• Title/Summary/Keyword: nocturnal

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Long-Term Management of Seizures after Surgical Treatment of Supratentorial Cavernous Malformations : A Retrospective Single Centre Study

  • Dziedzic, Tomasz A.;Koczyk, Kacper;Nowak, Arkadiusz;Maj, Edyta;Marchel, Andrzej
    • Journal of Korean Neurosurgical Society
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    • v.65 no.3
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    • pp.415-421
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    • 2022
  • Objective : Seizure recurrence after the first-ever seizure in patients with a supratentorial cerebral cavernous malformation (CCM) is almost certain, so the diagnosis and treatment of epilepsy is justified. The optimal method of management of these patients is still a matter of debate. The aim of our study was to identify factors associated with postoperative seizure control and assess the surgical morbidity rate. Methods : We retrospectively analysed 45 consecutive patients with a supratentorial CCM and symptomatic epilepsy in a single centre. Pre- and postoperative epidemiological data, seizure-related patient histories, neuroimaging results, surgery details and outcomes were obtained from hospital medical records. Seizure outcomes were assessed at least 12 months after surgery. Results : Thirty-five patients (77.8%) were seizure free at the long-term follow-up (Engel class I); six (13,3%) had rare, nocturnal seizures (Engel class II); and four (8.9%) showed meaningful improvement (Engel class III). In 15 patients (33%) in the Engel I group; it was possible to discontinue antiepileptic medication. Although there was not statistical significance, our results suggest that patients can benefit from early surgery. No deaths occurred in our study, and mild postoperative neurologic deficits were observed in two patients (4%) at the long-term follow-up. Conclusion : Surgical resection of CCMs should be considered in all patients with a supratentorial malformation and epilepsy due to the favourable surgical results in terms of the epileptic seizure control rate and low postoperative morbidity risk, despite the use of different predictors for the seizure outcome.

Morphology and Histology of the Olfactory Organ in the Korean Endemic Species, Pseudobagrus koreanus (Cypriniformes, Cyprinidae) (한국 고유종 눈동자개 Pseudobagrus koreanus 후각기관의 형태 및 조직학적 특성 연구)

  • Kim, Hyun-Tae;Chae, Dong-Hyun
    • Korean Journal of Ichthyology
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    • v.34 no.3
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    • pp.153-159
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    • 2022
  • The olfactory organ of a Korean endemic species, Pseudobagrus koreanus, was investigated to describe its morphology and histology and analyze correlation between habitat environment and its ecological habits and characters, using a stereo microscope, a light microscope, and a scanning electron microscope. Its external morphology showed tubular anterior nostril at the tip of the snout and slit posterior nostril at the base of the nasal barbel. The olfactory chamber showed the rosette structure consisting of numerous lamellae radial and parallel to the medium raphe. The olfactory lamella has the sensory epithelium with olfactory receptor nuerons, supporting cells, basal cells, lymphatic cells, plasma cells and the non-sensory epithelium with stratified epithelial cells, mucous cells, lymphatic cells. In particular, 1) 41~43 (n=20) lamellae, 2) lymphatic cells and plasma cells, 3) mucous cells including neutral polysaccharid may be olfactory characteristics relevant to a stagnant or a standing habitat environment, nocturnal habit dependent on olfaction, and taxonomic characters compared at least to other catfish species.

Prevalence of malocclusions and parafunctional habits in pediatric patients with developmental dyslexia

  • Federica Guglielmi;Anna Alessandri-Bonetti;Geraldine Gemelli;Linda Sangalli;Patrizia Gallenzi
    • The korean journal of orthodontics
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    • v.54 no.4
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    • pp.229-238
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    • 2024
  • Objective: The study aimed to assess the prevalence of dental malocclusion, orthodontic parameters, and parafunctional habits in children with developmental dyslexia (DD). Methods: Forty pediatric patients (67.5% boys and 32.5% girls, mean age: 11.02 ± 2.53 years, range: 6-15 years) with DD were compared with 40 age- and sex-matched healthy participants for prevalence of dental malocclusion, orthodontic parameters, and parafunctional habits. Dental examinations were performed by an orthodontist. Results: Pediatric patients with DD exhibited a significantly higher prevalence of Angle Class III malocclusion (22.5% vs. 5.0%, P = 0.024), deep bite (27.5% vs. 7.5%, P = 0.019), midline deviation (55.0% vs. 7.5%, P < 0.0001), midline diastemas (32.5% vs. 7.5%, P = 0.010), wear facets (92.5% vs. 15.0%, P < 0.0001), self-reported nocturnal teeth grinding (82.5% vs. 7.5%, P < 0.0001), nail biting (35.0% vs. 0.0%, P < 0.0001), and atypical swallowing (85.0% vs. 17.5%, P < 0.0001) compared to that in healthy controls. Conclusions: Pediatric patients with DD showed a higher prevalence of Class III malocclusion, greater orthodontic vertical and transverse discrepancies, and incidence of parafunctional activities. Clinicians and dentists should be aware of the vulnerability of children with dyslexia for exhibiting malocclusion and encourage early assessment and multidisciplinary intervention.

The effect of Lantus on glycemic control in children and adolescents with type 1 diabetes mellitus (1형 당뇨병을 가진 소아와 청소년에서 란투스 치료의 혈당 조절에 대한 효과)

  • Rhie, Young Jun;Chae, Hyun Wook;Kim, Ho Seong;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.565-569
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    • 2007
  • Purpose : With a duration of action of approximately 24 hours and peakless levels, Lantus is a more physiologic basal insulin analogue compared with NPH. The aim of this study was to compare the glycemic control of Lantus plus Humalog with that of premixed insulin in children and adolescents with type 1 diabetes mellitus. Methods : The subjects consisted of 25 patients with type 1 diabetes mellitus, aged 12-19 years, who changed their insulin regimen from premixed insulin to Lantus plus Humalog. Daily insulin doses, frequency of hypoglycemia, fasting blood glucose, C-peptide concentration and HbA1c before and 6 months after Lantus treatment were compared. 24 hour blood glucose of 11 patients among Lantus treatment group (n=25) and premixed insulin treatment group (n=10) were self-monitored and compared. Results : 6 months after Lantus treatment, the episodes of hypoglycemia were reduced by 50%(15.1 vs. 7.6 events/month), especially nocturnal hypoglycemia by 67%(6.7 vs. 2.5 events/month). HbA1c was reduced from 9.3% to 8.7% after Lantus treatment. Self-monitored blood glucose of Lantus treatment group at postbreakfast 30, 60, 90 and 120 minutes were 171.1, 169.5, 171.0 and 154.1 mg/dL respectively and lower than those of premixed insulin treatment group (259.7, 282.7, 280.0 and 250.9 mg/dL respectively). Conclusion : Compared with premixed insulin, Lantus plus Humalog is more effective in glycemic control and reduction in nocturnal hypoglycemia in children and adolescents with type 1 diabetes mellitus.

Estimation of Temporal Surface Air Temperature under Nocturnal Inversion Conditions (야간 역전조건 하의 지표기온 경시변화 추정)

  • Kim, Soo-ock
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.19 no.3
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    • pp.75-85
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    • 2017
  • A method to estimate hourly temperature profiles on calm and clear nights was developed based on temporal changes of inversion height and strength. A meteorological temperature profiler (Model MTP5H, Kipp and Zonen) was installed on the rooftop of the Highland Agriculture Research Institute, located in Daegwallyeong-myeon, Pyeongchang-gun, Gangwon-do. The hourly vertical distribution of air temperature was measured up to 600 m at intervals of 50 m from May 2007 to March 2008. Temperature and relative humidity data loggers (HOBO U23 Pro v2, Onset Computer Corporation, USA) were installed in the Jungdae-ri Valley, located between Gurye-gun, Jeollanam-do and Gwangyang-si, Jeollanam-do. These loggers were used to archive measurements of weather data 1.5 m above the surface from October 3, 2014, to November 23, 2015. The inversion strength was determined using the difference between the temperature at the inversion height, which is the highest temperature in the profile, and the temperature at 100 m from the surface. Empirical equations for the changes of inversion height and strength were derived to express the development of temperature inversion on calm and clear nights. To estimate air temperature near the ground on a slope exposed to crops, the equation's parameters were modified using temperature distribution of the mountain slope obtained from the data loggers. Estimated hourly temperatures using the method were compared with observed temperatures at 19 weather sites located within three watersheds in the southern Jiri-mountain in 2015. The mean error (ME) and root mean square error (RMSE) of the hourly temperatures were $-0.69^{\circ}C$ and $1.61^{\circ}C$, respectively. Hourly temperatures were often underestimated from 2000 to 0100 LST the next day. When temperatures were estimated at 0600 LST using the existing model, ME and RMSE were $-0.86^{\circ}C$ and $1.72^{\circ}C$, respectively. The method proposed in this study resulted in a smaller error, e.g., ME of $-0.12^{\circ}C$ and RMSE of $1.34^{\circ}C$. The method could be improved further taking into account various weather conditions, which could reduce the estimation error.

Efficacy and Safety during the Combination Therapy of Imipramine and Desmopressin in Primary Monosymptomatic Nocturnal Enuresis (어린이의 일차성 단일 증상성 야뇨증에서 Imipramine과 Desmopressin 복합 약물치료의 효과 및 안전성)

  • Yeo Ji-Hyun;Choi Jung-Youn;Chung Hyo-Seok;Lee Kyung-Soo;Ko Cheol-Woo;Kim Kyo-Sun;Kim Kee-Hyuk;Kim Jung-Soe;NamGoong Mee-Kyung;Park Young-Seo;Pai Ki-Soo;Yoo Kee-Hwan;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.129-137
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    • 2004
  • Purpose : Nocternal enuresis is a common disorder. Tricyclic antidepressant and desmopressin have been accepted pharmacological treatment for this disorder We conducted a cooperative study to investigate the efficacy and adverse reactions of imipramine, desmopressin and combination treatment in children with primary monosymptomatic nocturnal enuresis(PMNE). Methods: Data from a large multicenter study were analysed. In the period of 8 months in 2002, the study comprised of 168 children(78 boys and 90 girls, 5 to 15 years old) with PMNE for imipramine, desmopressin or combination treatment. Before treatment a history, physical examination and laboratory tests were performed and the children were observed for 2 weeks. Response rate, adverse reactions and enuresis episodes after stopping drug administration were evaluated after 12-weeks of imipramine, desmopressin or combination of both. Results: After 4 weeks, the frequency of bed wetting in all treated patients decreased during treatment significantly Even though a 30-50%, reduction in the number of wet nights were 68.6%, 74.4% and 86.1% during 12 weeks treatment by imipramine, desmopressin and both of them respectively, there was no significant difference between them. The most common adverse reaction was decreased appetite from imipramine administration. But no serious drug-related adverse events were reported. Conclusion: Efficacy of the combination therapy of imipramine and desmopressin in PMNE appears not to be better than either drug alone. It is necessary to pay attention on account of adverse reactions during imipramine treatment even though imipramine and desmopressin were generally well tolerated.

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The prevalences of asthma and allergic diseases in Korean children (한국 소아알레르기 질환의 유병률)

  • Hong, Soo-Jong;Ahn, Kang-Mo;Lee, Soo-Young;Kim, Kyu-Earn
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.343-350
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    • 2008
  • Asthma and allergic diseases are one of the most common disorders in children. Due to its increased prevalence, as well as the increased morbidity and mortality from these diseases, asthma and allergic diseases have come to be recognized as a major worldwide public health issue. In addition, socioeconomic burden of asthma and allergic diseases has increased in Korea also. The International Study of Asthma and Allergies in Childhood (ISAAC) investigated the worldwide prevalence of asthma and other allergic diseases using simple standardized methods because of the comparison of asthma and allergic diseases between the countries. In Korea, several epidemiologic studies have been conducted to determine the prevalence of asthma in children. Although these studies showed increased prevalence of asthma among Korean children (from 3.4% in 1964 to 10.1% in 1989), these findings were based on data from small numbers of subjects. The first Nationwide Study of Asthma and Allergies in Korean Children, which utilized the Korean version of ISAAC written and video questionnaire, was conducted in 1995 and the second Nationwide Study of Asthma and Allergies in Korean Children was conducted in 2000, directed by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We report here the prevalence of asthma and other allergic diseases in Korean children and adolescents, and show the changes that occurred over this 5 year period. We also describe the risk factors for development of these diseases in Korean children. We developed Korean versions of the ISAAC written (WQ) and video (AVQ) questionnaires for allergic diseases. In 1995, the enrolled population consisted of 25,117 children selected from 34 elementary school and 14,946 children selected from 34 middle school across the nation, the response rate was 94.8%. In 2000, 27,831 children selected from 34 elementary school and 15,214 children selected from 34 middle school, and the response rate was 96.4%. From these studies, we can confirm that increase of the prevalences of asthma, allergic rhinitis, and atopic dermatitis in Korea, except the prevalence of food allergy. Especially, the video questionnaire showed increases in the lifetime and 12 month prevalence rates of wheeze at rest, exercise-induced wheeze, nocturnal wheeze, nocturnal cough, and severe wheeze over this period of time in middle school children. In addition, the increase of prevalences of symptoms, diagnosis and treatment of atopic dermatitis was noted significantly. Risk factor analysis showed that body mass index (BMI), passive smoking and living with a dog or cat were associated with higher risk of wheeze. Also the occurrence of fever during infancy and the frequent use of antibiotics were associated with the risk of wheeze. In conclusion, during the 5 year period from 1995 to 2000, the prevalences of asthma, allergic rhinitis, and atopic dermatitis has increased in Korean children. BMI, passive smoking, living with a dog or cat, the fever episodes in infancy, and the frequent use of antibiotics in infancy are important risk factors to development of asthma and atopic dermatitis. In the near future, the birth cohort study will be needed to investigate the causes of this increase and the natural course of allergic diseases, then we develop the methods to control asthma and allergic diseases.

The Effect of Insomnia Severity on Daytime Sleepiness in Obstructive Sleep Apnea Syndrome (불면증 정도가 폐쇄성 수면무호흡 증후군에서의 주간졸림 정도에 끼치는 영향)

  • Nam, Ji-Won;Shin, Byoung-Hak;Shin, Hyeon-Sil;Park, Minji
    • Sleep Medicine and Psychophysiology
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    • v.22 no.1
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    • pp.11-19
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    • 2015
  • Objectives: Whether daytime sleepiness is proportional to the severity of sleep apnea in obstructive sleep apnea syndrome (OSAS) is controversial. In this study we investigated how insomnia severity affects the association between daytime sleepiness and sleep apnea severity in OSAS. Methods: The present study included 235 male subjects who were diagnosed with OSAS based on clinical history and nocturnal polysomnography. Pearson's correlation analysis was conducted among sleep and mood-related self-reported data, polysomnographic data and demographic data of all subjects. Based on Pittsburgh Sleep Quality Index (PSQI), the subjects were divided into 2 groups; group A (n = 75; $PSQI{\leq}5$) and group B (n = 160; PSQI > 5). Partial correlation analysis was performed between the Epworth Sleepiness Scale (ESS) and other data in both groups. Multiple linear regression analysis was conducted to investigate the factors which affected the ESS in group A. Results: Pearson's correlation analysis showed weak or non-existent correlations between ESS and apnea severity data such as apnea-hypopnea index (AHI) (r = 0.148, p = 0.023), apnea index (AI) (r = 0.137, p = 0.036), hypopnea index (HI) (r = 0.058, p = 0.377), oxygen desaturation index (ODI) (r = 0.149, p = 0.022) and arousal total index (ATI) (r = 0.129, p = 0.048). Positive correlations between ESS and apnea severity data such as AHI ($r_p=0.313$, p = 0.008), AI ($r_p=0.339$, p = 0.004), ODI ($r_p=0.289$, p = 0.015) and ATI ($r_p=0.256$, p = 0.031) were observed only in group A. Multiple regression analysis showed that AI (t = 2.996, p = 0.004) and BAI (t = 2.721, p = 0.008) were associated with ESS in group A. Conclusion: The correlation between daytime sleepiness and sleep apnea severity was shown only in group A. This result suggests that associations between daytime sleepiness in OSAS and sleep apnea severity will become prominent when controlling for insomnia-related variables.

The Clinical Characteristics Between the Positional Obstructive Sleep Apnea Patients with the Non-positional Obstructive Sleep Apnea Patients (체위성 폐쇄성수면무호흡 환자와 비체위성 폐쇄성수면무호흡환자의 임상적 특징 고찰)

  • Kang, Hyeon-Hui;Kang, Ji-Young;Lee, Sang-Haak;Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.22-26
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    • 2012
  • Objectives: The percentage of positional sleep apnea in obstructive sleep apnea (OSA) varies in different reports from 9% to 60%. If there is a positional dependency in patients with OSA, positional therapy alone could be successful in treating about 50% of all OSA cases. The aim of this report is to compare anthropomorphic and polysomnographic data between the positional sleep apnea group and non-positional sleep apnea group with OSA whose conditions were diagnosed in our sleep clinic. Methods: This is a retrospective study of anthropomorphic and polysomnographic data of patients with OSA who was performed a nocturnal polysomnography. Positional sleep apnea was defined as having a supine apnea-hypopnea index (AHI) of twice or more compared to the AHI in the non-supine position. The patients were divided in the positional sleep apnea group and the non-positional sleep apnea group. Results: In 101 patients with OSA, 81 were male, and the mean age was $49.2{\pm}11.9$ years. Seventy-six (75.2%) were diagnosed as the positional sleep apnea. Waist to hip ratio and body mass index (BMI) were significantly higher in non-positional sleep apnea group. The frequency of severe OSA was significantly higher in this group. In the positional sleep apnea group, nocturnal sleep quality was better preserved, and consequently these patients were less sleepy during daytime. AHI was significantly lower and minimal arterial oxygen saturation during sleep was significantly higher in this group. Conclusion: The percentage of positional sleep apnea in OSA was 75.2%. AHI, BMI, and waist to hip ratio were lower in the positional sleep apnea group. These patients have less severe breathing abnormalities than the non-positional sleep apnea group in polysomnography.

Correlation between Heart Rate Variability and Sleep Structure in Primary Insomnia (일차성 불면증에서 심박동률변이도와 수면구조 간의 상관관계)

  • Lee, Sang-Jin;Park, Doo-Heum;Yu, Jae-Hak;Ryu, Seung-Ho;Ha, Ji-Hyeon;Song, Man-Kyoo
    • Sleep Medicine and Psychophysiology
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    • v.17 no.1
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    • pp.21-27
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    • 2010
  • Objectives: It is well established that primary insomnia affects the activity of autonomic nervous system. We tried to know how the activity of autonomic nervous system during night sleep changes by analyzing correlation between heart rate variability (HRV) index and the variables related with sleep structure in primary insomnia. Methods: Thirty three subjects (mean age: $36.2{\pm}14.2$ years, male:female=15:18) who were diagnosed with primary insomnia were selected for the study. Nocturnal polysomnography (NPSG) was carried out on each subject and correlation was analyzed between high frequency/low frequency ratio (LF/HF ratio), one of HRV indices and the variables related with sleep structure which were calculated from NPSG. Results: When age and sex were controlled, LF/HF ratio showed negative correlations with slow wave sleep and stage 2 sleep, respectively ($r_p$=-0.43, p=0.01; $r_p$=-0.37, p=0.04). On the other hands LF/HF ratio showed a positive correlation with arousal index ($r_p$=0.65, p<0.001). The activity of autonomic nervous system responded differentially depending on the change of sleep structure in primary insomnia. Especially the increase of arousal index and the decrease of slow wave sleep and stage 2 sleep which are the components of non-REM sleep provoked hyperactivity of sympathetic nervous system. Conclusion: This study suggests that the typical change of sleep structure in primary insomnia can negatively impact on cardiovascular system.

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