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

A 49-year-old male had erythematous to rusky red papules, indurated plaques and lichenified patches with hyperpigmentation on sun-exposed areas for 6 years. Phototest revealed the decreased rninimal erythemal dose to UVA(10J/cm. Photopatch test with 5% Trandate ointment, 5% hydrochlorthiazide ointment and vaselin. as a control were all negative. Two weeks after cessation of Trandate, an oral challenge of hydrochlorthiazide followed by phototest was perfrirmed resulting in exacerbation of skin lesions and photosensitivity with a decreased MED to UVA(10J/cm) again. After the cesation of Trandate containing hydrochlorthiazide, the skin lesions were improved with complete loss of photosensitivity. But, improvement of the infiltrated or licheified plaques were delayed. Presenile cataract previously noted in the patient seemed to be related to his longstanding intake of hydrochlorthiazide.
Cataract ; Humans ; Hyperpigmentation ; Labetalol ; Male ; Middle Aged ; Skin

No abstract available.
Infarction* ; Liver*

Caffeine has been known to induce the contraction of rabbit aortic ring resulting from Ca2+ release from the intracellular stores. But in contrast, contraction of aortic ring induced by depolarizing agents or agonist was reported to be suppressed by caffeine. The present study was intended to examine the effect of caffeine on Ca2+ movement across the plasma membrane and actomyosin ATPase activity of vascular smooth muscle to elucidate the modes of action of caffeine on the vascular smooth muscle. Aortic ring preparation were made from the rabbit thoracic aorta and the endothelial cells were removed from the ring by gentle rubbing. The contractilty of the aortic ring was measured under varying conditions, and Ca2+ influx across the membranes of the aortic ring was measured with Ca2+ sensitive electrode with and without caffeine and the effect of caffeine on actomyosin ATPase activity were measured by modified Hartshrone's method. 45Ca wash out curves with and without caffeine were studied by Richard's method. The results were summarized as follows: 1) Caffeine inhibited the contractilty induced by norepinephrine. high K+, and histamine. but caffeine alone induced a transient contraction of vascular smooth muscle. The caffeine induced contraction was demonstrable even in the absence of external Ca2+. 2) Caffeine increased 45Ca efflux from vascular smooth muscle. 3) In the presence of propranolol, the inhibitory effect of caffeine on epinephrine induced contraction still persisted. 4) Caffeine decreased norepinephrine induced Ca2+ influx through the plasma membranes of aortic ring. 5) Caffeine decreased the actomyosin ATPase activity of vascular smooth muscle. From the above results, it is suggested that caffeine induces the contraction of vascular smooth muscle by release of Ca2+ from intracellular Ca2+ stone, but inhibits drug-induced contraction by decrease of Ca2+ influx across the plasma membranes and a decreased Ca2+ sensitivity of contractile protein in vascular smooth muscle.
Actomyosin* ; Aorta, Thoracic ; Caffeine* ; Cell Membrane ; Electrodes ; Endothelial Cells ; Epinephrine ; Histamine ; Membranes ; Muscle, Smooth, Vascular* ; Myosins* ; Norepinephrine ; Propranolol

A clinical study of 147 clavicle fracture patients (one patient had bilateral fractures) who were admitted and treated by the Department of orthopedic surgery of Wonju Christian Hospital, Wonju Medical College, Yon Sei University. The period covered was from September 1974 to August 1981, a total of seven years. The study focused on three fertors in relation to the pain and limitation of motion and these causes were comminution of fracture, shortening of the clavicle length and external deformity. The results were as followings; l. Of the 148 cases, 125 were male and 22 female (one with bilateral fractures). The majority were between 31 and 40 years of age. 2. The mid 1/3 fracture was most common and both sides showed no difference in incidence(left ; 73 cases, right; 75 cases). 3. The mean follow up ranged from 4 months to H3 months with a mean 49.5 months. 4. The complications resulting from comminution, shortening of clavicle length and malunion were shoulder joint pain-16 cases (10.8%), limitation of motion-17 cases(11.5%) and external deformity-18 cases(12.9%). 5. Using a rating scale of excellent(no apparent factors), good( one factor), fair(two factors), poor(more than three factors) the results showed, 106 excellent, 31 good, 9 fair and 2 poor. 6. On a percentage scale, the pain showed difference of 9 times with initial comminution, 7 times with shortening of clavicle length and 7 times with deformity. 8. On a percentage scale, the limitation of motion of shoulder joint showed difference of 6 times with initial comminution, 6 times with shortening of clavicle length and 17 times with deformity.
Clavicle ; Clinical Study ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Gangwon-do ; Humans ; Male ; Orthopedics ; Shoulder Joint

We report a case of ciliated hepatic foregut cyst which was incidentally found in a 64 year-old man. The cyst, 6 cm in diameter, was unilocular, solitary and was located in the medial segment of left lobe, just below the Glisson's capsule. Microscopically, the cyst wall consisted of 4 layers; pseudostratified ciliated columnar epithelium, subepithelial loose connective tissue, smooth muscle bundles and an outermost fibrous capsule. Although cartilage or subepithelial sero-mucous glands were absent, the morphologic features of the cyst correspond with those of an incomplete form of brochogenic cyst.
Cysts

No abstract available.
Trophoblastic Neoplasms* ; Trophoblasts*

Adenoid cystic carcinoma is a rare disease of which incidence is 10-15 % of bartholins gland carcinoma. The clinical presentation is characterized by a vulval mass that existed for a prolonged period to the onset of symptoms, usually infection, pain, and burningsensation Histologically, this tumor is characterized by cribriform pattern cell growing and perineural invasion. The obtaining of clear surgical margins is the most important aspect of treatment. Here we report a case of adenoid cystic carcinoma of the Bartholins gland with a brief review of literature.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Incidence ; Rare Diseases

Two-dimensional Doppler echocardiographic velocity profiles of four cardiac valves in a group of 85 infants and children with left to right shunt lesions(VSD, ASD and PDA) are presented. Velocities were obtained before operation and 10 days afterward. The results were as follows ; 1) VSD(type 2) Peak velocities of mitral valve were significantly decreased when compared preop. with postop. echocardiogram(n=37, preop 132+/-24, postop 98+/-16 cm/sec, p<0.0005). Peak velocities of tricuspid valve were also significantly decreased(n=30, perop 60+/-21, postop 50+/-17cm/sec, p<0.01). Peak velocities of aortic valve were decreased(n=18, perop 120+/-20, postop 108+/-26cm/sec, 0.010.05). Peak velocities of pulmonic valve were significantly decreased(n=17, perop 168+/-46, postop 104+/-51cm/sec, p<0.0005). 3) PDA Peak velocities of mitral valve were significantly decreased when compared perop. with postop. echocardiogram(n=29, perop 138+/-28, postop 111+/-19cm/sec, p<0.0005). Tricuspid valve velocities showed no significant changes between preop. and postop. echocardiogram (n=15, perop 47+/-12, postop 44+/-10cm/sec, p>0.05). Aortic valve velocities showed no significant changes (n=10, perop 134+/-23, postop 121+/-25cm/sec, p>0.05). Peak velocities of pulmonic valve were significantly decreased(n=28, perop 138+/-37, postop 107+/-27cm/sec, p<0.005). This study demonstrates that Doppler echocardiographic assessment of velovity changes are correlated with known hemodynamic data and also will be a good index in the evaluation of operation.
Aortic Valve ; Child ; Echocardiography* ; Echocardiography, Doppler ; Heart Valves* ; Hemodynamics ; Humans ; Infant ; Mitral Valve ; Tricuspid Valve

No abstract available.
Intestinal Obstruction*