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1.
Clin Exp Otorhinolaryngol ; 15(1): 5-23, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35158420

RESUMO

The Korean Society of Otorhinolaryngology-Head and Neck Surgery and Korean Rhinologic Society appointed a guideline development group (GDG) to establish a clinical practice guideline, and the GDG developed a guideline for nasal irrigation for adult patients with chronic rhinosinusitis (CRS). The guideline focuses on knowledge gaps, practice variations, and clinical concerns associated with nasal irrigation. Nasal irrigation has been recommended as the first-line treatment for CRS in various guidelines, and its clinical effectiveness has been demonstrated through a number of studies with robust evidence. However, no guidelines have presented a consistent nasal irrigation method. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a predefined search strategy. When insufficient evidence was found, the GDG sought expert opinions and attempted to fill the evidence gap. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. The committee developed 11 evidence-based recommendations. This guideline focuses on the evidence-based quality improvement opportunities deemed the most important by the GDG. Moreover, the guideline addresses whether nasal lavage helps treat CRS, what type of rinsing solution should be used, and the effectiveness of using additional medications to increase the therapeutic effect.

2.
J Clin Sleep Med ; 18(1): 193-202, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34310277

RESUMO

STUDY OBJECTIVES: We evaluated the interrater reliabilities of manual polysomnography sleep stage scoring. We included all studies that employed Rechtschaffen and Kales rules or American Academy of Sleep Medicine standards. We sought the overall degree of agreement and those for each stage. METHODS: The keywords were "Polysomnography (PSG)," "sleep staging," "Rechtschaffen and Kales (R&K)," "American Academy of Sleep Medicine (AASM)," "interrater (interscorer) reliability," and "Cohen's kappa." We searched PubMed, OVID Medline, EMBASE, the Cochrane library, KoreaMed, KISS, and the MedRIC. The exclusion criteria included automatic scoring and pediatric patients. We collected data on scorer histories, scoring rules, numbers of epochs scored, and the underlying diseases of the patients. RESULTS: A total of 101 publications were retrieved; 11 satisfied the selection criteria. The Cohen's kappa for manual, overall sleep scoring was 0.76, indicating substantial agreement (95% confidence interval, 0.71-0.81; P < .001). By sleep stage, the figures were 0.70, 0.24, 0.57, 0.57, and 0.69 for the W, N1, N2, N3, and R stages, respectively. The interrater reliabilities for stage N2 and N3 sleep were moderate, and that for stage N1 sleep was only fair. CONCLUSIONS: We conducted a meta-analysis to generalize the variation in manual scoring of polysomnography and provide reference data for automatic sleep stage scoring systems. The reliability of manual scorers of polysomnography sleep stages was substantial. However, for certain stages, the results were poor; validity requires improvement. CITATION: Lee YJ, Lee JY, Cho JH, Choi JH. Interrater reliability of sleep stage scoring: a meta-analysis. J Clin Sleep Med. 2022;18(1):193-202.


Assuntos
Fases do Sono , Sono , Criança , Humanos , Variações Dependentes do Observador , Polissonografia , Reprodutibilidade dos Testes
4.
Eur Arch Otorhinolaryngol ; 278(11): 4569-4574, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34032908

RESUMO

PURPOSE: Little is known about the incidence of thyroid cancer in patients with obstructive sleep apnea (OSA). This study aimed to evaluate whether OSA is associated with the incidence of thyroid cancer based on the Korea National Health Insurance Service (KNHIS) database. METHODS: This study was designed as a retrospective cohort data analysis of the KNHIS dataset. A total of 198,574 patients who were over 20 years of age and had been newly diagnosed with OSA between 2007 and 2014 were enrolled. A control group of 992,870 individuals was selected based on propensity score matching by age and sex. The mean follow-up duration was 4.5 ± 2.3 years. The primary endpoint was the incidence of newly diagnosed thyroid cancer. RESULTS: The hazard ratio (HR) for thyroid cancer incidence among OSA patients compared to the control was 1.72 (95% confidence interval [CI] 1.60-1.84) based on Model 1 (not adjusted by any covariate) and 1.64 (95% CI 1.53-1.76) based on Model 2 (adjusted by income level, diabetes, hypertension, and dyslipidemia). Thyroid cancer incidence was significantly higher in male patients (HR = 1.93, 95% CI 1.74-2.12) than female ones (HR = 1.39, 95% CI 1.26-1.54). When compared by age, the HR of thyroid cancer was higher in middle-aged (40 ≤ age < 65 years) patients (HR = 1.68, 95% CI 1.55-1.83) than in young (20 ≤ age < 40 years, HR = 1.53, 95% CI 1.32-1.77) or old (65 ≤ age, HR = 1.28, 95% CI 0.94-1.74) patients. CONCLUSION: OSA may increase the risk of developing thyroid cancer, especially in middle-aged men.


Assuntos
Apneia Obstrutiva do Sono , Neoplasias da Glândula Tireoide , Adulto , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Apneia Obstrutiva do Sono/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia
5.
Enzyme Microb Technol ; 147: 109788, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33992410

RESUMO

Isomaltooligosaccharide (IMO), considered to be a prebiotic, reportedly has health effects, particularly in terms of digestion; however, the prebiotic effects of IMOs depend largely on the degree of polymerization. Currently, IMOs are commercially produced using transglucosidase (TG) derived from Aspergillus niger. Here, we report a novel Thermoanaerobacter thermocopriae-derived TG (TtTG) that can produce long-chain IMOs (L-IMOs) using maltodextrin as the main substrate. A putative carbohydrate-binding gene comprising carbohydrate-binding module 35 and glycoside hydrolase family 15 domain was cloned and successfully overexpressed in Escherichia coli BL21 (DE3) cells. The resulting purified recombinant enzyme (TtTG) had a molecular mass of 94 kDa. TtTG displayed an optimal pH of 4.0 (higher than that of commercial TG) and an optimal temperature of 60 °C (same as that of commercial TG). TtTG also enabled the synthesis of oligosaccharides using various saccharides, such as palatinose, kojibiose, sophorose, maltose, cellobiose, isomaltose, gentiobiose, and trehalose, which acted as specific acceptors. TtTG could also produce a medium-sized L-IMO, different from that by dextran-dextrinase and TG, from maltodextrin, as the sole substrate. Thus, the novel combination of maltodextrin and TtTG shows potential as an effective method for commercially producing L-IMOs with improved prebiotic effects.


Assuntos
Glucosiltransferases , Thermoanaerobacter , Glucosiltransferases/genética , Glucosiltransferases/metabolismo , Oligossacarídeos , Polissacarídeos , Especificidade por Substrato , Thermoanaerobacter/genética
6.
PLoS One ; 15(11): e0241598, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33180841

RESUMO

The association between obstructive sleep apnea (OSA) and malignant brain tumors has yet to be fully investigated. Therefore, the purpose of this study was to elucidate the effect of OSA on brain tumor incidence based on the Korea National Health Insurance Service (KNHIS) dataset. The KNHIS data between 2007 and 2014 were analyzed, and the primary endpoint was newly diagnosed malignant brain tumor. A total of 198,574 subjects aged ≥ 20 years with newly diagnosed OSA were enrolled in the study, and 992,870 individuals were selected as a control group based on propensity score matching (PSM) by gender and age. The average follow-up duration was 4.8 ± 2.3 years. The hazard ratios (HRs) for brain tumor for patients with OSA were 1.78 (95% confidence interval [CI]: 1.42-2.21) in Model 1 (not adjusted with any covariate) and 1.67 (95% CI: 1.34-2.09) in Model 2 (adjusted for income level, diabetes, hypertension, dyslipidemia, and COPD). In subgroup analysis by gender, the odds ratios (OR) of OSA were 1.82 (95% CI: 1.41-2.33) in men and 1.26 (95% CI: 0.74-2.03) in women. The ORs were 1.97 (95% CI: 1.15-3.24) in the older (age ≥ 65 years) group, 1.66 (95% CI: 1.25-2.17) in the middle-aged (40 ≤ age < 65 years) group, and 1.41 (0.78-2.44) in the young (20 ≤ age < 40 years) group. In conclusion, OSA may increase the incidence of brain tumors.


Assuntos
Neoplasias Encefálicas/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Adulto , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde/estatística & dados numéricos , República da Coreia , Apneia Obstrutiva do Sono/complicações , Fatores Socioeconômicos
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5335-5338, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019188

RESUMO

Nocturnal pulse oximetry has been proposed as a tool for diagnosing sleep apnea. We established criteria in determining previous occurrences of apnea events by extracting quantitative characteristics caused by apnea events over the duration of changes in blood oxygen saturation values in our previous studies. In addition, the apnea-hypopnea index was estimated by regression modeling. In this paper, the algorithm presented in the previous study was applied to the data collected from the sleep medicine center of other hospitals to verify its performance. As a result of applying the algorithm to pulse oximetry data of 15 polysomnographic recordings, the minute-by-minute apneic segment detection exhibited an average accuracy of 87.58% and an average Cohen's kappa coefficient of 0.6327. In addition, the correlation coefficient between the estimated apnea-hypopnea index and the reference was 0.95, and the average absolute error was 5.02 events/h. When the algorithm is evaluated on the data collected by the other sleep medicine center, they still detected semi real-time sleep apnea events and showed meaningful results in estimating apnea-hypopnea index, although their performance was somewhat lower than before. With the recent popularity of devices for mobile healthcare, such as the wearable pulse oximeter, the results of this study are expected to improve the user value of devices by implementing mobile sleep apnea diagnosis and monitoring functions.


Assuntos
Síndromes da Apneia do Sono , Algoritmos , Humanos , Oximetria , Oxigênio , Polissonografia , Síndromes da Apneia do Sono/diagnóstico
8.
Leuk Res ; 98: 106455, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32950825

RESUMO

Obstructive sleep apnea (OSA) is known to be associated with several cancers, but studies assessing the association between OSA and lymphoma have not been conducted yet. This study aimed to investigate the associations between OSA and non-Hodgkin lymphoma, which accounts for the majority of lymphoma, using the Korea National Health Insurance Service database. This retrospective cohort study analyzed the data from the Korea National Health Insurance Service database. A total of 198,574 patients aged ≥ 20 years who were newly diagnosed with OSA between 2007 and 2014 were included. The control group comprising 992,870 subjects was selected using propensity score matching by age and sex. The mean follow-up duration was 4.8 ± 2.3 years. The primary endpoint was newly diagnosed non-Hodgkin lymphoma. The hazard ratio [95 % confidence interval] of OSA for the incidence of non-Hodgkin lymphoma was calculated based on Cox proportional hazard model. The incidence of non-Hodgkin lymphoma among patients with OSA was significantly higher than that among the controls (1.40 [1.16-1.69]). In particular, the incidence was higher in women than that in men (1.62 vs. 1.28). There was no difference in hazard ratio by age. In conclusion, OSA may be a risk factor for non-Hodgkin lymphoma.


Assuntos
Bases de Dados Factuais , Linfoma não Hodgkin/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Incidência , Linfoma não Hodgkin/diagnóstico , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , Apneia Obstrutiva do Sono/diagnóstico
9.
Ann Otol Rhinol Laryngol ; 129(10): 964-968, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32441108

RESUMO

OBJECTIVE: This study was performed to evaluate the incidence, timing, and factors contributing to recurrent maxillary sinusitis due to middle meatal antrostomy (MMA) site stenosis after endoscopic sinus surgery (ESS). METHODS: The medical records and endoscopic photographs of 288 patients with chronic rhinosinusitis who underwent ESS were evaluated. Patients visited the clinic with similar schedule after ESS; recurrent maxillary sinusitis due to MMA site stenosis was investigated, including in terms of the incidence and timing. The preoperative computed tomography (CT) scans, intraoperative findings, and possible factors contributing to MMA site stenosis were examined. RESULTS: Recurrent maxillary sinusitis due to MMA site stenosis occurred in 10 patients. Most had unilateral sinusitis and stenosis was observed within 6 months postoperatively. All patients had severe inflammation, pus retention, and thick mucosal hypertrophy in the maxillary sinus on preoperative CT; intraoperative findings confirmed these conditions. In most patients, extensive trimming of the hypertrophied mucosa was performed intraoperatively through canine fossa trephination. CONCLUSIONS: MMA site stenosis is a rare condition after ESS. We hypothesized that rapid shrinkage and fibrosis of the sinus mucosa after extensive trimming thereof may be the main causes of stenosis. Residual mucosal inflammation, granulation formation, and persistent sinus crust and debris may also be contributing factors. Therefore, conservative trimming, meticulous dressing, and removal of sinus crust and granulation tissue near the MMA site should be performed in patients with MMA site stenosis.


Assuntos
Endoscopia/métodos , Seio Maxilar/cirurgia , Sinusite Maxilar/cirurgia , Estomia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Complicações Pós-Operatórias/epidemiologia , Adulto , Constrição Patológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos
10.
Sci Rep ; 10(1): 4168, 2020 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-32144371

RESUMO

Normal-range sleep duration is an important factor for general health and metabolism, and insufficient or excessive sleep is associated with chronic metabolic disease. Among the many factors that affect sleep duration, sun exposure plays an important role in maintaining regular circadian rhythm and is also involved in the production and activation of 25-hydroxyvitamin D [25(OH)D], which regulates various functions in the body. However, 25(OH)D is available through food and various nutritional supplements without sun exposure, so it is important to find out the complex relationship among sun exposure, vitamin D status, and sleep duration. The relationship between sun exposure, vitamin D status, and sleep duration was analyzed in the nationwide survey and examination of 25,534 study populations, after adjusting for demographic characteristics, physical characteristics, lifestyle status, and socio-demographic variables. Vitamin D status alone did not show the relationship with sleep duration, although there were statistical relationships in the various factors including sun exposure with sleep duration. There was a statistical difference in 25(OH)D according to sleep duration, only in low sun exposure group. Subjects with low sun exposure and excessive sleep duration comparatively lower 25(OH)D than those with normal-range sleep, even after adjustment for potentially confounding factors. Individuals with limited exposure to sunlight should maintain adequate vitamin D status to have an appropriate sleep duration for health.


Assuntos
Sono/fisiologia , Luz Solar , Vitamina D/análogos & derivados , Adulto , Idoso , Animais , Estudos Transversais , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Fatores Socioeconômicos , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/fisiopatologia , Adulto Jovem
11.
Ann Otol Rhinol Laryngol ; 129(4): 388-393, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31779483

RESUMO

OBJECTIVES: Respiratory mechanics instability (RMI) based on paradoxical movement is correlated with respiratory disturbance such as apnea-hypopnea index (AHI) and reflects the severity of obstructive sleep apnea (OSA). The purpose of this study was to identify RMI as a method for assessing the effectiveness of continuous positive airway pressure (CPAP) in the management for OSA. METHODS: A total of 71 consecutive OSA patients with CPAP titration were included in this study. We compared sleep (sleep efficiency, arousal index, and sleep stages), respiratory (AHI, oxygen desaturation index ≥3% [ODI3], and lowest oxygen saturation), and RMI parameters (events, index, duration, and % of stage duration) between diagnostic polysomnography and CPAP titration data. RESULTS: All RMI parameters (events [157.5 ± 80.9 vs 80.0 ± 47.1; P < .001], index [25.3 ± 12.4 vs 12.7 ± 7.0; P < .001], duration [182.6 ± 96.2 vs 79.8 ± 88.9; P < .001], and % of stage duration [49.0 ± 24.4 vs 20.5 ± 21.3; P < .001]) were significantly improved by the alleviation of obstructive respiratory disturbance parameters (AHI [45.1 ± 23.0 vs 4.2 ± 4.3; P < .001], ODI3 [44.9 ± 22.6 vs 4.8 ± 4.6; P < .001], and lowest oxygen saturation [77.7 ± 7.3 vs 89.3 ± 3.8; P < .001]) compared to diagnostic polysomnography and CPAP titration data. CONCLUSION: RMI may be a useful method for evaluating the effect of CPAP in OSA patients.


Assuntos
Oxigênio/análise , Mecânica Respiratória/fisiologia , Apneia Obstrutiva do Sono , Pressão Positiva Contínua nas Vias Aéreas/métodos , Pressão Positiva Contínua nas Vias Aéreas/normas , Feminino , Humanos , Hipóxia/diagnóstico , Hipóxia/etiologia , Hipóxia/prevenção & controle , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde/métodos , Polissonografia/métodos , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/terapia , Resultado do Tratamento
12.
Int Clin Psychopharmacol ; 35(1): 29-35, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31714321

RESUMO

The purpose of the present double-blind randomized placebo-controlled clinical study was to investigate the effects of Passionflower on polysomnographic sleep parameters in subjects with insomnia disorder. A total number 110 adult participants (mean age = 40.47 ± 11.68, Female = 53.6%) met the inclusion criteria of insomnia disorder according to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). After randomization, patients received either the Passionflower extract or the placebo for 2 weeks. Patients underwent an overnight polysomnography and completed sleep diaries, Insomnia Severity Index, and Pittsburgh Sleep Quality Index. Within group comparisons were analyzed with paired t-tests or Wilcoxon's signed rank tests, and between-group comparisons were analyzed with independent t-tests or Mann-Whitney U Tests, as appropriate. Total sleep time (TST) was significantly increased in the Passionflower group compared with placebo (Passionflower vs placebo, 23.05 ± 54.26 vs -0.16 ± 53.12; P = 0.049). Sleep efficiency and wake after sleep onset (WASO) significantly improved after 2 weeks in the Passionflower group but there was no difference compared with the placebo group. The current study demonstrated the positive effects of Passionflower on objective sleep parameters including TST on polysomnography in adults with insomnia disorder. Further study is needed to investigate the clinical efficacy of Passionflower on insomnia.


Assuntos
Hipnóticos e Sedativos/uso terapêutico , Passiflora , Extratos Vegetais/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Sono/efeitos dos fármacos , Adolescente , Adulto , Método Duplo-Cego , Feminino , Humanos , Hipnóticos e Sedativos/efeitos adversos , Masculino , Pessoa de Meia-Idade , Extratos Vegetais/efeitos adversos , Polissonografia , Índice de Gravidade de Doença , Adulto Jovem
13.
J Microbiol Biotechnol ; 29(12): 1938-1946, 2019 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-31838796

RESUMO

Isomaltooligosaccharides (IMOs) have good prebiotic effects, and long IMOs (LIMOs) with a degree of polymerization (DP) of 7 or above show improved effects. However, they are not yet commercially available, and require costly enzymes and processes for production. The Nterminal region of the thermostable Thermoanaerobacter thermocopriae cycloisomaltooligosaccharide glucanotransferase (TtCITase) shows cyclic isomaltooligosaccharide (CI)-producing activity owing to a catalytic domain of glycoside hydrolase (GH) family 66 and carbohydrate-binding module (CBM) 35. In the present study, we elucidated the activity of the C-terminal region of TtCITase (TtCITase-C; Met740-Phe1,559), including a CBM35-like region and the GH family 15 domain. The domain was successfully cloned, expressed, and purified as a single protein with a molecular mass of 115 kDa. TtCITase-C exhibited optimal activity at 40°C and pH 5.5, and retained 100% activity at pH 5.5 after 18-h incubation. TtCITase-C synthesized α-1,6 glucosyl products with over seven degrees of polymerization (DP) by an α-1,6 glucosyl transfer reaction from maltopentaose, isomaltopentaose, or commercialized maltodextrins as substrates. These results indicate that TtCITase-C could be used for the production of α-1,6 glucosyl oligosaccharides with over DP7 (LIMOs) in a more cost-effective manner, without requiring cyclodextran.


Assuntos
Glucosiltransferases/química , Glucosiltransferases/metabolismo , Oligossacarídeos/metabolismo , Thermoanaerobacter/enzimologia , Domínio Catalítico , Clonagem Molecular , Estabilidade Enzimática , Escherichia coli/genética , Glucosiltransferases/genética , Glicosídeo Hidrolases , Concentração de Íons de Hidrogênio , Peso Molecular , Polimerização , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Alinhamento de Sequência , Análise de Sequência de Proteína , Temperatura , Thermoanaerobacter/genética
14.
Sci Rep ; 9(1): 19044, 2019 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-31836779

RESUMO

Some studies have argued that obstructive sleep apnoea (OSA) increases the risk of breast cancer. However, the results are often conflicting. This study aimed to investigate associations between OSA and breast cancer incidence using the Korea National Health Insurance Service (KNHIS) database. This retrospective cohort study analyzed data from the KNHIS database. A total of 45,699 women (≥20 years of age) newly diagnosed with OSA between 2007 and 2014 were included. The control groups were a 5-fold, age-matched women who had not been diagnosed with OSA. Mean follow-up duration was 3.7 ± 2.3 years. The primary endpoint was newly diagnosed breast cancer. The breast cancer hazard ratio (95% confidence interval) was calculated for patients with OSA and compared with that of the control group. The incidence of breast cancer among patients with OSA was significantly higher than that among the controls (1.20 [1.04-1.39]). In particular, the incidence of breast cancer was higher among patients aged ≥65 years (1.72 [1.10-2.71]). The result suggests that OSA may be a risk factor for breast cancer in women.


Assuntos
Neoplasias da Mama/epidemiologia , Programas Nacionais de Saúde , Apneia Obstrutiva do Sono/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia
15.
Korean J Fam Med ; 40(5): 323-328, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31476853

RESUMO

BACKGROUND: This study aimed to analyze the association of low vitamin D status with thyroid autoimmunity and dysfunction in the Korean population according to sex and menopausal status in women. METHODS: This study was based on the data acquired from the 6th Korea National Health and Nutrition Examination Survey. We enrolled 4,356 subjects who had data of thyroid function, antithyroid peroxidase antibody (TPOAb), and serum 25-hydroxyvitamin D (25[OH]D) levels. We excluded subjects who were pregnant and who had a history of thyroid disease or thyroid cancer, and those with transient thyroid dysfunction who tested negative for TPOAb (TPOAb[-]). RESULTS: TPOAb positivity (TPOAb[+]) with thyroid dysfunction (subclinical and overt hypothyroidism) was more prevalent in the vitamin D deficient group than in the vitamin D insufficient and sufficient groups including premenopausal (P=0.046) and postmenopausal women (P=0.032), although no significant differences were observed in men. The mean serum 25(OH)D level was significantly lower in the TPOAb(+) with thyroid dysfunction group than in the TPOAb(+) with euthyroidism and TPOAb(-) groups of premenopausal women (P=0.001), although no significant differences were observed in men and postmenopausal women. Multivariate binary logistic regression analysis, adjusted for age, body mass index, and current smoking status, showed that vitamin D insufficiency and deficiency were significantly associated with TPOAb(+) with thyroid dysfunction in premenopausal women (P<0.001), although no significant associations were observed in men and postmenopausal women. CONCLUSION: Low vitamin D status was significantly associated with thyroid autoimmunity and dysfunction in the Korean population, especially in premenopausal women.

16.
Artigo em Inglês | MEDLINE | ID: mdl-30813469

RESUMO

Irisin is a myokine with potential anti-obesity properties that has been suggested to increase energy expenditure in obese patients. However, there is limited clinical information on the biology of irisin in humans, especially in morbidly obese patients undergoing bariatric surgery. We aimed to assess the association of circulating irisin concentrations with weight loss in obese patients undergoing bariatric surgery. This was a pilot, single-centre, longitudinal observational study. We recruited 25 morbidly obese subjects who underwent Roux-en-Y gastric bypass surgery (RYGBP), and blood samples from 12 patients were taken to measure serum irisin concentrations before, and one and nine months after surgery. Their clinical characteristics were measured for one year. The preoperative serum irisin concentration (mean 1.01 ± 0.23 µg/mL, range 0.73⁻1.49) changed bidirectionally one month after RYGBP. The mean concentration at nine months was 1.11 ± 0.15 µg/mL (range 0.92⁻1.35). Eight patients had elevated irisin levels compared with their preoperative values, but four did not. Elevations of irisin levels nine months, but not one month, after surgery, were associated with lower preoperative levels (p = 0.016) and worse weight reduction rates (p = 0.006 for the percentage excess weight loss and p = 0.032 for changes in body mass index). The preoperative serum irisin concentrations were significantly correlated with the percentage of excess weight loss for one year (R² = 0.612; p = 0.04) in our study. Our results suggest that preoperative circulating irisin concentrations may be at least in part associated with a weight loss effect of bariatric surgery in morbidly obese patients. Further large-scale clinical studies are needed to ratify these findings.


Assuntos
Fibronectinas/sangue , Derivação Gástrica/métodos , Perda de Peso , Adulto , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
Otolaryngol Head Neck Surg ; 160(5): 928-934, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30668216

RESUMO

OBJECTIVES: Respiratory mechanic instability (RMI) is derived from analysis of paradoxical thoracoabdominal movements during airway obstruction. This study aimed to evaluate RMI parameters in obstructive sleep apnea (OSA) and the correlation between RMI parameters and other parameters in polysomnography. STUDY DESIGN: Retrospective review. SETTING: A university hospital. METHODS: A retrospective chart review was performed, and data from 189 adult patients who underwent an in-laboratory sleep study and were seen in our clinic during the past 8 months. The RMI parameters were measured from thoracoabdominal bands during polysomnography. RESULTS: Subjects were divided into 2 groups: control (n = 67, apnea-hypopnea index [AHI] <5) and OSA (n = 122, AHI ≥5). The OSA group was divided into 3 subgroups according to AHI: mild, 5 ≤ AHI < 15; moderate, 15 ≤ AHI < 30; severe, AHI ≥30. As AHI increased, all RMI parameters showed a significant rising pattern and difference between control and subgroups. Arousal index, lowest oxygen saturation, and oxygen desaturation index ≥3% were significantly correlated with all RMI parameters. Based on cutoff values, areas under the curves of the RMI index for predicting mild, moderate, and severe OSA were >0.85. CONCLUSION: All RMI parameters were well related to respiratory parameters of polysomnography, such as arousal index, lowest oxygen saturation, and oxygen desaturation index ≥3%. The areas under the curves of all RMI parameters for predicting OSA and subgroups showed significant diagnostic performance. These parameters may be useful to identify OSA cases from control.


Assuntos
Mecânica Respiratória/fisiologia , Apneia Obstrutiva do Sono/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Testes de Função Respiratória , Estudos Retrospectivos , Sensibilidade e Especificidade
18.
Asian Pac J Allergy Immunol ; 37(3): 130-137, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30447649

RESUMO

BACKGROUND: Vitamin D produces an anti-allergic effect that prevents inflammation due to asthma. OBJECTIVE: We investigated whether vitamin D has an anti-inflammatory effect on the sensitization and challenge stages of asthma development in a murine model. METHODS: Mice were divided into the following five groups according to ovalbumin (OVA) and vitamin D (VD) administration: control group, OVA group, preventive VD group (VD injection before OVA sensitization), inhibitory VD group (VD injection after OVA challenge), and dual VD groups (VD injection before OVA sensitization and after OVA challenge). Each group was evaluated for airway hyperresponsiveness (AHR), cell counts, cytokines, total IgE, and OVA-specific IgE using bronchoalveolar lavage fluid (BALF). Cytokines in the lysate and eosinophils in the lung tissue were also evaluated. RESULTS: AHR occurred less in the groups to which VD was administered than in the OVA group. The eosinophils, neutrophils, IL-5 in BALF, IL-4, TGF-ß, and eosinophils in lysate decreased with the administration of VD in the preventive, inhibitory, and dual VD groups compared with the OVA group. Although the lymphocytes, macrophages, IL-4 in BALF, and IL-5 in lysate decreased with administration of VD in the inhibitory and dual VD groups, they were not affected by preventive VD administration. These anti-allergic effects of VD were most noticeable with VD administration for dual (preventive and inhibitory) purposes. CONCLUSIONS: VD may produce preventive and inhibitory effects on the development and exacerbation of asthma in a murine model. These effects are most noticeable when VD is used for dual purposes.


Assuntos
Asma/tratamento farmacológico , Asma/prevenção & controle , Vitamina D/farmacologia , Alérgenos/imunologia , Animais , Asma/etiologia , Asma/metabolismo , Biomarcadores , Líquido da Lavagem Broncoalveolar/imunologia , Citocinas/metabolismo , Modelos Animais de Doenças , Feminino , Imunoglobulina E/imunologia , Imunomodulação/efeitos dos fármacos , Mediadores da Inflamação/metabolismo , Camundongos , Ovalbumina/imunologia , Vitamina D/uso terapêutico
19.
PLoS One ; 13(10): e0206328, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30352085

RESUMO

Olfactory dysfunction and tinnitus are age-related otorhinolaryngological disorders with a high prevalence in the elderly population and share several common clinical features. However, there is no study investigating the relationship between these two diseases. We studied the prevalence of olfactory dysfunction and tinnitus among Koreans and studied the relationship between these two diseases based on the Korean National Health and Nutrition Examination Survey. The subjects of this study were enrolled from the Fifth Korean National Health and Nutrition Examination Survey (2010-2012, n = 25,534). Data of subjects aged 40 years and older who underwent physical examination and completed a self-reported questionnaire and other anthropometric variables were statistically analyzed. Odds ratios were calculated to identify the relationship between olfactory dysfunction and tinnitus, using multiple logistic regression models. Older males, non-smokers, non/lower alcohol drinker groups exhibited the relationship between olfactory dysfunction and tinnitus. Metabolic syndrome and mental health problems were associated with both olfactory dysfunction and tinnitus. After adjusting for confounding factors, olfactory dysfunction was significantly associated with tinnitus (OR 1.318). There was a dose-response relationship between tinnitus severity and the odds of olfactory dysfunction (ORs for mild, moderate and severe tinnitus were, respectively, 1.134, 1.569 and 2.044). Additional molecular genetics and animal studies are needed to determine the shared pathophysiology of the two diseases.


Assuntos
Transtornos do Olfato/epidemiologia , Zumbido/epidemiologia , Consumo de Bebidas Alcoólicas , Feminino , Humanos , Masculino , Saúde Mental , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Inquéritos Nutricionais , Razão de Chances , Transtornos do Olfato/complicações , Transtornos do Olfato/patologia , Prevalência , República da Coreia/epidemiologia , Índice de Gravidade de Doença , Fumar , Inquéritos e Questionários , Zumbido/complicações , Zumbido/patologia
20.
J Clin Sleep Med ; 14(10): 1741-1747, 2018 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-30353803

RESUMO

STUDY OBJECTIVES: The aim of this study was to evaluate the accuracy of the Watch-PAT 200 (WP200) for diagnosing obstructive sleep apnea (OSA) in adolescents compared with polysomnography (PSG) according to the respiratory rules for children (RRC) and adults (RRA). METHODS: A total of 38 adolescents (mean age 15.1 ± 1.4 years; male 28 [73.7%]; body mass index [BMI] 23.1 ± 5.5 kg/m2) with suspected OSA were assessed with the WP200 and standard PSG simultaneously between July 2014 and September 2015 at a tertiary university hospital. All WP200 data were assessed according to the automatic algorithm, and PSG data were scored according to the RRC and RRA. We examined the correlation, agreement, and concordance in the apnea-hypopnea index (AHI) and minimum arterial oxygen saturation (mSaO2) between the WP200 and PSG-RRC or PSG-RRA. RESULTS: There were high correlations (r = .945, P < .001 [AHI-WP200 versus AHI-PSG-RRC]; r = .945, P < .001 [AHI-WP200 versus AHI-PSG-RRA]; r = .921, P < .001 [mSaO2-WP versus mSaO2-PSG]) and good agreements in AHI and mSaO2 between the WP200 and PSG. In addition, there were high concordances in AHI severity (Kendall tau-b = .848, P < .001 [AHI-WP200 versus AHI-PSG-RRC]; Kendall tau-b = .944, P < .001 [AHI-WP200 versus AHI-PSG-RRA]) between the WP200 and PSG. CONCLUSIONS: The WP200 may be a clinically reliable tool for diagnosing OSA in adolescents.


Assuntos
Monitorização Ambulatorial/métodos , Apneia Obstrutiva do Sono/diagnóstico , Adolescente , Feminino , Humanos , Masculino , Manometria , Polissonografia , Reprodutibilidade dos Testes , Fenômenos Fisiológicos Respiratórios , Sensibilidade e Especificidade
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