INTRODUCTION: In this study, we compared sleep structure, EEG characteristic of pediatric obstructive sleep apnea (OSA) and normal controls which were matched in sex and age. METHODS: Fifteen children (male:female=4:11) who complained snoring and were suspected to have sleep apnea and their age and sex matched normal controls (male:female=5:10) have been done nocturnal polysomnography (NPSG). Sleep parameters, sleep apnea variables and relative spectral components of EEG from NPSG have been compared between both groups. RESULTS: Pediatric OSA group were distinguished from normal controls in terms of apnea index, respiratory disturbance index and nadir of oxyhemoglobulin desaturation. Pediatric OSA group showed increased percent of sleep stage 1, decreased rapid eye movement sleep percent and increased delta power in O1 EEG channel. However other sleep parameters and spectral powers were not different between two groups. CONCLUSION: In pediatric OSA group, sleep structure parameter disruption may be not prominent as the previous studies for adult OSA group because of including mild OSA data in diagnostic criteria. In addition, EEG changes might not be distinct due to low arousal index compared to adult OSA patients. We can observe general characteristics and particularity of pediatric OSA through this study.
Adult ; Apnea ; Arousal ; Child ; Electroencephalography ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep Stages ; Sleep, REM ; Snoring

No abstract available.

Under the extreme change of the environment, animals react physiologically to adapt to the stress and secrete catecholamines. Cold exposure is a kind of the environmental stress. Author tried to determine the amount of catecholamines in rat urine as a parameter of physiological response to cold stress. Urinary catecholamine was measured by using HPLC with fluorescence detector, coation exchange column prepacked with Bio-Rex 70 and ammonium pentaborate as catecholamine eluent. The amount of dopamine in normal state rat urine was 42.0 ng, but under the low temperature of 5 degrees C, the dopamine amount was increased to 221.25 ng/5 ml. Above findings are suggesting that catecholamine secretion, especially dopamine, increase in the stressful condition such as cold exposure.
Ammonium Compounds ; Animals ; Catecholamines ; Chromatography, High Pressure Liquid ; Dopamine ; Fluorescence ; Rats*

PURPOSE: Cyclin D1 plays critical roles in the progression of cells through the G1 phase of the cell cycle, which has been implicated as a putative protooncogene, while p53 protein affects different phase checkpoint pathways in the normal cell cycle, which mutations occur in poor prognosis of cancer. We attempted to determine their significance for tumor behavior and prognosis of transitional cell carcinoma(TCCa) of the bladder in human. MATERIALS AND METHODS: Formalin fixed-paraffin embedded tissue specimens from 102 patients with TCCa of the urinary bladder were examined. Nuclear expression was detected by immunohistochemical analysis with a standard avidin-biotin immunoperoxidase method, using the monoclonal antibody cyclin D1 and p53(DO7). RESULTS: Cyclin D1 and p53 protein immunostaining of the nucleus was observed in 49 tumors(48.0%) and 55 tumors(53.9%) respectively. Overexpression of cyclin D1 showed significant inverse correlation with the histological grade and significant correlation with recurrence. Overexpression of p53 protein showed a significant correlation with the histological grade and stage(p<0.01). 65.3% (32 out of 49 tumors), of the cyclin D1 positive tumors exhibited expression for p53 protein(p<0.05). Patients with TCCa coexpressing cyclin D1 and p53 protein had a significantly poorer prognosis than those expressing neither cyclin D1 nor p53 protein(p<0.001). CONCLUSIONS: Cyclin D1 in bladder TCCa is closely related to early tumor differentiation and associated with recurrence. Simultaneous overexpression of both cyclin D1 and p53 protein is related to more aggressive tumor behavior and poorer prognosis. This indicates that cyclin D1 evaluation may be a further useful element for selecting subgroup of patients who should be treated with more aggressive therapies.
Carcinoma, Transitional Cell* ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Formaldehyde ; G1 Phase ; Humans ; Prognosis ; Recurrence ; Urinary Bladder*

A wide range of cognitive impairments and depression can be observed in most patients with Parkinson's disease (PD). But the underlying mechanism of these changes has not to be clarified yet. This study evaluated whether the frontal lobe dysfunctions contribute to the cognitive deficits in PD by comparison with age and education-matched controls. The neuropsychological tests known to be sensitive to frontal lobe dysfunction were performed to 38 patients with PD and matched 24 controls. These were composed of 'Category Fluency Test (CFT)' including objects, animals, & nations and 'Wisconsin Card Sorting Test (WCST)'. General cognition and depression were measured 'Korean Mini-Mental State Examination (K-MMSE)' and 'Beck Depression Inventory (BDI)' respectively. We examined the degree of motor disabilities in PD using the Hoehn-Yahr Stage. Patients with PD were assessed before noon and during the ""On"" time of levodopa to reduce the diurnal variation of mood and drug effects. Although PD patients, compared with controls, showed decreased ability in attention & calculation, memory, and visuo-spatial construction, the most prominent deficit was frontal lobe dysfunction evaluated with WCST and CFTs. Cognitive impairments in PD did not attribute to the discrepancy of education level or associated depression. So we suggest that the frontal lobe dysfunction may play an important role for cognitive impairments in PD.
Animals ; Cognition ; Depression ; Education ; Frontal Lobe* ; Humans ; Levodopa ; Memory ; Neuropsychological Tests ; Parkinson Disease*

Unlike the case of adult obstructive sleep apnea syndrome (OSAS), there was no consistent finding on the changes of sleep architecture in childhood OSAS. Further understanding of the sleep electroencephalogram (EEG) should be needed. Non-linear analysis of EEG is particularly useful in giving us a new perspective and in understanding the brain system. The objective of the current study is to compare the sleep architecture and the scaling exponent (alpha) from detrended fluctuation analysis (DFA) on sleep EEG between OSAS and normal children. Fifteen normal children (8 boys/7 girls, 6.0+/-2.2 years old) and twelve OSAS children (10 boys/2 girls, 6.4+/-3.4 years old) were studied with polysomnography (PSG). Sleep-related variables and OSAS severity indices were obtained. Scaling exponent of DFA were calculated from the EEG channels (C3/A2, C4/A1, O1/A2, and O2/A1), and compared between normal and OSAS children. No difference in sleep architecture was found between OSAS and normal controls except stage 1 sleep (%) and REM sleep latency (min). Stage 1 sleep (%) was significantly higher and REM latency was longer in OSAS group (9.3+/-4.3%, 181.5+/-59.9 min) than in controls (5.6+/-2.8%, 133.5+/-42.0 min). Scaling exponent (alpha) showed that sleep EEG of OSAS children also followed the 'longrange temporal correlation' characteristics. Value of alpha increased as sleep stages increased from stage 1 to stage 4. Value of alpha from C3/A2, C4/A1, O1/A2, O2/A1 were significantly lower in OSAS than in control (1.36+/-0.05 vs. 1.41+/-0.04, 1.37+/-0.04 vs. 1.41+/-0.04, 1.37+/-0.05 vs. 1.41+/-0.05, and 1.36+/-0.07 vs. 1.41+/-0.05, p<0.05). Higher stage 1 sleep (%) in OSAS children was consistent finding with OSAS adults. Lower 'alpha' in OSAS children suggests decrease of self-organized criticality or the decreased piling-up energy of brain system during sleep in OSAS children.
Adult ; Brain ; Child ; Electroencephalography ; Humans ; Polysomnography ; Sleep Apnea, Obstructive ; Sleep Stages ; Sleep, REM

Trichomoniasis, a common and sometimes distressing condition in women, is caused by infection of the genitourinary tract by the pathogenic protozoan Trichomonris aginalis(T. vaginalis). Men may also be infected, although frequently without any symptoms, and most cases of trichomoniasis are sexually transmitted. The best evidence for an etiologic role for T. vaginalis is in nongonococcal urethritis(NGU). In epidemiologic studies, T,ginalis has been isolated from 1 to 68 percent in men with NGU. The nurnber of NGU is increasing rapidly than gonorrhea in deeloped nations, and in some developing countries, especially in Korea, In view of the difficulties in findng trichomonads by direct microsco by in men, urine culture and serodiagnosis plays an important role in the diagnostic work. Urine culture, indirect fluorescent antibody test(IFAT) and enzyme-linked immunosorbent assay (ELISA) were used to elecect T.vaginalis in 221 patients with male NGU. These patients visited the VD Clinic of ChoongKu Public Health Center in Seoul from May to August, 1989 and from March, 1990 to December, 1991. The results obtained were as follows.: 1. T. vaginalis was grown from only one of the 221 samples on TPS-1 meida. 2. In 208 NGU patients, there were 10(4.8%) positive reactions on IgG antibody in IFAT. 3. In 208 NGU patient, there were 14(6.7%) positive reactions to IgG antibody in ELISA. 4. No statistical significant correlation was found between then sults of IFAT and ELISA in individual patients. In conclusion, 1. Male trichomoniasis in patients with NGU was detected at a, significantly low rate. Due to the small number of patients in the test, further epidemiologic stidies of trichomoniasis in male NGU patient are necessary. 2. Serologic studies (IFAT and ELISA) have detected sorre trichomoniasis in male patients with NGU. These tests seem to be helpful in the diagnosis of male t-ichomoniasis.
Developing Countries ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay ; Epidemiologic Studies ; Female ; Gonorrhea ; Humans ; Immunoglobulin G ; Korea ; Male* ; Public Health ; Seoul ; Serologic Tests* ; Urethritis*

The empty sella syndrome is characterized by obesity, frequent pregnancy, headache and high blood pressure, but its exact cause remains unknown. Usually the incomplete diaphragmatic sella has been considered as the cause of the empty sella syndrome, but some authors recently have suggested that the antipituitary antibody way be related to development of pituitary atrophy and the pituitary empty sella syndrome, and thus it may be clinically useful as screening test for the empty sella syndrome. We experienced two empty sella syndromes associated Graves disease and applied the antipituitary antibody as the diagnostic tool of the empty sella syndrome. But none of this two patients had antipituitary antibody and we report these cases with reviews of literatures.
Atrophy ; Empty Sella Syndrome ; Graves Disease ; Headache ; Humans ; Hypertension ; Mass Screening ; Obesity ; Pregnancy

PURPOSE: We compared estimates of ejection fraction (EF) determined by gated Tl-201 perfusion SPECT (g-TI-SPECT) with those by gated blood pool (GBP) scan. MATERIALS AND METHODS: Eighteen subjects underwent g-TI-SPECT and GBP scan. After reconstruction of g-TI-SPECT, we measured EF with Cedars software. The comparison of the EF with g-TI-SPECT and GHP scan was assessed by correlation analysis and Bland Altman plot. RESULTS: The estimates of EF were significantly different (p<0.05) with g-TI-SPECT (40%+/-14%) and GBP scan (43%+/-14%). There was an excellent correlation of EF between e-TI-SPECT and GBP scan (r=0.94, p<0.001). The mean difference of EF between GRP scan and g-TI- SPECT was +3.2%, Ninety-five percent limits of agreement were +9,8%. EF between g-TI-SPECT and GBP scan were in poor agreement. CONCLUSION: The estimates of EF by g-TI-SPECT was well correlated with those by GBP scan. However, EF of g-TI-SPECT doesn't agree with EF of GBP scan. EF of g-TI-SPECT cant be used interchangeably with EF of GBP scan.
Perfusion* ; Tomography, Emission-Computed, Single-Photon*

The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of 26.3 kg/m2 and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range (23.1 kg/m2) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.
Adenoids ; Body Mass Index ; Child ; Diagnostic Errors ; Diet ; Fatty Liver ; Follow-Up Studies ; Humans ; Hypertrophy ; Liver ; Obesity ; Physical Examination ; Polysomnography ; Reference Values ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Sinusitis ; Sleep Apnea, Obstructive ; Snoring