In order to evaluate the possible roles of secretory proteases in the pathogenesis of amoebic keratitis, we purified and characterized a serine protease secreted by Acanthamoeba lugdunensis KA/E2, isolated from a Korean keratitis patient. The ammonium sulfate-precipitated culture supernatant of the isolate was purified by sequential chromatography on CM-Sepharose, Sephacryl S-200, and mono Q-anion exchange column. The purified 33 kDa protease had a pH optimum of 8.5 and a temperature optimum of 55 degrees C. Phenylmethylsulfonylfluoride and 4- (2- Aminoethyl) -benzenesulfonyl-fluoride, both serine protease specific inhibitors, inhibited almost completely the activity of the 33 kDa protease whereas other classes of inhibitors did not affect its activity. The 33 kDa enzyme degraded various extracellular matrix proteins and serum proteins. Our results strongly suggest that the 33 kDa serine protease secreted from this keratopathogenic Acanthamoeba play important roles in the pathogenesis of amoebic keratitis, such as in corneal tissue invasion, immune evasion and nutrient uptake.
Acanthamoeba/*enzymology/isolation & purification/pathogenicity ; Acanthamoeba Keratitis/*parasitology ; Animals ; Cornea/parasitology ; Humans ; Hydrogen-Ion Concentration ; Korea ; Serine Endopeptidases/chemistry/*isolation & purification/*metabolism ; Substrate Specificity ; Temperature ; Virulence Factors

The authors reviewed the histories of the use of the term empathy, the different meanings of empathy, the origins of empathetic abilities, the referents for empathy, the paradoxical attitude of empathy, the therapeutic effect of empathy and the inadequate uses of empathy by referring to the recent psychoanalytic articles. We wanted to provide the psychoanalytic understanding of empathy for analytic psychotherapists. The important points for the psychoanalytic understandings of empathy were as follows:First, empathy is not a goal, but a method in the therapeutic process. Second, the empathetic attitude can be started at the beginning of treatment, yet it takes time for empathy to function in the treatment. Third, when providing empathy, a therapist needs both a subjective sense of sympathy for a patient and objective observation of the interaction between them during the treatment sessions. Fourth, a therapist needs to decrease his/her own narcissistic and omnipotent aspects and to use structured receptivity when providing empathy. Fifth, the process of empathy can be thought to be the result of the interaction between the patient and the therapist. Sixth, it may be more useful for a therapist to understand a patient through empathy rather than to provide a cure for a patient through empathy.
Empathy ; Humans ; Psychoanalysis

OBJECTIVES: This study aims to analyze the association between the severity of sleep apnea, sleep and mood related scales, and activity during sleep in obstructive sleep apnea syndrome (OSAS) patients. METHODS: One hundred seventy six drug-free male patients confirmed as OSAS (average age=43+/-11 years) were selected through nocturnal polysomnography (NPSG). OSAS was diagnosed with apnea-hypopnea index (AHI) >5, mean AHI was 39.6+/-26.0. Sleep related scales were Stanford Sleepiness Scale (SSS), Epworth Sleepiness Scale (ESS), Pittsburg Sleep Quality Index (PSQI) and Morningness-Eveningness Scale (MES). Mood related scales were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI) I, II and Profile of Mood States (POMS). NPSG was performed overnight with both wrist actigraphy (WATG). Parameters produced from WATG were total activity score, mean activity score and fragmentation index. We analyzed the correlation between each scale, AHI scored from NPSG and activity score analyzed from WATG. RESULTS: ESS showed significant positive correlation with PSQI, BDI, BAI and STAI I, II, respectively (p<0.01). SSS showed significant positive correlation with PSQI and BAI (p<0.05, p<0.01). BAI showed significant positive correlation with total activity score, mean activity score and fragmentation index (p<0.05, p<0.01, p<0.05). Total activity score showed significant positive correlation with ESS and BAI, respectively (p<0.05). Fragmentation index showed significant positive correlation with ESS, PSQI and BAI (p<0.05, p<0.01, p<0.05). AHI, indicator of sleep apnea is showed no significant correlation with each sleep and mood related scale. CONCLUSION: The degree of daytime sleepiness tends to be associated with night sleep satisfaction, depression and anxiety, and the activity during sleep rather than the severity of sleep apnea.
Actigraphy ; Anxiety ; Depression ; Humans ; Male ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Weights and Measures ; Wrist

No abstract available.
Spinal Stenosis*

No abstract available.

Verrucous carcinoma is a low-grade squamous cell carcinoma first described in 1948 by Ackerman. It is a slowly growing, fungating and verrucous tumor that may penetrate deep into the tissue. There are many causative agents such as HPV infection, chronic irritation, radiation, and etc. We report a case of verrucous carcinoma developed at the wrist joint, a relatively unusual site.

OVJECTIVES: As the attention devoted to children's mental health increases, medical costs and burdens mount as well. In the present study, we evaluated the association between socioeconomic status (SES) and major child psychiatric symptoms. METHODS: The subjects of this study were children of recruited from a mental health screening program in the Seoul Sungbuk mental health center over the course of 3 months. To establish the SES of each child, we collected data about each child's medical insurance, years of parental education, household income, family structure and housing. 149 children& parents completed questionnaires including the Childhood Depression Inventory (CDI) and the Korean Attention Deficit Hyperactivity Disorder Rating Scale (K-ARS). RESULTS: The mean K-ARS-P score was 12.1+/-11.1 and the suspected prevalence of ADHD was 20.8% (n=31). The mean CDI score was 12.9+/-7.9, and the prevalence of suspected depression was 16.8% (25). Depressive symptoms and ADHD symptoms were both more severe than those observed in a previous epidemiologic study in Korea. Depressive symptoms were more closely associated with family SES status. CONCLUSION: SES status is one of the most important risk factors in the development of major child psychiatric symptoms. In our study we found that depressive symptoms in particular were most tightly associated with psychosocial factors. Evaluation of the risk factors, early screening and intervention for low SES children would be valuable mental health management tactics to implement in a community mental health system.
Attention Deficit Disorder with Hyperactivity ; Child ; Depression ; Epidemiologic Studies ; Family Characteristics ; Housing ; Humans ; Insurance ; Korea ; Mass Screening ; Mental Health ; Parents ; Prevalence ; Risk Factors ; Social Class ; Surveys and Questionnaires

The authors reviewed the meanings of a psychoanalytic setting, which is composed of a patient's free association and an analyst's analytic neutrality. In particular, this was done by discussing the definitions of a psychoanalytic setting, the functions of free association, and the development of the meanings of analytic neutrality over time. The purpose this wasto provide an understanding of a psychoanalytic setting for psychoanalytic therapists. To fully understanda psychoanalytic setting, the several points must be considered. Firstly, a patient's introspection about his/her inner world in the presence of an analyst in a psychoanalytic setting facilitates the development of the psychoanalytic process. Secondly, both a patient's reflective functioning of his/her mental process and a patient's relational experiences of transference feelings toward their analyst is important for analytic treatment. Thirdly, a patient's progress withfree association during treatment sessions indicates spontaneity, a motivation to be cured from a patient's standpoint. Fourthly, a patient and an analyst become aware of the meaning of a patient's materials from free association through the process of Ed-highlight: Unclear. I'm not sure what you mean by this word. Are you referring to the patient's thoughts or feelings? free association itself. Fifth, the main aim of analytic neutrality is to understand the patient's psychic reality, and it is important to understand this reality through interaction between a patient and an analyst
Free Association ; Humans ; Motivation ; Psychoanalysis

OBJECTIVE: To evaluate working condition in way of measuring working posture and muscle tension using the desktop personal computer and notebook personal computer having different screen height. METHOD: Seventeen healthy men performed wordprocessing task in three workstation: desktop PC on the conventional computer table (DPC (on)); desktop PC under the 'inside' type computer table (DPC (under)); notebook PC on the table (NPC). The viewing distance and angle, head and neck angle, thoracic bending and trunk inclination were measured. Muscle tension of right posterior neck muscle, upper trapezius, sternocleidomastoid (SCM), and upper back muscle was also measured by integrated electromyogram (IEMG). RESULTS: 1) The viewing distance was the longest in DPC (under). 2) The lower the screen height, the more downward viewing angle and more flexed position in upper neck. 3) The posterior neck muscle tension was the lowest in DPC (on). 4) Stooped position was most frequently seen in NPC and the highest tension of posterior neck muscle and upper back muscle was shown in NPC. 5) In relation between postural analysis and muscle tension, muscle tension decreased with increasing backward reclining position, and the neck and thorax became more erect with increasing in viewing distance. CONCLUSION: These results suggest that the stooped posture was worst and most frequently seen in NPC. If neck flexion is avoided, DPC (under) position could lessen the visual and musculoskeletal problem. More Ergonomical study would be needed about working posture using computer.
Back Muscles ; Head ; Humans ; Male ; Microcomputers ; Muscle Tonus* ; Neck ; Neck Muscles ; Posture* ; Superficial Back Muscles ; Thorax

Trauma to the auricle is common given its prominent position, and various methods for ear reconstruction exist. Herein, we present our experience of ear reconstruction using diced autogenous cartilage. A 72-year-old woman fell from a 1-m height, damaging her ear in the process. The ear helix, which was approximately 3.5×3 cm² in size, was amputated. The cartilage was diced into 1-mm pieces. The detached skin was made into a pocket and filled with the diced cartilage. Molding was performed with tie-over dressings on the anterior and posterior areas of the scaphoid fossa. Ten days post-surgery, the wound showed signs of successful recovery, and the contour of the ear helix was maintained. Ten months later, the cartilage in the damaged ear helix was intact. Conventional composite grafts on amputated ears have size limitations and exhibit significant resorption, and loss of anatomical structures and stability often occur. In this case, the operating time required to complete the composite graft was short, and molding the contour was not complex. The original ear structure was maintained over the long term and did not require an additional operation for aesthetic purposes. We believe that this is a useful method for the reconstruction of an amputated ear.
Aged ; Bandages ; Cartilage ; Ear ; Female ; Fungi ; Humans ; Methods ; Skin ; Transplants ; Wounds and Injuries