OBJECTIVES: The purpose of this study was to assess the clinical and polysomnographic characteristics of Korean patients with obstructive sleep apnea syndrome (OSAS), especially in relation to differences due to age and gender. METHODS: All subjects were consecutive patients who were proven to have OSAS with nocturnal polysomnography. They were interviewed with a structured interview format including sociodemographic information, past medical history, medication, and sleep-related history. Simultaneously, they were also given Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) to answer in order to check subjective sleep quality and subjective sleepiness. RESULTS: Mean age of the 308 subjects was 49.5+/-13.3 years, with 77.6% of the subjects being males and 22.4% of the subjects being females. The aging effects on the sleep architecture in Korean OSAS corresponded with normal aging, but with the effect of OSAS itself superimposed, the extent of aging effects was more marked than that of normal aging. The severity of Korean patients of OSAS was not correlated with age. When divided into age subgroups, significant correlation was found between RDI and BMI in patients of each subgroup of those in the 4th to 7th decades. The oldest subgroup (>70 years) described their subjective sleep quality as poorer than any other age subgroups, despite of less subjective drowsiness. The severity of OSAS and the change of sleep architecture of male subjects turned out to be severer than those of female ones. The female/male ratio of the subjects tended to increase with aging. CONCLUSIONS: The aging effect on the sleep architecture in Korean OSAS seems to be a mixture of the changes by normal aging and sleep disorder per se. The severity of OSAS was not correlated with age, but highly correlated with BMI. The severity of OSAS and the change of sleep architecture of male patients were severer than those of female ones.
Aging ; Body Mass Index ; Female ; Humans ; Male ; Polysomnography ; Sleep Apnea, Obstructive ; Sleep Stages

BACKGROUND: Since the endothelin-1 may be implicated in the pathogenesis of peripheral vascular diseases associated with connective tissue diseases (CTDs), we examined the plasma endothelin-1 level in association with quantitative nailfold capillaroscopy in patients with CTDs. METHODS: We investigated 79 patients with connective tissue diseases (54 systemic lupus erythematosus (SLE), 18 systemic sclerosis (SSc), 4 mixed connective tissue disease, 3 polymyositis/dermatomyositis). Plasma samples were obtained and endothelin-1 levels were measured by sandwich enzyme-linked immunosorbent assay. The presence and duration of Raynaud phenomenon as well as nailfold capillaroscopy were evaluated in each patient. To examine the quantitative nailfold capillaroscopy, we measured the length of apical limb width, capillary width and capillary length. RESULTS: According to the presence or absence of Raynaud phenomenon, there was no statistically increased plasma endothelin-1 level between two groups (2.433 +/- 2.259 pg/mL n=33, vs. 1.905 +/- 1.371 pg/mL n=46, p=non specific). All the SSc patients had Raynaud phenomenon and according to the presence of abnormal capillaroscopic findings, there were increased level of endothelin-1 in abnormal capillaroscopy group compared to normal capillaroscopy group (3.940 +/- 3.335 pg/mL (n=12), vs 1.573 1.006 pg/mL (n=6), p<0.05). As compared quantitative examination of nailfold capillaroscopy with plasma endothelin-1 level, in SSc patients the endothelin-1 level correlated well with the length of apical limb width (r(s)=0.577 p<0.05). In SLE patients the endotheliln-1 level correlated well with the length of apical limb width and capillary width (r(s)=0.425 p<0.01, rs=0.278 p<0.05, respectively). CONCLUSION: Our data demonstrate that the presence of abnormal capillaroscopic findings reflect increased plasma endothelin-1 level in patients with connective tissue diseases, and quantitative analysis of nailfold capillaroscopy can be useful to predict the disease activity with the evidence of increased plasma endothelin-1.
Capillaries ; Connective Tissue Diseases* ; Connective Tissue* ; Endothelin-1* ; Enzyme-Linked Immunosorbent Assay ; Extremities ; Humans ; Lupus Erythematosus, Systemic ; Microscopic Angioscopy ; Mixed Connective Tissue Disease ; Peripheral Vascular Diseases ; Plasma* ; Raynaud Disease ; Scleroderma, Systemic

The Wiskott-Aldrich syndrome is a rare disease characterized by thrombocytopenia, recurrent eczema and a marked vulnerability to recurrent infection. Patients with Wiskott-Aldrich syndrome have frequent infections by bacteria which have polysaccharide capsules such as Pneumococcus, Hemophilus influenzae and Neisseria meningitidis due to poor antibody response to polysaccharide antigens. We experienced a 21 years old man with septic arthritis combined with Pneumococcal pneumonia, multifocal abscesses in back and iliacus muscle. After treatment with antibiotics for one month, he was treated successfully.
Abscess ; Anti-Bacterial Agents ; Antibody Formation ; Arthritis, Infectious* ; Bacteria ; Capsules ; Eczema ; Haemophilus influenzae ; Humans ; Neisseria meningitidis ; Pneumonia, Pneumococcal ; Rare Diseases ; Streptococcus pneumoniae ; Thrombocytopenia ; Wiskott-Aldrich Syndrome* ; Young Adult

Sacrococcygeal chordoma is a rare malignant tumor which is believed to take its origin from remnants of the fetal notochord, and presents in the sacral hollow or occasionally posteriorly. The growth is leisurely and it is invasive rather than metastatic. In treatment, there is evidence that early diagnosis of sacrococcygeal chordoma followed by radical resection c palliative radiotherapy does provide the opportunity for cure. We have experienced two cases of sacrococcygeal chordoma, which were treated with one case of a complete surgical resection and the other case of only biopsy.
Biopsy ; Chordoma ; Early Diagnosis ; Notochord ; Radiotherapy

Sulfasalazine, one of disease modifying anti-rheumatic drugs, is widely used in various rheumatic diseases. Very rarely, sulfasalazine causes drug-associated hypersensitivity syndrome that resembles infectious mononucleosis. Clinical signs include fever, lymphadenopathy, maculopapular skin rash and multivisceral involvement which appear 2 to 5 weeks after administration of drug. Atypical lymphocytosis, liver dysfunction and splenomegaly are also frequently observed. Severe infectious mononucleosis-like syndrome in sulfasalazine treated patients can be caused by reactivation of viruses such as human herpes virus-6, that often result in hypersensitivity syndrome. We report a case of patient who developed infectious mononucleosis-like syndrome after administration of sulfasalazine for the treatment of rheumatoid arthritis. This case warrents careful observation for infectious mononucleosis-like syndrome after sulfasalazine treatment.
Antirheumatic Agents ; Arthritis, Rheumatoid ; Exanthema ; Fever ; Humans ; Hypersensitivity ; Infectious Mononucleosis ; Liver Diseases ; Lymphatic Diseases ; Lymphocytosis ; Rheumatic Diseases ; Splenomegaly ; Sulfasalazine*

A severe adverse reaction to certain drug could be associated with hypersensitivity syndrome, showing the clinical features of infectious mononucleosis including maculopapular rash, fever, lymphadenopathy, leukocytosis, atypical lymphocytes, liver dysfunction, and renal disturbance. We report a systemic lupus erythematosus patient who developed infectious mononucleosis-like syndrome with administration of ceftriaxone/isepamicin for the treatment of pneumonia. This case warrants careful attention to infectious mononucleosis-like syndrome associated with antibiotics administration, especially in febrile patients with known autoimmune diseases such as systemic lupus erythematosus.

Discrimination (Psychology) ; Humans ; Methods ; Odors ; Precision Medicine ; Prevalence ; Prospective Studies ; Smell

There were many studies to investigate the pathogenesis and prevention of infection in artificial joint replacement due to the difficulty in management of infected arthroplasty in spite of using large amounts of antibiotics. Biomaterials play a major role in the development of infection because of the way the body responds to their chemical and physical characteristics. Exopolysaccharide glycocalyx or biofilm(slime) which is produced by organisms adhered to the biomaterials has been detected and regarded as an important factor in pathogenesis. The production of slime on the biomaterials in turn makes the pathogens resistant to the antibiotics and therefore they survive. The objects of this study are to evaluate which materials are more susceptible to the adherence by Staphylococcus epidermidis, to evaluate the amount of antibiotics needed to kill the S. epidermidis adhered to the biomaterials(Polymethymethacrylate, Titanium-6Aluminum-4Vanadium alloy, Ultrahigh molecular weight polyethylene), and to evaluate the timing of administration of the antibiotics(cephradine, gentamicin) and potadine for prevention of postoperative infection. The results are as follows. 1. The materials in order of greatest adherence due to the number of organisms colonized are poly- methylmethacrylate(PMMA), ultrahigh molecular weight polyethylene(UHMWPE), and titanium alloy(Ti-6A1-4V alloy) being the least adherent. 2. With the production of biofilm the S. epidermidis becomes resistant to even that of 4 times the minimum bactericidal concentration(MBC) of antibiotics. 3. For prevention of postoperative infection, the prophylactic administration of cephradine if effective when used within 4 hours after contamination and the gentamicin and potadine are effective when used within 8 hours after the contamination with S. epidermidis.
Alloys ; Anti-Bacterial Agents ; Arthroplasty ; Biocompatible Materials ; Biofilms ; Cephradine ; Colon ; Gentamicins ; Glycocalyx ; Joints ; Molecular Weight ; Staphylococcus epidermidis ; Titanium

A case report described a 72-year-old man with a history of a deceased-donor liver transplantation (due to hepatitis B-associated end-stage liver cirrhosis) performed in 1994. The patient was diagnosed with renal cell carcinoma and pulmonary metastasis in 1997 and was successfully treated with radiofrequency ablation and thoracoscopic superior segmentectomy. There was no evidence of newly diagnosed metastatic lesions or recurrence until the 19th post-operative month. Gastric cancer was identified by endoscopy during a routine follow-up examination; the pre-pyloric antral lesion measured 1.5 cm in size and was histologically well-differentiated and confined to the submucosal layers on endoscopic ultrasound. Laparoscopic gastrectomy and lymph node dissection (D1 + beta) was successfully performed in March 2009, and the patient was discharged on the 5th post-operative day without complications. This suggests that laparoscopic surgery is one of the feasible methods for resection of gastric cancer in liver transplant patients.
Aged ; Carbamates ; Carcinoma, Renal Cell ; Endoscopy ; Follow-Up Studies ; Gastrectomy ; Hepatitis ; Humans ; Laparoscopy ; Liver ; Liver Transplantation ; Lymph Node Excision ; Mastectomy, Segmental ; Neoplasm Metastasis ; Organometallic Compounds ; Recurrence ; Stomach Neoplasms ; Transplants

PURPOSE: To determine the relationship between the high-frequency component of accommodative microfluctuation (HFC) and accommodative lag in presbyopic eyes and how they affect the subjective accommodation power with other ophthalmic factors, such as pupil diameter and corneal multifocality. METHODS: Forty subjects (80 eyes) were included in this study, and the non-corrected distance and near visual acuity was measured and then converted to log MAR vision. The addition power for 33 cm near visual work was also measured and the accommodative power was measured by the push-up method. The HFC, accommodative lag and pupil size according to accommodative stimuli (-1.0 to -3.0 D) was measured by Speedy-i Autorefractor (Right Mfg Co., Tokyo). The corneal multifocality and corneal astigmatism was measured by corneal topography (TMS-4; Tomey, Erlangen, Germany). RESULTS: The mean age was 60.0 +/- 4.66 years (51-68) and there were 23 male and 17 female subjects (1.35:1). The HFC and pupil size showed no significant change according to accommodation demand, however, the accommodative lag showed a statistically significant increase (p < 0.001 by one-way ANOVA). Accommodative lag (-2.0 D) showed a statistically significant negative correlation with the subjective accommodative power, and the pupil size (0 D) showed a positive correlation with the subjective accommodative power. CONCLUSIONS: In presbyopia patients, the objective accommodative lag and initial pupil size showed a statistically significant relationship with subjective accommodative power. On the other hand, HFC, pupil size and corneal multifocality, alone may not be indicators to predict accommodative power, but these are important components to explain the dynamic aspect of accommodation.
Astigmatism ; Corneal Topography ; Female ; Hand ; Humans ; Male ; Presbyopia ; Pupil ; Visual Acuity