BMI) nor waist and hip circumferences were associated with exposure to hazardous chemicals. Among metabolic syndrome criteria, only HDL-cholesterol level increased on exposure to hazardous chemicals. Levels of epinephrine (EP) and norepinephrine (NEP) were not influenced by exposure to hazardous chemicals; however, the total antioxidative capacity (TAC) reduced because of increased oxidative stress. Both hazardous chemical exposure level and metabolite excretion were related to EP, NEP, and the oxidative stress index (OSI). Logistic regression analysis with these factors as independent variables and metabolic syndrome criteria as dependent variables revealed that EP was associated with blood pressure, and NEP with metabolic syndrome in the chemical-exposed group. In conclusion, the results suggest that reactive oxygen species generated and oxidative stress due to exposure to hazardous chemicals act as mediators and cause changes in the physiological levels of EP and NEP to increase blood pressure. This ultimately leads to the development of CVD through increase in cholesterol, triglyceride, and blood glucose levels by lipid peroxidation.
Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Catecholamines ; Cholesterol ; Epinephrine ; Hazardous Substances ; Hip ; Lipid Peroxidation ; Logistic Models ; Norepinephrine ; Oxidative Stress ; Reactive Oxygen Species ; Risk Factors

PURPOSE: The aim of this study was to examine the effects of obesity on the physiological levels of adiponectin, leptin and components of metabolic syndrome (MS) in male workers, aged 30-40 years. METHODS: Body mass index (BMI) was measured with Anthropometric equipment. Blood pressure and serum parameters were measured with an automatic digital sphygmomanometer and autochemical analyzer, respectively. Adiponectin and leptin were analysed by ELISA kits and MS was defined based on the NCEP-ATP III. RESULTS: Body fat mass of waist and hip, systolic and diastolic blood pressure were significantly higher, as expected, in the BMI> 25kg/m2 in comparison with the BMI< or =25kg/m2. While fasting glucose, insulin, HOMA-IR and leptin in the BMI>25kg/m2 were also significantly higher compared with BMI< or =25kg/m2, HDL- cholesterol and adiponectin were significantly higher in BMI< or =25kg/m2. On multiple logistic regression analysis for the components of MS, exercise, adiponectin and leptin were an only independent factor for MS in non-obese male workers(BMI< or =25kg/m2) after adjustment for age, cigarette smoking and drinking habits. CONCLUSION: These results suggested that the obesity in men was associated with physiological levels of adiponectin and leptin contributing to feedback control of MS and that dysfunction and/or declination in feedback control system associated with changes in physiological levels of neurptrophics: adiponectin and leptin might ultimately induce MS.
Adiponectin ; Adipose Tissue ; Aged ; Blood Pressure ; Body Mass Index ; Cholesterol ; Drinking ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Glucose ; Hip ; Humans ; Insulin ; Leptin ; Logistic Models ; Male ; Obesity ; Smoking ; Sphygmomanometers

PURPOSE: The aim of this study was to examine the effects of obesity on the physiological levels of adiponectin, leptin and components of metabolic syndrome (MS) in male workers, aged 30-40 years. METHODS: Body mass index (BMI) was measured with Anthropometric equipment. Blood pressure and serum parameters were measured with an automatic digital sphygmomanometer and autochemical analyzer, respectively. Adiponectin and leptin were analysed by ELISA kits and MS was defined based on the NCEP-ATP III. RESULTS: Body fat mass of waist and hip, systolic and diastolic blood pressure were significantly higher, as expected, in the BMI> 25kg/m2 in comparison with the BMI< or =25kg/m2. While fasting glucose, insulin, HOMA-IR and leptin in the BMI>25kg/m2 were also significantly higher compared with BMI< or =25kg/m2, HDL- cholesterol and adiponectin were significantly higher in BMI< or =25kg/m2. On multiple logistic regression analysis for the components of MS, exercise, adiponectin and leptin were an only independent factor for MS in non-obese male workers(BMI< or =25kg/m2) after adjustment for age, cigarette smoking and drinking habits. CONCLUSION: These results suggested that the obesity in men was associated with physiological levels of adiponectin and leptin contributing to feedback control of MS and that dysfunction and/or declination in feedback control system associated with changes in physiological levels of neurptrophics: adiponectin and leptin might ultimately induce MS.
Adiponectin ; Adipose Tissue ; Aged ; Blood Pressure ; Body Mass Index ; Cholesterol ; Drinking ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Glucose ; Hip ; Humans ; Insulin ; Leptin ; Logistic Models ; Male ; Obesity ; Smoking ; Sphygmomanometers

PURPOSE: The purpose of this study was to develop a system for the measurement and simulation of the TMJ movement and to analyze the mandibular movement quantitatively. MATERIALS AND METHODS: We devised patient-specific splints and a registration body for the TMJ movement tracking. The mandibular movements of the 12 subjects with facial deformity and 3 controls were obtained by using an optical tracking system and the patient-specific splints. The mandibular part was manually segmented from the CT volume data of a patient. Three-dimensional surface models of the maxilla and the mandible were constructed using the segmented data. The continuous movement of the mandible with respect to the maxilla could be simulated by applying the recorded positions sequentially. Trajectories of the selected reference points were calculated during simulation and analyzed. RESULTS: The selected points were the most superior point of bilateral condyle, lower incisor point, and pogonion. There were significant differences (P<0.05) between control group and pre-surgical group in the maximum displacement of left superior condyle, lower incisor, and pogonion in vertical direction. Differences in the maximum lengths of the right and the left condyle were 0.59+/-0.30 mm in pre-surgical group and 2.69+/-2.63 mm in control group, which showed a significant difference (P<0.005). The maximum of differences between lengths of the right and the left calculated during one cycle also showed a significant difference between two groups (P<0.05). CONCLUSION: Significant differences in mandibular movements between the groups implies that facial deformity have an effect on the movement asymmetry of the mandible.
Congenital Abnormalities ; Displacement (Psychology) ; Humans ; Incisor ; Mandible ; Maxilla ; Splints ; Temporomandibular Joint ; Track and Field

Acquired facial lipoatrophy is a rare disease with an unclear etiology and pathological pathway. The distinct causative factors of this disease have been not elucidated, but it is suspected to be associated with immune systemrelated diseases, most notably AIDS. Although the management of facial lipoatrophy is very important for patients’ social life and mental health, no treatment framework has been developed due to the unknown nature of the disease manifestation. The present case report was designed to provide sequential imaging to visualize the disease progression. The clinical backgrounds of the patients are also introduced, helping characterize this disease entity more clearly for maxillofacial specialists.