OBJECTIVES: The aim of this study was to investigate factors associated with sleep disorders in male firefighters working in a metropolitan city in South Korea. METHODS: Self-administered questionnaires including the Nordic Musculoskeletal Questionnaire, Korean Occupational Stress Scale-Short Form, Psychosocial Well-Being Index-Short Form, Pittsburg Sleep Quality Index, and Beck-Depression Inventory-2 as well as surveys collecting socio-demographic characteristics and work-related factors were given to 730 male firefighters. After exclusion for missing data, 657 male firefighters were included, and logistic regression analysis adjusted for the work-related factors, psychosocial factors, and general risk factors were used to assess the relationship between sleep disorders and associated factors. RESULTS: The prevalence of sleep disorders was 48.7%. Shift work (adjusted OR 1.58, 95% CI = 1.02-2.45), musculoskeletal symptoms (adjusted OR 2.89, 95% CI = 2.02-4.14), and depression (adjusted OR 7.04 95% CI = 4.03-12.30) were associated with sleep disorders. CONCLUSIONS: Musculoskeletal symptoms, shift work, and depression are associated with sleep disorders. Integrated health management is needed to promote good sleep quality among firefighters.
Depression ; Firefighters* ; Humans ; Korea ; Logistic Models ; Male* ; Prevalence ; Psychology ; Risk Factors ; Sleep Disorders*

OBJECTIVES: To understand the importance of the serum level of Ca-125 among pelvic mass, we performed a study. METHOD: From January to December 1998, we performed the study. Before hysterectomy, we performed a blood sampling to know the serum level of Ca-125, After hysterectomy, we weighed the uterus and measured the thickness of endometrium and other histologic characteristics. RESULTS: We performed my research to 80 peoples. The relation between uterine weight and the serum level of Ca-125 is little, if ever(R2=0.0007), and the relation between the thickness of endometrium and the serum level of Ca-125 is also little, if ever(R2=0.0353). The relation between leiomyoma, the cycle of endometrium and the serum level of Ca-125 were also little, but there was a close relationship between adenomyosis and the serum level of Ca-125. CONCLUSION: There was little relationship between uterine weight and the serum level of Ca-125.
Adenomyosis ; Endometrium ; Female ; Humans ; Hysterectomy* ; Leiomyoma ; Uterus

Malignant germ cell tumors of the ovary are uncommon neoplasms. Although 20-25% of all ovarian tumors are derived from germ cells, only about 3% of germ cell tumors are malignant. Mixed germ cell tumors contain at least two malignant germ cell elements. These lesions should be managed with combination chemotherapy, preferably BEP. Recently we experienced a case of mixed germ cell tumor with 6 components of germ cell and sarcomatous change in a 11 year old girl. Preoperative CA-125, B-hCG, aFP, LDH, a-1-antitrypsin were elevated and the final pathologic report was mixed germ cell tumor composed of endodermal sinus tumor, embryonal carcinoma, mature and immature teratoma, choriocarcinoma, dysgerminoma and sarcomatous change, Postoperative chemotherapy with 6 courses of BEP regimen was performed and all tumor markers became normal after 4 courses of chemotherapy. What we interested in this case was several components of germ cells and sarcomatous change and the sarcomatous change might be derived from the mature cystic teratoma component, so we present this case with a brief review of the literatures here.
Carcinoma, Embryonal ; Child ; Choriocarcinoma ; Drug Therapy ; Drug Therapy, Combination ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Pregnancy ; Teratoma ; Biomarkers, Tumor

BACKGROUND/AIMS: Synchronous/metachronous gastric epithelial neoplasias (GENs) in the remaining lesion can develop at sites other than the site of endoscopic resection. In the present study, we aimed to investigate the predictive value of serum pepsinogen for detecting multiple GENs in patients who underwent endoscopic resection. METHODS: In total, 228 patients with GEN who underwent endoscopic resection and blood collection for pepsinogen I and II determination were evaluated retrospectively. RESULTS: The mean period of endoscopic follow-up was 748.8+/-34.7 days. Synchronous GENs developed in 46 of 228 (20.1%) and metachronous GENs in 27 of 228 (10.6%) patients during the follow-up period. Multiple GENs were associated with the presence of pepsinogen I <30 ng/mL (p<0.001). Synchronous GENs were associated with the presence of pepsinogen I <30 ng/mL (p<0.001). CONCLUSIONS: Low pepsinogen I levels predict multiple GENs after endoscopic resection, especially synchronous GENs. Cautious endoscopic examination prior to endoscopic resection to detect multiple GENs should be performed for these patients.
Female ; Gastroscopy ; Humans ; Male ; Middle Aged ; Neoplasms, Glandular and Epithelial/*diagnosis/surgery ; Neoplasms, Multiple Primary/*diagnosis/surgery ; Pepsinogen A/*deficiency ; Predictive Value of Tests ; Retrospective Studies ; Stomach Neoplasms/*diagnosis/surgery

Choledochal cyst is a rare developmental malformation of the biliary tree and has serious problem of transformation to malignancy. The development of cholangiocarcinoma related to choledochal cyst increases as the age of patient increases and is more common in Orientals with female predominance of 2.5 times. Prevalence rate of cholangiocarcinoma is various from 2.5 to 15.6% in adult with choledochal cyst, but very low in children. We experienced a case of cholangiocarcinoma with multiple liver metastases arising from type I choledochal cyst in a 13-year-old girl who complained of sudden onset of right upper quadrant abdominal pain.
Abdominal Pain ; Adolescent* ; Adult ; Biliary Tract ; Child ; Cholangiocarcinoma* ; Choledochal Cyst* ; Female* ; Humans ; Liver ; Neoplasm Metastasis ; Prevalence

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the effect of pulmonary valve replacement (PVR) on exercise capacity and determine cardiopulmonary exercise (CPEX) parameters associated with improvement in right ventricle (RV) function. SUBJECTS AND METHODS: We retrospectively analyzed CPEX and magnetic resonance imaging parameters in a total of 245 patients who underwent PVR from January 1998 to October 2015. In addition, we analyzed the characteristics of the patients who showed improved exercise capacity after PVR. RESULTS: Twenty-eight patients met the inclusion criteria for the study. CPEX parameters after PVR showed no significant changes in all patients. However, baseline predicted peak oxygen uptake (VO2(peak)) (%) value was significantly lower in patients with significant improvement in exercise capacity after PVR, as compared to patients who showed decreased exercise capacity after PVR (60.83±10.28 vs. 75.81±13.83) (p=0.003). In addition, patients with improved exercise capacity showed a positive correlation between the change of right ventricular ejection fraction (RVEF) (%) and the change of anaerobic threshold (r=0.733, p=0.007); whereas, patients with decreased exercise capacity showed a negative correlation between the change of RVEF (%) and the change of predicted VO2(peak) (%) (r=−0.575, p=0.020). CONCLUSION: The importance of predicted VO2(peak) (%) in evaluating exercise capacity differentiated from other CPEX variables. The change of anaerobic threshold and predicted VO2(peak) (%) might be a useful predictor of the change in RV function after PVR.
Anaerobic Threshold ; Exercise Test ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Oxygen ; Pulmonary Valve* ; Retrospective Studies ; Stroke Volume ; Tetralogy of Fallot*

PURPOSE: Almost 80% of primary lung cancers are non-small cell lung cancer (NSCLC), and their prognosis is very poor since only one-fourth of patients with NSCLC present with a resectable disease at the time of diagnosis. During the last 10 years, the role of chemotherapy for NSCLC has been expanding as an adjunctive to radiation and surgery, as well as to palliative therapy for stage IV NSCLC. This study is a retrospective analysis of two chemotherapeutic regimens for the treatment of advanced NSCLC. MATERIALS AND METHODS: Between January 1999 and December 2001, 109 patients with histologically proven NSCLC (> or = stage IIIA), who received either the DP (Docetaxel 75 mg/m2 +Cisplatin 75 mg/m2, n=63, 57.8%) or the TC (Paclitaxel 175 mg/m2+ Carboplatin 5* AUC mg, n=46, 42.2%) combination chemotherapies were included. RESULTS: The patients ages ranged from 46 to 77 years, and the patients in the DP group (56.3+/-8.6 years) were younger than those in the TC group (62.1+/-8.8 years) (p<0.05). Seventy (DP: 39 and TC: 31) of 109 patients were eligible for their response to the combination chemotherapies. There were 2 complete responses (CR) (5.1%) and 19 partial responses (PR) (46.2%) documented in the DP group (response rate, RR: 51.3%), and 11 PR (35.5%) in the TC group (RR: 35.5%). The survival was longer in the DP group compared to the TC group (median survival 19.5 months vs. 17.1 months, p< 0.05). Grade 4 neutropenia occurred in 30 patients (47.6%) treated with the DP regimen and in 10 (21.7%) treated with the TC regimen (p<0.05). Grade 3~4 nausea and vomiting occurred in 11 patients (17.5%) in the DP group and 4 (8.7%) in the TC group (p>0.05). Grade 3~4 peripheral neuropathy occurred in 5 patients (7.9%) in the DP group and in 8 (17.4%) in the TC group (p>0.05). CONCLUSION: The combination chemotherapies of docetaxel plus cisplatin and paclitaxel plus carboplatin are active against advanced stage NSCLC, with acceptable toxicities. As there are differences in the baseline characteristics between the two groups, no differences in survivals or response rates could be concluded.
Area Under Curve ; Carboplatin* ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Lung Neoplasms ; Nausea ; Neutropenia ; Paclitaxel* ; Palliative Care ; Peripheral Nervous System Diseases ; Prognosis ; Retrospective Studies ; Vomiting

Self expandable metal stent can be used both as palliative treatment for malignant colorectal obstruction and as a bridge to surgery in patients with potentially resectable colorectal cancer. Here, we report a case of successful relief of malignant stomal obstruction using a metal stent. A 56-year-old man underwent loop ileostomy and was given palliative chemotherapy for ascending colon cancer with peritoneal carcinomatosis. Eight months after the surgery, he complained of abdominal pain and decreased fecal output. Computed tomography and endoscopy revealed malignant stomal obstruction. Due to his poor clinical condition, we inserted the stent at the stomal orifice, instead of additional surgery, and his obstructive symptoms were successfully relieved. Stent insertion is thought to be a good alternative treatment for malignant stomal obstruction, instead of surgery.
Abdominal Pain ; Carcinoma ; Colon ; Colon, Ascending ; Colonic Neoplasms ; Colorectal Neoplasms ; Endoscopy ; Humans ; Ileostomy ; Middle Aged ; Palliative Care ; Stents

Tailgut cysts (TGCs) are rare congenital cysts that occur in the retrorectal or presacral spaces. Although most tailgut cysts have been reported as benign, there have been at least 9 cases associated with malignant change. We report herein on an unusual case of a 40-year-old woman with a carcinoembryonic antigen (CEA) -producing adenocarcinoma arising within a TGC who underwent surgical resection and local radiation therapy. Despite the complete resection, metastatic adenocarcinoma developed five months after surgery. CEA-producing adenocarcinoma from a TGC is extremely rare and only two cases, including this case, have been reported in the English medical literature. Besides CEA, the serum levels of CA 19-9 became markedly elevated in this patient. Given that the serum CEA level decreased to the normal range after complete resection of tumor and that the tumor recurrence was associated with a rebound of the CEA serum level, our case shows that serial measurements of serum CEA can be used for treatment planning and for assessing the patient's treatment response for this rare disease.
Adenocarcinoma/blood/pathology/*therapy ; Adult ; CA-19-9 Antigen/blood ; Carcinoembryonic Antigen/*blood ; Cysts/blood/pathology/*therapy ; Female ; Hamartoma/blood/pathology/*therapy ; Humans ; Rectal Neoplasms/blood/pathology/*therapy ; Sacrococcygeal Region

OBJECTIVE: Cervical intraepithelial neoplasia (CIN) and invasive cervix cancer were detected in some cases of atypical squamous cells of undetermined significance (ASCUS) PAP smear. So it is reasonable to evaluate and manage ASCUS PAP smear. In this study, we attempted to assess the clinical significance of a cytologic diagnosis of ASCUS and determine the usefulness of HPV DNA chip test (which is a new diagnostic method for HPV) in management and evaluation of ASCUS patients. METHODS: This study was performed from November 2001 to June 2002 and included 48 cases of ASCUS. They were evaluated by HPV DNA chip test and the pathology was evaluated by punch biopsy, cone biopsy or hysterectomy. The result of type 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68 and 69 in HPV DNA chip test were categorized as high risk. RESULTS: The rate of CIN II or above in ASCUS was 18.8% (9/48). The detection rate of high risk HPV DNA in ASCUS was 41.7% (20/48). The detection rate of high risk HPV DNA was 30.6% (11/36) in normal or reactive, 33.3% (1/3) in CIN I, 80% (4/5) in CIN II, 100% (2/2) in CIN III, 100% (2/2) in invasive cervix cancer. Higher the grade of pathology, more the detection rate of high risk HPV DNA chip test. The sensitivity for the prediction of CIN II or above by HPV DNA chip test was 88.9% and specificity was 69.2%, respectively. CONCLUSION: The use of HPV DNA chip test in patients with ASCUS may provide usefulness in detection of CIN II, CIN III and invasive cervix cancer.
Biopsy ; Cervical Intraepithelial Neoplasia ; Diagnosis ; DNA* ; Humans ; Hysterectomy ; Oligonucleotide Array Sequence Analysis* ; Pathology ; Sensitivity and Specificity ; Uterine Cervical Neoplasms