PURPOSE: The purpose of this study was to identify the relationship of job stress, state of sleep, and depression and to identify factors influencing depression of emergency medical technicians. METHODS: The research was a cross-sectional, descriptive study. Data collection were done using self-report questionnaires with 162 emergency medical technicians working in hospitals who agreed to participate in the study. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple regression with the SPSS/WIN 18.0 Program. RESULTS: Depression had significant negative correlations with state of sleep, (r=-482, p<.001) and positive correlations with job stress (r=.196,p=.013). State of sleep had significant negative correlations with job stress (r=-.168, p=.033). The variance for life satisfaction was 23.7% (F=25.964, p<.001). Variable of state of sleep significantly predicted depression of emergency medical technicians. CONCLUSION: Considering these results, for emergency medical technicians' job stress, state of sleep, and depression, further studies are needed. Furthermore, there is a need to develop and implement new strategies to improve depression among emergency medical technicians.
Data Collection ; Depression ; Emergencies ; Emergency Medical Technicians ; Humans ; Surveys and Questionnaires

Non-tuberculous mycobacterium has a wide-spread occurrence in nature, and skin, soft tissue, bone, lung and disseminated infection can be involved. Non-tuberculous mycobacterium infection occurs both in immunocompetent patients without underlying diseases and in immunocompromised hosts. Non-tuberculous mycobactrial osteomyelitis is a rare cause of granulomatous osteomyelitis, and has been previously reported in the sternum, spine, humerus, femur, tibia or metatarsal. Mycobacterium abscessus osteomyelitis is a very rare infection in the foot and only 1 case has been reported. Authors report a case of Mycobacterium abscessus osteomyelitis involving the tarsal and metatarsal bones in a non-immunocompromized middle aged women.
Bone and Bones ; Female ; Femur ; Foot ; Humans ; Humerus ; Immunocompromised Host ; Lung ; Metatarsal Bones ; Middle Aged ; Mycobacterium ; Mycobacterium Infections ; Osteomyelitis ; Skin ; Spine ; Sternum ; Tibia

PURPOSE: We evaluated the usefulness of 24 hour/3 hour radio-uptake ratio, lesion to non-lesion ratio, in differentiating bony metastases from acute (<2 months) and healing ( 2 months) fractures. MATERIALS AND METHODS: Sixty-three patients (age range: 26-81, 32 males, 31 females) having 90 lesions (30 bone metastases, 30 acute fractures, 30 healing fractures) were included. Bone scans were obtained 3 and 24 hours after administration of 740 MBq of 99mTc-MDP. The ratio of radio-uptake in the lesion to normal area was measured as 24/3 hour radio-uptake ratio ([lesion/non-lesion RUR at 24 hour]/[lesion/non-lesion RUR at 3 hour], 24/3 RUR) and analyzed clinical significance in differentiating bone metastases from acute or healing fractures. RESULTS: Mean 24/3 RUR were 1.22+/-0.18 for bone metastases, 1.25+/-0.14 for acute fractures, and 0.99+/-0.15 for healing fractures. 24/3 RUR values of bone metastases and acute fractures were not significantly different. But 24/3 RUR values of bone metastases and healing fractures, and those of acute and healing fractures were found to be significantly different (p<0.001). When 24/3 RUR of 1.0 was considered as the cut off point separating metastases from fracture, a sensitivity of 100% (30/30) was obtained. The specificity was 0% (0/30) in separating metastases from acute fractures, and 47% (14/30) in separating metastases from healing fractures. When 24/3 RUR of 1.2 was considered as the cut off point, sensitivity of 53% (16/30) in the diagnosis of bone metastasis, and specificity of 37% (11/30) in separating metastases from acute fractures, and 100% (30/30) in separating metastases from healing fractures were obtained. CONCLUSION: 24/3 RUR is useful in differentiating bone metastases from healing fractures, but not in differentiating bone metastases from acute fractures. A 24/3 RUR of less than 1.0 suggests healing fractures. A 24/3 RUR of more than 1.2 suggests bone metastases or acute fractures.
Diagnosis ; Humans ; Male ; Neoplasm Metastasis* ; Radionuclide Imaging* ; Sensitivity and Specificity ; Technetium Tc 99m Medronate

Twin conceptus of a complete hydatidiform mole (CHM) and a normal fetus are rare but are important because of diagnostic difficulty, problems related to twin pregnancy, and high risk of persistent gestational trophoblastic tumor. Recently, we experienced one case of twin pregnancy consisting of a CHM and a normal fetus. A 26-year-old woman complained of vaginal bleeding. She had evidences of pregnancy-induced hypertension. A male fetus was delivered at 20 gestational weeks. The placenta demonstrated vesicles of molar change separated from normal placenta. Microscopically, the molar villi disclosed diffuse hydropic swelling with circumferential trophoblastic proliferation. DNA flow cytometric analysis showed diploid patterns in both molar and normal placental tissues. Fluorescent in situ hybridization in paraffin-embedded tissue presented that normal placental villi hybridized with X- and Y-chromosome probes (46, XY), while molar villi hybridized with X-chromosome only (46, XX). Thus, dizygotic twinning was confirmed because sex differences were shown between molar villi and normal placental villi. Follow up beta-hCG was within normal range after delivery.
Adult ; Chorionic Villi ; Diploidy ; DNA ; Female ; Fetus* ; Follow-Up Studies ; Humans ; Hydatidiform Mole* ; Hypertension, Pregnancy-Induced ; In Situ Hybridization, Fluorescence ; Male ; Molar ; Placenta ; Pregnancy ; Pregnancy, Twin ; Reference Values ; Sex Characteristics ; Trophoblastic Neoplasms ; Trophoblasts ; Twins ; Twins, Dizygotic ; Uterine Hemorrhage

Thirty - five cases of coarctation of aorta, diagnosed by cardiac catheterization and angiography during the period of 1980-1984, at the department of Pediatrics of Seoul National University Hospital, were studied on the clinical features and management. The followoing results were obtained : 1) The incidence of coartation of aorta was 1.2% of congenital heart disease and sex ratio of male to female was 2.2 : 1. 2) The anatomical type of coarctation was preductal in 19 cases, juxtaductal in 15 cases and postductal in 1 case. Most of preductal coarctation (89.5%) were associated with aortic arch or isthmus hypoplasia. 3) All of these patients had various type of additional cardiac anomalies and among them, PDA was the most common associated lesion and followed by VSD. 4) Significant BP gradient between upper and lower extremies and weak femoral pulsation were noticed in 15 cases(42.8%). 5) Congestive heart failure was present in all but one patient less than 1 year old, while only 3 cases(15%) had congestive heat failure in patients older than one year. 6) Overall surgical mortality was 31.8%, but significant decrease in surgical mortality was found since 1983.
Angiography ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Cardiac Catheterization ; Cardiac Catheters ; Estrogens, Conjugated (USP) ; Female ; Heart Defects, Congenital ; Heart Failure ; Hot Temperature ; Humans ; Incidence ; Male ; Mortality ; Pediatrics ; Seoul ; Sex Ratio

No abstract available.

PURPOSE: This study was performed to compare complications and perinatal factors according to the birth weight groups in the infants of diabetic mothers(IDM). METHODS: Three hundred and one singleton diabetic mothers and their babies of more than 30 weeks' gestational age admitted in the department of Pediatrics, Chonnam University Hospital from January 1996 to March 2002 were enrolled. Complications and perinatal factors were compared between large for gestational age(LGA) and appropriated for gestational age(AGA) infants. RESULTS: Hypomagnesemia was observed in 37.5%, jaundice in 21.3%, hypoglycemia in 11.1%, hypocalcemia in 7.0%, and birth injury in 19.6%. Congenital anomaly was noted in 24.9% with cardiovascular anomaly most commonly. In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, Cesarean section rate, maternal height, weight before pregnancy, weight gain during pregnancy, and the incidence of unawareness of gestational DM were significant compared with the AGA group. CONCLUSION: In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, maternal height, weight before pregnancy and weight gain during pregnancy were larger, and the incidence of unawareness of gestational DM was higher compared with the AGA group. These results suggest that careful examination and management are needed to detect the high risk, pregnant DM mothers with possible LGA babies.
Birth Injuries ; Birth Weight* ; Cesarean Section ; Female ; Gestational Age ; Humans ; Hypocalcemia ; Hypoglycemia ; Incidence ; Infant* ; Jaundice ; Jeollanam-do ; Mothers* ; Parturition* ; Pediatrics ; Pregnancy ; Tachypnea ; Weight Gain

Four cases of primary transitional cell carcinoma (TCC) arising in the ovary (3 cases) and the parovarium (1 case) were collected for clinicopathologic analysis. The mean age was 46.2 years (range, 39-57 years). Two patients complained abdominal discomfort and vaginal discharge, respectively. Other 2 cases were incidentally found from routine check. Grossly, the tumors were solid and cystic (2 cases), solid (1 case) and surface papillary growth on capsule (1 case). Microscopically, the tumor showed almostly same to the histologic features of TCC of urinary bladder. Three cases were pure TCC, and one was mixed TCC and serous carcinoma. FIGO stage were 1 IIa, 2 IIc, and 1 IIIc. Treatment was surgery with adjuvant chemotherapy. Two patients are alive with no evidence of disease, and two have lung or brain metastasis.
Brain ; Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Ovary ; Urinary Bladder ; Vaginal Discharge

INTRODUCTION: Cathepsin D (CD) is a lysosomal protease that can be used as an important prognostic cytosolic factor for breast cancer. Its over-expression in breast cancer cells and in the host stromal cells in the tumor has been proposed as being a poor prognostic indicator. However, its prognostic value is still being debated. Therefore, CD expression needs to be examined in more relevant subsets of tissue in order to refine its prognostic significance and the clinical applications. METHODS: Regardless of the lymph node status, 110 T1 invasive ductal carcinomas of the breast were immunohistochemically evaluated for the CD expression using rabbit anti-cathepsin D monoclonal antibody. This study separately assessed the expression of CD in the invasive component (IDC), in the in situ component (DCIS), and in the juxtatumoral stromal cells (JTSC). The CD expression level in these three kinds of tissues were correlated with the nuclear grade, ER, PR, c-erb-B2, p53, the N stage, the T stage, and the 5 year metastasis-free survival. RESULTS: Positive CD expression in the JTSC was associated with the T stage (p = 0.001) and the N stage (p = 0.029), whereas positive CD expression in the DCIS and IDC was not. In addition, strong CD expression in the JTSC correlated with the nuclear grade of the invasive component (p = 0.024). In all three components, no statistically significant correlation was found between the biomarker (ER, PR, cerb-B2, p53) and the CD expression. On univariate analysis, positive expression in the JTSC was correlated with a poor 5 year- metastasis free survival (p = 0.007), but the positive expression in the IDC and DCIS was not. CONCLUSION: CD expression of the JTSC could represent the N stage, the T stage, and the nuclear grade of T1 IDC. Whether or not it would have an independent influence on the prognosis of T1 IDC, CD expression in the JTSC is probably an indicator of the tumor virulence. CD expression in the JTSC will provide an important clue for the development of new CD targeted therapies, and it will serve as an important criterion for selecting the appropriate candidates for these future targeted therapies.
Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating ; Cathepsin D* ; Cathepsins* ; Cytosol ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Stromal Cells* ; Virulence

Meningioma associated with intratumoral hemorrhage is rarely reported. We present two patients with intratumoral hemorrhage. One 70-year-old man was admitted to our department with a decreased level of consciousness and left hemiparesis. CT scan and MRI scan revealed huge tumor with intratumoral hemorrhage in the frontal lobe. After surgical removal of the tumor, histopathological diagnosis was a meningotheliomatous meningioma. The other seemed patients was 56-year-old woman with headache and vomiting. She showed no specific neurological deficit. CT and MRI scan revealed large size tumor with intratumoral hemorrhage that looks like meningioma. The patient died suddenly before surgery. We reviewed the relevant literature and discussed the possible mechanism of hemorrhage in the meningioma.
Aged ; Consciousness ; Diagnosis ; Female ; Frontal Lobe ; Headache ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Middle Aged ; Paresis ; Tomography, X-Ray Computed ; Vomiting