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

We present two patients with a cerebral palsy who developed cervical myelopathy long from term involuntary movements. Frequently instability with a premature onset of spondylosis of the cervical spine is found in an athetoid cerebral palsy patient. These structural abnormalities appear to be related to the athetoid motion of neck in a cerebral palsy. The combination of a disk degeneration and listhetic instability with a narrow canal predisposes these patients for the relatively rapid progression to a devastating neurological defect. Early surgical management is a treatment of choice for the cervical myelopathy associated with an athetoid cerebral palsy.
Cerebral Palsy* ; Dyskinesias ; Humans ; Intervertebral Disc Degeneration ; Neck ; Spinal Cord Diseases* ; Spine ; Spondylosis

Objective: The purpose of this study was to analyze the symptoms of depression, anxiety, and childhood trauma in functional gastrointestinal disorder (FGID) patients who visited the brain-gut axis clinic. Methods: The study participants included 99 individuals who were diagnosed with FGID by gastroenterologists, 88 individuals who had no FGID but showed symptoms of FGID based on the Rome criteria, and 79 individuals who did not show any symptoms or were diagnosed with FGID. Symptoms of depression, anxiety, and childhood trauma were evaluated by the Korean version of Beck-depression inventory-II (K-BDI-II), Korean version of Beck anxiety inventory (K-BAI), and Korean version of childhood trauma questionnaire (K-CTQ), respectively. Results: The BDI score, BAI score, and CTQ score were significantly different between the groups. The group also had higher odds for developing anxiety as compared to the control group (odds ratio [OR] = 10.215, 95% confidence intervals [CI]: 2.49−41.76). Additionally, the FGID group had higher odds for developing symptoms of depression (OR = 5.554, 95% CI: 2.06−14.97) and experiencing physical violence (OR = 3.128, 95% CI: 1.53−6.38) than the non-FGID group. Conclusion This study showed that FGID patients were more likely to have symptoms of depression, severe anxiety, and childhood trauma, which were the risk factors of FGID.

Achalasia is a rare primary esophageal motility disorder characterized by the loss of enteric neurons leading to an absence of peristalsis and impaired relaxation of the lower esophageal sphincter. The subsequent stasis of ingested food not only leads to symptoms of dysphagia, regurgitation, chest pain, and weight loss, but also results in an increased risk of esophageal carcinoma. Structural or functional pulmonary abnormalities occur in more than half of patients and may be due to recurrent aspiration or tracheal compression from a dilated esophagus. Delayed diagnosis or ineffective intervention may lead to progressive dilation of the esophagus and the development of a megaesophagus. Respiratory distress and cardiopulmonary arrest from tracheal or left atrial compression secondary to a megaesophagus are rare complications of achalasia. There is only limited evidence that pneumatic dilation may be used as a first-line therapy for a megaesophagus. The choice of definitive treatment will depend on many factors including achalasia type, patient wishes, performance status, and surgical expertise.

OBJECTIVES: This study aimed to compare the psychosocial characteristics among patients with functional gastrointestinal disorder (FGID), adults with functional gastrointestinal symptoms, and normal control group and investigate factors related to quality of life (QoL) of FGID patients. METHODS: 65 patients diagnosed with FGID were selected. 79 adults were selected as normal control group based on the Rome III diagnostic criteria, and 88 adults who showed functional gastrointestinal symptoms were selected as “FGID positive group”. Demographic factors were investigated. Psychosocial factors were evaluated using the Korean-Beck Depression Inventory-II, Korean-Beck Anxiety Inventory, Korean-Childhood Trauma Questionnaire, Multi-dimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and WHO Quality of Life Assessment Instrument Brief Form. A one-way ANOVA was used to compare differences among groups. Pearson correlation test was used to analyze correlations between QoL and psychosocial factors in patients with FGID. RESULTS: There were group differences in the education level. Depression (F=29.012, p<0.001), anxiety (F=27.954, p<0.001) and Childhood trauma (F=7.748, p<0.001) were significantly higher in FGID patient group than in both FGID-positive and normal control group. Social support (F=5,123, p<0.001), Resilience (F=9.623, p<0.001) and QoL (F=35.991, p<0.001) were significantly lower in the FGID patient group than in others. QoL of FGID patients showed a positive correlation with resilience (r=0.475, p<0.01), and showed a negative correlation with depression (r=−0.641, p<0.01), anxiety (r=−0.641, p<0.01), and childhood trauma (r=−0.278, p<0.05). CONCLUSIONS: FGID patients have distinctive psychosocial factors compared to the both FGID-positive and normal control group. Therefore, the active interventions for psychosocial factors are required in the treatment of patients with FGID.
Adult ; Anxiety ; Demography ; Depression ; Education ; Gastrointestinal Diseases ; Humans ; Psychology ; Quality of Life

The prevalence of gastroesophageal reflux disease (GERD) in Western countries ranges between 10% and 20%. Although GERD is increasing in Korea, it is difficult to actively conduct studies due to restrictions in insurance regulations and there are practical limitations to prescribe drugs conforming the evidence-based guidelines. As novel drug therapy for GERD, drugs with new mechanisms that would overcome pharmacokinetic limits of proton pump inhibitors are being investigated. In this review, with regards to drug therapy of GERD, we discuss management strategies suitable for domestic circumstances and drugs that are being newly developed.
Gastroesophageal Reflux ; Insurance ; Korea ; Prevalence ; Proton Pump Inhibitors ; Social Control, Formal

No abstract available.
Muscle, Smooth* ; Smooth Muscle Tumor*

PURPOSE: This study was conducted to perform a comparative analysis of the efficacy and safety of conventional transurethral resection of the prostate (TUR-P), transurethral resection in saline (TURIS), and TURIS-plasma vaporization (TURIS-V) when performed by a single surgeon for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: The clinical data of 73 consecutive men who underwent conventional TUR-P (39), TURIS (19), or TURIS-V (15) for BPH were retrospectively analyzed. All procedures were carried out by a single surgeon between October 2007 and April 2010. The patients were assessed preoperatively and perioperatively and were followed at 1, 3, and 6 months postoperatively. Patient baseline characteristics, perioperative data, and postoperative outcomes were compared, and major complications were recorded. RESULTS: In all groups, significant improvements in subjective and objective voiding parameters were achieved and were sustained throughout follow-up. TURIS-V had the shortest operation time compared with conventional TUR-P and TURIS (p=0.211). TURIS-V significantly decreased procedural irrigation fluid volume, postoperative irrigation duration, catheter duration, and hospital stay compared with conventional TUR-P and TURIS. There were no significant differences between the groups in hemoglobin levels or serum sodium levels before and after the operations. There were three transfusions and four clot retentions in the TUR-P group, and one transfusion and one clot retention in the TURIS group. The TURIS-V group had no complications. CONCLUSIONS: TURIS and TURIS-V were effective for the surgical treatment of BPH in addition to conventional TUR-P. TURIS-V was not inferior to conventional TUR-P or TURIS in terms of safety.
Catheters ; Follow-Up Studies ; Hemoglobins ; Humans ; Length of Stay ; Male ; Pilot Projects ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Retention (Psychology) ; Retrospective Studies ; Sodium ; Transurethral Resection of Prostate ; Urologic Surgical Procedures ; Volatilization

OBJECTIVE: The purpose of this study was to investigate the characteristics of psychological factors that are related to irritable bowel syndrome (IBS) and their effects on the quality of life (QOL) of firefighters in South Korea. METHODS: This study examined data collected from 1217 firefighters in South Korea. After identifying firefighters with IBS according to the Rome III diagnostic criteria for functional gastrointestinal disorders (FGIDs), we collected demographic data and psychological variables through self-administered questionnaires. In order to observe the distribution of the high-risk group in the Korean occupational stress scale (KOSS) subcategories, we conducted logistic multiple linear regression. The correlations between psychological factors and QOL were analyzed and we performed a stepwise regression analysis. RESULTS: The groups (firefighters with and without IBS) showed differences by sex, working period, task, working pattern, Patient Health Questionnaire-9, Generalized Anxiety Disorder Questionnaire-7, Korean Occupational Stress Scale, Rosenberg's Self-Esteem Scale, and the World Health Organization Quality of Life-BREF. IBS risk was higher in the following KOSS subcategories: job demand (OR 1.79, 95% CI: 1.11–2.89), interpersonal conflict (OR 2.21, 95% CI: 1.25–4.33), organizational system (OR 1.87, 95% CI: 0.58–3.30), and lack of reward (OR 2.39, 95% CI: 1.08–5.26). The final regression model explained 42.6% of the variance in overall quality of life. CONCLUSION: The findings of this study indicate that a number of psychological factors increase the likelihood of irritable bowel syndrome (IBS) and affect QOL. Therefore, when diagnosing IBS in the future, mental health aspects should be considered in addition to physical health.
Anxiety Disorders ; Depression ; Firefighters* ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome* ; Korea* ; Linear Models ; Mental Health ; Psychology* ; Quality of Life* ; Reward ; World Health Organization

OBJECTIVES: The purpose of this study was to investigate the characteristics of psychosocial factors related to functional dyspepsia(FD) and their effects on quality of life(QOL) in firefighters. METHODS: This study examined data collected from 1,217 firefighters. We measured psychological symptoms by Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder questionnaire(GAD-7), Korean Occupational Stress Scale(KOSS), Ways of Coping checklist(WCCL), Rosenberg's Self-Esteem Scale(RSES) and World Health Organization Quality of Life Scale abbreviated version(WHOQOL-BREF). Chi-square test, independent t-test, Pearson's correlation test, logistic regression analysis, and hierarchical regression analysis were used as statistical analysis methods. RESULTS: For the group with FD, the male participants showed significantly higher frequency(p=0.006) compared to the female participants. The group with FD had higher scores for depressive symptoms(p<.001), anxiety (p<.001), and occupational stress(p<.001), and did lower scores for self-esteem(p=.008), quality of life(p<.001) than those without FD. The FD risk was higher in the following KOSS subcategories: job demand(OR 1.94, 95% CI : 1.29-2.93), lack of reward(OR 2.47, 95% CI : 1.61-3.81), and occupational climate(OR 1.51, 95% CI : 1.01-2.24). In the hierarchical regression analysis, QOL was best predicted by depressive symptoms, self-esteem, and occupational stress. Three predictive variables above accounts for 42.0% variance explained of total variance. CONCLUSIONS: The psychosocial factors showed significant effects on FD, and predictive variables for QOL were identified based on regression analysis. The results suggest that the psychiatric approach should be accompanied with medical approach in future FD assessment.
Anxiety ; Anxiety Disorders ; Depression ; Dyspepsia* ; Female ; Firefighters* ; Humans ; Logistic Models ; Male ; Psychology* ; Quality of Life* ; World Health Organization