Background and Objectives: The aim of this study was to investigate the compliance and treatment effects of both rapid eye movement sleep related obstructive sleep apnea (REM_ OSA) and non-stage specific OSA (NS_OSA) patients prescribed with positive airway pressure (PAP) therapy.Subjects and Method Medical records of 223 patients diagnosed with OSA from July 2021 to March 2023 were retrospectively analyzed. Six-month PAP compliance, symptoms questionnaires were compared for 60 patients in the REM_OSA group and 163 in the NS_OSA group. Results: For patients in mild NS_OSA, mild REM_OSA, moderate NS_OSA, moderate REM_ OSA, severe NS_OSA, and severe REM_OSA groups, the compliance of six-month PAP was 50.0%, 33.3% (p=0.467), 69.6%, 58.3% (p>0.999), 70.7%, and 0% (p=0.023), respectively. In the NS_OSA group, PAP led to significant daytime sleepiness score improvement (7.3±3.4 to 5.7±3.6, p=0.022). In contrast, the scores for the REM_OSA group changed insignificantly (8.4±4.7 to 6.8±2.9, p=0.332). Conclusion This study revealed that PAP therapy compliance of the REM_OSA group was not lower than that of the NS_OSA group, except for the severe subgroup. However, REM_OSA was found to be less effective in improving daytime sleepiness symptoms than NS_OSA after PAP therapy.

Background and Objectives: The aim of this study was to investigate the compliance and treatment effects of both rapid eye movement sleep related obstructive sleep apnea (REM_ OSA) and non-stage specific OSA (NS_OSA) patients prescribed with positive airway pressure (PAP) therapy.Subjects and Method Medical records of 223 patients diagnosed with OSA from July 2021 to March 2023 were retrospectively analyzed. Six-month PAP compliance, symptoms questionnaires were compared for 60 patients in the REM_OSA group and 163 in the NS_OSA group. Results: For patients in mild NS_OSA, mild REM_OSA, moderate NS_OSA, moderate REM_ OSA, severe NS_OSA, and severe REM_OSA groups, the compliance of six-month PAP was 50.0%, 33.3% (p=0.467), 69.6%, 58.3% (p>0.999), 70.7%, and 0% (p=0.023), respectively. In the NS_OSA group, PAP led to significant daytime sleepiness score improvement (7.3±3.4 to 5.7±3.6, p=0.022). In contrast, the scores for the REM_OSA group changed insignificantly (8.4±4.7 to 6.8±2.9, p=0.332). Conclusion This study revealed that PAP therapy compliance of the REM_OSA group was not lower than that of the NS_OSA group, except for the severe subgroup. However, REM_OSA was found to be less effective in improving daytime sleepiness symptoms than NS_OSA after PAP therapy.

Background and Objectives: The aim of this study was to investigate the compliance and treatment effects of both rapid eye movement sleep related obstructive sleep apnea (REM_ OSA) and non-stage specific OSA (NS_OSA) patients prescribed with positive airway pressure (PAP) therapy.Subjects and Method Medical records of 223 patients diagnosed with OSA from July 2021 to March 2023 were retrospectively analyzed. Six-month PAP compliance, symptoms questionnaires were compared for 60 patients in the REM_OSA group and 163 in the NS_OSA group. Results: For patients in mild NS_OSA, mild REM_OSA, moderate NS_OSA, moderate REM_ OSA, severe NS_OSA, and severe REM_OSA groups, the compliance of six-month PAP was 50.0%, 33.3% (p=0.467), 69.6%, 58.3% (p>0.999), 70.7%, and 0% (p=0.023), respectively. In the NS_OSA group, PAP led to significant daytime sleepiness score improvement (7.3±3.4 to 5.7±3.6, p=0.022). In contrast, the scores for the REM_OSA group changed insignificantly (8.4±4.7 to 6.8±2.9, p=0.332). Conclusion This study revealed that PAP therapy compliance of the REM_OSA group was not lower than that of the NS_OSA group, except for the severe subgroup. However, REM_OSA was found to be less effective in improving daytime sleepiness symptoms than NS_OSA after PAP therapy.

Background and Objectives: The aim of this study was to investigate the compliance and treatment effects of both rapid eye movement sleep related obstructive sleep apnea (REM_ OSA) and non-stage specific OSA (NS_OSA) patients prescribed with positive airway pressure (PAP) therapy.Subjects and Method Medical records of 223 patients diagnosed with OSA from July 2021 to March 2023 were retrospectively analyzed. Six-month PAP compliance, symptoms questionnaires were compared for 60 patients in the REM_OSA group and 163 in the NS_OSA group. Results: For patients in mild NS_OSA, mild REM_OSA, moderate NS_OSA, moderate REM_ OSA, severe NS_OSA, and severe REM_OSA groups, the compliance of six-month PAP was 50.0%, 33.3% (p=0.467), 69.6%, 58.3% (p>0.999), 70.7%, and 0% (p=0.023), respectively. In the NS_OSA group, PAP led to significant daytime sleepiness score improvement (7.3±3.4 to 5.7±3.6, p=0.022). In contrast, the scores for the REM_OSA group changed insignificantly (8.4±4.7 to 6.8±2.9, p=0.332). Conclusion This study revealed that PAP therapy compliance of the REM_OSA group was not lower than that of the NS_OSA group, except for the severe subgroup. However, REM_OSA was found to be less effective in improving daytime sleepiness symptoms than NS_OSA after PAP therapy.

Background and Objectives: The aim of this study was to investigate the compliance and treatment effects of both rapid eye movement sleep related obstructive sleep apnea (REM_ OSA) and non-stage specific OSA (NS_OSA) patients prescribed with positive airway pressure (PAP) therapy.Subjects and Method Medical records of 223 patients diagnosed with OSA from July 2021 to March 2023 were retrospectively analyzed. Six-month PAP compliance, symptoms questionnaires were compared for 60 patients in the REM_OSA group and 163 in the NS_OSA group. Results: For patients in mild NS_OSA, mild REM_OSA, moderate NS_OSA, moderate REM_ OSA, severe NS_OSA, and severe REM_OSA groups, the compliance of six-month PAP was 50.0%, 33.3% (p=0.467), 69.6%, 58.3% (p>0.999), 70.7%, and 0% (p=0.023), respectively. In the NS_OSA group, PAP led to significant daytime sleepiness score improvement (7.3±3.4 to 5.7±3.6, p=0.022). In contrast, the scores for the REM_OSA group changed insignificantly (8.4±4.7 to 6.8±2.9, p=0.332). Conclusion This study revealed that PAP therapy compliance of the REM_OSA group was not lower than that of the NS_OSA group, except for the severe subgroup. However, REM_OSA was found to be less effective in improving daytime sleepiness symptoms than NS_OSA after PAP therapy.

Background: Catheter-associated urinary tract infections (CAUTIs) account for a large proportion of healthcare-associated infections and have a significant impact on morbidity, length of hospital stay, and mortality. Adherence to the recommended infection prevention practices can effectively reduce the incidence of CAUTIs. This study aimed to assess the characteristics of CAUTIs and the efficacy of prevention programs across hospitals of various sizes. Methods: Intervention programs, including training, surveillance, and monitoring, were implemented. Data on the microorganisms responsible for CAUTIs, urinary catheter utilization ratio, rate of CAUTIs per 1,000 device days, and factors associated with the use of indwelling catheters were collected from 2017 to 2019. The incidence of CAUTIs and associated data were compared between university hospitals and small- and medium-sized hospitals. Results: Thirty-two hospitals participated in the study, including 21 university hospitals and 11 small- and medium-sized hospitals. The microorganisms responsible for CAUTIs and their resistance rates did not differ between the two groups. In the first quarter of 2018, the incidence rate was 2.05 infections/1,000 device-days in university hospitals and 1.44 infections/1,000 device-days in small- and medium-sized hospitals. After implementing interventions, the rate gradually decreased in the first quarter of 2019, with 1.18 infections/1,000 device-days in university hospitals and 0.79 infections/1,000 device-days in small- and medium-sized hospitals. However, by the end of the study, the infection rate increased to 1.74 infections/1,000 device-days in university hospitals and 1.80 infections/1,000 device-days in small- and medium-sized hospitals. Conclusion We implemented interventions to prevent CAUTIs and evaluated their outcomes. The incidence of these infections decreased in the initial phases of the intervention when adequate support and personnel were present. The rate of these infections may be reduced by implementing active interventions such as consistent monitoring and adherence to guidelines for preventing infections.

A case of persistent Ralstonia mannitolilytica bacteremia in the neonatal intensive care unit prompted source investigation due to its rarity. After an extensive investigation, a contaminated ultrasonic nebulizer was identified as the source, and the infection was controlled by removing the source. This study emphasizes the importance of further investigations, even in single cases of rare pathogens.

Caudal septal deviation is an important cause of nasal obstruction and is a major cause of nasal septal surgery. Although reinforcing and straightening the deviated nasal septum with bone fragment or cartilage is known to be quite effective, such procedure is complicated and time-consuming as it consists of three steps; ‘separation,’ ‘correction,’ and ‘reposition and fixation.’ In this article, we introduce a new technique that can reliably position the caudal septum along the midline and simplify the surgical process into two steps: ‘separation’ and ‘correction and fixation.’

Background and Objectives: Considering the prevalence and health effects of obstructive sleep apnea (OSA), early diagnosis and proper treatment are essential. Polysomnography (PSG) has limitations in diagnosing or tracking large-scale OSA patients. Smartwatches (SWs) can be equipped with a photoplethysmograph (PPG) that can indirectly measure heart rate and blood oxygen saturation by detecting the difference of light absorption through blood. The purpose of this study is to compare oxygen saturation parameters of PPG-based SWs with those of PSG to determine the diagnostic accuracy for OSA. Methods: After obtaining voluntary consent from patients who were scheduled to undergo PSG in a sleep clinic due to suspected OSA, they were randomly assigned to wear a Galaxy watch4 (GW) or Apple watch7 (AW) on their wrist. The agreement rates between the oxygen saturation parameters of the two SW types and PSG were evaluated. The accuracy, sensitivity, and specificity of the oxygen saturation parameters for diagnosis of OSA (apnea-hypopnea index [AHI] ≥5/h) were compared between the two types of SW. Results: A total of 133 patients underwent PSG while wearing an SW. Including duplicates, 109 patients wearing a GW and 69 wearing an AW were included. The diagnostic accuracy of AHI ≥5/h according to oxygen saturation time measured by a GW was less than 90%, the respective sensitivity and specificity were 82.9% and 75.8%. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.807 (p<0.001). Using the lowest oxygen saturation value of GW, the sensitivity was 81.6%, the specificity was 69.7%, and the AUC of the ROC was 0.849 (p<0.001). The diagnostic accuracy of AHI ≥5/h according to the average oxygen saturation of AW, and the sensitivity and specificity were 75.6% and 70.8%, respectively. The AUC of this ROC curve was 0.757 (p<0.001). Using the lowest oxygen saturation value of AW, the sensitivity was 71.1%, the specificity was 62.5%, and the AUC of the ROC was 0.705 (p=0.005). Conclusion This study found that the two types of SW showed considerable accuracy in diagnosing OSA, but the accuracy decreased as the severity of OSA increased.

Background and Objectives: Recurrent hypoxia, hypercapnia, and arousal during sleep can induce hyperactivity of the sympathetic nervous system (SNS) in patients with obstructive sleep apnea (OSA), which contributes to the development of hypertension and cardiovascular disease. This study was designed to compare changes in heart rate (HR) and heart rate variability (HRV), both of which reflect the activity of the autonomic nervous system (ANS) in OSA patients before and immediately after continuous positive airway pressure (CPAP) titration.Subjects and Method Thirty-five OSA patients (47.8±12.3 years) and 16 healthy subjects (43.2±12.5 years) were enrolled in this study. A night CPAP titration was performed on the OSA patients, and HRV was calculated by RR intervals from the electrocardiogram signals during the total sleep time. Results: The mean age of OSA patients was 47.8 years (M:F=34:1), and the control group was 43.3 years (M:F=14:2). The mean AHI of OSA patients was 53.4±31.9, and decreased 17.3±19.4 after CPAP titration, and 4.3±1.6 in the normal controls. During CPAP titration, the mean HR of OSA patients was 68.0±8.9, which was significantly higher than that of the normal controls, 59.5±9.0 (p=0.003). For HRV, standard deviation of all NN intervals (p=0.001), root mean square of the successive NN intervals (p<0.001), and low frequency (LF) (p=0.006) values were significantly decreased after CPAP titration compared to the baseline. After CPAP titration, LF (p=0.017) and LF/HF (p=0.003) values were still significantly higher than those of the normal controls. Conclusion HRV analysis revealed that CPAP titration for one day caused decreased SNS activity but did not induce a balance in ANS when compared to the normal controls.