Sleep changes substantially with age. There is a phase advance in the circadian sleep cycle and increased waking after sleep onset. The elderly people wake more frequently during the night and experience fragmented sleep and excessive daytime sleepiness. The prevalence of sleep disorders increases with age, and the composition of sleep disorders in the elderly differs from that in the young. The most frequently encountered sleep disorders are psychophysiologic insomnia, sleep disturbance due to dementia, sleep-related respiratory disorder, restless legs syndrome and periodic limb movement disorder, and REM sleep behavior disorder. To treat the elderly sleep problem appropriately, it is important to know how sleep pattern changes as we age and to understand the cause of sleep-related symptoms. This article will review the sleep physiology and common sleep disorders in the elderly.
Aged* ; Dementia ; Humans ; Nocturnal Myoclonus Syndrome ; Physiology* ; Prevalence ; REM Sleep Behavior Disorder ; Restless Legs Syndrome ; Sleep Wake Disorders* ; Sleep Initiation and Maintenance Disorders

Excessive daytime sleepiness in childhood might be abnormal phenomenon and often related to the sleep disorders or insufficient sleep duration. The most common cause of excessive daytime sleepiness would be insufficient sleep. However, narcolepsy, idiopathic hypersomnia, circadian rhythm sleep disorders, medication, medical illness and other sleep disorders that could cause insomnia and poor quality of sleep also result in excessive daytime sleepiness. The misdiagnosed and untreated excessive daytime sleepiness in childhood can lead to serious developmental and educational problem.
Child ; Humans ; Hypersomnolence, Idiopathic ; Narcolepsy ; Sleep Wake Disorders ; Sleep Wake Disorders, Circadian Rhythm ; Sleep Initiation and Maintenance Disorders

BACKGROUND: In recent years gonorrhea has been pandemic and remains one of the most common sexually transmitted diseases(STD) in the world, especially in developing countries. OBJECTIVE & METHOD: For the detection of a more effective therapeutic regimen and to assess the prevalence of penicillinase-producing Neisseria gonorrhoeae (PPNG), we have been studying patients who have visited the VD Clinic of Choong-ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. RESULTS: In 1995, 97 strains of N. gonorrhoeae were isolated, among which 41(42.3%) were PPNG. CONCLUSION: Since the prevalence of PPNG was reported as 21.9% in 1981, the rate fluctuated. However, in 1993, there was an increase up to 74.3%. Thereafter, the prevalence rate decreased to 64.3% in 1994 and 42.3% in 1995. These changes will therefore need continuous observation.
Developing Countries ; Gonorrhea ; Humans ; Methods ; Neisseria gonorrhoeae* ; Neisseria* ; Pandemics ; Prevalence* ; Public Health ; Seoul*

Nine scaphoid non-unions, which were treated by through curettage of the scar tissue on pseudarthrosis, iliac bone grafts between the fragments and Herbert screws fixation, were analysed. The average follow up period from operation was 16.9 months. The interval between the fracture and the time of the operation ranged from 10 months to 48 months(average 21.6 months). Average union time was 14 weeks after operation. The initial radiologic cystic changes disappeared and overall clinical results were improved. Mean postoperative range of motion of the wrist was flexion 55 and extension 45°. Three of them had DISI deformity preoperatively which their scapholunate angles (mean 104°) has been corrected after reduction (mean 75°). In one case among three DISI deformities, partial radial styloidectomy and triscaphe fusion were added (to bone graft and Herbert screw fixation). A case of incorrect positioning of the screw and a case of neuroma were complicated. Treatment of scaphoid nonunion with curettage of the scar tissue and iliac bone graft and Herbert screw fixation seems to be encouraging to regain the normal anatomy of scaphoid and function of the wrist.
Cicatrix ; Congenital Abnormalities ; Curettage ; Follow-Up Studies ; Neuroma ; Pseudarthrosis ; Range of Motion, Articular ; Transplants ; Wrist

The authors investigated the radioallergosorbent test (RAST) for the specific IgE and the prick test with hose dust mite in 129 patients with atopic dermatitis(AD) wit4 four or more family numbers. RAST and prick test results were described according to family background of respiratory atopy(RA) and severity of AD. The results are summarized as follows : l. A comparison between the prick test results and RAST reactions gave a concordance of 88%. The prick test was more sensitive than the RAST. 2. The level of specific IgE in patients with personal history(PH) or family history(FH) of RA was significantly increased compared to those in patients with only AD. 3. In patients without PH and FH of RA, the level of specific IgE in patients with FH of AD was significantly increased compared to those in patients without FH of AD. 4. The level of specific IgE did not reflect the severity of AD. From the above results, it could be concluded that type I allergy to house dust mite is not directly related to AD and it occurs predominantly in those patients with AD wha have a predisposition to RA.
Dermatitis, Atopic* ; Dust* ; Humans ; Hydrogen-Ion Concentration ; Hypersensitivity* ; Immunoglobulin E ; Mites ; Pyroglyphidae* ; Radioallergosorbent Test

Since 1983, the transtrochanteric rotational osteotomy has been performed in 38 hips of 36 patients for the nontraumatic avascular necrosis of the femoral head at the department of orthopaedic surgery of Seoul National University Hospital. Out of them, 26 hips(18 cases of Sugioka grade I and 8 cases of Sugioka grade II ) were followed up for more than 1 year. The average period of follow-up was 3 years and 5 months(range, 1 year and 2 months to 7 years). These cases include 3 cases of failure before 2 years after operation. Overall, the result was satisfactory in 20 cases(77%)out of a total of 26 cases(success in 18 cases(69%)and good in 2 cases(8%)). The results of the grade I lesions(14 cases of success and 1 case of good result out of 18 cases) were better than those of the grade I lesions(4 cases of success and 1 case of good result out of 8 cases). Complications occurred in 5 cases. These include an ectopic ossification, a stress fracture of the neck, a nonunion of the osteotomy site, a nonunion of the greater trochanter and a delayed union of the greater trochanter. There were 6 cases of failure. For the 4 cases of them, hip replacement arthroplasy was performed. The MRI images axial to the longitudinal axis of the femoral neck gave excellent information for the operation.
Femur ; Femur Neck ; Follow-Up Studies ; Fractures, Stress ; Head ; Hip ; Humans ; Magnetic Resonance Imaging ; Neck ; Necrosis ; Ossification, Heterotopic ; Osteotomy ; Seoul

This retrospective study comprised patiens with facial bone fractures in various accidents and treated in the department of Plastic and Reconstructive Surgery, Pildong hospital, Chung Ang university during the past 5 years from January 1994 to December 1998. The medical records of these patients (fractures) were reviewed and analysed in order to gain insight into a clinical pattern and understnad the therapeutic modalities. The following results were obtained: 1. The monthly incidence was highest in August and most common accident time was between 6:00 p.m and midnight. 2. The mean age of patients was 28.3 years, and age range was 3 to 69 years. The most prevalent age group was the third decade of life (42.9%). Males predominated more than female in the ratio of 4.1:1. 3. The most common etiology was assault (29.6%) followed by traffic accidents (28.5%), fall (23.1%), sports (7.9%). 4. 369 facial fractures in 277 patients were classifed. The most common sites were nasal bone, followed by zygoma, mandible, maxilla, orbit. 5. Associated soft tissue injuries were combined in 168 patients (60.6%), and fractures other than facial bone were developed in 61 patients (22%). 6. Treatment of facial bone fracture consisted of open reduction (42.6%), closed reduction (40.1%), and conservative treatment (17.3%). 7. The complication rate was 11.6% and the most common complication was the eye problem.
Accidents, Traffic ; Facial Bones* ; Female ; Humans ; Incidence ; Male ; Mandible ; Maxilla ; Medical Records ; Nasal Bone ; Orbit ; Plastics ; Retrospective Studies ; Soft Tissue Injuries ; Sports ; Zygoma

This study was undertaken to elucidate any quantitative abnormalities of Tlymphocyte subsets (helper/inducer T cell; T cell and suppressor/cytotoxic T cell: T cell) and IgE levels in the peripheraI blood in atopic dermatitis patients by using monoclonal antibodies and enzyme immunoassay, respectively. In addition we have tried to ascertain whether there are any correlations betveen such immuiiologic abnormalities and the severity of the disease. The results showed that there were significant decrease in the mean percentage of T Cells and increase in the mean value of T/T cell ratios in patients with atopic dermatitis. These changes seem to relate to the severity of the disease when evaluated as groups. A significant increase in the mean value of serum IgE was found in atopic dermatitis patients and the change was related to the severity of the disease. But increase of serum IgE level did not correlated closely with the T cell abnormalities in each patients.
Antibodies, Monoclonal ; Dermatitis, Atopic* ; Humans ; Immunoenzyme Techniques ; Immunoglobulin E* ; T-Lymphocyte Subsets* ; T-Lymphocytes

We experienced two cases of Gaucher's disease of adult type in brother aged four years and two years. The patients showed hepatosplenomegaly with anemia and thrombocytopenia. Typical Gaucher cells were found in bone marrow and biopsy specimens of liver and spleen through light and electron microscopic examination. Splenectomy was followed by improvement of anemia and thrombocytopenia. A brief review of literature was made.
Adult ; Anemia ; Biopsy ; Bone Marrow ; Gaucher Disease* ; Humans ; Liver ; Siblings* ; Spleen ; Splenectomy ; Thrombocytopenia

Circadian rhythms have been observed to be disturbed in mood disorders, especially seasonal affective disorder (SAD). Clock related gene variants also have been suggested to be associated with seasonality (seasonal variations in mood and behavior). This study tested the potential association between a length polymorphism of Period3 gene and seasonal variations in mood and behavior. 297 Korean college students were genotyped for the Period3 polymorphism and were for evaluated the seasonal variation by Seasonal Pattern Assessment Questionnaire (SPAQ). The genotype frequencies were 0.76 for 4R/4R, 0.22 for 4R/5R and 0.013 for 5R/5R. The global seasonality score was not different among Period3 gene variants (4R/4R, 4R/5R and 5R/5R) except for 'sleep length' subscore. The 5R/5R genotype showed the higher 'sleep length' subscore than others (p=0.024). The comparison between seasonals (syndromal plus subsyndromal SAD determined by SPAQ) and non-seasonals did not show any significant difference in frequencies of genotypes. These findings suggest that there is a possibility that the investigated Period3 polymorphism may play a partial role in the susceptibility of seasonal variations in a Korean population.
Circadian Rhythm ; Genotype ; Humans ; Mood Disorders ; Surveys and Questionnaires ; Seasonal Affective Disorder ; Seasons*