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Objective @# To investigate the changes in the sagittal diameter of the upper airway before and after the treatment of skeletal Class Ⅲ malocclusion in adults with microimplant anchorage and class Ⅲ intermaxillary elastics and to provide a reference for clinical treatment. @*Methods @#A total of 35 adult patients with skeletal Class Ⅲ malocclusion were selected to be treated with the straight-wire technique. Microimplant group, 15 cases (group A): patients with severe skeletal Class Ⅲ malocclusion (vertical high angle) were treated with the straight-wire technique combined with microimplant anchorage; class Ⅲ intermaxillary elastics group, 20 cases (group B): Patients with mild or moderate skeletal Class Ⅲ malocclusion (vertical low angle and average angle) were treated with the straight-wire technique combined with class Ⅲ intermaxillary elastics, and cephalometric radiographs obtained before and after treatment in the upper airway in the two groups were measured and analyzed.@*Results @#Changes in cranial and maxillofacial measurements after correction: in group A, (sella-nasion-supramental angle) the SNB angle decreased significantly (P < 0.05), and (subspinale-nasion-supramental angle) the ANB angle increased significantly (P < 0.05). In group B, the SNB angle decreased significantly (P < 0.05), while (subspinale-nasion-subspinale angle) the SNA angle、ANB angle and anterior skull base plane-mandibular plane angle (Sn-MP) angle increased significantly (P < 0.05). Changes in sagittal diameter of the upper airway measurements after corrections: In group A, the width of the glossopharyngeal segment of the upper airway (TB-TPPW) decreased significantly (P < 0.05). In group B, first segment width of the upper airway behind the hard palate (PNS-R) increased significantly (P < 0.05). After correction, the decreased SNB and increased ANB in group A was higher than that in group B, and the difference was statistically significant （P < 0.05）. The decreased of TB-TPPW in upper airway of group A was greater than that of group B, and the difference was statistically significant （P < 0.05）.@* Conclusions @#In the treatment of skeletal class Ⅲ malocclusion with microimplant anchorage, the sagittal diameter of the glossopharyngeal segment of the upper airway has a negative impact.
ABSTRACT
Background: The pre existing sagittal diameter is the distance from the middle of the posterior part of the vertebral body of each vertebra to the midpoint of corresponding lamina. The absolute diameter is the distance from the posterior aspect of spondylotic spur to the closest point in spinolaminar line at the particular inters space. They found in their study that pre existing sagittal diameter of 16.4 mm to 12.4 mm at C5 and the absolute diameter of 14.8 mm to 12.6 mm at C5-6 interspace. To study the importance of the sagittal diameters of the cervical spinal canal in relation to spondylosis and myelopathy. Methods: This study consisting of evaluation of initial and decreased sagittal diameters of cervical spines and its correlation with cervical spondylosis with and without myelopathy. The material of this analysis consisted of 150 patients who attended the outpatient department of the hospital. A detailed clinical examination was done in all the patients who included clinical history, general and systemic examination. Major groups under this study were the patients referred by a clinician with a provisional diagnosis of cervical spondylosis. A random survey of patients visited the Department of Radiology without any complaints were done, they were evaluated radiologically. While undertaking the radiological examination, we observed a specific proforma. Results: When multiple discs were involved, C5 – C6 disc involvement along with C4 – C5 was more common. When single disc involvement was there, then C5 – C6 disc involvement was maximum. Conclusion: The initial size of the canal may be an etiological factor in the development of cervical myelopathy.
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Objetivo: Correlacionar indicadores antropométricos; índice de cintura-cadera (ICC) y diámetro sagital (DS) con IAH en candidatos a cirugía bariátrica (CB). Materiales y métodos: Se registraron el IMC, ICC y DS. Se evaluó IAH relevante (> 15 eventos/hora) mediante poligrafía respiratoria (PR) y se correlacionó con sexo, edad > de 50 años, escala de Berlín, HTA, DS ≥ 30 e ICC ≥ 1. Resultados: Fueron analizados 81 pacientes (mujeres 50/61.73%). Las medias fueron; edad: 46.32, SD: 11.53, IMC: 45.98 SD: 8.41 (rango: 35-77 kg/m²) y Epworth (ESS): 8.87, SD: 4.86. El 100% presentó alto riesgo por Berlín, ESS >10: 33.86% e HTA: 39.51%. Los indicadores poligráficos (medias) fueron; tiempo de registro: 407 minutos (SD: 110) e IAH: 20.66 (SD: 24.02). La prevalencia de IAH > 5/hora fue del 77.77%, IAH > 15/hora; 34.56% y el 21% obtuvo > 30/hora. La media del DS fue de 30.9 (SD: 4.60) y del ICC de 0.97 (SD: 0.09). Modelos de regresión para DS ≥ 30 cm (OR: 1.97 y p = 0.239) + ICC ≥ 1 (OR: 1.394 y p = 0.636) no alcanzaron significación cuando se adicionó sexo masculino (OR: 5.29 y p = 0.003). En regresión logística las variables no alcanzaron significación; DS ≥ 30 cm: OR de 1.25 (CI95%: 0.33-4.66) p = 0.739, ICC ≥ 1; OR 0.93 (SD: 0.19-4.62) p = 0.939 y muestran predictor exclusivamente al sexo masculino (OR: 4.20. CI95%: 1.21-14.5) p = 0.023. Conclusiones: La obesidad central según ICC ≥ 1 y DS ≥ 30 cm no tuvo correlación con IAH > 15/hora. Continúan siendo necesarios métodos objetivos (PR o polisomnografía) para evaluar la severidad del trastorno.
Objective: To assess correlation between anthropometric indexes; waist to hip ratio (WHI), sagital diameter (SD) and AHI obtained from home respiratory polygraphy (RP) in bariatric surgery candidates (BS). Methods: BMI, WHI and SD were recorded for BS candidates. Sleep apnea was defined as significant if AHI >15 events/hour. Variables included in the model were; sex, age greater than 50 years, Berlin questionnaire, history of hypertension (HBP), SD ≥ 30 and WHI ≥ 1. Results: Data from 81 patients were analyzed (50 women, 61.73%), age 46.32, SD 11.53, BMI 45.98 SD: 8.41 (range: 35-77 kg/m²) and ESS: 8.87 (SD: 4.86). 100% had high risk by Berlin questionnaire, 33.86% had ESS >10, and 39.51% HBP. Respiratory polygraphy data were: recording time: 407 minutes (SD: 110) and AHI: 20.66 (SD: 24.02). Prevalence of AHI > 5/hour (pathological) was 77.77%; significant AHI (> 15/hour) 34.56%, and 21% had > 30/hour. The SD was 30.9 (SD: 4.60) and WHI of 0.97 (SD: 0.09). 48.15% had a WHI ≥ 1. Logistic regression showed: DS ≥ 30 cm (OR: 1.97, p = 0.239) + WHI ≥ 1 (OR 1.394, p = 0.636) and it did not reach significance when male sex is added. Both variables included in the model did not reach statistical significance; SD ≥ 30 cm: OR of 1.25 (95% CI: 0.33-4.66) p = 0.739, ICC ≥ 1, OR 0.93 (SD: 0.19-4.62) p = 0.939. In the model, male sex was the only predictor (OR: 4.20, CI 95%: 1.21. -14.5) p = 0.023. Conclusions: Central obesity measured by WHI ≥ 1 and SD ≥ 30 cm had no significant correlation with AHI > 15/h. Objective methods (RP or polysomnography) are needed to assess the severity of the disorder before prescribing bariatric surgery.
Subject(s)
Sleep Apnea Syndromes , Bariatric Surgery , Sagittal Abdominal DiameterABSTRACT
BACKGROUND: A predominant accumulation of adipose tissue in abdominal region confers increased risk of cardiovascular disease. The best technology available for measurement of regional fat distribution is computed tomography. However, computed tomography is limited its use for clinical purposes by cost. The aim of this study is to identify the best simple anthropometric index of abdominal visceral fat accumulation. METHODS: To quantify the relationship between anthropometric indices of abdominal obesity(waist circumference, waist to hip ratio, waist to height ratio, body mass index, abdominal sagittal diameter) and abdominal(total, visceral, subcutaneous) fat areas measured by computed tomography, correlation and multiple regression analyses have been conducted. RESULTS: No significant difference for waist circumference, body mass index and sagittal diameter between men and women have been found. Mean value of waist to hip ratio is larger in women, but waist to height ratio is larger in men. The mean abdominal total fat area and mean subcutaneous fat area are higher in women. Interestingly, men, despite lower total fat area, have higher mean abdominal visceral area. Thus, the mean visceral fat to subcutaneous fat ratio is much higher in men. Abdominal sagittal diameter shows the highest correlation(men: 0.69, women: 0.76) with abdominal visceral fat area in both genders. Stepwise regression analyses have been performed to determine the best simple anthropometric index of abdominal visceral fat accumulation. In men, the significant indices are abdominal sagittal diameter, body mass index, and waist to height ratio. In women, abdominal sagittal diameter is the only significant index. CONCLUSION: Abdominal sagittal diameter, in comparison with the waist circumference, waist to hip ratio, waist to height ratio and body mass index, is the best predictor of the amount of abdominal visceral fat.
Subject(s)
Female , Humans , Male , Adipose Tissue , Body Mass Index , Cardiovascular Diseases , Hip , Intra-Abdominal Fat , Obesity , Subcutaneous Fat , Waist Circumference , Waist-Hip RatioABSTRACT
@#Objective: To study the effects of mm. abdominis exercise on lumbar spinal stenosis. Methods: 9 patients with lumbar spinal stenosis were treated with mm. abdominis exercises. The static and dynamic strength indexes, the sagittal diameter of canales spinalis tested by ultrasonography were observed and compared before and after treatment. Results: The effect of 3 patients was excellent, 5 good and 1 bad, and the strengths of mm. abdominis increased after treatment. The sagittal diameter of canales spinalis were 8.72±0.44mm and 10.78±0.44mm respectively before and after treatment. The difference was significant (P<0.001). Conclusion: It is suggested that mm. abdominis exercise is an effective technique in management of lumgar spinal stenosis.
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The accepted radiographic method to determine cervical spinal stenosis is the direct measurement of the sagittal diameter of the spinal canal on the routine lateral view of the cervical spine. The reported normal and abnormal values for this measurement are inconsistent because of various methods of obtaining the roentgenograms and different body types which affect the size of the X-ray image. According to Pavlow, the ratio method of determining crevical spinal stenosis, in which the sagittal diameter of the spinal canal is divided by the sagittal diameter of the corresponding vertebral body, is independent of technical factor variables and is a reliable method for determining cervical spinal stenosis. In order to determine the Pavlov's ratio of normal Koreans, and compare it with that of radiculopathic group, we measured the diameter of cervicl canal in 47 normal persons(28 male, 19 female), and 32 patients( 9 male, 23 female) who had transient tingling sensation and radiculopathic symtom from the second to fifth decades. The results were as follows :1) The average Pavlov's ratio from C3 to C7 in normal Korean men are 0.906(0.70–1.13), 0.899 (0.070–1.13),0.948(0.70–1.67) and 0.948(0.67–1.17), respectively, and those of normal Korean women are 0.977(0.83–1.15), 1.021(0.83–1.13), 1.014(0.84–1.33) and 1.055(0.88–1.18), respectively. 2) The average Pavlov's ratio from C3 to C7 in radiculopathic Korean men are 0.88(0.65–1.12), 0.90(0.68–1.12), 0.95(0.79–1.12) and 0.95(0.78–1.06), respectively, and those of radiculopathic Korean women are 0.902(0.70–1.27), 0.905(0.69–1.27), 0.939(0.70–1.33) and 0.931(0.70–1. 18), respectively. 3) There are not statistically differences of the Pavlov's ratio between the control group and the radiculopathic group. 4) We believe that the Pavlov's ratio is an effective method in detection of cervical stenosis and is able to eliminate technical factor such as body position, target and object-to-film distanc.