Digital polysomnography was developed to overcome the limitations of Rechtschaffen and Kales rule and to compensate the shortcomings of paper polysomnography. It enables easy access to and secure preservation of sleep records, and provides various displays of sleep data to enhance efficiency of visual scoring of sleep records. Rechtschaffen and Kales rule had been criticized for its ambiguity and lack of considerations in spatial information of EEG. As sleep records are acquired and processed in digital mode, they can be analyzed at microscopic and macroscopic levels. Digital analysis of sleep records provides the basis for development of new sleep measures. Sleep staging in digital polysomnography is based on the various analyses of EEG. Sleep apnea, hypopnea and periodic limb movement are detected automatically by digital analysis of respiratory signals and leg EMG. Digital polysomnography plays a complementary role to visual scoring and compensates the limitations of paper polysomnography. Digital polysomnography, including acquisition, processing and analysis of sleep records in digital mode, can be a great help in the development of sleep medicine, enabling the development of new sleep measures and the exchange of sleep records between sleep laboratories.
Brassica ; Electroencephalography ; Extremities ; Leg ; Polysomnography* ; Sleep Apnea Syndromes

An epidemiological investigation was conducted on Metagonimus yokogawai infection in Hadong Gun (County), Gyeongsang Nam Do, Korea, and following findings were obtained. Overall prevalence rate of Metagonimus yokogawai infection was 29.1 percent from a total of 1,163 inhabitants examined. By area of river and stream, Seomjin-gang R.: 9.5 percent (out of 95 inhabitants examined) in Jeondo Ri in the lower river, 19.9 percent (156) at Dugog Ri near Hadong town, and 90.8 percent (65) in Tab Ri of Hwagae Myeon where Hwagae-cheon Stream joins; Hwagae-Cheon Stream: 42.2 percent (45) in Yonggang Ri of the middle stream and 27.5 percent (72) in Daeseong Ri of the upper stream; Hoengcheon-gang R.: 54.7 percent (161) in Gojeol Ri of the lower river, 40.6 percent (128) in Hoengcheon Ri of the middle stream, and 5.4 percent (93) in Jungi Ri of the upper stream, and 43.8 percent (89) in Uge Ri located along a tributary of the Hoengcheon-gang R. and 4.0 percent (101) in Jangam Ri which is located about 4 km away from the river; Deogcheon-gang R.: 18.5 percent (54) in Munam Ri; Gwangog-cheon Stream: 2.8 percent (107) in Gwangog Ri. The difference in prevalence rate of the infection by area was correlated with the opportunity and amount of raw eating of sweetfish by the inhabitants in the respective areas. By age and sex, the overall prevalence rate increased from young age group and reached a peak at 20-29 age group and then the rate decreased gradually. In high endemic areas, however, a peak level of the rate lasted up to 40-49 age group in male. On the other hand, in low endemic areas, the rate was significantly lower in female, though moderate level of the infection was seen in male. The overall prevalence rate was higher in male than in female and the difference was greater in middle age groups. The most significant mode of infection by the inhabitants was the raw eating of sweetfish which commonly harbour metacercariae of M. yokogawai during summer through autumn. Besides, it was noted that the infection can be acquired through contamination with the metacercariae on food of various side-dish and kitchen utensils as well as on hands of a cook when such fish are prepared or handled. The inhabitants usually begin to acquire infection from early June of a year when fishing of sweetfish opens and acquire infection more frequently in July and August when fish are caught more productively and favored for raw consumption by inhabitants. From September, sweetfish are no more favored for raw consumption and accordingly are dried and cooked in this season. The infection in the sweetfish Plecoglossus altivelis as the second intermediate host was first observed from May with low level of infection and the intensity of infection in a fish rapidly increased until reaching a peak in October when sweetfish season normally ends. The first intermediate host snail of M. yokogawai in this area was Semisulcospira coreana (Martens) which is widely distributed in the streams and rivers in this locality.
parasitology-helminth-trematoda ; Metagonimus yokogawai ; metacercaria ; Plecoglossus altivelis ; epidemiology

INTRODUCTION: Detrended fluctuation analysis (DFA) is used as a way of studying nonlinearity of EEG. In this study, DFA is applied on sleep EEG of normal subjects to look into its nonlinearity in terms of EEG channels and sleep stages. METHOD: Twelve healthy young subjects (age: 23.8+/-2.5 years old, male:female=7:5) have undergone nocturnal polysomnography (nPSG). EEG from nPSG was classified in terms of its channels and sleep stages and was analyzed by DFA. Scaling exponents (SEs) yielded by DFA were compared using linear mixed model analysis. RESULTS: Scaling exponents (SEs) of sleep EEG were distributed around 1 showing long term temporal correlation and self-similarity. SE of C3 channel was bigger than that of O1 channel. As sleep stage progressed from stage 1 to slow wave sleep, SE increased accordingly. SE of stage REM sleep did not show significant difference when compared with that of stage 1 sleep. CONCLUSION: SEs of Normal sleep EEG showed nonlinear characteristic with scale-free fluctuation, long-range temporal correlation, self-similarity and self-organized criticality. SE from DFA differentiated sleep stages and EEG channels. It can be a useful tool in the research with sleep EEG.
Electroencephalography* ; Polysomnography ; Sleep Stages ; Sleep, REM

Adenotonsillar hypertrophy is the leading cause of childhood obstructive sleep apnea. Obstructive sleep apnea syndrome in child-hood, however, can occur from various causes such as obesity or craniofacial abnormalities. Childhood obstructive sleep apnea syndrome can be accompanied by enuresis, parasomnias and behavior problems. For patients with the symptoms of snoring and apnea, obstructive sleep apnea should be suspected and diagnosed properly. In addition, the evaluation of complications and proper treatment are indispensable. When the cause of childhood obstructive sleep apnea is adenotonsillar hypertrophy, symptoms can be improved by surgical methods. If the cause is other than adenotonsillar hypertrophy, such as obesity, it should be treated with other therapeutic modalities, like nasal continuous positive airway pressure (nCPAP), weight reduction and modification of life style. This paper reports a case of nCPAP used to manage severe sleep apnea when it was not resolved after adenoidectomy and tonsillectomy. Differential diagnosis of narcolepsy in a case with excessive daytime sleepiness and reflections on accompanying enuresis and parasomnia were also described.
Adenoidectomy ; Apnea ; Child ; Continuous Positive Airway Pressure ; Craniofacial Abnormalities ; Diagnosis, Differential ; Enuresis ; Humans ; Hypertrophy ; Life Style ; Narcolepsy ; Obesity ; Parasomnias ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy ; Weight Loss

In the following report, we describe the case of a rapidly skeletonized corpse discovered in late summer. On the first day of September, a 57-year-old man was found almost completely skeletonized on a hill behind his house. His body lay prone, accompanied by a brush cutter at the entrance to the graveyard where his friend's parents were buried. His cap, clothes, and rubber boots were all intact and undamaged. Upon autopsy, no definite abnormalities were identified except for an old linear fracture on the frontoparietal bone. According to his friends and neighbors, he had likely died 8 or 9 days prior to the discovery of his body.
Autopsy ; Cadaver ; Friends ; Humans ; Middle Aged ; Parents ; Postmortem Changes ; Rubber ; Skeleton*

Potter's syndrome including bilateral renal agenesis or polycystic renal disease, bilateral pulmonary hypoplasia and characteristic face was first described in 1946. Although a great number of cases of Potter's syndrome was reported, Potter's syndrome with adult polycystic kidney disease(Potter type III) was very rarely found. In this report, we described an autopsy case of Potter's syndrome having adult polycystic kidneys disease, bilateral pulmonary hypoplasia and characteristic face in conjunction with multiple hepatic cysts, features of congenital hepatic fibrosis and a pancreatic cyst. Microscopically, all cysts were lined by cuboidal epithelial cells, showing positive for epithelial membrane antigen and cytokeratins.
Adult* ; Autopsy* ; Epithelial Cells ; Fibrosis ; Humans ; Keratins ; Mucin-1 ; Pancreatic Cyst ; Polycystic Kidney Diseases*

No abstract available.
Endoscopy ; Gastrointestinal Hemorrhage*

INTRODUCTION: Excessive daytime sleepiness and cataplexy are key features of narcolepsy. Modafinil is psychostimulant used in the treatment of narcolepsy. In this study, we evaluated effects of modafinil on nocturnal sleep structure and sleep latency in multiple sleep latency test and clinical features. METHODS: Twelve narcoleptic patients (7 male, age: 22.9 +/- 2.6 yrs) were participated in the study. All of them had done nocturnal polysomnography (nPSG), multiple sleep latency test (MSLT), clinical symptoms scales and have repeated same procedure after taking 200 mg of modafinil. We have done linear mixed model analysis to describe effects of group, medication and nap time on these measures. RESULTS: Modafinil did not affect clinical scales except PSQI which had been reduced after medication. In this study, Modafinil reduced total sleep time, sleep efficiency and increased wake after sleep onset and percent of arousal during sleep in nocturnal polysomnography and prolonged mean sleep latency in multiple sleep latency tests in both group. DISCUSSION: Modafinil has stimulant effect of central nervous system but its effect on night sleep is less than other psychostimulants such as methylphenidate. We ascertained that modafinil affected total sleep time, sleep efficiency and percent of wake during sleep but did not effect on sleep structure. Modafinil was effective in the management of day time sleepiness. Modafinil can enhance alertness of control group without day time sleepiness.
Arousal ; Cataplexy ; Central Nervous System ; Humans ; Male ; Methylphenidate ; Narcolepsy* ; Polysomnography ; Weights and Measures

Since urethral Foley catheterization is usually easy and safe, serious complications related to this procedure have been rarely reported. Herein, we describe a case of intraperitoneally placed urethral catheter via verumontanum presenting as intraperitoneal bladder perforation in a chronically debilitated elderly patient. A 82-yr-old male patient was admitted with symptoms of hematuria, lower abdominal pain after traumatic Foley catheterization. The retrograde cystography showed findings of intraperitoneal bladder perforation, but emergency laparotomy with intraoperative urethrocystoscopy revealed a tunnel-like false passage extending from the verumontanum into the rectovesical pouch between the posterior wall of the bladder and the anterior wall of the rectum with no bladder injury. The patient was treated with simple closure of the perforated rectovesical pouch and a placement of suprapubic cystostomy tube.
Aged, 80 and over ; Cystostomy ; Humans ; Male ; Peritoneum ; Rupture/diagnosis ; Urinary Bladder/*injuries/*surgery ; *Urinary Catheterization

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*