BACKGROUND: Previous studies have reported the effects of direction of shift rotation on sleep, however, the findings are inconsistent. In this study, we investigated sleep quality related to direction of shift rotation using large-scale data from shiftwork-specific health examinations of electronics workers. METHODS: This study included 4750 electronics workers working in a rotating 3-shift system who completed a medical examination for shift workers survey from January 1 to December 31, 2014, at a general hospital. The subjects were categorized into one of two groups according to direction of shift rotation. We compared sleep quality index between the subjects who worked in forward rotation and backward rotation systems. RESULTS: Backward rotation was positively associated with prevalence of poor sleep quality. In the multivariable-adjusted model, when comparing backward rotation to forward rotation, the odds ratio (OR) with 95 % confidence interval (95 % CI) for poor sleep quality was 1.95 (1.58–2.41). After stratifying by gender, the ORs (95 % CIs) for poor sleep quality in male and female was 1.92 (1.47–2.49) and 2.13 (1.47–3.08), respectively. In subgroup analyses, backward rotation was significantly associated with poor sleep quality in workers ≥30 years of age compared with workers <30 years of age (adjusted OR 2.60 vs. 1.89, respectively; P for interaction <0.001). CONCLUSIONS: Our study supports that a backward rotation system is associated with poor sleep quality. Forward rotation systems should be considered to reduce sleep problems.
Female ; Hospitals, General ; Humans ; Male ; Odds Ratio ; Prevalence

PURPOSE: Stem cell-based therapies represent new promises for the treatment of urinary incontinence. This study was performed to assess optimized cell passage number, cell dose, therapeutic efficacy, feasibility, toxicity, and cell trafficking for the first step of the pre-clinical evaluation of human amniotic fluid stem cell (hAFSC) therapy in a urinary incontinence animal model. MATERIALS AND METHODS: The proper cell passage number was analyzed with hAFSCs at passages 4, 6, and 8 at week 2. The cell dose optimization included 1x10(4), 1x10(5), and 1x10(6) cells at week 2. The in vivo cell toxicity was performed with 0.25x10(6), 0.5x10(6), and 1x10(6) cells at weeks 2 and 4. Cell tracking was performed with 1x10(6) cells at weeks 2 and 4. RESULTS: The selected optimal cell passage number was smaller than 6, and the optimal cell dose was 1x10(6) for the mouse model. In our pre-clinical study, hAFSC-injected animals showed normal values for several parameters. Moreover, the injected cells were found to be non-toxic and non-tumorigenic. Furthermore, the injected hAFSCs were rarely identified by in vivo cell trafficking in the target organs at week 2. CONCLUSION: This study demonstrates for the first time the pre-clinical efficacy and safety of hAFSC injection in the urinary incontinence animal model and provides a basis for future clinical applications.
Amniotic Fluid/*cytology ; Animals ; Cell Movement ; Disease Models, Animal ; Humans ; Injections ; Mice ; Stem Cell Transplantation/*methods ; Stem Cells/*cytology ; Treatment Outcome ; Urinary Incontinence/*therapy

BACKGROUND: Cryopreservation of hematopoietic stem cells has become an important process due to the therapeutic protocol, which includes stem cell transplantation after chemotherapy, for many hematological malignancies. The conventional medium contains 10% dimethyl sulfoxide (DMSO) as a cryoprotectant, but this has been reported to be related with many complications. We analyzed the usefulness of trehalose, catalase and zVAD-fmk for cryopreservation along with using a reduced concentration of DMSO to 5%. METHODS: Peripheral blood stem cells were frozen in 10% DMSO as a control and also in 5% DMSO with trehalose and catalase. After 3 weeks of storage in a liquid nitrogen tank, the viability of the thawed hematopoietic stem cells was measured using Trypan blue staining and 7-AAD analysis via conducting flow cytometry. The colony forming potential was assessed using methylcellulose culture. We measured the viability of cells in 5% DMSO medium with or without addition of 30 uM zVAD-fmk right after thawing, and we also did this 6 and 24 hours after incubation. RESULTS: Cryopreserved cells in 5% DMSO with trehalose and catalase showed similar survival (50.42%) compared with the control (49.78%). The viability of cells that were also treated with added zVAD-fmk showed a better result (13.12%) than without it (5.5%) after 24 hours of incubation. Colony forming assay showed similar colony formation in 5% DMSO with the natural cryoprotectants. CONCLUSION: According to the results, lowering the DMSO concentration to 5% is significant and we can expect better cell viability and prevent many side effects of high dose DMSO when adding natural cryprotectants in the cryopreservation medium or by adding caspase-inhibitor right after thawing.
Amino Acid Chloromethyl Ketones ; Catalase ; Cell Survival ; Cryopreservation ; Dimethyl Sulfoxide ; Diminazene ; Flow Cytometry ; Hematologic Neoplasms ; Hematopoietic Stem Cells ; Methylcellulose ; Nitrogen ; Safrole ; Stem Cell Transplantation ; Stem Cells ; Trehalose ; Trypan Blue

There has been a worldwide pandemic infection of influenza A (H1N1) since June 2009. A 23-year-old female presented with fever and sore throat and was diagnosed as having influenza A (H1N1) infection. After 2 days of illness, she had headache, nausea, and neck stiffness. Cerebrospinal-fluid findings were consistent with viral infection, and brain MRI revealed intense signals in both frontotemporal cortices. During her illness she developed repetitive seizures, which were considered to be status epilepticus.
Brain ; Encephalitis ; Encephalitis, Viral ; Female ; Fever ; Headache ; Humans ; Influenza, Human ; Nausea ; Neck ; Pandemics ; Pharyngitis ; Seizures ; Status Epilepticus ; Young Adult

PURPOSE: The 2005 resuscitation guidelines stipulate the need for monitoring CPR (cardiopulmonary resuscitation) quality. Recently, several clinical investigations have shown that a real time monitoring and feedback system is effective for improving the quality of chest compressions during resuscitation. However little data exists regarding the accuracy of the monitoring system using an accelerometer sensor and a pressure sensor for the measuring of compression rate and depth. Our goal for this study was to investigate how well chest compression rate and depth can be estimated using the monitoring system. METHODS: Thirty seconds of continuous chest compressions were delivered on a standard skillmeter manikin lying on the floor with the monitoring system. The chest compressions were delivered with variations in compression rate (67~142 /min) and with variations in compression depth (22~61 mm). A total of 120 sets of compressions were delivered for validation of rate and depth. RESULTS: The correlation coefficient for compression rate between the monitoring system and the standard method was 0.999 (p<0.001), and Bland-Altman analysis showed a mean bias of -0.10+/-0.77/min, with limits of agreement ranging from -1.60 to 1.40 /min. The correlation coefficient for compression depth between two methods was 0.983 (p<0.001), and Bland-Altman analysis showed a mean bias of 4.2+/-2.0 mm, with limits of agreement ranging from 0.24 to 8.10 mm. CONCLUSION: Compared with a skillmeter manikin, a monitoring system for the quality of CPR estimates chest compression rate precisely, but overestimates chest compression depth by an average of 10.3%.
Bias (Epidemiology) ; Cardiopulmonary Resuscitation ; Deception ; Delivery of Health Care ; Floors and Floorcoverings ; Manikins ; Monitoring, Physiologic ; Resuscitation ; Thorax

PURPOSE: Retinal blood vessels and cerebral small vessels possess similar characteristics anatomically, physiologically and embryologically. We studied the availability of abnormal fundus findings of patients who had an atherothrombotic ischemic stroke and who have the risk factors. METHODS: Fundus photographs and brain images were taken in patients who had a first-ever symptomatic ischemic stroke of large artery atherosclerosis (LAA) or small vessel occlusion (SVO) from March 2004 to February 2005. We analyzed the association between fundus abnormalities and ischemic stroke subtypes. RESULTS: Based on brain MRI and MRA, a total of 47 patients were classified into SVO and LAA groups. The SVO group consisted of 27 patients (mean age: 69.7 years), and the LAA group consisted of 20 patients (mean age: 65.4 years). The control group comprised 15 patients (mean age: 64.9 years). The baseline characteristics were similar among the three groups. The severity of the retinal arteriolar narrowing and sclerosis were associated with hypertension. Compared to the control group, both the SVO and LAA groups showed more severe arteriolar sclerosis, the SVO group showed more severe arteriolar narrowing and the LAA group showed more frequent AV crossing and retinal exudate. CONCLUSIONS: Retinal arteriolar abnormalities such as arteriolar narrowing and sclerosis are more severe in atherothrombotic ischemic stroke patients. Indirectly, retinal microvascular changes may indicate the status of the cerebral vasculature. Thus, analysis of fundus findings is useful for predicting an atherothrombotic ischemic stroke and planning follow-up examinations.
Arteries ; Arterioles* ; Atherosclerosis ; Brain ; Exudates and Transudates ; Follow-Up Studies ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Retinal Vessels ; Retinaldehyde* ; Risk Factors ; Sclerosis ; Stroke*

BACKGROUND: This study was performed to evaluate the effects of pre-emptive subdiaphragmatic instillation of lidocaine before pneumoperitoneum on postoperative pain following a laparoscopic cholecystectomy (LC) and also to evaluate it's effect on the changes of blood pressure during an operation. METHODS: Thirty-three relatively healthy patients for an LC were allocated into the two groups. after the induction of general anesthesia with sodium thiopental, vecuronium, nitrous oxide and enflurane (1-2 vol%), 0.2% lidocaine 200 ml was subdiaphragmatically instilled 10 min before pneumoperitoneum in the lidocaine group (n = 15), and normal saline in the control group (n = 18). The changes of the systolic and mean arterial pressure (SAP and MAP), postoperative pain score, and the number of analgesics used during the postoperative 24 h were compared between two groups. RESULTS: The pain scores at postoperative 1, 3, 6, 12, 18 and 24 h and the number of analgesics used were significantly low in the lidocaine group compared to the control group (P<0.01). The elevations of SAP and MAP during pneumoperitoneum were significantly attenuated in the lidocaine group (P<0.01). CONCLUSIONS: This data suggests that subdiaphragmatic instillation of lidocaine before pneumoperitoneum is effective in the control of postoperative pain following an LC and also effective to attenuate the elevation of blood pressure during pneumoperitoneum. However, further study is needed to evaluate the safety of these methods before recommendation of routine use.
Analgesics ; Anesthesia, General ; Arterial Pressure ; Blood Pressure* ; Cholecystectomy, Laparoscopic* ; Enflurane ; Humans ; Lidocaine* ; Nitrous Oxide ; Pain, Postoperative* ; Pneumoperitoneum* ; Sodium ; Thiopental ; Vecuronium Bromide

PURPOSE: Two types of chitosan oligosaccharides (COSs), COS I and COS II, were investigated for the effects on ascitic tumor and enzymes for cancer chemoprevention. MATERIALS AND METHODS: Chitosan oligosaccharides were administered once daily for 10 days after the tumor implantation. The change of body weight was observed for 20 days, and the survival rate of mice was determined after 21 days. Chitosan oligosaccharides were administered once daily for 10 days before the tumor implantation (1 106 cells). The number of ascitic tumor cells were measured at 6 days after tumor implantation. Chemopreventive potential of chitosan oligosaccharides was examined by the induction of quinone reductase and inhibition of cytochrome P450 1A1. RESULTS: Chitosan oligosaccharides exerted antitumor activity by inhibiting the growth of Ehrlich ascites tumor cells in vivo. Mice given Ehrlich cells and 10 or 100 mg/kg body weight of chitosan oligosaccharides had 33% survival after 21 days. Quinone reductase activity was increased with chitosan oligosaccharides. There were 26% and 33% inhibition in the activity of cytochrome P450 1A1 enzyme with the treatment of COS I and COS II, respectively. CONCLUSION: These results suggest that chitosan oligosaccharides has antitumor activity and cancer chemo preventive potential by inducing QR activity and inhibiting cytochrome P450 1A1.
Animals ; Body Weight ; Carcinoma, Ehrlich Tumor ; Chemoprevention* ; Chitosan* ; Cytochrome P-450 Enzyme System ; Mice ; NAD(P)H Dehydrogenase (Quinone) ; Oligosaccharides ; Survival Rate

OBJECT: The aim of this study is to determine whether exposure to chlorpromazine causes mutagenicity and genetic disorders. METHOD: Ames (Salmonella typhimurium) test and Rec assay (Bacillus subtilis) were used as indicators for DNA damage. Furthermore, the levels of umu operon expression by measuring the beta-galactosidase activity were monitered with the SOS umu test using S. typhimurium 1535 containing plasmid pSK1002. And the host-mediated assay was used to investigate the muta-genicity of chlorpromazine after the activation with in vivo metabolic systems. RESULTS: From the results, chlorpromazine did not affect DNA of S. typhimurium and B. subtilis strains and showed no mutagenicity at the all concentrations tested. These phenomena was also similar to that after metabolic activation of chlorpromazine in in vivo system. CONCLUSION: These results suggested that chlorpromazine did not show the mutagenicity and genotoxicity by four different methods used in this study.
beta-Galactosidase ; Biotransformation ; Chlorpromazine* ; DNA ; DNA Damage ; Operon ; Plasmids

BACKGROUND AND METHODS: To identify the long term survival rate and prognostic factors of acute myocardial infarction (AMI) in Korea, total 1139 patients who presented between Jan. 1980 and Dec. 1997 at Seoul National University Hospital were followed for an average of 115 months. 321 patients died during follow up periods, 238 patients were lost and 580 patients are alive till the end point of the study. RESULTS: Overall survival rates (+/-standard error) were 88.2+/-1%, 86.8+/-1%, 85.3+/-1.1%, 82.1+/-1.2%, 79.6+/-1.3%, 75.6+/-1.5%, 73.1+/-1.6%, 70.3+/-1.7%, 67.4+/-1.8%, 64.5+/-1.9%, 60.0+/-2.2%, 56.3+/-2.5% at 1,6,12,24,36,48,60,120 months. In univariate analysis, older, history of diabetes, higher degree of Killip class, higher peak creatine kinase level, residual ischemia on treadmill test or MIBI scan, lower ejection fraction on echocardiography or gated blood pool scan, more severe extent of coronary artery disease, lower HDL-cholesterol level at least 3 months after AMI proved as poor long term prognostic factors of AMI with statistical significance (p<0.05). Sex, body mass index, history of hypertension, hsitory of angina, history of infarction, infarct site on electrocardiography, existence of Q-wave, patency of infarct related arteries, total cholesterol level, HDL-and LDL-cholesterol at the time of AMI, total cholesterol and LDL-cholesterol at least 3 months after AMI did not show statistical significance (p>0.05). In mltivariate analysis, old age and Killip class III versusIproved as independent poor long term prognostic factors of AMI with statistical significance (p<0.05) at combinations of age, sex, Killip class, existence of Q-wave, history of diabetes, ejection fraction on gated blood pool scan. CONCLUSION: The morthality of AMI is composed of two components. At acute phase, within 1 month, the mortality reaches to about 12%, and at chronic phase, after 1 month from AMI, mortality increases by 3% a year for 10 years. The other conclusion is old patients who have poor left ventricular functions show poor prognosis.
Arteries ; Body Mass Index ; Cholesterol ; Coronary Artery Disease ; Creatine Kinase ; Echocardiography ; Electrocardiography ; Exercise Test ; Follow-Up Studies ; Humans ; Hypertension ; Infarction ; Ischemia ; Korea ; Mortality ; Myocardial Infarction* ; Prognosis ; Seoul ; Survival Rate* ; Ventricular Function, Left