Craniofacial anatomical risk factors in men with obstructive sleep apnea and heart failure: a pilot study

Purpose

Obstructive sleep apnea (OSA) is complicated with heart failure (HF); however, the reason for this is not well understood. Craniofacial anatomic risk factors may contribute to OSA pathogenesis in HF patients. However, there are no data about cephalometric findings among OSA patients with HF.

Methods

Consecutive patients with HF and OSA (defined as total apnea–hypopnea index (AHI) ≥15/h) were enrolled. As controls, OSA patients without HF but matching the test group in age, BMI, and obstructive AHI were also enrolled.

Results

Overall, 17 OSA patients with HF and 34 OSA patients without HF were compared. There are no significant differences in the characteristics or polysomnographic parameters between 2 groups. In the cephalometric findings, compared with patients without HF, patients with HF showed a significantly greater angle between the line SN to point “A” (SNA) and a longer inferior airway space and greater airway area. However, the tongue area of patients with HF was more than those without HF.

Conclusions

The craniofacial structures of OSA patients with HF were different from those without HF. OSA patients with HF had an upper airway anatomy that is more likely to collapse when sleeping while recumbent, despite having a larger airway space.     

经睫状体平坦部行颞上或鼻下Baerveldt青光眼植入术的短期临床疗效比较

目的:研究并探讨Baerveldt青光眼植入术(BGI)的不同植入部位对眼压(IOP)的影响。方法:对日本Toho大学Sakura医疗中心接受BGI治疗的新生血管性青光眼的病例进行回顾性分析。所有患者分为两组:颞上植入组(16例患者18眼,其中男性13例,女性3例;平均年龄62.9±14.4岁)和鼻下植入组(15例患者17眼,其中男性11例,女性4例;平均年龄56.9±10.7岁)。术后12mo随访复查。比较两组术后12mo与术前相比的眼压降低率。结果:颞上植入组:术前平均IOP为31.1±10.0 mmHg,术后平均IOP为14.4±4.5 mmHg;鼻下植入组:术前平均IOP为34.9±9.7 mmHg,术后平均IOP为15.9±3.7 mmHg。颞上植入组IOP降低率为(50.0±19.0)%,鼻下植入组降低率为(51.2±16.3)%。两组间无显著统计学差异(t-test,P=0.590)。结论:经睫状体平坦部行颞上或鼻下BGI的短期临床疗效无差异。     

Assessment of the differences in the short-term clinical outcomes of superotemporal and inferonasal Baerveldt glaucoma implantation surgeries performed via the pars plana route

AIM: To investigate and discover whether different insertion areas for Baerveldt glaucoma implant (BGI) surgery produce different outcomes in terms of the reduction of intraocular pressure (IOP). METHODS: This retrospective study involved the review of cases of patients admitted at Toho University Sakura Medical Center, who underwent BGI surgery via the pars plana route for the treatment of neovascular glaucoma. The patients were divided into two groups: the superotemporal insertion group [18 eyes in 16 subjects (13 males, 3 females; mean age 62.9±14.4y)] and the inferonasal insertion group [17 eyes in 15 subjects (11 males, 4 females; mean age 56.9±10.7y)]. The patients were followed up and re-evaluated at 12mo. The IOP reduction rate 12mo after surgery relative to preoperative IOP was compared between the two groups. RESULTS: The mean preoperative IOP was 31.1±10.0 mm Hg and postoperative IOP was 14.4±4.5 mm Hg in the superotemporal group, whereas for the inferonasal group, the mean preoperative IOP was 34.9±9.7 mm Hg and postoperative IOP was 15.9±3.7 mm Hg. The IOP reduction rate of the superotemporal group was 50.0%±19.0% and that of the inferonasal group was 51.2%±16.3%. There was no significant correlation between the two groups (Student’s t-test, P=0.590). CONCLUSION: There was no difference in the short-term clinical outcomes between superotemporal and inferonasal BGI performed via the pars plana route.     

SCAPHOLUNATE DISSOCIATION CAUSED BY GOUTY ARTHRITIS OF THE WRIST: Case report

Gouty arthritis of the wrist is rare, and may be associated with scapholunate dissociation. To our knowledge, only two cases have been reported so far. In this report, we describe a 40-year-old patient with scapholunate dissociation caused by acute gouty arthritis of the wrist. His clinical findings and radiographs mimicked infectious arthritis or osteomyelitis of the carpal bones.     

Sex differences in clinical outcomes in Japanese incident dialysis patients: a prospective observational multicenter study

Clinical and Experimental Nephrology - A Dialysis Outcomes and Practice Patterns Study (DOPPS) has shown a one-to-one male-to-female mortality ratio, notwithstanding the statistically longer life...     

Effect of <Emphasis Type="Italic">Kaempferia parviflora</Emphasis> extract on knee osteoarthritis

Knee osteoarthritis (OA) is becoming more prevalent worldwide due to increases in the numbers of elderly and obese patients. Currently, pharmaceutical medicines used for the treatment of OA are for symptomatic therapy and therefore new therapeutic agents are needed. Kaempferia parviflora (KP) is a plant growing naturally in Southeast Asia and has various pharmacological effects including an anti-inflammatory effect, but no effect on OA has yet been reported. We therefore conducted a search for the effects KP and the active components of KP extract (KPE) exert on OA as well as its mechanism of action. Results from a study of KPE using the monoiodoacetic acid rat OA model revealed that KPE reduced the pain threshold and severity of osteoarthritic cartilage lesions. The mechanism of action and active components were then investigated using IL-1β-treated human knee-derived chondrocytes. KPE, as well as 5,7-dimethoxyflavone and 5,7,4′-trimethoxyflavone, which are key constituents of KPE and highly absorbable into the body, reduced the expression of matrix metalloproteinases (MMPs), which are the main extracellular matrix enzymes that degrade collagen within cartilage. As mentioned above, KPE acted to suppress OA and 5,7-dimethoxyflavone and 5,7,4′-trimethoxyflavone were shown to be involved as part of KPE’s mechanism that inhibits MMPs.