PURPOSE: This study is to explore the relationships among spirituality, death anxiety and burnout level of nurses caring for cancer patients. METHODS: Participants were 210 nurses from a cancer hospital in Seoul. Data were collected from April until June 2012 and analyzed using t-test, one-way ANOVA, Scheffe's test, and Pearson's correlation coefficient. RESULTS: The mean score for spirituality was 3.51 out of six. Among sub-categories, the one that scored the highest was the purpose and meaning of life, followed by unifying interconnectedness, inner resources and transcendence. The mean score for death anxiety was 3.22, and the sub-categories in the order of high score were denial of death, awareness of the shortness of time, pure death anxiety and fear of matters related to death. For the burnout, the mean was 4.10. Among sub-categories, highest mark was found with emotional exhaustion, followed by depersonalization and personal accomplishment. The spirituality level was negatively correlated with those of death anxiety and burnout. Death anxiety was positively correlated with burnout levels. Nurses with the higher spirituality level also had a higher level of education and experience of spiritual education, believed in the existence of God. In contrast, death anxiety and burnout levels were higher among those with a lower level of education, atheists, and for those who answered that religion has little influence on life. CONCLUSION: Thus, it is necessary to provide spiritual interventions for nurses who care for cancer patients to develop their spirituality, reduce death anxiety and prevent them from burning out easily.
Anxiety* ; Burnout, Professional ; Burns ; Cancer Care Facilities* ; Denial (Psychology) ; Depersonalization ; Education ; Humans ; Spirituality*

No abstract available.
Endocrinology

BACKGROUND: Hes6 is a transcriptional regulator that induces transcriptional activation by binding to transcription repressor Hes1 and suppressing its activity. Hes6 is controlled by the ubiquitin-proteosome-mediated degradation system. Here we investigated the sumoylation of Hes6 and its functional role in its rhythmic expression. METHODS: Hes6, SUMO, and ubiquitin were transfected into HeLa cells and the expression pattern was observed by Western blot and immunoprecipitation. To confirm the effect of sumoylation on the rhythmic expression of Hes6, we generated mouse Hes6 promoter-driven GFP-Hes6 fusion constructs and expressed these constructs in NIH 3T3 cells. RESULTS: Overexpression of SUMO led to sumoylation of Hes6 at both lysine 27 and 30. Protein stability of Hes6 was decreased by sumoylation. Moreover, expression of a Hes6 sumoylation-defective mutant, the 2KR (K27/30R) mutant, or co-expression of SUMO protease SUSP1 with native Hes6, strongly reduced ubiquitination. In addition, sumoylation was associated with both the rhythmic expression and transcriptional regulation of Hes6. Wild type Hes6 showed oscillatory expression with about 2-hour periodicity, whereas the 2KR mutant displayed a longer period. Furthermore, sumoylation of Hes6 derepressed Hes1-induced transcriptional repression. CONCLUSION: Hes6 sumoylation plays an important role in the regulation of its stability and Hes1-mediated transcription. These results suggest that sumoylation may be crucial for rhythmic expression of Hes6 and downstream target genes.
Animals ; Blotting, Western ; HeLa Cells ; Humans ; Immunoprecipitation ; Lysine ; Mice ; NIH 3T3 Cells ; Periodicity ; Protein Stability ; Proteolysis* ; Repression, Psychology ; Sumoylation* ; Transcriptional Activation ; Ubiquitin ; Ubiquitination

Serum levels of LH, FSH and prolactin and plasma levels of estradiol and progesterone were measured by radioimmunoassay from 8 healthy volunteers on no medication for at least 3 months prior to study and with histories of regular menstrual cycle. The following criteria were used to define a normal menstrual cycle:1) mid-cycle LH surge, 2) luteal phase duration between 12 and 16 days, 3) plasma progesterone levels above 5 ng/m1 5-10 days after LH surge. Six of eight cycles studied were considered normal. Serum levels of LH from 6 women were fair1y constant through the cycle, except at midcycle, when a surge occurred. The rapid increase of LH secretion was during the late follicular phase with a mean peak value of 147.5 mIU/ml. Concentration of FSH started to rise after the onset of menses and decreased slight1y during the late follicular phase. FSH rose sharply at midcycle with a mean peak value reaching 36.8 mIU/ml. Following the midcycle FSH and LH surge, FSH and LH decreased sharply and remained at lower concentration during the luteal phase than during the follicular phase. Serum prolactin concentrations fluctuated throughout the menstrual cycle. There was no peak value of prolactin concomitant to the LH peak. Plasma estradiol gradually increased during the follicular phase reaching a maximum of 354.3 pg/ml prior the midcycle LH surge. Following its peak, the level of estradiol dropped sharply and started to increase from the 3rd day after LH peak, rising to 235.9 pg/ml during the midluteal peak. Plasma progesterone levels remained consistently low during the follicular phase and started to rise after the midcycle surge of LH. This rise persisted from day 5 to day 9 after the LH surge, showing a mean value of 26.1 ng/m1. Afterward, a sharp decline occurred resulting in menstruation. Two cycles studied were considered abnormal. Both cycles showed a "short luteal phase".
Estradiol/blood ; Female ; Follicle Stimulating Hormone/blood ; Gonadotropins, Pituitary/blood* ; Human ; Korea ; Luteinizing Hormone/blood ; Menstruation* ; Progesterone/blood ; Prolactin/blood ; Sex Hormones/blood*

BACKGROUND: In mammals, the CLOCK/BMAL1 heterodimer is a key transcription factor complex that drives the cyclic expression of clock-controlled genes involved in various physiological functions and behavioral consequences. Recently, a growing number of studies have reported a molecular link between the circadian clock and metabolism. In the present study, we explored the regulatory effects of SIRTUIN1 (SIRT1), an NAD+-dependent deacetylase, on CLOCK/BMAL1-mediated clock gene expression. METHODS: To investigate the interaction between SIRT1 and CLOCK/BMAL1, we conducted bimolecular fluorescence complementation (BiFC) analyses supplemented with immunocytochemistry assays. BiFC experiments employing deletion-specific mutants of BMAL1 were used to elucidate the specific domains that are necessary for the SIRT1-BMAL1 interaction. Additionally, luciferase reporter assays were used to delineate the effects of SIRT1 on circadian gene expression. RESULTS: BiFC analysis revealed that SIRT1 interacted with both CLOCK and BMAL1 in most cell nuclei. As revealed by BiFC assays using various BMAL1 deletion mutants, the PAS-B domain of BMAL1 was essential for interaction with SIRT1. Activation of SIRT1 with resveratrol did not exert any significant change on the interaction with the CLOCK/BMAL1 complex. However, promoter analysis using Per1-Luc and Ebox-Luc reporters showed that SIRT1 significantly downregulated both promoter activities. This inhibitory effect was intensified by treatment with resveratrol, indicating a role for SIRT1 and its activator in CLOCK/BMAL1-mediated transcription of clock genes. CONCLUSION: These results suggest that SIRT1 may form a regulatory complex with CLOCK/BMAL1 that represses clock gene expression, probably via deacetylase activity.
Cell Nucleus ; Circadian Clocks ; Complement System Proteins ; Fluorescence ; Gene Expression ; Immunohistochemistry ; Luciferases ; Mammals ; Metabolism ; Transcription Factors

BACKGROUND: In mammals, the master circadian pacemaker is localized in an area of the ventral hypothalamus known as the suprachiasmatic nucleus (SCN). Previous studies have shown that pacemaker neurons in the SCN are highly coupled to one another, and this coupling is crucial for intrinsic self-sustainability of the SCN central clock, which is distinguished from peripheral oscillators. One plausible mechanism underlying the intercellular communication may involve direct electrical connections mediated by gap junctions. METHODS: We examined the effect of mefloquine, a neuronal gap junction blocker, on circadian Period 2 (Per2) gene oscillation in SCN slice cultures prepared from Per2::luciferase (PER2::LUC) knock-in mice using a real-time bioluminescence measurement system. RESULTS: Administration of mefloquine causes instability in the pulse period and a slight reduction of amplitude in cyclic PER2::LUC expression. Blockade of gap junctions uncouples PER2::LUC-expressing cells, in terms of phase transition, which weakens synchrony among individual cellular rhythms. CONCLUSION: These findings suggest that neuronal gap junctions play an important role in synchronizing the central pacemaker neurons and contribute to the distinct self-sustainability of the SCN master clock.
Animals ; Circadian Rhythm ; Electrical Synapses ; Gap Junctions* ; Hypothalamus ; Luminescent Measurements ; Mammals ; Mefloquine* ; Mice* ; Neurons ; Phase Transition ; Suprachiasmatic Nucleus*

The characteristics of hand trauma are changing due to automation of industrial facilities, improved access to health care, and the aging population. Since the inception of hand surgery as a subspecialty, hand defects have been reconstructed with the restoration of the original functionality as the primary goal. With advancement and maturation of surgical techniques, however, restoration of aesthetics also began to take hold as an important aspect of hand surgery practice. After the first successful replantation of an amputated digit, the rapid development of microsurgical techniques had a significant impact on the field of reconstructive hand surgery. In the first two decades, the success of replantation was evaluated by the survival rate for a single operator or a specialized institution. These days, however, microsurgical techniques have been widely adopted, with digital replantation possible even for infants. In addition to various local flaps, the evolution of free flaps has vastly expanded the repertoire of reconstructive options for hand surgeons. With the wide variety of free flaps available, it is possible for a severely injured hand to be salvaged and restored to its original functional and aesthetic status. In South Korea, hand surgery is becoming an established profession with a separate subspecialty certification. Hand surgery has a bright outlook, with future research directed at new biocompatible materials and novel reconstructive methods.
Aging ; Automation ; Biocompatible Materials ; Certification ; Esthetics ; Free Tissue Flaps ; Hand* ; Health Services Accessibility ; Humans ; Infant ; Korea ; Microsurgery ; Replantation ; Survival Rate

OBJECTIVES: An era of deindustrialization has begun in Korea after the industrial development that occurred up until the 1990's. Post industrialization dictates the development of the service industry and information technology with the associated musculoskeletal disorders in such industries. The association between musculoskeletal symptoms and psychosocial factors has been investigated by several researchers. The aims of this study was to characterize the relationship between musculoskeletal symptoms and psychosocial factors including occupational stress and depressive symptoms, and to provide basic data to group health practices for the prevention of musculoskeletal symptoms in the service industry. METHODS: Musculoskeletal symptoms, depressive symptoms and occupational stress were surveyed in 311 female call center employees. The prevalence of musculoskeletal symptoms, depressive symptoms and occupational stress scores were assessed. The odds ratio of the high risk occupational stress group into musculoskeletal symptom group was assessed in an effort to determine the associations between occupational stress and musculoskeletal symptoms. RESULTS: The overall prevalence of musculoskeletal and depressive symptoms was 53.7% and 20.6% respectively. The high risk occupational stress group of the total scores (p=0.049), physical environment (p=0.022), job demand (p=0.014) and interpersonal conflict (p=0.032) to musculoskeletal symptom were significant. The depression group was also significant (p=0.015). The adjusted odds ratio of the high risk stress group into the musculoskeletal symptom group inclusion was 1.687 (95% CI; 1.014~2.808) for the physical environment, and 1.948 (95% CI; 1.031-3.683) for depression. CONCLUSIONS: Overall, the relationship between musculoskeletal symptom and the psychosocial factors was not significant. Only the physical environmental stress factor and depression showed marginal significance, which suggests the possibility of an increased risk of musculoskeletal symptoms. However, since the group in this study was a homogeneous occupational population, further study with a reference group will be needed.
Depression ; Female ; Humans ; Korea ; Odds Ratio ; Prevalence ; Psychology

Purpose: Base deficit (BD) is superior to vital signs in predicting trauma outcomes in adults. The authors aimed to compare BD and vital signs as criteria for the four-tiered hemorrhagic shock classification in children with trauma. Materials and Methods: We retrospectively reviewed the data of 1046 injured children who visited a Korean academic hospital from 2010 through 2018. These children were classified separately based on BD (class I, BD ≤2.0 mmol/L; II, 2.1–6.0 mmol/L; III, 6.1–10 mmol/L; and IV, ≥10.1 mmol/L) and vital signs (<13 years: age-adjusted hypotension and tachycardia, and Glasgow Coma Scale; 13–17 years: the 2012 Advanced Trauma Life Support classification). The two methods were compared on a class-by-class basis regarding the outcomes: mortality, early transfusion (overall and massive), and early surgical interventions for the torso or major vessels. Results: In total, 603 children were enrolled, of whom 6.6% died. With the worsening of BD and vital signs, the outcome rates increased stepwise (most p<0.001; only between surgical interventions and vital signs, p=0.035). Mortality more commonly occurred in BD-based class IV than in vital signs-based class IV (58.8% vs. 32.7%, p=0.008). Early transfusion was more commonly performed in BD-based class III than in vital signs-based class III (overall, 73.8% vs. 53.7%, p=0.007; massive, 37.5% vs. 15.8%, p=0.001). No significant differences were found in the rates of early surgical interventions between the two methods. Conclusion BD can be a better predictor of outcomes than vital signs in children with severe hemorrhagic shock.

As a consequence of the Earth's rotation, almost all organisms experience day and night cycles within a 24-hr period. To adapt and synchronize biological rhythms to external daily cycles, organisms have evolved an internal time-keeping system. In mammals, the master circadian pacemaker residing in the suprachiasmatic nucleus (SCN) of the anterior hypothalamus generates circadian rhythmicity and orchestrates numerous subsidiary local clocks in other regions of the brain and peripheral tissues. Regardless of their locations, these circadian clocks are cell-autonomous and self-sustainable, implicating rhythmic oscillations in a variety of biochemical and metabolic processes. A group of core clock genes provides interlocking molecular feedback loops that drive the circadian rhythm even at the single-cell level. In addition to the core transcription/translation feedback loops, post-translational modifications also contribute to the fine regulation of molecular circadian clocks. In this article, we briefly review the molecular mechanisms and post-translational modifications of mammalian circadian clock regulation. We also discuss the organization of and communication between central and peripheral circadian oscillators of the mammalian circadian clock.
Brain ; Circadian Clocks ; Circadian Rhythm ; Hypothalamus, Anterior ; Mammals ; Protein Processing, Post-Translational ; Suprachiasmatic Nucleus