Purpose: The aim of this study was to longitudinally compare novice nurses’ sleep disturbance, sleep hygiene, and physical activity and analyze factors affecting sleep disturbance. Methods: Data were obtained from three follow-up surveys of 178 novice nurses. The data were analyzed using SPSS 25.0 to calculate descriptive statistics. A repeated measures ANOVA and Cochran’s Q test were performed, and a logistic regression analysis was conducted using generalized estimation equations. Results: The sleep disturbance rate increased significantly over time in the following order: before the start of shift work, after six months of shift work, and after 18 months of shift work (T=98.67, p<.001). Sleep hygiene significantly deteriorated over time after the start of shift work (F=127.95, p<.001). Arousal behavior (OR=10.34, p<.001) and the sleep environment (OR=1.54, p=.005) in sleep hygiene, significantly influenced sleep disturbance. Stretching exercises were an influencing factor in sleep disturbance (OR=1.71, p=.039). Conclusion Sleep disturbance among novice nurses increased after the start of shift work. Sleep hygiene and stretching were influencing factors. Therefore, to prevent and reduce sleep disturbance in novice nurses, efforts are needed to improve sleep hygiene and promote stretching exercises.

Purpose: The purpose of this study was to identify the quality of sleep in novice and experienced shift work nurses and compare the factors associated with their quality of sleep. Methods: We analyzed the data of 192 and 256 novice and experienced nurses, respectively. The quality of sleep, sleep hygiene, job stress, and fatigue were measured using Insomnia Severity Index, Sleep Hygiene Practice Scale, the Korean Occupational Stress Scale, and Fatigue Severity Scale. Data were analyzed using SPSS 25.0 to calculate descriptive statistics and logistic regression. Results: Sleep quality was lower in experienced nurses (12.55 ± 5.71) than in novice nurses (11.18 ± 5.78). Fatigue was more severe in experienced nurses (4.47 ± 1.13) than in novice nurses (4.23 ± 1.12). In the logistic regression, factors related to sleep quality in novice nurses were sleep hygiene (odds ratio; OR = 1.06, p < .001) and fatigue (OR = 2.49, p < .001). Factors related to sleep quality in the experienced nurses were also sleep hygiene (OR = 1.04, p = .001) and fatigue (OR = 1.53, p = .012). Conclusion Sleep quality of experienced nurses is lower than those of novice nurses. Factors associated with sleep quality in novice and experienced nurses are equally identified as sleep hygiene and fatigue. Therefore, personal efforts to improve sleep hygiene, such as providing comfortable sleep environment, are needed. Furthermore, organized efforts to decrease fatigue, such as constructing a working environment with a bright light at night and providing a fatigue-decreasing program that includes meditation, are required.

The patient is a 43-year-old male with medical history significant for severe alcoholic cirrhosis who presented with a one-month history of periumbilical pain. The patient did not have any symptoms of bowel obstruction. Physical examination revealed an umbilical defect containing an intra-abdominal structure, mimicking incarcerated umbilical hernia. Computed tomography revealed an engorged, umbilical varix 1.6 cm in diameter, herniating through the umbilical defect. No surgical intervention was offered for this patient and medical management for varix resulted in clinical resolution in three months.
Adult ; Hernia* ; Hernia, Umbilical ; Humans ; Hypertension, Portal ; Liver Cirrhosis, Alcoholic ; Male ; Physical Examination ; Varicose Veins*

OBJECTIVE: To evaluate the impact of energy and access methods on extrahepatic tumor spreading and the ablation zone in an ex vivo subcapsular tumor mimic model with a risk of extrahepatic tumor spreading. MATERIALS AND METHODS: Forty-two tumor-mimics were created in bovine liver blocks by injecting a mixture of iodine contrast material just below the liver capsule. Radiofrequency (RF) ablations were performed using an electrode placed parallel or perpendicular to hepatic surface through the tumor mimic with low- and high-power protocols (groups 1 and 2, respectively). Computed tomography (CT) scans were performed before and after ablation. The presence of contrast leak on the hepatic surface on CT, size of ablation zone, and timing of the first roll-off and popping sound were compared between the groups. RESULTS: With parallel access, one contrast leak in group 1 (1/10, 10%) and nine in group 2 (9/10, 90%) (p < 0.001) were identified on post-ablation CT. With perpendicular access, six contrast leaks were identified in each group (6/11, 54.5%). The first roll-off and popping sound were significantly delayed in group 1 irrespective of the access method (p = 0.002). No statistical difference in the size of the ablation zone of the liver specimen was observed between the two groups (p = 0.247). CONCLUSION: Low-power RF ablation with parallel access is proposed to be effective and safe from extrahepatic tumor spreading in RF ablation of a solid hepatic tumor in the subcapsular location. Perpendicular placement of an electrode to the capsule is associated with a risk of extrahepatic tumor spreading regardless of the power applied.
Animals ; Catheter Ablation ; Electrodes ; Iodine ; Liver ; Liver Neoplasms, Experimental ; Methods ; Neoplasm Seeding

BACKGROUND: Omega-3 fatty acids derived from fish oil have been reported to exert a beneficial effect on reducing cardiovascular disease. Reports about their mechanism have generated several interesting findings, including a change in small dense low density lipoprotein (sdLDL) cholesterol proportion, adiponectin, and apolipoprotein B (apoB), in addition to changes in the lipid profile. The principal objective of our study was to evaluate the effects of omega-3 fatty acids on plasma sdLDL, adiponectin, apoB100, and B48 in type 2 diabetic patients with hypertriglyceridemia. METHODS: We randomized 28 type 2 diabetic patients in a placebo-controlled, double-blind trial to receive either omega-3 fatty acids or placebo, both administered at a dose of 4 g daily for 12 weeks. LDL subfractions prior to and after treatment were separated via low-speed ultracentrifugation and analyzed via immunoelectrophoresis. Adiponectin, apoB100, and B48 levels were measured using an ELISA kit. RESULTS: sdLDL proportions were reduced in the omega-3 fatty acids group by 11% after 12 weeks of treatment (n = 17, P = 0.001), and were reduced by 4% in the control group (n = 11, P = 0.096). The patients receiving the omega-3 fatty acids evidenced a significant reduction in the levels of triglyceride (P = 0.001), apoB100, and B48 after 12 weeks (P = 0.038 and P = 0.009, respectively) relative to the baseline. Omega-3 fatty acids supplementation increased fasting blood glucose (P = 0.011), but the levels of HbA1c in each group did not change to a statistically significance degree. The adiponectin value was not reduced in the omega-3 fatty acids group (P = 0.133); by way of contrast, the placebo group evidenced a significant reduction in adiponectin value after 12 weeks (P = 0.002). CONCLUSION: Omega-3 fatty acid treatment proved effective in the reduction of atherogenic sdLDL and apoB in type 2 diabetic patients (Clinical trials reg. no. NCT 00758927, clinicaltrials.gov).
Adiponectin ; Apolipoprotein B-48 ; Apolipoproteins ; Apolipoproteins B ; Blood Glucose ; Cardiovascular Diseases ; Cholesterol ; Diabetes Mellitus, Type 2 ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Fatty Acids, Omega-3 ; Humans ; Immunoelectrophoresis ; Lipoproteins ; Plasma ; Ultracentrifugation

BACKGROUND: To accelerate the healing of diabetic wounds, various kinds of growth factors have been employed. It is the short half-life of administered growth factors in hostile wound beds that have limited wide-spread clinical usage. To overcome this limitation, growth factor gene therapy could be an attractive alternative rather than direct application of factors onto the wound beds. We administered two growth factor DNAs, epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) into a cutaneous wound on diabetic mice. We compared the different characteristics of the healing wounds. METHODS: Streptozotocin was injected intraperitoneally to induce diabetes into C57BL/6J mice. The ultrasound micro-bubble destruction method with SonoVue as a bubbling agent was used for non-viral gene delivery of EGF828 and VEGF165 DNAs. Each gene was modified for increasing efficacy as FRM-EGF828 or minicircle VEGF165. The degree of neoangiogenesis was assessed using qualitative laser Doppler flowmetry. We compared wound size and histological findings of the skin wounds in each group. RESULTS: In both groups, accelerated wound closure was observed in the mice receiving gene therapy compared with non treated diabetic control mice. Blood flow detected by laser doppler flowmetry was better in the VEGF group than in the EGF group. Wound healing rates and histological findings were more accelerated in the EGF gene therapy group than the VEGF group, but were not statistically significant. CONCLUSION: Both non-viral EGF and VEGF gene therapy administrations could improve the speed and quality of skin wound healing. However, the detailed histological characteristics of the healing wounds were different.
Animals ; DNA ; Epidermal Growth Factor ; Genetic Therapy ; Half-Life ; Intercellular Signaling Peptides and Proteins ; Laser-Doppler Flowmetry ; Mice ; Phospholipids ; Skin ; Streptozocin ; Sulfur Hexafluoride ; Vascular Endothelial Growth Factor A ; Wound Healing

BACKGROUND: Forkhead box P3 (FOXP3) is an important marker of regulatory T cells. FOXP3 polymorphisms are associated with autoimmune diseases, cancers, and allograft outcomes. We examined whether single nucleotide polymorphisms (SNPs) at the FOXP3 locus are associated with clinical outcomes after allogenic hematopoietic stem cell transplantation (HSCT). METHODS: Five FOXP3 SNPs (rs5902434, rs3761549, rs3761548, rs2232365, and rs2280883) were analyzed by PCR-sequencing of 172 DNA samples from allogenic HSCT patients. We examined the relationship between each SNP and the occurrence of graft-versus-host disease (GVHD), post-HSCT infection, relapse, and patient survival. RESULTS: Patients with acute GVHD (grades II-IV) showed higher frequencies of the rs3761549 T/T genotype, rs5902434 ATT/ATT genotype, and rs2232365 G/G genotype than did patients without acute GVHD (P=0.017, odds ratio [OR]=5.3; P=0.031, OR=2.4; and P=0.023, OR=2.6, respectively). Multivariate analysis showed that the TT genotype of rs3761549 was an independent risk factor for occurrence of acute GVHD (P=0.032, hazard ratio=5.6). In contrast, the genotype frequencies of rs3761549 T/T, rs5902434 ATT/ATT, and rs2232365 G/G were lower in patients with post-HSCT infection than in patients without infection (P=0.026, P=0.046, and P=0.031, respectively). CONCLUSIONS: rs3761549, rs5902434, and rs2232365 are associated with an increased risk of acute GVHD and decreased risk of post-HSCT infection.
Allografts ; Autoimmune Diseases ; DNA ; Genotype ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Multivariate Analysis ; Odds Ratio ; Polymorphism, Single Nucleotide* ; Recurrence ; Risk Factors ; T-Lymphocytes, Regulatory

Patients with diabetes mellitus (DM) often suffer from diverse skin disorders, which might be attributable to skin barrier dysfunction. To explore the role of lipid alterations in the epidermis in DM skin disorders, we quantitated 49 lipids (34 ceramides, 14 free fatty acids (FFAs), and cholesterol) in the skin epidermis, liver, and kidneys of db/db mice, a Type 2 DM model, using UPLC-MS/MS. The expression of genes involved in lipid synthesis was also evaluated. With the full establishment of hyperglycemia at the age of 20 weeks, remarkable lipid enrichment was noted in the skin of the db/db mice, especially at the epidermis and subcutaneous fat bed. Prominent increases in the ceramides and FFAs (>3 fold) with short or medium chains ( Animals ; Ceramides ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Epidermis ; Fatty Acids, Nonesterified ; Humans ; Hyperglycemia ; Kidney ; Liver ; Mice ; Receptors, Cytoplasmic and Nuclear ; Skin ; Stearoyl-CoA Desaturase ; Subcutaneous Fat

Bone diseases such as osteoporosis and periodontitis are induced by excessive osteoclastic activity, which is closely associated with inflammation. Benzydamine (BA) has been used as a cytokine-suppressive or non-steroidal anti-inflammatory drug that inhibits the production of pro-inflammatory cytokines or prostaglandins. However, its role in osteoclast differentiation and function remains unknown. Here, we explored the role of BA in regulating osteoclast differentiation and elucidated the underlying mechanism. BA inhibited osteoclast differentiation and strongly suppressed interleukin-1 (IL-1) production. BA inhibited osteoclast formation and bone resorption when added to bone marrow-derived macrophages and differentiated osteoclasts, and the inhibitory effect was reversed by IL-1 treatment. The reporter assay and the inhibitor study of IL-1 transcription suggested that BA inhibited nuclear factor-B and activator protein-1 by regulating IB kinase, extracellular signal regulated kinase and P38, resulting in the down-regulation of IL-1 expression. BA also promoted osteoblast differentiation. Furthermore, BA protected lipopolysaccharide- and ovariectomy-induced bone loss in mice, suggesting therapeutic potential against inflammation-induced bone diseases and postmenopausal osteoporosis.