Background: This study aimed to generate a Z score calculation model for coronary artery diameter of normal children and adolescents to be adopted as the standard calculation method with consensus in clinical practice. Methods: This study was a retrospective, multicenter study that collected data from multiple institutions across South Korea. Data were analyzed to determine the model that best fit the relationship between the diameter of coronary arteries and independent demographic parameters. Linear, power, logarithmic, exponential, and square root polynomial models were tested for best fit. Results: Data of 2,030 subjects were collected from 16 institutions. Separate calculation models for each sex were developed because the impact of demographic variables on the diameter of coronary arteries differs according to sex. The final model was the polynomial formula with an exponential relationship between the diameter of coronary arteries and body surface area using the DuBois formula. Conclusion A new coronary artery diameter Z score model was developed and is anticipated to be applicable in clinical practice. The new model will help establish a consensus-based Z score model.

Background: : This study aims to report the development process of a communication training program targeting residents and nurses in a university hospital and discuss the results of the analysis of questionnaire responses received from the participants. Methods : A training program comprising a lecture on prescription principles, team communication, role-playing using cases based on medical errors related to prescriptions was developed. This two-hour program was conducted four times from September to December in 2022, with 31 residents and 37 nurses. After the program, the participants completed a questionnaire about program satisfaction. Results : An analysis of the questionnaire responses received from 28 residents and 37 nurses revealed that participants had an average satisfaction score ranging from 4.18 to 4.44 for each item. No difference was found between the residents’ and nurses’ responses. The participants shared positive opinions regarding the efficiency of the role-playing experience. The areas highlighted as those requiring improvement were the inclusion of various cases, improvement of teamwork, and a reduction in lecture volume. Conclusion : The participants reported being satisfied with the two-hour program to improve prescribing-related communication for residents and nurses. Future research should improve the program contents by reflecting on the opinions of the participants, and grasp the efficacy of the program by using a tool to measure communication skills or attitudes toward interprofessional collaboration before and after the program.

Purpose: The purpose of the study was to analyze the priorities for educational content regarding precautions to be taken to prevent safety accidents for employees in school foodservice using the Borich priority formula and the Locus for Focus model. Methods: A survey was conducted in February 2019 on 194 employees in elementary school and 122 employees in middle- and high school foodservice in the Jeonbuk area. Demographic characteristics, status of safety accidents, safety education, and their importance and performance levels were assessed using a self-administered questionnaire. The priorities for the educational content on precautions to prevent safety accidents were based on a 3-step analysis method, including the paired sample t-test, Borich priority formula, and the Locus for Focus Model. Results: The average perceived importance of the precautions to be taken against safety accidents of employees in elementary-, middle-, and high schools was higher compared to the average performance of the employees (p < 0.001). The top priority for elementary school employees was caution against falls during the cleaning of the gas hood and the trench in the kitchen. In addition, ‘awareness of chemical signs’ was added as one of the top priorities of middle- and high school employees. The second highest priority items were ‘do stretching’, ‘safely adjusting workbench height’, ‘keeping the right attitude’, ‘using assistive devices when moving heavy things’, and ‘checking the material safety data sheet’, which were the same for all elementary, middle- and high school employees. Conclusion Thus, to improve the educational preparedness of employees in the area of safety precautions, eight safety/accident prevention items should be included in the safety education program.

N,N-dimethylformamide (DMF), a widely used solvent in the chemical industry, is known to induce toxic hepatitis. However, there have been no reported cases of DMF-associated autoimmune hepatitis. A 31-year-old healthy man working at a glove factory since July 2015 had intermittently put his bare hands into a diluted DMF solution for his first 15 days at work. After 2 months, he felt nausea, fatigue, and hand cramping, and a jaundice followed. His laboratory findings showed positive autoantibodies and elevated immunoglobulin G (IgG), and his liver biopsy pathology was typical of autoimmune hepatitis (AIH). Prednisolone and azathioprine therapy began, and he recovered rapidly without adverse events. Though his liver chemistry was normalized, the IgG level remained persistently upper normal range. His 2nd liver biopsy performed in April 2019 showed mild portal activity, and he was well under a low dose immunosuppressive therapy up to April 2020. This case warns of the hazard of occupational exposure to DMF, and clinicians should be aware of DMF-related AIH for timely initiation of immunosuppressive therapy.

In patients with epilepsy, depression is a common comorbidity but difficult to be treated because many antidepressants cause pro-convulsive effects. Thus, it is important to identify the risk of seizures associated with antidepressants. To determine whether paroxetine, a very potent selective serotonin reuptake inhibitor (SSRI), interacts with ion channels that modulate neuronal excitability, we examined the effects of paroxetine on Kv3.1 potassium channels, which contribute to highfrequency firing of interneurons, using the whole-cell patch-clamp technique. Kv3.1 channels were cloned from rat neurons and expressed in Chinese hamster ovary cells. Paroxetine reversibly reduced the amplitude of Kv3.1 current, with an IC₅₀ value of 9.43 µM and a Hill coefficient of 1.43, and also accelerated the decay of Kv3.1 current. The paroxetine-induced inhibition of Kv3.1 channels was voltage-dependent even when the channels were fully open. The binding (k₊₁) and unbinding (k₋₁) rate constants for the paroxetine effect were 4.5 µM⁻¹s⁻¹ and 35.8 s⁻¹, respectively, yielding a calculated K(D) value of 7.9 µM. The analyses of Kv3.1 tail current indicated that paroxetine did not affect ion selectivity and slowed its deactivation time course, resulting in a tail crossover phenomenon. Paroxetine inhibited Kv3.1 channels in a usedependent manner. Taken together, these results suggest that paroxetine blocks the open state of Kv3.1 channels. Given the role of Kv3.1 in fast spiking of interneurons, our data imply that the blockade of Kv3.1 by paroxetine might elevate epileptic activity of neural networks by interfering with repetitive firing of inhibitory neurons.
Animals ; Antidepressive Agents ; Clone Cells ; Comorbidity ; Cricetinae ; Cricetulus ; Depression ; Epilepsy ; Female ; Fires ; Humans ; Interneurons ; Ion Channels ; Neurons ; Ovary ; Paroxetine* ; Patch-Clamp Techniques ; Rats ; Seizures ; Serotonin ; Shaw Potassium Channels* ; Tail

PURPOSE: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. METHODS: Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively. RESULTS: Among 29 patients, 14 patients underwent right ventricle to pulmonary artery (RV-PA) connection, 11 palliative BT shunt, 2 central shunt, and 2 ductal stent insertion. Median age at the initial palliation was 13 days (1–98 days). Additional procedure for pulmonary blood flow was required in 5 patients; 4 additional BT shunt operations and 1 RV-PA connection. There were 2 early deaths among patients with RV-PA connection, one from RV failure and the other from severe infection. Finally, 25 patients (86%) had a complete repair. Median age of total correction was 12 months (range, 2–31 months). At last follow-up, 2 patients had required reintervention after total correction; 1 conduit replacement and 1 right ventricular outflow tract (RVOT) patch enlargements. CONCLUSION: For initial palliation of patients with PA VSD or TOF with severe PS, not only shunt operation but also RV-PA connection approach can provide an acceptable outcome. To select the most proper surgical strategy, we recommend thorough evaluation of cardiac anomalies such as RVOT and PA morphologies and consideration of the patient's condition.
Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans ; Infant ; Infant, Newborn ; Methods ; Palliative Care ; Prognosis ; Pulmonary Artery ; Pulmonary Atresia* ; Pulmonary Valve Stenosis* ; Retrospective Studies ; Stents ; Tertiary Care Centers ; Tetralogy of Fallot*

No abstract available.
Coronary Vessels* ; Endocarditis* ; Fistula*

BACKGROUND: Response to cardiac resynchronization therapy (CRT) is commonly assessed after 6 or 12 months. We evaluated subsequent echocardiographic changes, serial QRS duration, and clinical outcomes in patients showing delayed responses to CRT after 12 months. METHODS: Among all patients who received CRT in Seoul St. Mary's Hospital, 36 one-year survivors were enrolled. Indicators of a positive CRT response were ≥ 15% reduction in left ventricular end-systolic volume (LVESV) or ≥ 10% increase in left ventricular ejection fraction (LVEF) on any follow up echocardiogram. We defined the early responders as patients responding before one year, the late responders as patients responding after one year, and the non-responders as patients who did not respond on any follow-up echocardiogram. RESULTS: We identified 17 early responders, 10 late responders, and 9 non-responders. The late responders showed modest improvement in LVESV and LVEF at two years after CRT. QRS duration was shortened the day after CRT in all three groups. Narrowed QRS was maintained for two years in early and late responders, whereas it was continuously prolonged over time in non-responders. Incidence of all-cause death or heart failure hospitalization was comparable between early and late responders, while non-responders showed worst prognosis. CONCLUSION: Patients responding to CRT after one year show modest echocardiographic improvement but clinical outcome is similar to early responders. Shorter baseline QRS duration and long-term maintenance of QRS duration shortening are important features of the late responders to CRT.
Cardiac Resynchronization Therapy* ; Echocardiography* ; Electrocardiography* ; Follow-Up Studies ; Heart Failure ; Hospitalization ; Humans ; Incidence ; Prognosis ; Seoul ; Stroke Volume ; Survivors

PURPOSE: This study was conducted to identify the factors affecting container terminal worker's recovery experience from job stress. METHODS: The subjects were 299 workers from one S dock in P city. Data were collected from April 5 to June 5, 2015 and analyzed by SPSS/WIN 18.0 program using descriptive statistics, t-test, ANOVA, Sheffe test, Pearson's correlation coefficients, and logistic regression. RESULTS: The mean scores of job stress, ego-resilience, and recovery experience from job stress were 47.18, 46.90, and 49.17 respectively. Recovery experience according to the general characteristics showed significant correlation between daily exercise. There was a significant negative correlation between recovery experience and job stress, and a positive correlation between recovery experience and ego-resilience. Recovery experience was 2.54 times higher for a high ego-resilience group than for a low ego-resilience group, and the group that exercised was 2.25 times higher, than the non-exercising group. The group with a low level of interpersonal conflict was 1.97 times higher, than a group with a high level of interpersonal conflict. CONCLUSION: Based on this study, intervention programs to increase ego-resilience, decrease interpersonal conflict, and encourage over 30-minute-daily exercise for in container terminal workers should be developed to improve recovery experience of job stress.
Clinical Trial ; Logistic Models ; Recovery of Function

PURPOSE: The purpose of this study was to identify the impacts of job stress and job embeddedness on presenteeism among container terminal workers. METHODS: The participants were 299 workers at the S Harbor in P City. Data were collected from April 22 to June 5, 2015. The data were analyzed using t-test, ANOVA, Scheffé's test, Pearson's correlation coefficients, and logistic regression. RESULTS: These workers on presenteeism were affected by the department of work, annual pay, and exercise of more than 30 minutes per day, revealing a statistically significant difference according to these variables. In other words, when job stress was high, job embeddedness was less, the extent of work impairment was higher, and in turn perceived productivity was lower. Work impairment was 3.11 times higher in workers with above-average job stress than those with lower job stress. Perceived productivity was 2.31 times higher in workers with above-average job embeddedness than those with lower job embeddedness. CONCLUSION: To reduce work impairment and increase productivity among container terminal workers, it is necessary to decrease their job stress, to increase their job embeddedness, and especially to do exercise for more than 30 minutes a day.
Career Mobility ; Efficiency ; Logistic Models ; Stress, Psychological