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.     

Moderate-to-vigorous physical activity and the risk of stroke recurrence in patients with a history of minor ischemic stroke in Japan: a retrospective analysis

Background: Physical activity (PA) is beneficial for stroke prevention; in particular, moderate-to-vigorous physical activity (MVPA). However, few studies have investigated its relationship with recurrent ischemic stroke (RIS).

Objectives: To clarify the relationship between MVPA and RIS and the burden of risk factors after a first-ever ischemic stroke.

Methods: A total of 45 outpatients (mean age 67.1 ± 10.2 years) who had previously experienced a transient ischemic attack or a minor non-cardioembolic ischemic stroke at a single hospital in Japan (mean 6.4 ± 4.2 years previously), were enrolled between March and June 2016. All patients wore an accelerometer around their hips for 10 days, and their percentage body fat (%BF) and visceral fat level (VFL) were measured by bioelectrical impedance. Retrospective information about the history of RIS and risk factors (blood pressure, lipoprotein cholesterol and estimated glomerular filtration rate) were extracted from the clinical records. Binary logistic regression models were used to estimate the relevance of the RIS history to MVPA and potential risk factors such as sociodemographic and clinical variables (obesity, smoking and hypertension).

Results: RIS occurred in 9 patients; they had significantly higher VFL (p = 0.007) and %BF (p = 0.007) values and lower MVPA (p = 0.011) values than patients without recurrence. A multivariate analysis of these factors indicated that age, VFL and MVPA were signi?cant independent predictors of RIS.

Conclusions: Patients with a history of mild ischemic stroke had low MVPA and high VFL values, which together may be a risk factor for RIS.     

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.     

Effects of a calcium phosphate cement on mineralized nodule formation compared with endodontic cements

The aim of this study was to investigate mineralizing ability of a premixed calcium phosphate cement (premixed-CPC) compared to mineral trioxide aggregate (MTA) and zinc oxide eugenol cement (SuperEBA) in ROS17/2.8 cells. The measurements of cell proliferation, alkaline phosphatase (ALPase) activity and mineralized nodule formation in the presence or absence (control) of the test materials were performed using a cell culture insert method with the test materials placed on a porous membrane of culture plate insert. Mineralized nodules were detected by staining with alizarin red, and the calcium content of the mineralized nodules was determined quantitatively using a calcium assay kit. Premixed-CPC and MTA indicated significantly higher cell proliferation, ALPase activity, mineralized nodule formation, and calcium content in nodules than those of SuperEBA (p<0.05). The present results suggest that premixed-CPC has the same mineralizing ability as MTA.     

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...     

In vitro and in silico characterisation of Lactobacillus paraplantarum D2-1, a starter culture for soymilk fermentation

Soymilk contains several functional nutrients and is thus a promising ingredient for production of functional foods. The present research aimed to study starter properties, functional characteristics and safety of Lactobacillus paraplantarum D2-1, a promising starter culture for soymilk fermentation. Strain D2-1 actively fermented soymilk within 24?h but had weak activity of additional acid production after 7 d. Succinate and acetoin, which could be linked to flavour and taste, were accumulated in fermented soymilk. In vitro study revealed that the organism has several beneficial properties, including high survival ability in artificial gastric juice, high abilities of mucus adhesion and biofilm formation and production of γ-aminobutyric acid and conjugated linoleic acid, without any significant risks for consumption. Genome sequencing supported the desirable metabolic properties of the strain. These results indicate that L. paraplantarum D2-1 is a suitable starter for soymilk fermentation and is a promising probiotic candidate that can be used safely.     

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.