Kato T.,Osaka University |
Mikami A.,Osaka University |
Sugita H.,Osaka Kaisei Hospital |
Muraki H.,Osaka Kaisei Hospital |
And 3 more authors.
Sleep and Breathing | Year: 2013
Objectives: Prior to oral appliance therapy for snoring and obstructive sleep apnea syndrome (OSAS), patients are screened for jaw symptoms (e.g., pain). However, the presence of jaw symptoms in a large spectrum of OSAS patients remains unknown. This study aimed to assess the distribution of subjective jaw symptoms in patients with symptoms of OSAS. Methods: Five hundred and eleven consecutive patients (66 female, 445 male; mean age 49.6 ± 12.6 years) with clinical symptoms of OSAS were enrolled for cardiorespiratory evaluation. Self-administered questionnaires were used to assess jaw symptoms, tooth grinding and clenching during sleep, morning oral dryness, morning heartburn sensation, and pain in the neck and back. Results: The mean apnea-hypopnea (AHI) index was 32.5 ± 30.6 per hour of sleep. Nineteen percent of patients (n = 96) reported at least one jaw symptom. The presence of jaw symptoms was more frequently reported by patients with AHI less than 15 (25 %) than those with AHI of 15 and more (15 %, p = 0.012). In the crude analyses, jaw symptoms were associated with tooth grinding, tooth clenching, morning oral dryness, morning heartburn sensation, and neck/back pain. Multiple logistic regression analysis confirmed that jaw symptoms were associated with AHI less than 15 (odds ratio (OR) 1.99, p = 0.009), tooth clenching (OR 1.79, p = 0.006), morning oral dryness (OR 2.17, p = 0.02), and neck/back pain (OR 1.99, p = 0.005). Conclusions: Jaw symptoms can be found in 19 % of patients with symptoms of OSAS and are more frequently reported in patients with lower AHI, a patient population for whom oral appliances are often prescribed. © 2012 Springer-Verlag.
Sato T.,Tokoha University |
Sato N.,Hamamatsu University School of Medicine |
Masui K.,Osaka Kaisei Hospital |
Hirano Y.,University of Shizuoka
Journal of Manipulative and Physiological Therapeutics | Year: 2014
Objective: The purpose of this study was to investigate the immediate effects of manual traction of the hip joint on joint space width (JSW) on asymptomatic subjects.Methods: Asymptomatic, healthy male volunteers (n = 15), aged 25 to 34 years were included in this study. Three radiographs were obtained with the subjects in the supine position, before and after loading with 10% of his body weight, and after manual traction on only the right hip joint. Joint space width was measured by a radiologist at the point described by Jacobson and Sonne-Holm.Results: There were significant changes in JSWon the right hip joint and left hip joint between the baseline (before loading) and immediately after loading. We also observed a significantly increased JSW on only the right hip joint between periods that followed loading and manual traction on the right hip joint. There was no significant change in JSW on the left hip joint between periods that followed loading and manual traction on the right hip joint.Conclusions: The results of this study suggest that a significant increase in JSW in young, healthy male patients can occur immediately after manual traction of the hip joint. © 2014 by National University of Health Sciences.
Mizutani K.,Osaka Kaisei Hospital |
Oda Y.,Osaka City University |
Sato H.,Hyogo College of Medicine
Journal of Anesthesia | Year: 2011
A 24-year-old man underwent surgery for a fractured left clavicle and received an interscalene brachial plexus block for intraoperative and postoperative analgesia. After injection of 40 ml 0.5% ropivacaine and confirmation of analgesia, general anesthesia was induced and maintained with propofol. Although the operation was completed uneventfully, the patient was restless and there was limb twitching during emergence from anesthesia. Ropivacaine-induced toxicity was suspected, and a dose of 100 ml 20% lipid emulsion was infused intravenously. The symptoms of toxicity disappeared, and there was full recovery of consciousness within 5 min. Plasma concentrations of total and protein-unbound ropivacaine measured 2 h 20 min after local injection were 1.99 and 0.13 μg/ml, respectively. After infusion of lipid emulsion, the ropivacaine concentrations decreased to 1.72 and 0.05 μg/ml, respectively. The patient had no pain, and neurological examination revealed sensory loss around the clavicle. The patient was discharged without any complications. © 2011 Japanese Society of Anesthesiologists.
Tsuboi T.,National Hospital Organization Minami Kyoto Hospital |
Oga T.,Kyoto University |
Sumi K.,National Hospital Organization Minami Kyoto Hospital |
Machida K.,National Tokyo Hospital |
And 2 more authors.
Respiratory Care | Year: 2014
BACKGROUND: The significance of changes in PaCO2 during long-term noninvasive ventilation (NIV) on prognosis remains unclear. We aimed to clarify whether stabilizing PaCO2 during NIV had a favorable prognostic effect. METHODS: Data from 190 subjects with restrictive thoracic disease and who received long-term NIV were studied retrospectively. The annual change in PaCO2 during NIV was determined using a simple linear regression method for each subject who had at least 4 6-month intervals of PaCO2 data. Annual changes in PaCO2 during long-term NIV and possible confounders were analyzed with discontinuation of long-term NIV as the main outcome. RESULTS: One hundred and twenty-five subjects who had > 4 6-month intervals of PaCO2 data were included in the study. PaCO2 during long-term NIV decreased in 41 subjects (group 1; < 0 mm Hg/y), increased slightly in 42 subjects (group 2; between 0 and 1.85 mm Hg/y), and increased significantly in 42 subjects (group 3; > 1.85 mm Hg/y). Smaller annual changes in PaCO2 (P <.001) and a control ventilator mode (P =.008) were associated with a significantly higher probability of continuing NIV, compared with decreased PaCO2 3–6 months after the start of long-term NIV (P =.11). The 10-y probability of continuing NIV was 69% in group 1, 39% in group 2, and 12% in group 3. CONCLUSIONS: A decrease in the annual change of PaCO2 during long-term NIV was shown to be a significantly prognostically favorable factor. Efforts to reduce PaCO2 should be made if PaCO2 increases at a greater rate during long-term NIV. © 2014 Daedalus Enterprises.
Mohri I.,Osaka University |
Kato-Nishimura K.,Osaka University |
Kato-Nishimura K.,Osaka Kaisei Hospital |
Kagitani-Shimono K.,Osaka University |
And 4 more authors.
Sleep Medicine | Year: 2012
Objective: We conducted a retrospective chart review of children with restless legs syndrome (RLS) to evaluate the efficacy of oral iron treatment, which was administered open-label during the course of clinical care. In addition, we provided detailed clinical information about RLS in this pediatric cohort. Patients and methods: The study included 30 consecutive Japanese children with RLS who visited the Pediatric Sleep Clinic at Osaka University Hospital, and consisted of 17 boys and 13 girls, aged 2-14. years (mean. ±. SD, 6.5. ±. 2.8). All-night polysomnography was performed in 18 patients and serum ferritin levels were measured in all the patients. After the diagnosis of RLS, iron was administered at doses between 1.6 and 7.8. mg/kg/day (3.2. ±. 1.3). Serum ferritin was re-evaluated 3-6. months after iron treatment, or when RLS symptoms had disappeared. Results: The patient age at onset of RLS symptoms ranged from six months to 13. years (4.3. ±. 3.6). A positive family history was recognized in 19 children (63.3%). Serum ferritin levels before therapy were 9-62. ng/ml (26.6. ±. 12.8) and oral iron supplementation was reported to be highly effective in 17 children, effective in 10, and ineffective in three. The serum ferritin level at follow-up was 23-182. ng/ml (83.5. ±. 49.8). The onset of treatment effect was within approximately three months. Conclusions: Iron treatment could be effective in Japanese pediatric RLS. © 2012 Elsevier B.V.
PubMed | Hyogo College of Medicine, Osaka Hospital of Japan Community Healthcare Organization and Osaka Kaisei Hospital
Type: Clinical Trial | Journal: International journal of molecular sciences | Year: 2016
The restoration of innate immune responses has potential as a novel therapeutic strategy for chronic hepatitis C (CHC). We compared the efficacy and safety of induction therapy (IT) with natural interferon- (n-IFN-) followed by pegylated-IFN-/ribavirin (PR) alone (group A, n = 30) and IT with a protease inhibitor (PI) (simeprevir or vaniprevir)/PR (group B, n = 13) in CHC patients with genotype 1b and high viral loads. During IT with nIFN-, virologic response rates in group A and group B were 10% and 8% (p = 0.6792) at week 4, 30% and 16% (p = 0.6989) at week 12 and 47% and 20% (p = 0.0887) at week 24 respectively. During and after the treatment with PR alone or PI/PR, virologic response rates in groups A and B were 50% and 82% (p = 0.01535) at week 4, 53% and 91% (p = 0.006745) at week 8, 57% and 91% (p = 0.001126) at week 12, 57% and 100% (p < 0.001845) at the end of the treatment and 57% and 80% (p < 0.005166) after treatment cessation. IT with PI/PR linked to the restoration of innate immune response was tolerated well, overcame virological breakthrough, enhanced early virologic responses, and resulted in a sustained virologic response in difficult-to-treat CHC patients. IT with PI/PR is beneficial for treating difficult-to-treat CHC patients.
PubMed | Tottori University and Osaka Kaisei Hospital
Type: Journal Article | Journal: Auris, nasus, larynx | Year: 2016
The aim of this report is to evaluate the effects of voice rehabilitation with a voice prosthesis in a young patient with thyroid cancer. A 17-year-old girl underwent voice restoration with a voice prosthesis after laryngectomy to treat thyroid cancer. She completed voice-related questionnaires (the Voice Handicap Index-10 and Voice-Related Quality Of Life Survey) at ages 17 and 21 and underwent phonetic functional evaluation. The sound spectrograms of her phonation using the voice prosthesis showed low frequency sounds without an obvious basic frequency. She was ashamed of her hoarse voice and did not use her voice prosthesis during high school. However, after beginning to work at age 20, she used her voice to communicate in the workplace. At age 21, her questionnaire scores, especially those related to the physical and functional domains, improved compared with those at age 17. Voice restoration with a voice prosthesis is recommended for young patients who undergo laryngectomy for advanced thyroid cancer. The advantages of voice restoration with a voice prosthesis may increase when the patient reaches working age, and it may improve post-laryngectomy quality of life considerably.
PubMed | Osaka Medical College and Osaka Kaisei Hospital
Type: Journal Article | Journal: Japanese journal of ophthalmology | Year: 2016
To evaluate the clinical findings and original treatment method of granulation tissue formation post silicone intubation (SI) for primary acquired lacrimal drainage obstruction (PALDO).This retrospective, consecutive, comparative, interventional case series study involved 85 consecutive PALDO patients treated by SI and followed by dacryoendoscopy for 12 months post surgery. Patients in whom complication by granulation tissue formation occurred were treated every 2weeks until it disappeared with an injection of prednisolone acetate ophthalmic ointment into the lacrimal duct without removing the tube. The frequency of granulation tissue formation post SI, relationship between the locations where the primary obstruction and granulation tissue formation occurred, and impact of the complication on the surgical outcome were evaluated.Granulation tissue formation occurred in 9 of the 85 cases (10.6%) at 2-8weeks post surgery, yet disappeared via treatment during that same period. No relationship was found between the location of the primary obstruction and the granulation tissue formation, and no statistical difference was found when comparing the success rate of our surgical treatment in patients with or without the complication (P=0.46, Fishers exact test).Complication by granulation tissue formation occurred in 10.6% of the patients who underwent SI for PALDO, yet the injection of prednisolone acetate ophthalmic ointment into the lacrimal passage may have successfully treated the complication without removal of the silicone tube.
PubMed | Osaka Medical College and Osaka Kaisei Hospital
Type: Comparative Study | Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie | Year: 2016
To evaluate the effect of the postoperative administration of rebamipide ophthalmic suspension on the success rate of lacrimal stent intubation (LSI) for the treatment of primary acquired nasolacrimal duct obstruction (PANDO).This comparative interventional cohort study investigated 110 consecutive patients with PANDO who were treated with LSI and followed up for 12 months postoperatively at one institution. LSI was performed by one surgeon, and all patients received identical postoperative care. Among the total 110 patients, 71 underwent LSI with postoperative administration of rebamipide ophthalmic suspension, and 39 underwent LSI without administration of the suspension. Data related to patient age, gender, laterality, and postoperative administration of rebamipide ophthalmic suspension were collected and used as independent variables, and logistic regression analyses were performed to compare the anatomical success rate at 12 months postoperatively between patients with and without postoperative administration of the suspension.The anatomical success rate of LSI in patients with and without postoperative administration of rebamipide ophthalmic suspension was 90.1 and 69.2%, respectively. A comparison of these success rates showed statistical significance, in that the rate of treatment success was higher in PANDO patients who underwent LSI with postoperative administration of the suspension [odds ratio (OR), 3.37; P<0.05].The findings of this study show that postoperative administration of rebamipide ophthalmic suspension increases the rate of anatomical success in patients who undergo LSI for the treatment of PANDO.
PubMed | Osaka Medical College and Osaka Kaisei Hospital
Type: Journal Article | Journal: Case reports in ophthalmology | Year: 2016
Congenital uveal colobomas, including inferior iris and choroidal colobomas, are associated with microcornea and microphthalmia and often show left-right differences (laterality). The purpose of this study was to report a case of choroidal coloboma associated with left-right differences in diabetic retinopathy (DR).This study reports a 59-year-old male with bilateral iris and choroidal colobomas. The colobomatous area in the patients right eye extended to the macula, and his right eye had been amblyopic since birth. The colobomatous area in his left eye was less extensive and did not involve the macula. Examination of the patients left eye revealed multiple hemorrhages and hard exudates in the macula due to DR, but examination of his right eye showed almost no changes in DR, thus revealing a marked left-right difference. Optical coherence tomography showed more extensive retinal thinning in the patients right eye than in his left eye. Fluorescein fundus angiography revealed a retinal nonperfusion area only in the left eye, and panretinal photocoagulation was subsequently performed.Our findings show that the reason for the left-right difference in DR was attributed to the more severe choroidal coloboma and retinal thinning in the patients right eye compared to his left eye, thus reducing oxygen demand, as is also seen in eyes with severe myopia.