INTRODUCTION: Although it is well known that medical students are not getting an adequate amount of sleep, there have been only few studies on the sleep patterns of medical students in Korea. Therefore, the present study aimed to investigate the life style and sleep patterns of Korean medical students and the impact they have on the students' academic performance. METHODS: A questionnaire package was administered to the 3rd year medical students at the Seoul National University to examine their sleep patterns on weekdays and weekends. It consisted of questions asking about their lifestyles as well as Pittsburgh sleep quality index (PSQI) and GPA (Grade Point Average) that are considered relevant to their sleep patterns. A total of 110 students (85 males and 25 females, mean age 24.4+/-20.6) responded to the survey and the result was analyzed using the independent t-test, the chi-square test, the paired t-test, Pearson's rank correlation and ANOVA. P-values of less than 0.05 were considered statistically significant in all analyses. RESULTS: The weekend bedtime was significantly delayed (01:24 on weekday; 03:12 on weekend; t=-5.23, p<0.01), the weekend rise time was delayed (07:36 on weekday; 10:30 on weekend; t=-24.48, p<0.01) and the total sleep time was increased on weekends (5:57 on weekday; 8:17 on weekend; t=15.94, p<0.01). They wished to sleep for 7 hours 6 minutes which was different from their actual weekday total sleep time (t=-11.41, p<0.01). The poor sleeper group had lower GPAs than the good sleeper group (t=2.05, p<0.05). The GPA of medical students were negatively correlated with age (r=-0.23, p<0.05), daily amount of smoking (r=-0.78, p<0.01), total amount of smoking (r=-0.75, p<0.01), weekday sleep latency (r=-0.23, p<0.05), weekend sleep latency (r=-0.23, p<0.05) and PSQI score (r=-0.30, p<0.01). CONCLUSION: Medical students were experiencing a lack of sleep during weekdays as they have a later bedtime and earlier rise time, and consequently had more hours of sleep on weekends. Overall, the responded students were experiencing poor sleep quality, and the GPAs of the poor sleeper group were lower than those of the good sleeper group.
Female ; Humans ; Korea ; Life Style ; Male ; Surveys and Questionnaires ; Smoke ; Smoking ; Students, Medical

Better palliative management of patients with disseminated cancer has prolonged their lives but has raised the incidence of pathologic fractures in their variable lives. The essence of treatment is to prolong life, maintain comfort, and stabilize the patient with metastatic disease. The treatment of pathologic fractures with internal fixation has long been accepted by orthopedic surgeons and the benefits afforded to the patient are well known, so adequate fixation is essential. A combination of methylmethacrylate and internal fixation devices can greatly enhance the stability of fixation, because diseased bone is a poor base on which to insert an internal fixation device. The authors have treated 19 cases of the pathologic fracture of spine, humerus and femur by use of bone cement with and without internal fixation devices. The results are as follwed. 1. All cases utilized methylmethacrylate and there was no complication in methylmethacrylate in itself. 2. All cases had received various type of ancillary treatment: radiation in 9 cases, chemotherapy in 4 cases and in 8 cases, conservative pain control. 3. In spinal pathologic fracture with paraplegia or neurologic deficiency, the patients could walk with walker at an average of two weeks after operation. 4. Among the 19 cases, the pain was relieved markedly and ambulation was possible easily and early after operation in 16 cases. 5. Among the 19 cases, two survived less than 2 months, 7 surrived from 2 month to 3 month, five survived from 3 months to 6 months, four survived from 6 months to a year and one survived more than a year.
Drug Therapy ; Femur ; Fractures, Spontaneous ; Humans ; Humerus ; Incidence ; Internal Fixators ; Methylmethacrylate ; Orthopedics ; Paraplegia ; Spine ; Surgeons ; Walkers ; Walking

BACKGROUND: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. METHODS: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. RESULTS: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. CONCLUSIONS: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.
Arthrography* ; Dislocations ; Follow-Up Studies ; Humans ; Incidence ; Joint Instability ; Recurrence ; Retrospective Studies ; Shoulder*

BACKGROUND: With the recent development in arterial reconstructive procedure such as percutaneous transluminal coronary angioplasty or atherectomy, the incidence of vascular complications involving femoral artery is increasing due to greater use of larger percutaneous instruments(including arterial sheath) and periprocedural anticoagulant therapy. Femoral pseudoaneurysm requires rapid diagnosis and management to prevent limb ischemia, worsening of the arterial injury or repair of the arterial defect. Recently, accurate diagnosis of these injuries can be made nonivasively with duplex sonography and Doppler color flow imaging, and nonsurgical treatment may be possible by using external compression guided by ultrasound even in patients requiring prolonged anticoagulant therapy. METHOD: Three patients, one undergoing coronary angiography and two undergoing percutaneous transluminal coronary angioplasty, developed expansile groin masses at the vascular access sites diagnosed as femoral artery pseudoaneurysm s by Doppler ultrasound. All patients were hypertensives, taking aspirin and two patients who underwent PTCA received intravenous heparin after procedure. After diagnosis of femoral pseudoaneurysm, all patients underwent mechanical(C-clamp) external compression guided by ultrasound for 3 hours. RESULT: Follow up color flow scans were obtained after 24 hours and in one patients, blood flow in the tract was eliminated but persistent blood flow was observed in two patients who underwent PTCA. Before closure of pseudoaneurysm, one patient needed another 6 hours of ultrasound guided compression and the other needed more 12 hours. All patients were discharged without complication or recurrence of pseudoaneurysm. CONCLUSION: These cases suggest that nonsurgical closure of femoral pseudoaneurysms is feasible even in patients requiring prolonged antiplatelet and anticoagulant therapy.
Aneurysm, False* ; Angioplasty, Balloon, Coronary ; Aspirin ; Atherectomy ; Cardiac Catheterization* ; Cardiac Catheters* ; Coronary Angiography ; Diagnosis ; Extremities ; Femoral Artery ; Follow-Up Studies ; Groin ; Heparin ; Humans ; Incidence ; Ischemia ; Recurrence ; Ultrasonography

OBJECTIVE : To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in recurrent spontaneous abortion associated with hyperhomocysteinemia. MATERIAL AND METHOD: The blood Sample of habitual aborter with high fasting homocysteine level was tested by PCR-RFLP method. RESULTS: The patient was found to be a homozygosity for MTHFR gene mutation that was confirmed by the finding which is consistent with the mutation at the nucleotide 677 C to T, Corresponding to Ala to Val. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the MTHFR mutation should be examined in the workup of recurrent spontaneous abortion showing hyperhomocysteinemia.
Abortion, Spontaneous* ; Fasting ; Female ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

No abstract available.
Dermatitis, Atopic ; Pyroglyphidae

To determine the value of ultrasonography for the diagnosis of testicular rapture due to blunt trauma, we reviewed 69 patients of blunt scrotal trauma, which were evaluated by ultrasound before treatment. Thirty patients were managed conservatively, of which 3 cases were explored lately due to persistent pain or mass, and 39 explored immediately. Of the 30 patients treated conservatively the injury was resolved in 27. Surgical exploration of the 42 cases revealed testicular rupture in 29 and simple hematocele in 13. Analysis of the 29 cases with testicular rupture demonstrated that orchiectomy rates were 20% in early exploration and 53% in delayed exploration. in the 27 cases the testicular rupture was correctly diagnosed by ultrasonography, and there were 4 false-positive and 2 false-negative diagnoses of rupture. The specificity and sensitivity for the diagnosis of testicular rupture are 70% and 93%, and the positive and negative predictive values are 87% and 82%, respectively. Ultrasonography used in conjunction with a thorough physical examination is highly sensitive in identifying testicular rupture, and can provide objective information supporting the need for early surgical exploration in patients with blunt scrotal trauma.
Diagnosis ; Hematocele ; Humans ; Male ; Orchiectomy ; Physical Examination ; Rupture* ; Sensitivity and Specificity ; Ultrasonography*

Sacrococcygeal chordoma is a rare malignant tumor which is believed to take its origin from remnants of the fetal notochord, and presents in the sacral hollow or occasionally posteriorly. The growth is leisurely and it is invasive rather than metastatic. In treatment, there is evidence that early diagnosis of sacrococcygeal chordoma followed by radical resection c palliative radiotherapy does provide the opportunity for cure. We have experienced two cases of sacrococcygeal chordoma, which were treated with one case of a complete surgical resection and the other case of only biopsy.
Biopsy ; Chordoma ; Early Diagnosis ; Notochord ; Radiotherapy

PURPOSE: The number of patients with HIV disease has been increasing rapidly, with anorectal discomfort being the most common complaint of these patients. However, there are no data on HIV disease relating to the benign anorectal area in Koreans. METHODS: A retrospective chart review was performed on patients diagnosed with benign anal diseases, combined with HIV disease, between 1996 and 2001. Their clinical aspects were compared with HIV patients registered with the National Institute of Health in Korea between 1985 and 2001. RESULTS: A total of 1,613 patients were registered, with the National Institute of Health in Korea, as having HIV disease. The ratio of sex was 7.2:1, with a male predominance. The disease was most common in the 3rd & 4th decades, with 64.2%, of the patients in this age range. As for the routes of transmission, sexual contact was the most common (96.9%), followed by blood transfusion (including blood products) (2.8%), vertical transmission (0.1%) and drug injection (0.1%). With regard to the sexual contact routes, homosexuality accounted for 28.0%. Of the cases of HIV disease presenting with a benign anal disease, 32 patients, with a sex ratio of 31:1, with an overwhelming male predominance, were selected. Twenty-six cases had been newly diagnosed at our hospital. As for the routes of the transmission, the disease had been transmitted by sexual contact in all cases. In 43.8% of these cases, the disease had been transmitted by homosexual contact, which showed a marked difference to that of the National database (P<0.05). For those associated with an anal diseases, there were 10 cases of anal fistula, 9 of perianal abscess, 7 of condyloma acuminata, 7 of anal fissure, 5 of hemorrhoids and 2 of ulceration on the lower rectum, noted. CONCLUSIONS: Nowadays, the numbers of anorectal-disease patients with HIV are increasing in Korea. Since HIV is common in the area of benign proctology, all proctologists must consider the possibility of HIV when managing patients.
Abscess ; Blood Transfusion ; Colorectal Surgery ; Fissure in Ano ; Hemorrhoids ; HIV Infections ; HIV* ; Homosexuality ; Humans ; Korea ; Male ; Rectal Fistula ; Rectum ; Retrospective Studies ; Sex Ratio ; Ulcer

Small cell carcinoma is derived from APUDcells of any parts of the body. Usually the cases are discovered in the lungs and have poor prognosis. Small cell carcinoma has been increasingly reported in various organ outside the lungs, such as the larynx, thymus, esophagus, stomach, pancreas, uterine cervix, and prostate. Primary small cell carcinoma of the stomach is extremly rare. The histology of the tumor was similar to that of ordinary small cell carcinoma of the lung, and the secretory granules were identified by electron microscopy. We report a patient with gastric pure small cell carcinoma who treated by a radical total gastrectomy and chemotherapy.
Carcinoma, Small Cell* ; Cervix Uteri ; Drug Therapy ; Esophagus ; Female ; Gastrectomy ; Humans ; Larynx ; Lung ; Microscopy, Electron ; Pancreas ; Prognosis ; Prostate ; Secretory Vesicles ; Stomach ; Thymus Gland