ABSTRACT
A 59-year-old man with obesity was admitted with nocturnal dyspnea and nocturnal precordial oppression. Catheter data disclosed no cardiac failure. Polysomnography was performed for a total of 3 nights. The diagnosis of obstructive sleep apnea syndrome was made because apnea index was 50 times/hour in average, the max apnea time was about 80 seconds and disappearance of airflow during decrease of endoesophageal pressure was observed. At the max apnea time, ST-T change in leads V2-5 was observed with severe desaturation (arterial oxygen saturation: 49%). It was considered that myocardial hypoxia following sleep apnea might be the cause of nocturnal precordial oppression.
Subject(s)
Electrocardiography , Hypoxia/physiopathology , Sleep Apnea Syndromes/physiopathology , Humans , Hypoxia/complications , Male , Middle Aged , Obesity , Oxygen/blood , Sleep Apnea Syndromes/complicationsABSTRACT
The purposes of this paper are to evaluate degree of dysphagia at the pharyngeal stage of swallowing in patients with polymyositis. A catheter with three diode transducers 5 cm apart was swallowed through the nose into the upper esophagus. Firstly a patient was commanded to drink water of 2 ml at about five second intervals, and the swallowing pressures were recorded on condition that the speed of paper recording and catheter pull-through is the same 1 mm/sec. Secondly the swallowing pressures were recorded on condition that the middle transducer is fixed at the level of the upper esophageal sphincter and the speed of paper recording is 5 mm/sec. Thirdly the resting pressure of upper esophageal sphincter was recorded on the same condition of the first recording. The results were as follows: (1) All eight patients showed extremely low swallowing pressure at the all level of the pharynx compared with healthy men. (2) Four patients showed poor relaxation of the upper esophageal sphincter. (3) The resting pressure of the upper esophageal sphincter was low in seven. In polymyositis manometrical study of the pharynx and the pharyngoesophageal sphincter is a useful method for evaluating swallowing function.
Subject(s)
Deglutition/physiology , Esophagus/physiopathology , Myositis/physiopathology , Pharynx/physiopathology , Adult , Aged , Electromyography , Female , Humans , Male , Manometry , Middle Aged , PeristalsisABSTRACT
A 60 year-old Japanese man having a 20-year history of diabetes mellitus presented with truncal neuropathy. The severe pain, especially its nocturnal exacerbation, prevented him from sleeping and eating, resulting in rapid emaciation. However, he recovered from the condition with oral mexiletine, which dramatically controlled the pain.
Subject(s)
Back Pain/drug therapy , Diabetic Neuropathies/drug therapy , Mexiletine/therapeutic use , Back Pain/etiology , Diabetic Neuropathies/complications , Drug Administration Schedule , Humans , Male , Middle AgedABSTRACT
The purposes of this paper are to evaluate degree of dysphagia at the pharyngeal stage of swallowing in patients with myasthenia gravis (Osserman IIB). A catheter with three diode transducers 5 cm apart was swallowed through the nose into the upper esophagus. Firstly a patient was commanded to drink water of 1 ml at about five second intervals, and the swallowing pressures were recorded on condition that the speed of paper recording and catheter pull-through is the same 1 mm/sec. Secondly the swallowing pressures were recorded on condition that the middle transducer is fixed at the level of the upper esophageal sphincter and the speed of paper recording is 5 mm/sec before and after intravenous injection of 10 mg edrophonium chloride. Thirdly the resting pressure of upper esophageal sphincter was recorded on the same condition of the first recording. The results were as follows: (1) All seven patients showed extremely low swallowing pressure at the all level of the pharynx compared with healthy men. (2) At the edrophonium test all seven patients revealed increased percentage of swallowing pressure. (3) One patient showed poor relaxation of the upper esophageal sphincter. (4) The resting pressure of the upper esophageal sphincter was low compared with control. In myasthenia gravis manometric study of the pharynx and the pharyngoesophageal sphincter is a useful method for evaluating swallowing function.
Subject(s)
Deglutition , Esophagogastric Junction/physiopathology , Myasthenia Gravis/physiopathology , Pharynx/physiopathology , Adult , Female , Humans , Male , Manometry , Middle Aged , Monitoring, Physiologic , Transducers, PressureSubject(s)
Dopamine/physiology , Hypothalamo-Hypophyseal System/physiology , Parkinson Disease/physiopathology , Spinocerebellar Degenerations/physiopathology , Adolescent , Adult , Aged , Aged, 80 and over , Aging , Child , Female , Humans , Male , Middle Aged , Neurons/physiopathology , Prolactin/metabolism , Sex Factors , Sulpiride , Thyrotropin-Releasing HormoneABSTRACT
Transesophageal ultrasound endoscopy by the linear array transducer built-in on top of the fiber optic gastroduodenoscope was applied for 13 clinical cases with various mediastinal lesions. It was quite valuable to diagnose mediastinal lesions such as lymphadenopathy in sarcoidosis, lymph node metastasis and direct invasion of lung cancer, dilatation of the diameter of the right pulmonary artery in pulmonary hypertension.
