Digital polysomnography was developed to overcome the limitations of Rechtschaffen and Kales rule and to compensate the shortcomings of paper polysomnography. It enables easy access to and secure preservation of sleep records, and provides various displays of sleep data to enhance efficiency of visual scoring of sleep records. Rechtschaffen and Kales rule had been criticized for its ambiguity and lack of considerations in spatial information of EEG. As sleep records are acquired and processed in digital mode, they can be analyzed at microscopic and macroscopic levels. Digital analysis of sleep records provides the basis for development of new sleep measures. Sleep staging in digital polysomnography is based on the various analyses of EEG. Sleep apnea, hypopnea and periodic limb movement are detected automatically by digital analysis of respiratory signals and leg EMG. Digital polysomnography plays a complementary role to visual scoring and compensates the limitations of paper polysomnography. Digital polysomnography, including acquisition, processing and analysis of sleep records in digital mode, can be a great help in the development of sleep medicine, enabling the development of new sleep measures and the exchange of sleep records between sleep laboratories.
Brassica ; Electroencephalography ; Extremities ; Leg ; Polysomnography* ; Sleep Apnea Syndromes

INTRODUCTION: Excessive daytime sleepiness and cataplexy are key features of narcolepsy. Modafinil is psychostimulant used in the treatment of narcolepsy. In this study, we evaluated effects of modafinil on nocturnal sleep structure and sleep latency in multiple sleep latency test and clinical features. METHODS: Twelve narcoleptic patients (7 male, age: 22.9 +/- 2.6 yrs) were participated in the study. All of them had done nocturnal polysomnography (nPSG), multiple sleep latency test (MSLT), clinical symptoms scales and have repeated same procedure after taking 200 mg of modafinil. We have done linear mixed model analysis to describe effects of group, medication and nap time on these measures. RESULTS: Modafinil did not affect clinical scales except PSQI which had been reduced after medication. In this study, Modafinil reduced total sleep time, sleep efficiency and increased wake after sleep onset and percent of arousal during sleep in nocturnal polysomnography and prolonged mean sleep latency in multiple sleep latency tests in both group. DISCUSSION: Modafinil has stimulant effect of central nervous system but its effect on night sleep is less than other psychostimulants such as methylphenidate. We ascertained that modafinil affected total sleep time, sleep efficiency and percent of wake during sleep but did not effect on sleep structure. Modafinil was effective in the management of day time sleepiness. Modafinil can enhance alertness of control group without day time sleepiness.
Arousal ; Cataplexy ; Central Nervous System ; Humans ; Male ; Methylphenidate ; Narcolepsy* ; Polysomnography ; Weights and Measures

INTRODUCTION: Detrended fluctuation analysis (DFA) is used as a way of studying nonlinearity of EEG. In this study, DFA is applied on sleep EEG of normal subjects to look into its nonlinearity in terms of EEG channels and sleep stages. METHOD: Twelve healthy young subjects (age: 23.8+/-2.5 years old, male:female=7:5) have undergone nocturnal polysomnography (nPSG). EEG from nPSG was classified in terms of its channels and sleep stages and was analyzed by DFA. Scaling exponents (SEs) yielded by DFA were compared using linear mixed model analysis. RESULTS: Scaling exponents (SEs) of sleep EEG were distributed around 1 showing long term temporal correlation and self-similarity. SE of C3 channel was bigger than that of O1 channel. As sleep stage progressed from stage 1 to slow wave sleep, SE increased accordingly. SE of stage REM sleep did not show significant difference when compared with that of stage 1 sleep. CONCLUSION: SEs of Normal sleep EEG showed nonlinear characteristic with scale-free fluctuation, long-range temporal correlation, self-similarity and self-organized criticality. SE from DFA differentiated sleep stages and EEG channels. It can be a useful tool in the research with sleep EEG.
Electroencephalography* ; Polysomnography ; Sleep Stages ; Sleep, REM

Adenotonsillar hypertrophy is the leading cause of childhood obstructive sleep apnea. Obstructive sleep apnea syndrome in child-hood, however, can occur from various causes such as obesity or craniofacial abnormalities. Childhood obstructive sleep apnea syndrome can be accompanied by enuresis, parasomnias and behavior problems. For patients with the symptoms of snoring and apnea, obstructive sleep apnea should be suspected and diagnosed properly. In addition, the evaluation of complications and proper treatment are indispensable. When the cause of childhood obstructive sleep apnea is adenotonsillar hypertrophy, symptoms can be improved by surgical methods. If the cause is other than adenotonsillar hypertrophy, such as obesity, it should be treated with other therapeutic modalities, like nasal continuous positive airway pressure (nCPAP), weight reduction and modification of life style. This paper reports a case of nCPAP used to manage severe sleep apnea when it was not resolved after adenoidectomy and tonsillectomy. Differential diagnosis of narcolepsy in a case with excessive daytime sleepiness and reflections on accompanying enuresis and parasomnia were also described.
Adenoidectomy ; Apnea ; Child ; Continuous Positive Airway Pressure ; Craniofacial Abnormalities ; Diagnosis, Differential ; Enuresis ; Humans ; Hypertrophy ; Life Style ; Narcolepsy ; Obesity ; Parasomnias ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy ; Weight Loss

No abstract available.
Endoscopy ; Gastrointestinal Hemorrhage*

In the following report, we describe the case of a rapidly skeletonized corpse discovered in late summer. On the first day of September, a 57-year-old man was found almost completely skeletonized on a hill behind his house. His body lay prone, accompanied by a brush cutter at the entrance to the graveyard where his friend's parents were buried. His cap, clothes, and rubber boots were all intact and undamaged. Upon autopsy, no definite abnormalities were identified except for an old linear fracture on the frontoparietal bone. According to his friends and neighbors, he had likely died 8 or 9 days prior to the discovery of his body.
Autopsy ; Cadaver ; Friends ; Humans ; Middle Aged ; Parents ; Postmortem Changes ; Rubber ; Skeleton*

An epidemiological investigation was conducted on Metagonimus yokogawai infection in Hadong Gun (County), Gyeongsang Nam Do, Korea, and following findings were obtained. Overall prevalence rate of Metagonimus yokogawai infection was 29.1 percent from a total of 1,163 inhabitants examined. By area of river and stream, Seomjin-gang R.: 9.5 percent (out of 95 inhabitants examined) in Jeondo Ri in the lower river, 19.9 percent (156) at Dugog Ri near Hadong town, and 90.8 percent (65) in Tab Ri of Hwagae Myeon where Hwagae-cheon Stream joins; Hwagae-Cheon Stream: 42.2 percent (45) in Yonggang Ri of the middle stream and 27.5 percent (72) in Daeseong Ri of the upper stream; Hoengcheon-gang R.: 54.7 percent (161) in Gojeol Ri of the lower river, 40.6 percent (128) in Hoengcheon Ri of the middle stream, and 5.4 percent (93) in Jungi Ri of the upper stream, and 43.8 percent (89) in Uge Ri located along a tributary of the Hoengcheon-gang R. and 4.0 percent (101) in Jangam Ri which is located about 4 km away from the river; Deogcheon-gang R.: 18.5 percent (54) in Munam Ri; Gwangog-cheon Stream: 2.8 percent (107) in Gwangog Ri. The difference in prevalence rate of the infection by area was correlated with the opportunity and amount of raw eating of sweetfish by the inhabitants in the respective areas. By age and sex, the overall prevalence rate increased from young age group and reached a peak at 20-29 age group and then the rate decreased gradually. In high endemic areas, however, a peak level of the rate lasted up to 40-49 age group in male. On the other hand, in low endemic areas, the rate was significantly lower in female, though moderate level of the infection was seen in male. The overall prevalence rate was higher in male than in female and the difference was greater in middle age groups. The most significant mode of infection by the inhabitants was the raw eating of sweetfish which commonly harbour metacercariae of M. yokogawai during summer through autumn. Besides, it was noted that the infection can be acquired through contamination with the metacercariae on food of various side-dish and kitchen utensils as well as on hands of a cook when such fish are prepared or handled. The inhabitants usually begin to acquire infection from early June of a year when fishing of sweetfish opens and acquire infection more frequently in July and August when fish are caught more productively and favored for raw consumption by inhabitants. From September, sweetfish are no more favored for raw consumption and accordingly are dried and cooked in this season. The infection in the sweetfish Plecoglossus altivelis as the second intermediate host was first observed from May with low level of infection and the intensity of infection in a fish rapidly increased until reaching a peak in October when sweetfish season normally ends. The first intermediate host snail of M. yokogawai in this area was Semisulcospira coreana (Martens) which is widely distributed in the streams and rivers in this locality.
parasitology-helminth-trematoda ; Metagonimus yokogawai ; metacercaria ; Plecoglossus altivelis ; epidemiology

Potter's syndrome including bilateral renal agenesis or polycystic renal disease, bilateral pulmonary hypoplasia and characteristic face was first described in 1946. Although a great number of cases of Potter's syndrome was reported, Potter's syndrome with adult polycystic kidney disease(Potter type III) was very rarely found. In this report, we described an autopsy case of Potter's syndrome having adult polycystic kidneys disease, bilateral pulmonary hypoplasia and characteristic face in conjunction with multiple hepatic cysts, features of congenital hepatic fibrosis and a pancreatic cyst. Microscopically, all cysts were lined by cuboidal epithelial cells, showing positive for epithelial membrane antigen and cytokeratins.
Adult* ; Autopsy* ; Epithelial Cells ; Fibrosis ; Humans ; Keratins ; Mucin-1 ; Pancreatic Cyst ; Polycystic Kidney Diseases*

PURPOSE: The BTA stat test is a one-step immunochromatographic assay to detect bladder tumor antigen in the urine. We evaluated the efficacy of the BTA stat test and bladder wash cytology(BWC) in the detection and follow-up of bladder cancer. MATERIALS AND METHODS: A voided urine sample for BTA stat test and bladder washing urine for cytology were obtained. The BTA stat test with or without BWC was performed in normal volunteers(n=20), patients with hematuria of unknown origin(n=29), patients with benign genitourinary(GU) disease(n=17), patients with other GU cancer(n=12), patients with bladder cancer(n=46) and patients with a history of bladder cancer(n=54). RESULTS: The overall sensitivities of the BTA stat and BWC in bladder cancer were 69.6% and 41.3%, respectively(p<0.01). For T2 or higher stage tumors, sensitivity was 94.1% for BTA stat and 64.7% for BWC(p<0.05). Grade II tumors were detected at 64.3% with BTA stat and 35.7% with BWC(p<0.05). The sensitivities of the BTA stat and BWC in the follow-up of patients after transurethral resection of bladder tumor were 45.5%(5/11) and 27.3% (3/11), respectively. The specificities of the BTA stat and BWC in the same patients were 88.4%(38/43) and 100%(43/43), respectively(p<0.05). The specificity in patients with hematuria but without disease was 69% for BTA stat and 100% for BWC. The specificities of the BTA stat in healthy volunteers, benign GU disease and other GU cancer were 95%, 82.4% and 75%, respectively. CONCLUSIONS: Our results demonstrate that BTA stat test is a simple, noninvasive test that is superior to bladder wash cytology for detection of bladder cancer in its sensitivity and a useful adjunct of cystoscopy in surveillance and diagnosis of bladder cancer. However, the BTA stat test can not replace cystoscopy due to low specificity.
Cystoscopy ; Diagnosis* ; Follow-Up Studies* ; Healthy Volunteers ; Hematuria ; Humans ; Immunochromatography ; Sensitivity and Specificity ; Urinary Bladder Neoplasms* ; Urinary Bladder*

To estimate the child and infant mortality rates among Korean children, a mortality survey was carried out in the province of Kyongsangnam,buk-do. The study population are the beneficiaries of Korea Medical Insurance Coorporation (KMIC), Kyongsangnam,buk-do area, among which the 3,867 and 1767 deaths occurred from January, 1989 to December, 1990 in Kyongsangnam-do area and from January, 1991 to December, 1991 in Kyongsangbuk-do area respectively. We reviewed the data to confirm the causes of death. These were based on the death certificates and medical utilization records before dying which were available through the computerized databases on medical care utility of KMIC. The survey conducted along three steps. At first, the death certificates were examined, as a second step, medical utilization records were reviewed, and finally direct contacts to the family members of the deceased were done. As a result, 115 deaths were found under 20 years of age. Using them, age specific mortalities and causes of death were estimated. Mortality rate in this area was estimated 129 per 100,000 person-years during 1 month to 11 months of age, 67 during 1 year to 4 years of age, 23 during 5 years to 9 years of age, 10 during 10 years to 14 years of age, and 29 during 15 years to 19 years of age, respectively. And the frequent causes of death were congenital anomalies, central nervous system (CNS) diseases, certain condition originating from perinatal period during 1 months of age; accidents, congenital anomalies, malignancies, CNS diseases, and pneumonia or bronchiolitis during 1 to 4 years of age; accidents, malignancies, CNS diseases, and congenital anomalies during 5 to 14 years of age; and accidents, suicide, malignancies, and CNS diseases during 15 to 19 years of age.
Bronchiolitis ; Cause of Death ; Central Nervous System ; Central Nervous System Diseases ; Child ; Child Mortality* ; Child* ; Death Certificates ; Gyeongsangbuk-do ; Gyeongsangnam-do ; Humans ; Infant ; Infant Mortality ; Insurance ; Korea ; Mortality ; Pneumonia ; Suicide