The objective of this study was to investigate the relationship between insomnia severity, depression, anxiety, and anxiety sensitivity and to find out the explanatory variables that account for the insomnia severity among depression, anxiety, and anxiety sensitivity in general population. 95 mentally healthy volunteers who visit health promotion center of Kangbuk Samsung hospital for their regular medical examination were requested to complete Athens Insomnia Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, and Anxiety Sensitivity Index. Association between total scores of Athens Insomnia scale and other variables (total scores of Beck Depression Inventory excluded item 16, total scores of State Anxiety, total scores of Trait Anxiety, and total scores of Anxiety Sensitivity Scale) was assessed individually with partial correlations adjusted by age and then together using multiple regression analysis. The total scores of Athens Insomnia Scale were significantly associated with total scores of Beck Depression Inventory excluded item 16(r = 0.541, p<0.001), total scores of Trait Anxiety(r = 0.642, p<0.001), total scores of State Anxiety(r = 0.267, p<0.05), and total scores of Anxiety Sensitivity Index(r = 0.312, p<0.01). Total scores of trait anxiety showed the highest correlation with the total scores of Athens Insomnia Scale and was the significant predictor to total scores of Athens Insomnia Scale among the other predictor variables (p<0.001). These results show that insomnia severity is positively correlated with depression, anxiety, and anxiety sensitivity. The correlation was strongest with trait anxiety. In addition, our results suggest that trait anxiety is associated with insomnia severity in general populations.
Anxiety* ; Depression* ; Health Promotion ; Healthy Volunteers ; Sleep Initiation and Maintenance Disorders*

Wilms' tumor is malignant renal tumor, originated from undifferentiated mesonephric blastema. Adult Wilms' tumor, unlike that of childhood, is a rare disease and a total of l67 cases have been reported in the world medical literature until 1980. Diagnosis of adut Wilms` tumor is very difficult preoperatively and the pathologic hallmark is the presence of abortive or embryonal glomerulotubular structure with an immature spindle cell stroma. The therapeutic guidelines and surgical principles that govern childhood Wilms' tumor should be applied to adult Wilms' tumor. We reported a case of Wilms' tumor developed in 34 year-old male patient complaining of right flank pain with gross hematuria for 2 months.
Adult* ; Diagnosis ; Flank Pain ; Hematuria ; Humans ; Male ; Rare Diseases ; Wilms Tumor*

Angiosarcoma is the most common primary intracardiac malignancy, but many published papers have reported it to be rather rare. The prognosis of angiosarcoma is known to be very poor, and the treatment of choice has been surgery until recently, but many centers currently tend to try multimodal therapies, including chemotherapy and radiotherapy. In this report, we present a rare case in which an intracardiac angiosarcoma could have threatened the patient's life in short time by the rapid progression of the tumor, which caused right atrial rupture.
Heart Rupture ; Hemangiosarcoma ; Prognosis ; Rupture ; Sarcoma

Small cell carcinoma of the gallbladder is a type of neuroendocrine tumor and very rare. We report ultrasound, CT and MR findings of a small cell carcinoma of the gallbladder that was confirmed by pathology. Small cell carcinoma of the gallbladder was seen as a well-defined mass with peripheral rim enhancement in the gallbladder. In spite of the large size of the mass, direct and extensive invasion of the liver was not detected. However, there were many metastatic lymph nodes.
Carcinoma, Small Cell ; Gallbladder ; Liver ; Lymph Nodes ; Neuroendocrine Tumors

BACKGROUND: This research is to determine the chief complaints and related features of elderly patients who are presented to emergency department with medical problems. METHODS: Medical records of patients, 65 years or above, who visited Uijeongbu Hospital Emergency Center between January 1, 2012 and June 30, 2012 were reviewed retrospectively. Age, gender, mode of transportation to the hospital, chief complaints, and diagnosis were among the subjects analyzed. RESULTS: Elderly patients with medical problems, 3,468 visited the emergency department, constituting 12.66% from 27,396 patients in total during the research period. Patients aged 70 to 74 were 28.45%, composing the most among the age groups. Ambulance was the mode of transportation used by 43.06% of the patients and 42.96% of them stayed overnight, while 11.13% stayed in the intensive care units. The most frequent chief complaints were abdominal pain (16.81%), dyspnea (13.96%), and fever (11.16%). The most common diagnosis for patients with abdominal pain was gastritis (20.75%), chronic heart failure (26.03%) for dyspnea, and pneumonia (28.96%) for fever. The main diagnoses of in-patients according to the order of frequency were cerebral vascular accident (16.38%), pneumonia (12.48%), and chronic heart failure (6.04%). CONCLUSION: The number of elderly patients who stayed overnight and stayed in the intensive care units have increased comparing to younger patients. The top 10 most frequent chief complaints accounted for 78.92% by medical elderly patients. The results of this research could be used for the development of geriatric emergency medicine training programs and critical pathway for interns and residents.
Abdominal Pain ; Aged ; Ambulances ; Critical Pathways ; Dyspnea ; Emergencies ; Emergency Medicine ; Fever ; Gastritis ; Heart Failure ; Humans ; Intensive Care Units ; Medical Records ; Pneumonia ; Retrospective Studies ; Transportation

The role of lung mast cells in exercise-induced asthma (EIA) is controversial. To investigate whether the skin mast cell releasability is increased after exercise in EIA, 49 young atopic men with or without asthma took part in a free-running test for 6 min and were given skin prick tests using morphine, a mast cell secretagogue, before and after the exercise. The mean diameters of the wheal induced by morphine in patients with EIA were not significantly different from those in patients without EIA before exercise, although the baseline lung function was significantly lower and the airway hyperresponsiveness, the peripheral blood eosinophil count, and the size of the wheal in response to Dermatophagoides pteronyssinus were significantly higher in patients with EIA. However, the differences of the morphine-induced wheal diameter between patients with EIA and those without EIA became significant at 120 min after exercise (p<0.05), while the responses to histamine were not significantly different. These results suggest that exercise increases the releasability of skin mast cells in EIA patients whose asthma/allergy are relatively severe.
Adolescent ; Adult ; Analgesics, Opioid/diagnostic use ; Asthma/*immunology/physiopathology ; *Exercise ; Histamine/diagnostic use ; Humans ; Male ; Mast Cells/drug effects/*immunology ; Morphine/diagnostic use ; Skin/cytology/*immunology ; Skin Tests

An anomalous left coronary artery from the pulmonary artery(Bland-White-Garland syndrome) is a rare congenital malformation and sometimes fatal. It is caused by an abberant endothelial budding from or an anomalous division of the truncus arteriosus. Echocardiography (transthoracic and transesophageal) and angiographical imaging are essential for the diagnosis of this anomaly. Corrective Surgery is recommended due to its fatal natural course. A case was diagnosed in a 45-year-old man who presented with intermittent palpitation. This patient was successfully treated with closure of anomalous left coronary artery orifice combined with right saphenous vein graft anastomosis.
Bland White Garland Syndrome ; Coronary Vessels* ; Diagnosis ; Echocardiography ; Humans ; Middle Aged ; Pulmonary Artery* ; Saphenous Vein ; Transplants ; Truncus Arteriosus

A 72-year-old woman presented with generalized edema and proteinuria. Renal biopsy disclosed highly organized fibrillary deposits in subendothelial area by electron microscopy. The microfibrils were 14 nm in diameter and randomly arranged. They did not have a microtubular appearance. These materials were negative for Congo red staining. Cryoglobulinemia or paraproteinemia including light chains was not found. So we can diagnose her as fibrillary glomerulonephritis (GN). In fibrillary GN serum complement levels are usually normal except in rare cases with systemic disease. Here we present a rare case of fibrillary GN with unusual hypocomplementemia.
Aged ; Biopsy ; Complement C3 ; Complement System Proteins ; Congo Red ; Cryoglobulinemia ; Edema ; Female ; Glomerulonephritis ; Humans ; Light ; Microfibrils ; Microscopy, Electron ; Paraproteinemias ; Proteinuria

We report the case of a 16-year-old boy with a solid pancreatic mass which proved to be a nonfunctioning, malignant pancreatic neuroendocrine tumor (PNET). In pediatric patients, malignant pancreatic tumors are rare, especially malignant PNET. When dynamic contrast enhanced MRI showed a well enhancing solid pancreatic tumor on arterial and delayed phases and combined with malignant features, such as vascular invasion, invasion of adjascent organs, and lymphadenopathy, we should include malignant pancreatic neuroendocrine tumor in the differential diagnosis of childhood pancreatic tumors.
Adenoma, Islet Cell ; Adolescent ; Child ; Diagnosis, Differential ; Humans ; Lymphatic Diseases ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors

OBJECTIVE: Spinal tuberculosis-associated symptoms are not so unique as to immediately indicate the proper diagnosis in most cases. Distinguishing spinal tuberculosis (Pott's disease) from pyogenic spondylitis is often difficult, and lesions metastatic from systemic malignancy are the other major entity from which spinal tuberculosis must be distinguished. CLINICAL PRESENTATION: A 27-year-old male patient presented with a history of back pain after a minor trauma 1 month ago. Computed tomography and magnetic resonance imaging of the thoracic spine showed multiple osteolytic bone lesions at the bodies of T9, T10 and T11 vertebrae and the spinous processes of T12 and L1. Other noncontiguous osteolytic lesions were noted at S2 body and right sacro-iliac joint. INTERVENTION: To confirm the pathologic diagnosis, the patient underwent an open biopsy for the T12 and L1 spinous process lesions and a percutaneous transpedicular biopsy on T9, T10, T11 lesions. Frozen biopsy was reported as compatible with chronic granulomatous caseating necrosis without malignant cells. The final diagnosis was an atypical presentation of multiple spinal tuberculosis. The patient received an appropriate enteral anti-tuberculosis therapy and recovered without any complications. Follow-up MRI taken after a year of medical treatment revealed marked resolution of the lesions. CONCLUSION: Current research indicates the incidence of multi-level noncontiguous, remote vertebral tuberculosis is 1.1% to 16%. Because tuberculous spondylitis could represent variant and atypical pattern, the disease should be considered in differential diagnosis along with other diseases such as metastatic neoplasm, pyogenic spondylitis, especially when the radiologic studies are revealing multiple spinal lesions.
Adult ; Back Pain ; Biopsy ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Magnetic Resonance Imaging ; Male ; Necrosis ; Spine ; Spondylitis ; Tuberculosis ; Tuberculosis, Spinal*