Obstructive sleep apnea (OSA) has been definitively shown to be a risk factor for the development of cardiovascular disease and mortality. Recent reports have indicated that obstructive sleep apnea is associated with insulin resistance and impaired glucose metabolism, also have type 2 diabetes. The potential mechanisms leading to the development of type 2 diabetes in OSA patients are likely to be various. Reduced physical activity resulting from daytime somnolence, sympathetic nervous system activation, intermittent hypoxia, sleep fragmentation and sleep loss, dysregulation of the hypothalamic-pituitary axis, alteration in adipokine profiles, and activation of inflammatory pathways have been proposed. Based on the current evidence, clinicians should assess the risk of OSA in patients with type 2 diabetes and, conversely, consider that possibility of glucose intolerance in patients with OSA. Further large-scale and long-term follow-up studies in patient populations with selected by reliable but inexpensive diagnostic measures, controlled for potential confounder factor, are needed.
Adipokines ; Anoxia ; Axis, Cervical Vertebra ; Cardiovascular Diseases ; Glucose ; Glucose Intolerance ; Humans ; Insulin Resistance ; Motor Activity ; Risk Factors ; Sleep Apnea, Obstructive ; Sleep Deprivation ; Sympathetic Nervous System

This study was performed to estimate the correlation between the histopathological grade and the clinical stage, which are known as important prognostic factors, and EGFR expression status in 57 cases of transitional cell carcinoma of the urinary bladder. There was a significant correlation between the histopathological grade and clinical stage of transitional cell carcinoma of the urinary bladder and between expression grades of EGFR and histopathological grades, or clinical stages of transitional cell carcinoma of the urinary bladder. Therefore, the presence of a high intensity of EGFR staining in the transitional cell carcinoma of the urinary bladder was associated with poor differentiation and invasion. On the basis of the above results, it was suggested that the degree of EGFR expression is one of the objective and reliable prognostic factors in transitional cell carcinoma of the urinary bladder.

No abstract available.
Magnetic Resonance Imaging*

OBJECTIVES: The percentage of positional sleep apnea in obstructive sleep apnea (OSA) varies in different reports from 9% to 60%. If there is a positional dependency in patients with OSA, positional therapy alone could be successful in treating about 50% of all OSA cases. The aim of this report is to compare anthropomorphic and polysomnographic data between the positional sleep apnea group and non-positional sleep apnea group with OSA whose conditions were diagnosed in our sleep clinic. METHODS: This is a retrospective study of anthropomorphic and polysomnographic data of patients with OSA who was performed a nocturnal polysomnography. Positional sleep apnea was defined as having a supine apnea-hypopnea index (AHI) of twice or more compared to the AHI in the non-supine position. The patients were divided in the positional sleep apnea group and the non-positional sleep apnea group. RESULTS: In 101 patients with OSA, 81 were male, and the mean age was 49.2+/-11.9 years. Seventy-six (75.2%) were diagnosed as the positional sleep apnea. Waist to hip ratio and body mass index (BMI) were significantly higher in non-positional sleep apnea group. The frequency of severe OSA was significantly higher in this group. In the positional sleep apnea group, nocturnal sleep quality was better preserved, and consequently these patients were less sleepy during daytime. AHI was significantly lower and minimal arterial oxygen saturation during sleep was significantly higher in this group. CONCLUSION: The percentage of positional sleep apnea in OSA was 75.2%. AHI, BMI, and waist to hip ratio were lower in the positional sleep apnea group. These patients have less severe breathing abnormalities than the non-positional sleep apnea group in polysomnography.
Body Mass Index ; Dependency (Psychology) ; Humans ; Male ; Oxygen ; Polysomnography ; Respiration ; Retrospective Studies ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Waist-Hip Ratio

OBJECTIVES: The Berlin Questionnaire (BQ) has been used to help identify patients at high risk of having sleep apnea in primary care. But it has not been validated in a sleep clinic for Korean patients. The aim of this study is to evaluate the usefulness of the BQ as a screening tool for obstructive sleep apnea (OSA) for Korean patients in a sleep clinic. METHODS: The BQ was prospectively applied to 121 subjects with OSA suspicion who visited to our sleep clinic. All subjects performed overnight polysomnography. OSA was defined as an apnea-hypopnea index (AHI) > or =5. We investigated the sensitivity, specificity, positive and negative predictive values of the BQ according to severity by AHI. RESULTS: In 121 subjects, 73.6% were males, with a mean age of 48.8+/-13.0 years. Twenty-five (20.6%) patients did not have OSA (AHI<5), 30 (25%) patients had mild OSA (AHI> or =5 and <15), 26 (21.4%) had moderate (AHI> or =15 and <30), and 40 (33%) had severe OSA (AHI> or =30). The BQ identified 69.4% of the patients as being at high risk for having OSA. The sensitivity and specificity of the BQ were 71.9% and 40%, for AHI> or =5, 75.8% and 38.2% for AHI> or =15, 77.5% and 34.6% for AHI> or =30, respectively. The positive and negative predictive values of the BQ were 82.1% and 27.0% for AHI> or =5, respectively. Positive and negative likelihood ratios were 1.2 and 0.7, and the overall diagnostic accuracy of the BQ was 65.3%, using an AHI cut-off of 5. CONCLUSION: Due to modest sensitivity and low specificity, the BQ does not seem to be an appropriate tool for identifying patients with obstructive sleep apnea in a sleep clinic population.
Berlin ; Humans ; Male ; Mass Screening ; Polysomnography ; Primary Health Care ; Prospective Studies ; Surveys and Questionnaires ; Sensitivity and Specificity ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

In the antero-posterior and lateral viewe of the lumbar X-ray film of 258 normal Korean adults(120 males, 138 females), the following measurement was made ; the measurement of the interpeduncular distance, anteroposterior diaameter, width of the lumbar vertebral body and height, and thickness of the pedicle. The mean value of interpeduncular distances and anteroposterior diameter of each lumbar vertebral level was measured in relation to the variables of sex and age. The value of interpeduncular distance at each level was related to the pedicle index and width of the vertebral bodies. Statistical analysis was made. The percentage of type A was 74.42%, type B 21.32%, type C 4.26%, but type D was not observed. The mean value of the interpeduncular distances of each level of the lumbar vertebra was measured. In male, Ll was 23.57mm, L2 24.29mm, L3 25.36mm, L4 27.09mm, and L5 was 29.77mm. In female, Ll was 22.24mm, L2 23.03mm, L3 24.11mm, L4 25.70mm, and L5 28.29mm. The difference between male and female was significant (P<0.05). The difference between each age group was not signifcant (F>3.58). There was no significant relationship between the interpeduncular distance, anteroposterior diameter, pedicle indices and the width of the body at all levels.
Adult* ; Female ; Humans ; Male ; Spinal Canal* ; Spine ; X-Ray Film

Materials and Methods: A total of 264 patients (74 CN and 190 AD), who underwent FBB imaging test and neuropsychological tests, were retrospectively analyzed. Early- and delay-phase FBB images were spatially normalized with an in-house FBB template. The regional standard uptake value ratios were calculated with the cerebellar region as a reference region and used as independent variables that predict the diagnostic label assigned to the raw image. Results: AD positivity scores estimated from dual-phase FBB showed better accuracy (ACC) and area under the receiver operating characteristic curve (AUROC) for AD detection (ACC: 0.858, AUROC: 0.831) than those from delay phase FBB imaging (ACC: 0.821, AUROC: 0.794). AD positivity score estimated by dual-phase FBB (R: −0.5412) shows a higher correlation with psychological test compared to only dFBB (R: −0.2975). In the relevance analysis, we observed that LSTM uses different time and regions of early-phase FBB for each disease group for AD detection. Conclusions These results show that the aggregated model with dual-phase FBB with long short-term memory and attention mechanism can be used to provide a more accurate AD positivity score, which shows a closer association with AD, than the prediction with only a single phase FBB.

PURPOSE: To evaluate the ultrasonographic and CT findings of hepatosplenic tuberculosis MATERIALS AND METHODS: We retrospectively reviewed the ultrasonographic and CT findings of confirmed hepatosplenic tuberculosis in 12patients. Six were men and six were women ; their average age was 41, and most were in their twenties. Lesions ofthe liver and spleen, as well as associated findings such as abdominal tuberculosis and other organ involvement oftuberculosis were analyzed. RESULTS: There were three cases of hepatic tuberculosis, seven of splenictuberculosis, and two of hepatosplenic involvement of tuberculosis. On the basis of the ultrasonographic and CTfindings, hepatosplenic tuberculosis was classified as one of two patterns : miliary or micronodular, ormacronodular. The micronodular type was more common (9/12 cases) being characterized by innumerable micronodules,and with easy coalescence in the liver and spleen in five of the nine cases. The macronodular type of low densitymass was noted in the other three patients. Splenomegaly was noted in 12 cases and hepatomegaly in ten. Pulmonarytuberculosis-including the miliary type(n=5)-was noted in eight patients. Associated abdominal tuberculosis suchas lymphadenopathy with central low density and peripheral rim enhancement (n=6), tuberculous peritonitis(n=3),highly attenuated ascites(n=6), adrenal tuberculosis(n=1), renal tuberculosis(n=1), ovarian abscess(n=1), psoasabscess(n=1), and systemic tuberculosis such as central nervous system tuberculoma(n=2), cervicallymphadenopathy(n=4) and tuberculous spondylitis(n=1) were noted. CONCLUSION: Ultrasonography and CT werevaluable in the detection and diagnosis of hepatosplenic tuberculosis
Central Nervous System ; Diagnosis ; Female ; Hepatomegaly ; Humans ; Liver ; Lymphatic Diseases ; Male ; Retrospective Studies ; Spleen ; Splenomegaly ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Hepatic ; Ultrasonography

OBJECTIVES: Several studies suggest that nocturia may be related to obstructive sleep apnea syndrome (OSAS). The mechanism by which OSAS develops nocturia has not been determined. The present study aimed to determine the prevalence of nocturia among adults with OSAS and to identify factors that may be predictive in this regard. METHODS: Retrospective review of clinical and polysomnographic data obtained from patients evaluated at the sleep clinics of the St. Paul's Hospital between 2009 and 2012. The urinary symptoms were assessed on the basis of the International Prostate Symptom Score (IPSS). Pathologic nocturia was defined as two or more urination events per night. OSAS was defined as apnea-hypopnea index (AHI) > or =5. A multivariate analysis using logistic regression was performed to examine the relationship between polysomnographic variables and the presence of pathologic nocturia, while controlling for confounding factor. RESULTS: A total of 161 men >18 years of age (mean age 46.7+/-14.1), who had been referred to a sleep laboratory, were included in the present study. Among these, 27 patients with primary snoring and 134 patients with obstructive sleep apnea were confirmed by polysomnography. Nocturia was found in 53 patients with OSAS (39.6%) and 8 patients with primary snoring (29.6%). The AHI was higher in patients with nocturia than in those without nocturia (p=0.001). OSAS patients with nocturia had higher arousal index (p=0.044), and lower nadir oxyhemoglobin saturation (p=0.001). Multiple regression analysis showed that age (beta=0.227, p=0.003), and AHI (beta=0.258, p=0.001) were associated with nocturia, and that the presence of pathologic nocturia was predicted by age (OR 1.04 ; p=0.004) and AHI (OR 1.02 ; p=0.001). CONCLUSION: Nocturia is common among patients with OSAS. The strongest predictors of nocturia are age and AHI in patients with OSAS.
Adult ; Arousal ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Nocturia* ; Oxyhemoglobins ; Polysomnography ; Prevalence* ; Prostate ; Retrospective Studies ; Sleep Apnea, Obstructive* ; Snoring ; Urination

No abstract available.
Nephrotic Syndrome*