BACKGROUND: Sleep is an essential restorative physiologic phenomenon. Impaired sleep results in significant negative effect to the health. Symptoms like sleep initiation difficulty, frequent awakening, severe snoring have related to poor sleep quality. We studied frequency and compared the characteristics of common sleep disorders at family practice. METHODS: We surveyed patients over 18 years of age and their guardians who visited 16 familial practices for 6 days. We investigated sleep characteristics, frequency of sleep disorder and associated factors by questionnaires and analyzed by frequency analysis, Spearman's correlation coefficient, multiple logistic regression. RESULTS: We enrolled 1,117 participants. Older participants were more likely to report early sleep onset and off time, short sleep duration. Mean number of awakening during a typical night is 1.69. Female complained difficulties in initiation and maintenance of sleep more than male. A total of 32.5% had these insomnia symptoms and related to hypertension, stroke, stress, arthralgia, depression, urological disorder. 31.1% had excessive daytime sleepiness, related to stress, arthralgia, depression. Loud snoring and gasp for breath showed positive correlation between male, high BMI. Disrupted sleep over 3 times was related to old age, female, diabetes, hypertension, stroke, stress, arthralgia, depression. Restless leg syndrome were high in elderly, high BMI, stress, arthralgia and depression. CONCLUSION: About one in three who visit in primary medical practice have sleep disorder symptoms like insomnia, daytime fatigue, snoring. 3% of them have gasp for breath, 8% have restless leg syndrome.
Aged ; Arthralgia ; Depression ; Family Practice ; Fatigue ; Female ; Humans ; Hypertension ; Leg ; Male ; Prevalence ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Snoring ; Stroke

BACKGROUND: To define the final outcome of large cell carcinomas (LCC) after surgical treatment, the histopathology, clinical features and follow-up results of 28 cases were reviewed. METHODS: Twenty eight patients, with LCC that underwent a surgical resection between 1986 and 2001, at the Severance Hospital, were retrospectively reviewed. We analyzed clinical data, radiological findings, pathologic findings, treatment modalities, and survival. RESULTS: The prevalence of LCC was 2.9% (29 cases) among the surgically resected primary lung cancer cases (1003 cases) during the 15 year period of the study. The mean age of the patients was 59 years old, with 25 male cases. There were 23 smokers, smoking an average of 33 pack years. A cough was the most frequent symptom. There were 15 cases located in the peripheral part of the lung and 26 consisted of a lobulated mass. From a chest CT scan, 26 cases had necrotic portions, which appeared to be low density. The postoperative stages were IA, IB, IIB, IIIA and IV in 1 (3.6%), 11 (39.3%) 8 (28.5%), 7 (25%), 1 case (3.6%), respectively. The concordance rate of the pre- and postoperative stage was 43%. The median survival time and 5 year-survival rate were 54.5 months and 45%, respectively. CONCLUSION: Our results suggested that a LCC in the lung was predominant in males, and equally located at the center and periphery of the lung in the surgically resected cases. To define the treatment outcome and risk factors of a LCC of the lung, further multicenter studies are needed.
Adenocarcinoma/diagnosis/epidemiology/surgery ; Adolescent ; Adult ; Age Distribution ; Aged ; Carcinoma, Large Cell/*diagnosis/epidemiology/*surgery ; Female ; Human ; Lung Neoplasms/*diagnosis/epidemiology/*surgery ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Sex Distribution ; Support, Non-U.S. Gov't ; Survival Analysis

BACKGROUND: The lung is the most common site for a metastasis of extrapulmonary malignant tumors. however, reports on an endobronchial metastasis are rare. An endobronchial metastasis is defined as a documented extrapulmonary neoplasms metastatic to the segmental or more proximal central bronchus within a bronchoscopically visible range. The purpose of this study was to define the clinical characteristics of an endobronchial metastasis of extrapulmonary malignancies. METHODS: The clinical features and treatment outcomes of 27 endobronchial metastatic cancer cases were reviewed from June, 1991 to May, 2001 in the Severance Hospital. RESULTS: The patients' age ranged from 18 to 75. There were 17 men and 10 women. The primary tumors included the colorectum in 7, the uterine cervix in 4, the stomach and the breast in 3 patients each, and an osteosarcoma in 2 patients. The main complaint of most patients was coughing and a chest X-ray revealed a hilar mass, a parenchymal nodule, and an atelectasis. The mean recurrence interval time was 45.5 months. The median and mean survival times were 10 and 12.3 months, respectively. CONCLUSION: An endobronchial metastasis is an ominous finding, and is associated with advanced-stage disease. It requires differential diagnosis with a primary bronchogenic carcinoma. If atypical clinical features are present or an atypical cell type is discovered by a biopsy of the lesion in the lung mass, the appropriate diagnostic studies should be undertaken.
Female ; Male ; Humans ; Diagnosis, Differential ; Biopsy ; Neoplasm Metastasis

Anomalous origin of the coronary artery in children is a rare disease. Especially anomalous origin of the left coronary artery from pulmonary artery(ALCAPA) is a fatal condition in neonates with myocardial failure. Among the ALCAPA, origin of the circumflex coronary artery from the pulmonary artery is an extremely rare congenital coronary anomaly. We report a case of reimplantation of the left circumflex coronary artery from the left pulmonary artery to the ascending aorta in a 4-year-old girl.
Aorta ; Bland White Garland Syndrome ; Child ; Child, Preschool ; Coronary Vessels* ; Female ; Heart Failure ; Humans ; Infant, Newborn ; Pulmonary Artery* ; Rare Diseases ; Replantation

BACKGROUND: To define the final outcome of large cell carcinoma (LCC) after surgical treatment, we reviewed the histopathology, clinical features and follow-up results of 28 cases. METHODS: We retrospectively reviewed 28 patients with LCC who underwent surgical resection during the last 15 years from 1986 to 2001 in Severance Hospital. We evaluated clinical data, radiologic findings, pathologic findings, treatment modalities, and survival. RESULTS: The prevalence of LCC was 2.9% (29 cases) among the surgically resected cases in primary lung cancer (1003 cases) during 15 years. The mean age was 59 years old and twenty five cases were male. There were 23 smokers and the average pack year was 33. The cough was the most frequent symptom. Fifteen cases were located in the peripheral part of the lung. Twenty cases consisted of lobulated mass. In chest CT scan, twenty six cases had necrotic portions which appeared to be lower density. Postoperative stage was IA in 1 case (3.6%), IB in 11 cases (39.3%), IIB in 8 cases (28.5%), IIIA in 7 cases (25%), and IV in 1 case (3.6%). Preoperative and postoperative stage concordance rate was 43%. Median survival time was 54.5 months and 5 year-survival rate was 45%. CONCLUSION: Our results suggest that LCC in the lung is predominant in male and is equally located in the central and peripheral parts of the surgically resected cases. To define the treatment outcome and risk factors of LCC of the lung, further multicenter studies are needed.
Carcinoma, Large Cell* ; Cough ; Diagnosis ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUND: Lung cancer is the leading cause of malignant pleural effusions, which is currently most commonly treated using pleurodesis via bedside thoracostomy. Several agents had been used for the treatment of pleural sclerosis, but with differing efficacies and associated side effects. Our purpose with this study was to compare the efficacy, side effects and disease free survival times of patients being treated with OK-432 and doxycycline sclerotherapy in lung cancer induced malignant pleural effusions. PATIENTS AND METHODS: 79 patients who underwent pleurodesis with OK-432 and doxycycline, between Jan. 1994 and Aug. 2001, were retrospectively reviewed. Resopnses 30 days following pleurodesis were determined from chest radiographs, with the disease free survival time being evaluated according to the response. RESULTS: The success rates, 30 day followint pleurodesis, with OK-432 and doxycycline 83 and 87%, respectively (p=0.677). With regard to the side effects, fever was more common when OK-432 was used (59%, p=0.001), and pain was more common with doxycycline use (73%, p=0.008). There was no significant difference in disease free survival times between OK-432 (13.6 Months) and doxycycline (11.6 Months) (p=0.532). CONCLUSION: with the use of OK-432, for pleurodesis, was as effective as doxycycline, can be considered as an alternative treatment for malignant effusion in patients with lung cancer.
Disease-Free Survival ; Doxycycline* ; Fever ; Humans ; Lung Neoplasms* ; Lung* ; Picibanil* ; Pleural Effusion, Malignant* ; Pleurodesis* ; Radiography, Thoracic ; Retrospective Studies ; Sclerosis ; Sclerotherapy ; Thoracostomy

BACKGROUND: Lung cancer is the leading cause of malignant pleural effusions, which is currently most commonly treated using pleurodesis via bedside thoracostomy. Several agents had been used for the treatment of pleural sclerosis, but with differing efficacies and associated side effects. Our purpose with this study was to compare the efficacy, side effects and disease free survival times of patients being treated with OK-432 and doxycycline sclerotherapy in lung cancer induced malignant pleural effusions. PATIENTS AND METHODS: 79 patients who underwent pleurodesis with OK-432 and doxycycline, between Jan. 1994 and Aug. 2001, were retrospectively reviewed. Resopnses 30 days following pleurodesis were determined from chest radiographs, with the disease free survival time being evaluated according to the response. RESULTS: The success rates, 30 day followint pleurodesis, with OK-432 and doxycycline 83 and 87%, respectively (p=0.677). With regard to the side effects, fever was more common when OK-432 was used (59%, p=0.001), and pain was more common with doxycycline use (73%, p=0.008). There was no significant difference in disease free survival times between OK-432 (13.6 Months) and doxycycline (11.6 Months) (p=0.532). CONCLUSION: with the use of OK-432, for pleurodesis, was as effective as doxycycline, can be considered as an alternative treatment for malignant effusion in patients with lung cancer.
Disease-Free Survival ; Doxycycline* ; Fever ; Humans ; Lung Neoplasms* ; Lung* ; Picibanil* ; Pleural Effusion, Malignant* ; Pleurodesis* ; Radiography, Thoracic ; Retrospective Studies ; Sclerosis ; Sclerotherapy ; Thoracostomy

It is known that E-cadherin, playing a role in the differentiation of the various tissues, is expressed in the early stage of development. In this research, the expression of E-cadherin and the presence of the intracellular E-cadherin mRNA in the developing fetal rat palatine epithelium using immunohistochemistry and in situ RT-PCR are studied. The investigator also performs TUNEL method and TEM technique for detecting the apoptosis in the palatine epithelium. Fetal rats on the 14th, 15th, 16th and 18th day of gestation were used. The results obtained were as follows: Before the fusion of the both palatine shelves, E-cadherin was expressed in the oral part epithelium. After the fusion oral epithelium and original triangular area were reacted strongly. TUNEL positive cells were rarely found on the midline palatine epithelium in fused palatine processes. On the 18th day of gestation, the remodeling time, many apoptotic cells were observed in the original triangular area. It is suggested that E-cadherin plays a role in the fusion of the palatine shelves, especially in the fusion between the oral part and lower part of midline epithelium, and apoptosis plays a major role in the remodeling of the palate.
Animals ; Apoptosis* ; Cadherins* ; Epithelium ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Palate ; Pregnancy ; Rats* ; Research Personnel ; RNA, Messenger

BACKGROUND AND OBJECTIVES: MAGE (melanoma antigen gene) gene, coding for a tumor antigen recognized by cytotoxic T lymphocytes, is expressed specifically in a variety of cancers, but not in normal tissues that exclude those of the testis. Therefore, most studies of MAGE gene are reported for the cancer immunotherapy. There are, however, few reports for the molecular diagnosis of cancers with MAGE gene. The purpose of this study is to evaluate the MAGE common primers in discriminating the malignant from benign lesions of the head and neck. MATERIALS AND METHODS: Reverse transcriptase-polymerase chain reaction (RT-PCR) and the nested PCR with the MAGE common primers (C1/C2, C3/C4) designed to detect MAGE 1-6 genes in this study were conducted in 37 cancer tissues (27 squamous cell carcinomas and 10 nonsquamous cell carcinoma lesions) and 18 benign tumors and 20 normal tissues of the head and neck . The PCR product was also assayed by RT-PCR with the MAGE 1-6 specific primer (M1-M6) to investigate which MAGE isotypes were detected. RESULTS: At least more than one isotype of MAGE 1-6 genes were detected in 70.4% (19/27) of squamous cell carcinomas and 30% (3/10) of non-squamous cell carcinoma lesions. But there was no MAGE expression in 18 benign lesions and 20 normal tissues. CONCLUSION: MAGE common primers designed in this study showed high sensitivity and specificty in discriminating the malignant from benign lesions of the head and neck. This result suggests MAGE gene might be a potential tumor marker in the head and neck cancer.
Carcinoma, Squamous Cell ; Clinical Coding ; Diagnosis ; Head and Neck Neoplasms ; Head* ; Immunotherapy ; Neck* ; Polymerase Chain Reaction ; RNA, Messenger* ; T-Lymphocytes, Cytotoxic ; Testis ; Biomarkers, Tumor

A 30 year-old women who had had moderately advanced pulmonary tuberculosis and taken antituberculosis regimens including rifampicin was admitted with the symptoms of petechiae on the trunk and extremities and gum bleeding. The thrombocytopenic purpura appeared 20 days after the treatment with rifampicin, and which was rapidly improved with discontinuation of the drug. The diagnosis was confirmed by relapse of thrombocytopenia after retreatment with rifampicin. The paper presents a patient with thrombocytopenia induced by rifampicin and a brief review of pertinent literature.
Adult ; Diagnosis ; Extremities ; Female ; Gingiva ; Hemorrhage ; Humans ; Purpura ; Purpura, Thrombocytopenic* ; Recurrence ; Retreatment ; Rifampin ; Thrombocytopenia ; Tuberculosis, Pulmonary