The Mediating Effects of the Depression, Anxiety on the Relationship Between Temperament and Character and Maternal-Fetal Attachment in High-Risk Pregnant Women / 생물치료정신의학

OBJECTIVES: The objectives of this study were to investigate the correlations of the temperament and character, depression, anxiety, and maternal-fetal attachment and the mediating effects of the depression, anxiety on the relationship between temperament and character and maternal-fetal attachment.METHODS: A hundred and eleven high-risk pregnant women were recruited in this study. All subjects were administered a sociodemographic and obstetric questionnaire, Temperament and Character Inventory, Beck Depression Inventory-II, State Trait Anxiety Inventory-State, and Maternal-Fetal Attachment Scale.RESULTS: The results of this study were as follows. Higher scores on the reward dependence, persistence, cooperativeness, and self-transcendence scale were associated with higher scores on maternal-fetal attachment scale. Higher scores on the harm avoidance scale and lower scores on the self-directedness scale were associated with higher depression scores. Higher scores on the harm avoidance scale and lower scores on the persistence, self-directedness, and cooperativeness scale were associated with higher anxiety scores. Higher anxiety scores were associated with higher scores on maternal-fetal attachment scale. The anxiety was found to have a partial mediating effect on the relationship between persistence and the maternal-fetal attachment. It was also found to have a partial mediating effect on the relationship between cooperativeness and the maternal-fetal attachment.CONCLUSION: In this study, we found that the anxiety has partial mediating effect on the relationship between temperament and character and maternal-fetal attachment. Based on these findings, it is suggested that examining temperament and character and screening vulnerable pregnant women can help to prevent negative results for high-risk pregnant women.

Spatial analysis between particulate matter and emergency room visits for conjunctivitis and keratitis

BACKGROUND: The concentration of particulate matter in the air varies depending on the region because it is lightweight and generated from a variety of sources. To assess the relationship between particulate matter and eye disease, this study analyzes the concentration data obtained from spatial analysis of particulate matter and emergency visit data. METHODS: The study included 769 residents of Daegu, Korea who had visited an emergency room for the problem of conjunctivitis or keratitis. Concentrations of PM10 and other air pollutants were obtained from the Korean Ministry of the Environment. PM10 concentrations and the number of patients from each of 143 administrative dongs (sub-municipal level administrative units) of the city of Daegu were obtained using spatial analysis. The patient distribution and PM10 concentration were mapped for comparison, and their relationship was examined using scatter plot, regression analysis, and the independent sample t-test. RESULTS: The number of patients with conjunctivitis and keratitis was significantly higher in the regions of the top 20% areas than the bottom 20% areas in terms of PM10 concentration. The distribution of PM10 concentration and number of patients was visually similar on the map. The concentration of PM10 and the number of patients showed a dose–response relationship. When the concentrations of other air polluta9nts were controlled for, the numbers of conjunctivitis and keratitis patients were 0.04 per 1000 ER patients and 0.10 per 1000 ER patients, respectively. CONCLUSION: As PM10 is associated with the prevalence of conjunctivitis and keratitis, measures to reduce particulate matter through environmental methods are needed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40557-018-0252-x) contains supplementary material, which is available to authorized users.

Development of Predictive Model for Assessment of Grip Strength among Koreans: Data from 2014-2015 Korea National Health and Nutrition Examination Survey / 계명의대학술지

Grip strength is used in the various field to assess the disorder of upper limb. Normative data on the grip strength of population is needed to assess decreased grip strength. In this study, we tried to make a estimating model considering age and anthropometry investigation data, by analyzing 2014-2015 Korean National Health and Nutrition Examination Survey data. The subjects of this study were 10,430 participants who measured grip strength of both hands, have no missing data on anthropometry data and survey. Analysis showed that the grip strength had a curve-shaped correlation which could best be explained by the cubic expression of age, and linear correlation between height, weight and waist circumference. After the stratification of the gender, a prediction formula with age, height, and body weight as independent variables for dominant hand and non-dominant hand grip strength was presented. In addition, the distribution of estimated value to measured value ratio among subjects was suggested, which can be used to assess the abnormal value of grip strength. The distribution of non-dominant hand grip strength to dominant hand grip strength was also suggested, which can be used to determine decreased unilateral grip strength. Several studies have suggested normative value for grip strength by gender and age of Koreans, but there are no consideration for adjusting heightand weight. In this study, the model was developed to calculate the predicted grip force considering age, height, and weight. With the distribution data of measured value to predicted value ratio and non-dominant hand grip strength to dominant hand grip strength ratio, the model can be helpful to assess a reduction in grip strength.

Effect of Follow-up Management on Cerebro-cardiovascular Disease Risk for Small Sized Company Workers / 계명의대학술지

To explore the effect of follow-up management after health examination for the cerebro-cardiovascular disease risk, a survey applied with the KOSHA cerebro-cardiovascular disease risk assessment tool was conducted with 500 workers in small scale enterprise less than 50 employees. They were provided two types of health services; post-examination management and health consultation, and finally compared the cerebro-cardiovascular disease risk changes between 2014 and 2015. In normal group in 2014, only 18.7% of workers who received the follow-up management had elevated risks, while 23.8% of workers who received the health consultation had elevated risks in 2015. In risk group in 2014, only 2.8% of workers who got follow-up management had elevated risks, while 7.7% of workers who got only health consultation had elevated risks in 2015. After adjustment for gender, age, exercise, body mass index, nationality and type of industry, negative correlation was found in association to the follow-up management (odds ratio = 0.87). This study shows that workers with cerebro-cardiovascular disease or who are at high cerebro-cardiovascular risk in small scale enterprise should receive early detection and management using counselling and regular follow-up after periodic health examination. Also the health counselling including preventive education for cerebro-cardiovascular disease is needed for all workers to improve their self-management for health.

Factors related to heart rate variability among firefighters

OBJECTIVES: The aim of this study was to investigate factors associated with heart rate variability in firefighters working in a metropolitan city in South Korea. METHODS: Self-administered questionnaires including Korean Occupational Stress Scale (KOSS) as well as surveys collecting socio-demographic characteristics and work-related factors were given to 962 firefighters. After exclusion for missing data, 645 firefighters were included, and analysis of covaiance adjusted for the general risk factors and job characteristics were used to assess the relationship between heart rate variability and associated factors. RESULTS: SDNN and RMSSD and were decreased in the area of occupational climate of the group with high job stress (p = 0.027, p = 0.036). HF(ln) was decreased in the area of organizational system and occupational climate of the group with high stress that statistically significant level (p = 0.034, p = 0.043). CONCLUSIONS: Occupational climate and organizational system are associated with reduction of heart rate variability. Preventive medical care plans for cardiovascular disease of firefighters through the analysis and evaluation of job stress factors are needed.

Minnesota multiphasic personality inventory as related factor for post traumatic stress disorder symptoms according to job stress level in experienced firefighters: 5-year study

OBJECTIVES: As first responders to an increasing number of natural and manmade disasters, active-duty firefighters are at increased risk for physical and psychiatric impairment as reflected by high rates of posttraumatic stress disorder (PTSD). Because little is known about related factor with PTSD according to job stress level among firefighters, we assessed utility of the Minnesota Multiphasic Personality Inventory (MMPI) using 5-year medical surveillance. METHODS: Data were analyzed from 185 male firefighters without psychiatric disease history and who at assessments in 2006 and 2011 completed all questionnaires on personal behaviors (including exercise, drinking and smoking habits) and job history (including job duration and department). MMPI, Events Scale-Revised-Korean version (IES-R-K) and Korean Occupational Stress Scale-Short Form (KOSS-SF) were used to screen for personality trait, PTSD symptom presence and job stress level, respectively. IES-R-K subgroups were compared using two-sample t- and chi2 tests, and factors influencing IES-R-K according to KOSS-SF were determined using uni- and multivariate logistic regression. RESULTS: Mean age and job duration were higher in PTSD-positive than negative groups. In multivariate analysis, increased PTSD risk was associated with: job duration (Odds ratio (OR) = 1.064, 95 % CI 1.012-1.118) for firefighters overall; masculinity-femininity (OR = 5.304, 95 % CI 1.191-23.624) and job duration (OR = 1.126, 95 % CI 1.003-1.265) for lower job stress level; and social introversion (OR = 3.727, 95 % CI 1.096-12.673) for higher job stress level. CONCLUSIONS: MMPI relates with PTSD according to job stress level among experienced firefighters. Masculinity-femininity and social introversion were the strongest related factor for PTSD symptom development in low and high job stress levels, respectively.

Preclinical Efficacy and Mechanisms of Mesenchymal Stem Cells in Animal Models of Autoimmune Diseases

Mesenchymal stem cells (MSCs) are present in diverse tissues and organs, including bone marrow, umbilical cord, adipose tissue, and placenta. MSCs can expand easily in vitro and have regenerative stem cell properties and potent immunoregulatory activity. They inhibit the functions of dendritic cells, B cells, and T cells, but enhance those of regulatory T cells by producing immunoregulatory molecules such as transforming growth factor-beta, hepatic growth factors, prostaglandin E2, interleukin-10, indolamine 2,3-dioxygenase, nitric oxide, heme oxygenase-1, and human leukocyte antigen-G. These properties make MSCs promising therapeutic candidates for the treatment of autoimmune diseases. Here, we review the preclinical studies of MSCs in animal models for systemic lupus erythematosus, rheumatoid arthritis, Crohn's disease, and experimental autoimmune encephalomyelitis, and summarize the underlying immunoregulatory mechanisms.

Characteristics of Function-Anatomy Mismatch in Patients with Coronary Artery Disease

BACKGROUND AND OBJECTIVES: Coronary lesions with mismatched functional and anatomical significance are not uncommon. We assessed the accuracy and predictors of mismatch between fractional flow reserve (FFR) and quantitative coronary angiography (QCA) analyses in patients with coronary lesions. SUBJECTS AND METHODS: A total of 643 lesions with pre-interventional FFR and QCA measurements were consecutively enrolled and divided into four groups using FFR or =50% as cutoffs for functional and anatomical significance, respectively. Accordingly, FFR >0.80 and DS > or =50%, and FFR < or =0.80 and DS <50% defined false-positive (FP) and false-negative (FN) lesions, respectively. RESULTS: Overall, 40.4% (260/643) of the lesions were mismatched, and 51.7% (218/414) and 18.3% (42/229) were FP and FN lesions, respectively. In a multivariate analysis, independent predictors of FP were non-left anterior descending artery location {odds ratio (OR), 0.36; 95% confidence interval (CI), 0.28-0.56; p<0.001}, shorter lesion length (OR, 0.96; 95% CI, 0.95-0.98; p<0.001), multi-vessel disease (OR, 0.47; 95% CI, 0.30-0.75; p=0.001), and larger minimal lumen diameter by QCA (OR, 2.88; 95% CI,1.65-5.00; p<0.001). Independent predictors of FN were multi-vessel disease (OR, 1.82; 95% CI, 1.24-5.27; p=0.048), aging (OR, 0.96; 95% CI, 0.93-0.99; p=0.034), smoking (OR, 0.36; 95% CI, 0.14-0.93; p=0.034), and smaller reference vessel diameter by QCA (OR, 0.30; 95% CI, 0.10-0.87; p=0.026). CONCLUSION: A mismatch between FFR and angiographic lesion severity is not rare in patients with coronary artery disease; therefore, an angiography-guided evaluation could under- or over-estimate lesion severity in specific lesion subsets.

Pulmonary function decline in firefighters and non-firefighters in South Korea

OBJECTIVES: The purpose of this study was to evaluate and compare changes to pulmonary function among firefighters and non-firefighters who were exposed to harmful substances in their work environments. METHODS: Firefighters (n = 322) and non-firefighters (n = 107) in Daegu who received a pulmonary function test in 2008 and 2011 as well as a regular health examination were included. Repeated measures ANOVA was performed to evaluate the pulmonary function of the two groups over the three-year period. RESULTS: After adjusting for age, height, body mass index, duration of exposure, physical activity, and smoking, which were statistically different between the two groups and known risk factors of pulmonary function, the forced expiratory volume in one s FEV1, forced vital capacity FVC, and FEV1/FVC% over the 3 year period were significantly lower among firefighters compared with non-firefighters. CONCLUSIONS: Evaluating the working environment of firefighters is difficult; however, our study revealed that pulmonary function declined in firefighters. Thus, more effort should be made to prevent and manage respiratory diseases early by preforming strict and consistent pulmonary function tests in firefighters.

Factors Related to Sleep Disorders among Male Firefighters

OBJECTIVES: The aim of this study was to investigate factors associated with sleep disorders in male firefighters working in a metropolitan city in South Korea. METHODS: Self-administered questionnaires including the Nordic Musculoskeletal Questionnaire, Korean Occupational Stress Scale-Short Form, Psychosocial Well-Being Index-Short Form, Pittsburg Sleep Quality Index, and Beck-Depression Inventory-2 as well as surveys collecting socio-demographic characteristics and work-related factors were given to 730 male firefighters. After exclusion for missing data, 657 male firefighters were included, and logistic regression analysis adjusted for the work-related factors, psychosocial factors, and general risk factors were used to assess the relationship between sleep disorders and associated factors. RESULTS: The prevalence of sleep disorders was 48.7%. Shift work (adjusted OR 1.58, 95% CI = 1.02-2.45), musculoskeletal symptoms (adjusted OR 2.89, 95% CI = 2.02-4.14), and depression (adjusted OR 7.04 95% CI = 4.03-12.30) were associated with sleep disorders. CONCLUSIONS: Musculoskeletal symptoms, shift work, and depression are associated with sleep disorders. Integrated health management is needed to promote good sleep quality among firefighters.

Long-term outcomes of simple crossover stenting from the left main to the left anterior descending coronary artery

BACKGROUND/AIMS: Although complex bifurcation stenting in patients with non-left main (LM) bifurcation lesions has not yielded better clinical outcomes than simpler procedures, the utility of complex bifurcation stenting to treat LM bifurcation lesions has not yet been adequately explored. METHODS: In the present study, patients who underwent LM-to-left anterior descending (LAD) coronary artery simple crossover stenting to treat significant de novo distal LM or ostial LAD disease, in the absence of angiographically significant ostial left circumflex (LCX) coronary artery disease, were consecutively enrolled. The frequencies of 3-year major adverse cardiovascular events (MACEs; cardiac death, myocardial infarction, and target lesion revascularization), were analyzed. RESULTS: Of 105 eligible consecutive patients, only 12 (11.4%) required additional procedures to treat ostial LCX disease after main vessel stenting. The mean percentage diameter of ostial LCX stenosis increased from 22.5% +/- 15.2% to 32.3% +/- 16.3% (p < 0.001) after LM-to-LAD simple crossover stenting. The 3-year incidence of MACEs was 9.7% (cardiac death 2.2%; myocardial infarction 2.2%; target lesion revascularization 8.6%), and that of stent thrombosis 1.1%. Of seven cases (7.5%) requiring restenosis, pure ostial LCX-related repeat revascularization was required by only two. CONCLUSIONS: Simple crossover LM-to-LAD stenting without opening of a strut on the LCX ostium was associated with acceptable long-term clinical outcomes.

Occupational Risk Factors Associated with Musculoskeletal Symptoms in Public Workers / 대한산업의학회지

OBJECTIVES: The purpose of this study was to examine the occupational risk factors associated with musculoskeletal symptoms in public workers. METHODS: In November 2010, 544 participants anwered a survey that included questions on the participants' general characteristics, job-related factors, health-related behaviors, and psychosocial stress. We measured the relationship of risk factors to musculoskeletal symptoms using a logistic regression analysis. RESULTS: After adjusting for general characteristics, factors associated with occupational musculoskeletal symptoms were gender (OR=2.858, 95% CI=1.701~4.801), unnatural posture (OR=2.386, 95% CI=1.308~4.354), psychosocial stress (OR=4.051, 95% CI=1.336~12.282) and sleep quality (OR=1.672, 95% CI=1.052~2.660). CONCLUSIONS: These findings suggest that psychosocial stress levels and physical environment (especially in professions requiring an unnatural posture) are related to musculoskeletal symptoms in public workers.

The Relationship between the Korean Occupational Stress Scale and Carotid Intima-Media Thickness among Male Firefighters / 대한산업의학회지

OBJECTIVES: This study examined the relationship between job stress and the common carotid intima-media thickness as an indicator of atherosclerosis (cardiovascular disease) among male firefighters in a metropolitan city. METHODS: Between November and December 2011, a total of 838 participants were analyzed using a questionnaire, which included the participants' general characteristics, job-related factors, health-related behaviors, and job stress. Job stress was measured using the Korean Occupational Stress Scale-Short Form (KOSS-SF). The job stress data was merged with the clinical laboratory data and common carotid intima-media thickness (CIMT) by a medical examination. The relationship between job stress and the CIMT was examined by multiple logistic regression analysis. RESULTS: Multiple logistic regression analyses adjusted for the general and cardiovascular risk factors revealed, the organizational system (adjusted OR 1.381 95% CI=1.005~1.898) to be associated with the right CIMT. Multiple logistic regression analyses adjusted for general and cardiovascular risk factors and job types, the occupational climate (adjusted OR 1.392, 95% CI=1.009~1.922) was also associated with the right CIMT. CONCLUSIONS: The level of job stress, particularly in regard to the organizaional system, shows a correlation with the right CIMT. Therefore, further preventive efforts and studies of firefighters will be needed to reduce job stress and help prevent cardiovascular disease.

Correlations between Janus Kinase 2 V617F Allele Burdens and Clinicohematologic Parameters in Myeloproliferative Neoplasms

BACKGROUND: This study evaluated potential correlations between the allele burden of the Janus kinase 2 (JAK2) V617F mutation and clinicohematologic characteristics in patients with myeloproliferative neoplasms (MPN). METHODS: Clinical and hematologic features were reviewed for 103 MPN patients, including patients with polycythemia vera (PV, 22 patients), essential thrombocythemia (ET, 64 patients), and primary myelofibrosis (PMF, 17 patients). JAK2 V617F allele status and allele burdens were measured by allele-specific PCR and pyrosequencing, respectively. RESULTS: The JAK2 V617F mutation was detected in 95.5%, 68.8%, and 52.9% of PV, ET, and PMF patients, respectively. JAK2 V617F-positive ET patients were significantly older and exhibited higher neutrophil fractions, a higher frequency of thrombotic events, and a higher myelofibrosis rate than JAK2 V617F-negative patients (P <0.05). PV patients carried the highest mean T allele burden (66.0%+/-24.9%) compared with ET (40.5%+/-25.2%) and PMF patients (31.5%+/-37.0%) (P =0.00). No significant correlations were detected between V617F allele burden and patient age, white blood cell count, Hb, Hct, or the platelet count for PV, ET, or PMF patients. ET patients with organomegaly had a higher JAK2 V617F allele burden (53.4%+/-23.7%) than patients without organomegaly (35.6%+/-24.3%) (P =0.03). CONCLUSIONS: The JAK2 V617F mutational status and its allele burden correlate with the clinicohematologic phenotypes of ET patients, including older age, higher neutrophil count, and greater rates of organomegaly, thrombotic events, and myelofibrosis. For PV and PMF patients, larger-scale studies involving more MPN patients are needed.

Fractional Flow Reserve Versus Angiography in Left Circumflex Ostial Intervention After Left Main Crossover Stenting

BACKGROUND AND OBJECTIVES: Discrepancy between angiographic percent (%) diameter stenosis and fractional flow reserve (FFR) exists in non-left main bifurcation lesions. The aim of this study was to compare angiographic stenosis severity and FFR in jailed ostial left circumflex artery (LCX) lesions after left main (LM)-to-left anterior descending artery (LAD) crossover stenting. SUBJECTS AND METHODS: Twenty-nine (n=29) patients with distal LM or ostial LAD lesions treated by LM-to-LAD crossover stenting were consecutively enrolled. After successful stenting, FFR was measured at the jailed LCX. Additional intervention was performed in lesions with FFR 50%) at the ostial LCX occurred in 59% (17/29) of cases. Among them, only five (29%) lesions had functional significance, and underwent additional procedure. During follow-up, three patients in the deferral group and two patients in the additional intervention group had target lesion revascularization. CONCLUSION: There was a discrepancy between angiographic percent diameter stenosis and FFR in jailed LCX lesions after LM crossover stenting.

The Relationship between the Korean Occupational Stress Scale and Pulse Wave Velocity among Male Firefighters / 대한산업의학회지

OBJECTIVES: The aim of this study was to investigate the relationship between job stress and the pulse wave velocity as an indicator of vessel stiffness among male firefighters in a metropolitan city. METHODS: In November and December 2008, a total of 404 participants were analyzed. The questionnaire survey included the participants' general characteristics, job-related factors, health-related behaviors, and job stress. Job stress was measured using the Korean Occupational Stress Scale (KOSS). We merged the job stress data with clinical laboratory data and brachial-ankle Pulse Wave Velocity (baPWV) by conducting medical surveillance. We measured the relationship of job stress to baPWV by using a logistic regression analysis. RESULTS: After adjusting for cardiovascular risk factors, the baPWV was significantly higher in the groups possessing high levels of job insecurity (OR=2.17, 95% CI=1.06~4.42). CONCLUSIONS: Our findings suggest that the level of job stress, especially in regards to job insecurity, was directly related to the baPWV. Therefore, further preventive efforts and studies in regards to firefighters are needed in order to reduce job stress and thereby help to prevent cardiovascular disease.

Association between Work Departments and Carotid Intima-media Thickness in a Metal Manufacturing Plant / 대한산업의학회지

OBJECTIVE: To evaluate the relationship of work departments, carotid IMT, and plaque formation as predictors of cardiovascular disease in white-collar and blue-collar workers. METHOD: A total of 201 workers from a metal agricultural equipment manufacturing plant near Daegu were administered questionnaires to obtain information on their general characteristics, their work-related factors. In addition, the workers were given a clinical examination, which included a carotid artery ultrasonography. In total, 193 (96.0%) of questionnaires were completed and analyzed for this study. Multiple regression analysis and multiple logistic regression analysis were performed on the data for analysis. RESULT: Blue-collar workers had thicker carotid artery IMT when compared to white-collar workers. After adjustment, the carotid IMT was affected by age, working department, hypertension, and diabetes; plaque formation was affected by age, hypertension, total cholesterol, and excessive drinking. CONCLUSION: This study suggests that carotid IMT is associated with working department. Therefore, we need to examine the effect that occupational health services has on cardiovascular disease, focusing on the characteristics of each department.

Induction of Inducible Nitric Oxide Synthase Expression by Manganese in C6 Glioma Cells / 대한산업의학회지

OBJECTIVE: It is well established that manganese neurotoxicity is associated with clinical symptoms similar to those of idiopathic Parkinson's disease. Recent research has shown that the exposure to manganese (MnCl2) leads to induction of iNOS in BV2 microglial cells via iNOS transcriptional up-regulation and activation of both MAPKs and PI3K/Akt signaling pathways. Here, we further investigated the effect and the action mechanism of MnCl2 on iNOS expression in C6 glioma cells. METHODS: Western blot analyses demonstrated that treatment with MnCl2 at 250 micronmeter was sufficient to induce iNOS at both the protein and mRNA levels in C6 cells. RESULTS: These studies demonstrated that the induction of iNOS protein and mRNA was visible after 4h- and 2 h-treatment with MnCl2, respectively. MnCl2 treatment led to strong phosphorylation of JNKs and ERKs, members of MAP kinases (MAPKs), and Akt, a PI3-kinase (PI3K) downstream effector, in C6 cells. MnCl2 treatment had no effect on I kappa B-alpha in C6 cells. Notably, pretreatment with LY294002 (a PI3K inhibitor), which inhibited phosphorylation of Akt by MnCl2, caused strong suppression of MnCl2- induced iNOS protein and mRNA expression in C6 cells. Moreover, pretreatment with SP600125 (an inhibitor of JNKs) and PD98050 (an inhibitor of ERKs), which respectively interfered with MnCl2-mediated phosphorylation of JNKs and ERKs, led to the partial suppression of MnCl2-induced iNOS protein. Interestingly, pretreatment with LY294002 inhibited phosphorylation of not only Akt, but also ERKs and JNKs, in response to MnCl2. Moreover, there was an effective suppression of MnCl2-mediated phosphorylation of AKT by SP600125. CONCLUSION: These results collectively suggest that MnCl2 induces iNOS expression in C6 glioma cells via activation of PI3K/Akt and JNK-ERK MAPK signaling proteins, whose activations seem to be mutually interconnected in response to MnCl2.

Association between Job Stress and the Minnesota Multiphasic Personality Inventory in Firefighters / 대한산업의학회지

OBJECTIVE: To investigate the relationship of job stress and scores on the Minnesota Multiphasic Personality Inventory (MMPI) clinical scales in firefighters. METHOD: A total of 648 firefighters from Daegu Metropolitan City were given 2 sets of questionnaires, the Korean Occupational Stress Scales (KOSS) and the MMPI. The results of 428 qualifying questionnaires were analyzed using ANOVA, correlation, and multiple regression. RESULTS: The study demonstrated that job stress differed by age, department, amount of exercise, and duty period. MMPI clinical scales differed by age, smoking, and amount of exercise. Job stress correlated with MMPI clinical scales and in particular with 2 MMPI clinical scales, -Depression and Social introversion-. In addition, job stress subscales were related. On multiple regression analysis, some MMPI clinical scales were affected by job stress subscales. CONCLUSION: This study suggests that job stress is associated with psychogenic factors in firefighters. The effective management for job stress might be helpful for the overall mental health of firefighters. Further study is required to determine which psychogenic factors are related to job stress.

Impact of Optimal Stent Expansion on Late Outcomes after Sirolimus-Eluting Stent Implantation: An Intravascular Ultrasound Study

BACKGROUND AND OBJECTIVES: Sirolimus-eluting stents (SESs) have a considerably lower optimal minimal stent area (MSA) threshold compared to bare metal stents (BMSs). In the SIRIUS IVUS sub study, the absolute optimal stent expansion (OSE) of SESs was described as > or =5.0 mm2. The purpose of this study was to evaluate the impact of the OSE on long-term outcomes following SES implantation using absolute IVUS criteria. SUBJECTS AND METHODS: The study included 157 patients (BMS: 57; SES; 100), who underwent 6-month follow-up angiography and 18-month clinical follow-up after bare metal stent or drug-eluting stent (DES) implantation. According to the absolute measurement IVUS criteria, patients were divided into two groups: OSE and non-OSE. The IVUS criteria for OSE were MSA > or =6.5 mm2 for BMS implantation and MSA > or =5.0 mm2 for SES implantation. RESULTS: Angiographic binary restenosis was higher in the non-OSE than the OSE group with BMS (33.3% vs. 11.4%; p<0.039), but the rates were similar between the two groups with SES (4.5% vs. 3.2%; p=1.00). With the BMS, the MACE rates were 5.7% and 30% in the OSE and non-OSE group, respectively (p=0.017). However, with the SES, the MACE rates were similar between the two groups (OSE group, 3.2% vs. non-OSE group, 4.5%, p=1.00). CONSLUSION: After SES implantation, there were no significant differences in the late outcomes in relation to the achievement of absolute OSE. A variety of restenosis related factors should be considered for better outcomes after DES implantation. Therefore, the concept of OSE in the era of DESs might need to be revisited.