Sleep-related behaviors observed in parasomnias can result in serious injuries of patients and/or spouses. Parasomnia is defined as undesirable physical or behavioral phenomenon occurring during sleep. If these disorders are accurately diagnosed, effective treatments are available. Often, these disorders can be even cured. Environmental management for patient and/or spouse safety and good sleep hygiene are the most recommended for individuals behaving abnormally during sleep. The aim of this article is to review the clinical features, diagnosis and treatment of several sleep-related behavior disorders.
Diagnosis ; Humans ; Hygiene ; Mental Disorders ; Parasomnias ; Spouses

INTRODUCTION: REM sleep which shows characteristic muscle atonia and increased resistance of upper respiratory track is known to be vulnerable to sleep apnea. Previous studies reported that REM sleep-dependent (or related) obstructive sleep apnea syndrome (REM-dependent OSA) could be one of sleep disordered breathing. The present study aimed to investigate clinical findings and polysomnographic variables of REM-dependent OSA. METHODS: Fifty-six patients diagnosed with mild to moderate obstructive sleep apnea by overnight polysomnography (52. We compared clinical and polysomnographic findings between REM-dependent OSA and No REM-dependent OSA patients. RESULTS: Among 56 patients, 37.5% (n=21, average age of 52.3+/-19.7 years, 14 males) met the REM-dependent OSA criteria. There were no significant differences in age, sex and body mass index between two groups. After controlling for age, sex, body mass index and periodic leg movements index, REM-dependent OSA patients showed significantly lower AHI, lower number of oxygen desaturation events and higher stage 2 sleep proportion compared to No REM-dependent OSA patients (p=0.010, p=0.006, p=0.031, respectively). After controlling for age, sex, body mass index and periodic legs movements index, AHI-REM was positively correlated with the number of oxygen desaturation events in REM-dependent OSA group (p=0.002). CONCLUSION: Current results suggested that 37.5% of patients with mild to moderate severity of obstructive sleep apnea could be classified into REM-dependent OSA. REM-dependent OSA was more common in mild severity of OSA, equally prevalent in both sexes and accompanied with sleep architecture changes, i.e. increased proportion of stage 2. In addition, apneic events during REM sleep in REM-dependent OSA were related to oxygen desaturation.
Body Mass Index ; Humans ; Leg ; Muscles ; Oxygen ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep, REM ; Track and Field

No abstract available.
Animals ; Epidermal Growth Factor* ; Gene Expression* ; Gonadotropin-Releasing Hormone* ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Rats*

Adenotonsillar hypertrophy is the leading cause of childhood obstructive sleep apnea. Obstructive sleep apnea syndrome in child-hood, however, can occur from various causes such as obesity or craniofacial abnormalities. Childhood obstructive sleep apnea syndrome can be accompanied by enuresis, parasomnias and behavior problems. For patients with the symptoms of snoring and apnea, obstructive sleep apnea should be suspected and diagnosed properly. In addition, the evaluation of complications and proper treatment are indispensable. When the cause of childhood obstructive sleep apnea is adenotonsillar hypertrophy, symptoms can be improved by surgical methods. If the cause is other than adenotonsillar hypertrophy, such as obesity, it should be treated with other therapeutic modalities, like nasal continuous positive airway pressure (nCPAP), weight reduction and modification of life style. This paper reports a case of nCPAP used to manage severe sleep apnea when it was not resolved after adenoidectomy and tonsillectomy. Differential diagnosis of narcolepsy in a case with excessive daytime sleepiness and reflections on accompanying enuresis and parasomnia were also described.
Adenoidectomy ; Apnea ; Child ; Continuous Positive Airway Pressure ; Craniofacial Abnormalities ; Diagnosis, Differential ; Enuresis ; Humans ; Hypertrophy ; Life Style ; Narcolepsy ; Obesity ; Parasomnias ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy ; Weight Loss

OBJECTIVES: This study was to investigate the fertilization rate after intracytoplasmic sperm injection (ICSI) or partial zona dissection (PZD) of human and hamster sperm into hamster oocyte in in vitro fertilization (IVF). In addition, the possibility of clinical application was evaluated by the comparison of usefulness and difference of these method. MATERIALS AND METHODS: Hamster immature oocytes were obtained from oviducts superovulated by PMSG and hCG, and hamster sperms were obtained from epididymis. The freezed human sperms were thawed before use. Fertilization were confirmed by two pronuclei, one pronucleus, swollen sperm head or/and two polar bodies at 7~8 hour after ICSI or PZD. RESULTS: The fertilization rates after ICSI and PZD of human sperm to hamster oocyte were 3.6%, 64.2%, 73.6%, and 55.6% for negative control, positive control, ICSI, and PZD respectively, suggesting that ICSI only showed improved fertilization rate (p<0.01). The fertilization rates after ICSI and PZD of hamster sperm to hamster oocyte were 11.1%, 51.2%, 39.6%, and 72.7% for negative control, positive control, ICSI, and PZD respectively, suggesting that PZD only showed improved fertilization rate (p<0.01). PZD showed significantly higher fertilization rate than ICSI (p<0.05). CONCLUSIONS: As for the fertilization rate by ICSI and PZD using hamster oocyte in IVF, ICSI technique was considered to be more useful for human sperm and PZD technique for hamster sperm. Therefore, ICSI technique was considered more appropriate for experimental application using human sperm and hamster oocyte.
Humans

OBJECTIVES: This study was carried out to evaluate the effects of embryonic stage, cryoprotectant, and freezing-thawing method on the rates of survival and development of the cryopreserved mouse early embryo and finally to establish the cryopreservation method of surplus embryos obtained during assisted reproductive technology (ART). MATERIALS AND METHODS: Two to eight cell embryos were obtained from oviducts of mated F1 hybrid female mice superovulated by pregnant mare's serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG). Two-step 1,2-propanediol (PROH), dimethylsulfoxide (DMSO) and 4-step PROH, DMSO were used as cryoprotectant and dehydration and rehydration method of embryos, and slow- cooling or rapid-cooling method was used as frozen program. The survival rates of embryos were measured after thawing and rehydration, and the developmental rates of embryos were compared and observed during culturing embryos for 24, 48, 72, 96 hrs. RESULTS: As for the survival and development rates of embryos according to embryonic stage, the survival rate of 2 cell stage in PROH and DMSO was significantly higher than 4-8 cell (64.5% versus 62.1%, 79.7% versus 73.2%) (p<0.01, p<0.01), but the development rates of 4-8 cell embryos in PROH and DMSO were significantly higher than 2 cell embryos for whole culture period (p<0.01) and the development rates of 4-8 cell embryos in PROH were significantly higher than 2 cell embryos in DMSO (p<0.01). As for the survival and development rates of embryos according to cryoprotectant, the survival rate of 2 cell embryo in DMSO was significantly higher than that in PROH (74.4% versus 64.5%) (p<0.01), whereas the development rate of embryos was not differ till 24 hrs. The development rate from morular to hatching blastocyst, however, was significantly higher in PROH than in DMSO during 48 hr (p<0.01). The survival rate of 4-8 cell embryo was 62.1% in PROH and 73.2% in DMSO. The development rates of embryo in PROH were significantly higher for whole culture periods (p<0.01, 0.05). In respect to the effect of freezing and thawing program on the survival and development rates of embryos, method of slow cooling and rapid thawing was more effective than that of rapid cooling and rapid thawing. CONCLUSIONS: The survival rate of embryo in 2 cell stage was higher than in 4-8 cell stage, and PROH appears more effective cryoprotectant than DMSO because PROH showed better development rates of embryos in 2 and 4-8 cell stage. Moreover, slow cooling and rapid thawing method was considered as the best cryopreservation program.
Pregnancy ; Female ; Humans ; Mice ; Animals

No abstract available.
Insemination* ; Spermatozoa*

OBJECTIVE: To estimate the predictive value of initial serum B-hCG and progesterone measurement for pregnancy outcome in IVF-ET. METHODS: Serum B-hCG at 11-12th day after embryo transfer and progesterone at 7th day after oocyte aspiration were measured in 48 successful pregnant IVF-ET cases from July 1993 to June 1997. RESULTS: Of 48 cases, 26 cases (54.2%) successfully carried to sustaining gestation and 22 cases (45.8%) failed to sustain gestation. The estimated initial serum B-hCG levels in the normal sustaining pregnancy group (132.28+ 22.42 mlU/ml) were statistical significantly higher than 29.43+8.08 mIU/ml in the failed sustaining pregnancy group (p<0.001), while the estimated initial serum progesterone levels showed no significant differences (p=0.159). In order to determine the predictive values using the Receiver Operator Curve (ROC), an appropriate cutoff value of 38 mIU/ml for initial serum B-hCG was obtained. In IVF-ET pregnancies, the estimated serum B-hCG levels in cases of chemical abortion in failed sustaining pregnancy were significantly lower compared to the normal sustaining pregnancy group (p<0.001). CONCLUSION: The initial serum B-hCG levels at 11 days after embryo transfer could be used to predict the pregnancy outcome in an IVF program. An initial progesterone level acquired on the 7th day after oocyte retrieval is not a useful indicator to predict pregnancy outcome.
Chorionic Gonadotropin* ; Embryo Transfer* ; Embryonic Structures* ; Female ; Humans* ; Oocyte Retrieval ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Progesterone*

OBJECTIVE: To evaluate whether the rate of early mouse embryonal development could be enhanced by cumulus cell coculture in vitro. METHODS: Ham's F-10 culture media supplemented with 0.4% bovine serum albumin were used. Two-cell F1 mouse embryos were cultured in media with or without cumulus cells of female ICR mouse embryo for 96 hours, and the rates of embryonal development were observed and compared. RESULTS: The percentage of hatched blastocyst in the coculture group was significantly higher than that in the control group by 87.3% vs 64.8% respectively (p< 0.05). CONCLUSION: This study provides confirmative information that cumulus cell coculture will be useful in enhancing early mouse embryonal development.
Animals ; Blastocyst ; Coculture Techniques* ; Culture Media ; Cumulus Cells* ; Embryonic Structures ; Female ; Humans ; Mice* ; Mice, Inbred ICR ; Serum Albumin, Bovine

No abstract available.
Animals ; Embryonic Structures* ; Fertilization in Vitro* ; Humans* ; Mice* ; Quality Control*