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41.
42.
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
43.
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
44.
S Nishijima T Sugimachi T Higashida Y Asada K Okuda K Murata 《The Journal of dermatology》1992,19(6):356-361
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important causative microorganisms for nosocomial infections. Recently, the incidence of isolation of MRSA has been increasing every year in Japan and is, notably, much more frequently found in inpatients than in outpatients. Therefore, we have done epidemiological studies of MRSA isolated from medical staff, inpatients, and the hospital environment in one ward of our hospital. Thereafter, we examined the antibiotic susceptibility (ABPC, DMPPC, CET, CMZ, IPM, GM, MINO, OFLX, EM, CLDM, VCM), phage typing, and coagulase typing of these MRSA. MRSA were isolated more frequently from anterior nares of inpatients than from doctors and nurses. MRSA were isolated more frequently from the environment near carriers of MRSA. Coagulase type II and phage type N.T. (not typable) were the dominant types of MRSA in our hospital (69% and 61%). MRSA strains were resistant to most antibiotics with a few exceptions (VCM, IPM, CMZ, CET). The high isolation frequency of MRSA in our hospital seems to suggest that inpatients who are carrying MRSA spread MRSA throughout the hospital environment and that the anterior nares of inpatients are the major MRSA harbor. 相似文献
45.
T Kiyama M Onda A Tokunaga I Fujita T Okuda T Mizutani T Yoshiyuki Y Shimizu K Nishi N Matsukura 《Gastroenterologia Japonica》1992,27(4):459-465
Seven human gastric cancer xenografts with different concentrations of EGF receptor were established in nude mice. The expression of EGF receptor in the tumors was demonstrated by Western blotting with anti-EGF receptor antibody, binding assay with 125I-EGF and immunohistochemistry with anti-EGF receptor antibody. Western blotting revealed EGF receptor doublet bands at molecular masses of 150 KDa and 170 KDa in all of the samples. The concentration of 125I-EGF binding activity in the tumors ranged from 36.0 to 11,000 fmol/mg protein, with a mean of 345 fmol/mg protein. EGF receptor was also demonstrated immunohistochemically on the apical border of the glands and the cell membrane of the tumor cells. There seemed to be a close correlation between the concentration of 125I-EGF binding activity and the doubling time of these tumors in nude mice (gamma = -0.68). However, no definite correlation was observed between EGF ligand binding and histological features of intestinal type or diffuse type. The expression of EGF receptor appears to facilitate the growth of human gastric cancer xenografts in nude mice. 相似文献
46.
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
47.
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
48.
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
49.
Sarcomas were induced in Fl mice between C57BL/6N and C3H/He strains by subcutaneous injection of methylcholanthrene. The c-myc oncogene was found to be amplified in 16 cases among 43 sarcomas of C57BL/6N × C3H/He mice and 1 case among 5 sarcomas of the reciprocal cross. The origin of the amplified allele was determined by the polymerase chain reaction single strand conformation polymorphism analysis. Among the 17 sarcomas, only one had both of the alleles amplified. The rest of the tumors carried the amplified c-myc allele coming either from C57BL/6N (9 cases) or from C3H/He (8 cases). These results indicate that the c-myc allele is amplified randomly in methylcholanthrene-induced mouse sarcomas irrespective of its origin, such as paternal or maternal allele and C57BL/6N or C3H/He allele. In addition to these changes, the unamplified c-myc oncogene was found to be lost in 12 cases out of the 17 sarcomas with the amplification. 相似文献
50.
S. H. Kim J. W. Milsom J. M. Church K. A. Ludwig A. Garcia-Ruiz J. Okuda V. W. Fazio 《Surgical endoscopy》1997,11(10):1013-1016
Background: Because of the inability to palpate colonic tumors during laparoscopy, their location must be precisely identified before
resection is undertaken.
Method: A retrospective study was performed of 58 patients in order to be able to describe our methods of tumor localization for
laparoscopic colorectal operations and to review their effectiveness.
Results: In all patients, the entire colon was examined preoperatively by colonoscopy. In one patient, preoperative colonoscopic localization
was inaccurate. In 31 patients, tumors were easily detectable at surgery. In five patients with the tumor in the right colon,
even though the lesion was not detectable at surgery, right colectomy was performed without marking because preoperative colonoscopy
reliably identified the lesion adjacent to the ileocecal valve. Twenty-two patients required some type of procedure to localize
the tumor. The procedures and their problems were as follows: preoperative tattoo (five)—tattoo not visualized (one); intraoperative
colonoscopy alone (six), combined with intraoperative tattoo (four) or clip (three)—poor operative exposure due to bowel distension
(nine), hard to see the clip (three), dislodged clip (two), inadequate resection margin (one); intraoperative proctoscopy
alone (two), combined with laparoscopic stitch (two)—no problems. In no patient was tumor present at a resection line and
in no patient was the wrong segment resected.
Conclusions: Reliable preoperative identification of the tumor adjacent to the ileocecal valve can permit right colectomy without marking.
Lesions in the upper rectum can be approached via intraoperative proctoscopy ± suture placement. If the surgeon anticipates
intraoperative localization may be difficult, lesions other than rectal or cecal ones should probably be marked by preoperative
tattooing. Further studies regarding the technique of tattooing are warranted.
Received: 18 July 1996/Accepted: 10 March 1997 相似文献