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

No abstract available.
Biomarkers* ; Child* ; Hepatitis B* ; Hepatitis* ; Humans ; Prevalence*

Hydranencephaly is congenital absence of the cerebral hemispheres which are replaced by a large fluid-filled cavity. The brain stem and basal ganglia are well formed and rudiments of frontal k occipital cortex may be present. We experienced a case of hydranencephaly caused by both internal carotid artery stenosis. We diagnosed it through the brain CT sonogram and doppler sonogram. A brief review of the related literatures was made.
Basal Ganglia ; Brain ; Brain Stem ; Carotid Artery, Internal* ; Carotid Stenosis* ; Cerebrum ; Hydranencephaly*

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

PURPOSE: The purpose of this study was to describe the anglographic finding and clinical result of transarterial embolotherapy(TAE) in patients with injuries of renal artery branches by blunt trauma. MATERIALS AND METHODS: The study was based on retrospective analysis of seven cases, in which TAE was attempted for the control of traumatic renal arterial bleeding. All procedures were performed via the transfemoral approach. TAE was performed with stainless steel coil in two cases, Gelfoam in one case, and Gelfoam and stainless steel coil in four cases. RESULTS: Angiographic findings of vascular injuries were pseudoaneurysm in four cases, extravasation in two cases and arteriocalyceal fistula in one case. All procedures were performed successfully without complication. CONCLUSION: Pseudoaneurysm is a common anglographic finding in patients with injury of renal artery branches and TAE is considered a safe and effective method for treating such cases.
Aneurysm, False ; Embolization, Therapeutic* ; Fistula ; Gelatin Sponge, Absorbable ; Hemorrhage ; Humans ; Renal Artery* ; Retrospective Studies ; Stainless Steel ; Vascular System Injuries

PURPOSE: Failure of adequate gastric emptying frequently interferes with successful enteral nutrition in infants. Study of gastric emptying in preterm infants has been hampered by the absence of a suitable and, valid technique, but ultrasonic assessment is well tolerated by infants. The aim of this study is to compare gastric emptying rates of breast milk and formula within preterm infants using an ultrasonic technique. METHODS: Ten infants(6 males, 4 females) were studied on 20 occasions. Median gestation of the group was 33 wks(29-38 wks), birthweight was 1506gms(850-1870gms). Each infant was receiving a minimum of 150 ml/kg/day of breast milk. We conducted the study with breast milk first and with formula milk 2 days later. With the infant in the right lateral position, ultrasonic images of the gastric antrum were obtained using the aorta bifurcational branch of superior mesenteric artery as constant landmarks. Measurements of antral cross sectional area(ACSA) were made before the feed and then sequentially, following its completion until ACSA returned to its pre-feeding state. Half-emptying time(t1/2) was calculated as the time taken for the ACSA to fall to half the maximal increment. The test was well tolerated by all subjects. RESULTS: There was a strong linear relationship between gastric volume and ACSA. The half-emptying time for breast milk was less than formula : t1/2 breast milk 32.0+/-9.8 min; t1/2 formula 45.0+/-11.6 min, P=0.0004. CONCLUSION: The data demonstrate that human milk increases gastric emptying compared to formula. This has important implications for the management of preterm infants who have feeding intolerances.
Aorta ; Breast* ; Enteral Nutrition ; Gastric Emptying* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Male ; Mesenteric Artery, Superior ; Milk* ; Milk, Human* ; Pregnancy ; Pyloric Antrum ; Ultrasonics

PURPOSE: Antenatal dexamethasone administration is associated with a significant lowering respiratory distress syndrome (RDS) incidence, but can increase neonatal infection. Ambroxol has been accepted as an alternative treatment to dexamethasone and is of at least equal efficacy but without adverse reaction. The aim of this study was to evaluate the effectiveness of ambroxol versus dexamethasone in RDS incidence and neonatal infection. METHODS: In this study, 30 infants, who received prenatal dexamethasone therapy, were compared retrospectively to 19 infants who received prenatal ambroxol therapy and 45 infants who received placebo during 28 to 34 weeks' of gestation. RESULTS: RDS incidence was comparable in both the dexamethasone (10.0%) and ambroxol (10.5%) groups but higer in the control group (26.6%). The puerperal infection rate in the mothers of these infants was 33.3% in the dexamethasone group, 10.5% in the ambroxol group and 20.0% in the control group. Neonatal infection in the 28 days following delivery was 56.6% in the dexamethasone group, 26.3% in the ambroxol group and 26.6% in the control group. Neonatal infection rate of the dexamethasone group was higher than ambroxol and control groups (P<0.05). When premature rupture of membrane was controlled, the sepsis rate (<28 days) was significantly lower in the ambroxol group than in the dexamethasone group (P<0.05), but puerperal infection and sepsis (<7 days) were not significantly different. CONCLUSOIN: Ambroxol was as effective as the dexamethasone in reducing the RDS incidence. Neonatal and puerperal infection were significantly higher in the dexamethasone group than in the ambroxol group.
Ambroxol* ; Dexamethasone* ; Humans ; Incidence ; Infant ; Membranes ; Mothers ; Pregnancy ; Puerperal Infection ; Retrospective Studies ; Rupture ; Sepsis

PURPOSE: The Pediatric Risk of Mortality(PRISM) III score was developed from the Physiologic Stability Index(PSI) to assess pediatric ICU mortality and Provide an objective data as a severity index. Although the PRISM score has been applied to many comparisions and analyses in previous studies, there are few reports applied to pediatric intensive care patients in Korea. To evaluate the effectiveness of the PRISM III score as a severity index for expecting mortality and find important variables influencing mortality, we applied this scoring scale to pediatric neurologic patients admitted to the ICU and analyzed the data statistically. METHODS: Data collection was done by careful review of medical records and scored each clinical variable. The outcome at discharge was determined as non-survival, survival, and hopeless discharge. Determination of mortality in the hopeless discharge group was done within 48 hours after discharge by telephone interview. The study populations were classified into four groups; CNS infection(26 patients), acute encephalopathy(31 patients), status epilepticus(35 patients) and cerebrovascular disorder(4 patients). The difference of the PRISM III score between the survival group and non-survival group was compared by using the nonparametric Mann~Whitney test in the entire study population and for each diagnostic group. To confirm the degree of fitness between the actual mortality and Predicted mortality, the Hosmer-Lemeshow goodness-of-fit test, a multiple logistic regression model was used. All clinical variables used for scoring were compared for survivals and non-survivals by the Chi-square test. f values <0.05 were considered significant. RESULTS: The PRISM III score was significantly higher in the non-survival groups than in the survival group. Predicted mortality from the PRISM III score has fitted to actual mortality According to the results of analyses in each diagnostic groups, the PRISM III score was higher in non-survivals of the acute encephalopathy and CNS infection groups, but statistically insignificant in the cerebrovascular disorders and status epilepticus groups. The important variables of the PRISM III score associated with mortality were mental state, Pupil reflex, systolic blood pressure, acidosis, blood sodium level blood creatinine level, blood glucose level, and PT/PTT. , CONCLUSION: The PRISM III score is helpful in predicting mortality in pediatric intensive care neurologic patients, especially those in the acute encephalopathy or the CNS infection groups. However, this score was not useful in the status epilepticus group, and insignificant in cerebrovascular group. Due to the smallness of the study group, more massive and comprehensive studies are needed as a follow up to this study.
Acidosis ; Blood Glucose ; Blood Pressure ; Cerebrovascular Disorders ; Creatinine ; Data Collection ; Follow-Up Studies ; Humans ; Critical Care* ; Interviews as Topic ; Korea ; Logistic Models ; Medical Records ; Mortality* ; Pupil ; Reflex ; Sodium ; Status Epilepticus

We report a case of myelodysplastic syndrome (MDS) with unique histopathological findings in which numerous infiltrated neutrophils exhibited nuclear segmentation anomalies. In comparison with well-described neutrophilic dermatoses of myelodysplastic syndrome such as Sweets syndrome and pyoderma gangrenosum, this case took a rapid and aggressive clinical course. We suggest that a nuclear segmentation anomaly, pseudo Pelger-Hiiet anomaly, is likely to reflect acute transformation of MDS and can be a poor prognostic marker.
Myelodysplastic Syndromes ; Neutrophils* ; Pyoderma Gangrenosum ; Skin Diseases ; Sweet Syndrome

A clinical observation was performed on 2,122 cases of premature infants who were admitted to Ilsin Christian during the past 5 years from Jan. 1986 to Dec. 1990. The results were as follows; 1) The incidence of prematurity was 5.7%, overall mortality rate was 15.8%, and the sex ratio of male to female was 1.5:1. 2) Concomitant maternal diseases were premature rupture of membrane 457 cases (21.5%), preeclampsia & eclampsia 424 cases (19.9%), multiple pregnancy 250 cases (11.7%) etc, in the order of frequency. 3) Prematurity was most prevalent among multipara over 3. 4) Incidence of prematurity according to maternal age was frequent in woman more than 35 years old. 5) Mortality of prematurity was higher inversely propotional to birth weight & gestational age. 6) Main causes of death were IRDS 45 cases (43%), congenital anomaly 72 cases (21.6%), sepsis 31 cases (9.3%), and unknown 84 cases (25.0%). 7) Clinical problems were hyperbilirubinemia 38.9%, hypoglycemia 28.6%, IRDS 18%, sepsis & other infections 8.1% etc, in the order of frequency. 8) Most deaths were seen within first 24hr (74.5%).
Adult ; Birth Weight ; Cause of Death ; Eclampsia ; Female ; Gestational Age ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Incidence ; Infant, Newborn ; Infant, Premature ; Male ; Maternal Age ; Membranes ; Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Multiple ; Rupture ; Sepsis ; Sex Ratio