INTRODUCTION: It has been proposed that narcolepsy and REM sleep behavior disorder (RBD) have overlapped symptom profile and pathophysiology. This study was aimed at measuring and comparing changes in EEG frequency band of REM sleep in narcolepsy and RBD, applying EEG spectral analysis method. METHODS: Nine patients diagnosed as narcolepsy and the same number of RBD patients were studied. Spectral analysis of the REM sleep EEG was performed in each patient on 9 epochs selected evenly from the first, second, and third REM periods. Then, we compared frequency band percentages of REM sleep EEG in narcolepsy and RBD. RESULTS: Narcolepsy patients had significantly higher delta frequency ratio than RBD ones (p=0.00). In alpha and beta2 frequency bands, RBD patients showed higher percentage than narcolepsy ones. Slow wave sleep was more prevalent in narcolepsy patients. But, no difference of REM sleep percentage was found between the two groups (p=0.93). CONCLUSION: Higher delta frequency ratio in REM sleep of narcolepsy patients than RBD ones reflects that sleep-promoting mechanism is more dominant in narcolepsy than in RBD.
Electroencephalography ; Humans ; Narcolepsy ; REM Sleep Behavior Disorder ; Sleep, REM

BACKGROUNDS: The pathophysiology of chronic airflow obstruction, such as bronchial asthma, is characterized by mucus hypersecretion, goblet cell hyperplasia(GCH), smooth muscle hypertrophy, cells infiltration. In fatal asthma patients, one findings is mucus hypersecretion due to GCH. However, the mechanisms of GCH in these hypersecretory diseases remain still unknown. In this study, a rat model was rapidly induced with GCH by instillation of TiO2 intratracheally. We intend to confirm GCH and association of concomitant inflammatory cells infiltration and to observe the effect of potent antiinflammatory agent, that is dexamethasone, on GCH with inflammatroy cells. METHODS: Twenty-one-8-weeks-old male Sprague-Dawley rats were divided into three groups. Endotoxin-free water was instilled intratracheally in group 1(control) ; TiO2 was instilled in the group 2 ; and dexamethasone was injected intraperitoneally to group 3 before TiO2 instillation. After 120 hours, all rats were sacrificed, and trachea, bronchi, and lungs were resected respectively. These tissues were made as paraffin blocks and stained as PAS for goblet cells and Luna stain for eosinophils. We calculated the ratio of goblet cell to respiratory epithelium and number of infiltrated eosinophils from each tissue. RESULTS: (1) Fraction of goblet cells was significantly increased in group 2 than in group 1 in the trachea and in the main bronchus. (10.19±11.33% vs 4.09±8.28%, p<0.01 and 34.09±23.91% vs 3.61±4.84%, p<0.01, respectively). (2) Eosinophils were significantly increased in the airway of group 2 than that of group 1. (5.43±3.84% vs 0.17±0.47 in trachea and 47.71±16.91 vs 2.71±1.96 in main bronchi). (3) There was significant difference in the decrease of goblet cells and eosinophils(r=0.719, p=0.001). (4) There was significant difference in the decrease of goblet cells after dexamethasone infection between group 2 and group 3 (p<0.01). Also, infiltration of eosinophils was suppressed by dexamethasone. CONCLUSION: We made an animal model of TiO2-induced goblet cell hyperplasia. GCH was observed mainly in the main bronchi with concomitant eosinophilic infiltration. Both goblet cell hyperplasia and eosinophilic infiltration were suppressed by dexamethasone. This animal model may serve as a useful tool in understanding of the mechanism of GCH in chronic airway diseases.
Animals ; Asthma ; Bronchi ; Dexamethasone* ; Eosinophils ; Goblet Cells* ; Humans ; Hyperplasia* ; Hypertrophy ; Inflammation* ; Lung ; Male ; Models, Animal ; Mucus ; Muscle, Smooth ; Paraffin ; Pulmonary Disease, Chronic Obstructive ; Rats ; Rats, Sprague-Dawley* ; Respiratory Mucosa ; Trachea ; Water

No abstract available.

Treatment of chronic localized osteomyelitis is the same as the other osteomyelitis, that is, curettage and debridement of all dead tissue which is called saucerization. After saucerization there leaves empty cavity and autogenous bone graft has been used for filling the cavity in lower extremity hecause of weight bearing and avoiding fracture. We treated seven cases of chronic localized osteomyelitis with one-staged saucerization and cancellous chip allograft and retrospective analysis was done. All healed without complication and no recurrence was ohserved. Most orthopaedic surgeons are not willing to use allograft on the site of osteomyelitis because of the fear of recurrence. But. we think that as far as complete removal of infected and dead tissue, allograft could he a good solution in terms of rapid remodelling and early weight hearing. Another advantages of allograft are to get a large amount of bone and no damage of iliac apophysis. In summary, one-staged saucerization and cancellous chip allograft would he very useful treatment for chronic localized osteomyelitis.
Allografts* ; Curettage ; Debridement ; Hearing ; Lower Extremity ; Osteomyelitis* ; Recurrence ; Retrospective Studies ; Transplants ; Weight-Bearing

Recent studies indicated that cellular and humoral immune reactions against Afycobacterium leprae may be involved in the development of some of the pathological manifestations. In lepromatous leprosy one might anticipate the formation of immune complexes from concomitant occurrence of large amounts of mycobacteria and corresponding antibodies. Indeed, there are some evidences of an involvement of immune complexes in the pathogenesis of erythema nodosum leprosum(ENL), mainly based on clinical and pathological studies. Some of numerous immune cornplex tests have been applied for the study of leprosy, But no single test has yet been shown to be the rnost sensitive and the most specific for the entire spectrum of circulating immune complexes. Furthermore. Leprosy has been found to differ in its clinical manifestations and immunological behaviors in different geographic areas and races. The authors considered it is necessary to determine the circulating immune complexes in Korean patients with leprosy to evaluate the immune status and the differences in the immunologic reactivity between the lepromatous and the tuberculoid spectrum of Ieprosy.
Antibodies ; Antigen-Antibody Complex* ; Continental Population Groups ; Erythema Nodosum ; Humans ; Leprosy* ; Leprosy, Lepromatous

In leprosy, it is generally believed that the defense against Mycobacterium leprae (M. leprae) is largely dependent on cell-mediated immunity (CMI) and there is an accumulating evidence that the patients with lepromatous leprosy have not only defective CMI specific for M. leprae, but also have generalized impairment of CMI. In contrast, the humoral immune reactivity, both specific and nonspecific, have been found to be normal or slightly increased. Recently, several investigators have enumerated the peripheral blood T and B lympocytes in patients with leprosy; however, there is no agreement as to the results. Furthermore, leprosy has been found to differ in its clinicai manifestations and immunological behaviors in different geographic areas and races. Nevertheless, there is yet no report in Korea concerning the T and B lymphocyte enumeration. The authors considered it is necessary to enumerate the peripheral blood T and B lymphocytes in Korean patients with leprosy to evaluate the immune status and the differences in the immunologic reactivity between the lepromatous and the tuberculoid spectrum of leprosy. (countinued..)
B-Lymphocytes* ; Continental Population Groups ; Humans ; Immunity, Cellular ; Korea ; Leprosy* ; Leprosy, Lepromatous ; Lymphocytes ; Mycobacterium leprae ; Research Personnel

Normal lymphocyte transfer (NLT) test is composed of two peaks of delaycd. hypersensitivity reaction of erythema and/or induration developed at the site of intradermal inoculatioa of allogenic lymphocyte. It has been suggested that NLT test is a px.siblc homograft raaction, how var tlv exact mecha.nism is remained to be resolved. In leprosy, there has been accumulating evidenc. indicating defective cell mediated. immunity detected by varioua immunological tests. The present study was undertaken to evaluate the immune capability of patients with leprosy using NLT test. A total of 20 hea,lthy volunteers, 20 lepromatous and 22 tuberculoid leprosy patients who were under antileprosy chemotherapy with DDS for varying periods, entered this study. Lymphocytes from hepatitis associati antigen (HAA) negative donor were isolated with Ficoll- Hypaque density gradient method and the cell concentration was adjusted by normal saline so as to give 2, 5 million cells per 0. 1 ml. Each recipient was given 0. 1 ml lymphocyte suspension on the flexor surface of th right forearm intrad.ermally using 1 ml tuberculi n syringe with a 26 gauge needle. The appearance and the size of induration was checked daily for 2 weeks. In this atudy, the NLT reaction pattem was classified as follows: a. normal pattem showing the first peak and second peak of reaction. b. first peak only showing the first peak, but no second peak, of reaction. c. flat pattem showing neitger the first peak nor the second peak of reaction The results were as follows: 1. There were normal pattem in sixteen persons(80%) and first peak only in 4 persons(20%) among twenty healthy human volunteers. 2. There were normal pattem in four patients(20%), first peak only in six patients(30%) and flat pattem in ten patients(50%) among twenty letromatous leprosy patients. 3. There were normal pattem in twelve patients(54.5%), first peak only in eight patients(36.4%) and flat pattem in two patients(9.1%) among twenty-two tuberouloid leprosy patients. These findings suggest that NLT test may be useful in evaluating the immune capability in leprosy and host factor in belived to be important in the development of both first and second peaks of NLT test.
Allografts ; Diatrizoate ; Drug Therapy ; Erythema ; Forearm ; Healthy Volunteers ; Hepatitis ; Humans ; Hypersensitivity ; Immunologic Tests ; Leprosy* ; Leprosy, Tuberculoid ; Lymphocytes* ; Needles ; Syringes ; Tissue Donors ; Volunteers

Complete decompression is very important for the surgical treatment of the spinal stenosis. But it may produce the segmental instability or spondylolisthesis as postoperative complications. So rigid internal fixation is mandatory to reduce this problem. Authors treated 16 cases of spinal stenosis by complete decompression and pedicale screw fixation and posterolateral fusion, analyzed 11 cases which were followed more than 9 months. The results were as follows: 1. Among the 11 cases, the mean age was 49 years old and there were 5 males and 6 females. 2. The most common cause was degenerative type, 7 cases. The most frequent level of involvement was L4–L5, 10 cases and two level involvement was 3 cases. 3. Among the 11 cases, 6 cases were excellent and 4 cases were good, and 1 case was fair, in Hanley's criteria. 4. In spondylolisthetic stenosis, the average percentage of slippage was changed from 22% pre-operatively to 2.7% postoperatively and 3.8% after 9 months follow up. 5. The complications were relatively few(1 case of hematoma and 3 cases of pain on the bone graft donor site).
Constriction, Pathologic ; Decompression ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Male ; Pedicle Screws ; Postoperative Complications ; Spinal Stenosis ; Spondylolisthesis ; Tissue Donors ; Transplants

The fractures of the both forearm bones are extremely common in children. Between the radius and ulna, there is normally through an arc of 180° rotation. To restore full rotation, rotational deformity and angulation after fracture must be corrected. The goal of treatment of the unstable forearm fracture is to increase the function of the forearm and hand as well as to get solid bone union. The general principle of treatment of forearm fracture in children is conservative due to remodeling and spontaneous correction ability. Thus, most fractures at any level need not and should not be treated by open reduction and internal fixation. But the operation will be perform frequently who shortly before maturity. We reviewed twenty-three children between 8-13 age, who had dsiplaced both forearm bones fracture, and who were treated with fixation using K-wire(14 cases) or plate(9 cases). Of the twenty-three fractures, sixteen were unsatisfactory reduction with more than 10° of angulation after initial closed reduction, two were loss of reduction in cast immobilization, and five were internally fixed primarily because of soft tissue interposition between fragment. The results were as follows. l. Operation time was 51.4 minutes in K-wire group and 86.7 minutes in plate group. 2. Bone union occured in all cases, at 7.3 weeks in K-wire fixation group and 8.9 weeks in plate fixation group. And immobilization period 7 weeks in K-wire fixation group and 4 weeks in plate fixation group. 3. Functional results were satisfactory all cases in both group. 4. The advantage of K-wire is a simple safe operation with minimal morbidity and small scar and compares with the extensive approach need for plate fixation which often giving a poor cosmetic result. Moreover, a second operation, with significant morbidity, is need to remove the plate after solid union. In Conclusion, this method is a favorable altenative to plate fixation of children forearm fractures. It allows rapid bone union with minimal morbidity, complication and scar.
Child ; Cicatrix ; Congenital Abnormalities ; Forearm ; Hand ; Humans ; Immobilization ; Methods ; Radius ; Ulna

Bone defect occurs due to various causes, such as neoplasms, cysts, trauma, infection, congenital disease and surgical intervention. Autograft is generally considered to be the gold standard in bone graft surgery. But, allograft, xenograft and bone substitutes have been used because of complication and limited quantity of autograft. Calcium sulfate is one of the bone substitutes. We reviewed and analyzed 18 cases with bone defects that were treated with calcium sulfate from January 1997 to April 1997. We used the Osteoset' pellets that contained calcium sulfate 98%, produced by Wright Medical Technology Inc. in U.S.A., to fill defects in all cases. Except in 2 cases, autogenous cancellous bone from patients own iliac crest was mixed with calcium sulfate from 30% to 50%. Follow-up time averaged 13.7 months(range, from 12 to 15 months). The degree of absorption of calcium sulfate and new bone growth at conventional roentgenography was represented by percentage at each follow-up. The results were as follows. First, 8 weeks after operation, 93% of calcium sulfate was absorbed. Second, 6 months after operation, nearly 90% of new bone growth was observed. Third, until last follow-up, there was no noticeable complication, such as infection or foreign body reaction. We concluded that calcium sulfate might be on effective material for bone defects because of rapid absorption rate and easy recognition of new bone growth.
Absorption ; Allografts ; Autografts ; Bone Development ; Bone Substitutes* ; Calcium Sulfate* ; Calcium* ; Follow-Up Studies ; Foreign-Body Reaction ; Heterografts ; Humans ; Radiography ; Transplants