Objective: To determine if there is an indicator on the lateral cephalometric radiograph that can be used for the differential diagnosis of severe obstruct sleep apnea syndrome and simple snoring in nonobese young male adults. Materials and Methods: The subjects were Taiwanese male patients with a complaint of snoring and/or sleep apnea, whose body mass index was less than 25 kg/m 2 and who were younger than 40 years old. Forty-six patients with severe obstructive sleep apnea and 36 patients with simple snoring were selected and underwent lateral cephalometric radiography, from which 24 linear and 34 angular measurements were calculated. Differences between the two groups were studied, and a discriminatory analysis was performed. Results: Soft palate length, mandibular body length, tongue size, and distance from the hyoid bone to the mandibular plane were significantly larger in patients with severe obstructive sleep apnea syndrome. Of the original grouped cases, 76.5% were correctly classified using these five variables. The position of the hyoid bone in simple snorers was near the straight line from the third vertebra to the menton, whereas the position of the hyoid bone in severe obstruct sleep apnea syndrome patients was far below the line from the third vertebra to the menton. Conclusion:The position of the hyoid bone relative to the line from the third vertebra to the menton can be used as an indicator for a diagnosis of severe obstruct sleep apnea syndrome in nonobese young male Taiwanese adults.

vagal pathways mediating respiratory reflexes evoked by ROS in the lungs of anesthetized rats. J Appl Physiol 94: 1987, 2003. First published January 10, 2003 10.1152/ japplphysiol.01047.2002We investigated the afferent vagal pathways mediating respiratory reflexes evoked by reactive oxygen species (ROS) in the lungs of anesthetized rats. Spontaneous inhalation of 0.2% aerosolized H 2O2 acutely evoked initial bradypnea followed by delayed tachypnea, which was frequently mixed with delayed augmented inspiration. The initial response was abolished after perivagal capsaicin treatment (PCT), but was prolonged during vagal cooling (VC) to 7°C; PCT and VC are known to differentially block the conduction of unmyelinated C and myelinated fibers, respectively. The delayed responses were eliminated during VC but emerged earlier after PCT. Vagotomy, catalase (an antioxidant for H 2O2), dimethylthiourea (an antioxidant for ⅐ OH), or deferoxamine (an antioxidant for ⅐ OH) largely or totally suppressed these reflexive responses, whereas sham nerve treatment, heat-inactivated catalase, saline vehicle, or iron-saturated deferoxamine failed to do so. These results suggest that 1) the H 2O2-evoked initial and delayed airway reflexes are antagonistic and may result from stimulation of lung C fibers and rapidly adapting receptors, respectively, and 2) the reflex effects of H 2O2 are, in part, due to the action of ⅐ OH on these afferents. vagal sensory receptors; oxygen radicals; reactive oxygen species; hydrogen peroxide LUNG DISEASES, SUCH AS ASTHMA (10), chronic obstructive pulmonary disease (12), endotoxin shock (33), and vascular microembolism (50), or inhalation of oxidant irritants, such as toxic smoke (35), cigarette smoke (35), and ozone (45), may cause increased pulmonary production of reactive oxygen species from endogenous and/or exogenous sources. The major reactive oxygen species are the superoxide anion radical, hydrogen peroxide (H 2 O 2 ), and the hydroxyl radical (⅐ OH) (5). The superoxide anion radical dismutates to form H 2 O 2 , which, in the presence of iron, can further react to form ⅐ OH, a more reactive oxygen radical, via the Fenton reaction (5). Vagal sensory receptors are known to play an important role in detecting the onset of pathophysiological conditions and are responsible for triggering defensive or protective airway reflexes (8, 29, 39).While abundant information suggests the importance of reactive oxygen species in producing pulmonary pathophysiological consequences (4), very few studies have investigated their role and mechanism in eliciting airway reflexes.The concept that reactive oxygen species may stimulate pulmonary sensory receptors and play a vital role in eliciting airway reflexes is considerably new (29). This concept is indirectly supported from findings that vagally mediated airway reflexes evoked by inhaled cigarette smoke (27), inhaled wood smoke (22), or pulmonary air embolism (6) and responses of vagal sensory receptors to the latter two insults (7,24,25) are greatly attenuated b...

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Nasopharyngeal carcinoma (NPC) is relatively rare in Western countries but is a common cancer in southern Asia. Many differentially expressed genes have been linked to NPC; however, how to prioritize therapeutic targets and potential drugs from unsorted gene lists remains largely unknown. We first collected 558 upregulated and 993 downregulated NPC genes from published microarray data and the primary literatures. We then postulated that conversion of gene signatures into the protein-protein interaction network and analyzing the network topologically could provide insight into key regulators involved in tumorigenesis of NPC. Of particular interest was the presence of cliques, called fully connected subgraphs, in the inferred NPC networks. These clique-based hubs, connecting with more than three queries and ranked higher than other nodes in the NPC protein-protein interaction network, were further narrowed down by pathway analysis to retrieve 24 upregulated and 6 downregulated bottleneck genes for predicting NPC carcinogenesis. Moreover, additional oncogenes, tumor suppressor genes, genes involved in protein complexes, and genes obtained after functional profiling were merged with the