PURPOSE: The purpose of this study was to compare the quality of sleep with the serum lipid profile in patients who have restless legs syndrome (RLS). METHODS: The data were obtained from 116 patients with RLS through questionnaires and blood sampling. RESULTS: The results of this study showed correlations between lower quality of sleep and serum lipid profile (LDL Cholesterol) in patients with RLS (r=.19, p=.040). There were correlations for scores of quality of sleep from the, Pittsburgh Sleep Quality Index (PSQI) sub-region between lower subjective sleep quality and serum lipid profile (LDL Cholesterol) (r=.20, p=.026), between fewer hours of sleep duration and serum lipid profile (Total Cholesterol) (r=-.21, p=.024), and, between higher daytime dysfunction and serum lipid profile (LDL Cholesterol) (r=.42, p<.001) of patients with RLS. CONCLUSION: Patients with RLS have sleep disorders with lower quality of sleep and changes in the serum lipid profile for total cholesterol and LDL cholesterol. That is, patients with RLS have lower quality of sleep and dyslipidemia compared to persons without RLS. Further research is needed to monitor serum the lipid profile in early stage symptoms of midlife adult patients with RLS and especially older women.
Adult ; Aged ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Female ; Humans ; Lipids/*blood ; Male ; Middle Aged ; Questionnaires ; Restless Legs Syndrome/blood/*psychology ; *Sleep ; Triglycerides/blood

No abstract available.
Gas Chromatography-Mass Spectrometry* ; Humans* ; Steroids*

BACKGROUND AND OBJECTIVES: Stroke onset is known to vary by several factors. Although it has been known that stroke may develop most frequently in the morning, its association with the type of activity has quite rarely been described. METHODS: We prospectively investigated by interview the time of and the activity during or before the onset of stroke in patients with acute cerebral infarction from Aug. 1995 to Mar. 1996. The activities were subdivided into basal metabolic rate state, sedentary, light, moderate, and heavy movements based on the caloric expenditure. RESULTS: One hundred-twenty five patients were enrolled. The time of day when ischemic stroke most frequently occurred was from 8:00 AM to noon. The type of activity was significantly associated with stroke onset in that it developed most commonly during and just after sleep or resting. The relationship between the onset of stroke and such patterns of onset time and the activity was found only in the atherothrombotic infarction, but not in the other stroke types. CONCLUSION: We demonstrated that stroke has clear diurnal variation. Our observations also suggested that the activity may be significantly associated with stroke onset. These findings may be useful for better understanding of the pathogenesis and prevention of ischemic stroke.
Basal Metabolism ; Cerebral Infarction* ; Health Expenditures ; Humans ; Infarction ; Prospective Studies ; Stroke

PURPOSE: This research was conducted to explore the experiences of graduate student women with children fulfilling multiple roles and to generate a substantive theory. METHODS: This study uses the grounded theory method based on Strauss and Corbin(1988)'s method. Interviews were conducted with 11 graduate student women who had children aged three of older. RESULTS: The core category of this research is 'Role balancing for self-generativity'. Based on the core category, three types of married women graduate students' experiences were found. They are 'concentrating on graduate-work' 'postponing graduate-work' and 'adjustment between two roles' CONCLUSIONS: Through understanding the married women's multiple roles experience process, there can be a basis for making a women's health system and social support system for the married women graduate student. Also, this research is to generate a substantive theory which can helps to change social perspectives on the quality of life for the women who will contribute in Korean society as professionals.
Aged ; Child ; Female ; Humans ; Quality of Life ; Women's Health

BACKGROUND: All currently available mechanical and bioprosthetic valves are associated with various types of deterioration leading to dysfunction and/or valvular complications. Reoperation on prosthetic heart valves is increasingly under consideration for both clinical and prophylactic indications. This review was conducted to determine the factors affecting the risk of reoperation for prosthetic valve replacement. MATERIAL AND METHOD: From January 1985 to July 1996, 124 patients underwent reoperation on prosthetic heart valves, and 3 patients had a second valve reoperation. The causes of reoperation were prosthetic valve failure (96 cases, 77.4%), prosthetic valve thrombosis (16 cases, 12.9%), prosthetic valve endocarditis (7 cases, 5.6%) and paravalvular leak (5 cases, 4.1%). This article is based on the analysis of the experience with particular emphasis on the preoperative risks affecting the outcome of the reoperation. RESULT: Overall hospital mortality rate was 8.9% (11/124). Low cardiac output was the most common cause of death (70.6%). Left ventricular systolic dimension (p=0.001), New York Heart Association functional class IV (p=0.003) and serum creatinine level (p=0.007) were the independent risk factors, but age, sex and cardiothoracic ratio did not have any influence on the operative mortality. Follow-up period was ranged from 3 to 141 months (mean, 50.6 months). A late mortality rate was 1.8%. CONCLUSION: The surgical risk of reoperation on heart valve prostheses in the advanced NYHA class patients is higher, therefore reoperation is recommended before the hemodynamic impairment become severe.
Cardiac Output, Low ; Cause of Death ; Creatinine ; Endocarditis ; Follow-Up Studies ; Heart Valve Prosthesis* ; Heart Valves* ; Heart* ; Hemodynamics ; Hospital Mortality ; Humans ; Mortality ; Reoperation ; Risk Factors ; Thrombosis

BACKGROUND: Thirty children ranging from 3 to 15 years of age underwent cardiac valve replacement at Dongsan Medical Center from 1982 to 1997. MATERIAL AND METHOD: There were 16 boys and 14 girls. The mean age was 12.1. The underlying pathological cause for valve replacement was congenital heart disease in 17 children and acquired heart disease in 13. The valve replaced was mitral in 15 children, aortic in 11, tricuspid in 3, and combined aortic and mitral in 1. Twenty-one mechanical and 10 tissue valves were placed: primary mechanical valve have been utilized since 1985. Eight of ten patients with tissue valves have had successful second valve replacements 4 to 11 years after the initial operation. RESULT: The operative mortality was 6.7%, but mortality was higher among patients less than 5 years of age and patients who had previous cardiac operations. Of the 28 operative survivors, 4 patients were lost to follow-up: the remaining patients were observed for a total of 2091 patient/months(mean 74.7 months, maximum 187 months). There was one late death from dilated cardiomyopathy after mitral valve replacement in 7 year-old patient with atrioventricular septal defect. After the operation, all patients with mechanical valves were placed on a strict anticoagulant regimen with Coumadin. The actuarial survival rate was 96% at the end of the follow-up. No instance of thromboembolism or major bleeding were observed in the survivors. CONCLUSION: These results indicate that valve replacement can be performed with low mortality in children, and with satisfactory long-term survival.
Cardiomyopathy, Dilated ; Child* ; Female ; Follow-Up Studies ; Heart Defects, Congenital ; Heart Diseases ; Heart Valves ; Hemorrhage ; Humans ; Lost to Follow-Up ; Mitral Valve ; Mortality ; Survival Rate ; Survivors ; Thromboembolism ; Warfarin

Squamous cell carcinoma of the ovary is rare and usually arise from preexisting cystic teratomas, endometriosis or Brenner tumors which undergo carcinomatous degeneration in their epithelial elements. Some of squamous cell carcinoma of the ovary is known to be associated with cervical neoplasm, but the pathogenesis is still unknown. Recently we experienced one case of ovarian squamous cell carcinoma in patients with microinvasive squamous cell carcinoma of uterine cervix. We report this case with possible pathogenesis and brief review of literatures.
Brenner Tumor ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Endometriosis ; Female ; Humans ; Ovary ; Teratoma ; Uterine Cervical Neoplasms

Homologous blood transfusion entails substantial risks, including allergic reactions, transmission diseases such as hepatitis, acquired immunodeficiency syndrome. Autotransfusion system is a common method of reducing the need for homologous blood transfusion during cardiac operation. Between July 1993 and July 1995, a series of 40 patients undergoing open heart surgery was selected to an autotransfusion group (n=20) or a control group (n=20). The cell saver system (AT1000, Electromedics, Englewood, CO, USA) was employed for autotransfusion. With this system, shed blood in operative field during cardiopulmonary bypass (CPB) and remained blood in cardiotomy reservior after CPB was aspirated by means of a locally heparinized collecting system. After centrifuge salvaged blood, the resulting red cell concentrate reinfused subsequently. The amounts of blood loss were 766.5+/-121.3 ml in cell saver group, 770.1+/-113.6 ml in control group, and there were no significant differences between two groups (P=NS). The amounts of blood transfused were 2.91+/-1.72 units in cell saver group, 4.82+/-1.72 units in control group. Composition of processed blood by cell saver was hemoglobin 17.4 gm%, hematocrit 56.4%, RBC 5,780,000/ul, WBC 9,900/ul, and platelet 33,000/ul. There was no complication related to cell saver. Conclusively, cell saver autotransfusion system is safe, effective method for reducing the homologous blood trasfusion in cardiac surgery.
Acquired Immunodeficiency Syndrome ; Blood Platelets ; Blood Transfusion ; Blood Transfusion, Autologous* ; Cardiopulmonary Bypass ; Heart* ; Hematocrit ; Heparin ; Hepatitis ; Humans ; Hypersensitivity ; Thoracic Surgery*

Total body water is increased after cardiopulmonary bypass resulting in tissue edema and organ dysfunction. Ultrafiltration has been used to reduce this accumulation of water. We have carried out a prospective randomized study in 17 children undergoing open heart surgery, comparing modified ultrafiltration (MUF) with nonfiltered controls. MUF was carried out for about 10 minutes after completion of cardiopulmonary bypass to a hematocrit 36~42%. Blood loss, blood transfused, hemodynamics, and laboratory data were recorded for 24 hours postoperatively. The results were analyzed using Mann-Whitney U test, comparing controls (n=7) to ultrafiltered (n=10). There was no death in each group. The mean filtrate volume (ml/kg) was 42 (30~68). Blood loss (ml/kg/24hr) was 14.5 mean (4.0~26.6) in controls versus 12.1 mean (6.0~21.5) in MUF (p>0.05) ; blood transfused (ml/kg/24hr) was 9.4 mean (6.0~36.3) in controls versus 3.4 mean (0~11.4) in MUF (p<0.05). There was rise in arterial blood pressure during MUF. Percent rise of systolic blood pressure was 4.2 (0~11.7) in controls versus 19.8 (7.0~36.9) in MUF (P=0.001). Percent rise of diastolic blood pressure was 10.0 (1.6~20.8) in controls versus 30.6 (5.8~73.3) in MUF (p<0.05). Platelet count, fibrinogen, and oncotic pressure rose after MUF. No complications directly attributable to the ultrafiltration were observed. Conclusively, MUF is safe, effective means of removing body water and beneficial to hemodynamics.
Arterial Pressure ; Blood Pressure ; Body Water ; Cardiopulmonary Bypass ; Child ; Edema ; Fibrinogen ; Heart* ; Hematocrit ; Hemodynamics ; Humans ; Platelet Count ; Prospective Studies ; Thoracic Surgery* ; Ultrafiltration*

PURPOSE: Many of the enzymes handling environmental factors are polymorphic and may confer variable susceptibility to renal cell carcinoma (RCC). Among those, the author studied genetic polymorphisms of CYP2D6 (B & T) and CYP1A1 in RCCs and controls in Korean. MATERIALS AND METHODS: Using 132 RCCs and 94 controls, first PCR products were obtained in 104 RCCs and 94 controls with CYP2D6, and 74 RCCs and 56 controls with CYP1A1. Res triction enzyme - BstN I/EcoN I for CYP2D6 (B & T), and NCo I for CYP1A1-digestion was followed to analyze constitutive DNA. RESULTS: In both RCCs and controls, no mutant allele of CYP2D6 (B & T) was detected and the susceptibility for occurrence of RCC was unable to evaluate. With CYP1A1 RFLP, homozy gous wild type (WW) was seen in 68 (52.3%; 37 RCCs, 31 controls), heterozygous mutant type (WM) in 54 (41.5%; 32 RCCs, 22 controls) and homozygous mutant type (MM) in 8 (6.2%; 5 RCCs, 3 controls). The odds ratios (95% CI) of RCC susceptibility for CYP1A1 genotype were 1.15 for WM and 1.36 for MM. Even though not significant statistically, higher tendency in MM presented. CONCLUSION: There is no association between susceptibility for the occurrence of RCC and genetic polymorphism of CYP2D6 (B & T) and CYP1A1.
Alleles ; Carcinoma, Renal Cell* ; Cytochrome P-450 CYP1A1* ; Cytochrome P-450 CYP2D6* ; DNA ; Genotype ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Polymorphism, Restriction Fragment Length