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A Study of Upper Airway Resistance Syndrome : Clinical and Polysomnographic Characteristics (상기도저항 증후군에 대한 연구 : 임상 및 수면다원검사 특징)

  • Yang, Chang-Kook;Clerk, Alex
    • Sleep Medicine and Psychophysiology
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    • v.3 no.2
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    • pp.32-42
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    • 1996
  • Objectives : Upper airway resistance syndrome(UARS) is a sleep-related breathing disorder characterized by abnormal negative intrathoracic pressure during sleep. Abnormally increased negative intrathoracic pressure results in microarousal and sleep fragmentation which underlay UARS-associated complaints of daytime fatigue and sleepiness. Although daytime dysfunction in patients with UARS is comparable to that of sleep apnea syndrome, UARS has been relatively unnoticed in clinical setting. That is why UARS is apt to be excluded in diagnosing of sleep-related breathing disorders since its respiratory disturbance index and arterial oxygen saturation are within normal limits. The current study presents a summary of clinical and polysomnographic characteristics found in patients with UARS. The present study aims (1) to explore characteristics of patients diagnosed with UARS, (2) to characterize the polysomnographic findings of UARS patients, and (3) to enhance the understanding of UARS through those clinical and laboratory characteristics. Methods : This was a retrospective study of 20 UARS patients (male 15, female 5) and 30 obstructive sleep apnea (OSA) patients (male 21, female 9) at the Stanford Sleep Disorders Clinic. We diagnosed patients as having UARS when they met critenia, RDI < 5 characteristic findings of an elevated esophageal pressure($<-10\;cmH_2O$), frequent arousals secondary to an elevated esophageal pressure, and symptoms of daytime fatigue and sleepiness. We used polysomnographic value, which is standardized by Williams et al(1974), as normal control. Statiotical test were done with student t-tests. Results : (1) Mean age of UARS was $41.0\;{\pm}\;14.8$ years and OSA was $50.9\;{\pm}\;12.0$ years. UARS subject was significantly younger than OSA subject (p<0.05). (2) The total score of Epworth Sleepiness Scale (ESS) was UARS $9.7\;{\pm}\;6.3$ and OSAS $11.2\;{\pm}\;6.3$. There was no significant difference between two groups. (3) The mean body mass index was UARS $28.1\;{\pm}\;5.7\;kg/m^2$ and OSAS $32.9\;{\pm}\;7.0\;kg/m^2$. UARS had significantly lower meen body man index than OSAS subjects (p<0.05). (4) The polysomnographic parameters of UARS were not significantly different from those of OSA except RDI(p<0.001), $SaO_2$ (p<0.001) and slow wave sleep latency (p<0.05). (5) Compared with normal control, Total sleep time in UARS subjects was significantly shorter (p<0.001), sleep efficiency index was significantly lower (p<0.001), total awakening percentage was significantly higher (p<0.001), and sleep stage 1 (p<0.001) were significantly higher. (6) OSA patients showed poor sleep quality and distinct abnormal sleep architectures compared with normal control. Conclusions : Conclusions from the above results are as follows : (1) UARS patients were younger and had lower body mass index when umpared with OSA patients. (2) The quality of sleep and sleep architectures of the UARS and OSA patients are significantly different from those of normal control. (3) ESS scores and awakening frequencies of UARS are similar with those of OSA, suggesting that daytime dysfunction of UARS patients may be comparable to those of OSA patients. (4) The RDI and the $SaO_2$ which are important indicators in diagnosing sleep-related breathing disorders, of UARS subjects are close to normal value. (5) According to the the above results, we unclude that despite the absence of $SaO_2$ drops and the absence of an elevated number of apnea and hypopnea, subjects developed clinical complaints which were associated with laborious breathing, elevated Pes nadir, and frequently snoring. (6) Accordingly, we suggest including LIARS in the differential diagnosis list when sleep related breathing disorder is suspected clinically and overnight polysomnographic findings except snoring and frequent microarousal are within normal limits.

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Toll-like Receptor 4-mediated Apoptotic Cell Death in Primary Isolated Human Cervical Cancers (부인과질환 특이적 종양의 TLR4 매개성 apoptosis 유발에 관한 연구)

  • Won, Jinyoung;Hong, Yunkyung;Park, Sookyoung;Kim, Joo-Heon;Hong, Yonggeun
    • Journal of Life Science
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    • v.28 no.6
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    • pp.718-725
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    • 2018
  • Toll-like receptor 4 (TLR4) has been implicated in cell proliferation and apoptosis in several types of cancer. In this study, the impact of TLR4 activation on apoptotic cell death in gynecologic cancers induced by lipopolysaccharide (LPS) was investigated. Cervical cancer cell lines were produced from isolated surgical specimens supplied by Paik Hospital. The primary cultures of normal myometrium and gynecologic cancers, including cervical, endometrial, and ovarian cancers, were used to examine the differences in morphological characteristics between normal and cancerous cells. A reverse transcription polymerase chain reaction analysis was used to determine the relative expression levels of TLR4 gene involved in apoptosis-associated signaling in cervical cancer cells. The cancer cell colonies showed a tendency to reach high levels of confluency compared with normal cells. In addition, an enhanced growth rate and loss of contact inhibition were observed in gynecologic cancer cells compared with normal cells (doubling times of 16.6 hr vs. 26 hr, respectively). The expression level of ITGA5, an alpha-5 integrin marker, was upregulated in normal myometrial cells, but this tendency was not exhibited in cervical cancer cells. Furthermore, p53 tumor suppressor gene expression was upregulated, whereas TLR4 and caspase-3 gene expressions were downregulated in cervical cancer cells. Notably, the expression levels of TLR4 and caspase-3 were increased significantly in LPS-treated cancer cells compared with those in non-LPS-treated cells. These results suggest that the TLR4-mediated caspase-dependent apoptotic signaling pathway could be suggested as a therapeutic target for the treatment of gynecologic cancers, including cervical cancers.

The Correlation between Depression and Physical Health in the Elderly (노인의 신체적 건강과 우울과의 관계)

  • Kim, Hyo-Jung
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.193-203
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    • 2001
  • The purpose of this study was to identify the relationship between depression and physical health of the elderly and to provide fundamental data for programs which improve the health of this population. The subjects were 168 elderly people(55 years and older) who resided at home in Taegu. They were surveyed by interview using a closed- ended questionnaire. The survey was done from September 16 to October 16 in 2000. The instruments used in this study were general characteristics, Short form Geriatric Depression Scale(SGDS), Barthel Index, Muscular skeletal symptoms scale, Northern Illinois University's Health Self Rating Scale. The data were analyzed by using descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient, multiple regression with SPSS PC 10.0 version for Windows. The findings were as follows: 1. As compared 65-74 years elderly group, 75-84 years group was significantly higher score for depression(F=3.17, p=.026). As compared elderly group who has own spouse, the group who has no own spouse was significantly higher score for depression(t=- 2.44, p=.016). 2. The aged who have more limitation of Activities of Daily Living(ADL)(t=3.93, p=.000), pain of muscular skeletal symptoms(F=5.33, p=.002) and poor perceived health state(F=17.04, p=.000) showed the higher severity of depression than the aged who have not. 3. ADL correlated negatively with depression(r=- .293, p=.000), pain of muscular skeletal symptoms correlated positively(r=.251, p=.001), perceived health status correlated negatively(r=-.522, p=.000). 4. The combination of perceived health status and ADL explained 29.1% of the varience of depression. On the basis of the above findings the following recommendations are made; 1. Developing health programs is needed considering ADL, pain of muscular skeletal symptoms, perceived health status, demographic variables (age, spouse status) which have an significant effects on depression of the elderly. 2. In the following study, the use of the various scale is needed which reflects physical status of the elderly in home.

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Rapid comparison of metabolic equivalence of standard medicinal parts from medicinal plants and their in vitro-generated adventitious roots using FT-IR spectroscopy (한약자원 품목별 표준시료와 기내 생산 부정근의 FT-IR 스펙트럼 기반 대사체 동등성 신속 비교)

  • Ahn, Myung Suk;Min, Sung Ran;Jie, Eun Yee;So, Eun Jin;Choi, So Yeon;Moon, Byeong Cheol;Kang, Young Min;Park, So-Young;Kim, Suk Weon
    • Journal of Plant Biotechnology
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    • v.42 no.3
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    • pp.257-264
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    • 2015
  • To determine whether metabolite fingerprinting for whole cell extracts based on Fourier transform infrared (FT-IR) spectroscopy can be used to discriminate and compare metabolic equivalence, standard medicinal parts from four medicinal plants (Cynanchum wilfordii Hemsley, Atractylodes japonica Koidz, Polygonum multiflorum Thunberg and Astragalus membranaceus Bunge) and their in vitro-produced adventitious roots were analyzed by FT-IR spectroscopy. The principal component analysis (PCA) and partial least square discriminant analysis (PLS-DA) from the FT-IR spectral data showed that the whole metabolic pattern from Cynanchum wilfordii was highly similar to Astragalus membranaceus. However, Atractylodes japonica and Polygonum multiflorum showed significantly different metabolic patterns. Furthermore, adventitious roots from Cynanchum wilfordii and Astragalus membranaceus also showed similar metabolic patterns compared to their standard medicinal parts. These results clearly show that mass proliferation of adventitious roots may be applied to aquire novel supply of standard medicinal parts from medicinal plants. However, the whole metabolic pattern from adventitious roots of Atractylodes japonica and Polygonum multiflorum were not similar to their standard medicinal parts. Furthermore, FT-IR spectroscopy combined with multivariate analyses established in this study may be applied as an alternative tool to discriminate the whole metabolic equivalence from several standard medicinal parts. Thus, we suggest that these metabolic discrimination systems may be applied for metabolic standardization of herbal medicinal resources.

Expression of nitric oxide synthase isoforms and N-methyl-D-aspartate receptor subunits according to transforming growth factor-β1 administration after hypoxic-ischemic brain injury in neonatal rats (신생 백서의 저산소 허혈 뇌손상에서 Transforming Growth Factor-β1 투여에 따른 Nitric Oxide Synthase 이성체와 N-methyl-D-aspartate 수용체 아단위의 발현)

  • Go, Hye Young;Seo, Eok Su;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.594-602
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    • 2009
  • Purpose : Transforming growth factor (TGF)-${\beta}1$ reportedly increases neuronal survival by inhibiting the induction of inducible nitric oxide synthase (NOS) in astrocytes and protecting neurons after excitotoxic injury. However, the neuroprotective mechanism of $TGF-{\beta}1$ on hypoxic-ischemic (HI) brain injury in neonatal rats is not clear. The aim of this study was to determine whether $TGF-{\beta}1$ has neuroprotective effects via a NO-mediated mechanism and N-methyl-D-aspartate (NMDA) receptor modulation on perinatal HI brain injury. Methods : Cortical cells were cultured using 19-day-pregnant Sprague-Dawley (SD) rats treated with $TGF-{\beta}1$ (1, 5, or 10 ng/mL) and incubated in a 1% O2 incubator for hypoxia. Seven-day-old SD rat pups were subjected to left carotid occlusion followed by 2 h of hypoxic exposure (7.5% $O_2$). $TGF-{\beta}1$ (0.5 ng/kg) was administered intracerebrally to the rats 30 min before HI brain injury. The expressions of NOS and NMDA receptors were measured. Results : In the in vitro model, the expressions of endothelial NOS (eNOS) and neuronal NOS (nNOS) increased in the hypoxic group and decreased in the 1 ng/mL $TGF-{\beta}1-treated$ group. In the in vivo model, the expression of inducible NOS (iNOS) decreased in the hypoxia group and increased in the $TGF-{\beta}1$-treated group. The expressions of eNOS and nNOS were reversed compared with the expression of iNOS. The expressions of all NMDA receptor subunits decreased in hypoxia group and increased in the $TGF-{\beta}1$-treated group except NR2C. Conclusion : The administration of $TGF-{\beta}1$ could significantly protect against perinatal HI brain injury via some parts of the NO-mediated or excitotoxic mechanism.

The Study on Bone Mineral Density Measurement Error in Accordance with Change in ROI by Utilizing Dual Energy X-ray Absorptiometry (DEXA를 이용한 골밀도 측정시 검사자의 ROI 변화에 따른 골밀도 측정값의 오차에 관한 연구)

  • Lee, Yun-Hong;Lee, In-Ja;Yong, Hyung-Jin
    • Journal of radiological science and technology
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    • v.35 no.1
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    • pp.1-7
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    • 2012
  • Dual Energy X-ray Absorptiometry(DEXA) is commonly used to diagnose Osteoporosis. The errors of DEXA bone density operation are caused by operator, bone mineral density meter, blood testing, patient. We focus on operator error then study about how much influence operator's region of intest(ROI) in bone testing result. During from March to July in 2011. 50 patients ware selected respectively from 30, 40, 50, 60, and 70 age groups who came to Korea University Medical Center(KUMC) for their Osteoporosis treatment. A-test was performed with usually ROI and B-test was performed with most widely ROI. Then, We compare A-test and B-test for find maximum difference of T-score error which occurred operator ROI controlling. Standard deviation of T-score of B-test showed 0.1 higher then A-test in femur neck. Standard deviation of B-test showed 0.2 higher then A-test in Ward's area which in Greater trocanter and Inter trocanter. Standard deviation of B-test showed 0,1 lower then A-test in L-1. Bone density testing about Two hundred patients results are as follow. When operator ROI was changed wider than normal ROI, bone density of femur was measured more higher but bone density of L-spine was measured more lower then normal bone density. That means, sometime DEXA bone density testing result is dependent by operator ROI controlling. This is relevant with the patient's medicine and health insurance, thus, tester always keep the size of ROI for to prevent any problem in the patient.

Serum Leptin Levels and Changes in Body Weight and Obesity Index in Gwacheon Elementary School Children (과천지역 초등학생의 Leptin 수준과 열량섭취, 체중 및 비만도 변화와의 관계)

  • Kim, In-Kyoung;Kang, Jae-Heon;Song, Ji-Hyun
    • Journal of Nutrition and Health
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    • v.40 no.8
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    • pp.736-744
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    • 2007
  • Leptin, as an adipocyte-derived hormone, is an important regulator of food intake and energy expenditure. In the cross-sectional study, leptin was shown to be positively related to body adiposity and metabolic disorders in adults. However, there were very few studies which reported the leptin as a predictor of weight gain over time. We examined whether serum leptin can be used as an indicator of the present and 1-year past weight status in very young children. First grade students from elementary schools in Gwacheon City were enrolled in the study since 2005. The study subjects(total 375 students; 195 boys and 180 girls) participated in the investigation of both 2005 and 2006. Physical examinations including height, weight, waist circumference were done. To examine the prevalence of obesity, obesity index was used. Serum leptin was measured, and their nutritional status was also evaluated based on 3-Day dietary records. Serum leptin levels were strongly positively related with the value of the present BMI and with the value of the BMI one year before. We found no association with leptin levels and amount of energy intake and macronutrient intake in this children population. Children were divided into three groups according to leptin tertiles. The highest leptin tertile group showed highest prevalence of obesity in year 2006 as well as in year 2005. Serum leptin levels can reflect the weight status now and as well as 1-year before. Possibly serum leptin levels can predict the weight gain of year later. Without an action against the obesity on children with high leptin level, those children would maintain the excess adiposity growth and progress into the obesity-related metabolic disorders. Further studies are needed to predict the obesity as early as possible and preventive system then after.

Treatment and Results of Olfactory Neuroblastoma (후각신경아세포종의 치료 및 결과)

  • Wu Hong-Gyun;Kim Il Han
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.177-181
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    • 2000
  • Purpose : Rarity of olfactory neuroblastoma makes it difficult for treating Physician to Practice with a consistent protocol. This study is peformed to analyze our experience with various treatment modalities for patients with olfactory neuroblastoma. Discussion includes review of some recently published literatures. Methods and Materials : Between June of 1979 and April of 1997, 20 patients were treated under the diagnosis of olfactory neuroblastoma at Seoul National University Hospital. There were 14 male and 6 female patients. Age at initial treatment ranged from l3 to 77 years with median or 24 years. fifteen or 20 patients had Kadish stage C. They were treated with various combinations of surgery, radiation therapy and chemotherapy; surgery+postoperative radiation therapy+adjuvant chemotherapy for 2 patients, surgery+postoperative radiation therapy for 6, neoadjuvant chemotherapy+surgery for 1, surgery+adjuvant chemotherapy for 1, surgery only for 2, neoadiuvant chemotherapy+ radiation therapy for 3, radiation therapy+adjuvant chemotherapy for 1, radiation therapy only for 3, and no treatment for 1 patient. Results : Follow-up ranged from 2 month to 204 months with mean of 39.6 months. The overall 5- and 10-year survival rates are 20% and 10%, respectably. Four patients are alive at the time of data analysis. One of four living patients was treated with radical surgery, postoperative radiation therapy and adjuvant chemotherapy, two patients with radical surgery and postoperative radiation therapy, and one with radical surgery only. Conclusion : Multidisciplinary approach, including radical surgery, pre- or post-operative radiation therapy and chemotherapy, should be addressed at the initial time of diagnosis. Although limited by small number of the patients, this study suggests importance of local treatment modality, especially radical surgery in the treatment of lofactory neuroblastoma.

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Effect of Epidermal Growth Factor on In Vitro Maturation in Pig Immature Oocytes;IV. Effect of Epidermal Growth Factor on In Vitro Development (Epidermal Growth Factor가 돼지 미성숙난포란의 체외성숙에 미치는 영향;IV. 체외 배발달에 미치는 Epidermal Growth Factor의 효과)

  • Uhm, S.J.;Kim, E.Y.;Kim, M.K.;Kim, T.;Yoon, S.H.;Park, S.P.;Chung, K.S.;Lim, J.H.
    • Clinical and Experimental Reproductive Medicine
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    • v.23 no.3
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    • pp.303-310
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    • 1996
  • The objective of this study was to examine the effect of embryos development following IVF of in vitro-matured porcine oocytes treated with epidermal growth factor (EGF). When cumulus-enclosed oocytes were incubated in TCM 199 medium supplemented with (1) control group, (2) 10 ng/ml EGF, (3) 10${\mu}g$ml FSH and 10% FBS, or (4) 10 ng/ml EGF, 10 ${\mu}g$/ml FSH, and 10% FBS for 42 hr, the late developmental rates on NCSU (0.4% BSA) medium after fertilization were higher in (3) and (4) groups (13.4, 18.3%) than in (2) group (5.2%, p < 0.005), but (2) group is significantly higher than the development to blastocyst of oocytes of (1) group (1.2%). Also, when the cell number of total, ICM, and TE of those blastocysts at 6 day produced in vitro was investigated by double staining (PI and bisbenzimide), total cell number of (4) group (58.80${\pm}$ 11.90) was higher than that of (2) and (3) groups (42.17${\pm}$9.97, 49.07${\pm}$9.77, P < 0.05). ICM cell number of blastocysts of (4) group (11.69${\pm}$5.56) was higher than that of (2) and (3) groups (5.00${\pm}$4.24, 6.77${\pm}$4. 92, P < 0.05). Furthermore, the proportion of ICM in (4) group (19.0${\pm}$1.6) was higher than that in (2) and (3) groups (11.1${\pm}$3.0, 12. 7${\pm}$2.1). These results suggested that in vitromatured porcine oocytes treated with EGF alone can be developed to blastocyst, but high proportion on the development to blastocyst and number of total cell and ICM in blastocyst can be obtained when supplemented with additional FSH and FBS.

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Investigation on Daily Life and Consciousness of Longevous People in Korea -III. On the Dietary Life and Its Habit of Longevous People in the Past- (우리나라 장수자(長壽者)의 생활(生活) 및 의식조사(意識調査)에 관한 연구(硏究) -III. 장수자(長壽者)의 과거(過去) 식생활(食生活) 특성(特性)-)

  • Choi, Jin-Ho;Pyeun, Jae-Hyeung;Rhim, Chae-Hwan;Yang, Jong-Soon;Kim, Soo-Hyun;Kim, Jeung-Han;Lee, Byeong-Ho;Woo, Soon-Im;Choe, Sun-Nam;Byun, Dae-Seok;Kim, Mu-Nam
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.15 no.4
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    • pp.56-63
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    • 1986
  • This study was designed to be link in the chain of the investigation on daily life and consciousness of longevous people in Korea, and to investigated the dietary life and its habit of longevous people in the past. The dietary life ana its habit were surveyed on 379 subjects (male 121, female 258) of the aged who were above 80 years of age, from June to November in 1985. 1. Of the taste on staple food of longevous peoples in the past(between 40 and 60 years), 'meal mixed with barley' had the highest figure of 49.9%, followed by 'boiled rice'(47.0%). But it is showed that male preferred 'meal mixed with barley'(56.2%) to 'boiled rice'(41.3%). whereas female slightly preferred 'boiled rice'(49.6%) to 'meal mixed with barley'(46.9%). 2. Of the experience of the food taste of these aged in the past, 'not salted' and 'light' had the highest figures of all 40.6%. It is showed that longevous peoples preferred 'not salted'(40.6%) and 'light'(40.6%) to 'salty'(24.5%) and 'oily'(9.8% ), respectively. 3. By comparison of the intake state of animal protein(meat and fish) of these aged in the past, 'occasionally' was the highest of 55.4%, and decreased in the order of 'almost daily'(31.9%) and 'scarcely'(12.7%). Therefore, it is believed that 87.5% of longevous peoples has taken animal protein 'occasionally' and 'almost daily'. 4. The intakes of major foods above $4{\sim}6$ times a week of these aged in the past and present showed 50.4% and 67.5% for meat, fish, egg and soybean products, 26.6% and 51.5% for milk and its products, 89.9% and 81.0% for vegetables, 58.9% and 64.0% for oiled food, and 57.0% ana 62.934 for seaweeds, respectively.

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