Background: In addition to vascular endothelial cells, vascular smooth muscle cells (VSMCs) are subject to continuous shear stress because of blood circulation. The angiogenic properties of VSMCs in extracranial arteriovenous malformations (AVMs) may exceed those of normal blood vessels if the body responds more sensitively to mechanical stimuli. This study was performed to investigate the hypothesis that rapid angiogenesis may be achieved by mechanical shear stress. Methods: VSMCs were obtained from six patients who had AVMs and six normal controls. The target genes were set to angiopoietin-2 (AGP2), aquaporin-1 (AQP1), and transforming growth factor-beta receptor 1 (TGFBR1). Reverse-transcriptase polymerase chain reaction (RT-PCR) and real-time PCR were implemented to identify the expression levels for target genes. Immunofluorescence was also conducted. Results: Under the shear stress condition, mean relative quantity values of AGP2, AQP1, and TGFBR1 in AVM tissues were 1.927±0.528, 1.291±0.031, and 2.284±1.461 when compared with neutral conditions. The expression levels of all three genes in AVMs were higher than those in normal tissue except for AQP1 under shear stress conditions. Immunofluorescence also revealed increased staining of shear stress-induced genes in the normal tissue and in AVM tissue. Conclusions Shear stress made the VSMCs of AVMs more sensitive. Although the pathogenesis of AVMs remains unclear, our study showed that biomechanical stimulation imposed by shear stress may aggravate angiogenesis in AVMs.

Background/Aims: Myelodysplastic syndrome (MDS) is caused by genetic and epigenetic alteration of hematopoietic precursors and immune dysregulation. Approximately 20% of patients with MDS develop an autoimmune disease (AID). Here, we investigated whether particular genetic mutations are associated with AID in patients with MDS. Methods: Eighty-eight genetic mutations associated with myeloid malignancy were sequenced in 73 MDS patients. The association between these mutations and AID was then analyzed. Results: The median age of the 73 MDS patients was 70 years (interquartile range, 56 to 75), and 49 (67.1%) were male. AID was observed in 16 of 73 patients (21.9%). Mutations were detected in 57 (78.1%) patients. The percentage (68.8% vs. 80.7%, p = 0.32) and the mean number of mutations (1.8 ± 1.6 vs. 2.2 ± 1.8, p = 0.34) in MDS patients with or without AID were similar. However, the ten-eleven translocation- 2 (TET2) mutation rate was significantly higher in patients with AID than in those without (31.3% vs. 5.3%, respectively; p = 0.001). All TET2 mutations were variants of strong clinical significance. Conclusions Mutation of TET2 in patients with MDS may be associated with increased risk of developing AID.

Microorganisms play important roles in obesity; however, the role of the gut microbiomes in obesity is controversial because of the inconsistent findings. This study investigated the gut microbiome communities in obese and lean groups of captive healthy cynomolgus monkeys reared under strict identical environmental conditions, including their diet. No significant differences in the relative abundance of Firmicutes, Bacteroidetes and Prevotella were observed between the obese and lean groups, but a significant difference in Spirochetes (p < 0.05) was noted. Microbial diversity and richness were similar, but highly variable results in microbial composition, diversity, and richness were observed in individuals, irrespective of their state of obesity. Distinct clustering between the groups was not observed by principal coordinate analysis using an unweighted pair group method. Higher sharedness values (95.81% ± 2.28% at the genus level, and 79.54% ± 5.88% at the species level) were identified among individual monkeys. This paper reports the association between the gut microbiome and obesity in captive non-human primate models reared under controlled environments. The relative proportion of Firmicutes and Bacteroidetes as well as the microbial diversity known to affect obesity were similar in the obese and lean groups of monkeys reared under identical conditions. Therefore, obesity-associated microbial changes reported previously appear to be associated directly with environmental factors, particularly diet, rather than obesity.
Bacteroidetes ; Diet ; Environment, Controlled ; Firmicutes ; Gastrointestinal Microbiome ; Haplorhini ; Macaca fascicularis ; Methods ; Microbiota ; Obesity ; Prevotella ; Primates ; Spirochaetales

BACKGROUND: It is well known that ergonomic risk factors and back pain are related. However, few studies have examined the relationship between simultaneous exposure to these risk factors and back pain in a Korean population. We aimed to investigate the relationship between simultaneous exposure to ergonomic risk factors and work-related lower back pain (LBP) based on the fourth Korean Working Conditions Survey (KWCS). METHOD: The fourth KWCS (2014) was used for this study. Chi-square tests and logistic regression were used to assess relationship between 5 ergonomic risk factors and work-related LBP. We also analyzed the relationship between simultaneous exposure to 2 risk factors and work-related LBP. RESULTS: All 5 ergonomic risk factors (fatigue-inducing and painful posture; lifting or moving people; dragging, pushing, or moving heavy objects; standing posture; and repetitive hand or arm movements) were significantly correlated with work-related LBP in the severe exposure group (adjusted odd ratios [aOR] 5.09, 95% confidence interval [CI] 4.46–5.83; aOR 1.98, 95% CI 1.62–2.42; aOR 2.09, 95% CI 1.82–2.40; aOR 1.79, 95% CI 1.60–2.01; aOR 2.04, 95% CI 1.82–2.30, respectively). When exposed to 2 risk factors simultaneously, the relationship between exposure and work-related LBP was not greater than exposure to only 1 risk factor in our study (usually exposed to ‘fatigue-inducing or painful posture’ aOR 2.17, 95% CI 2.02–2.34; high exposure to both ‘fatigue-inducing or painful posture’ and ‘dragging, pushing, or moving heavy objects’ aOR 2.00, 95% CI 1.82–2.20). CONCLUSIONS: There was a strong relationship between severe exposure to each ergonomic risk factor and work-related LBP. However, when exposed to 2 ergonomic risk factors simultaneously, the relationship between exposure and work-related LBP was not stronger than when exposed to only 1 risk factor in our study.
Arm ; Back Pain ; Cross-Sectional Studies ; Hand ; Lifting ; Logistic Models ; Low Back Pain ; Methods ; Posture ; Risk Factors

PURPOSE: This study aimed to examine levels of stress and professionalism of nurses who provided nursing care during the 2015 Middle East respiratory syndrome outbreak based on their experience, to investigate the nurses' intention to respond to possible future outbreaks in relation to their experience during the outbreak, and to determine the relationship between the outbreak experience and nursing intention considering stress and professionalism. METHODS: A self-administered questionnairewas designed based on modifications of related questionnaires, and used to assess levels of stress, professionalism, and nursing intention according to participants' experiences during the outbreak. Multiple regression analysiswas used to examine the relationship between the outbreak nursing experience and nursing intention considering stress and nursing professionalism. RESULTS: The overall stress, professionalism, and nursing intention scores for the firsthand experience group were 33.72, 103.00, and 16.92, respectively, whereas those of the secondhand experience group were 32.25, 98.99, and 15.60, respectively. There were significant differences in professionalism and nursing intention scores between the groups (p = .001 and p < .001, respectively). The regression analysis revealed that the regression estimate between stress and nursing intention was B(SE) = −0.08(0.02), beta = −0.21, p < .001 and the regression estimate between professionalism in nursing and nursing intention was B(SE) = 0.05(0.01), beta = 0.23, p < .001. CONCLUSIONS: Prior outbreak nursing experience was importantly associated with intention to provide care for patients with a newly emerging infectious disease in the future considering stress and professionalism. Gathering information about nurses' experience of epidemics and regular assessment of job stress and professionalism are required.
Communicable Diseases* ; Communicable Diseases, Emerging ; Coronavirus ; Coronavirus Infections ; Disease Outbreaks ; Emergencies* ; Hospitals, Public* ; Humans ; Intention* ; Korea* ; Nursing Care ; Nursing* ; Professionalism* ; Stress, Psychological

BACKGROUND: This study was conducted to analyze the distribution of the psychosocial well-being index among adults living in two rural communities in Korea and to examine its correlation with lifestyle variables such as sleep duration, regular exercise, and sedentary time. METHODS: Using the cohort data of the Atherosclerosis Risk of a Rural Area Korean General Population, this study examined 3631 participants living in Wonju and Pyeongchang in Gangwon Province; their preliminary data were established from 2005 to 2007 while their follow-up data were collected 3 years later. This study investigated demographic characteristics, lifestyle habits, disease history, Psychosocial Well-being Index-Short Form (PWI-SF) scores, sleep duration, regular exercise, and sedentary time during work. Using repeated measures ANOVA, this study examined how the variables and PWI-SF scores changed over the course of 3 years and identified the correlation between them based on mixed model analysis. Afterwards, using the generalized estimation equation, this study identified each variable's risk towards the PWI-SF high-risk group and performed a stratified analysis by occupation after dividing the participants into farmers and non-farmers. RESULTS: The PWI-SF high-risk group was found to be 18.9% of the participants from preliminary data and 15.5% from follow-up data. The odds ratio towards the PWI-SF high-risk group was 1.503 (95% CI 1.241–1.821) in the short sleep duration group and 1.327 (95% CI 1.136–1.550) in the non-regular exercise group. A stratified analysis by occupation showed that middle and long sedentary time in the white-collar group increased the risk toward the PWI-SF high-risk group. CONCLUSIONS: Short sleep duration, no regular exercise, and long sedentary time in the white-collar group were identified as risk factors toward the PWI-SF high-risk group in the rural communities, and policy interventions are needed to address this issue.
Adult* ; Atherosclerosis ; Cohort Studies ; Farmers ; Follow-Up Studies ; Gangwon-do ; Humans ; Korea ; Life Style ; Occupations ; Odds Ratio ; Risk Factors ; Rural Population

No abstract available.
Education* ; Humans ; Licensure* ; Physical Therapists*

PURPOSE: To analyze the result of a repeat discectomy for ipsilateral recurrent lumbar disc herniation and to investigate the potential factors that influenced the outcomes for this surgery. MATERIALS AND METHODS: Fifty-nine patients, who underwent reoperation after lumbar discectomy with a minimum follow-up period of 2 years, were reviewed. The surgical outcome was assessed using the visual analogue scale (VAS) and Macnab classification, and the recovery rate was calculated in accordance with VAS. A statistical analysis was carried out by SPSS to evaluate the possible factors that may have influenced the outcomes of the reoperation. RESULTS: The rate of reoperation after lumbar disc surgery due to the recurrent disc herniation was 6.0% (59/983 cases). The average recovery rate of VAS from the 1st operation was approximately 77%, and from the 2nd operation was 71%. According to the Macnab criteria, the results were “excellent” or “good” in 96% of cases. Statistical analysis revealed that there was no difference of the average recovery rate (p<0.05). There is no additional instability after repeat discectomy. Factors, such as smoking, precipitating traumatic events, and diabetes mellitus did not have much influence on the average recovery rate after repeat discectomy for ipsilateral recurrent lumbar disc herniation. CONCLUSION: The outcomes of repeat discectomy were satisfactory. Moreover, factors, smoking, trauma history and diabetic mellitus, only had a minor impact on the outcomes of a repeat discectomy.
Classification ; Diabetes Mellitus ; Diskectomy* ; Follow-Up Studies ; Humans ; Reoperation ; Smoke ; Smoking

BACKGROUND: This study was conducted to check whether self-resilience, one of the characteristics known to affect the occurrence of post-traumatic stress disorder (PTSD) symptoms after experiencing traumatic events, could serve as a protective factor for police officers whose occupational factors are corrected. METHODS: We conducted a cross-sectional study in which 112 male police officers in Gangwon Province participated. They visited the Wonju Severance Christian Hospital Occupational Environment Center for medical check-ups from June to December 2015. Their general characteristics were identified using structured questionnaires, and they were asked to fill in the Korean Occupational Stress Scale-Short Form (KOSS-SF). Further, the Center for Epidemiologic Studies-Depression Scale (CES-D), Connor–Davidson Resilience Scale-Korean (CD-RI-K), and Impact of Event Scale-Revised-Korean version (IES-R-K) were used to evaluate their job stress, depression, self-resilience, and PTSD symptoms. Logistic regression analysis was conducted to correct their personal, occupational, and psychological factors to analyze the relationship between self-resilience and PTSD symptoms. RESULTS: Among 112 respondents who experienced a traumatic event, those with low self-resilience had significantly higher rate of PTSD symptoms than those with high self-resilience even after correcting for the covariate of general, occupational, and psychological characteristics (odds ratio [OR] 3.51; 95 % CI: 1.06–19.23). CONCLUSIONS: Despite several limitations, these results suggest that a high degree of self-resilience may protect police officers from critical incident-related PTSD symptoms.
Cross-Sectional Studies ; Depression ; Gangwon-do ; Humans ; Logistic Models ; Male ; Police* ; Protective Factors* ; Psychology ; Stress Disorders, Post-Traumatic* ; Surveys and Questionnaires

PURPOSE: To evaluate the clinical outcomes, complications and surgically induced astigmatism (SIA) after scleral fixation in patients with intraocular lens (IOL) or crystalline lens dislocation. METHODS: The present study retrospectively investigated the postoperative best corrected visual acuity (BCVA), refractory change, corneal astigmatism, clinical outcomes, and influencing factors of SIA in 57 eyes of 55 patients with a follow-up of 6 months after the IOL scleral fixation. RESULTS: In comparison of preoperative and postoperative 6 months, BCVA, spherical equivalent and astigmatism were significantly improved but corneal astigmatism was not and SIA (diopter, D) improved from 2.10 +/- 1.88 D to 0.86 +/- 0.73 D (p = 0.002). 4 eyes having redislocation were repositioned and 4 eyes having tilted IOL, 6 eyes having elevated intraocular pressure, 3 eyes having exposure scleral knots, 1 eye having endophthalmitis, and 1 eye showing macular edema were observed. At postoperative 3 months, the SIA of a large incision size (>3 mm) and small incision size (< or =3 mm) was significantly differented (p = 0.041). According to the location of scleral fixation, SIA at postoperative 1 month was significantly different but, was not different at postoperative 6 months. CONCLUSIONS: Surgical management of dislocated IOLs or crystalline lens resulted in significant improvement of visual acuity and absence of influencing SIA factors. However, location of scleral fixation and small incision size influenced corneal astigmatism.
Astigmatism ; Dislocations ; Endophthalmitis ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lens, Crystalline ; Lenses, Intraocular ; Macular Edema ; Retrospective Studies ; Visual Acuity