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Biomedical subjects

Y Itasaka

Publications and source records attributed to Y Itasaka.

At least 19 recordsLinked to original sources
PubMed2001

A trial study of RhinoSleep for the diagnosis of sleep apnea.

RhinoSleep was developed to diagnose obstructive sleep apnea (OSA). The RhinoSleep consists of a soft catheter, a measuring probe, and a computer. The soft catheter is inserted through the naris into the esophagus. The catheter is connected to the measuring probe, which creates and sends a continuous noise signal into the catheter. When the catheter is compressed during an obstruction, the sound reflections change, making it possible to identify both the level and the duration of the obstruction. Sixteen OSA patients were examined using RhinoSleep and daytime polysomnography simultaneously. With RhinoSleep, we successfully examined 13 cases. This trial study identified problems with RhinoSleep, such as vomiting of the catheter, hardware instability, and the criteria decision for the analysis of OSA.

Acoustics↗
PubMed2001

Comparison of Ricketts analysis and Downs-Northwestern analysis for the evaluation of obstructive sleep apnea cephalograms.

To determine which analysis is suitable to examine the dentofacial skeletal pattern characteristics of the obstructive sleep apnea syndrome (OSAS), we took lateral cephalograms of 44 Japanese OSAS patients and 34 Japanese non-OSAS controls. By Ricketts analysis, we found significant differences between OSAS patients and non-OSAS controls on facial axis, lower facial height and total facial height, which showed that Japanese OSAS patients have dolico facial patterns. However, by Downs-Northwestern analysis, we did not find any significant difference between OSAS patients and non-OSAS controls using the same cephalograms as the Ricketts analysis.

Adult↗
PubMed2001

Uvulopalatopharyngoplasty for obstructive sleep-related breathing disorders: one-year follow up.

The effectiveness of uvulopalatopharyngoplasty was evaluated in 28 patients (25 men and three women; mean age 47.6 years) with obstructive sleep apnea by comparing preoperative daytime polysomnography with those carried out 6 months and 1 year postoperatively. The mean apnea plus hypopnea index (AHI) in the supine position decreased from 51.0/h to 23.0/h 6 months postoperatively and 57.1% of patients showed a 50% or more reduction of AHI. By changing the sleep position from supine to lateral, 71.4% of the 28 patients indicated a 50% or more reduction in AHI before surgery, which increased to 92.3% of 26 patients 6 months postoperatively. The positive results of uvulopalatopharyngoplasty were maintained at least until 1 year after surgery.

Body Mass Index↗
PubMed2000

Influence of alcohol on respiratory disturbance during sleep.

Oxygen saturation was measured in 37 patients with sleep-related breathing disorders over 2 nights: after alcohol intake and under control conditions. Both the number of 3% oxygen desaturation per hour (ODI3) and the lowest saturation (LSAT) were significantly aggravated after alcohol ingestion. Oxygen saturation was degraded in 28 cases after alcohol intake. In 69% of the cases in which ODI3 increased after alcohol ingestion, the aggravation during the alcohol metabolism time was noted. No correlation was found between the quantity of alcohol and oxygen desaturation following alcohol ingestion. Our study revealed that alcohol aggravates sleep-related breathing disorders.

Adult↗
PubMed2000

Facial patterns of obstructive sleep apnea patients using Ricketts' method.

To analyze the facial patterns of obstructive sleep apnea syndrome (OSAS) patients, we took lateral cephalograms of 31 OSAS patients and 26 non-OSAS controls and utilized Ricketts' method. In addition, we measured the hyoid bone position, the length of mandibular plane to H-point, the length of soft palate, and lower pharynx. The facial patterns of OSAS patients were dolico, the hyoid bone was positioned low, the soft palate was longer and the width of the airway was narrower than that of the non-OSAS controls.

Adult↗
PubMed2000

The influence of sleep position and obesity on sleep apnea.

The influence of sleep position and the degree of obesity were examined in 257 subjects with sleep apnea. Subjects were divided into three groups according to obesity: normal weight (body mass index (BMI) under 24.0 kg/m2), mild obese (BMI 24.0-26.4 kg/m2) and obese group (BMI 26.4 kg/m2 and heavier). The apnea + hypopnea index (AHI), the intraesophageal pressure and the lowest oxygen saturation became significantly worse according to the degree of obesity. The subjects were also divided into two groups according to the reduction in the AHI by lateral position: good responders showed 50% or more reduction of AHI in lateral position and poor responders indicated less than 50% reduction. The percentage of good responders to sleep position change was 90.9% in normal weight group, 74.0% in mild obese group and 57.4% in the obese group. The ratio of the subjects who had indicated two or more obstructive sites in normal weight group was 36.0% in good responders and 40.0% in poor responders. The ratio in the mild obese group was 51.8% in good responders and 66.7% in poor responders. In the obese group, the ratio was 59.4% in good responders and 78.9% in poor responders.

Adult↗
PubMed1999

Intensity of snoring in patients with sleep-related breathing disorders.

The intensity of snoring was measured in 73 patients with snoring or sleep apnea using a noise meter. The mean intensity of snoring at 50 cm in front of the mouth was 61.7 dB in the supine position and 53.7 dB in the lateral position. There existed a definite correlation between the logarithmic transformation of the intra-esophageal pressure amplitude and the intensity of snoring in the supine and lateral decubitus positions. These findings suggest that the intensity of snoring may be a useful index for sleep-related breathing disorders.

Adult↗
PubMed1999

Evaluation of the auto continuous positive airway pressure efficacy by upper airway pressure measurement.

The efficacy of auto continuous positive airway pressure (CPAP) was prospectively evaluated in 11 obstructive sleep apnea cases by the upper airway pressure measurement. Their apnea plus hypopnea index decreased from 68.3+/-20.2/h to 0.5+/-0.9/h during manually adjusted and 9.6+/-14.5/h during auto CPAP The intraesophageal pressure decreased from -88.0+/-34.0 cm H2O to 11.9+/-7.2 cm H2O during manually adjusted and -26.0+/-13.7 cm H2O during auto CPAP. The manually adjusted CPAP level was 9.1+/-1.7 cm H2O and the maximum pressure of the auto CPAP was 9.4+/-2.0 cm H2O. Auto CPAP could automatically detect the optimal CPAP level. However, the efficacy of the auto CPAP was less than that of the manually adjusted CPAP.

Aged↗
PubMed1998

Influence of nasal obstruction on obstructive sleep apnea.

Nasal obstruction, either partial or complete, may cause snoring and/or obstructive sleep apnea (OSA). However, there is no clear answer to the question, in how many cases nasal airway is a main or combined site of obstruction. Fifty-four OSA cases (47 men and 7 women) were examined by measuring the upper airway pressure gradient while they were asleep, using a multi-sensor pressure transducer. Their average apnea + hypopnea index was 35.6/h and body mass index was 26.5 kg/m2. Our hypothesis was that elevation of the inspiratory negative airway pressure at the epipharynx could indicate the influence of nasal obstruction. Seven cases out of 54 proved to have inspiratory negative pressure more than -3 cmH2O at the epipharynx during sleep. Four cases indicated elevated negative pressure in the lateral position, and 3 cases out of 19 CPAP candidates showed the same elevation in the supine position. In all 7 cases, the main obstructive site was either at the soft palate or the base of the tongue. Although nasal airway is the preferred route of respiration during sleep, nasal obstruction itself cannot be a main factor causing OSA, but a co-factor of OSA during sleep.

Adult↗
PubMed1998

Evaluation of uvulopalatopharyngoplasty in treatment of obstructive sleep apnea syndrome.

Many methods have been reported to select the proper candidates for uvulopalatopharyngoplasty (UPPP) among obstructive sleep apnea patients. Polysomnography with intraluminal pressure recordings in the upper airway was found useful to predict obstructive site(s) and hence the success of surgery. According to the pressure analysis, 11 cases with high negative pressure at the mesopharynx were selected for UPPP, while UPPP combined with midline partial glossectomy (UPPP-MLG) was done in 18 cases proved to have high negative pressure difference between the mesopharynx and esophagus. A reduction of the apnea hypopnea index (AHI) of more than 50% after UPPP was found in 8 cases (72.7%) and in 11 cases (61.l%) after UPPP-MLG. It was found that the response rate was lower among the second group if compared to that of the first because of other aggravating factors rather than simple obstruction at the level of the soft palate and or tonsils-tongue base level.

Adult↗
PubMed1998

Effectiveness of tonsillectomy in adult sleep apnea syndrome.

Tonsillectomy was performed on 10 adult sleep apnea patients (five males, five females; average age, 39 years old; average body mass index, 24.8 kg/m2). Tonsillectomy alone was indicated if tonsillar hypertrophy was moderate to severe and the length of the soft palate was less than 35 mm according to cephalometry. Remarkable improvements were observed in all cases following surgery. The average weight of the resected tonsils was 11 g. The patients demonstrated a preoperative apnea + hypopnea index (AHI) of 14.4/h. This decreased to 2.9/h postoperatively. The intraesophageal pressure change improved from -36.6 to -15.7 cmH2O following surgery. A significant correlation between preoperative AHI and the degree of obesity (r=0.684, P < 0.05) was found. Although uvulopalatopharyngoplasty has been used extensively to treat sleep apnea, the present results suggests that certain subjects can be effectively treated through only tonsillectomy.

Adult↗
PubMed1998

Effectiveness of prosthetic mandibular advancement for obstructive sleep apnea: analysis by sleep position.

Fifteen patients with obstructive sleep apnea were treated using prosthetic mandibular advancement (PMA). Each patient was evaluated in the supine and lateral decubitus positions with and without PMA. After PMA treatment, the mean intraesophageal pressure (Peso) in the supine position improved from -42.6 to -27.3 cmH2O and the mean apnea + hypopnea index (AHI) decreased from 48.8/h to 23.7/h. The mean Peso in the lateral decubitus position improved from -27.9 to -18.6 cmH2O and the mean AHI decreased from 9.6/h to 6.6/h. With PMA, respiratory, disturbance during sleep further improved by changing the body position from the supine to lateral decubitus position.

Adult↗
PubMed1998

Acoustic analysis of snoring and the site of airway obstruction in sleep related respiratory disorders.

Seventy-five adult patients with sleep related respiratory disorders were examined by polysomnography with simultaneous recordings of the intraluminal pressure of the upper airway and snoring sound. Obstructed sites in the upper airway during sleep were determined by comparing the amplitude of respiratory fluctuation of the pressures in the epipharynx, mesopharynx, hypopharynx and esophagus. A definite correlation existed between the intensity of snoring sound and the amplitude of respiratory fluctuation of the intraesophageal pressure. Based on the results of the intraluminal pressure partitioning, the subjects were divided into the soft palate type (28), the tonsil/tongue base type (14), the combined type (27) and the larynx type (6). The average value of fundamental frequency (ff) was 102.8+/-34.9 Hz in the soft palate type, 331.7+/-144.8 Hz in the tonsil tongue base type, 115.7+/-58.9 Hz in the combined type and around 250 Hz in the larynx type.

Adult↗
PubMed1997

Immunopotentiating activities of polysaccharide fraction from pine seed shell extract.

The function of polysaccharide (PSE) extracted from pine seed shells as a immunopotentiator was investigated. The phagocytosis and chemotaxis of mouse peritoneal macrophages (MP) were augmented by oral administration of PSE. The incorporation of 3H-thymidine by Con A-stimulated mouse splenic cells was significantly intensified by administration of PSE but the adherent-cells (MP)-eliminated splenic lymphocytes was not increased. It is shown that the existence of activated MP is needed for the activation (proliferation) of T lymphocytes. The responsiveness of mouse T cells to alloantigen was also augmented by administration of PSE. The number of anti-SRBC plaque-forming cells in the spleen of mouse and chicken was also significantly increased. The results indicate that MP are first activated by oral administration of PSE and that the activation of T cells is then initiated indirectly by humoral factors (cytokines) produced by activated MP.

Adjuvants, Immunologic↗
PubMed1983

Computer analysis of changes in pulmonary resistance induced by nasal stimulation in man.

Changes in pulmonary resistance induced by various nasal stimuli were recorded in 16 subjects with nasal allergy and 16 laryngectomized subjects. To avoid human errors in sampling respiratory curves, computer analysis was performed breath by breath, automatically and continuously. In the subjects with nasal allergy the nasal mucosa was stimulated with pressure using a nasal balloon, and by a paper patch with 0.1 ml of 5% histamine hydrochloride. Laryngectomized subjects were stimulated with pressure and by pepper powder. Nasal pressure stimulation up to 50 cm H2O did not cause a statistically significant change in the pulmonary resistance of both groups of subjects. Pepper stimulation caused a statistically significant increase of the pulmonary resistance amounting to 40.4 +/- 28.2% of the prestimulatory level. Histamine stimulation caused a statistically significant change of the pulmonary resistance, but it was difficult to discern whether it caused an increase or a decrease of the resistance. Maximum efforts were used to control the respiratory pattern using the metronome and by visual monitoring of the peak flow rate on the cathode ray oscilloscope, but pepper and histamine stimulation caused a statistically significant increase, although slight, of tidal volume. The effect of slight changes of respiratory patterns induced by nasorespiratory reflex on the observed change of pulmonary resistance could not be ruled out in this human study.

Adult↗
PubMed1982

Neurophysiological mechanism of shrinkage of nasal mucosa induced by exercise.

Change of serum norepinephrine level and nasal patency were measured in 10 normal volunteers during exercise and effect of unilateral cervical sympathetic ganglion block on exercise-induced shrinkage of nasal mucosa was evaluated. Serum norepinephrine elevated markedly after 10-min exercise. Unilateral blocking of cervical ganglion completely inhibited mucosal shrinkage induced by exercise in 8 of 10 subjects. Mucosal shrinkage during exercise in these subjects was assumed to be mediated through cervical sympathetic ganglion, and not by increase in circulating cathecolamine. However, in 2 subjects, moderate shrinkage of the nasal mucosa was observed in 10-min after initiation of exercise. It was impossible to rule out some effect of circulating cathecolamine on the capacitance vessels of the nasal mucosa completely.

Adolescent↗