PURPOSE: The Purposes of this study are to identify the circulating etiologic viruses of acute lower respiratory tract infection in children and to understand the relation with clinical diagnosis. METHODS: We obtained a total of 418 nasopharyngeal aspirates from children admitted for their acute lower respiratory tract infections at three tertiary hospitals in Seoul from September 2008 to March 2009. We performed multiplex RT-PCR to identify 14 etiologic viruses and analyzed their emerging patterns and clinical features. RESULTS: Average age of patients was 16.4 months old and the ratio of male to female was 1.36. Viruses were detected in 56.2% of a total of 418 samples. Respiratory syncytial virus (35%) was the most frequently detected and followed by human rhinovirus (22%), human bocavirus, adenovirus, human metapneumovirus, parainfluenza virus, influenza virus and human coronavirus. Co-infection reached 21.9% of positive patients. CONCLUSION: When we manage the patients with acute lower respiratory infectious diseases, we should remind the role of various viral pathogens, which might be circulating by seasons and by local areas.
Adenoviruses, Human ; Child ; Coinfection ; Communicable Diseases ; Coronavirus ; Female ; Human bocavirus ; Humans ; Male ; Metapneumovirus ; Orthomyxoviridae ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Respiratory System ; Respiratory Tract Infections ; Rhinovirus ; Seasons ; Tertiary Care Centers ; Viruses

OBJECTIVES: To investigate the factors associated with symptoms from job stress among Korean dental laboratory technicians. METHODS: We collected the data of 786 technicians for life-style, job stressor, social support, self-esteem, personality, and various dimension of stress symptoms included roomatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and hostility by self-administerd questionnaire. Global severity index of dental technician (GSID) was calculated by total sum of sub-dimension. RESULTS: We used 80 percentile as a cut-off point, and got the 81.5 % of sensitivity, 86.1 % of specificity by receiver operating characteristic curve. The odds ratios of various factors in high group of GSID compared with low group were 1,49(95 % Cl 1.00-2.00) for smoker, 1,53 (1.06-2.21) for unhealthy group, 6,69 (4.74-9.44) for work overload, 8.34(5.82-11.97) for work demand, 9.89 (6.76-74.94) for work process, 8.27 (5.80-11,79) for work environment, 5.82 (4.04-8.39) for interpersonal relationship, 8.34 (5.82-11.97) for occupational conflict, 5.70 (4.04-8.04) for labor remuneration, 7.58 (5.37-10.71) for role conflict, but 0.39 (0.27-0.57) for social support, 0.41 (0.29-0.60) for self-esteem. By multiple logistic regression, factors were significantly associated with GSID were age, working area, role overload, work demand, work procedure, physical environment, occupational conflict, role conflict, social support, personality traits. CONCLUSIONS: Factors associated with symptoms from stress were role overload, work demand, work procedure, occupational conflict, interpersonal relationship, labor remuneration and role conflict in Korean dental laboratory technicians. It is suggested that health promotion program to reduce job stress and to enforce social support and self-esteem should be developed.
Anxiety ; Dental Technicians ; Depression ; Health Promotion ; Hostility ; Humans ; Laboratories, Dental* ; Logistic Models ; Odds Ratio ; Questionnaires ; Remuneration ; ROC Curve ; Sensitivity and Specificity

No abstract available.
Disorders of Excessive Somnolence* ; Pituitary Neoplasms*

A condition of underestimation of sleep is classified as paradoxical insomnia or sleep state misperception. However, overestimation of sleep, so called positive sleep state misperception has not been clearly described. Here we report a middle-aged woman with positive sleep state misperception who presented excessive sleepiness mimicking hypersomnia.
Disorders of Excessive Somnolence* ; Female ; Humans ; Sleep Disorders, Intrinsic* ; Sleep Initiation and Maintenance Disorders

Autogenous costal cartilage graft has been commonly used for reconstruction of auricular deformity. However, the risk of complication and discomfort at the donor site, as well as distortion of the graft due to morphological change in the cartilage have been serious drawbacks to this procedure. Previous studies examining the chondrogenic potential of perichondrium have suggested that perichondrium may be used as graft for cartilage reconstruction. When a perichondrial flap or a free perichondrium was used as graft, new cartilage formed appositional to the grafted perichondrium. However, the neocartilage was often irregular in shape and varied considerably in quantity. In this study, the feasibility of controlling the shape and the mass of neocartilage was investigated using coral, a porous biomaterial, as a template. A coral a template was wrapped with perichondrial flap from the ears of New Zealand white rabbits and placed into a subcutaneous pocket in the rabbits and placed into a subcutaneous pocket in the rabbit's back by incision. A total of 12 animals were used. Formation of new cartilage was later evaluated by gross and histological examination of the perichondrial flap and the coral template. New cartilage was formed in 11 animals. Immature chondrocytes were visible by 3 weeks after the surgery, and by 8 weeks the immature chondrocytes had formed a cartilage. New cartilage was formed only on the surface of the coral template. These results indicated that the shape and the mass of new cartilage may be controlled by using coral template. Therefore, the desired shape of cartilage may be achieved using a coral template of corresponding shape, and this may help in correcting subtle auricular contour defect and in correcting other structural defects that also require new cartilage formation.
Animals ; Anthozoa* ; Cartilage ; Chondrocytes ; Congenital Abnormalities ; Ear ; Humans ; Rabbits ; Tissue Donors ; Transplants

Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are prevalent and commonly co-occur as overlap syndrome. Patients with an overlap syndrome have a worse prognosis than those with COPD or OSA alone. Here we report a middle-aged man with overlap syndrome who had multiple comorbidities, managed with continuous positive airway pressure and oxygen therapy.
Comorbidity ; Continuous Positive Airway Pressure ; Humans ; Oxygen ; Prognosis ; Pulmonary Disease, Chronic Obstructive ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

Obstructive sleep apnea (OSA), a common condition observed in clinical practice, is a significant public health concern; however, several patients with OSA remain underdiagnosed and untreated. OSA is not merely anatomically driven but is a heterogeneous disorder attributable to complex pathophysiology. Therefore, anatomically driven therapy such as continuous positive airway pressure (CPAP), dental device use, or upper airway surgery offers limited benefit because these approaches do not consider the various clinical and other pathophysiological contributors to OSA. Poor long-term adherence is a limitation of CPAP, the most effective modality recommended as first-line therapy in patients with OSA. Recent advances in our understanding of the pathophysiology and heterogeneity of OSA have led to the identification of three OSA phenotypes based on pathophysiological traits, polysomnographic traits, and clinical/symptombased characteristics. In this review, we summarize recent progress and research trends in the phenotypic approach to OSA.

Silicone gel breast implants may induce local(fibrous capsular contracture) or systemic(rheumatoid arthritis, systemic sclerosis, etc) complications. The exact mechanism of fibrous capsular contracture has not been fully understood. In the present study, we tried to find out the effect of silicone gel on the fibroblast proliferation which has been known as a major contributing factor in fibrous capsular contracture formation. In vitro, activated macrophages are known to secrete monokines which affect fibroblast proliferation and collagen synthesis. And tumour necrosis factor-alpha(TNF-alpha) and interleukin-6(IL-6), which were released by macrophages, were reported as potent stimulator of fibroblast proliferation. The goal of this study is to investigate the role of macrophages and tumour necrosis factor-alphaor interleukin-6 in the interaction of fibroblasts and silicone gel. We designed four groups, two experimental and two control, using Institute for Cancer Research(ICR) mouse peritioneal macrophage and silicone gel. For the preparation of the conditioned medium of macrophages, peritoneal macrophages were prepared and cultured for 24 hours on the silicone gel-coated and naked (not coated) surface [silicone gel-macrophage conditioned medium(SCM; experimental group) and normal polystyrene-macrophage conditioned medium(NCM; control group) respectively]. To correct the effect of 10% fetal bovine serum which was included in Rapid Prototyping and Manufacturing Institute (RPMI) 1640 medium and draw the effect only by macrophages, the RPMI 1640 medium with 10% fetal bovine serum was cultured by the same method on the silicone gel-coated and naked surface (silicone gel-macrophage free conditioned medium; SFM and normal polystyrene-macrophage free conditioned medium; NFM respectively). Each conditioned medium was added onto NIH 3T3 fibroblasts culture at a final 25% concentration of total culture medium and followed by the cultivation for 24 hours. For antibody neutralizing experiments, each conditioned medium was preincubated with polyclonal rabbit anti-mouse TNF-alpha antibody or polyclonal rat anti-mouse IL-6 antibody for 1 hour and then, conditioned medium with antibody was added to the culture medium of NIH 3T3 fibroblasts by the same method. After 24 hours cultivation, total number of viable fibroblast(cell growth), DNA synthesis and collagen synthesis of fibroblasts with each medium were measured by sulforhodamine B(SRB) assay, 3H-thymidine and 3H-proline incorporation respectively. The results were as follows: 1. In the experiment about the effect of the conditioned medium on the fibroblast activity, the experimental group(SCM), compared with the control group(NCM), showed a significant increase of the cell growth (p<0.01), a significant decrease of DNA synthesis(p<0.001), but no significant difference in the collagen synthesis. 2. In the experiment about the effect of polyclonal rabbit anti-mouse TNF-alpha antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.01), but no significant difference in the collagen syn thesis. 3. In the experiment about the effect of polyclonal rat anti-mouse IL-6 antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.0001), but no significant difference in the collagen synthesis. In conclusion, culture supernatants (conditioned medium) of peritoneal macrophages, activated by silicone gel, stimulate the NIH 3T3 fibroblast proliferation. TNF-alpha and IL-6, products of macrophage, are involved in the stimulation of NIH 3T3 fibroblast proliferation in an in vitro condition.
Animals ; Arthritis ; Breast Implants ; Collagen ; Contracture ; Culture Media, Conditioned ; DNA ; Fibroblasts* ; Interleukin-6* ; Macrophages ; Macrophages, Peritoneal* ; Mice ; Monokines ; Necrosis ; Rats ; Scleroderma, Systemic ; Silicone Gels* ; Tumor Necrosis Factor-alpha*

BACKGROUND: REM sleep behavior disorder (RBD) commonly occurs in old-age group and shows very good response to clonazepam. However, clonazepam can aggravate or even precipitate sleep-disordered breathings (SDBs) that is highly prevalent among elderly people. Melatonin has been known to be effective in RBD treatment and is much less likely to increase the airway resistance. The aim is to document the efficacy of melatonin therapy in RBD with co-existing significant SDB. METHODS: We recruited consecutive patients who have both RBD and significant SDB (apnea-hypopnea index, AHI>15) confirmed by nocturnal polysomnography. Melatonin was started at the dose of 0.5 mg/night and increased according to the clinical response. Successful response is defined when symptoms are free or reduced in frequency more than 90% and any physical injury or violence should not be present. RESULTS: Eleven among 16 RBD patients were eligible and enrolled (eight male, median age 69 years, range 54-89). All had significant obstructive sleep-disordered breathings (mean AHI = 28.8, range 22.6-35.2). Melatonin was prescribed(dosage 2-8 mg/night, treatment duration, 7-35 months). Nine patients showed successful response (2-8 mg/night) but two showed unsatisfactory response to 6 mg or 8 mg/night. Two of nine patients with favorable response complained of mild sleepiness. CONCLUSIONS: Melatonin can be effective for controlling RBD with co-existing SDB. Effective dosage range is variable without intolerable adverse effect.
Aged ; Airway Resistance ; Clonazepam ; Humans ; Male ; Melatonin* ; Polysomnography ; REM Sleep Behavior Disorder* ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Sleep, REM* ; Violence