RESUMO
A 4-yr-old girl has exhibited severe snoring, restless sleep and increasing daytime sleepiness over the last 3 months. The physical examination showed that she was not obese but had kissing tonsils. Polysomnography demonstrated increased apnea-hypopnea index (AHI) of 5.2, and multiple sleep latency tests (MSLT) showed shortened mean sleep latency and one sleep-onset REM period (SOREMP). She was diagnosed with obstructive sleep apnea (OSA) and underwent tonsillectomy and adenoidectomy. After the surgery, her sleep became much calmer, but she was still sleepy. Another sleep test showed normal AHI of 0.2, the mean sleep latency of 8 min, and two SOREMPs. Diagnosis of OSA to be effectively treated by surgery and narcolepsy without cataplexy was confirmed. Since young children exhibiting both OSA and narcolepsy can fail to be diagnosed with the latter, it's desirable to conduct MSLT when they have severe daytime sleepiness or fail to get better even with good treatment.
Assuntos
Pré-Escolar , Feminino , Humanos , Adenoidectomia , Povo Asiático , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Metilfenidato/uso terapêutico , Narcolepsia/complicações , Polissonografia , República da Coreia , Apneia Obstrutiva do Sono/diagnóstico , TonsilectomiaRESUMO
PURPOSE: DNA flow cytometry is a simple and easy method to assess the DNA content and the cell-cycle distribution of a tumor cell. The prognostic significance of the DNA content and the S-phase fraction in a gastric carcinoma has been controversial. The purpose of this study was to evaluate the prognostic significance of the nuclear DNA content and the S-phase fraction in patients with a gastric carcinoma. METHODS: Between May 1995 and March 1996, 94 patients who were underwent a gastric resection for a gastric carcinoma were evaluated with DNA flow cytometry. Of them, 88 patients underwent a gastric resection with curative intent. The relationship of variable clinicopathological factors and of recurrence pattern to survival and nuclear DNA content were assessed. RESULTS: The mean age was 55 years. 55 patients (58.5%) exbitied diploidy and 39 patients (41.5%) aneuploidy. There was no relationship between the clinicopathological factors and either the ploidy pattern or the S-phase fraction. Though the recurrence and its pattern were not different between the two ploidy group (p=0.860, 0.137), diploidy tended to recur locoregionally and aneuploidy hematogenously. CONCLUSION: The ploidy pattern was a significant prognostic factor in gastric carcinomas, but should be interpreted carefully.