No abstract available.
Aged* ; Humans

OBJECTIVES: Continuous positive airway pressure (CPAP) is effective in the treatment of obstructive sleep apnea syndrome (OSAS), but the major limitation of CPAP may be poor compliance. The aims of the study were to investigate the compliance and side effects of CPAP, and to evaluate the efficacy of CPAP in patients with OSAS. METHODS: This study enrolled 106 patients with OSAS who took the CPAP treatment. The severity of daytime sleepiness was measured using Epworth Sleepiness Scale (ESS), and sleep quality and depressive symptoms were assessed by Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), respectively. RESULTS: During 29 months of the study period, 41.5% of patients were using CPAP and 38.7% of patients stopped using it. Compared to non-compliant patients, compliant patients had a higher PSQI score and obstructive apnea index. Among non-compliant patients, 51.2% of them stopped using CPAP within 1months. 85.7% of non-compliant patients were discomforted by the CPAP, but much more nasopharyngeal symptoms were reported in the compliant group. ESS (p<0.01), PSQI (p<0.01) and BMI (p<0.01) were reduced significantly after CPAP treatment but not BDI (p=0.86). CONCLUSIONS: We concluded that CPAP can reduce the daytime sleepiness, nocturnal sleep disturbance, and body mass index. To increase the compliance of CPAP, we suggested that some education and support is needed at the early stage of the CPAP treatment.
Apnea ; Body Mass Index ; Compliance* ; Continuous Positive Airway Pressure ; Depression ; Education ; Humans ; Sleep Apnea, Obstructive*

With a rapid development of neuroscience, the theories related to the pathophysiology of schizophrenia have been changed a lot from a simple hyperdopaminergic one to the various complicated ones. Among these, the theories regarding prefrontal cortex(PFC) pathology as a cause of schizophrenia are gaining more recognition as the results of neuroimaging and neuropsychological tests in schizophrenia consistently report abnormalities in PFC. Therefore, we first reviewed the unique characteristics of PFC in anatomy, neurochemistry and neurophysiology to enhance an understanding of those ones. Secondly, various neurotransmitter, neurodevelopmental and neural network theories of schizophrenia introduced recently were reviewed in terms of PFC pathology.
Dopamine ; Neurochemistry ; Neuroimaging ; Neurophysiology ; Neuropsychological Tests ; Neurosciences ; Neurotransmitter Agents ; Pathology ; Prefrontal Cortex* ; Schizophrenia*

Because the postmortem changes rapidly distort values of many constituents in the body fluids, the determination of postmortem chemical changes and relation among body fluids is very important in medicolegal community. A laboratory result is not useful if appropriate data for comparison are lacking. The aim of this paper is to determine the reference ranges and the postmortem changes for chemical constituents in postmortem specimen. We examined 17 clinical laboratory parameters in cadaveric blood and vitreous humor obtained from 51 autopsy cases. The mean, standard error, standard deviation and confidence interval of all measured constituents were shown in Table 2 & Figure 1. The postmortem blood level of amylase, phosporus, LDH, ALT, AST and CPK are very higher than those of antemortem blood. The postmortem vitreous level of total bilirubin, triglyceride, GGT, alkaline phosphatase, albumin, total protein and cholesterol are very low and is not reliable. The ratio of vitreous/blood in calcium, BUN, creatine and uric acid are 0.74, 0.68, 0.29 and 0.23 in decreasing orders(Table 3,4). For the medical examiner or pathologist, routine chemical examinations of the vitreous humor can provide evidence of abnormality not apparent in gross or microscopic examination of the tissue. A more extensive study will be required, using a larger number of subjects, to establish the full range of variability.
Alkaline Phosphatase ; Amylases ; Autopsy ; Bilirubin ; Body Fluids ; Cadaver ; Calcium ; Cholesterol ; Confidence Intervals ; Coroners and Medical Examiners ; Creatine ; Humans ; Postmortem Changes ; Reference Values ; Triglycerides ; Uric Acid ; Vitreous Body

PURPOSE: To evaluate morphologic characteristics of the clustered microcalcifications in benign lesions and to compare with that of malignant lesions. MATERIALS AND METHODS: We retrospectively reviewed 33 patients with clustered microcalcifications( five calcifications in number per square centimeter)on mammography. We analyzed mammographic findings with regard to shape, size, number/cm2, irregularity of size and shape, presence of central lucency, and accompanied mass density. RESULTS: Of 12 benign lesions, the most frequent shape was dot or round form (4/12, 33.3%) followed by ring form (3/12, 25%). The size was smaller than 0.5mm in 5 patients (41.7%), 0.5-1 mm in one and more than 1 mm in 6 patients(50%). The number of calcifications per square centimeter were five to ten in 41.7%, more than ten in 58.3%. Of all 21 malignant lesions, the most frequent shape was branching form (8/21, 38.1%). The sizes of calcification were less than 0.5ram in 76.1%(16/21). Central lucency within the calcification was seen only in benign lesions (3/14, 21%). Irregularity ih size and shape of calcifictions was noted in both benign and malignant lesions. Accompanied parenchymal mass density was more commonly associated with malignant lesions(80. 9%) than benign lesions(58.3%). CONCLUSION: Our results suggest that benign clutered microcalcifications on mammography could be differentiated from malignant calcifications with the criteria of larger size, central lucency and infrequent accompanied mass.
Humans ; Mammography* ; Retrospective Studies

PURPOSE: To evaluate morphologic characteristics of the clustered microcalcifications in benign lesions and to compare with that of malignant lesions. MATERIALS AND METHODS: We retrospectively reviewed 33 patients with clustered microcalcifications( five calcifications in number per square centimeter)on mammography. We analyzed mammographic findings with regard to shape, size, number/cm2, irregularity of size and shape, presence of central lucency, and accompanied mass density. RESULTS: Of 12 benign lesions, the most frequent shape was dot or round form (4/12, 33.3%) followed by ring form (3/12, 25%). The size was smaller than 0.5mm in 5 patients (41.7%), 0.5-1 mm in one and more than 1 mm in 6 patients(50%). The number of calcifications per square centimeter were five to ten in 41.7%, more than ten in 58.3%. Of all 21 malignant lesions, the most frequent shape was branching form (8/21, 38.1%). The sizes of calcification were less than 0.5ram in 76.1%(16/21). Central lucency within the calcification was seen only in benign lesions (3/14, 21%). Irregularity ih size and shape of calcifictions was noted in both benign and malignant lesions. Accompanied parenchymal mass density was more commonly associated with malignant lesions(80. 9%) than benign lesions(58.3%). CONCLUSION: Our results suggest that benign clutered microcalcifications on mammography could be differentiated from malignant calcifications with the criteria of larger size, central lucency and infrequent accompanied mass.
Humans ; Mammography* ; Retrospective Studies

No abstract available.
Animals ; Carcinoma, Hepatocellular* ; Mice*

BACKGROUND: The high concentration of plasma total homocysteine is recently considered an independent risk factor for atherosclerosis. The purpose of this study was to provide reference ranges for plasma homocysteine levels and to investigate the relationship between plasma homocysteine and cardiovascular risk factors in healthy Korean men. METHODS: Anthropometric parameters, alcohol intake, cigarette use and nutrient intake were determined in 166 healthy men within a wide age range(30-69 yr). Serum levels of lipids, glucose and insulin levels during oral glucose tolerance test(OGTT), plasma amino acid concentrations and levels of antioxidant nutrients and enzymes were also measured. Hyperhomocysteinemia was defined as plasma homocysteine levels above the 90th percentile(> or =15micromol/L) of respective plasma homocysteine distribution in study subjects. Characteristics of hyperhomocysteinemic men(n=16) were compared to normohomocys- teinemic men(n=16) matched for age and body mass index. RESULTS: Plasma total homocysteine values ranged from 2.4 to 38.1micromol/L, a skewed, right-tailed distribution. The homocysteine levels of 25th, 50th and 75th percentile were 7.02, 9.61 and 12.4micromol/L, respectively. The mean concentration of plasma total homocysteine was 10.7micromol/L. Plasma total homocysteine level was positively correlated to body mass index, serum cholesterol and triglyceride levels and alcohol intake, but negatively correlated to serum bata-carotene concentration. In multivariate analysis, serum triglyceride level was the strongest determinant of plasma total homocysteine concentration. There were no significant differences between two groups in waist to hip ratio, alcohol intake, cigarette use, blood pressure and serum levels of glucose and insulin during OGTT. Hyperhomocysteinemic men had significantly higher mean values of serum triglyceride(258mg/dl), total cholesterol(226mg/dl), and LDL-cholesterol(140mg/dl) than normohomocysteinemic men. Hyperhomocysteinemic men showed a decrease in lipid corrected values of serum bata-carotene and alpha-tocopherol and plasma concentrations of serine and taurine, when compared to normohomocysteinemic men. The mean intakes of vitamin B6, folate, vitamin B12 and bata-carotene tended to decline by 25-30% in hyper- homocysteinemic group, when compared to normohomocysteinemic group. CONCLUSION: Our results indicate that healthy Korean men with hyperhomocys- teinemia show signs of hyperlipidemia and decreased antioxidants nutrients and these factors increase risk for coronary artery disease. In addition, hyperhomocysteinemia may affect amino acid metabolism related to homocysteine.
alpha-Tocopherol ; Antioxidants ; Atherosclerosis ; Blood Pressure ; Body Mass Index ; Cholesterol ; Coronary Artery Disease ; Folic Acid ; Glucose ; Glucose Tolerance Test ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hyperlipidemias ; Insulin ; Male ; Metabolism ; Multivariate Analysis ; Plasma* ; Reference Values ; Risk Factors* ; Serine ; Taurine ; Tobacco Products ; Triglycerides ; Vitamin B 12 ; Vitamin B 6 ; Waist-Hip Ratio

Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands' care for their wives through a qualitative research into husbands' experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands' burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband's burden correlated with the age of the patients, numbers in the family, therapy methods, patient's level of discomfort, patient's disease severity, patient's level of dependence and the husband's understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands' burden is explained in 22.5% by husband's recognition of level of severity and husbands' age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient's level of discomfort, patient's disease severity, patient's level of dependence and husband's understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients' experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands' identification of housework and husbands' concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients' to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands' companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.
Aging ; Arthritis ; Chronic Disease* ; Diagnosis ; Education ; Family Characteristics ; Female ; Housekeeping ; Humans ; Interviews as Topic ; Marriage ; Models, Theoretical ; Negotiating ; Nursing Care ; Qualitative Research ; Quality of Life ; Surveys and Questionnaires ; Social Class ; Spouses* ; Stress, Psychological

Based on the theory that benign prostatic hypertrophy may be induced by androgenic effect of testosterone derivatives, especially 5-alpha - dihydrotestosterone, on prostatic tissue, Chlormadinone acetate(CMA), potent oral synthetic antiandrogen was investigated in the treatment of benign prostatic hypertrophy. Twenty-two patients of prostatic hypertrophy were studied over six months period with a special reference to uroflowmetry and following results were obtained : 1) Chlormadinone acetate induced improvement of obstructive urinary symptoms in terms of uroflowmetric measurement. 2) It is very worthwhile to initiate medical treatment before undergoing any surgical intervention or when surgery is contraindicated.
Chlormadinone Acetate* ; Dihydrotestosterone ; Humans ; Prostatic Hyperplasia* ; Testosterone