A survey was carried out from August to December 2004 in Pusan, Korea to document the presence of free-living amoeba (FLA), including the genus Acanthamoeba, in both contact lens storage cases and domestic tap water. Acanthamoeba was isolated from 5 (4.2%) in 120 contact lens storage cases. Four house tap water samples from residents, whose contact lens storage cases had been contaminated by Acanthamoeba, were also found to be contaminated with Acanthamoeba. Therefore, the contamination rate of FLA and Acanthamoeba in domestic tap water was investigated in order to examine the role of domestic tap water in Acanthamoeba contamination of contact lens storage cases. FLA and Acanthamoeba were identified in 97 (46.8%) and 16 (7.7%) of the 207 domestic tap water samples, respectively. There were no significant differences between the contamination rates of FLA in tap water according to the filtration plant of origin. No FLA was detected in the tap water directly supplied by the water purification plants. Water storage tanks appear to promote FLA colonization, including Acanthamoeba, in domestic tap water. This increases the risk of Acanthamoeba contamination in contact lens storage cases as well as increasing the risk of Acanthamoeba keratitis.
Acanthamoeba/*isolation & purification ; Amebiasis/epidemiology ; Animals ; Comparative Study ; Contact Lenses/parasitology ; Data Collection ; Humans ; Korea/epidemiology ; Research Support, Non-U.S. Gov't ; Risk Factors ; Water/*parasitology ; Water Supply/*standards

Sleep-related behaviors observed in parasomnias can result in serious injuries of patients and/or spouses. Parasomnia is defined as undesirable physical or behavioral phenomenon occurring during sleep. If these disorders are accurately diagnosed, effective treatments are available. Often, these disorders can be even cured. Environmental management for patient and/or spouse safety and good sleep hygiene are the most recommended for individuals behaving abnormally during sleep. The aim of this article is to review the clinical features, diagnosis and treatment of several sleep-related behavior disorders.
Diagnosis ; Humans ; Hygiene ; Mental Disorders ; Parasomnias ; Spouses

INTRODUCTION: REM sleep which shows characteristic muscle atonia and increased resistance of upper respiratory track is known to be vulnerable to sleep apnea. Previous studies reported that REM sleep-dependent (or related) obstructive sleep apnea syndrome (REM-dependent OSA) could be one of sleep disordered breathing. The present study aimed to investigate clinical findings and polysomnographic variables of REM-dependent OSA. METHODS: Fifty-six patients diagnosed with mild to moderate obstructive sleep apnea by overnight polysomnography (52. We compared clinical and polysomnographic findings between REM-dependent OSA and No REM-dependent OSA patients. RESULTS: Among 56 patients, 37.5% (n=21, average age of 52.3+/-19.7 years, 14 males) met the REM-dependent OSA criteria. There were no significant differences in age, sex and body mass index between two groups. After controlling for age, sex, body mass index and periodic leg movements index, REM-dependent OSA patients showed significantly lower AHI, lower number of oxygen desaturation events and higher stage 2 sleep proportion compared to No REM-dependent OSA patients (p=0.010, p=0.006, p=0.031, respectively). After controlling for age, sex, body mass index and periodic legs movements index, AHI-REM was positively correlated with the number of oxygen desaturation events in REM-dependent OSA group (p=0.002). CONCLUSION: Current results suggested that 37.5% of patients with mild to moderate severity of obstructive sleep apnea could be classified into REM-dependent OSA. REM-dependent OSA was more common in mild severity of OSA, equally prevalent in both sexes and accompanied with sleep architecture changes, i.e. increased proportion of stage 2. In addition, apneic events during REM sleep in REM-dependent OSA were related to oxygen desaturation.
Body Mass Index ; Humans ; Leg ; Muscles ; Oxygen ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep, REM ; Track and Field

Adenotonsillar hypertrophy is the leading cause of childhood obstructive sleep apnea. Obstructive sleep apnea syndrome in child-hood, however, can occur from various causes such as obesity or craniofacial abnormalities. Childhood obstructive sleep apnea syndrome can be accompanied by enuresis, parasomnias and behavior problems. For patients with the symptoms of snoring and apnea, obstructive sleep apnea should be suspected and diagnosed properly. In addition, the evaluation of complications and proper treatment are indispensable. When the cause of childhood obstructive sleep apnea is adenotonsillar hypertrophy, symptoms can be improved by surgical methods. If the cause is other than adenotonsillar hypertrophy, such as obesity, it should be treated with other therapeutic modalities, like nasal continuous positive airway pressure (nCPAP), weight reduction and modification of life style. This paper reports a case of nCPAP used to manage severe sleep apnea when it was not resolved after adenoidectomy and tonsillectomy. Differential diagnosis of narcolepsy in a case with excessive daytime sleepiness and reflections on accompanying enuresis and parasomnia were also described.
Adenoidectomy ; Apnea ; Child ; Continuous Positive Airway Pressure ; Craniofacial Abnormalities ; Diagnosis, Differential ; Enuresis ; Humans ; Hypertrophy ; Life Style ; Narcolepsy ; Obesity ; Parasomnias ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy ; Weight Loss

BACKGROUND/AIMS: Inflammation plays a key role in ischemic acute renal failure (ARF). The present study investigated the infiltration of macrophages in the early phase of ischemic ARF in mice. METHODS: Ischemic ARF was induced by renal clamping for 22 min, while the control mice underwent sham surgery (no clamping). The serum creatinine and blood urea nitrogen (BUN) levels were measured in the control and post-ischemia mice. Immunofluorescence staining was used to measure the number of CD 11b-positive cells in the kidney tissue sections to determine the amount of post-ischemic macrophage infiltration. Lipo-Cl2MBP (clodronate) for macrophages depletion was injected via a tail vein 5 d before ischemia induction and again 2 d before ischemia induction. RESULTS: The study found that the post-ischemia mice had higher levels of serum creatinine and BUN at 16 and 24 h compared to the controls. Immunofluorescence staining showed there were more macrophages in the post-ischemic tissue at 2, 8, 16 and 24 h compared to the control tissue, and that most of these macrophages were located in the outer medulla. The mice treated with clodronate prior to ischemia induction were found to have lower levels of serum creatinine compared to those mice that weren't treated with clodronate. CONCLUSIONS: There was significant infiltration of macrophages from the early phase of ischemic ARF, and this peaked at 16-24 h. Macrophage depletion using clodronate was protective against ischemic ARF.
Animals ; Antigens, CD11b ; Blood Urea Nitrogen ; Clodronic Acid ; Creatinine/blood ; Fluorescent Antibody Technique ; Inflammation/*physiopathology ; Ischemia/*complications/pathology/physiopathology ; Kidney Failure, Acute/blood/etiology/*pathology/physiopathology ; Kidney Medulla/*pathology ; *Macrophages ; Male ; Mice ; Mice, Inbred C57BL ; Perfusion ; Time Factors

OBJECTIVE: To evaluate the effect of obesity on obstructive sleep apnea syndrome (OSAS) by age in relation to anthropometric measurements. METHODS: The medical records of 1,110 participants diagnosed with OSAS were analyzed according to age. All participants underwent nocturnal polysomnography and had their body mass index, waist circumference, neck circumference (NC), and waist-to-hip ratio measured. RESULTS: According to the multiple linear regression analysis model for the natural logarithm of the apnea-hypopnea index treating all four anthropometric measurements and gender as covariates, the final stepwise model accounted for an increasing percentage of the variability in the severity of OSAS as a function of age: 7.0, 9.1, 14.5, and 25.6% for those aged <30, 30–39, 40–49, and 50–59 yrs, respectively. It accounted for a decreased percentage among those 60–69 (20.3%) and 70 yrs or older (3.9%). The correlation between NC and the severity of OSAS linearly increased as a function of age for those aged 30–59 yrs, peaked among those in their 60s, and dramatically decreased thereafter. CONCLUSION: Middle-aged patients with OSAS were more likely to be obese, as measured by anthropometric measurements, than were younger or older OSAS patients. In particular, the predictive value of NC was significantly lower for younger and older OSAS patients.
Age Distribution ; Body Mass Index ; Body Weights and Measures ; Humans ; Linear Models ; Medical Records ; Neck ; Obesity* ; Polysomnography ; Sleep Apnea, Obstructive* ; Waist Circumference ; Waist-Hip Ratio

OBJECTIVES: The prevalence of smoking in schizophrenic patients (74-92%) is higher than that of all psychiatric patients (34-54%) or general population (30-35%). This higher smoking Prevalence is demonstrated even after controlling for known confounders, such as marital status, alcohol use, and socioeconomic status. This study was conducted to determine whether there would be any difference in nicotine intake and metabolism between schizophrenics and normal controls. METHODS: Sixteen schizophrenic patients and sixteen normal controls were collected. All subjects were supplied with a pack of cigarette a day. Urinary cotinine excretion was measured by using gas chromatographic mass spectrometric method. RESULTS: Cotinine excretion was significantly increased in schizophrenic patients compared to normal controls (p<0.05). None of variables such as age at initial smoking, the average number of cigarettes at initial smoking, pack year (packs daily smoked x smoking year), abstinence history were found to influence cotinine levels when examined via the ANOVA, even when the interaction with diagnosis was considered. CONCLUSION: This result suggests that nicotine intake and consumption are increased in schizophrenic patients compared to normal controls, which can be an attempt to improve sensory inhibition and counteract neuronal effect of antipsychotic medications.
Cotinine* ; Diagnosis ; Humans ; Marital Status ; Metabolism ; Neurons ; Nicotine ; Prevalence ; Schizophrenia ; Smoke ; Smoking ; Social Class ; Tobacco Products

Purpose: : Intensive care unit (ICU) diaries have been implemented across the international ICU community. This study aimed to comprehend the meaning and nature of the lived experience of patients’ families using the ICU diary in Korea. Methods: : This qualitative study adopted van Manen’s hermeneutic phenomenology. The participants comprised eight women and two men who were the family members of patients in the ICU for more than three days. Data were collected using in-depth interviews and observation from July 2018 to January 2019. Results: : Patients’ families who experienced the ICU diary recognized it with six beings according to time: a good idea, forgotten stuff, burdensome work, touching service, my stuff, and a thing in the memory. The ICU diary had three essential meanings for the families: communication, solace and hope, and a record of life. These findings were rearranged according to van Manen’s fundamental existential, and the lived things and lived others were remarkably confirmed. Conclusion : Patients’ families experienced various ICU diary forms over time and recognized an ICU diary as a means of communication. Therefore, the ICU diary is expected to be used as an intervention between families and healthcare providers in the ICU to support mutual communication.

PURPOSE: We accidentally found out the decrease of color M-mode propagation velocity of LV inflow(Vp) in several Atrial septal defect(ASD) infants. The aim of this study was to identify it in more number of patients, and to find out the relationship of it to clinical characteristics and other cardiac function study results. METHODS: The present study was conducted on 16 isolated secundum ASD infants with defect diameter greater than 3 mm(L group), 10 infants with a defect diameter less than 3 mm(S group) and 11 infants with no structural abnormal findings(N group), among infants who visited the Pediatric Department of Soonchunhyang University Hospital and underwent a echocardiographic examination from April 2001 through June 2003. The systolic function tests via parasternal long axis, and other diastolic function tests were done at the same time. RESULTS: The mean ages of these three groups(L group, S group and N group) were 0.35+/-0.34 years, 0.22+/-0.22 years and 0.45+/-0.27 years, respectively. The Vp values were 48.42+/-10.84 cm/sec, 65.26+/-16.25 cm/sec, 65.28+/-13.36 cm/sec in groups, and significant difference between L group and other 2 groups(P=0.001). The only affecting variable to Vp values is defect area. There was significant causal relationship between them(P= 0.000). CONCLUSION: We identified the decrease of Vp in ASD infants, and it was linearly related to defect area size. It may be result of early diastolic ventricular interdependence in ASD.
Axis, Cervical Vertebra ; Echocardiography ; Heart Septal Defects, Atrial* ; Humans ; Infant*

OBJECTIVE: The purpose of this paper is to study the possible differences in clinical and polysomnographic findings, depending on the presence or absence of subjective complaints of abnormal sleep behavior, in patients with RWA on polysomnography. METHOD: We reviewed patient records and polysomnographic data of patients referred to the Sleep Laboratory at Seoul National University Hospital from June 1996 through October 2002. We defined the manifest RBD group (n=32) as patients having both complaints of abnormal sleep behavior and RWA on polysomnography. The latent RBD group (n=20) consisted of patients who exhibited RWA on polysomnography but did not complain of abnormal sleep behavior. The clinical characteristics and polysomnographic findings between the two groups were compared and analyzed. RESULTS: Fifty-two subjects had RWA, as detected by polysomnography (42 males and 10 females, mean age of 55.1+/-19.1 years). Subjects in the manifest RBD group were significantly older than those in the latent RBD group (61.59+/-13.5 vs. 44.70+/-2.76 years, independent t-test, p<0.01). More subjects in the manifest RBD group exhibited abnormal REM behavior on polysomnography than did subjects in the latent RBD group (81.3 vs. 50.0%, Fisher's exact test, p<0.05). No significant differences between the groups were found in the prevalence of brain disorders and primary sleep disorders, gender proportion, and sleep architecture. CONCLUSION: No difference in sleep architecture was found between the manifest and the latent RBD groups. Only age and the presence of abnormal sleep behavior on polysomnography differentiated the two groups. We suggest that RWA on polysomnography without complaints of abnormal sleep behavior may be early manifestation of manifest RBD. Attention to RWA on polysomnography is necessary to help prevent full-blown RBD from developing.
Brain Diseases ; Female ; Humans ; Male ; Mental Disorders* ; Polysomnography ; Prevalence ; REM Sleep Behavior Disorder ; Seoul ; Sleep Wake Disorders ; Sleep, REM*