Relatively little is known about the neurobiology of insomnia, despite its wide prevalence and broad medical impact. Although much is still to be learned about the pathophysiology of the disorder, identification, systematic assessment, and appropriate treatment are clearly beneficial to patients. Recent research, using quantitative EEG, polysomnography (PSG), multiple sleep latency test (MSLT) and neuroimaging techniques, suggests that some broad areas can be identified as possible pathophysiological models. Sleep-wake homeostat model hypothesizes a failure in homeostatic regulation of sleep, an attenuated increase in sleep drive with time awake, and/or defective sensing of sleep need. Circadian clock model hypothesizes a dysfunctional circadian clock, resulting in changes in the timing of sleep-wake propensity that are incompatible with normal sleep. Intrinsic sleep-wake state mechanism model suggests that abnormal function of insomnia comprises the systems responsible for expression of the sleep states themselves. Extrinsic over-ride mechanism (stress-response) model suggests that insomnia reflects the consequences of overactivity of one of the systems considered "extrinsic" to normal sleep-wake control. Many current therapies for insomnia are based on these physiological models. Several attempts have been made to create a physiological model that would explain this disorder and could be used as a foundation for treatment. However, it appeared that no model can fully explain and clarify all aspects of insomnia. Future research should be necessary to expand our knowledge on the biological dimensions of insomnia.
Circadian Clocks ; Electroencephalography ; Humans ; Neurobiology ; Neuroimaging ; Polysomnography ; Prevalence ; Sleep Initiation and Maintenance Disorders

No abstract available.

The cyclophilins (Cyps) are family members of proteins that exhibit peptidylprolyl cis-trans isomerase (PPIase, EC 5.2.1.8) activity and bind the immunosuppressive agent cyclosprin A (CsA) in varying degrees. During the process of random sequencing of a cDNA library made from Giardia intestinalis WB strain, the cyclophilin gene (gicyp 1) was isolated. An open reading frame of gicyp 1 gene was 576 nucleotides, which corresponded to a translation product of 176 amino acids (Gicyp 1). The identity with other Cyps was about 58-71%. The 13 residues that constituted the CsA binding site of human cyclophilin were also detected in the amino acid sequence of Gicyp 1, including tryptophan residue essential for the drug binding. The single copy of the gicyp 1 gene was detected in the G. intestinalis chromosome by southern hybridization analysis. Recombinant Gicyp 1 protein clearly accelerated the rate of cis-- Amino Acid Sequence ; Animals ; Cloning, Molecular ; Cyclophilins/antagonists & inhibitors/chemistry/genetics/*isolation&purification ; Cyclosporine/metabolism/pharmacology ; Giardia lamblia/*chemistry/genetics ; Human ; Immunosuppressive Agents ; Molecular Sequence Data ; Protein Binding ; Protozoan Proteins ; Recombinant Proteins

The prevalences of dermographism in 106 patients with atopic dermatitis and 45 patients with allergic rhinitis were studied using a dermographic tester. The results are as follows : 1. Dermographism was more common in atopic dermatitis(17.0%) than in the general population(6.7%), but no significant difference was observed between allergic rhinitis(6.7%) and general population. 2. The prevalence rates of dermographism were not significantly correlated with the level of serum IgE in both atopic dermatitis and allergic rhinitis.
Dermatitis, Atopic* ; Humans ; Immunoglobulin E ; Prevalence* ; Rhinitis*

A 24-year-old woman was seen for evaluation of an skin lesion on thiright nipple. Examination revealed a solitary 1.5 x 1cm-sized, erythematous, oozing, eroded andruted, verrucous nodule on the right nipple. A small amount of serous discharge was found but there was no pain or tenderness. Histopathologic findings showed cystic invaginations extending down vard from the epidermis and papillary projections extending into the lumina of the invagination. Pupiae were lined by two rows of cells. In stroma, there were marked inflammatory infiltrates containing any plasma cells. The overlying dermis showed an adenomatous growth pattern with a prolifertion of round, oval or irregular shaped ducts and fibrotic stroma.
Adenoma* ; Cytochrome P-450 CYP1A1 ; Dermis ; Epidermis ; Female ; Humans ; Nipples* ; Plasma Cells ; Skin ; Young Adult

No abstract available.
Humans ; Hypophosphatemia*

Prevention of fatal postoperative complications and improved management of patients with complications are important means for achieving increased survival in gastric cancer patients. A study of 390 patients undergoing gastrectomies at the Department of Surgery, Chonbuk National University Hospital, during 6 years from 1990 to 1995 was performed to examine factors related to a high rate of postoperative complications and to compare specific and non-specific complications. Postoperative complications developed in 185 (47.4%) out of the total 390 cases undergoing gastrectomies for gastric cancer; including 107 (27.4%) specific and 78 (20.0%) non-specific. Typical complications were 46 cases of diarrhea, 20 cases of intestinal obstruction including an adhesive and paralytic ileus, 16 cases of vomiting, 7 cases of anastomotic leakage, 7 cases of hemorrhage, 6 cases of anastomosis stenosis, 2 cases of duodenal stump leakage, 1 case of acute pancreatitis, 1 case of pancreatic fistula, 1 case of enterocutaneous fistula within the category of specific complications and 22 cases of elevated hepatic enzymes, 21 cases of pulmonary disease, 2 cases of abnormal EKG, 2 cases of sepsis, 2 cases of cerebral infarction, and 1 case of renal failure within the category of non-specific complications. Multivariate analysis identified combined resection, radical resection in stage IV in operative factors, blood(PRC) transfusion of over 4 units, elevation of sGOT and sGPT, age between 50 and 65, diabetic mellitus of coexistic diseases in non-operative factors as detrimental factors with an independent influence on the postoperative complications for gastric cancer. We believe that the postoperative complications for gastric cancer did not develope because of local and operative factors, but were significantly common when general and non-operative factors were combined with gastrectomy.
Adhesives ; Alanine Transaminase ; Anastomotic Leak ; Aspartate Aminotransferases ; Cerebral Infarction ; Constriction, Pathologic ; Diarrhea ; Electrocardiography ; Gastrectomy ; Hemorrhage ; Humans ; Intestinal Fistula ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction ; Jeollabuk-do ; Lung Diseases ; Multivariate Analysis ; Pancreatic Fistula ; Pancreatitis ; Postoperative Complications ; Renal Insufficiency ; Sepsis ; Stomach Neoplasms* ; Vomiting

OBJECTIVE: To determine the characteristic pattern of information processing in the children with specific language impairment (SLI) using the Kaufman-Assessment Battery (K-ABC) for children. METHOD: Thirty patients were responded to K-ABC. Twenty-three of them were diagnosed as SLI without any abnormalities in other developmental areas, visual or auditory system. Seven patients showed language delay with other developmental abnormalities. Mean chronological age of SLI patients was 61.0 months. Patterns of information processing was measured using K-ABC. Sequential processing, simultaneous processing, mental processing, and achievement scales were obtained and compared between two groups. RESULTS: In SLI patients, sequential processing, simultaneous processing, mental processing, and achievement scales were 32.9+/-34.2, 54.3+/-26.9, 42.5+/-31.1, and 33.8+/-28.7, respectively. The SLI patients showed significantly poor scales in sequential than in simultaneous processing (p<0.01). CONCLUSION: The patients with SLI exhibited significant deficits in sequential processing, whereas simultaneous processing was better than that of the other group in this study. This characteristics of SLI patients will be useful for understanding and establishing proper therapeutic strategies for these patients.
Automatic Data Processing* ; Child* ; Humans ; Language Development Disorders ; Weights and Measures

The authors reviewed 3145 pediatric patients who visited the emergecy room in this hospital during 3yrs period from Jan. 1989 to Dec. 1991. 1) Among the patients visiting the emergency room, the patients under 15 years of age were 26.4% (3145) of total emergency patients (11930). 2) yearly distribution of patients were decreased 17% between 1989 and 1991. 3) Monthly distribution of visits showed higher incidence in June and July. The male to female ratio was 1.5:1. 4) Weekly distribution of visits showed higher incidence on Sunday and Saturday, relatively. 5) Most popular time of visiting the emergency room was between 8:00 PM to 12:00 PM during which time 29.5% of all pediatric patient were seen. 6) Distribution of age showed peak incidence between 6 and 12 years of age (30.9%). 7) 65.18% of total emergency room isits were pediatric patients. 8) Distribution of cases was as follows: Respiratory disease 37%, accident, GI disease in turn listed respectively in ecreasing order of freqency. 9) The admission rate through emergency was 8.5% of total pediatric emergency patients. 10) 82.3% of total emergency visits had medical insurance coverage, 7% had no insurance and 10.7% were on medical aid program.
Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Incidence ; Insurance ; Insurance Coverage ; Male

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