No abstract available.
Bile Ducts* ; Bile*

OBJECTIVE: It has been reported that the sleep apnea syndrome in the asthmatic patients is prevalent, however, the systematic study in this field using polysomnography has rarely been performed. The aim of this study is to investigate the relationship between the apnea-hypopnea index (AHI) and the pulmonary function in asthmatic children. METHODS: This study enrolled 19 male and 12 female asthmatic children aged 6-13 years (average 8.2+/-1.7 years old). Complete overnight polysomnography and pulmonary function test were performed for the participants. RESULTS: Of the 31 asthmatic children, 21 (67.7%) met the diagnostic criteria of the pediatric sleep apnea and the average AHI was 1.7+/-1.5/h. The children with higher AHI showed poorer pulmonary function (FEV1/FVC ratio : p=0.002, FEV1%pred : p=0.047). CONCLUSION: These results suggest that the prevalence of the pediatric sleep apnea could be very high among the asthmatic children and the severity of the sleep apnea correlates with the pulmonary function. However, the case-control study to compare the AHI between the asthma and control groups is absolutely necessary because few normative data are available for the children.
Aged ; Asthma ; Case-Control Studies ; Child ; Female ; Humans ; Male ; Polysomnography ; Prevalence ; Respiratory Function Tests ; Sleep Apnea Syndromes

A 35-year-old man was admitted with a 20 day history of generalized edema and muscular weakness of the lower extremities. He was alert with a pale puffy face and an ejection murmur was heard at the cardiac apex. The electrocardiogram disclosed low voltage, first degree atrioventricular block, and a right bundle branch block. During the hospitalization an intractable diastolic hypotension developed, which measured 0 mmHg at the lowest point. At that time the echocardiogram revealed a dilated, akinetic right ventricle. Eventually a multiorgan failure developed and an autopsy following his death presented a fibrofatty replacement of the right ventricular myocardium. This might be a case of an arrhythmogenic right ventricular dysplasia/cardiomyopathy, which is usually characterized clinically by a ventricular tachycardia and may cause a sudden death in young adults.
Adult ; Atrioventricular Block ; Autopsy* ; Bundle-Branch Block ; Death, Sudden ; Edema ; Electrocardiography ; Heart Ventricles ; Hospitalization ; Humans ; Hypotension ; Lower Extremity ; Muscle Weakness ; Myocardium ; Systolic Murmurs ; Tachycardia, Ventricular ; Young Adult

Ibandronate (a bisphosphonate) is commonly used as an treatment of osteoporosis in combination with vitamin D. Monthly DP-R206-a novel, fixed-dose combination tablet (150 mg ibandronate/24,000 IU vitamin D3)-was recently developed to enhance patient compliance. This open, randomized, two-period crossover study was conducted to compare the pharmacokinetics of ibandronate when administered as DP-R206 or 150 mg ibandronate to healthy adult volunteers. Each volunteer was randomly allocated to receive single-dose DP-R206 or ibandronate with a 28-day washout period between treatments. Blood samples were assessed using pharmacokinetic analysis. Plasma ibandronate concentrations were determined using liquid chromatography-tandem mass spectrometry. Safety and tolerability assessments were performed throughout the study. In total, 103 participants received the study drugs and 72 participants completed the study. The geometric mean ratios (DP-R206/ibandronate) of the maximum concentration (C(max)) and the area under the plasma concentration time curve from time zero to the last concentration (AUC(last)) values were 0.959 (90% CI: 0.820-1.120) and 0.924 (90% CI: 0.805-1.060), respectively. The frequencies of adverse events (AEs) and drug reactions were similar between treatment groups, and all AEs were recovered without sequalae. Ibandronate pharmacokinetics, tolerability, and safety are comparable when administered to healthy individuals, regardless if administered as DP-R206 or ibandronate.
Adult* ; Cross-Over Studies ; Humans ; Mass Spectrometry ; Osteoporosis ; Patient Compliance ; Pharmacokinetics ; Plasma ; Vitamin D ; Vitamins* ; Volunteers

Extrahepatic metastasis of Hepatocellular carcinoma(HCC) to the gastrointestinal tract is uncommon. Because most of metastases to the gastrointestinal tract have no clinical manifestations, they are usually found incidentally at the time of an autopsy or a laparotomy, We experienced a case of duodenal metastasis of HCC, which presented UGI bleeding. A 59 years old male was admitted to our hospital due to generalized jaundice, which lasted for about a week. From the third day of admission, he had episodes of hematemesis and melena. An abdoinal CT scan demonstrated multiple, variable sized low-density masses in the entire liver with portal vein thrombosis and conglomerated lymph nodes. An esophagogastroduodenoscopy showed a protruded submucosal mass-like lesion with multiple ulceration in the duodenal bulb. We confirmed the duodenal mass-like lesion to be hepatocellular carcinoma by a biopsy and a histoimmunochemical study.
Autopsy ; Biopsy ; Carcinoma, Hepatocellular* ; Endoscopy, Digestive System ; Gastrointestinal Tract ; Hematemesis ; Hemorrhage* ; Humans ; Jaundice ; Laparotomy ; Liver ; Lymph Nodes ; Male ; Melena ; Middle Aged ; Neoplasm Metastasis* ; Tomography, X-Ray Computed ; Ulcer ; Venous Thrombosis

BACKGROUND: The phosphoinositide 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) signaling axis has emerged as a novel target for cancer therapy. Agents that inhibit this pathway are currently under development for lung cancer treatment. In the present study, we have tested whether dual inhibition of PI3K/Akt/mTOR signaling can lead to enahnced antitumor effects. We have also examined the role of autophagy during this process. METHODS: We analyzed the combination effect of the mTOR inhibitor, temsirolimus, and the Akt inhibitor, GSK690693, on the survival of NCI-H460 and A549 non-small cell lung cancer cells. Cell proliferation was determined by MTT assay and apoptosis induction was evaluated by flow cytometry and terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Autophagy induction was also evaluated by acridine orange staining. Changes of apoptosis or autophagy-related proteins were evaluated by western blot analysis. RESULTS: Combination treatment with temsirolimus and GSK690693 caused synergistically increased cell death in NCI-H460 and A549 cells. This was attributable to increased induction of apoptosis. Caspase 3 activation and poly(ADP-ribose) polymerase cleavage accompanied these findings. Autophagy also increased and inhibition of autophagy resulted in increased cell death, suggesting its cytoprotective role during this process. CONCLUSION: Taken together, our results suggest that the combination of temsirolimus and GSK690693 could be a novel strategy for lung cancer therapy. Inhibition of autophagy could also be a promising method of enhancing the combination effect of these drugs.
Acridine Orange ; Apoptosis ; Autophagy ; Axis, Cervical Vertebra ; Blotting, Western ; Carcinoma, Non-Small-Cell Lung ; Caspase 3 ; Cell Death ; Cell Proliferation ; DNA Nucleotidylexotransferase ; Flow Cytometry ; Lung Neoplasms ; Oxadiazoles ; Phosphatidylinositol 3-Kinases ; Poly(ADP-ribose) Polymerases ; Proteins ; Sirolimus ; TOR Serine-Threonine Kinases

Purpose: This study was conducted in order to examine the usefulness of osteoconductive bone substitutes with zeta potential control (geneX® ds; Biocomposites, England) by comparing the complications and radiographic evaluation with or without geneX® ds augmentation for internal fixation with proximal femur nail antirotation (PFNA) for treatment of osteoporotic unstable intertrochanteric fractures. Materials and Methods: A retrospective study of 101 patients who underwent fixation with PFNA in osteoporotic unstable intertrochanteric fractures was conducted from December 2015 to August 2020. The radiographic evaluation and complication rates were compared between patients with geneX® ds (Group A: 41 cases) and those without geneX® ds (Group B: 60 cases). Results: In radiological valuation, the degree of blade sliding from the time immediately after surgery to one year after surgery was 1.4±1.2 mm and 5.8±2.7 mm in Group A and Group B, respectively (P<0.001). During the same time frame, a significant difference of 2.3±2.2° and 7.4±3.1° , respectively (P<0.001), in varus collapse, was observed for Group A and Group B. Conclusion Among patients fixed with PFNA for treatment of unstable intertrochanteric fractures, less blade sliding and varus collapse was observed for those with geneX® ds augmentation compared to those without it. In addition, there was no increase in the incidence of complications. The authors believe it can be regarded as a safe and effective additive for intramedullary fixation for treatment of unstable intertrochanteric fractures.

OBJECTIVE: Few studies have evaluated the personality characteristics of patients with obstructive sleep apnea (OSA) and simple snoring. We investigated the personality characteristics of OSA and simple snoring patients and compared differences in personality between the two groups using the Eysenck Personality Questionnaire (EPQ). MATERIALS AND METHODS: Two hundred and thirty-seven patients who were suspected to have OSA or simple snoring participated in this study. A self-questionnaire which included the EPQ was administered to all participants. All subjects underwent polysomnography in a sleep laboratory and those with an apnea-hypopnea index (AHI) > or =5 were included in the OSA group, while those with an AHI <5 were included in the simple snoring group. RESULTS: OSA patients had significantly lower scores for Psychoticism (F=4.563, p=0.034) than simple snorers. There were no significant differences in Extraversion (F=3.029, p=0.083), Lie (F=0.398, p=0.529), or Neuroticism (F=3.367, p=0.068) scores between the two groups. In the correlation analysis of the OSA group, AHI was positively correlated with Extraversion score (r=0.16, p=0.029) and negatively correlated with Lie score (B=-0.31, p<0.001). Using multiple stepwise linear regression analysis with the four EPQ parameter scores as dependent variables, Lie score was associated with older age (B=0.14, p<0.001) and lower AHI (B=-0.05, p<0.001), Psychoticism score was associated with higher Pittsburgh Sleep Quality Index (PSQI ; B=0.14, p<0.001), Neuroticism score was associated with higher PSQI (B=0.34, p=0.001) and female sex (B=3.15, p=0.003), and Extraversion score was associated with younger age (B=-0.08, p=0.020) and higher body mass index (B=0.26, p=0.023). CONCLUSION: This study suggests that patients with OSA are significantly less prone to psychotic personality characteristics than those with simple snoring. Among OSA patients, higher AHI was correlated with low falsehood and high extraversion tendencies.
Body Mass Index ; Extraversion (Psychology) ; Female ; Humans ; Linear Models ; Polysomnography ; Surveys and Questionnaires ; Sleep Apnea, Obstructive* ; Snoring*

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing and affects quality of life. Several questionnaires have been developed for screening OSA. The aim of this study was to compare the anthropometric measurements of OSA patients using sleep questionnaires as a tool to screen patients with OSA. MATERIALS AND METHOD: This study enrolled 126 adult OSA patients. All subjects underwent overnight polysomnography (PSG) and were measured for body mass index (BMI), neck circumference, waist circumference, and tonsil size. Patients were screened using the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin questionnaire (Berlin Q), and STOP questionnaire (STOP Q). Correlation and multiple regression analyses were conducted to determine the predictive value of the anthropometric measurements of OSA patients. RESULTS: ESS, Berlin Q, and STOP Q results were associated with apnea hypopnea index (AHI), minimal oxygen saturation of PSG and BMI, neck circumference, waist circumference, and hip circumference of OSA patients. However, facial contour did not significantly influence the results of sleep questionnaires. CONCLUSION: Some anthropometric characteristics are associated with sleep questionnaire results. Not only sleep questionnaires, but also anthropometric data can be used as predictive tools of OSA.
Adult ; Apnea ; Berlin ; Body Mass Index ; Hip ; Humans ; Mass Screening ; Neck ; Oxygen ; Palatine Tonsil ; Polysomnography ; Quality of Life ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Waist Circumference

BACKGROUND: General anesthetics induce neuronal apoptosis in the immature brain. Regional anesthesia using local anesthetics can be an alternative to general anesthesia. Therefore, this study investigated the possible effect of lidocaine on neuronal apoptosis. METHODS: Fifty-one 7-day-old C57BL6 mice were allocated into control (group C), lidocaine (group L), lidocaine plus midazolam (group LM) and isoflurane (group I) groups. Group C received normal saline administration. Groups L and LM were injected with lidocaine (4 mg/kg, subcutaneously) only and the same dose of lidocaine plus midazolam (9 mg/kg, subcutaneously). Group I was exposed to 0.75 vol% isoflurane for 6 h. After 6 h, apoptotic neurodegeneration was assessed using caspase-3 immunostaining and terminal deoxynucleotidyl transferase dUTP nick-end labelling (TUNEL) staining. RESULTS: For the entire brain section, neuronal cells exhibiting caspase-3 activation were observed more frequently in group I than in group C (P < 0.001). In the thalamus, apoptosis of group L was more frequent than that of group C (P < 0.001), but less freqent than that of groups LM and I (P = 0.0075 and P < 0.001, respectively). In the cortex, group I experienced more apoptosis than group L and C (all Ps < 0.001). On TUNEL staining, the difference in apoptosis between the lidocaine and control groups was marginal (P = 0.05). CONCLUSIONS: Lidocaine induced minimal apoptosis in the developing brain compared with isoflurane and lidocaine plus midazolam. However, we cannot fully exclude the possible adverse effect of subcutaneously administered lidocaine on the developing brain.
Anesthesia, Conduction ; Anesthesia, General ; Anesthetics, General ; Anesthetics, Local ; Animals ; Apoptosis ; Brain* ; Caspase 3 ; DNA Nucleotidylexotransferase ; In Situ Nick-End Labeling ; Isoflurane ; Lidocaine* ; Mice* ; Midazolam ; Neurons ; Thalamus