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

The authors report seven cases of carotid-ophthalmic artery aneurysms who were surgically treated using the combined extradural-intradural or intradural approach from March, 1991, to December, 1993. Carotid-ophthalmic artery aneurysms are of considerably surgical interest because some of these were considered to have technical difficulties of clipping and disastrous surgical results. Removal of the anterior clinoid process and unroofing of the optic canal are the key points to exposure the operative field adequately. On the basis of these experiences, authors concluded that this approach is very useful, because of adequate surgical field and better mobilization of the internal carotid artery and optic nerve for direct clipping of carotid-ophthalmic artery aneurysm and basilar tip aneurysm.
Aneurysm* ; Arteries* ; Carotid Artery, Internal ; Optic Nerve

The incidence of severe hepatitis A virus (HAV) infection has been increasing. However, clinicopathologic features of severe HAV infection that lead to liver transplantation (LT) have not been reported in Korea. We retrieved 16 LT cases with HAV infection during the last 3 years at Asan Medical Center, Seoul, Korea. Fifteen cases progressed to hepatic encephalopathy. Thirteen cases survived with or without complications, and three patients died of sepsis. The explanted liver showed massive or zonal necrosis with moderate to severe cholestasis. The zonal distribution of necrosis was frequently associated with endothelialitis of portal and/or central veins. Degenerative changes of hepatocytes were various in degree and distribution. Viral inclusions were suspected in two cases. Although HAV infection is usually confirmed by serological tests, significant venulitis of central and/or portal veins and viral inclusions, which are rarely observed, can suggest an HAV infection as a cause of massive hepatic necrosis of unknown mechanism.
Cholestasis ; Fluconazole ; Hepatic Encephalopathy ; Hepatitis ; Hepatitis A ; Hepatitis A virus ; Hepatocytes ; Humans ; Incidence ; Korea ; Liver ; Liver Transplantation ; Massive Hepatic Necrosis ; Necrosis ; Portal Vein ; Sepsis ; Serologic Tests ; Veins

OBJECTIVE: Pituitary adenylate cyclase-activating polypeptide (PACAP), a novel hypothalamic neuropeptide, has been suggested to play a role in ovarian folliculogenesis. The present study evaluated the effect of PACAP on the growth of preantral follicles. METHODS: Preantral follicles were mechanically isolated from ovaries of 21-day-old rats and cultured in groups for 3 days in serum-free medium in the absence or presence of PACAP-38 (10-6 M). RESULTS: Treatment with PACAP-38 resulted in an increase in follicle diameter by 75% whereas treatment with follicle stimulating hormone (FSH) increased follicle diameter by 65%. PACAP-38 treatment enhanced the granulosa cell proliferation as measured by thymidine incorporation analysis. Furthermore, the production of progesterone by cultured granulosa cells and GFSHR-17 cell line was stimulated by PACAP-38. Interestingly, PACAP enhanced FSH action on stimulation of SF-1 and aromatase gene expression. CONCLUSION: The present results demonstrate that PACAP stimulated preantral follicle growth by potentiating proliferation and by stimulating steroidogenesis.
Animals ; Aromatase ; Cell Line ; Female ; Follicle Stimulating Hormone* ; Gene Expression ; Granulosa Cells ; Neuropeptides ; Ovarian Follicle* ; Ovary ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Progesterone ; Rats ; Thymidine

Zinc oxide nanoparticles (ZnO NPs) and titanium dioxide nanoparticles (TiO2 NPs) are well known as photoreactive nanoparticles (NPs). Various phototoxicities of ZnO NPs and TiO₂ NPs were reported on several organisms. It was still necessary to evaluate the toxicity of photoreactive ZnO NPs and TiO₂ NPs due to species-specific effects under various irradiation conditions. We compared the acute toxicity of Moina macrocopa under visible, ultraviolet (UV) A, and B irradiations, according to the Organization for Economic Cooperation and Development guidelines for the testing of chemicals (Test No. 202). The sensitivity of ZnO NPs for M. macrocopa was UVB>UVA>visible light irradiation. There were no significant lethal and immobile effects of TiO₂ NPs on juveniles under all irradiations and in the tested concentrations of TiO₂ NPs. Photoreactive NPs have a potential and accelerated toxicity on organisms in the ambient environments.
Dermatitis, Phototoxic ; Nanoparticles* ; Organisation for Economic Co-Operation and Development ; Titanium ; Zinc Oxide

Zinc oxide nanoparticles (ZnO NPs) and titanium dioxide nanoparticles (TiO2 NPs) are well known as photoreactive nanoparticles (NPs). Various phototoxicities of ZnO NPs and TiO₂ NPs were reported on several organisms. It was still necessary to evaluate the toxicity of photoreactive ZnO NPs and TiO₂ NPs due to species-specific effects under various irradiation conditions. We compared the acute toxicity of Moina macrocopa under visible, ultraviolet (UV) A, and B irradiations, according to the Organization for Economic Cooperation and Development guidelines for the testing of chemicals (Test No. 202). The sensitivity of ZnO NPs for M. macrocopa was UVB>UVA>visible light irradiation. There were no significant lethal and immobile effects of TiO₂ NPs on juveniles under all irradiations and in the tested concentrations of TiO₂ NPs. Photoreactive NPs have a potential and accelerated toxicity on organisms in the ambient environments.
Dermatitis, Phototoxic ; Nanoparticles ; Organisation for Economic Co-Operation and Development ; Titanium ; Zinc Oxide

PURPOSE: The purpose of this study was to measure meaning in life of elderly and to delineate basic data for developing nursing strategies for improving the meaning in life of elderly. METHOD: Subjects were 240 elderly above 65 years old staying in Busan and Kyungnam Province. The data was collected from May to Jun 2004. The instrument was utilizing Elderly Meaning In Life(EMIL) scale developed by Choi et al.(2003). RESULTS: The mean for elderly was 100.4, the range was from 37 to 148. 63.3% of subjects were in existential vacuum. The mean of 1 phase 'acceptance and awareness of self and life' was 36.9, 2 phase 'creative value realization' was 17.8, 3phase 'experiential value realization' was 2.8, 4 phase 'contentedness of past and present' was 43.7. There were significant differences according to the gender, religion, educational level, spouse, spending money, living arrangement and disease. CONCLUSION: On the viewpoint of above results, 63.3% of subjects were in level of existential vacuum, which required logotherapy. Therefore it shows that developing nursing-logotherapy to improve the meaning in life for elderly is demanded.
Aged* ; Busan ; Gyeongsangnam-do ; Humans ; Nursing ; Psychotherapy ; Residence Characteristics ; Spouses ; Vacuum

Reconstruction of lower extremity wounds in patients with abnormalities in vascular anatomy is often challenging. A 71-year-old man was admitted to our hospital after sustaining two contact burns on his right leg while sleeping on an electric blanket. Fourth-degree burns amounting to approximately 3% of total body surface area were confirmed, with eschar formation on the right instep and pretibial area. Both wounds on the lower leg required flap reconstruction. In addition, the patient had anterior tibial artery hypoplasia. We considered a two-flap reconstruction method that should leave the source artery and muscle intact and generally has a good prognosis. A peroneal artery perforator-based keystone flap was used on the right lower leg, and a right dorsalis pedis island flap on the foot dorsum. Surgery was performed successfully, and at 8 months postoperatively, the patient walked naturally and had no complaints of discomfort. Additionally, cosmetic results were satisfactory. Accordingly, we introduce a surgical method that is useful in cases similar to that described.

Reconstruction of lower extremity wounds in patients with abnormalities in vascular anatomy is often challenging. A 71-year-old man was admitted to our hospital after sustaining two contact burns on his right leg while sleeping on an electric blanket. Fourth-degree burns amounting to approximately 3% of total body surface area were confirmed, with eschar formation on the right instep and pretibial area. Both wounds on the lower leg required flap reconstruction. In addition, the patient had anterior tibial artery hypoplasia. We considered a two-flap reconstruction method that should leave the source artery and muscle intact and generally has a good prognosis. A peroneal artery perforator-based keystone flap was used on the right lower leg, and a right dorsalis pedis island flap on the foot dorsum. Surgery was performed successfully, and at 8 months postoperatively, the patient walked naturally and had no complaints of discomfort. Additionally, cosmetic results were satisfactory. Accordingly, we introduce a surgical method that is useful in cases similar to that described.

Crimes committed by the mentally ill may initially be mistaken as unmotivated or hate crimes, which may cause public anxiety and conflict between social classes. In this context, special attention is needed to secure social safety and to effectively respond against crimes committed by the mentally ill. For these purposes, comprehensive analysis of the details of such crimes, including the type of crime, the content of criminal behavior, the tool of crime, unusual behavior before and after the crime, and the triggering factor of the crime, can provide valuable information. If specific tendencies or common characteristics shared in criminal acts related to mental illness can be found, they would assist criminal investigations and determination of criminal responsibility. The authors analyzed 19 precedents of crimes with mental disorders. The results of the analysis are as follows: frequency of injured area was the highest in the face, neck, and head; perpetrator’s body (hands/feet) and knife were used the most as tools of assault; premeditation was revealed in eight cases, and crimes with active intention of harming and impulsive crimes happened at a similar frequency; schizophrenics usually committed crimes between 03:00-06:00, which is related to sleep disturbance in schizophrenia; in five cases, criminal acts—violent crimes such as murder, arson, and rape—were committed under the influence of alcohol; and homicide is related more frequently to schizophrenia, personality disorder, and intellectual disability.