Childhood narcolepsy is one of the underdiagnosed diseases even the first symptoms often appear in childhood. Making diagnosis through history taking is not always easy because the symptoms of childhood narcolepsy are different from those of adulthood. Diagnostic laboratory tests such as sleep studies, tests for human leukocyte antigens, cerebrospinal fluid hypocretin measurement should be considered when the child has excessive daytime sleepiness without cataplexy. Treatment approach should be start as early as possible to avoid secondary academic, emotional difficulties. Both pharmacological and non-pharmacological management, and close cooperation between parents and school teachers should be maintained. In the near future, childhood narcolepsy can be a key to understand the pathogenesis of narcolepsy.
Cataplexy ; Child ; HLA Antigens ; Humans ; Intracellular Signaling Peptides and Proteins ; Narcolepsy ; Neuropeptides ; Parents ; Orexins

Sleep problems and disorders are common in patients with cancer. Sleep of the cancer patients is affected by various factors, including thermoregulatory changes associated with chemotherapy and radiotherapy, cancer related symptoms, such as pain, fatigue, and emotional difficulties. As one of the most common symptoms in cancer patients, fatigue is positively correlated with sleep difficulties. Cytokine is also frequently associated with chemotherapy and radiotherapy. It provokes excessive daytime sleepiness and hypersomnia. Medications for controlling pain, depression, and anxiety can affect sleep of the cancer patients. Medications as well as behavior therapy are reported to be effective for controlling sleep problems, and the physicians need to be accustomed to use the modalities appropriately. This paper reviews causative factors, evaluation, and management of sleep problems and disorders, experienced by cancer patients.
Anxiety ; Behavior Therapy ; Depression ; Disorders of Excessive Somnolence ; Fatigue ; Humans ; Sleep Wake Disorders

GH concentration in plasma decline with age. GH and GH response to GHRH are influenced by sex hormones, thereby changing around the menopause. In several aspects, features of aging resemble those of a state of GH deficiency. It has been argued the declining GH function, along with other factors, might be a causal factor in osteoporosis. The purpose of this study was to investigate that postmenopausal osteoporosis in ovariectomized rat could be prevented by rhGH. Fifty-four Sprague-Dawley rats(weight 140-200g) were devided 3 groups. Group 1(n=18) was sham operation; Group 2(n=18) was ovariectomized and received subcutaneous injection with 0.05 cc normal saline; Group 3(n=18) was ovariectomized and received subcutaneous injection with 0.2 IU rhGH. Group 2 and 3 were injected daily, 6 day per week. Each group was devided three subgroups(n=6) and were sacrificed at 6 week, 10 week, 14 week, respectively. Group 2 showed a significant increase in body weight, femur length, serum IGF-1 level, serum PICP and ICTP level at 6 weeks, 10 weeks, 14 weeks and a significant decrease in ash weight of tibia, width of bony spicules, at 14 weeks than Group 1. Group 3 demonstrated a significant increase in body weight, femur length, serum IGF-1, serum PICP and ITCP levels and a insignificant decrease in ash weight of tibia and width of bony spicules, at 6 weeks, 10 weeks, 14 weeks than Group 1. At 14 weeks, Group 3 showed a significant increase in serum IGF-1, Serum PTH, Serum PICP. From these data, we conclude that although rhGH administration leads to an activation of bone turnover and more stimulation of bone formation, it does not prevent a bone loss in ovariectomized rat.
Aging ; Animals ; Body Weight ; Female ; Femur ; Gonadal Steroid Hormones ; Humans* ; Injections, Subcutaneous ; Insulin-Like Growth Factor I ; Menopause ; Osteogenesis ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Ovariectomy ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Tibia

OBJECTIVES: This study was performed to evaluate intelligence, memory, and neurocognitive function differences after one night of sleep deprivation. METHODS : Healthy medical students were recruited and randomly divided into normal sleep and sleep deprivation groups. Each group was given an initial test of Korean Form of the WAIS (K-WAIS) and the Korean Form of Memory Assessment Scales (K-MAS). Each group also performed Continuous Performance Tests (CPT), Controlled Continuous Performance Tests (CCPT) and the Wisconsin Card Sorting Tests (WCST). The CPT and the CCPT had both visual and auditory components. One week later, the normal sleep group performed the same tests in the same conditions. The sleep deprivation group stayed up all night in a psychiatric ward and then repeated the same tests. RESULTS : The scores on the calculation subscale in the K-WAIS and the verbal memory subscale in the K-MAS were not increased by the repetition of the same tests for the sleep deprivation group. Thus, it seems that verbal functions were influenced by transient sleep deprivation. In visual CPT, the sleep deprivation group had decreased numbers of correct response, increased numbers of commission errors, and prolonged reaction times. Finally, increased reaction times were consistently observed in the sleep deprivation group in all forms of the CPT and CCPT. CONCLUSION : Even one night of sleep deprivation influences verbal function, visual function, and reaction time in cognitive tests. It was assumed that many sleep deprivation-related accidents might be associated with difficulties in visual attention and prolonged reaction times.
Humans ; Intelligence ; Memory ; Reaction Time ; Sleep Deprivation* ; Students, Medical ; Weights and Measures ; Wisconsin

It has been known that childhood bipolar disorder is rare, especially combined with attention deficit hyperactivity disorder (ADHD). But, recent studies reported that childhood bipolar is more common than our guess. Many symptoms of childhood mania overlapped with ADHD, so it is difficult to differentiate from ADHD. It also often reported that psychostimulants, medication for ADHD, induce manic symptoms. Clinically, childhood mania has several characteristics. It is frequently chronic, mixed type, rapid cycling and often refractory to treatment. So it is important to diagnose, differentiate, treat childhood bipolar disorder and ADHD, but there is no report about comorbidity, treatment, clinical characteristics about that. We report a patient combined ADHD, mental retardation and childhood bipolar disorder.
Attention Deficit Disorder with Hyperactivity* ; Bipolar Disorder* ; Child* ; Comorbidity ; Humans ; Intellectual Disability*

Changes in core body temperature are closely related to initiation and maintenance of sleep, and are influenced by various factors such as air temperature, room temperature, clothing, human activities, and medications. These factors are closely related to sleep fragments, insomnia and other sleep disorders. Understanding the effect of the temperature related to human surroundings on the core body temperature and sleep, will be useful for understanding the physiology of sleep and to treat sleep disorders.
Body Temperature ; Circadian Rhythm ; Clothing ; Human Activities ; Humans ; Physiology ; Sleep Disorders ; Sleep Initiation and Maintenance Disorders

Parasomnias are characterized by undesirable physical events or experiences during sleep. They occur alone or combined with other parasomnias. Parasomnias in childhood are more common than those of adulthood. Most of them are mild, benign and self remitted. Careful history takings from the patients and their parents, videotaped recordings of the episodes are invaluable to diagnose parasomnias. Sometimes polysomnographic recordings are helpful to differentiate ambiguous conditions and to diagnose comorbid conditions. Even many parasomnias do not need treatment, some conditions need therapeutic interventions. Medication, cognitive behavioral treatment, biofeedback, and oral appliance are helpful to reduce frequency and complexity of certain kinds of parasomnias.
Biofeedback, Psychology ; Humans ; Parasomnias* ; Parents

Parasomnias are characterized by undesirable physical events or experiences during sleep. They occur alone or combined with other parasomnias. Parasomnias in childhood are more common than those of adulthood. Most of them are mild, benign and self remitted. Careful history takings from the patients and their parents, videotaped recordings of the episodes are invaluable to diagnose parasomnias. Sometimes polysomnographic recordings are helpful to differentiate ambiguous conditions and to diagnose comorbid conditions. Even many parasomnias do not need treatment, some conditions need therapeutic interventions. Medication, cognitive behavioral treatment, biofeedback, and oral appliance are helpful to reduce frequency and complexity of certain kinds of parasomnias.
Biofeedback, Psychology ; Humans ; Parasomnias* ; Parents

Purpose: To analyze the causes and to prevent dislocations of the hip joint that occur in patients who underwent revisions of total hip arthroplasties by changing only the polyethylene liners and femoral heads, subsequent to primary total hip arthroplasties. Materials and Methods: We evaluated 28 patients who underwent acetabular component revisions of total hip arthroplasties subsequent to primary total hip arthroplasties. The average age of the patients was 55 years old and all 28 patients had operations through the posterolateral approach. In 17 of the cases, the acetabular cups, polyethylene liners, and femoral heads were changed; in 10 cases, just the polyethylene liners and femoral heads were changed; and in 1 case, only the polyethylene liner was changed. Results: We observed 7 cases of hip dislocations that occurred among a total of 28 cases after revisions of total hip arthroplasties. In all 7 cases, the polyethylene liners and femoral heads were changed, but not the acetabular cups. In additional, in all 7 cases of dislocation, the patients were non-compliant and started weight-bearing prematurely after revisions of the total hip arthroplasties Conclusion: We observed new dislocations in the 7 cases in which the polyethylene liners and femoral heads were changed. The main reasons were inadequate soft tissue tension and hip joint laxity. Therefore, it is necessary to increase the neck length, use elevated rim polyethylene liners, readjust the acetabular cups to their optimal positions, and apply hip abduction braces to patients early after revision of total hip arthroplasties in order to lessen the danger of dislocations.
Acetabulum* ; Arthroplasty ; Braces ; Dislocations* ; Head ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Neck ; Polyethylene ; Risk Factors* ; Weight-Bearing

Objectives: ：Adolescents cigarette smoking is a major public health concern, because it is highly associated with physical and mental development of adolescents. This study examines the psychosocial variables affecting smoking behaviors and smoking cessation plan. Methods: ：A total of 74 (35 smokers and 40 non-smokers) students in Daegu metropolitan city were included in this study. 35 smokers visited smoking cessation center between September 2019 and November 2019. Subjects were asked to complete a self-reported questionnaire evaluating smoking status, self-esteem, parent-adolescent communication, parent and peer attachment, and peer relationship quality. The independent t-test was conducted to determine the difference in psychological variables between smoker and non-smoker. Additionally, logistic regression analysis was done to identify the factors that affect smoking cessation plan and willingness. Results: ：The majority of adolescent smoker was male (94.3%) and middle school students (82.9%). Twenty-four smokers (68.5%) started smoking at sixth and seventh grade. The smoking amount and smoking days were related to plan and willingness of smoking cessation in logistic regression analysis and the number of friends who smoke was related to smoking cessation plan. The openness of communication in smoking students was significantly higher than that of non-smoking students. Conclusion ：Our findings indicate that the environmental factors such as peer or parental smoking is important in adolescents smoking. In addition to individual factors such as smoking amount and days, openness of communication related with impulsivity and susceptibility in peer pressure can affect plan or willingness of smoking cessation.