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

No abstract available.
Nocardia Infections*

It remains a problem that successful revascularization and reperfusion after ischemia are associated with high systemic complication rates and severe local tissue injuries. With prolonged ischemia, there is damage to tissue from anoxia, but further injury may occur after reperfusion. The activation of leukocytes and endothelial cells during reperfusion causes neutrophil adhesion in capillaries, resulting in plugging and further ischemia, Alternativety, neutrophil adhesion to endothelium leads to the migration of neutrophil with local edema formation, hemorrhage and thrombosis. Some chemotactic and activating factors are needed to propel neutrophils to the site of local inflammation. The chief cytikines that induce a pro-adhesive state in endothelium are tumor necrosis factor-alpha(TNF-alpha), interleukin-1 beta(IL-1 beta) and endotoxin or lipopolysaccharide(LPS). Similarly, TNF-alpha,and to a lesser extent interleukin-8(IL-8), is the important stimulus that acts on neutrophils and other leukocytes to alter their adhesion. The purpose of this study was to evaluate the pathogenetic role of IL-8 after perfusion with CDl8 monoclonal antibody(CDl8 mAb), the blocking antibody of neutrophil adherence, on reperfusion injury in rat epigastric island skin flap. A 6 X 3 cm-sized island skin flap was made on the abdomen. The epigastric pedicle was occluded for six hours with ambient temperature. Fifteen minutes before reperfusion, the flap was perfused with saline and CDl8 mAb(1 mg/kg). For evaluation of IL-8 levels, tissue fluid and serum were obtained at 4, 8, 12 and 24 hours after reperfusion. IL-8 concentrations of the CDl8 mAb group in the tissue fluid were significantly decreased at 8, 12 and 24 hours compared to the control group(P > 0.01), but the difference between the two groups was not significant at 4 hours after reperfusion IL-8 concentrations of the CDl8 mAb group in the serum were significantly decreased over time compared to the control group(P > 0.05, p > 0.01). Form the above results, we concluded that blocking neutrophil adherence using CD18 mAb within the peak level of IL-8 at 4 hours after reperfusion may be a better method of reducing reperfusion injury to the island skin flap.
Abdomen ; Animals ; Anoxia ; Capillaries ; Edema ; Endothelial Cells ; Endothelium ; Hemorrhage ; Inflammation ; Interleukin-1 ; Interleukin-8* ; Ischemia ; Leukocytes ; Necrosis ; Neutrophils ; Perfusion ; Rats ; Reperfusion Injury* ; Reperfusion* ; Skin ; Thrombosis

BACKGROUND: Epidermal growth factor (EGF) is a 6Kd polypeptide hormone produced by the glands of the gastrointestinal tract, namely the salivary and Brunner's glands. In fetal and neonatal life, EGF appears to play an important role in the developement of the gastrointestinal tract and the liver. METHODS: EGF and EGFR (EGF receptor), which play important roles in the onset of liver regeneration, were investigated with regard to the proteins and mRNA according to the developmental periods of the livers of prenatal rats (24 female Spraque Dawley rats weighting from 200 to 250g) by using immunohistochemical stains, the solution reverse transcription polymerase chain reaction (RT PCR), and in-situ (IS) RT PCR. RESULTS: 1) On the immunohistochemical stains, the immunoreactivities for EGF started to be observed at an early stage of the developing rat liver. As the developmental stage progressed, the reactivites were observed in embryo tissues containing epithelial cells. The strongest reactivity for EGF was found from the 17th to the 19th day after pregnancy and decreased gradually till full term. The reactivities of EGFR were detected earlier than those of EGF. 2) In solution RT PCR studies, EGF and beta-actin (house keeping gene) were detected in all developmental stages, reached a peak level at the 18th day after pregnancy, and decreased gradually till the final developmental stage. The peak level of EGF beta-actin was about 4 times higher than the lowest level. 3) The expressions of EGF in IS RT PCR were detected mainly on hepatocytes rather than Kupffer cells and endothelial cells. CONCLUSIONS: The EGF expression was observed over the entire time of development for experimental rat livers and is related strongly to growth and developing rate of liver.
Actins ; Animals ; Brunner Glands ; Coloring Agents ; Embryonic Structures ; Endothelial Cells ; Epidermal Growth Factor* ; Epithelial Cells ; Female ; Gastrointestinal Tract ; Hepatocytes ; Humans ; Kupffer Cells ; Liver ; Liver Regeneration ; Polymerase Chain Reaction ; Pregnancy ; Rats ; Reverse Transcription ; RNA, Messenger

PURPOSE: The Aim of this study was to find the value of intravesical permeability of potassium as a diagnostic measure of the interstitial cystitis and to find importance of intravesical mucosal layer by intravesical instillation of potassium chloride solution. MATERIALS AND METHODS: 20 patients with interstitial cystitis and 20 normal subjects without UTI, frequency and urgency underwent intravesical challenge with 40ml water and 40ml of 400meq/L potassium chloride solution. After 5 minutes, patients were asked about increase or decrease of urgency or suprapubic pain and subjective response of urgency or suprapubic pain were recorded on a scale of 0 to 5. RESULTS: Neither normal subjects nor patients with interstitial cystitis reacted to water administered intravesically. There was marked sensitivity to intravesical potassium in 85% of patients with interstitial cystitis versus 10% of normal controls (p<0.05). CONCLUSIONS: Diffusion of urinary potassium ion into the bladder interstitium may induce sensory symptoms, damage the tissue and be a major toxic factor in the pathogenesis of interstitial cystitis. Intravesical potassium sensitivity can be a reliable method for detecting abnormal epithelial permeability and useful diagnostic test for interstitial cystitis.
Administration, Intravesical ; Cystitis, Interstitial* ; Diagnosis* ; Diagnostic Tests, Routine ; Diffusion ; Humans ; Permeability* ; Potassium Chloride ; Potassium* ; Urinary Bladder ; Water

Percutaneous biopsy is the most frequent interventional radiographic procedure. Its increased use is relatedto new imaging techniques facilitating needle placement, greater safety of fine needle and advances in cytology.CT because of its characteristic high spatial and density resolution, permits the accurate localization of anylesion in the body. Because of the ability of CT scans to precisely localize lesions and biopsy needle, along withthe delineation of adjacent structure, it is widely used in percutaneous biopsy. Sixty-six cases of CT-guidedpercutaneous fine-needle biopsy were performed in order to diagnose suspected malignant or infectious disease(49malignant and 17 infectious) over a 7-month period(June 1984 through Dec. 1984). Most of these procedures wereperformed on, but not limited to, the lung(21), liver(20), and pancreas(7). The spine and nasopharynx could alsosafely be biopsied. 4 cases of hepatic abscesses were successfully drained following insertion of drainingcatheter under the CT-guidance. The overall accuracy of both suspected malignant and infectious disease was 82%.Complication rate was low as 6%(4 cases only in thorax). Neither complication require any further intervention.Three were self-limited pneumothoraces and one was minimal hemorrhage around the needle tract.
Biopsy ; Biopsy, Fine-Needle ; Communicable Diseases ; Hemorrhage ; Liver Abscess ; Nasopharynx ; Needles ; Spine ; Tomography, X-Ray Computed

OBJECTIVE: This study aims the electrophysiological documentation of possible neurological abnormalities in diabetic patients with or without neuropathy symptoms. METHOD: Forty five diabetic patients, 15 male and 30 female, were included in this study. They were divided into symptomatic and asymptomatic groups and received various electrophysiologic studies including a nerve conduction study, F-wave study and median and tibial SSEP study. The clinical parameters were the clinical symptom and sign of neuropathy, disease duration, complications, HbA1c, and fasting blood sugar. Statistical significances of the parameters were observed between symptomatic and asymptomatic groups. RESULTS: The most sensitive electrophysiologic parameter was the tibial SSEP. For the documentation of diabetic neuropathy, the electrophysiologic study of posterior tibial, median, superficial peroneal and sural nerves were most useful. F-wave study did not reflect the early involvement of proximal nerve segment in diabetic patients. CONCLUSION: Multimodal neurophysiological approaches including a tibial SSEP study rather than the conventional nerve conduction studies can depict a broader and more complete map of the possible abnormalities of diabetic neuropathy.
Blood Glucose ; Diabetic Neuropathies ; Evoked Potentials, Somatosensory* ; Fasting ; Female ; Humans ; Male ; Neural Conduction* ; Sural Nerve

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*

Primary heterotopic ossification has been previously noted in abdominal laparotomy scars, but the presence of ectopic bone within the peritoneum is extremely rare and chracterized by new bone formation in a tissue which does not normally undergo ossification. Our patient in a 59-year-old man who underwent operation for acute cholecystitis had formation of heterotopic bone involving mesentery of intestine. The features of various types of ectopic calcification are discussed, and several theories concerning the pathogenesis and treatment of heterotopic ossification are examined.
Cholecystitis, Acute ; Cicatrix ; Humans ; Intestines* ; Laparotomy ; Mesentery* ; Middle Aged ; Ossification, Heterotopic* ; Osteogenesis ; Peritoneum