Instrumental role of Na+ and Ca2+ influx via Na+/K+ adenosine triphosphatase (Na+/K+-ATPase) and Na+/Ca2+ exchanger 1 (NCX1) is examined in the N-Methyl-D-aspartate (NMDA) receptor-mediated pathogenesis of penumbra after focal cerebral ischemia. An experimental model of 3, 6, and 24 h focal cerebral ischemia by permanent occlusion of middle cerebral artery was developed in rats. The changes in protein expression of Na+/K+-ATPase and NCX1 as well as functional subunits of NMDA receptor 2A and 2B (NR2A and NR2B) in the penumbra were assessed using by quantitative immunoblottings. The most prominent changes of Na+/K+-ATPase (78+/-6%, n=4, *P<0.05) and NCX1 (144+/-2%, n=4, *P<0.05) in the penumbra were developed 24 h after focal cerebral ischemia. The expression of NR2A in the penumbra was significantly increased (153+/-9%, n=4, *P<0.05) whereas the expression of NR2B was significantly decreased (37+/-2%, n=4, *P<0.05) as compared with sham-operated controls 3 h after focal cerebral ischemia. However, the expression of NR2A and NR2B in the penumbra was reversed 24 h after focal cerebral ischemia (NR2A: 40+/-7%; NR2B: 120+/-16%, n=4, *P<0.05). Moreover, the decreased expression of neuronal nuclei (NeuN) in the penumbra was most prominent than that of glial fibrillary acidic protein (GFAP) 24 h after focal cerebral ischemia. These findings imply that intracellular Na+ accumulation via decreased Na+/K+-ATPase exacerbate the Ca2+ overload cooperated by the increased NCX1 and NR2B-containing NMDA receptor which may play an important role in the pathogenesis of the penumbra.
Adenosine Triphosphatases ; Animals ; Brain ; Brain Ischemia ; Glial Fibrillary Acidic Protein ; Glutamic Acid ; Immunoblotting ; Middle Cerebral Artery ; Models, Theoretical ; N-Methylaspartate ; Neurons ; Rats ; Receptors, N-Methyl-D-Aspartate

Therapeutic manipulation of the renin-angiotensin-aldosterone system (RAAS) is an important strategy for improving hypertension, diabetes, cardiovascular disease, and chronic kidney disease. Development of hyperkalemia after the administration of RAAS inhibitors is of particular concern because patients at highest risk for this complication are often the same patients who derive the greatest cardiovascular or renoprotective benefit. Based on an overview of the incidence of hyperkalemia during treatment with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers alone and in combination, this review suggests approaches for monitoring, detecting, and managing hyperkalemia in patients treated with RAAS inhibitors. Although the incidence of hyperkalemia with RAAS inhibitors is generally low, hyperkalemia can be associated with increased mortality. When using RAAS inhibitors, it is important to monitor on-treatment electrolyte levels and renal function parameters in patients with a high risk for hyperkalemia.
Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Cardiovascular Diseases ; Humans ; Hyperkalemia ; Hypertension ; Incidence ; Organothiophosphorus Compounds ; Peptidyl-Dipeptidase A ; Renal Insufficiency, Chronic ; Renin-Angiotensin System

We retrospectively reviewed the results of nine children who were less than sixteen years old and in whom partial or total arthroscopic meniscectomy was performed for symptomatic discoid meniscus in eleven knees between March 1991 and February 1997. On arthroscopic findings, there were two complete and eight incomplete type of lateral discoid menisci and one medial discoid meniscus. Among eleven cases, partial meniscectomy was performed in seven and total meniscectomy in four. The average duration of follow-up was two and a half years (range, one to five years). In this study, arthroscopic total meniscectomy was superior to partial meniscectomy for a symptomatic discoid meniscus including pain, click and locking in children. Therefore, arthroscopic meniscectomy may offer the best prognosis following accurate diagnosis in children.
Child* ; Diagnosis ; Follow-Up Studies ; Humans ; Knee ; Prognosis ; Retrospective Studies

Background: Although recent evidence supports that prolonged sedentary behavior and reduced physical activity are associated with colorectal cancer risk, there are few studies analyzing the colorectal cancer risk according to different types of physical activity and combined effects of sedentary behavior and physical activity on colorectal cancer. This study aimed to investigate the association of sedentary behavior and physical activity with colorectal cancer. Methods: A cross-sectional study included a total of 33,403 participants from the Korea National Health and Nutrition Examination Survey from 2014 to 2019. Sedentary behavior was dichotomized into < 10 hr/day and ≥ 10 hr/day, and three types of physical activity were investigated, including leisure-time, occupational, and transportation physical activity. Multiple logistic regression analyses were performed to assess the risk of colorectal cancer in relation to sedentary behavior and physical activity. Results: Sedentary behavior was associated with an increased risk of colorectal cancer (odds ratio [OR] 1.64; 95% confidence interval [CI], 1.22–2.21), while the different domains of physical activity were not significantly associated with colorectal cancer risk. In a combined analysis, those with sedentary behavior and without physical activity showed an increased risk of colorectal cancer compared to that of the reference category without sedentary behavior and with physical activity (OR, 1.49; 95% CI, 1.02–2.16). Conclusion This study found that sedentary behavior was significantly associated with the increased risk of colorectal cancer. Moreover, sedentary behavior without physical activity increased the risk of colorectal cancer. Reducing sedentary behavior and recommending any type of physical activity may reduce the risk of colorectal cancer.

With a developing worldwide epidemic of diabetes mellitus, the renal complications associated with diabetes have become a serious health concern. Primary therapy for treating diabetic nephropathy is a multifactorial process. Peroxisome proliferator-activated receptor alpha (PPARalpha) agonists have been used primarily in clinical practice for the treatment of dyslipidemia and insulin resistance. Given that PPARalpha expression and regulation of metabolic pathways are involved in oxidative stress, inflammation, blood pressure regulation, and the renin-angiotensin aldosterone system, PPARalpha likely influences the development and pathogenesis of diabetic nephropathy via indirect effects on glucose and lipid homeostasis and also by direct action on the kidneys. These findings suggest that PPARalpha may become an important therapeutic target for treating diabetic renal complications.
Aldosterone ; Blood Pressure ; Diabetes Mellitus ; Diabetic Nephropathies ; Dyslipidemias ; Glucose ; Homeostasis ; Inflammation ; Insulin Resistance ; Kidney ; Metabolic Networks and Pathways ; Oxidative Stress ; Peroxisomes ; PPAR alpha

BACKGROUND: Rest breaks at work are reported to reduce fatigue and job stress. Apartment janitors in Korea who perform night shift work and work long hours can be exposed to various health problems (HPs). However, few studies have evaluated relationships between their rest breaks and HPs. This study was conducted to examine the relationships between long working hours, shift work, and insufficient rest breaks and HPs among Korean apartment janitors.METHODS: Data on 1,212 selected male apartment janitors were obtained from the 3rd and 4th Korean Working Conditions Surveys. Demographic and occupational characteristics were collected using self-reported questionnaires. Rest breaks at work were classified as “sufficient” or “insufficient.” Long working hours were considered as working more than 60 hours per week. Zero-inflated negative binomial (ZINB) regression was performed to investigate the effects of shift work and long working hours on HPs and the effects of rest breaks on relationships between HPs and long working hours and shift work.RESULTS: Among those with insufficient rest breaks at work, significant associations were found between long working hours and the risk of HPs [odds ratio (OR) = 1.489; 95% confidence interval (CI) = 1.038–2.136] and work-related HPs (WRHPs) [OR 1.621; 95% CI = 1.156–2.272], and between shift work and HPs [OR = 1.603; 95% CI = 1.084–2.372]. These relationships became nonsignificant when sufficient rest breaks were provided.CONCLUSION: It is important to provide breaks at work to reduce HPs because of long working hours and shift work among aged workers such as apartment janitors.
Fatigue ; Humans ; Korea ; Male

Objectives: This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience. Methods: The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants’ characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience. Results: Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38). Conclusions During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.

Objectives: This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience. Methods: The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants’ characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience. Results: Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38). Conclusions During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.

Background: The socioeconomic burden of musculoskeletal disorders (MSDs) is significant, and kitchen work is a high-risk occupation for MSDs due to the intensive manual workload and repetitive movements that are involved. However, there are very few studies on MSDs and rest breaks as a workplace intervention among kitchen workers. This study examined the relationship between insufficient rest breaks and increased MSD risk among Korean kitchen workers. Methods: Sociodemographic and occupational factors of 1,909 kitchen workers were collected from the 3rd–4th Korean Working Conditions Survey data. Five items on rest breaks at work were categorized into two groups, “sufficient” and “insufficient.” The number of MSDs and work-related MSDs (WMSDs), an outcome variable, was obtained from the sum of MSDs/WMSDs in three anatomical sites (back, neck, and upper limb, lower limb). The association between rest breaks and MSDs was estimated using zero-inflated negative binomial analyses, with adjustments for age, education level, and weekly working hours, and the analyses were stratified by sex. Results: After adjustment, significant associations were found between insufficient rest breaks and an increased risk of MSDs (odds ratio [OR] 1.68 95% confidence interval [CI] 1.11–2.54) and WMSDs (OR 1.40 95% CI 1.01–1.96) among female kitchen workers. Insufficient rest breaks were significantly associated with MSDs in female kitchen workers in all three anatomical sites. Conclusion This study emphasizes the need for rest breaks as a workplace intervention for preventing MSDs in kitchen workers. Further studies to reveal the causality of this relationship are required.

Background: The socioeconomic burden of musculoskeletal disorders (MSDs) is significant, and kitchen work is a high-risk occupation for MSDs due to the intensive manual workload and repetitive movements that are involved. However, there are very few studies on MSDs and rest breaks as a workplace intervention among kitchen workers. This study examined the relationship between insufficient rest breaks and increased MSD risk among Korean kitchen workers. Methods: Sociodemographic and occupational factors of 1,909 kitchen workers were collected from the 3rd–4th Korean Working Conditions Survey data. Five items on rest breaks at work were categorized into two groups, “sufficient” and “insufficient.” The number of MSDs and work-related MSDs (WMSDs), an outcome variable, was obtained from the sum of MSDs/WMSDs in three anatomical sites (back, neck, and upper limb, lower limb). The association between rest breaks and MSDs was estimated using zero-inflated negative binomial analyses, with adjustments for age, education level, and weekly working hours, and the analyses were stratified by sex. Results: After adjustment, significant associations were found between insufficient rest breaks and an increased risk of MSDs (odds ratio [OR] 1.68 95% confidence interval [CI] 1.11–2.54) and WMSDs (OR 1.40 95% CI 1.01–1.96) among female kitchen workers. Insufficient rest breaks were significantly associated with MSDs in female kitchen workers in all three anatomical sites. Conclusion This study emphasizes the need for rest breaks as a workplace intervention for preventing MSDs in kitchen workers. Further studies to reveal the causality of this relationship are required.