Deglutitive tongue movement after correction of mandibular protrusion: A pilot study

Objective:To investigate any change in deglutitive tongue movement following the correction of malocclusion by orthognathic surgery.Materials and Methods:The subjects were nine patients with mandibular protrusion. A control group consisted of 10 individuals with a similar age range and normal occlusion. Swallowing events before and after mandibular setback via sagittal split ramus osteotomy were recorded by cineradiography, and the tongue movement was analyzed. Time and linear measurements were compared before and after surgical treatment by the Wilcoxon signed rank test; control and test subjects were compared with the Mann-Whitney U-test.Results:Tongue-palate contact and the tongue-tip position changed after orthognathic surgery and became similar to those of the controls. Movements of the anterior and middorsal regions of the tongue did not change after orthognathic surgery and remained different from those of the controls.Conclusion:Our findings suggest that tongue-palate contact and tongue-tip position during deglutition adapted to the corrected oral and maxillofacial morphology, but the anterior and middorsal regions of the tongue during deglutition may have been affected by pharyngeal constrictors rather than by the oral and maxillofacial morphology.     

Early abnormality detected by speckle-tracking echocardiography in a patient with suspected cardiac sarcoidosis

A 56-year-old female was admitted to our hospital because of respiratory symptoms. Her admission ECG showed normal sinus rhythm and standard echocardiographic evaluation showed no structural or functional abnormalities. She was diagnosed as having sarcoidosis by imaging modalities and mediastinum lymph node biopsy. In this case, 2-dimensional speckle-tracking echocardiography (STE) demonstrated abnormal regional myocardial function and delayed enhancement cardiac magnetic resonance imaging revealed a high intensity area in the same segments. This case suggests that STE is potentially useful for the detection of cardiac sarcoidosis in the early phase.     

Dose-related effects of direct hemoperfusion using a cytokine adsorbent column for the treatment of experimental endotoxemia

Objective To clarify the dose-related effects of direct hemoperfusion using a cytokine adsorbent column (CTR) on the mortality and inflammatory responses to endotoxin-induced shock in rats. Design Prospective and randomized study. Setting University research laboratory. Subjects Male Wistar rats. Interventions Forty-eight rats were injected intravenously with Escherichia coli endotoxin (15 mg/kg over 2 min), and then were randomly allocated to one of the following four groups (n = 12 per group): control group, treated without CTR for 120 min; quarter-dose treatment group, treated with CTR 0.25 ml for 120 min; half-dose treatment group, treated with CTR 0.50 ml; and full-dose treatment group, treated with CTR 1.0 ml. Measurements and results Hemodynamics and arterial blood gases were recorded, and mortality and plasma cytokine concentrations were calculated for the 8-h observation period. The mortality rates 8 h after endotoxin injection were 92%, 58%, 42% and 17% for the control column, quarter-dose, half-dose, and full-dose CTR groups, respectively. The increases in plasma cytokine concentrations were smaller in the half-dose and full-dose CTR treatment groups than in the endotoxemic group. Conclusions The present study showed that CTR treatment dose-dependently decreased the mortality rate and inhibited inflammatory responses in vivo. There was no supported funding in this study.     

Perioperative changes in plasma antithrombin activity and platelet counts in patients undergoing gynecologic surgery

The relationships among perioperative changes in plasma antithrombin (AT) activity, platelet counts, and clinical risk factors for postoperative thromboembolism has not been studied extensively in gynecologic patients. AT activity and platelet counts were determined preoperatively and on postoperative days 1 and 7 in 74 patients who underwent gynecologic surgery. The relationships between each clinical risk factor for postoperative thromboembolism and the decrease in AT activity and platelet count were analyzed using a univariate logistic regression model. No clinically significant thromboembolism occurred in any patient. AT activity and platelet counts decreased significantly on postoperative day 1 and exceeded preoperative levels on day 7. Postoperative patients with malignancy were more likely to exhibit decreased AT activity. AT activity decreased significantly with increases in operating time and blood loss. Known risk factors for postoperative thromboembolism did not appear to be associated with postoperative decreases in platelet counts. Transient hyperconsumption of AT and platelets occurs immediately after gynecologic surgery. Surgery-induced AT deficiency may contribute to postoperative thromboembolism in patients with long operating times and significant blood loss.