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51.
The effect of oral appliance therapy on blood pressure in patients with obstructive sleep apnea 总被引:1,自引:1,他引:0
Ryo Otsuka Fernanda Ribeiro de Almeida Alan A. Lowe Wolfgang Linden Frank Ryan 《Sleep & breathing》2006,10(1):29-36
The objective of the study was to investigate the effects of oral appliance (OA) therapy on ambulatory blood pressure in patients
with obstructive sleep apnea (OSA). Eleven OSA patients who received OA therapy were prospectively investigated. Ambulatory
blood pressure was measured for 20 h from 4:00 p.m. to 12:00 noon the next day using an ambulatory blood pressure monitor. The Respiratory Disturbance Index (RDI) was measured
in the pretreatment and posttitration periods. The OA was titrated to reach a therapeutic jaw position over 2 to 8 months,
and posttitration measurements were repeated. At posttitration, the RDI was significantly decreased from a mean (SD) of 24.7
(20.1) to 6.1 (4.5). Significant reductions in diastolic blood pressure (DBP) and mean arterial pressure (MAP) were found
for the 20-h periods, and systolic blood pressure (SBP), DBP, and MAP while asleep. The mean values were 79.5 (5.5) to 74.6
(6.0) for DBP and 95.9 (5.4) to 91.2 (5.9) for MAP, for over a 20-h period, and 118.4 (10.0) to 113.7 (9.1) for SBP, 71.6
(8.0) to 67.2 (7.9) for DBP, and 88.4 (8.0) to 83.9 (7.5) for MAP, while asleep. This study suggests that successful OSA treatment
with an OA may also be beneficial to lower blood pressure in OSA patients, as previously suggested for nasal continuous positive
airway pressure therapy.
This study was conducted in the Division of Orthodontics, The University of British Columbia, Canada 相似文献
52.
Toshiji Ishiwata Ryo Koyama Noriyuki Homma Mitsuhiro Fujii Naoko Iwakami Yuta Nakao Shin-ichiro Iwakami Kazuhisa Takahashi 《Nihon Kokyūki Gakkai zasshi》2006,44(10):749-753
A 28-year-old man complaining of myiodesopsia was given a diagnosis of uveitis. Subsequently he complained facial nerve palsy and enlargement of parotid gland. Heerfordt's syndrome was diagnosed based on the results of several examinations. Facial nerve palsy, enlargement of the parotid gland and uveitis were improved by systemic corticosteroid therapy. At present he is receiving systemic corticosteroid therapy, but numbness in the mouth, thought to be the involvement of the trigeminal nerve, remains. Systemic corticosteroid therapy is usually effective for most cases with Heerford's syndrome. On the other hand, there are some cases with the prolonged peripheral nerve involvement despite systemic corticosteroid therapy, as seen in this case. If peripheral nerve involvement is prolonged, it is necessary to consider small-fibre neuropathy as one possible cause. 相似文献
53.
We reported double-dissociation between the visual processing of the edges and the surfaces of objects. Patients with lateral occipital damage showed selective impairment in the perception of edges whereas those with medial ventral occipital damage showed selective impairment in the perception of the 3D structure of the surface. Patients with medial ventral occipital damage also exhibited impaired perception of color, which is also a surface property. Those results were consistent with those from neuroimaging studies. Taken together, those studies suggest that objects may be processed in two separate pathways in the ventral occipital cortex: the edges of objects are processed in the lateral pathway and the surface of objects are processed in the medial pathway. Both edges and surfaces play important roles in object recognition, and both types of perception should be evaluated in patients with visual agnosia. 相似文献
54.
Yasuo Ito Yoshihiko Nakazato Ryo Tomioka Naotoshi Tamura Kunio Shimazu 《Clinical neurology》2007,47(8):512-515
We present a suspicious case of central neurosarcoidosis that presented with progressive gait disturbance probably caused by central vestibular dysfunction. And this case showed elevated level of angiotensin converting enzyme (ACE) in the cerebrospinal fluid, compared with the average level of two cases with acute inflammatory demyelinating neuropathy syndrome and four cases of multiple sclerosis. A 33-year-old man was admitted to our hospital with chief complaint of a gait disturbance that had appeared 3 years prior to the admission. And the symptom had exacerbated in these 3 months. Except for the gait disturbance and positive Romberg's sign, no neurological abnormality was detected. The findings of the cerebrospinal fluid test supported the diagnosis of meningitis. An increased level of angiotensine converting enzyme was detected when compared with our previous samplings from two cases of Guillain Barré syndrome and four cases of multiple sclerosis. With T1 weighted imaging of brain MRI, a high intensity lesion with gadolinium enhancement was identified in the central gray matter of the midbrain. Scan of the chest confirmed bilateral hilar lymphadenopathy. Based on these findings and the patient's clinical course, central neurosarcoidosis was suspected. The patient's symptoms improved dramatically after the administration of corticosteroid. The enhancement of the central gray matter ameliorated, and the ACE level of the CSF was decreased to the level of the demyelinating disorders. 相似文献
55.
Tomomi Iwashita Kazuo Kitazawa Jun-Ichi Koyama Hisashi Nagashima Toru Koyama Yuichiro Tanaka Kazuhiro Hongo Hiroshi Okudera Kazufumi Okamoto 《Journal of clinical neuroscience》2007,14(1):68-71
A patient with cerebral deep sinus thrombosis, which was not diagnosed on the first examination, is reported. A 46-year-old woman presented with headache and vomiting. Neurological examination and a brain computed tomography (CT) scan showed no obvious abnormal findings. The patient suffered disturbed consciousness on the day after the examination, and was admitted to our emergency centre. A CT scan and magnetic resonance imaging revealed an ischaemic lesion in the left basal ganglia, suggesting deep sinus occlusion. Anticoagulant therapy was administered. One day after admission, a CT scan showed a haematoma and severe brain swelling in the same region. Cerebral angiography demonstrated a straight sinus occlusion. Intracranial pressure was not controlled with hypothermia, and the patient died 25 days after admission. Review of the initial CT scan revealed subtle, early findings of deep venous thrombosis that were missed on first examination. 相似文献
56.
Mitsuo Miyazawa Takahiro Torii Yasuko Toshimitsu Katsuya Okada Isamu Koyama Yoshito Ikada 《American journal of transplantation》2005,5(6):1541-1547
The aim of this study was to fabricate an artificial bile duct for the development of a new treatment for biliary diseases. Eighteen hybrid pigs were implanted with a bile duct organoid unit (BDOU) made of a bioabsorbable polymer. Twelve of the transplanted BDOUs had been seeded with autologous bone marrow cells (BMCs) in advance. Six animals, the controls, were grafted with the scaffold alone with no BMCs seeded. The common bile duct was cut, the hepatic cut end of the native common bile duct was anastomosed to the BDOU and the other end was anastomosed to the duodenum. The controls underwent a similar operation. The neo-bile duct was removed at pre-determined time points and investigated histologically. All 18 recipient pigs survived until their sacrifice at 6 weeks, 10 weeks or 6 months. Histological examination revealed incomplete epithelialization of the neo-bile duct at 6 weeks and 10 weeks after transplantation. At 6 months, the organoid exhibited a morphology almost identical to that of the native common bile duct. No differences were found between the controls and BMC-seeded pigs. These results show that the artificial bile duct thus fabricated can serve as a substitute for the native bile duct. 相似文献
57.
Hitoshi Higuchi Shigeru Maeda Takuya Miyawaki Atsushi Kohjitani Takayuki Mori Ryo Ishida Masahiko Egusa Masahiko Shimada 《Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics》2007,103(3):e26-e29
Takotsubo cardiomyopathy (TCM) is a relatively new concept in cardiovascular disease. The clinical symptoms of TCM are similar to those of a myocardial infarction, but both the mechanism and the management of TCM are different from those of myocardial infarction. The cause of TCM is unclear, but it is suggested to occur in conjunction with excessive circulating catecholamines due to stress. Thus, control of the stress reaction and restriction of catecholamine levels are considered important for prevent of TCM onset. We report the dental management of a patient with intellectual disability who had anamnesis of TCM and cardiopulmonary arrest under restraint during a previous dental appointment in another dental clinic. We used intravenous sedation with both midazolam and propofol, by which the excessive hormonal reaction that caused TCM onset and cardiopulmonary arrest was controlled, for dental treatment in our facility. All planned dental treatment was then performed without any problems. 相似文献
58.
Takeshiro Fujii Yoshinori Watanabe Noritsugu Shiono Muneyasu Kawasaki Hiroki Yokomuro Tsukasa Ozawa Satoshi Hamada Hiroshi Masuhara Tetsuo Teramoto Masanori Hara Tomonori Katayanagi Yuki Sasaki Nobuya Koyama 《Annals of thoracic and cardiovascular surgery》2006,12(5):324-332
OBJECTIVE: To clarify the position of on-pump beating coronary artery bypass (CAB) and to define preoperative indicators of intentional conversion to the procedure in the era of advancement of off-pump CAB (OPCAB), we assessed on-pump beating CAB performed after the introduction of OPCAB. SUBJECTS AND METHODS: We assessed 130 patients who underwent single CAB [117 (90%) with OPCAB and 13 (10%) with on-pump beating CAB] between August 1999 (when OPCAB was selected as the first-line surgical procedure) and December 2004. RESULTS: No significant differences were seen between the groups in the number of coronary lesions or the prevalence of left main trunk (LMT) lesion. Reduced left cardiac function, cardiac dilatation, and mitral regurgitation (MR) were more remarkable in the on-pump beating CAB group. Preoperative ischemic condition was generally unstable in the both groups. A conversion to on-pump beating CAB occurred at anastomosis for the left anterior descending (LAD) branch in 61% and for the left circumflex (LCX) branch in 15%. LAD patients had more severe left cardiac dysfunction and cardiac dilatation than LCX patients. CONCLUSION: To perform safe and reliable CAB surgery, cardiovascular surgeons should define preoperative indicators of difficult OPCAB and convert OPCAB to on-pump beating CAB intentionally without hesitation when unstable hemodynamics is detected. 相似文献
59.
Patients with typical left unilateral spatial neglect bisected lines after cueing to the left end-point, the fixation point being monitored with an eye camera. They persisted with the point of initial fixation made after cueing and placed the mark there without searching leftwards again. The rightward shift of fixation to the initial point of fixation thus determined the location of the subjective midpoint. We consider that rightward attentional bias increased the amplitude of this shift that was planned on the basis of the perception of the whole line while cueing. This hypothesis may explain smaller but obvious rightward bisection errors found in the cueing condition. 相似文献
60.
Masahiro Nishihara Ryo Sumimoto Yasuhiko Fukuda James H. Southard Toshimasa Asahara Kiyohiko Dohi 《Surgery today》1997,27(7):645-650
In this study, we tested the effect of donor fasting with or without the use of an essential fatty acids deficiency (EFAD)
diet in the recipient using rat heart, pancreas, and liver transplant models. We then compared the survivals, tumor necrosis
factor alpha (TNF-α) response, and white cell accumulation in rats in order to clarify the mechanisms of the beneficial effect
of donor fasting and recipient EFAD. It was found that when the grafts were obtained from fasted donors and then transplanted
into fed recipients, the survival rate was significantly higher for all three grafts than for those obtained from fed rats
and transplanted into fed rats. The best survival was seen for pancreas grafts obtained from fasted donors and then transplanted
into EFAD recipients. TNF-α secretion was significantly suppressed in both fasted and EFAD rats, and both the total cell count
and neutrophil count were suppressed in EFAD rats. These results clearly indicate that in addition to liver grafts, both heart
and pancreas grafts obtained from fasted animals are more tolerant to warm ischemic injury. Furthermore, the combination of
donor fasting and recipient EFAD acts synergistically to inhibit the post-transplantation inflammatory reaction (through decreased
TNF-α secretion and white cell accumulation), thus resulting in an improved survival. 相似文献