Increased Risk of Ischemic Stroke during Sleep in Apneic Patients.

BACKGROUND AND PURPOSE:The literature indicates that obstructive sleep apnea (OSA) increases the risk of ischemic stroke. However, the causal relationship between OSA and ischemic stroke is not well established. This study examined whether preexisting OSA symptoms affect the onset of acute ischemic stroke. METHODS:We investigated consecutive patients who were admitted with acute ischemic stroke, using a standardized protocol including the Berlin Questionnaire on symptoms of OSA prior to stroke. The collected stroke data included the time of the stroke onset, risk factors, and etiologic subtypes. The association between preceding OSA symptoms and wake-up stroke (WUS) was assessed using multivariate logistic regression analysis. RESULTS:We identified 260 subjects with acute ischemic strokes with a definite onset time, of which 25.8% were WUS. The presence of preexisting witnessed or self-recognized sleep apnea was the only risk factor for WUS (adjusted odds ratio=2.055, 95% confidence interval=1.035-4.083, p=0.040). CONCLUSIONS:Preexisting symptoms suggestive of OSA were associated with the occurrence of WUS. This suggests that OSA contributes to ischemic stroke not only as a predisposing risk factor but also as a triggering factor. Treating OSA might therefore be beneficial in preventing stroke, particularly that occurring during sleep

Epidemiological Aspects of Exotic Malaria and Dengue Fever in Travelers in Korea

In order to compare the epidemiological aspects of exotic malaria (EM) and dengue fever (DF) imported by travelers in Korea, we have analyzed the current state both of the disease incidence and related risk factors. A total of 345 cases of EM occurred between 2001 and 2008 in Korea, and the average incidence rate per 100,000 population was 0.091. A total of 252 of DF cases occurred during the same period, and its rate was 0.063. While most of the EM and DF prevalence occurred in summer, prevalence in spring and winter was more prominent for EM (P < 0.05 ~ P < 0.01), while outbreaks in summer were more frequent for DF (P < 0.01). In Korea, more males were infected with EM and DF than females (P < 0.01). The remarkable difference between gender distributions in Korea is believed to reflect cultural differences in terms of work and travel. In both diseases, the manhood age bracket (20 - 39 years old) is possible due to increased oversea activities and travel. Moreover, reported EM cases in several prefectures in the regions of Asia and Africa were widely spread by the appropriate vector of mosquitoes, while the vectors of DF in the region of Asia are limited

Development of an ex vivo model for the study of cerebrovascular function utilizing isolated mouse olfactory artery

OBJECTIVE: Cerebral vessels, such as intracerebral perforating arterioles isolated from rat brain, have been widely used as an ex vivo model to study the cerebrovascular function associated with cerebrovascular disorders and the therapeutic effects of various pharmacological agents. These perforating arterioles, however, have demonstrated differences in the vascular architecture and reactivity compared with a larger leptomeningeal artery which has been commonly implicated in cerebrovascular disease. In this study, therefore, we developed the method for studying cerebrovascular function utilizing the olfactory artery isolated from the mouse brain. METHODS: The olfactory artery (OA) was isolated from the C57/BL6 wild-type mouse brain. After removing connective tissues, one side of the isolated vessel segment (approximately -500 µm in length) was cannulated and the opposite end of the vessel was completely sealed while being viewed with an inverted microscope. After verifying the absence of pressure leakage, we examined the vascular reactivity to various vasoactive agents under the fixed intravascular pressure (60 mm Hg). RESULTS: We found that the isolated mouse OAs were able to constrict in response to vasoconstrictors, including KCl, phenylephrine, endothelin-1, and prostaglandin PGH(2). Moreover, this isolated vessel demonstrated vasodilation in a dose-dependent manner when vasodilatory agents, acetylcholine and bradykinin, were applied. CONCLUSION: Our findings suggest that the isolated olfactory artery would provide as a useful ex vivo model to study the molecular and cellular mechanisms of vascular function underlying cerebrovascular disorders and the direct effects of such disease-modifying pathways on cerebrovascular function utilizing pharmacological agents and genetically modified mouse models

ON POSITIVE QUATERNIONIC KÄHLER MANIFOLDS WITH b_4=1

Let M be a positive quaternionic Kähler manifold of dimension 4m. In earlier papers, Fang and the first author showed that if the symmetry rank is greater than or equal to [m=2]+3, then M is isometric to HP^m or Gr_2(C^). The goal of this paper is to give a more refined classification result for positive quaternionic Kähler manifolds (in particular, of relatively low dimension or with even m) whose fourth Betti number equals one. To be precise, we show in this paper that if the symmetry rank of M with b_4(M)=1is no less than [m/2]+2 for ≥5, then M is isometric to HP^m

The Singer's Formant and Speaker's Ring Resonance: A Long-Term Average Spectrum Analysis

ObjectivesWe previously showed that a trained tenor's voice has the conventional singer's formant at the region of 3 kHz and another energy peak at 8-9 kHz. Singers in other operatic voice ranges are assumed to have the same peak in their singing and speaking voice. However, to date, no specific measurement of this has been made.MethodsTenors, baritones, sopranos and mezzo sopranos were chosen to participate in this study of the singer's formant and the speaker's ring resonance. Untrained males (n=15) and females (n=15) were included in the control group. Each subject was asked to produce successive /a/ vowel sounds in their singing and speaking voice. For singing, the low pitch was produced in the chest register and the high notes in the head register. We collected the data on the long-term average spectra of the speaking and singing voices of the trained singers and the control groups.ResultsFor the sounds produced from the head register, a significant energy concentration was seen in both 2.2-3.4 kHz and 7.5-8.4 kHz regions (except for the voices of the mezzo sopranos) in the trained singer group when compared to the control groups. Also, the chest register had a significant energy concentration in the 4 trained singer groups at the 2.2-3.1 kHz and 7.8-8.4 kHz. For speaking sound, all trained singers had a significant energy concentration at 2.2-5.3 kHz and sopranos had another energy concentration at 9-10 kHz.ConclusionThe results of this study suggest that opera singers have more energy concentration in the singer's formant/speaker's ring region, in both singing and speaking voices. Furthermore, another region of energy concentration was identified in opera singer's singing sound and in sopranos' speaking sound at 8-9 kHz. The authors believe that these energy concentrations may contribute to the rich voice of trained singers