Background: Long working hours have been associated with adverse physical and mental health outcomes; however, evidence regarding their relationship with satisfaction with work environment remains limited, particularly when long working hours are defined using a specific daily threshold. This study examined the association between working ≥10 hours per day and satisfaction with work environment among Korean wage workers, focusing on the cumulative number of such workdays per month. Methods: This cross-sectional study analyzed data from the 7th Korean Working Conditions Survey. A total of 24,269 wage workers aged ≥18 years were included after excluding self-employed workers, unpaid family workers, shift workers, and respondents with missing data. Working ≥10 hours per day was categorized as 0, 1–9, and ≥10 days per month. Satisfaction with work environment was categorized as satisfied or dissatisfied. Multiple logistic regression analyses were conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for dissatisfaction with work environment according to the number of long working days, adjusting for demographic and occupational characteristics. Results: Compared with workers who did not work ≥10 hours per day, those who worked 1–9 days and ≥10 days per month showed progressively higher levels of dissatisfaction with work environment. After adjustment for demographic and occupational factors, the odds of dissatisfaction with work environment were significantly higher among workers who worked ≥10 hours per day for 1–9 days per month (OR: 1.380; 95% CI: 1.145–1.665) and ≥10 days per month (OR: 2.106; 95% CI: 1.627–2.725), demonstrating a dose–response relationship. Conclusions Among the analytic sample of Korean wage workers included in this study, working ≥10 hours per day was associated with greater dissatisfaction with work environment, with a dose–response pattern according to the number of long working days per month.

Background: Although there is general agreement on performing concomitant ablation of atrial fibrillation (AF) during left-sided heart valve surgery in low-risk patients due to its proven long-term clinical benefits, its role in reoperative cases remains debated because of perceived high risks. Methods: This study included 338 consecutive patients with AF who underwent redo surgery for left-sided valve disease between 2000 and 2015 at 2 tertiary referral centers.Among them, 143 patients underwent concomitant surgical ablation for AF (ablation group), while 195 did not (no-ablation group). To evaluate comparative long-term clinical outcomes between the 2 groups, inverse probability of treatment weighting was applied. Results: Early mortality rates were 3.5% (4/143) in the ablation group and 9.2% (18/195) in the no-ablation group (p=0.064). At 5 years, the cumulative incidence of AF recurrence was 12.3%±0.1% in the ablation group and 85.2%±0.1% in the no-ablation group (p<0.001). During follow-up (median, 103 months), the ablation group demonstrated significantly lower risks of death (adjusted hazard ratio [aHR], 0.495; 95% confidence interval [CI], 0.312–0.784; p=0.003) and thromboembolic events (aHR, 0.212; 95% CI, 0.058–0.771;p=0.019) compared with the no-ablation group. Conclusions Concomitant AF ablation during redo valve surgery was associated with improved rhythm outcomes, survival, and freedom from thromboembolic events, supporting its consideration as a reasonable option even in this high-risk group.

Although gemcitabine-based regimens are widely used as an effective treatment for pancreatic cancer, acquired resistance to gemcitabine has become an increasingly common problem. Therefore, a novel therapeutic strategy to treat gemcitabine-resistant pancreatic cancer is urgently required. Piceamycin has been reported to exhibit antiproliferative activity against various cancer cells; however, its underlying molecular mechanism for anticancer activity in pancreatic cancer cells remains unexplored. Therefore, the present study evaluated the antiproliferation activity of piceamycin in a gemcitabine-resistant pancreatic cancer cell line and patient-derived pancreatic cancer organoids. Piceamycin effectively inhibited the proliferation and suppressed the expression of alpha-actinin-4, a gene that plays a pivotal role in tumorigenesis and metastasis of various cancers, in gemcitabine-resistant cells. Long-term exposure to piceamycin induced cell cycle arrest at the G0/G1 phase and caused apoptosis. Piceamycin alsoinhibited the invasion and migration of gemcitabine-resistant cells by modulating focal adhesion and epithelial-mesenchymal transition biomarkers. Moreover, the combination of piceamycin and gemcitabine exhibited a synergistic antiproliferative activity in gemcitabine-resistant cells. Piceamycin also effectively inhibited patient-derived pancreatic cancer organoid growth and induced apoptosis in the organoids. Taken together, these findings demonstrate that piceamycin may be an effective agent for overcoming gemcitabine resistance in pancreatic cancer.

Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.

Background: Coronary artery disease patients undergoing percutaneous coronary intervention (PCI) often exhibit reduced left ventricular ejection fraction (LVEF). However, the impact of LV dysfunction status in conjunction with platelet reactivity on clinical outcomes has not been previously investigated. Methods: From the multicenter PTRG-DES (Platelet function and genoType-Related long-term prognosis in DES-treated patients) consortium, the patients were classified as preserved-EF (PEF: LVEF ≥ 50%) and reduced-EF (REF: LVEF< 5 0%) group by echocardiography. Platelet reactivity was measured using VerifyNow P2Y 12 assay and high platelet reactivity (HPR) was defined as PRU ≥ 252. The major adverse cardiac and cerebrovascular events (MACCEs) were a composite of death, myocardial infarction, stent thrombosis and stroke at 5 years after PCI. Major bleeding was defined as Bleeding Academic Research Consortium bleeding types 3–5. Results: A total of 13,160 patients from PTRG-DES, 9,319 (79.6%) patients with the results of both PRU and LVEF were analyzed. The incidence of MACCE and major bleeding was higher in REF group as compared with PEF group (MACCEs: hazard ratio [HR] 2.17, P < 0.001, 95% confidence interval [CI] 1.85–2.55; major bleeding: HR 1.78, P < 0.001, 95% CI 1.39–2.78).The highest rate of MACCEs was found in patients with REF and HPR, and the difference between the groups was statistically significant (HR 3.14 in REF(+)/HPR(+) vs. PEF(+)/HPR(-) group,P <0.01, 95% CI 2.51–3.91). The frequency of major bleeding was not associated with the HPR in either group. Conclusion LV dysfunction was associated with an increased incidence of MACCEs and major bleeding in patients who underwent PCI. The HPR status further exhibited significant increase of MACCEs in patients with LV dysfunction in a large, real-world registry.Trial Registration: ClinicalTrials.gov Identifier: NCT04734028

Background: Different from adults, adolescents with genu varum or valgum can be treated with hemi-epiphysiodesis. We conducted a study to report our recent experience of treating idiopathic genu varum and valgum with clinical relevance to planning of hemi-epiphysiodesis. The aim of this study was to compare the varus and valgus groups focusing on the contribution of the distal femur and proximal tibia to the deformities. Methods: Among patients who visited the outpatient clinic during the recent 4 years, adolescents with genu varum (the varus group) or valgum (the valgus group) greater than 5° were included. The mechanical lateral distal femoral angle (mLDFA) and medial proximal tibial angle (MPTA) were measured. The contribution to deformity (%) in each of the distal femur and the proximal tibia was calculated. Results: One hundred twenty patients and their 120 legs (randomly selected in bilateral cases) were included. In the varus group (n = 51), the mean hip-knee-ankle alignment was varus 7.1° (range, 5.1°–12.1°). The contribution to deformity was 74.1% ± 27.6% at the proximal tibia (MPTA, 81.9° ± 2.0°) and 14.9% ± 25.1% at the distal femur (mLDFA, 88.1° ± 1.7°). In the valgus group (n = 69), the mean alignment was valgus 6.6° (range, 5.1°–11.9°). The contribution was 69.8% ± 30.8% at the distal femur (mLDFA, 82.4° ± 2.1°) and 33.1% ± 27.8% at the proximal tibia (MPTA = 89.2° ± 1.9°). In subgroup analyses, the MPTA was significantly lower in the varus ≥ 8.4° group than the varus < 8.4° group. The mLDFA was significantly lower and the frequency of MPTA > 91.5° was significantly higher in the valgus ≥ 7.7° group than the valgus < 7.7° group. Conclusions Genu varum was mainly associated with deformity of the proximal tibia, whereas genu valgum was related to deformities of the distal femur and proximal tibia. Considering the predominant deformity of the proximal tibia, performing hemiepiphysiodesis only at the proximal tibia is ideal in most adolescents with genu varum.

Background: Different from adults, adolescents with genu varum or valgum can be treated with hemi-epiphysiodesis. We conducted a study to report our recent experience of treating idiopathic genu varum and valgum with clinical relevance to planning of hemi-epiphysiodesis. The aim of this study was to compare the varus and valgus groups focusing on the contribution of the distal femur and proximal tibia to the deformities. Methods: Among patients who visited the outpatient clinic during the recent 4 years, adolescents with genu varum (the varus group) or valgum (the valgus group) greater than 5° were included. The mechanical lateral distal femoral angle (mLDFA) and medial proximal tibial angle (MPTA) were measured. The contribution to deformity (%) in each of the distal femur and the proximal tibia was calculated. Results: One hundred twenty patients and their 120 legs (randomly selected in bilateral cases) were included. In the varus group (n = 51), the mean hip-knee-ankle alignment was varus 7.1° (range, 5.1°–12.1°). The contribution to deformity was 74.1% ± 27.6% at the proximal tibia (MPTA, 81.9° ± 2.0°) and 14.9% ± 25.1% at the distal femur (mLDFA, 88.1° ± 1.7°). In the valgus group (n = 69), the mean alignment was valgus 6.6° (range, 5.1°–11.9°). The contribution was 69.8% ± 30.8% at the distal femur (mLDFA, 82.4° ± 2.1°) and 33.1% ± 27.8% at the proximal tibia (MPTA = 89.2° ± 1.9°). In subgroup analyses, the MPTA was significantly lower in the varus ≥ 8.4° group than the varus < 8.4° group. The mLDFA was significantly lower and the frequency of MPTA > 91.5° was significantly higher in the valgus ≥ 7.7° group than the valgus < 7.7° group. Conclusions Genu varum was mainly associated with deformity of the proximal tibia, whereas genu valgum was related to deformities of the distal femur and proximal tibia. Considering the predominant deformity of the proximal tibia, performing hemiepiphysiodesis only at the proximal tibia is ideal in most adolescents with genu varum.

Background: Different from adults, adolescents with genu varum or valgum can be treated with hemi-epiphysiodesis. We conducted a study to report our recent experience of treating idiopathic genu varum and valgum with clinical relevance to planning of hemi-epiphysiodesis. The aim of this study was to compare the varus and valgus groups focusing on the contribution of the distal femur and proximal tibia to the deformities. Methods: Among patients who visited the outpatient clinic during the recent 4 years, adolescents with genu varum (the varus group) or valgum (the valgus group) greater than 5° were included. The mechanical lateral distal femoral angle (mLDFA) and medial proximal tibial angle (MPTA) were measured. The contribution to deformity (%) in each of the distal femur and the proximal tibia was calculated. Results: One hundred twenty patients and their 120 legs (randomly selected in bilateral cases) were included. In the varus group (n = 51), the mean hip-knee-ankle alignment was varus 7.1° (range, 5.1°–12.1°). The contribution to deformity was 74.1% ± 27.6% at the proximal tibia (MPTA, 81.9° ± 2.0°) and 14.9% ± 25.1% at the distal femur (mLDFA, 88.1° ± 1.7°). In the valgus group (n = 69), the mean alignment was valgus 6.6° (range, 5.1°–11.9°). The contribution was 69.8% ± 30.8% at the distal femur (mLDFA, 82.4° ± 2.1°) and 33.1% ± 27.8% at the proximal tibia (MPTA = 89.2° ± 1.9°). In subgroup analyses, the MPTA was significantly lower in the varus ≥ 8.4° group than the varus < 8.4° group. The mLDFA was significantly lower and the frequency of MPTA > 91.5° was significantly higher in the valgus ≥ 7.7° group than the valgus < 7.7° group. Conclusions Genu varum was mainly associated with deformity of the proximal tibia, whereas genu valgum was related to deformities of the distal femur and proximal tibia. Considering the predominant deformity of the proximal tibia, performing hemiepiphysiodesis only at the proximal tibia is ideal in most adolescents with genu varum.

Background: Different from adults, adolescents with genu varum or valgum can be treated with hemi-epiphysiodesis. We conducted a study to report our recent experience of treating idiopathic genu varum and valgum with clinical relevance to planning of hemi-epiphysiodesis. The aim of this study was to compare the varus and valgus groups focusing on the contribution of the distal femur and proximal tibia to the deformities. Methods: Among patients who visited the outpatient clinic during the recent 4 years, adolescents with genu varum (the varus group) or valgum (the valgus group) greater than 5° were included. The mechanical lateral distal femoral angle (mLDFA) and medial proximal tibial angle (MPTA) were measured. The contribution to deformity (%) in each of the distal femur and the proximal tibia was calculated. Results: One hundred twenty patients and their 120 legs (randomly selected in bilateral cases) were included. In the varus group (n = 51), the mean hip-knee-ankle alignment was varus 7.1° (range, 5.1°–12.1°). The contribution to deformity was 74.1% ± 27.6% at the proximal tibia (MPTA, 81.9° ± 2.0°) and 14.9% ± 25.1% at the distal femur (mLDFA, 88.1° ± 1.7°). In the valgus group (n = 69), the mean alignment was valgus 6.6° (range, 5.1°–11.9°). The contribution was 69.8% ± 30.8% at the distal femur (mLDFA, 82.4° ± 2.1°) and 33.1% ± 27.8% at the proximal tibia (MPTA = 89.2° ± 1.9°). In subgroup analyses, the MPTA was significantly lower in the varus ≥ 8.4° group than the varus < 8.4° group. The mLDFA was significantly lower and the frequency of MPTA > 91.5° was significantly higher in the valgus ≥ 7.7° group than the valgus < 7.7° group. Conclusions Genu varum was mainly associated with deformity of the proximal tibia, whereas genu valgum was related to deformities of the distal femur and proximal tibia. Considering the predominant deformity of the proximal tibia, performing hemiepiphysiodesis only at the proximal tibia is ideal in most adolescents with genu varum.

Objective: To evaluate the effects of Catalpa bignonioides fruit extract on the promotion of muscle growth and muscular capacity in vitro and in vivo. Methods: Cell viability was measured using the 3-(4,5-dimethylthiazol- 2-yl)-2,5-diphenyltetrazolium bromide assay. Cell proliferation was assessed using a 5-bromo-2’-deoxyuridine (BrdU) assay kit. Western blot analysis was performed to determine the protein expressions of related factors. The effects of Catalpa bignonioides extract were investigated in mice using the treadmill exhaustion test and whole-limb grip strength assay. Chemical composition analysis was performed using high-performance liquid chromatography (HPLC). Results: Catalpa bignonioides extract increased the proliferation of C2C12 mouse myoblasts by activating the Akt/mTOR signaling pathway. It also induced metabolic changes, increasing the number of mitochondria and glucose metabolism by phosphorylating adenosine monophosphate-activated protein kinase. In an in vivo study, the extract-treated mice showed improved motor abilities, such as muscular endurance and grip strength. Additionally, HPLC analysis showed that vanillic acid may be the main component of the Catalpa bignonioides extract that enhanced muscle strength. Conclusions: Catalpa bignonioides improves exercise performance through regulation of growth and metabolism in skeletal muscles, suggesting its potential as an effective natural agent for improving muscular strength.