The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.
Adenoidectomy ; Adenoids ; Child ; Continuous Positive Airway Pressure ; Enuresis ; Failure to Thrive ; Follow-Up Studies ; Humans ; Hypertension ; Hypertrophy ; Palatine Tonsil ; Pulmonary Heart Disease ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy

No abstract available.
Otitis Media* ; Otitis* ; Tympanoplasty*

No abstract available.
Animals ; Guinea Pigs* ; Guinea* ; Perilymph*

No abstract available.
Mouth* ; Oropharynx*

BACKGROUND: Tamoxifen, a synthetic antiestrogen, increases disease-free and overall survival when used as adjuvant therapy for primary breast cancer. Because it is given for long periods, it is important to know whether tamoxifen affects bone mineral metabolism in women. However few reports on this topic have been published in Korea. METHODS: We classified patients into four subgroups by age, hormone receptor status, and menstrual status, and during a five-year randomized, uncontrolled clinical investigation we studied retrospectively the effects of tamoxifen on biochemical measures of bone mineral metabolism in 112 women with axillary-node-negative breast cancer. RESULTS: In all four subgroups, neither the serum calcium nor the phosphorus level showed any fluctuation beyond the reference range. Serum alkaline phosphatase (ALP) decreased one year after the operation in all subgroups, and then increased afterwards in the reference range. However, women in the under 40-years-old subgroup and in the both estrogen and progesterone receptor negative subgroup showed a prominent rise in the upper value of the reference range up to 436 IU/l. In the 60 or older subgroup, ALP values showed some fluctuations similar to those for the both estrogen and progesterone receptor positive subgroup. CONCLUSIONS: We think that treatment with tamoxifen may be associated with preservation of bone minerals in women after menopause, in women 60 and older, and in women with a positive estrogen and progesterone receptor. Also, this effect probably can help to prevent or to delay the development of osteoporosis in these women with breast cancer, but a possible relation with a decrease in the risk of fractures still remains to be evaluated.
Alkaline Phosphatase ; Breast Neoplasms* ; Breast* ; Calcium ; Estrogen Receptor Modulators ; Estrogens ; Female ; Humans ; Korea ; Menopause ; Metabolism* ; Minerals ; Osteoporosis ; Phosphorus ; Receptors, Progesterone ; Reference Values ; Retrospective Studies ; Tamoxifen*

We report a 37-year-old man with adrenomyeloneuropathy who presented as progressive gait disturbance. He had spastic paraparesis, hyperreflexia with Babinski's signs, a sensory level at T-4, and loss of the vibration sense in the legs. No adrenal insufficiency was noted. There were frontal white matter abnormalities but no cervical spinal lesions on MRI. A nerve conduction study showed distal axonal neuropathy predominantly in the lower extremities. The plas-ma level of the saturated very long chain fatty acids was elevated. (J Korean Neurol Assoc 19(4):431~434, 2001)
Adrenal Insufficiency ; Adrenoleukodystrophy* ; Adult ; Axons ; Fatty Acids ; Gait ; Humans ; Leg ; Lower Extremity ; Magnetic Resonance Imaging ; Neural Conduction ; Paraparesis, Spastic ; Reflex, Abnormal ; Reflex, Babinski ; Vibration

Elevation of aspartate aminotransferase (AST), alanine aminotransferase(ALT),and bilirubin levels was noted incidentally in patients who received laparoscopic cholecystectomy(LC). This study was attempted to investigate the elevation of liver enzymes and bilirubin levels after LC and its clinical significance. Twenty patients who showed normal levels of preoperative liver function test were entered into this study, and blood was collected at 24hours, 72hours and 7days after operation for measurement of AST, ALT, alkaline phosphatase(ALP), and bilirubin levels. In AST, a mean 2.76-fold postoperative increase was observed in 18 patients(90%) and 12 patients(60%) showed an elevation rise above normal limits. In ALT, a mean 2.14-fold postoperative increase was observed in 16 patients(80%) and 10 patients(50%) showed an elevation rise above normal limits. A mean 1.42-fold and a mean 2.12-fold increase were observed in total and direct bilirubin level respectively and elevation above normal limits occured in 7 patients(35%) and 4 patients (20%) respectively. The patients with an elevation of AST, ALT and bilirubin levels did not show any related clinical problem, and the elevations were transitory and returned to normal value within several days without any specific treatment.. Although the exact causes of these elevations need further investigation, theys appear to have no obvious clinical significance.
Alanine ; Aspartate Aminotransferases ; Bilirubin* ; Cholecystectomy, Laparoscopic* ; Humans ; Liver Function Tests ; Liver* ; Reference Values

No abstract available.
Constriction, Pathologic* ; Stents*

No abstract available.
Hemodynamics* ; Ketanserin* ; Positive-Pressure Respiration* ; Pulmonary Embolism* ; Ventilation*

The ultraviolet radiation (UVR) is known to be a potent modulator of many host immune functions and the exposure of experimental animals to the inflammatory effects of UVR induces depressions in their ability to initiate and effectuate various types of cellular immune responses. In this study, the effects of UV-B (280 320 nm) radiation on resistance to a facultative intracellular bacterium, Listeria monocytogenes (LM), were examined at the cellular level. The numbers of cultivable LM recovered from the spleens of UV-B-irradiated mice were decreased at 2 days postinfection compared with those of untreated control mice. However, the acquired immunity, developed 7 days after immunization with streptomycin (SM)-sensitive LM, in either UV-irradiated, LPS- or IL-1-pretreated mice was less stronger than that developed in untreated, control mice. To elucidate the possible mechanisms underlying the observation that UVR did increase innate immunity but decreased acquired immunity of mice to the infection with LM, the effects of UVR of mice on the production of IFN-r by activated splenocytes and TNF-a by peritoneal macrophages were assessed. Activated splenocytes from UV-irradiated mice exhibited a reduced capacity to produce IFN-r and cultured peritoneal macrophages produced more TNF-a in the presence of LPS during 24 hours after UV radiation. Though TNF-r activity was not detected in the sera of LM-infected mice, intravenous LPS injection induced TNF-r production and UVR decreased TNF activity in sera obtained from LM-infected mice with LPS induction 9 days after irradiation. Although Ia-negative macrophages were predominant in the peritoneal macrophages from untreated control mice, the infection of mice with LM caused a marked increase in Ia expression on peritoneal macrophages. However, UVR resulted in decreased expression of Ia molecule on the peritoneal macrophages during the LM infection. These findings suggest that the dual effects of UVR on the innate and acquired immunity of mice to the LM infection may be associated with altered capacities of splenocytes and peritoneal macrophages of the mice to produce cytokines, in addition to decrease of la molecule expression on the macrophages.
Adaptive Immunity ; Animals ; Cytokines ; Depression ; Immunity, Cellular ; Immunity, Innate ; Immunization ; Listeria monocytogenes* ; Listeria* ; Macrophages ; Macrophages, Peritoneal ; Mice* ; Spleen ; Streptomycin ; Tumor Necrosis Factor-alpha*