No abstract available.
Humans ; Pulmonary Disease, Chronic Obstructive*

No abstract available.
Hypertension, Pulmonary*

Building-related illness is an increasingly common problem. The disease fall into two categories : those that have an identifiable cause-such as legionellosis, humidifier fever, and conditions resulting from exposure to known substances such as asbestos, lead in paint, formaldehyde, etc-and those that have no readily identifiable cause but can be described only by a group of symptoms known as sick building syndrome (SBS). Although objective physiologic abnormalities are generally not found and permanent sequelae are rare, the symptoms of SBS can be uncomfortable, even disabling, and whole workplaces may be rendered non-functional. In assessment of patients with SBS complaints, specific building-related illnesses should be ruled out by history or physical examination. On-site assessment of buildings is extremely useful. Symptoms of non-specific building-related illnesses are common ; their heterogeneity suggests that they do not represent a single disorder. Although there is little convincing, direct evidence to implicate specific causative agents, there is sufficient indirect evidence to support a number of recommendations. For example, it seems prudent to maintain an outdoor-air supply of more than 10 liters per second per person ; to select the building materials, furnishings, and equipments that are least likely to release pollutants such as formaldehyde or volatile organic compounds ; to ensure proper maintenance and cleaning ; and to avoid materials that may act as substrates for the proliferation of microbes or dust mites.
Asbestos ; Construction Materials ; Dust ; Fever ; Formaldehyde ; Humans ; Humidifiers ; Legionellosis ; Mites ; Paint ; Physical Examination ; Population Characteristics ; Sick Building Syndrome ; Volatile Organic Compounds

This report aimed to discuss two nearly identical cases of primary conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma mimicking allergic conjunctivitis. Two patients were referred to the Department of Ophthalmology, Ilsan Paik Hospital, Inje University because of the intractability to conventional treatment for initially diagnosed allergic conjunctivitis. On ocular examinations, normally pigmented, giant papillae-like lesions were found in the bilateral upper conjunctivae. Excisional biopsies were performed. Histopathologic and immunohistochemical examinations of the conjunctival biopsies revealed MALT lymphoma in both patients. The patients subsequently received radiation therapy and achieved complete remission with no evidence of recurrence during the follow-up periods of 13 and 11 months, respectively. Ophthalmologists should be reminded that a primary conjunctival low-grade malignant lymphoma may masquerade as allergic conjunctivitis with similar clinical features.
Biopsy ; Conjunctiva ; Conjunctivitis, Allergic* ; Follow-Up Studies ; Humans ; Lymphoid Tissue* ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Ophthalmology ; Recurrence

No abstract available.

The reciprocal interaction between sleep and pain has been reported by numerous studies. Patients with acute or chronic pain often complain of difficulty falling asleep, frequent awakenings, shorter sleep duration, unrefreshing sleep, and poor sleep quality in general. According to the majority of the experimental human studies, sleep deprivation may produce hyperalgesic changes. The selective disruption of slow wave sleep has shown this effect more consistently, while results after selective REM sleep deprivation remain unclear. Patients with chronic pain have a marked alteration of sleep structure and continuity, such as frequent sleep-stage shifts, increased nocturnal awakenings, decreased slow wave sleep (SWS), decreased rapid eye movement (REM) sleep, and alpha-delta sleep. Many analgesic medications can alter sleep architecture in a manner similar to the effects of acute and chronic pain, suppressing SWS and REM sleep.
Chronic Pain ; Humans ; Sleep Deprivation ; Sleep, REM

OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) not only causes respiratory disturbances during sleep but also decreases the quality of nocturnal sleep through sleep fragmentation and sleep structure change. We aimed at comparing the changes in sleep fragmentation and structure between baseline (diagnostic) nocturnal polysomnography (NPSG) and nCPAP (nasal continuous positive airway pressure) titration trial. METHODS: One hundred and three patients with a baseline night of respiratory disturbance index (RDI) of 5 or greater and reduced RDI score during nCPAP titration night were retrospectively selected for the study. Sleep fragementation and sleep structure between baseline NPSG and the NPSG during nCPAP titration were compared. Sleep fragmentation index (SFI) was defined as the total number of awakenings and shifts to stage 1 sleep divided by the total sleep time in hour. SFI and other polysomnographic parameters were statistically compared between the two nights. RESULTS: SFI during baseline NPSG and nCPAP titration nights were 29.0+/-13.8 and 15.2+/-8.8, respectively, indicating a significant SFI decrease during nCPAP titration (t=9.7, p<0.01). SFI showed significant negative correlations with sleep efficiency (r=-0.60, p<0.01) and total sleep time (r=-0.45, p<0.01) and a positive correlation with RDI (r=0.28, p<0.01). CONCLUSION: Use of nCPAP, even during the titration, significantly decreases sleep fragmentation and improves sleep structure in OSAS patients. We suggest that SFI may be utilized as a measure of assessing OSAS severity and nCPAP efficacy.
Humans ; Polysomnography ; Retrospective Studies ; Sleep Apnea, Obstructive ; Sleep Deprivation

Sleep-related behaviors observed in parasomnias can result in serious injuries of patients and/or spouses. Parasomnia is defined as undesirable physical or behavioral phenomenon occurring during sleep. If these disorders are accurately diagnosed, effective treatments are available. Often, these disorders can be even cured. Environmental management for patient and/or spouse safety and good sleep hygiene are the most recommended for individuals behaving abnormally during sleep. The aim of this article is to review the clinical features, diagnosis and treatment of several sleep-related behavior disorders.
Diagnosis ; Humans ; Hygiene ; Mental Disorders ; Parasomnias ; Spouses

BACKGROUND: Plasmodium vivax malaria was recently re-presenting infectious disease in Korea since was being controlled for about 10 years age, but has been increasing years by year in the soldiers or farmers working at the near Demilitarized Zone(DMZ). So we analyzed the Characteristics of the patients diagnosed as malaria since 1997 in Yeungnam university hospital. METHODS: From January 1997 to August 1999, the 23 patients complainted of the febrile and chilly sense were diagnosed as Plasmodium vivax malaria in Yeungnam university hospital. We analyzed the patient's records for clinical findings(i.e. clinical symptoms and signs), occupation and regions of working or visiting, laboratory findings, treatment and its results, etc. RESULTS: Male patients were 21 and female patients were 2 among the total 23 patients, the 19 of 21 male patients were soldiers discharged from military services. All patients had been visited or worked near the DMZ, as the northern part of Kyungki-do(21 cases) or Kangwon-do(2 cases). And all patients complainted of delayed onset(means 6 months) of fever and chills after working or visiting at this zones. On physical examination, liver or spleen were palpated initially at least 1 finger breadth in 9 cases(39.1%), and peripheral blood smears showed the infected RBCs(i.e. gametocyte, ring form, schizont, trophozoite) in all cases, and 21 cases(91.3%) showed thrombocytopenia. All patients were treated by the combined regimen of 2-days hydroxychloroquine and 14-days primaquine. All cases showed clinical and laboratory improvement initially, but 5 cases were recurred after 2 months and showed re-improvement. And none of 23 cases showed the significant complications and deaths after medical treatment. CONCLUSION: Plasmodium vivax malarial infection is currently re-presenting disease near the DMZ. So we should consider the active prevention and management of malaria.
Chills ; Communicable Diseases ; Female ; Fever ; Fingers ; Humans ; Hydroxychloroquine ; Korea ; Liver ; Malaria ; Malaria, Vivax* ; Male ; Military Personnel ; Occupations ; Physical Examination ; Plasmodium vivax* ; Plasmodium* ; Primaquine ; Schizonts ; Spleen ; Thrombocytopenia

BACKGROUND: The medicolegal problems can be occurred in all medical field, Especially ED can be more exposed to the legal claims due to the very nature of ED business and characteristics of ED patient (or their family member). All emergency physicians, as a ED manager, should be concerned about the law associated with emergency cairo for handling the medicolegal problem. So they can deal with and prevent the legally risky situations that may be occurred in ED practice. Ultimately we can reduce the risk of a malpractice lawsuit and provide good emergency care services. SUGGESTION: The authors would like to suggest several items that we have thought the ED physicians and managers always have to remember to manage the medicolegally risky situations. 1. Every member of ED health care team must be trained in understanding the patients' wants and desires. 2. The emergency physicians and nurses must realize that they are the best risk management tools in the hospital. 3. ED physician should have the knowledge of the law associated with emergency health care. 4. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care providers of every health care institutes. 5. We should never forget the time honored sentences, 'Good medicine is good law'.
Academies and Institutes ; Commerce ; Delivery of Health Care ; Emergencies ; Emergency Medical Services ; Empathy* ; Health Personnel ; Humans ; Jurisprudence ; Malpractice ; Patient Care Team ; Risk Management