Automatic Derivation of Continuous Positive Airway Pressure Settings: Comparison with In-Laboratory Titration

Background@#and PurposeThis study was designed to investigate differences in the final recommended pressure setting between that derived from an autotitrating continuous positive airway pressure (APAP) device and manual in-laboratory continuous positive airway pressure (CPAP) titration, as well as the factors that influence pressure differences in patients with obstructive sleep apnea (OSA). @*Methods@#This study enrolled 50 patients with OSA. All patients underwent both APAP titration and manual CPAP titration. We obtained the average device pressure ≤90% of the time (APAP90) from the downloaded manual for the APAP machine and the optimal pressure obtained by manual CPAP titration (CPAPmanual). We placed the subjects into three groups based on the pressure difference (ΔP) obtained by subtracting CPAPmanual from APAP90: 1) Prequal (ΔP=0), 2) CPAPmanual+ (ΔP ≤−1), and 3) APAP90+ (ΔP ≥1). Regression analysis was conducted to identify predictive factors associated with ΔP. @*Results@#The values of APAP90 and CPAPmanual were 9.50±3.03 cmH2O and 9.48±2.71 cmH2O (mean±SD), respectively (p=0.95). The Prequal, CPAPmanual+, and APAP90+ groups comprised 9 (18%), 23 (46%), and 18 (36%) subjects, respectively. Regression analyses revealed that male sex [β=3.539, 95% confidence interval (CI)=0.040–7.039], body mass index (BMI) (β=0.186, 95% CI=0.020–0.352), and average usage per day (β=0.768, 95% CI=0.077–1.459) were associated with ΔP. @*Conclusions@#While the mean pressure in the overall cohort did not differ significantly between APAP90 and CPAPmanual, there was a discordance majority showing different single pressures obtained when applying the two titration methods. Being Male, having an increased BMI, and having an increased average usage per day of APAP were significantly correlated with increased ΔP in this study.

Significance of Parafibromin Expression in Laryngeal Squamous Cell Carcinomas

BACKGROUND: Parafibromin is a product of the tumor suppressor gene that has been studied as a potential indicator of tumor aggressiveness in the parathyroid, breast, colorectum, and stomach. However, the clinical significance and potential function of parafibromin expression in head and neck squamous cell carcinomas remain largely unknown. The aim of this study was to evaluate the expression of parafibromin in laryngeal squamous cell carcinoma (LSCC) and to verify its potential as a biomarker of tumor behavior. METHODS: Parafibromin expression was evaluated in 30 cases of LSCC using immunohistochemistry. The correlations between parafibromin expression and clinicopathologic parameters were investigated. RESULTS: Parafibromin expression was positive in 15 cases (50%) and negative in 15 cases (50%). Tumor size and T stage showed a statistically significant inverse relationship with parafibromin expression (p=.028 and p.05). CONCLUSIONS: Our results indicate that the downregulation or loss of parafibromin expression can be employed as a novel marker of tumor progression or aggressiveness in LSCC.

Prognostic Implications of the Expression of CXCL16 in Breast Carcinoma

BACKGROUND: Of the many prognostic factors for breast cancer, the relationship between an infiltration of inflammatory cells and the prognosis is debatable. Of the chemokines affecting cancer's inflammatory reactions, chemokine (C-X-C motif) ligand 16 (CXCL16) has attracted attention for its prognostic value in many cancers, including colorectal cancer and renal cell carcinoma. But the situation for breast carcinoma is unknown. The aim of this study was to examine the relationship between the prognostic factors and the CXCL16 expression in patients with breast carcinoma. METHODS: The patients (n=106) diagnosed with invasive ductal cancer of the breast were enrolled. We reviewed the clinicopathological factors of these patients, hematoxylin and eosin stains were prepared and estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2/neu) and CXCL16 immunostaining was performed. RESULTS: The ER expression was significantly correlated with age and inflammation. A CXCL16 expression was noted in 81.1% of the cases. No association was evident between a CXCL16 expression and any other parameter, including the survival rate. Multivariate analysis did not implicate ER, HER2/neu or CXCL16 as an independent prognostic factor, but the tumor size was independent predictive factor for the patient outcome. CONCLUSIONS: An inflammatory reaction mediated by CXCL16 is not associated with the prognosis of breast cancer or any clinicopathological factors.

Preschool Vision Screening in Korea: Results in the Year of 2001

PURPOSE: To report the results of preschool vision screening of South Korean children in the year of 2001. METHODS: Nation-wide population-based vision screening tests were conducted in a stepwise manner on the preschool children over 3 years of age. The first step of test was home-screening using 5 familiar picture cards. The children who didn't pass the first step (VA < 0.5 in at least one eye) were sent to the Public Health Care Centers and re-tested there with regular vision charts. After this second step of test, some children were referred to the ophthalmologists. The referral criteria for visual acuity were: at 3 years less than 0.5, at 4 or above 4 years less than 0.63 in at least one eye. Data were collected for the 67, 315 children to evaluate the ophthalmologic conditions. RESULTS: Among 67, 315 subjects who had been enrolled, 97% of children had visual acuity of 0.5 or better. Of those screened, 5, 221 (7.8%) children were referred to the ophthalmologists. The feedback results for 3, 058 (4.6%) children could be collected. Of those referred, 2, 488(80.6%) had one or more ophthalmologic disorders. Refractive errors were found in 2183 children. Amblyopia was discovered in 560 children. Manifest strabismus was detected in 144 children. CONCLUSIONS: In this population setting, ocular disorders which can affect visual development were found in 2, 488 children. This attests to the importance of performing early and effective screening tests for preschool children.