• Tuberculosis and Respiratory Diseases
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• v.47 no.6
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• pp.824-835
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• 1999

Background: Sleep-related breathing disorders are commonly found in patients with chronic renal failure and particularly, sleep apnea may have an influence on the long-term mortality rates in these patients. Maintenance hemodialysis is the mainstay of medical measures for correcting the metabolic derangements of chronic renal failure but it is uncertain whether it may alleviate sleep disorders including sleep apnea. Methods: Forty seven patients on maintenance hemodialysis were surveyed with the sleep questionnaire about their clinical symptoms related to sleep disorders. Among them, 15 patients underwent the polysomnography and their blood levels of urea nitrogen, creatinine, electrolytes and the arterial blood gases in the nights before and following hemodialysis were measured. Results: Forty(85.1%) of the 47 patients complained of the symptoms associated with sleep-wake cycle disturbances, 55.3% experienced snoring and 27.7% reported witnessed apneas. The duration of REM sleep increased significantly in the nights after hemodialysis compared to the nights without hemodialysis(p<0.05) and the percentage of total sleep time comprising NREM sleep decreased significantly in the nights following hemodialysis compared to the nights before hemodialysis(p<0.05). The percentage of total sleep time consisting of the stage 1 and 2 NREM sleep showed the trend for a decrease in the nights after hemodialysis(p=0.051), while the percentage of total sleep time comprising the stage 3 and 4 NREM sleep did not change between nights. The obstructive sleep apnea was more predominant type than the central one in both nights and there were no differences in the apnea index and the apnea-hypopnea index between the nights. The decrease in the blood level of urea nitrogen, creatinine, potassium and phosphorus was observed after hemodialysis(p<0.05), but the differences of parameters measured during polysomnography between the nights did not correlate with the changes of biochemical factors obtained on the two nights. Arterial blood gas analysis showed that pH was significantly greater in the nights after hemodialysis than in the nights before hemodialysis(p<0.05), but there were no correlations between the parameters examined during polysomnography and the parameters of arterial blood gas analysis(p<0.05). Conclusion: These results suggest that chronic renal failure is an important systemic disorder which is strongly associated with sleep disorders. Maintenance hemodialysis, although it is a widely accepted measure to treat chronic renal failure, did not significantly modulate the sleep architecture and the severity of sleep apnea. Thus, taking the patients with chronic renal failure into account, it is advisable to try not only to find a substantial way for correcting metabolic derangements but also to consider the institution of more effective treatments for sleep disorders.

• Current Research on Agriculture and Life Sciences
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• v.2
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• pp.68-76
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• 1984

A $2{\times}4$ factorial study was carried out to investigate the interaction of aflatoxin and vitamin $D_3$ in broiler chicks. The day-old 336 chicks were allocated to triplicate 8 treatments. The 0 or 0.5 ppm of aflatoxin $B_1$ (AFB) and 0, 500, 1,000 or 1,500 IU/Kg of vitamin $D_3$ (VD) were supplemented to the basal diet. There were no significant differences among treatments in respect to the body weight gain, feed intake, feed conversion, shank color, mortality and incidence of weak legs. The utilization efficiencies of dry matter, crude protein, ether extract, N-free extract and crude ash showed also no significant differences among treatments, respectively. The mean utilization efficiency of crude fiber in AFB group was lower than that in normal groups (P<.01). However, no significant difference was found among groups fed different levels of VD, and no interaction between AFB and VD was found. The utilization efficiency of Ca in AFB group was somewhat higher than that in normal group without statistical significance, and the similar values were found among groups fed different VD. The utilization efficiencies of P and Na were not significantly different among treatments, respectively. The tibia ash appeared to be similar among treatments fed different levels of AFB and VD. However, the Ca content in tibia of birds fed 0.5 ppm of AFB was higher than that of normal chicks (P<.05). The slightly increasing trend was shown in Ca contents when fed increasing revel of VD, and the interaction between AFB and VD was recognized(P<.01). The P content of tibia was increased by feeding AFB(P<.05). However, there was no significant difference among groups fed different level of VD and no interaction between AFB and VD in respect to the P content of tibia. Feeding AFB did not affect the Na content in tibia. However, there was a highly significant difference among groups fed different levels of VD(P<.01), the highest values were at 1,000 IU/Kg group, and the interaction between AFB and VD was not significant. The Ca content in serum of birds fed AFB was higher than in control group (P<.01). The Ca of serum increased when fed more VD, although no significance was found among groups, and there was an interaction between AFB and VD(P<.05). The P content of serum showed no significant difference among treatments. The alkaline phosphatase activity in serum of chicks fed AFB was higher than that of control group (P<.01). The enzyme activity increased slightly with increasing level of VD, however, there was no interaction between AFB and VD.