Longitudinal Trends in Sleep and Related Factors Among South Korean Adults From 2009 to 2018

Background@#and Purpose Excess or insufficient sleep, irregular sleep-wake patterns, and an extreme early or late chronotypes adversely impact physical and mental health. Changes in sleep characteristics should therefore be tracked, and factors that contribute to poor sleep should be identified. We investigated the changes in sleep patterns among South Korean adults during 2009–2018. @*Methods@#Using data of a representative sample of South Korean adults from the 2009 (n= 2,658, 48.5% males; age=44.5±15.0 years old [mean±standard deviation], age range=19–86 years) and 2018 (n=2,389, 49.1% males; age=47.9±16.3 years, age range=19–92 years) Korean Headache-Sleep Study, we explored changes in sleep timing, sleep duration, chronotype, and social jetlag (SJL). Logistic regression analysis was used to examine the association between average sleep duration and depression. @*Results@#From 2009 to 2018, bedtimes were advanced by 10 and 25 min on workdays and free days, respectively. Meanwhile, wake-up times were advanced by 13 min and delayed by 12 min on workdays and free days, respectively. The average sleep duration significantly decreased from 7.45 h to 7.13 h. The prevalence of short sleep duration (<7 h) increased, whereas that of long sleep duration (≥8 h) decreased. A circadian preference toward eveningness and SJL increased. The prevalence of depression increased from 4.6% to 8.4%, and there were significant reverse J-shaped and U-shaped associations between average sleep duration and depression in 2009 and 2018, respectively. @*Conclusions@#Changes in sleep patterns and the association between sleep duration and depressive mood were determined from a representative sample of the South Korean adult population. Interventions to modify sleep behaviors might improve public health.

Alterations of Functional Connectivity in Patients With Restless Legs Syndrome

Restless legs syndrome (RLS) is a common neurological illness marked by a strong desire to move one’s legs, usually in association with uncomfortable sensations. Recent studies have investigated brain networks and connectivity in RLS. The advent of network analysis has greatly improved our understanding of the brain and various neurological disorders. A few studies have investigated alterations in functional connectivity in patients with RLS. This article reviews functional connectivity studies of patients with RLS, which have identified significant alterations relative to healthy controls in several brain networks including thalamic, salience, default-mode, and small-world networks. In addition, network changes related to RLS treatment have been found, including to repetitive transcranial magnetic stimulation, transcutaneous spinal cord direct-current stimulation, and dopaminergic drugs. These findings suggest that the underlying pathogenesis of RLS includes alterations in the functional connectivity in the brain and that RLS is a network disorder.

Serious Neurological Disorders That Mimic Bell’s Palsy: A 10-Year Experience / 대한신경근육질환학회지

Background@#Unilateral peripheral facial nerve palsy may have a detectable cause (secondary facial nerve palsy) or may be idiopathic (Bell’s palsy). Facial palsy is attributable to various causes ranging from mild infection to severe neurological disorders. We investigated the prevalence and types of serious neurological disorders in patients with unilateral facial palsy. @*Methods@#We reviewed the medical records of patients with unilateral facial nerve palsy and identified patients diagnosed with facial palsy secondary to serious or life-threatening causes. We investigated the clinical characteristics, as well as electrodiagnostic and imaging findings in these patients. @*Results@#Of 924 patients with facial palsy, 11 patients (1.2%) were diagnosed with the following serious neurological disorders: acoustic schwannoma in two patients, facial nerve schwannoma, glossopharyngeal schwannoma, meningioma, epidermoid cyst, parotid gland tumor, pontine infarct, skull base osteomyelitis, brain metastasis, and pachymeningitis. @*Conclusions@#Although unilateral facial palsy is rarely associated with serious neurological disorders, early detection of the etiopathogenetic contributors is important for prompt initiation of optimal management. Therefore, clinicians should be mindful of disorders that can mimic Bell’s palsy.

Synergic Effects of Cranial Electrotherapy Stimulation with Sleep Hygiene in Patients with Chronic Insomnia

OBJECTIVES: To investigate the therapeutic effect of cranial electrotherapy stimulation (CES) with sleep hygiene in patients with chronic insomnia. METHODS: This study was designed as a prospective, double-blinded, and randomized controlled trial. Twenty-seven patients with chronic insomnia were recruited and randomly allocated to two groups; cranial microcurrent therapy (MC) group and sham group. All patients received sleep hygiene education. Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were measured at baseline (pre-treatment), and 2 weeks and 4 weeks of treatment. RESULTS: In MC group, the PSQI and ISI showed a tendency to decrease consistently until 4 weeks of treatment. In sham group, PSQI and ISI initially decreased during the first 2 weeks, but it increased after 2 weeks of treatment. CONCLUSIONS: This study showed that combination treatment of CES and sleep hygiene is more effective in treating chronic insomnia than sleep hygiene only as demonstrated by improvement and maintenance of sleep score for 1 month.

Molecular Analysis of Eight American Type Culture Collection Gonococcal Strains by Neisseria gonorrhoeae Multiantigen Sequence Typing and PorB Sequence Typing / 임상검사와정도관리

BACKGROUND: Molecular epidemiological typing of Neisseria gonorrhoeae is crucial for monitoring the spread of resistant strains. As reference strains can be used for laboratory internal quality control, we genetically characterised the American Type Culture Collection (ATCC) gonococcal strains by Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) and porB sequence typing using public multilocus sequence typing (PubMLST). METHODS: Eight ATCC gonococcal reference strains (ATCC 19424, ATCC 31426, ATCC 35541, ATCC 43069, ATCC 43070, ATCC 49226, ATCC 49926, and ATCC 49981) from Culti-Loops (Thermo Fisher Scientific, USA) were cultured. After DNA extraction, porB and tbpB were amplified and sequenced. Sequence types (STs) and allele numbers were each determined by NG-MAST (http://www.ng-mast.net) and porB sequence typing using PubMLST (http://pubmlst.org/neisseria/porB/). RESULTS: ATCC 19424 was identified as ST 266 by NG-MAST, and as Allele 946 by PubMLST. ATCC31426 was assigned a novel ST by NG-MAST, and was assigned Allele 958 with 1.2% mismatch by PubMLST. ATCC 35541 was identified as ST 12 by NG-MAST, and as Allele 624 by PubMLST. ATCC 43069 and ATCC 43070 were both identified as ST 681 by NG-MAST, and as Allele 984 by PubMLST. ATCC 49226 was identified as ST 1572 by NG-MAST, and as Allele 2110 by PubMLST. ATCC 49926 and ATCC 49981 were both identified as ST 16496 by NG-MAST, and as Allele 928 by PubMLST. CONCLUSIONS: The ST data obtained for ATCC gonococcal reference strains by NG-MAST and porB sequence typing using PubMLST can be used for quality assurance of molecular epidemiological typing in clinical microbiological laboratories.

Myasthenia Gravis with Thymoma Recurrence 20 Years after Thymectomy: What Is the Optimal Follow-up Duration?

Thymoma occurs in about 20% of patients with myasthenia gravis (MG), but the recurrence of thymoma has rarely been reported. A 68-year-old man presented with ptosis and weakness of the neck muscles. He had undergone thymectomy for ocular MG with invasive thymoma 20 years previously. Chest computed tomography revealed recurrence of the thymoma. This 20-year period is, to our knowledge, the longest reported interval for recurrence of an MG-associated thymoma. The literature on the optimal follow-up duration after thymectomy is reviewed.

Radial Neuropathy after Cryolipolysis

Cryolipolysis has become available for the noninvasive reduction of adipose tissue. A 33-year-old woman presented with wrist drop of the right arm that had first appeared 7 days previously. She had undergone cryolipolysis on both upper arms immediately prior to the onset of symptoms. A nerve conduction study showed radial neuropathy proximal to the elbow, and ultrasonography revealed focal swelling of the radial nerve at the spiral groove. Although cryolipolysis has been known as a safe method, nerve injury can result from compression and/or hypothermia during the procedure.

Carotid-Cavernous Fistula Due to Giant Aneurysm in a Postpartum Woman

A carotid-cavernous fistula (CCF) is an abnormal communication between the venous cavernous sinus and the carotid artery. The rupture of an intracavernous aneurysm is usually caused by trauma, but spontaneous rupture can also occur, with pregnancy being a contributing factor. We report a case of direct CCF due to rupture of a giant aneurysm in a postpartum woman.

Effects of Sleep on Balance Control and Reaction Time to Visual Stimuli / 수면정신생리

OBJECTIVES: To find evidence that sleep is necessary for normal brain function, thus indicating that declines in both sleep quality and quantity are related to worse performance of many daily tasks and deteriorated physical functions. The present study investigates the relationships of balance control and reaction time with sleep quality. METHODS: 58 healthy (male 20, female 38) volunteers with informed consent participated in this study. The Self-reported Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality and relevant factors, and the subjects were divided into groups A (PSQI < 5) and B (PSQI ≥ 5) based on this index. Static balance control and reaction time to visual stimuli were conducted to assess their relationship with sleep quality. RESULTS: Group B exhibited excessive daytime sleepiness significantly more often compared to group A. Static balance control did not markedly change relative to sleep quality, but reaction time and error to visual stimuli were significantly increased in group B compared to group A. CONCLUSION: These findings indicate that a decline in sleep quality can result in delayed reactions, as well as decreased accuracy of these reactions. They also suggest that low sleep quality may be associated with changes in physical functions, including balance control through reduced selective attention.

A Case Report of Thyrotoxic Periodic Paralysis; Serial Nerve Conduction Studies before and after Recovery / 대한임상신경생리학회지

No abstract available.

Effects of Gender on White Blood Cell Populations and Neutrophil-Lymphocyte Ratio Following Gastrectomy in Patients with Stomach Cancer

Alterations of absolute number or percentage of circulating white blood cell (WBC) subsets are associated with psychological and physical stress. Gender effects on the changes of circulating WBC subsets following surgical treatment have not been determined. Therefore, the current study aimed to determine whether circulating neutrophils, lymphocytes and monocytes, and neutrophil-lymphocyte ratio (N/L) are different following major surgery according to the gender. We studied 409 male patients and 212 female patients who underwent total or subtotal gastrectomy due to stomach cancer, from 1 January to 31 December in 2005. The WBC count and percentage of its subsets were obtained from database and N/L was directly calculated from the full blood count preoperatively, immediate postoperatively, and postoperative day 1, 3, 5 in a retrospective manner. Compared to preoperative values, neutrophilia, lymphopenia, monocytopenia, and increased N/L were associated with gastrectomy in all patients. In the comparison study between genders, there were significantly increased proportion of neutrophils, decreased lymphocytes and monocytes, and higher N/L in female patients than in male patients after gastrectomy. These findings indicate that female patients showed more immune-compromised response to gastrectomy than male patients.

Changes of Core Temperature on Tourniquet Duration / 대한마취과학회지

BACKGROUND: Core temperature changes during tourniquet inflation and deflation have been reported. The aim of this study is to investigate the extent of core temperature changes during inflation and deflation, depending on tourniquet time. METHODS: Esophageal temperature in sixty patients who undergoing knee arthroscopy with tourniquet longer than 1 h (group L, n = 30) and less than 1 h (group S, n = 30) were measured before inflation, 30 and 60 min after inflation, just before deflation, and 1 min interval for 10 min after deflation. RESULTS: Tourniquet time in L and S group was 109 +/- 20 min and 46 +/- 10.7 min, respectively. Compared to baseline value of 35.7 +/- 0.07 degrees C, significant increase of 0.14 +/- 0.02 degrees C, 0.25 +/- 0.03 degrees C, 0.4 +/- 0.05 degrees C were observed at 30, 60 min after inflation, and just before deflation, respectively in group L, and the increase of 0.11 +/- 0.03 degrees C and 0.18 +/- 0.03 degrees C at 30 min after inflation and just before deflation, respectively in group S. Temperatures from 2 to 10 min after deflation were significantly lower than value of just before deflation in each group (P < 0.05). At 10 min after deflation, 0.76 +/- 0.13 degrees C in group L and 0.4 +/- 0.04 degrees C in group S were lower than values of just before deflation in each group (P < 0.05). Temperature at 10 min after deflation was significantly different between the groups (P < 0.05). CONCLUSIONS: Extent of core temperature decrease after tourniquet deflation was dependent on the duration of tourniquet application.

A Study on Calcium and Iron Status of Lactating Women

This study was intended to investigate the nutritional status between lactating and non- lactating women, especially calcium and iron. The subjects were 84 lactating women and 20 non-lactating women visiting a public health center and hospital in Daegu. Each subject was interviewed to collect the information on dietary intake for 2 consecutive days. Biochemical assessment of iron status and bone mineral density (BMD) measurement were conducted. Dietary intake of carbohydrate, potassium, Vit B1, B2, Vit C were significantly higher in women during lactating period (p < 0.05). However, relative intake as expressed by percentage of Korean Recommended Dietary Allowances (RDA) was not significantly different between the two groups. The dietary intake of iron and calcium were 58.8%, 60.4% of Korean RDA respectively in women during lactating period. The current food habit score of these women was significantly higher than that of non-lactating women (p < 0.05). When we compared the quality of nutritional status, the Index of nutritional quality (INQ) was significantly higher for vitamin B2, P in lactating women than in non-lactating women (p < 0.1). Mean adequacy ratio (MAR) was not significantly different between two groups. Dietary variety score (DVS) was significantly higher in women during the lactating period (p < 0.05). There was no significant difference in biomarkers (Hb, Hct, Serum ferritin, Transferrin) related to iron status between the two groups. No significant difference in bone mineral density (BMD) T-score was not observed. However, it appeared that BMD of lactating women was lower than that of non- lactating women.

Comparison of Dietary Habits and Nutrient Intakes in Subjects with Obesity or Hyperglycemia Classified Metabolic Syndrome

Metabolic syndrome (MS) was defined as condition in which the subjects have two or more abnormalities among obesity, hyperlipidemia, hypertension and hyperglycemia. To develop a nutritional education program for MS, this study was performed to compare the dietary habits and nutrients intake of complex symptoms of MS with obesity or hyperglycemia. The participants in this study were 84 normal adults, 62 MS with obesity, 33 MS with hyperglycemia and 54 MS with obesity and hyperglycemia (OB + HG). A dietary survey was conducted using 24-hour recall method. Total cholesterol level of MS with obesity group was significantly higher than other groups. WHR and systolic blood pressure showed no significant difference among MS with obesity, hyperglycemia and OB + HG groups. Dietary intakes of energy, Fe, Vit A, Vit B2 and Ca were less than 75% of 7th Korean RDA in the all groups. Especially, dietary intakes of Vit B2, Vit A and Ca were less than 50% of RDA in MS with hyperglycemia and OB + HG groups. The other nutrient intakes of each group were also below the RDA level except for P, Vit C. It appeared that most of the nutrient intakes in MS with hyperglycemia and OB + HG groups were significantly lower than normal group. In MS with obesity group, each consumption of sweet, organ meat and soup was higher than other groups. Each consumption of garlic and onion in MS with obesity, hyperglycemia and OB + HG groups was lower than normal group. Also, each consumption of soup in MS with hyperglycemia and OB + HG groups was higher than normal group. Indices of nutritional quality (INQ) for Ca, Vit A and Vit B2 were below 1 in all the groups. Food composition group score of MS with hyperglycemia group was significantly lower than normal and MS with obesity groups. Our results indicated that nutritional education program for MS with obesity or hyperglycemia should include specific strategies to modify unsound dietary habits and inappropriate food intake for health.

Dietary Behaviors and Status of Nutrient Intakes by the Obesity Levels of Housewives in Daegu / 대한지역사회영양학회지

This study was intended to collect the baseline information on dietary behavior of adults to develop nutrition education program in the context of healthy weights at community level. Nutrient intakes of 128 housewives were assessed by 24 hour recall method. Also food habits, nutrition knowledge and attitude were investigated by self-administered questionnaires. Subjects were divided to under-weight, normal-weight, over-weight groups by body mass index (BMI). Most under-weight groups evaluated as their current body images were normal. 41% of normal-weight groups judged as their current body images were obese. Energy and fat intakes of over-weight group were significantly higher than that of under-weight and normal weight groups (p < 0.05). However, carbohydrate and protein intakes showed no significant differences among the three groups. It appeared that active attitude toward change in nutrition attitude of normalweight group was significantly higher than that of under-weight group (p < 0.05). There were no significant differences of food habit score, nutrition knowledge, and obesity habit scores among the three groups. The frequency of eating-out showed significant difference among three groups (p < 0.05). Food habit scores were positively related to health-concerned attitude (r = 0.174), convenience-concerned attitude (r = 0.229) and food enjoyed attitude (0.213) and negatively related to obesity habit score (r = -0.206). Also, positive correlation of body fat mass with frequency of eatingout (r = 0.213), instant food (r = 0.227) and amount of meal (r = 0.187) existed (p < 0.05). We concluded that nutrition education programs for housewives should include specific strategies to modify unsound food behaviors and inappropriate perception of body image for a healthy weight.

A Comparison of Energy Intake and Energy Expenditure in Normal-Weight and Over-Weight Korean Adults / 대한지역사회영양학회지

The purpose of this study was to compare the energy expenditure and energy intake of normal-weight and overweight Korean adults. We recruited 242 adults to determine resting energy expenditure, physical activity and energy intake. Resting energy expenditure was measured by indirect calorimetry. Energy intake for consecutive two days was assessed by 24 hour recall method. Daily activity pattern for 24 hour was collected from each subject. Body weight, lean body mass and percentage body fat were measured by INBODY 3.0. The subjects were divided into normal (20 or = 25) groups by BMI. There was no significant difference in intake of energy between two groups. Energy intake of each group was lower than the 7th Korean RDA of energy. Overweight subjects showed significantly lower REE/kg body weight. However, REE/kg lean body mass (LBM) did not differ between the two groups. Total activity energy was significantly higher in the overweight group compared to the normal group. Daily activity coefficient of overweight group in male was lower than that of normal group. Daily activity coefficient was almost same in two female groups. LBM was highly correlated with REE and total energy expenditure. We concluded that the overweight group consumed more energy than the normal group due to the heavier body weight.

A Comparison of the Resting Energy Expenditure of Korean Adults Using Indirect Calorimetry / 대한지역사회영양학회지

The purpose of this study was to provide baseline data for revising the recommended energy intake for Korean adults. We recruited 290 adults so as to determine their resting energy expenditure (REE) and energy intake. The REE was measured by indirect calorimetry. We also calculated the REE from prediction equations formulated by World Health Organization (WHO). The energy intake for two consecutive days was assessed using the 24 hour recall method. The body weight, lean body mass (LBM) and percentage body fat were measured using the INBODY 3.0 system. We compared the results of three age groups; 20 to 29 years, 30 to 49 years and 50 years or more. The average energy intake of each age group was below the 7th Korean Recommended Dietary Allowances (RDA). The average energy intake was lower in the older age groups. However, no difference was observed among the age groups when the energy intake as a percentage of the Korean RDA was compared. Our measurement of the REE was higher than the REE calculated by the WHO's method. Correlation coefficients between the measured and the calculated values of REE for all age groups showed significant correlations (r = 0.475-0.672). As the ages of all the subjects increased, the REE/kg of body weight decreased. There were no significant differences in the REE / kg of the LBM between the different age groups; however, the REE/kg of the LBM was higher in the female group than in the male group. Negative correlations of the REE with the age (r = -0.242) and body fat ratio (r = -0.313) were observed; positive correlations of the REE with the BMI (r = 0.265), height (r = 0.570), weight (r = 0.562) and LBM (r = 0.586) were also found (p < 0.01).

A Screening Tool for Identifying High-Risk Pregnant Women of Fe Deficiency Anemia : Process II / 대한지역사회영양학회지

Pregnant women in South Korea are a highly risk group for iron deficiency anemia. Previous studies indicated that the 24-hour recall method was insensitive in distinguishing iron deficiency anemic women from normal women. This method is also impractical to when used at community health centers where no public health dietitians are employed. The objective of this study was to develop a convenient tool to evaluate the usual iron (Fe) intake of pregnant women. The study participants were 115 pregnant women (age 23 to 37 years) at gestational stage of 13 to 24 weeks. Anemic subjects were classified on the basis of their serum ferritin < 12.0 microgram/L and hemoglobin < 12.0microgram/dL levels. Food frequency questionnaires with 46, 29, and 15 commonly consumed food items were used to measure the usual intake of iron of the subjects. Hemoglobin and serum ferritin were measured from fasting blood samples. Nutrients intake was assessed on three consecutive days using the 24-hour recall method and the food record method. The iron index score calculated using the food frequency method showed a significantly positive correlation with iron intake for the three days dietary intake. The iron index showed a significantly difference (p < 0.05) between the normal and anemic groups. However, there was no significant difference in the iron intake between the anemic and the normal women as measured by the 24-hour recall and food record method. Our study indicated that the 29-food items questionnaire could be used as a screening tool to identify poor dietary intake of iron.

The Iron Status and Diet Quality of Pregnant Women during the First Five Months of Pregnancy / 대한지역사회영양학회지

Literature suggests that iron deficiency anemia is prevalent among pregnant women all over the world. This study was designed to evaluate the iron status of pregnant women during the fist five months, with the intention of determining ways to reduce the prevalence of iron deficiency anemia among pregnant women in Korea. We collected dietary information and measured the biochemical status of iron in 171 pregnant women over 16 weeks of gestation (= 16.7 +/- 2.34 week). Dietary intakes for 3 days were collected using the 24 hour recall and food record methods. The daily Fe intake was measured using the food frequency method. The Body Mass Index (BMI), calculated by using the pre-pregnancy weight and height, indicated that 31.3% of subjects were under-weight. We divided the subjects into normal and anemic group by using the serum ferritin levels. It appeared that the mean dietary intake of iron was 52.3% of the recommended level for pregnant women. The dietary quality evaluation showed that pregnant women ate only 58% of the recommended amount in the food groups of meat, fish, eggs, beans and milk and dairy products. The hematological indices showed that the mean Hemoglobin (Hb) was 11.9 g/dl, Hematocrit (Hct) was 35.1%, ferritin was 23.9 ng/ml, and transferrin was 297.3 microgram/dl. The dietary intake of iron was significantly lower and the vitamin C intake was significantly higher in the anemic group. The pre-pregnancy BMI was significantly lower in the anemic group. Variables affecting iron intake were the Fe intake frequency index and the food group score. The Fe index showed significantly positive correlation with the pre-pregnancy food intake and the food group score. Hb showed a significantly positive correlation with the prepregnancy food intake. We concluded that strategies to improve iron status be implemented in the pre-pregnant stage so as to reduce the prevalence of iron deficiency and that we should stress on the importance of an adequate diet as well as the maintenance of a heathy weight.

The Effect of Individualized Nutritional Education on Adults having two or more Symptoms of Chronic Degenerative Disease / 대한지역사회영양학회지

This study was intended to evaluate the overall effects of nutritional education on adults having two or more symptoms of chronic degenerative disease. A nine week nutritional education program was provided for 65 adults with chronic diseases. We assessed the changes in dietary knowledge, eating behavior and socio-psychological factors. When we evaluated the nutrient intakes of the subjects, their energy intake was 79.4% of the Korean Recommended Dietary Allowances (RDA). Their dietary intake of other nutrients was also below the RDA level except for Vitamin C. Their knowledge of dietary therapy was slightly improved after the implementing of nutritional education. The dietary behavior of 'night snacks before sleep' was significantly improved. While the overall fear due to disease was significantly increased, self-efficacy was not improved. Self-efficacy for eating "three regular meals" and "choosing fruit, vegetable and grain" were significantly decreased. Family support for "buying food which is good for my health" was also significantly increased, whereas "advises me to eat appropriate foods for health" was decreased. Biochemical analysis indicated that blood levels of triglyceride, cholesterol and blood pressure improved after nutrition education. Therefore, we concluded that nutritional education program for people with chronic degenerative diseases could change the diet therapy knowledge, dietary behavior, and the fear due to disease, support from family and behavior intention toward the direction to improve the chronic disease condition. However, it did not improve self-efficacy. Our study also indicated that nutritional education strategies to improve self-efficacy should be an important aspect in a long term education plan for patients to establish desirable eating habits.