OBJECTIVES: This study aims to analyze the association between the severity of sleep apnea, sleep and mood related scales, and activity during sleep in obstructive sleep apnea syndrome (OSAS) patients. METHODS: One hundred seventy six drug-free male patients confirmed as OSAS (average age=43+/-11 years) were selected through nocturnal polysomnography (NPSG). OSAS was diagnosed with apnea-hypopnea index (AHI) >5, mean AHI was 39.6+/-26.0. Sleep related scales were Stanford Sleepiness Scale (SSS), Epworth Sleepiness Scale (ESS), Pittsburg Sleep Quality Index (PSQI) and Morningness-Eveningness Scale (MES). Mood related scales were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI) I, II and Profile of Mood States (POMS). NPSG was performed overnight with both wrist actigraphy (WATG). Parameters produced from WATG were total activity score, mean activity score and fragmentation index. We analyzed the correlation between each scale, AHI scored from NPSG and activity score analyzed from WATG. RESULTS: ESS showed significant positive correlation with PSQI, BDI, BAI and STAI I, II, respectively (p<0.01). SSS showed significant positive correlation with PSQI and BAI (p<0.05, p<0.01). BAI showed significant positive correlation with total activity score, mean activity score and fragmentation index (p<0.05, p<0.01, p<0.05). Total activity score showed significant positive correlation with ESS and BAI, respectively (p<0.05). Fragmentation index showed significant positive correlation with ESS, PSQI and BAI (p<0.05, p<0.01, p<0.05). AHI, indicator of sleep apnea is showed no significant correlation with each sleep and mood related scale. CONCLUSION: The degree of daytime sleepiness tends to be associated with night sleep satisfaction, depression and anxiety, and the activity during sleep rather than the severity of sleep apnea.
Actigraphy ; Anxiety ; Depression ; Humans ; Male ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Weights and Measures ; Wrist

During the microsurgery or during the postoperative period, the occurrence of the vascular spasm increases the failure rate of microvascular anastomosis,and in cases of trauma, the thrombogenic possibility is increased by the endothelial damage. The author thought that the vascular freezing of crushed vessels could improve the patency rate of microvascular anastomosis. Vascular freezing destroys most of the cells in the intima and media. There by causing degeneration of adrenergic fibers. Even though regeneration occurs after 2-3 weeks, regeneration in the smooth muscle layer is still incomplete. So vascular freezing has beneficial effects on relief of vasospasm. Fifteen Sprague-Dawley rats weighing approximately 300 g each were inflicted with crushing injury on the femoral arteries of the right side and the crushing injury with vascular freezing on the femoral arteries of the left side. The gross and histologic findings, as well as the patency rates, were observed at the postoperative 2nd, 10th, and 30th day,and the results were compared between the crushed and crush-freezing groups. The left side (crush-freezing group) showed less vasospasm and less thrombogenesis than the right side (crushed group). There were no significant differences in the patency rate between the crushed group and crush-freezing group. Vascular freezing is suggested to be effective on a potentially thrombogenic, endothelial damaged vessel as a prophylactic treatment method against vasospasm. Clinical application of vascular freezing awaits further experimentation.
Adrenergic Fibers ; Endothelium* ; Femoral Artery ; Freezing* ; Microsurgery ; Muscle, Smooth ; Postoperative Period ; Rats, Sprague-Dawley ; Regeneration ; Spasm

The increasingly successful results of hair restoration surgery in the last years have developed the interest and the confidence of patients and it is the most frequently performed esthetic surgery among male patients. Currently, various kinds of techniques for hair restoration surgery including hair transplantation, scalp reduction, and scalp flaps are performed in our clinic. Among these, hair transplantation is the basic and the most popular procedure, which can be performed not only by itself but also in conjunction with other procedures. 123 consecutive cases of hair transplantations were peformed from Jan. 1995 to Feb. 1996 for male pattern baldness, traumatic alopecia, and female pattern baldness under out patient base. The authors introduced a new classification for male pattern baldness, which are the type M, O, C, U, M-O, and C-O after alphabet to make simple and easy for clinical application. The ancillary procedures were scalp reduction, preauricular flap, and scalp expansion. An ellipsis of hair bearing scalp taken from the occipital area was sliced into slit-, mega-, mini-, and micro-grafts. The survival rate of the grafts was over 90% with minimal complications. This hair transplantation technique enabled us to achieve a good density and more natural looking hair with avoidance of cobble stoning and apparent scar.
Alopecia* ; Cicatrix ; Classification ; Hair* ; Humans ; Male* ; Scalp ; Surgery, Plastic ; Survival Rate ; Transplants

The relationship between infective endocarditis and mycotic aneurysm formation appers clear : In about two to ten percent of patients with infective endocarditis harbor septic intracranial aneurysms. But the pathogenesis, natural course and management of these lesions remains controversial. Aggressive medical treatment of the underlying infected cardiac valve or surgical replacement therapy have significantly reduced the morbidity and mortality rates associated with infective endocarditis. Clinical predictors of mycotic aneurysm, especially neurologic prodromes prior to rupture have been ill-defined since most series contain few patients or include patients with infective aneurysms who have no infective endoarditis. Similarly there has been no consensus regarding the indications and timing of cerebral angiography in patients with infective endocarditis. We have experienced a case of cerebral mycotic aneurysm complicated with subarachnoid hemorrhage due to infective endocarditis in a 29 year-old female patient, who admitted to our hospital because of the pain and paralysis of sudden onset in right forearm, which was diagnosed by echocardiography, brain computed tomography and 4-vessel cerebral angiography. The patient died of sudden rupture of mycotic aneurysm in the 7th hospital day despite intensive medical treatment. We report one case of cerebral mycotic aneurysm with a brief of literature.
Adult ; Aneurysm ; Aneurysm, Infected* ; Brain ; Cerebral Angiography ; Consensus ; Echocardiography ; Endocarditis* ; Female ; Forearm ; Heart Valves ; Humans ; Intracranial Aneurysm ; Mortality ; Paralysis ; Rupture ; Subarachnoid Hemorrhage*

In brachytherapy of uterine cervical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. The post-treatment calculated point A dose was not much different from the pretreatment planned dose (500 cGy). The average+/-standard deviation was 500+/-18 cGy and 84 percent of 82 intracavitary radiotherapy was within the range of 500+/-25 cGy.
Brachytherapy ; Cervix Uteri* ; Female ; Radiotherapy* ; Uterine Cervical Neoplasms

Arteriovenous malformations of the uterus are extremely rare and they occur either in congenital or acquired forms. The most common clinical presentation is abnormal uterine bleeding, which may be aggravated by therapeutic curettage. Because of their rare incidence and clinical importance in management of patients, we report a case of arteriovenous malformation causing serious bleeding during a hysterectomy for uterine leiomyoma. The patient was a 47-year-old multiparous woman who had a history of chronic vaginal bleeding for one year. Numerous anomalous blood vessels draining into the right and left uterine arteries were found on the anterior wall of the uterus and parametrium.
Arteriovenous Malformations/*complications ; Female ; Humans ; Hysterectomy/adverse effects ; Intraoperative Complications/etiology ; Leiomyoma/blood supply/surgery ; Middle Aged ; Uterine Hemorrhage/*etiology ; Uterine Neoplasms/blood supply/surgery ; Uterus/*abnormalities/*blood supply

No abstract available.
Myocardial Infarction*

No abstract available.
Gelatin Sponge, Absorbable* ; Hemorrhage* ; Thrombin*

With the recent increase of coronary artery disease in Korea, coronary arteriography israpidly gaining importance as a diagnostic procedure in the management of ischemic heart disease in this country. In order to delineate normal angiographic anatomy of the coronary arteries in Korean adults, the author reviewed 63 normal or near normal coronary angiograms out of 113 consecutive cases done at the cardiac laboratory of Yonsei University Severance Hospital from February, 1976 through September, 1982 and obtained the following results. 1) The diameter of the main stems of the left and the right coronary arteries measured 2.7-6.3mm(mean, 4.0mm) and 2.1-6.0mm(mean, 3.6mm) respectively, and the length of the left main stem measured 0-23mm(mean, 9.3mm). 2) The conus branch was visualized to originate from the proximal right coronary artery in 50 cases(79.4%), and in the other 13(20.6%) in whom the conus branch was not visualized, it was assumed to have a separate ostium directly from the aortic root. 3) The sinus node artery originated from the right coronary artery in 35 cases(55.5%) and from the left circumflex 20(31.7%). The remaining 8 cases(12.7%) appeared to have dual blood supply. 4) The artery to the A-V node arose from the proximal part of the posterior descending artery as a branch of the right coronary artery in 59 cases(93.7%) and of the left circumflex in only 4(6.3%), and the pattern of the A-V node blood supply coincided with the dominancy(crossing the crux of the heart and giving rise to the posterior descending artery) of the right or the left circumflex arteries. 5) In 33 cases(52.4%), both of the arteries to the SA and the AV nodes arose from the right coronary, and in 19(30.2%), the SA node artery came from the right, whereas the AV node artery originated from the left circumflex. 6) The number of ramifications(furcation) of the main left coronary artery was two in 53 cases(83.1%), three in 9(14.3%), and four in 1(1.6%). 7) The number of diagnoal branches of the left anterior descending artery was one in 34 cases(54%), two in 28(44.4%) and 3 in 1(1.6%).
Adult* ; Angiography ; Arteries ; Atrioventricular Node ; Conus Snail ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Vessels* ; Heart ; Humans ; Korea ; Myocardial Ischemia

BACKGROUND: The treatment for multi-drug resistant tuberculosis(MDRTB) is encountered to be important clinically, but there are still a few reports about it all over the world. So, we evaluated the outcomes of only chemotherapy for the pulmonary MDRTB retrosptctively. METHOD: We reviewed the clinical courses of 63 patients with pulmonary disease due to M.tuberculosis resistant to rifampin and isoniazid who were under follow-up between March 1996 and June 1996 after hospitalization at our hospital between January 1993 and January 1996. We performed cohort retrospective study for all these patient's records. Their regimens were selected individually and preferably included four medications that they had not been given previously and to which the strain was fully susceptible. RESULTS: The 63 patients(mean age, 43.2 years) had previously received a median 5.1drugs. Fifty two(82.5%) patients responded to chemotherapy(as indicated by negative sputum cultures for at least three consecutive months); eleven patients(17.5%) had no response, as shown by continually positive cultures. In a univariate analysis, an unfavorable response was significantly associated with greater number of resistant drugs before the current courses of therapy(relative risk 21.5; 95 percent confidence interval, 1.2-3.0; p<0.05). The mean period of follow-up was seventeen months. There was no relapse subsequently among the patients with responses. There was no death related to tuberculosis. CONCLUSION: In this report from National Masan Tuberculosis Hospital in Korea, multi-drug resistant pulmonary tuberculosis responded relatively well to carefully selected regimens.
Cohort Studies ; Drug Therapy* ; Follow-Up Studies ; Hospitalization ; Hospitals, Chronic Disease ; Humans ; Isoniazid* ; Korea ; Lung Diseases ; Recurrence ; Retrospective Studies ; Rifampin* ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary*