Sleep-waking cycle disturbance in patients with obstructive sleep apnea syndrome.

Eighteen (18) obese patients with clinically confirmed obstructive sleep apnea syndrome (OSAS) and five (5) obese persons with no apnea crises noticed during sleep apart from occassional loud snoring, have been polysomnographically assessed. The obtained results show that the patients with apnea syndrome sleep very badly, and consequently, shortened sleep latency and frequent body movements, along with apneas, are regarded as the leading polysomnographic symptoms. Vigilance profile during sleep, that is, interchange and frequency of each of sleep stages (I, II, III, IV, REM) are similar in both tested groups. The suppression of restitutive stages of sleep (III, IV, REM) is considered to be a dominant characteristic of vigilance during sleep in obese persons and obese persons with manifest apnea syndrome. Relatively prolonged sleep latency in obese persons without manifest apnea syndrome indicates, however, restitutively higher quality of their nocturnal sleep. Contrary to the patients with apnea syndrome, they do not suffer from excessive evening somnolence, so that their daily alertness and sleep vigilance during night are of a better quality, although the lack of deep and REM sleep is observed in them as well.

[Breast cysts--diagnosis and therapy]. / Ciste dojke--dijagnostika i lijecenje.

The authors present the results of the diagnosis of 1405 cases of macroscopically evident breast cysts. Only 15% patients were younger than 40 and only 6% older than 55 years. All lesions were cytologically analysed. The results were classified as negative in 1120 (79.9%), suspect in 27 (1.9%) and positive in 6 (0.4%) of cases. In 18% (n = 252) of cases aspirates were not adequate for cytologic evaluation. During a five-year follow-up period no new cyst was confirmed in 69.2% of cases, while in 30.8% of cases new cysts were diagnosed in yearly examinations during the observed period. Five (2.6%) intracystic proliferations were selected from the 190 cysts studied by means of pneumocystography. In the group presented three intracystic cancers were diagnosed by the combination of different diagnostic methods. The authors conclude that the introduction of ultrasound in breast cyst diagnostic work has reduced indications for pneumocystography and the cytologic evaluation of aspirates.