Cheyne-Stokes Breathing With an Obstructive Airway During Rapid Eye Movement Sleep

Cheyne-Stokes breathing (CSB) is common in patients with heart failure due to circulation delay and increased chemoreflex instability. CSB usually disappears during rapid eye movement (REM) sleep. Here, we report a case of a 72-year-old man who had heart failure and other multiple cardiovascular comorbidities with CSB and obstructive sleep apnea. Polysomnography showed typical CSB—central apnea with a pattern of crescendo-decrescendo breathing—during non-REM sleep. However, CSB changed to mixed apnea with a pattern of crescendo-decrescendo breathing during REM sleep

Atypical Catathrenia Mimicking Sleep Choking Sound of Obstructive Sleep Apnea

Catathrenia is a rare type of sleep-related breathing disorder with benign course and generally does not require treatment. However, the psychological burden on patients and bed partners is not light. In most cases, due to the sound characteristic of identifiable harmonics, it can be easily diagnosed; however, in some cases, it has non-typical sounds, and polysomnography is essential to diagnose. Here, I report a middle-aged woman with choking sounds like an obstructive sleep apnea patient during sleep, with typical polysomnography features of catathrenia

(7-Dimethylamino-1-hydroxy-3-naphthyl)(morpholino)methanone

In the title compound, C17H20N2O3, the morpholine ring is in a slightly distorted chair form. The crystal structure is stabilized by an inter­molecular O—H⋯O hydrogen bond between the H atom of the hydroxyl group and the O atom of a neighbouring carbonyl group. A weak inter­molecular C—H⋯π inter­action is also present

Verilog Modeling of Transmission Line for USB 2.0 High-Speed PHY Interface

A Verilog model is proposed for transmission lines to perform the all-Verilog simulation of high-speed chip-to-chip interface system, which reduces the simulation time by around 770 times compared to the mixed-mode simulation. The single-pulse response of transmission line in SPICE model is converted into that in Verilog model by converting the full-scale analog signal into an 11-bit digital code after uniform time sampling. The receiver waveform of transmission line is calculated by adding or subtracting the single-pulse response in Verilog model depending on the transmitting digital code values with appropriate time delay. The application of this work to a USB 2.0 high-speed PHY interface reduces the simulation time to less than three minutes with error less than 5% while the mixed-mode simulation takes more than two days for the same circuit.X1133Ysciescopu

Effects of a dianion compound as a surface modifier on the back reaction of photogenerated electrons in TiO2-based solar cells

The TiO2 films were modified with a dianion compound, 1,2-ethanedisulfonic acid disodium salt (ESD), to give a negative charge (ethane sulfonate anion) on the TiO2 surface, i.e., TiO2-O-SO2-CH2-CH2-SO3 −), and effects of repulsion between the negative charge and ions (I3 −) of the electrolyte on the performance of dye-sensitized solar cells (DSSCs) were investigated. The reference device without any modification showed a power conversion efficiency (PCE) of 9.89%, whereas for the device with ESD(20)-TiO2/FTO, which was prepared by soaking bare TiO2/FTO in an ESD solution for 20 min, the PCE was increased to 10.97%, due to an increase in both short-circuit current (Jsc) and open-circuit voltage(Voc). It was verified from the measurements of electrochemical impedance, open-circuit voltage decay and dark current that the enhancement in the Jsc and Voc values was attributed to the reduced back reaction between photoinjected electrons and I3 − ions, resulting from the presence of the ethane sulfonate anions on the TiO2 surface. © 2018 King Saud University1

DiGeorge syndrome who developed lymphoproliferative mediastinal mass

DiGeorge syndrome is an immunodeficient disease associated with abnormal development of 3rd and 4th pharyngeal pouches. As a hemizygous deletion of chromosome 22q11.2 occurs, various clinical phenotypes are shown with a broad spectrum. Conotruncal cardiac anomalies, hypoplastic thymus, and hypocalcemia are the classic triad of DiGeorge syndrome. As this syndrome is characterized by hypoplastic or aplastic thymus, there are missing thymic shadow on their plain chest x-ray. Immunodeficient patients are traditionally known to be at an increased risk for malignancy, especially lymphoma. We experienced a 7-year-old DiGeorge syndrome patient with mediastinal mass shadow on her plain chest x-ray. She visited Severance Children's Hospital hospital with recurrent pneumonia, and throughout her repeated chest x-ray, there was a mass like shadow on anterior mediastinal area. We did full evaluation including chest computed tomography, chest ultrasonography, and chest magnetic resonance imaging. To rule out malignancy, video assisted thoracoscopic surgery was done. Final diagnosis of the mass which was thought to be malignancy, was lymphoproliferative lesion

Conventional reversal of rocuronium-induced neuromuscular blockade by sugammadex in Korean children: pharmacokinetics, efficacy, and safety analyses

Background: Sugammadex is known to reverse neuromuscular blockade induced by non-depolarizing agents. In children, the recommended dose for reversal of moderate neuromuscular blockade is 2 mg/kg. We investigated the pharmacokinetics and pharmacodynamics of sugammadex in Korean children.Methods: Children (2–17 years of age) undergoing brain or spine surgery were enrolled and randomly assigned to control (neostigmine) and 2, 4, or 8 mg/kg sugammadex groups. Following induction of anesthesia and monitoring of the response to train-of-four stimulation, 1 mg/kg rocuronium was intravenously administered. Upon reappearance of the second twitch to train-of-four stimulation, the study drug was administered according to group allocation. The plasma concentrations of rocuronium and sugammadex were serially measured at nine predefined time points following study drug administration. To determine efficacy, we measured the time elapsed from drug administration to recovery of T4/T1 ≥ 0.9. For pharmacokinetics, non-compartmental analysis was performed and we monitored adverse event occurrence from the time of study drug administration until 24 h post-surgery.Results: Among the 29 enrolled participants, the sugammadex (2 mg/kg) and control groups showed recovery times [median (interquartile range)] of 1.3 (1.0–1.9) and 7.7 (5.3–21.0) min, respectively (p = 0.002). There were no significant differences in recovery time among the participants in sugammadex groups. The pharmacokinetics of sugammadex were comparable to those of literature findings. Although two hypotensive events related to sugammadex were observed, no intervention was necessary.Conclusion: The findings of this pharmacokinetic analysis and efficacy study of sugammadex in Korean children indicated that sugammadex (2 mg/kg) may be safely administered for reversing moderate neuromuscular blockade. Some differences in pharmacokinetics of sugammadex were observed according to age.Clinical Trial Registration:http://clinicaltrials.gov (NCT04347486

Obesity and incidence of diabetes: Effect of absence of metabolic syndrome, insulin resistance, inflammation and fatty liver

Background and aimsObesity is frequently associated with non-alcoholic fatty liver disease (NAFLD), insulin resistance (IR), inflammation and metabolic syndrome (MetS), all of which increase the risk of type 2 diabetes (T2DM). However, the role of these risk factors in mediating the effect of obesity remains unclear. We investigated the association between obesity and T2DM in the absence and presence of NAFLD, IR, inflammation and MetS components.Methods29,836 obese subjects without diabetes were studied in a Korean health screening program. Obesity was defined by the appropriate ethnic-specific body mass index (BMI) threshold ≥25 kg/m2. Hazard ratios (HRs and 95% confidence intervals, CIs) for incident T2DM were estimated for the group with no hypertension, dyslipidemia, impaired fasting glucose, fatty liver, IR, or inflammation (n = 1717), compared to the reference group, with one or more of these factors (n = 19,757).ResultsMean (SD) age at baseline was 37 (7) years and 1200 incident cases of diabetes occurred. Crude T2D incidence was 12.6/10,000 person-years in the group without metabolic abnormality and 143/10,000 person-years in the reference group. HR (95% CIs) for incident diabetes was 0.13 (0.06, 0.33) in the group without metabolic abnormality.ConclusionsObese subjects without components of the metabolic syndrome, IR, fatty liver and inflammation have an approximately 11-fold lower risk of incident type 2 diabetes than obese subjects who have these risk factors. These simple factors could be used to target limited resources in high risk obese subjects in the prevention of diabetes