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 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

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

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

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

Infants are highly vulnerable, requiring the protection of caregivers for their survival. Unfortunately, infant abandonment continues to be committed regularly, posing a serious challenge to the dignity of human life. To identify the motivation and background information of this crime, we analyzed 20 cases of infant abandonment to determine their critical characteristics. We aimed to gather data to assist in crime prevention and ultimately to address the need for new policies to prevent this crime. The results of our analysis are as follows: The mothers who abandoned their infants were in their teens and twenties in 15 cases (75%). The relationship between the biological parents was that of longterm partners in 12 cases (60%). The place of childbirth was the perpetrator’s home in 16 cases (80%). The place of abandonment wasoutdoors in 9 cases (5 cases alive, 4 cases dead) and indoors in 10 cases (5 cases alive, 5 cases dead). Basic life support for the infant was provided in 4 cases. The most common excuse for abandonment was to conceal childbirth in 12 cases, followed by economic hardship in 8 cases. Executions were suspended in 19 cases, and the reasons for the sentences often seemed inadequate, even in light of the provisions of the criminal code. These results indicate that our society has the need to develop the appropriate acts or policies to stop the crime of infant abandonment.

Among the various crimes, the ones committed by the mentally ill provoke more serious public concern, which is probably caused by such characteristics such as unpredictability, brutality, unknown motives, or random targeting of victims. The purpose of this study was to analyze the characteristics of crimes committed by the mentally ill, to investigate the type of mental disorders and assaulting weapons, and to examine the correlation between the type of mental disorders and their criminal behavior patterns. Through the combination of the forensic and psychological approach, the authors examined the psychological and behavioral characteristics of mentally ill criminals to identify the criminal and behavioral characteristics of crimes committed by them. The cases for this analysis were collected through the search for precedents at National Law Information Center where 19 cases were selected. In conclusion, the diagnoses of mental disorders were schizophrenia, pedophilia, intellectual disability, personality disorder, and depressive disorder, in descending order. Among them, schizophrenia accounted for 6 cases (31.6%), where especially the paranoid type (3 cases) committed the premeditated crimes. Mental handicap was recognized in 9 cases and was rejected in 4 cases. However, in 6 cases, it was not mentioned by court. Further, the judgment of being mental handicapped was made without reference of mental appraisal in 3 out of 19 cases, and so its credibility might be argued. The number of defendants who had past criminal histories was 7 (33.3%) out of 21 defendants, which may illustrate the rate of recidivism of mental disorder criminals.

Crimes committed by the mentally ill may give rise to critical conflicts on whether the criminals should receive punishment or treatment. Therefore, our criminal code has a legal provision for mental handicap and criminal responsibility, which can reduce or exempt the criminal penalty. This process requires a psychiatric evaluation of the defendants as well as normative decisions by judges. The psychiatric evaluation and diagnosis precede the court judgement, and are used by the court to judge the mental handicap of the defendant at the time of the crime. However, judgments on the criminal responsibility of a defendant with mental disorder are very complex and challenging because of time gaps and difficulties faced in the evaluation of human mental ability. We analyzed court rulings in 19 cases where the defendants claimed to be mentally handicapped. The analysis results showed that the mental handicap was recognized in nine cases, rejected in four cases, and not mentioned by the court in six cases. Further, psychiatric evaluation was not performed in three cases. Apart from the result of the evaluation, the judges seem to consider other factors for sentencing, like recidivism risk, premeditation of crimes, and their brutality. These results suggest that the rationale and procedure of court rulings involving mentally handicapped persons may be debatable. We argue that psychiatric evaluations should be made indispensable in judicial procedures for cases involving mentally handicapped persons, and judges should clearly indicate their decision on mental handicap or criminal responsibility in the sentencing.