No abstract available.
Antioxidants* ; Oxidative Stress*

OBJECTIVES: Continuous positive airway pressure (CPAP) is effective in the treatment of obstructive sleep apnea syndrome (OSAS), but the major limitation of CPAP may be poor compliance. The aims of the study were to investigate the compliance and side effects of CPAP, and to evaluate the efficacy of CPAP in patients with OSAS. METHODS: This study enrolled 106 patients with OSAS who took the CPAP treatment. The severity of daytime sleepiness was measured using Epworth Sleepiness Scale (ESS), and sleep quality and depressive symptoms were assessed by Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), respectively. RESULTS: During 29 months of the study period, 41.5% of patients were using CPAP and 38.7% of patients stopped using it. Compared to non-compliant patients, compliant patients had a higher PSQI score and obstructive apnea index. Among non-compliant patients, 51.2% of them stopped using CPAP within 1months. 85.7% of non-compliant patients were discomforted by the CPAP, but much more nasopharyngeal symptoms were reported in the compliant group. ESS (p<0.01), PSQI (p<0.01) and BMI (p<0.01) were reduced significantly after CPAP treatment but not BDI (p=0.86). CONCLUSIONS: We concluded that CPAP can reduce the daytime sleepiness, nocturnal sleep disturbance, and body mass index. To increase the compliance of CPAP, we suggested that some education and support is needed at the early stage of the CPAP treatment.
Apnea ; Body Mass Index ; Compliance* ; Continuous Positive Airway Pressure ; Depression ; Education ; Humans ; Sleep Apnea, Obstructive*

Because the postmortem changes rapidly distort values of many constituents in the body fluids, the determination of postmortem chemical changes and relation among body fluids is very important in medicolegal community. A laboratory result is not useful if appropriate data for comparison are lacking. The aim of this paper is to determine the reference ranges and the postmortem changes for chemical constituents in postmortem specimen. We examined 17 clinical laboratory parameters in cadaveric blood and vitreous humor obtained from 51 autopsy cases. The mean, standard error, standard deviation and confidence interval of all measured constituents were shown in Table 2 & Figure 1. The postmortem blood level of amylase, phosporus, LDH, ALT, AST and CPK are very higher than those of antemortem blood. The postmortem vitreous level of total bilirubin, triglyceride, GGT, alkaline phosphatase, albumin, total protein and cholesterol are very low and is not reliable. The ratio of vitreous/blood in calcium, BUN, creatine and uric acid are 0.74, 0.68, 0.29 and 0.23 in decreasing orders(Table 3,4). For the medical examiner or pathologist, routine chemical examinations of the vitreous humor can provide evidence of abnormality not apparent in gross or microscopic examination of the tissue. A more extensive study will be required, using a larger number of subjects, to establish the full range of variability.
Alkaline Phosphatase ; Amylases ; Autopsy ; Bilirubin ; Body Fluids ; Cadaver ; Calcium ; Cholesterol ; Confidence Intervals ; Coroners and Medical Examiners ; Creatine ; Humans ; Postmortem Changes ; Reference Values ; Triglycerides ; Uric Acid ; Vitreous Body

Fisting is an uncommon sexual activity, and death due to fisting is very rare. In the present report, we describe a case of a woman who died from fisting by her male partner. A 38-year-old woman went to a motel with a man after consuming alcohol, and there they kissed each other. As desired by woman, the man inserted his fingers into her vagina and anus, and later inserted his fist and forearm into her vagina and anus. After 20-30 minutes of fisting, the woman became unconscious and died. The autopsy confirmed the presence of perineal and vaginal lacerations with massive internal pelvic soft tissue injury with uterine artery rupture. A partial tear was noted at the rectosigmoid junction. The cause of death was hypovolemic shock due to uterine artery rupture. Following court trials, the assailant was sentenced to 4 years of imprisonment for the felony of inflicting bodily injury resulting in death.
Anal Canal ; Autopsy ; Cause of Death ; Female ; Fingers ; Forearm ; Humans ; Lacerations ; Male ; Rupture ; Sexual Behavior ; Shock ; Soft Tissue Injuries ; Unconscious (Psychology) ; Uterine Artery ; Vagina

PURPOSE: This study was done to identify and compare nursing performance including job stress, emotional labor and burnout between nurses who work in comprehensive nursing care service wards and general wards. METHODS: Participants were 187 nurses working in a general hospital in Busan which provides comprehensive nursing care service (comprehensive nursing care service ward: 95, general ward: 92). Data were collected using questionnaires and analyzed using descriptive statistics, χ² test, t-test, ANOVA, and multiple regression with the SPSS/WIN 23.0 program. RESULTS: There was no significant difference in the variables between comprehensive nursing care service ward nurses and general ward nurses. Factors influencing burnout were emotional labor in comprehensive nursing care service ward nurses while job stress and emotional labor were the factors influencing burnout in general ward nurses. CONCLUSION: The findings of this study indicate that comprehensive nursing care service can be a positive delivery system for nurses. Therefore, there is a need for strategies to integrate comprehensive nursing care service systematically.
Busan ; Hospitals, General ; Nursing Care* ; Nursing* ; Patients' Rooms* ; Stress, Psychological*

Forty-nine lobectomized hepatocellular carcinomas(HCC) were classified according to the gross anatomical features. Because the presence of cirrhosis in the remaining liver has a good clinico-pathological implication, cases of HCC were divided into non-cirrhotic(non-LC) and cirrhotic(LC) groups. In both groups, the tumors themselves belonged to either expanding, focal spreading, spreading or mixed type. Another special type, which has been called a "diffuse type" is added in the LC group with the name of "cirrhotomimetic type" Among 49 cases, 21 belonged to the non-LC group and 28 to the LC group. Most common was expanding type(20 cases, 40.8%), which was followed by spreading(32.7%), focal spreading(16.3%), mixed(6.1%) and cirrhotomimetic(4.1%) types. Expanding type of the LC group was the single most common type(13 cases, 26.5%). The accordance rate of gross typing was 0.94. Tumor masses of the LC group showed a greater tendency of having a fibrous capsule(60.7%) and a lobulated cut surface(82.1%), in contrast to those of the non-LC group (28.6% and 42.9% respectively). The patient's age and the HBsAg seropositivity were not different between the groups and between the types. Increased serum level of AFP was particularly frequent in the spreading type(81.3%) of both groups and in the cirrhotomimetic type(100%).
Carcinoma, Hepatocellular

No abstract available.
Child* ; Drug Therapy* ; Graves Disease* ; Humans ; Receptors, Thyrotropin* ; Thyroid Function Tests* ; Thyroid Gland*

Vertigo mimicking labyrinthine lesions may have resulted from ischemic insult to the inner ear or the vestibular nerve and nucleus in the AICA infarction syndrome. A 56-year-old female was admitted to the emergency room with vertigo and hearing loss in right ear. On neurological examination, she had left beating jerky torsional and horizontal nystagmus with falling and past pointing to right side. Brain magnetic resonance images showed high signal intensity in anterolateral portion of inferior pons on T2- weighted images. Severe right facial palsy of peripheral type developed 24 hours after admission. Audiometry and electronystagmography documented absent auditory and vestibular function on the affected side. We argue that vertigo of the acute infarction in AICA territory can be involved the eight and seventh nerve root entry zoon and mimic labyrinthine lesions
Audiometry ; Brain ; Ear ; Ear, Inner ; Electronystagmography ; Emergency Service, Hospital ; Facial Nerve* ; Facial Paralysis ; Female ; Hearing Loss ; Humans ; Infarction* ; Middle Aged ; Neurologic Examination ; Nystagmus, Pathologic ; Pons ; Vertigo* ; Vestibular Nerve

Neonatal alloimmune thrombocytopenia(NAIT) is a rare disease caused by maternal alloimmunization against fetal platelet surface antigen, which is mainly platelet specific alloantigen or human leukocyte antigen(HLA). During routine hemotology, we accidentally discovered thrombocytopenia in a female fullterm newborn admitted due to jaundice. We excluded NAIT due to human platelet alloantigen(HPA), because the HPA of the mother and baby were the same on PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism). Mother's serum was tested for lyrnphocytotoxity against 36 donor lymphocytes, and anti-HLA A2, A24 and B58 were found. HLA typing of the father and baby revealed A2 antigen which was not present on the mothers lymphocytes. The patient received concentrated platelet and intravenous globulin. Her platelet count increased to 222,000/mm from 3,000/mm on the 11th day of life. We described a case of NAIT due to anti-HLA A2 antibody with a detailed clinical feature. (J Korean Pediatr Soc 1999;43:861-865)
Antigens, Surface ; Blood Platelets ; Fathers ; Female ; Histocompatibility Testing ; Humans ; Infant, Newborn ; Isoantigens ; Jaundice ; Leukocytes ; Lymphocytes ; Mothers ; Platelet Count ; Rare Diseases ; Thrombocytopenia ; Thrombocytopenia, Neonatal Alloimmune* ; Tissue Donors

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