Role of dental sleep medicine in management of patients with obstructive sleep apnea disorders using a team approach.

OBJECTIVE: Obstructive sleep apnea (OSA) is a significant social and health issue. An integrated multidisciplinary approach to OSA management may be the most effective owing to its multifactorial etiology. In this study, we evaluated the frequency and efficacy of various treatment modalities for OSA administered via an integrated care delivery model, and assessed the role of dental sleep medicine as part of a multidisciplinary team. MATERIALS AND METHODS: We retrospectively evaluated 1115 patients with OSA treated at the Tokyo Medical University Hospital's Outpatient Clinic for OSA by a multidisciplinary team under one roof. The various treatment methods included the following: continuous positive airway pressure (CPAP), oral appliance (OA), surgery, and behavioral treatment. RESULTS: The patient number of study group was as follows: 771 (69.1%) CPAP; 240 (21.5%) OA; 76 (6.8%) behavioral treatment and 28 (3%) surgery. Because significantly fewer patients underwent surgery, there was a discrepancy between the recommended first-choice treatment and the actual treatment. A statistically significant number of younger patients in each treatment group underwent surgery. Success rate of OA and MMA were 74.4 and 80%, respectively. CONCLUSIONS: Proper selection of primary treatment to manage patients with OSA was possible under one-roof system that included dental sleep medicine.

High-throughput Ru(III) analysis using the hydrothermal flow reactor-mediated FIA by the extreme acceleration of Ru(III) complexation with 1,10-phenanthroline.

A new type of flow injection analysis (FIA) combined with a high-temperature reactor maintained at 100-400 °C, namely hydrothermal flow injection analysis (HT-FIA), has been successfully applied to high throughput determination of Ru(III) on the basis of a conventional chromogenic reaction with 1,10-phenothroline (phen). Although this classical chromogenic reaction using phen is sensitive and selective for Ru(III), the complex formation of Ru(phen)(3) requires 2 h. The acceleration using HT-FIA is extraordinary high so that the determination reaction of Ru(III) was successfully shortened to 5 s at 150 °C, where the analytical procedure was accelerated more than 1000-fold. This enabled a high-throughput analysis of Ru(III) with 100 µL sample, of which at least 10 samples can be analyzed within 10 min. The detection limit of Ru(III) determined on the basis of 3 times of standard deviation was 5.3×10(-7) M (53 pmol or 5.4 ng Ru in 100 µL sample). The present study emphasizes the importance of the revival of classical chromogenic reactions, which are potentially valuable but not regarded anymore as useful because they are time-consuming and tedious, to fit for the demand for environmentally harmless analytical techniques.

Navigation surgery for Le Fort 1 osteotomy in a fibrous dysplasia patient.

Orthognathic surgery is sometimes performed for fibrous dysplasia to correct malocclusion or facial asymmetry. However, Le Fort 1 osteotomy for this disease is difficult because of severe anatomical abnormality. Computer-assisted surgery is a rapidly developing technique in oral and maxillofacial surgery that is helping to ensure the safety of the surgery. We report a case of polyostotic craniofacial fibrous dysplasia in which two-jaw orthognathic surgery was performed using a navigation system with the Le Fort 1 osteotomy procedure. A 29-year-old woman presented with swelling and asymmetry on the right side of her face. Craniofacial fibrous dysplasia on the right side had been previously diagnosed, and she had undergone conservative surgery several times before. The disease extended to the right mandible, maxilla, and zygomatic, temporal frontal, and orbital areas, including the skull base. We first performed conservative contouring around the frontal and orbital areas, and then Le Fort I osteotomy and sagittal split ramus osteotomy to correct the asymmetry and cant of the occlusal plane. A passive infrared navigation system (Vector Vision surgical navigation system) was used for the Le Fort I osteotomy. The postoperative course was stable, and the facial asymmetry and cant of the occlusal plane improved and remained suitable 2 years after surgery. Thus, Le Fort 1 osteotomy can be performed safely in fibrous dysplasia with the aid of a passive infrared navigation system.

The ion-pair formation between dodecylsulfate and ammine-complexes of copper(II), nickel(II), zinc(II), palladium(II) and platinum(II), and the extraction behavior of the ammine-complexes by using sodium dodecylsulfate.

A micellar solution of sodium dodecylsulfate (SDS) exhibits the property of being separated into two phases due to a temperature change or the addition of salts. The ammine-complexes of copper(II), nickel(II) and palladium(II) reacted with the dodecylsulfate anion to form the corresponding ion-pair, and were extracted into the SDS gel phase. The SDS plays the roles of a pairing-ion for the ammine-complexes and of an extraction medium. The ion-pair extraction mechanism was investigated; the extractability of metals was given by the function of the solubility products of the ion-pairs. This method was applied to the mutual separation of Ni(II)/Cu(II) and Pd(II)/Pt(II). The driving force for the extraction was an electrostatic interaction between the cationic complex and the surfactant anion. The use of the SDS gel as ion-exchanger is also expected.

Ion-pair formation of a copper(II)-ammine complex with an anionic surfactant and the recovery of copper(II) from ammonia medium by the surfactant-gel extraction method.

The extraction and separation of copper(II), zinc(II), cobalt(II), and cadmium(II) were investigated. Both copper(II) and zinc(II) formed ammine-complexes, while cadmium(II) and cobalt(II) formed hydroxide precipitates in an ammonia medium. By the addition of sodium dodecylsulfate (SDS), a copper(II) complex formed an ion-pair (copper-ammine-DS), which was extracted into the SDS phase. However, a zinc(II) complex did not form an ion-pair, and was soluble in water. Copper(II) ion was recovered by stripping (back-extraction) after the addition of hydrochloric acid. This method was applied to the separation of copper(II) in a brass alloy.