OBJECTIVES: A few studies have compared REM sleep-dependent obstructive sleep apnea syndrome (REM-OSA) with sleep stage non-dependent apnea syndrome (SND-OSA). Despite that REM-OSA might be more common in women than men, no studies have examined the probable characteristics of women patients with obstructive sleep apnea syndrome (OSAS). This study aimed at finding out the characteristics of REM-OSA in women by comparing it with SND-OSA. METHODS: Fifty-three subjects diagnosed as OSAS (AHI>5; AHI: apnea-hypopnea index) with nocturnal polysomnography at the Center for Sleep and Chronobiology of the Seoul National University Hospital between October 2004 and February 2006 were studied. Of them, 44 subjects with OSAS severity of mild (52 and AHI-NR<15 (AHI-R: AHI during REM sleep, AHI-NR: AHI during non-REM sleep). We compared REM-OSA group with SND-OSA as well as the criteria-determined REM-OSA cases with the visually-determined ones. RESULTS: Among 44 subjects, 28 persons (63.6%) turned out to have REM-OSA by our criteria and 24 persons (54.5%) by visual determination. Statistically significant differences (p<0.05) were found between REM-OSA and SND-OSA groups in AHI, hypopnea index, total sleep time, total wake time, sleep efficiency index, percents of stage 1, 2 and REM sleep, and REM latency. Percent of stage REM sleep (%REM) turned out to have influence on AHI ratio (AHI-R/AHI-NR) (B=0.537, p=0.002). REM-OSA was likely to be diagnosed in milder severity of OSAS (chi-square=13.117, p<0.001) and those with higher %REM (chi-square=11.325, p=0.001). There was no significant difference between the criteria-determined and the visually-determined cases of REM-OSA. CONCLUSION: We suggest that REM-OSA and SND-OSA patients be differentiated in terms of pathophysiology and treatment strategies. Visual determination of REM-OSA might be useful as the screening procedure of REM-OSA. Further studies on women with OSAS and REM-OSA need to be done.
Apnea ; Female ; Humans ; Male ; Mass Screening ; Polysomnography ; Sleep Apnea, Obstructive ; Sleep Stages ; Sleep, REM

No abstract available.
Facial Bones* ; Humans

INTRODUCTION: It has been proposed that narcolepsy and REM sleep behavior disorder (RBD) have overlapped symptom profile and pathophysiology. This study was aimed at measuring and comparing changes in EEG frequency band of REM sleep in narcolepsy and RBD, applying EEG spectral analysis method. METHODS: Nine patients diagnosed as narcolepsy and the same number of RBD patients were studied. Spectral analysis of the REM sleep EEG was performed in each patient on 9 epochs selected evenly from the first, second, and third REM periods. Then, we compared frequency band percentages of REM sleep EEG in narcolepsy and RBD. RESULTS: Narcolepsy patients had significantly higher delta frequency ratio than RBD ones (p=0.00). In alpha and beta2 frequency bands, RBD patients showed higher percentage than narcolepsy ones. Slow wave sleep was more prevalent in narcolepsy patients. But, no difference of REM sleep percentage was found between the two groups (p=0.93). CONCLUSION: Higher delta frequency ratio in REM sleep of narcolepsy patients than RBD ones reflects that sleep-promoting mechanism is more dominant in narcolepsy than in RBD.
Electroencephalography ; Humans ; Narcolepsy ; REM Sleep Behavior Disorder ; Sleep, REM

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

In order to increase the performance of automatic sleep stage scoring, we propose a hybrid neural-network and rule-based expert system taking advantages of each system. The suggesting hybrid system comprises signal cleaning. feature extraction, event detection, rule-based sleep scoring and neural network classification. We selected segment based EEG features. the state of EOG. and EMG tone as a major feature set. With the extracted features, the rule-based expert system classities the sleep stages by symbolic reasoning. The scoring process of rule-based expert system comprises the single epoch reasoning based on the typical events and the multi-epoch adjusting when no events are detected. If the decision of rule-based expert system is uncertain, then these features are fed into the neural network. We used a two hidden layer feed forward network using error hack propagation algorithm. The agreement rate between human scorer and automatic algorithm were evaluated. The neural network supplements the shortcomings of rule-based system by dealing with exceptions of rules. The result shows that the compuational ol computational and symbolic intelligence is promising approach sleep signal anal) sis.
Classification ; Electroencephalography ; Electrooculography ; Expert Systems ; Humans ; Intelligence ; Sleep Stages*

BACKGROUND: The implementation of intraoperative normovolemic hemodilution is a strategy used in an attempt to diminish the need for or obviate allogeneic transfusion and to avert the potential complications. The goal of this study was to evaluate the safety and efficacy of moderate intraoperative normovolemic hemodilution. METHODS: Fifteen patients scheduled for posterolateral spinal fusion underwent intraoperative normovolemic hemodilution with 10% pentastarch to a target hematocrit level of 25% (hemodilution group). All units of blood procured by hemodilution and additional allogeneic blood was transfused in the perioperative period to maintain the hematocrit level of>25%. We investigated the effect of hemodilution on whole blood coagulation as measured by the thromboelastography and, evaluated its efficacy of decreasing the need for allogeneic blood transfusion as compared to the nonhemodilution group, retrospectively. RESULTS: Hemodilution with pentastarch caused a decrease in response and coagulation time (p<0.01) but did not influence on the alpha angle and maximum amplitude on thromboelstogram. Amount of transfusion of allogeneic blood was 4.1 1.7 units for the hemodilution group and 5.0 1.5 units for the nonhemodilution group. Net red blood cell volume ""saved"" from hemodilution was about 120 ml. CONCLUSION: Moderate intraoperative normovolemic hemodilution with pentastarch does not affect the coagulability of whole blood. But its efficacy of decreasing the need for allogeneic blood transfusion is minimal.
Blood Coagulation ; Blood Transfusion ; Erythrocytes ; Hematocrit ; Hemodilution* ; Humans ; Hydroxyethyl Starch Derivatives ; Perioperative Period ; Retrospective Studies ; Spinal Fusion* ; Thrombelastography

No abstract available.
Lymphocele*

Osteolipoma is an ossified lipoma with distinct components of fat and bone. We present a case of interhemispheric osteolipoma associated with total agenesis of the corpus callosum. A 20-year-old man complained of severe headache, nausea and vomiting. Brain computed tomography showed a low-density mass in an interhemispheric fissure, with high T1 and T2 magnetic resonance signals compatible with fat. The mass measured 4.9 x 2.9 cm in size and showed peripheral calcifications. There was another small piece of same signal mass within the lateral ventricular choroid plexus. The interhemispheric lesion was removed by an interhemispheric approach. Osteolipoma is rare in interhemispheric region, however, it should be a differential diagnosis of lesions with fat intensity mass and calcifications.
Brain ; Choroid Plexus ; Corpus Callosum ; Diagnosis, Differential ; Headache ; Humans ; Lipoma ; Magnetic Resonance Spectroscopy ; Nausea ; Vomiting ; Young Adult

The leiomyoma of the vagina is relatively rare benign solid tumor, and majority of them were not recognized until after operation. Variable opinion exists as to the exact origin of this lesion. The most frequent location is the anterior vaginal wall. Recently we experienced a case of vaginal leiomyoma arising in the anterior vaginal wall and now we present it with a brief review of the literatures.
Leiomyoma* ; Vagina*

No Abstract Available.
Clone Cells* ; Cloning, Organism* ; Mycobacterium tuberculosis* ; Mycobacterium*