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The fine structure of sleep electrocortical activity reflects health and disease. The current study provides normative data for sleep structure and electroencephalography (EEG) spectral power measures derived from overnight polysomnography (PSG) and examines the effect of age and sex among Korean middle‐aged and older adults with or without obstructive sleep apnea (OSA). We analysed home PSG data from 1,153 adult participants of an ongoing population‐based cohort study, the Korean Genome and Epidemiology Study. Sleep stages were visually scored and spectral power was measured on a single‐channel EEG (C4‐A1). We computed spectral power for five frequency ranges. The EEG power was reported in relative (%) and log‐transformed absolute values (µV2). With ageing, the proportion of N1 sleep increased, whereas N3 decreased, which is more noticeable in men than in women. The amount of N3 was relatively low in this cohort. With ageing, relative delta power decreased and alpha and sigma power increased for the whole sleep period, which was more pronounced during REM sleep in non‐OSA. For men compared with women, relative theta power was lower during REM and sigma and beta were higher during N1 sleep. The differences of relative powers by age and sex in OSA were comparable to those in non‐OSA. In a community‐based Korean population, we present normative data of sleep structure and spectral power for middle‐aged or older adults of a non‐Caucasian ethnicity. The values varied with age and sex and were not influenced by sleep apnea. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to investigate sex differences in the prevalence and clinical presentation of migraine and probable migraine in a general population‐based sample. Background: While there is research on sex differences in clinical characteristics and their impact on migraine headache, only few studies have investigated sex differences in probable migraine in population‐based settings. Moreover, compared with Western countries, the prevalence of probable migraine in Asia is relatively high. This cross‐sectional study was designed to investigate sex differences in the prevalence and clinical presentation of migraine and probable migraine in a general population‐based sample. Methods: We used the data of the Korean Headache‐Sleep Study, which is a nationwide survey on headache and sleep. Results: We interviewed 7430 people, and 3114 of them agreed to participate in our study (rejection rate, 58.1%). Among these people, 419 withdrew their participation during the interview. Ultimately, 2695 people completed our survey (cooperation rate, 36.3%). The prevalence of overall migraine and probable migraine was 350/1350 (25.9%) for women and 172/1345 (12.8%) for men (P < .001, respectively). The prevalence of migraine (107/1350 [7.9%] vs 36/1345 [2.7%], P < .001) and probable migraine (243/1350 [18.0%] vs 136/1345 [10.1%], P < .001) was significantly higher among women than among men. Headache frequency per month (median [interquartile range]) (1.0 [0.3–3.0] vs 0.8 [0.3–2.0], P = .037), the visual analog scale score for headache intensity (5.0 [4.0–7.0] vs 5.0 [3.0–6.0], P = .019), and the impact of headache {Headache Impact Test‐6 score (47.0 [42.0–54.0] vs 44.0 [42.0–51.8], P = .013)} were significantly higher among women with probable migraine than men. Headache frequency per month (2.0 [0.4–4.0] vs 1.0 [0.3–2.0], P = .073), headache intensity (6.0 [5.0–8.0] vs 6.0 [4.2–7.0], P = .281), and the impact of headache (55.0 [48.0–61.0] vs 49.0 [46.3–60.8], P = .225) were not significantly different between women and men with migraine. Other comorbidities or associated symptoms, such as anxiety and depression, were not significantly different between women and men with migraine and probable migraine, except for nausea in probable migraine. Conclusion: Women experience more severe symptoms and a higher impact of headache than men among participants with probable migraine. Our findings suggest that women with PM need a more intensive evaluation and treatment than men with PM. [ABSTRACT FROM AUTHOR]

Objective: Recent studies have revealed a link between Toll-like receptor (TLR) signaling and the adipose tissue inflammation associated with obesity. Although TLR9 is known to play an important role in inflammation and innate immunity, its role in mediating adipose tissue inflammation has not yet been investigated. Thus, the objective of this study was to determine the role of TLR9 in regulating immune cells in visceral adipose tissue and maintaining the metabolic homeostasis.Methods: Wild-type and TLR9-deficient mice were fed with a high-fat diet, and the body weight gain, glucose tolerance, insulin sensitivity, and adipose tissue inflammation were examined.Results: TLR9-deficient mice gained significantly more weight and body fat under a high-fat diet than wild-type mice and exhibited more severe glucose intolerance and insulin resistance. We also found a dramatic increase of M1 macrophages as well as TH 1 cells in the adipose tissue of TLR9-deficient mice compared to wild-type mice. Furthermore, the levels of various proinflammatory cytokines and chemokines were higher in TLR9-deficient mice.Conclusions: TLR9 signaling is involved in regulating adipose tissue inflammation and controlling obesity and the metabolic syndrome. [ABSTRACT FROM AUTHOR]

BACKGROUND A chemosensitizing effect of levetiracetam (LEV) has been suggested because LEV inhibits O-6 methylguanine-DNA methyltransferase (MGMT). However, the survival benefit of LEV has not been clinically documented. The objective of this study was to assess the survival benefit of LEV compared with other antiepileptic drugs as a chemosensitizer to temozolomide for patients with glioblastoma. METHODS In total, 103 consecutive patients with primary glioblastoma who received concomitant chemoradiotherapy and adjuvant chemotherapy with temozolomide were retrospectively reviewed, and 58 patients (56%) received LEV during temozolomide chemotherapy for at least 3 months. A Cox regression survival analysis was performed to adjust for confounding factors, including age, extent of lesion, Karnofsky performance scale score, extent of removal, and MGMT promoter methylation status. RESULTS The median progression-free survival (PFS) and overall survival (OS) for patients who received LEV in combination with temozolomide (PFS: median, 9.4 months; 95% confidence interval [CI], 7.5-11.3 months; OS: median, 25.7 months; 95% CI, 21.7-29.7 months) were significantly longer than those for patients who did not receive LEV (PFS: median, 6.7 months; 95% CI, 5.8-7.6 months; OS: median, 16.7 months; 95% CI, 12.1-21.3 months; P = .010 and P = .027, respectively). In multivariate analysis, the variables that were identified as significant prognostic factors for OS were preoperative Karnofsky performance scale score (hazard ratio [HR], 0.37; P = .016), MGMT promoter methylation (HR, 0.30; P = .002), and receipt of LEV (HR, 0.31; P < .001. CONCLUSIONS LEV may provide a survival benefit in patients with glioblastoma who receive temozolomide-based chemotherapy. A prospective randomized study may be indicated. Cancer 2015;121:2926-2932. © 2015 American Cancer Society. [ABSTRACT FROM AUTHOR]

Pandemics in poultry caused by the highly pathogenic avian influenza ( HPAI) A virus occur too frequently globally, and there is growing concern about the HPAI A virus due to the possibility of a pandemic among humans. Thus, it is important to develop a vaccine against HPAI suitable for both humans and animals. Various approaches are underway to develop such vaccines. In particular, an edible vaccine would be a convenient way to vaccinate poultry because of the behaviour of the animals. However, an edible vaccine is still not available. In this study, we developed a strategy of effective vaccination of mice by the oral administration of transgenic Arabidopsis plants ( HA- TG) expressing haemagglutinin ( HA) in the endoplasmic reticulum ( ER). Expression of HA in the ER resulted in its high-level accumulation, N-glycosylation, protection from proteolytic degradation and long-term stability. Oral administration of HA- TG with saponin elicited high levels of HA-specific systemic IgG and mucosal IgA responses in mice, which resulted in protection against a lethal influenza virus infection with attenuated inflammatory symptoms. Based on these results, we propose that oral administration of freeze-dried leaf powders from transgenic plants expressing HA in the ER together with saponin is an attractive strategy for vaccination against influenza A virus. [ABSTRACT FROM AUTHOR]

This study aimed to explore the association between restless legs syndrome and irritable bowel syndrome in an epidemiological cohort. We included 3365 adults, of whom 1602 were female (age 52.5 ± 7.5 years), who had participated in the Korean Genome and Epidemiology Study (2005-2006). The diagnosis of restless legs syndrome was based on the criteria proposed by the International Restless Legs Syndrome Study Group, and irritable bowel syndrome was defined according to the Rome II criteria. The prevalence of each condition was determined and their association was tested by logistic regression analysis. Age, sex, haemoglobin concentration, renal insufficiency, use of medications and depressive mood were all adjusted for. The prevalence of restless legs syndrome and irritable bowel syndrome was 4.5 and 11.1%, respectively. Irritable bowel syndrome was more prevalent in the group with restless legs syndrome (24.0 versus 10.5%, P < 0.001). Subjects with restless legs syndrome were older (54.2 ± 8.4 versus 52.4 ± 7.4, P = 0.006) and more depressive (26.7 versus 12.5%, P < 0.001), and were predominantly female (57.3 versus 47.2%, P = 0.015), had more frequent insomnia symptoms (44.0 versus 28.2%, P < 0.001), had lower haemoglobin concentration (13.7 ± 1.5 versus 14.1 ± 1.6 g dL−1 P = 0.004) and higher highly sensitive C-reactive protein (1.8 ± 5.1 versus 1.4 ± 2.9 mg dL−1, P = 0.08). The adjusted odds ratio of restless legs syndrome in relation to irritable bowel syndrome was 2.59 (1.74-3.85, P < 0.001). Irritable bowel syndrome appeared to be associated with restless legs syndrome independently from other major risk factors for restless legs syndrome. Searching for the mechanisms underlying this association is indicated. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: The aim of this study was to demonstrate postoperative changes in sleep quality in children with obstructive sleep apnea (OSA), using both conventional sleep staging and electrocardiogram-based cardiopulmonary coupling (CPC) analysis. The hypothesis is that being electroencephalography (EEG)-independent, CPC may detect changes in sleep quality that traditional sleep architecture analysis cannot. Study Design: Retrospective outcome research. Methods: We included 37 children (aged 6.89 ± 2.76 years, 28 male) with OSA who underwent adenotonsillectomy, and analyzed standard polysomnography and CPC parameters from a full-night study before and after adenotonsillectomy. High-frequency coupling (HFC) and low-frequency coupling (LFC) were used as indices of stable and unstable sleep, respectively. Results: Adenotonsillectomy led to a significant change in CPC parameters (HFC, 50.3 ± 16.1% to 56.1 ± 14.7%, P = .03; LFC, 35.1 ± 14.5% to 27.3 ± 13.0%, P = .003), which was paralleled by improvements in the apnea-hypopnea (12.7 ± 13.7 to 1.0 ± 0.8, P < .001) and arousal index (20.8 ± 11.5 to 9.9 ± 3.9, P < .001). Polysomnographic sleep stage parameters other than the arousal index did not reflect postoperative resolution of OSA. Conclusions: In pediatric OSA, postoperative improvement of sleep quality is more readily discernible by CPC analysis than EEG-based sleep staging. The CPC analysis may have potential advantages in the assessment of sleep quality in pediatric populations. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: To test the effect of upper airway surgery on sleep quality in adults with obstructive sleep apnea (OSA) and the potential usefulness of electrocardiogram (ECG)-based cardiopulmonary coupling (CPC) analysis as metrics of sleep quality., Study Design: Retrospective outcome research., Methods: A total of 62 consecutive adult patients with OSA, consisting of 36 with successful and 26 with unsuccessful outcomes, were included in the study. Mean age was 37.7 ± 8.9 years, and body mass index (BMI, kg/m(2) ) was 26.9 ± 2.3. We compared clinical characteristics (age, BMI, and Epworth Sleepiness Scale [ESS]), sleep (sleep efficiency, stage non-rapid eye movement [N]1, N2, N3, rapid eye movement, and arousal index [ArI]), respiratory (apnea index [AI], apnea-hypopnea index [AHI], and minimum arterial oxygen saturation [SaO2 ]), and CPC (high-frequency coupling [HFC], low frequency coupling [LFC], very-low-frequency coupling, and elevated low-frequency coupling [e-LFC]) parameters between the success and nonsuccess groups before and after surgery. Surgical success was defined when the postoperative AHI was both <20 per hour and 50% of the preoperative value., Results: Sleep quality measured by CPC analysis improved significantly (HFC, P = .001; LFC, P = .002; e-LFC, P = .003), along with parallel reduction in ESS, respiratory parameters (AHI, AI, minimum SaO2 ), and sleep fragmentation (ArI) in the group with surgical success after upper airway surgery., Conclusions: Successful upper airway surgery can improve objective sleep quality in adult patients with OSA. CPC metrics of sleep quality are potentially useful to monitor therapeutic responses during long-term postoperative follow-up, as the ECG-based analysis is available as a standalone option outside laboratory polysomnography., (© 2015 The American Laryngological, Rhinological and Otological Society, Inc.)