A Case of Undiagnosed Sleep Disorder with Hearing Difficulty and Dizziness.

INTRODUCTION: The aim of this case report was to investigate the relationship between sleep disorders and audio vestibular symptoms. CASE REPORT: A case of undiagnosed sleep disorder, presenting as a temporary auditory processing difficulty, is presented. The disorder was initially treated as sudden deafness with dizziness. A 23-year-old male patient complained of acute hearing disturbance despite normal results on pure tone audiometry. The patient was initially administered a steroid injection in the hospital. After treatment, his hearing symptoms improved only slightly and he reported balance difficulty with rightward spontaneous nystagmus. Vestibular rehabilitation was performed. We also suspected that his hearing symptom was due to an auditory processing difficulty. Despite steroid treatment and vestibular rehabilitation, neither of his symptoms improved. We subsequently identified the presence of insomnia. He was prescribed zolpidem 5 mg, which slightly improved his symptoms, and referred to a sleep specialist for further examination. Polysomnography was performed, which identified restless leg syndrome and sleep disturbance with delayed sleep phase syndrome. After pharmacological treatment, his sleep disturbance, hearing difficulty, and balance disorder completely resolved. CONCLUSION: Sleep disorders may provoke reversible auditory processing difficulties. We should carefully evaluate patients for a potentially undiagnosed sleep disorder, even in patients chiefly complaining of intractable sensory dysfunction such as hearing or balance disturbance.

Objective and non-invasive evaluation of dry mouth.

OBJECTIVE: This study was designed to evaluate the moisture checker (MucusIII), a new device for measuring moisture of the oral submucosa. METHODS: Defective salivary secretion was induced by sialoadenectomy (n=8), while the remaining five guinea pigs underwent sham surgery (control group). We measured the unstimulated salivary flow rate, wetness of the oral mucosa using the oral tester (L-SALIVO) and moisture of the submucosa of the tongue using MucusIII. All tests were performed before (baseline) and 1 month after surgery. RESULTS: Sialoadenectomy significantly reduced both the salivary flow rate and the tester reading at 10 and at 30s (p<0.01). The vale due to the MucusIII as significantly reduced in animals with sialoadenectomy (p<0.01). CONCLUSION: The MucusIII is a device for objective evaluation of the moisture of the oral cavity.

Comparison between nicorandil and magnesium as an adjunct cardioprotective agent to percutaneous coronary intervention in acute anterior myocardial infarction.

BACKGROUND: It has been reported that both nicorandil and magnesium have a cardioprotective effect in experimental ischemia - reperfusion models. In the present study, the cardioprotective effects of nicorandil and magnesium as an adjunct to reperfusion therapy in patients with acute myocardial infarction (AMI) were compared. METHODS AND RESULTS: Forty consecutive patients with AMI caused by occlusion of anterior descending coronary artery were randomized into 3 groups: (1) Group N: nicorandil was given as 4 mg iv and 4 mg ic before reperfusion, followed by continuous infusion at 4 mg/h for 24 h; (2) Group M: magnesium was administered at 10 mmol iv before reperfusion, followed by continuous infusion at 0.4 mmol/h for 24 h; and (3) Group C: neither nicorandil nor magnesium was given. Left ventriculography was performed immediately after reperfusion and 3 months later. There was no significant change in regional wall motion (RWM) in either Group C or M, whereas that of group N improved significantly. The change in RWM in Group N was significantly greater than in Group C (Group N: 0.92+/-0.92, Group M: 0.44+/-0.80, Group C: -0.01+/-0.65, p<0.05). CONCLUSIONS: The early administration of nicorandil as an adjunct to reperfusion is useful for cardioprotection in AMI, but magnesium is not.