BACKGROUND: There are a few studies on the effects of job strain on the prevalence of sleep problems in the foreign countries. In Korea, it has not been studied till now. In this article, the combined effects of job strain, shift work and some life style on the prevalence of sleep proplems were studied among workers in middle aged men. METHODS: 998 cases were chosen from 1109 men who visited health screening center from October to November, 1999. Sleep problems were categorized to insomnia, sleep deprivation, daytime sleepiness and snoring on the base of result of factor analysis of 11 questions. Job strain was measured by 11 questions which developed by Karasek and Theorell. All data set were analyzed using Chi square test and multiple logistic regression analysis. RESULTS: The 4 sleep proplems were analyzed by multiple logistic regression analysis in relation to job strain, shift work, occupation, obesity, sedentary life style, smoking, drinking. Insomnia was increased significantly from highest job strain group(Odds ratio (OR:2.02)) and non exercise group(OR:2.05). In these groups, daytime sleepiness was increased significantly(OR=1.92 in the highest job strain group, OR=1.72 in non exercise group). Sleep deprivation was increased in the highest job strain group(OR=2.18), managers & clerks(OR:1.67) and non exercise group(OR:1.78). Snoring was increased from BMI(Body mass index)> OR =25(OR=1.77), BMI> OR =27(OR=2.80) and non exercise group(OR:1.87). CONCLUSION: In the highest job strain group, insomnia, sleep deprivation and daytime sleepiness was increased significantly. And sedentary life style increased all sleep problems.
Dataset ; Drinking ; Humans ; Korea ; Life Style* ; Logistic Models ; Male ; Mass Screening ; Middle Aged* ; Obesity ; Occupations ; Prevalence* ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders ; Smoke ; Smoking ; Snoring

PURPOSE: The purpose of this study was to investigate the prognostic significance of the expression of EGFR and C-erbB-2 gene products by immunohistochemical analysis for curatively resected gastric adenocarcinoma. MATERIALS AND METHODS: Between January 1996 and December 2001, 739 patients with curatively resected gastric cancer patients underwent Immunohistochemical staining for EGFR and C-erbB-2 proteins, and we retro spectively analyzed their correlation with the clinical outcome. RESULTS: The overexpressions of EGFR and C-erbB-2 were 25.4% and 26.2%, respectively. The overexpressions of EGFR was associated with the more poorly differentiated tumor (p=0.000) and with neuronal invasion (p=0.03). Overexpression of C-erbB-2 was associated with less vascular invasion (p=0.001). Tumor depth or node metastasis was not related to the overexpression of EGFR or C-erbB-2. The seven-year overall survival and relapse-free survival rates were 87.2% and 75.8%, respectively. Upon multivariate Cox regression analysis, the tumor stage, tumor size and patient age were important prognostic factors for overall survival, and tumor stage was the important factor for relapse-free survival. Overexpressions of EGFR or c-erbB-2 were not significant prognostic factors. CONCLUSION: Immunohistochemical staining of EGFR and C-erbB-2 gene products were not independent prognostic factors for predicting the overall survival and the relapse-free survival in curatively resected gastric cancer.
Adenocarcinoma ; Genes, erbB-2 ; Humans ; Immunohistochemistry ; Neoplasm Metastasis ; Neurons ; Prognosis ; Receptor, erbB-2 ; Regression Analysis ; Stomach Neoplasms*

This study was designed to identify expression of calcium-binding proteins and synaptic reorganizations of dentate mossy fibers in hippocampal sclerosis of human temporal lobe epilepsy. Hippocampal neuronal density was quantitively analyzed in temporal lobe epilepsy group (n=50) to investigate the degree of hippocampal sclerosis and it was compared with that of autopsy control (n=3). To verify the distribution of calcium-binding proteins in neurons of epileptic hippocampi, the parvalbumin (PV)-immunoreactive and calbindin-D28K (CB)-immunoreactive neurons were quantitively analyzed in each area of Ammon's horn by immunohistochemical stain. Also, to clarify synaptic reorganizations of the dentate mossy fibers, a part of each hippocampus was examined under light microscopy and transmission electron microscopy using Timm sulphide silver method. In epileptic hippocampi, severity of hippocampal sclerosis (HS) was graded four, which consisted of 3 cases with no HS, 6 mild HS, 12 moderate HS, and 29 severe HS. The hippocampal neuronal loss was most prominent in CA1, followed by CA4 and CA2. Expression of calcium-binding proteins was more prevalent in CA2 of all groups. The proportion of PV-immunoreactive neurons in CA1 and CA4 significantly increased in the moderate and severe HS group, whereas the proportion of CB-immunoreactive neurons did not correlated with the severity of HS. Timm granules were noted in inner molecular supragranular layer of dentate gyrus of epileptic hippocampi and they tended to increase in proportion along with the severity of hippocampal sclerosis. Transmission electron microscopy showed that supragranular Timm granules corresponded to synaptic terminals of mossy fibers. These results suggest that parvalbumin appears to have more protective effect against neuronal loss and that mossy fiber synaptic reorganization seems to play a major role in pathogenesis of hippocampal sclerosis of human temporal lobe epilepsy.
Autopsy ; Calbindin 1 ; Calcium* ; Calcium-Binding Proteins* ; Dentate Gyrus ; Epilepsy, Temporal Lobe* ; Hippocampus ; Humans ; Microscopy ; Microscopy, Electron, Transmission ; Nerve Fibers, Myelinated ; Neurons ; Presynaptic Terminals ; Sclerosis* ; Silver ; Temporal Lobe*

Treatment with certain DNA-damaging agents induce a complex cellular response comprising pertubation of cell cycle progression and/or apoptosis on proliferating mammalian cells. Our studies were focused on the cellular effects of nickel (II) acetate, DNA-damaging agent, on Chinese hamster ovary (CHO) cells. Fragmented DNAs were examined by agarose gel electrophoresis and cell cycle was determined by DNA flow cytometry using propidium iodide fluorescence. Apparent DNA laddering was observed in cells treated with 240 microM nickel (II) and increased with a concentration-dependent manner. Treatment of nickel (II) acetate resulted in apoptosis which was accompanied by G2/M cell accumulation. Proportion of CHO cells in G2/M phase was also significantly increased in cells exposed to at least 480 microM nickel (II) from 57.7% of cells in the G0/G1 phase, 34.7% in the S phase, and 7.6% in the G2/M1 phase for 0 microM nickel (II), to 58.6%, 14.5%, and 26.9% for 640 microM nickel (II). These findings suggest that nickel (II) can modulate cellular response through some common effectors involving in both apoptotic and cell cycle regulatory pathways.
Animal ; Apoptosis/drug effects* ; CHO Cells/drug effects* ; CHO Cells/cytology ; Cell Cycle/drug effects* ; DNA Fragmentation/drug effects ; Flow Cytometry ; G2 Phase/drug effects ; Hamsters ; Mitosis/drug effects ; Nickel/pharmacology*

Insulinoma with hyperproinsulinemia and normal serum insulin level is a rare disease. Because of the neuroglycopenic symptoms, the initial diagnosis tends to be made as epilepsy or as psychosis. A 43-year-old man was admitted to our hospital because of recurrent confusional episodes. Symptoms are intermittent and consist of staring, confusion, amnesia, and bizarre behavior. Vital signs during the episode were normal but the serum glucose level was 27 mg/dl. The serum level of insulin during the episode was lower than normal and those of proinsulin and growth hormone were higher than normal. Solitary pancreatic mass was found by abdominal CT, measuring 15 mm in diameter. Pathologic evaluation showed islet cell tumor. This suggests that the serum level of proinsulin should be checked when insulinoma with neuroglycopenic symptom is suspected.
Adenoma, Islet Cell ; Adult ; Amnesia ; Blood Glucose ; Diagnosis ; Epilepsy ; Growth Hormone ; Humans ; Insulin ; Insulinoma* ; Proinsulin ; Psychotic Disorders ; Rare Diseases ; Seizures* ; Tomography, X-Ray Computed ; Vital Signs

Leprosy is a chronic granulomatous disease affecting the skin and peripheral nervous system. Because of its variable manifestations, leprosy can be misdiagnosed as syphilis, sarcoidosis, psoriasis and eczema. A 73 year-old man showed erythematous papules on his arms and legs. He had been erroneously treated as eczema before the correct clinicopathological diagnosis of borderline lepromatous leprosy was made. We report this case to suggest that dermatologists should pay careful attention while diagnosing new cases of leprosy.
Arm ; Diagnosis ; Eczema* ; Granulomatous Disease, Chronic ; Leg ; Leprosy* ; Leprosy, Multibacillary* ; Peripheral Nervous System ; Psoriasis ; Sarcoidosis ; Skin ; Syphilis

BACKGROUND: This prospective phase II trial was performed to determine the efficacy and toxicity of mitomycin C, vinorelbine and cisplatin combination chemotherapy for patients with previously untreated stage IIIB or IV non-small cell lung cancer (NSCLC). METHODS: Between January 1999 and April 2001, 30 patients with chemotherapy- naive stage IIIB or IV NSCLC were entered into this study. Mitomycin C at a dose of 7 mg/m2, vinorelbine at a dose of 25 mg/m2 and cisplatin at a dose of 75 mg/m2 on day 1 and vinorelbine at a dose of 25 mg/m2 on day 8 were administered. This regimen was repeated every 4 weeks. RESULTS: 29 patients out of 30 patients were assessable. Among the assessable patients, 15 (51.7%) patients had a partial response. The median duration of response and survival was 22 weeks and 39 weeks, respectively. Grade 3 or 4 leukopenia and thrombocytopenia were observed in 28.3% and 4.7% of all the cycles, respectively. Nausea and vomiting of grade 3 occurred only in 2.4% of all the cycles. CONCLUSION: The regimen of mitomycin C, vinorelbine and cisplatin for non-small cell lung cancer is active against advanced NSCLC with tolerable toxicities.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carcinoma, Non-Small-Cell Lung/*drug therapy/pathology ; Cisplatin/*administration & dosage ; Dose-Response Relationship, Drug ; Female ; Human ; Lung Neoplasms/*drug therapy/pathology ; Male ; Middle Aged ; Mitomycin/*administration & dosage ; Treatment Outcome ; Vinblastine/*administration & dosage/*analogs & derivatives

PURPOSE: To compare the clinical results of spontaneous rupture of extensor pollicis longus tendon treated by palmaris longus tendon graft (group I) versus extensor indicis proprius tendon transfer (group II). MATERIALS AND METHODS: Out of twenty-five patients who suffer from spontaneous extensor pollicis longus tendon rupture, twelve patients were treated by palmaris longus tendon graft and thirteen patients were treated by extensor indicis proprius tendon transfer. Postoperatively thumbs were immobilized with thumb spica splint for three weeks. Active and passive movement was allowed subsequently for six weeks. The functions of the thumbs were assessed by the Geldmacher criteria and statistically compared. RESULTS: The overall outcome was excellent in 5(20%) of patients and good in 17(68%) of patients and satisfactory in 3(12%) of patients. The mean scores using the Geldmacher criteria were 18.50 for palmaris longus tendon graft and 19.69 for extensor indicis proprius tendon transfer. No significant difference was noted between two groups. CONCLUSION: Both methods establish equally good clinical results in patient with chronic extensor pollicis longus tendon rupture. Extensor indicis proprius tendon transfer seems more available methods.
Humans ; Rupture ; Rupture, Spontaneous ; Splints ; Tendon Injuries ; Tendon Transfer ; Tendons ; Thumb ; Transplants

OBJECTIVES: Nitrogen dioxide (NO2) has been inconsistently associated with gradual decreases in lung function. Here, we studied the effects of NO2 exposure in asthmatics by examining the association between changes in lung function and concentrations of NO2 which were personally measured. METHODS: Peak expiratory flow (PEF) and daily personal exposures to NO2 were recorded on 28 patients with asthma (confirmed by methacholine provocation test) over 4 weeks. We used generalized estimating equations to assess the relationship between personal NO2 exposure and PEF, adjusting for potential confounders such as age, gender, outdoor particulate matter, temperature, humidity, and exposure to environmental tobacco smoke. RESULTS: The personal NO2 exposures were higher than the corresponding ambient levels. The mean personal: ambient ratio for NO2 was 1.48. The personal NO2 exposures were not associated with the morning PEF, evening PEF, or the diurnal PEF variability. However, environmental tobacco smoke was negatively associated with both the morning and evening PEF. CONCLUSIONS: Among the asthmatic adults who participated in this study, we found no apparent impact of personal NO2 exposures on the peak expiratory flow.
Tobacco Smoke Pollution/adverse effects/analysis ; Time Factors ; Peak Expiratory Flow Rate/*drug effects ; Nitrogen Dioxide/*adverse effects ; Male ; Lung/*drug effects/physiology ; Korea/epidemiology ; Inhalation Exposure/*adverse effects/analysis ; Humans ; Female ; Asthma/epidemiology/*physiopathology ; Air Pollution, Indoor/adverse effects/analysis

Aeromonas hydrophila is a facultative, anaerobic gram-negative bacillus. It's a member of the family Vibrionaceae. Aeromonas, which is known to cause gastroenteritis and wound infections ranging from mild cellulitis to fulminant myonecrosis. It is responsible for opportunistic infections in patients with compromised immune function due to an underlying disease such as malignant hematological disorders, liver cirrhosis, and malignant neoplasm. We report a case of 72-year-old woman who recovered from necrotizing fasciitis caused by A. hydrophila. The patient had undergone prolonged hemodialysis and had no history of trauma.
Aeromonas hydrophila* ; Aeromonas* ; Aged ; Bacillus ; Cellulitis ; Fasciitis, Necrotizing* ; Female ; Gastroenteritis ; Humans ; Liver Cirrhosis ; Opportunistic Infections ; Renal Dialysis* ; Vibrionaceae ; Wound Infection