Abstract The aim of the study was to assess cardiovascular risk in men with high body fat percentage (BF%) and normal body mass index (BMI) and men with normal BF% and high BMI. This study was a ...cross-sectional study using data on 5534 Korean male adults. Body mass index, BF%, and waist circumference were measured as adiposity indices. Bioelectrical impedance analysis was used for measuring BF%. Blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and high-density lipoprotein cholesterol were measured routinely. Information regarding alcohol consumption, smoking, exercise, and past/current medical history was obtained by structured questionnaires. Subjects were categorized into 4 groups by means of BMI and BF% (group 1, BMI <25 kg/m2 and BF% <25%; group 2, BMI <25 kg/m2 and BF% ≥25%; group 3, BMI ≥25 kg/m2 and BF% <25%; group 4, BMI ≥25 kg/m2 and BF% ≥25%). Cardiovascular risk factors (CVRFs) such as high blood pressure, hyperglycemia, and dyslipidemia were estimated in each group. As might be expected, the prevalences of high blood pressure, hyperglycemia, and dyslipidemia were lowest in group 1 and were highest in group 4. Multivariate analyses showed that subjects in group 2 or group 4 had a 1.8 times increased risk of clustering of 2 or more CVRFs compared with subjects in group 1 ( P < .001). The adjusted odds ratio (1.15; 95% confidence interval, 0.94-1.40) of subjects in group 3 on clustering of 2 or CVRFs was not significantly increased ( P = .180). High BF% was related to increase of cardiovascular risk regardless of the level of BMI in Korean men. However, cardiovascular risk of men with high BMI without high BF% was not significantly increased.
Purpose: This study aumed to identify the effects of job satisfaction, nursing organizational culture and social support on intention retention among general hospital nurses. Methods: The subjects ...were 254 nurses working in one general hospital. Data were collected from January 1 to 30, 2023. Data were analyzed by t-test, ANOVA, Pearson correlation, and multiple regression analysis using the SPSS/WIN 25.0 program. Results: (a) In this study, the mean value of job satisfaction was 3.07±0.43, relation-oriented culture was 3.45±0.51, hierarchy-oriented culture was 3.39±0.49, task-oriented culture was 3.35±0.48, innovation-oriented culture was 3.00±0.46, social support was 3.75±0.49, and intention retention was 4.98±1.39. (b) Intention retention had a positive correlation with job satisfaction (r=.41, p<.001), social support (r=.29, p<.001), innovation-oriented culture (r=.29, p<.001), relation-oriented culture (r=.20, p=.001), and hierarchy-oriented culture (r=.18, p=.002). (c) Factors that affect intention retention include job satisfaction (β=.41, p<.001), Working type (Non-shift) (β=.18, p=.001), Nursing job selection (Recommendation, employment) (β=-.16, p=.003), and the explanation power was 23.1% (F=9.43, p<.001). Conclusion: Our study shows that job satisfaction plays a significant role in the intention retention of nurses. It is important to strengthen job satisfaction to increase the retention of nurses. The results of this study may serve as basic data for the development of strategies to improve intention retention in nurses.
Background: This study evaluated the efficacy and safety of add-on gemigliptin in patients with type 2 diabetes mellitus (T2DM) who had inadequate glycemic control with metformin and dapagliflozin.
...Methods: In this randomized, placebo-controlled, parallel-group, double-blind, phase III study, 315 patients were randomized to receive either gemigliptin 50 mg (n=159) or placebo (n=156) with metformin and dapagliflozin for 24 weeks. After the 24-week treatment, patients who received the placebo were switched to gemigliptin, and all patients were treated with gemigliptin for an additional 28 weeks.
Results: The baseline characteristics were similar between the two groups, except for body mass index. At week 24, the least squares mean difference (standard error) in hemoglobin A1c (HbA1c) changes was -0.66% (0.07) with a 95% confidence interval of -0.80% to -0.52%, demonstrating superior HbA1c reduction in the gemigliptin group. After week 24, the HbA1c level significantly decreased in the placebo group as gemigliptin was administered, whereas the efficacy of HbA1c reduction was maintained up to week 52 in the gemigliptin group. The safety profiles were similar: the incidence rates of treatment-emergent adverse events up to week 24 were 27.67% and 29.22% in the gemigliptin and placebo groups, respectively. The safety profiles after week 24 were similar to those up to week 24 in both groups, and no new safety findings, including hypoglycemia, were noted.
Conclusion: Add-on gemigliptin was well tolerated, providing comparable safety profiles and superior efficacy in glycemic control over placebo for long-term use in patients with T2DM who had poor glycemic control with metformin and dapagliflozin.
Background: We lack full understanding on the determinants of left ventricular (LV) systolic mechanical dyssynchrony. We here tried to evaluate the effect of preload alterations on LV dyssynchrony ...using echocardiographic tissue velocity imaging. Methods: Thirty‐eight patients with a history of heart failure who were in sinus rhythm (24 men, mean age of 61 ± 12 years range, 26–82) were consecutively recruited. Twenty‐four patients were allocated into a mild diastolic dysfunction group (Gr 1), and 14 to an advanced diastolic dysfunction group, which included pseudonormalization or restrictive mitral inflow patterns (Gr 2). The leg‐raising maneuver was performed for 5 minutes in Gr 1, whereas two tablets (1.2 mg) of sublingual nitroglycerin (SLNG) were given to Gr 2 to manipulate preload status. An index representing LV systolic mechanical dyssynchony (DYSsys) was defined as the maximal differences in time intervals from the QRS onset to the systolic peak velocities in 4 basal segments derived from the apical four‐ and two‐chamber views. Results: DYSsys decreased significantly after SLNG administration (74.2 ± 50.2 vs. 46.9 ± 34.8 ms, P < 0.01), whereas it showed a significant elevation after leg‐raising maneuver (76.3 ± 33.5 vs. 88.8 ± 37.5 ms, P < 0.05). Maximal difference in DYSsys between before and after SLNG administration in a patient of Gr 2 was estimated to be 120.2, whereas with the leg‐raising maneuver, maximal difference in DYSsys in a patient of Gr 1 was found to be 66.8. Changes in heart rate induced by preload manipulation did not display any association with changes in DYSsys. Conclusions: DYSsys is significantly affected by preload alterations, and thus it can be considered a “dynamic” parameter that could be modified depending on the loading status. Therefore, loading status of individual patients should be considered when DYSsys is assessed. (Echocardiography 2011;28:196‐202)
Trichomonas vaginalis, a causative agent of trichomoniasis, may trigger symptomatic or asymptomatic nongonococcal urethritis and chronic prostatitis in men. Despite the availability of highly ...sensitive diagnostic tests, such as nucleic acid amplification tests, including PCR, few prospective studies present data on male T. vaginalis infection in South Korea. In the present study, the prevalence of T. vaginalis and associated clinical conditions were evaluated in 201 male patients from a primary care urology clinic in South Korea. The prevalence of T. vaginalis infection in our cohort was 4% (8/201) by PCR. T. vaginalis infection was common in men older than 40 years (median age, 52 years). Among the 8 Trichomonas-positive patients, 87.5% (7/8) had prostatic diseases, such as prostatitis and benign prostatic hyperplasia, and 25.0% (2/8) and 12.5% (1/8) were coinfected with Chlamydia trachomatis and Mycoplasma genitalium, respectively. Our results suggest that T. vaginalis infection is not rare in men attending primary care urology clinics in South Korea, especially in those older than 40 years, in whom it may explain the presence of prostatic disease. The possibility of T. vaginalis infection should be routinely considered in older male patients with prostatic diseases in South Korea.
DKK1 modulates Wnt signaling, which is involved in the atherosclerosis. However, no data exist regarding the usefulness of measuring serum DKK1 concentration in predicting coronary atherosclerosis. A ...total of 270 consecutive patients (62.8 ± 11.2 yr; 70% male) were included. A contrast-enhanced 64-slice coronary MDCT was performed to identify the presence of atherosclerotic plaques. Agatston calcium scores (CS) were calculated to quantify the coronary artery calcification (CAC). DKK1 concentrations were measured by enzyme-linked immunosorbent assay. For each subsequent DKK1 quartile, there was a significant increase in CAC (P = 0.004) and the number of segments with coronary atherosclerosis (P < 0.001). In addition, DKK1 concentration was significantly higher in patients with atherosclerotic plaques, regardless of plaque composition (P = 0.01). Multivariate analysis identified DKK1 as an independent risk factor for the presence of coronary atherosclerotic plaque. The adjusted odds ratio for coronary atherosclerotic plaque was 4.88 (95% CI, 1.67 to 14.25) for highest versus lowest quartile of the DKK1 levels. Furthermore, patients with DKK1 concentrations ≥ 68.6 pg/mL demonstrated coronary atherosclerotic plaques even when they had low CS. Serum DKK1 concentrations correlate with the coronary atherosclerosis and play an independent role in predicting the presence of coronary atherosclerosis.
Background/Aims
Patient-reported outcomes (PROs) are essential for clinical decision making, conduction of clinical research, and drug application acquisition in functional gastrointestinal ...disorders. The aim of this study is to develop a PRO instrument and to determine the respondents’ perception of the efficacy of therapeutic agents for functional dyspepsia (FD).
Methods
A self-evaluation questionnaire for dyspepsia (SEQ-DYSPEPSIA) was developed and validated through a structured process. The 2-week reproducibility was evaluated, and the construct validity was assessed by correlating the scores of SEQ-DYSPEPSIA (including typical and major FD symptom subscales). Finally, the response to medication was assessed by comparing the changes after 4 weeks of treatment.
Results
A total of 193 Korean patients (age 48.5 ± 13.6 years, 69.4% women) completed the questionnaire. SEQ-DYSPEPSIA with 11 items had a good internal consistency (alpha = 0.770-0.905) and an acceptable test-retest reliability (intraclass correlation coefficient = 0.733-0.859). The self-evaluation questionnaire (SEQ)-major FD score highly correlated with the postprandial fullness/early satiety domain of the Patient Assessment of Gastrointestinal Symptom Severity Index (correlation coefficient r = 0.741, P < 0.001), Nepean Dyspepsia Index-Korean version (NDI-K) (r = 0.839, P < 0.001), and NDI-K quality of life (r = -0.275 to -0.344, P < 0.001). After medical treatment, decrease in the SEQ-typical FD and SEQ-major FD was significantly greater in the responder group than in nonresponder group (P = 0.019 and P = 0.009, respectively).
Conclusion
This study suggests that the Korean version of SEQ-DYSPEPSIA has good reliability and validity, and can be a useful PRO measurement tool in patients with FD.
(J Neurogastroenterol Motil 2022;28:111-120)
Abstract Background Impact of plaque composition on late stent malapposition (LSM) after drug-eluting stent (DES) implantation has not been evaluated. Methods We evaluated the relation between plaque ...components at poststenting peristent area (between external elastic membrane and stent areas) and LSM after DES implantation in 266 patients (314 native lesions; paclitaxel-eluting stent in 205 lesions, sirolimus-eluting stent in 66 lesions, zotarolimus-eluting stent in 32 lesions and everolimus-eluting stent in 11 lesions) in whom virtual-histology intravascular ultrasound was performed at index (poststenting) and follow-up (mean: 11.7 ± 4.8 months). Results LSM occurred in 24 patients with 30 lesions (9.6%) and there were no significant differences in the incidences of LSM among 4 DES groups 21/205 (10.2%) in paclitaxel-eluting stent, 6/66 (9.1%) in sirolimus-eluting stent, 2/32 (6.3%) in zotarolimus-eluting stent and 1/11 (9.1%) in everolimus-eluting stent, p = 0.5). Patients with LSM were presented with more acute myocardial infarction (50% vs. 28%, p = 0.026) and were more diabetics (50% vs. 30%, p = 0.030) compared with those without LSM. Lesions with LSM had more poststenting peristent %necrotic core (NC) volume compared with those without LSM (25.8 ± 11.1% vs. 21.0 ± 5.7%, p < 0.001). Independent predictors of LSM were poststenting peristent %NC volume odds ratio (OR); 1.216, 95% CI; 1.053–1.405, p = 0.008, acute myocardial infarction (OR; 2.897, 95% CI; 1.675–4.118, p = 0.029), and diabetes mellitus (OR; 2.413, 95% CI; 1.543–3.996, p = 0.038). Conclusions Poststenting peristent NC component especially in patients with acute myocardial infarction and in those with diabetes mellitus is associated with the development of LSM after DES implantation.
A total loss of all heat sinks is considered a severe accident with a low probability of occurrence. Following a total loss of all heat sinks, the degasser/condenser relief valves (DCRV) become the ...sole means available for the depressurization of the primary heat transport system. If a nuclear power plant has a total loss of heat sinks accident, high-temperature steam and differential pressure between the primary heat transport system (PHTS) and the steam generator (SG) secondary side can cause a SG tube creep rupture. To protect the PHTS during a total loss of all heat sinks accident, a sufficient depressurization capability of the degasser/condenser relief valve and the SG tube integrity is very important. Therefore, an accurate estimation of the discharge through these valves is necessary to assess the impact of the PHTS overprotection and the SG tube integrity of the primary circuit. This paper describes the analysis of DCRV discharge capacity and the SG tube integrity under a total loss of all heat sink using the CATHENA code. It was found that the DCRV's discharge capacity is enough to protect the overpressure in the PHTS, and the SG tube integrity is maintained in a total loss of all heat accident.
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