OBJECTIVE: To determine clinicians' patterns of use of the International Classification of Sleep Disorders (ICSD) and their ratings of its utility and organization. METHODS: A telephone survey was conducted in one clinician practicing at each of 206 sleep centers accredited by the American Academy of Sleep Medicine (AASM). Descriptive analyses were performed, and ratings for various sleep classifications were compared with ANOVA and post- hoc tests. RESULTS: Clinicians at 230/251 (92%) of contacted centers agreed to participate, and data from 206/251 (82%) were actually collected. The ICSD was used by 91.7% of clinicians for clinical decision making but by lower percentages for billing or medical record keeping. Features of the ICSD pertaining to clinical descriptions and differential diagnosis were rated as most useful. The Association of Sleep Disorders Centers (ASDC) classification was rated more highly than ICSD in organization and ease of use. The ICSD and ASDC systems were rated more highly than other sleep disorders classifications in terms of organization, "fit" to patients, and ease of use. CONCLUSIONS: The ICSD is used widely by clinicians, primarily for diagnostic purposes, and is preferred over more general sleep disorders classification systems. However, more favorable ratings for the ASDC compared to ICSD indicate the value clinicians place on easy-to-use, symptom-oriented classifications.

Adolescent↗

PubMed2003

Cell cycle-dependent regulation of structure of endoplasmic reticulum and inositol 1,4,5-trisphosphate-induced Ca2+ release in mouse oocytes and embryos.

The organization of endoplasmic reticulum (ER) was examined in mouse eggs undergoing fertilization and in embryos during the first cell cycle. The ER in meiosis II (MII)-arrested mouse eggs is characterized by accumulations (clusters) that are restricted to the cortex of the vegetal hemisphere of the egg. Monitoring ER structure with DiI18 after egg activation has demonstrated that ER clusters disappear at the completion of meiosis II. The ER clusters can be maintained by inhibiting the decrease in cdk1-cyclin B activity by using the proteasome inhibitor MG132, or by microinjecting excess cyclin B. A role for cdk1-cyclin B in ER organization is further suggested by the finding that the cdk inhibitor roscovitine causes the loss of ER clusters in MII eggs. Cortical clusters are specific to meiosis as they do not return in the first mitotic division; rather, the ER aggregates around the mitotic spindle. Inositol 1,4,5-trisphosphate-induced Ca(2+) release is also regulated in a cell cycle-dependent manner where it is increased in MII and in the first mitosis. The cell cycle dependent effects on ER structure and inositol 1,4,5-trisphosphate-induced Ca(2+) release have implications for understanding meiotic and mitotic control of ER structure and inheritance, and of the mechanisms regulating mitotic Ca(2+) signaling.

Animals↗