Research on Sleep Dynamics in Cleft Lip and Palate Patients Using Simple Sleep Testing.

Sleep-disordered breathing affects children's growth and development, mental health, and learning ability. Postoperative scarring causes anteroposterior and vertical developmental disorders of the maxilla. Obstructive apnea is likely to occur due to the influence on the maxillofacial and airway morphology. In this study, we investigated the sleep-respiratory dynamics of school-aged children with unilateral cleft lip and palate by performing a simple overnight sleep study, maxillofacial morphology, airway analysis using lateral cranial radiographs, and model analysis. Children with unilateral cleft lip and palate showed a significantly higher respiratory event index (REI) than normal children; the maxilla was located in the posterior position in terms of maxillofacial morphology and airway morphology showed narrow values for all distance measurement items. Moreover, the width and length of the dental arch and the width of the alveolar base arch were significantly smaller. Furthermore, REI and SNA, ANB, and REI were negatively correlated with alveolar base arch width. Children with unilateral cleft lip and palate are more likely than normal children to develop sleep-disordered breathing due to increased airway resistance caused by undergrowth of the maxilla and narrowing of the upper airway and oral volume.

Acidic extracellular pH promotes epithelial mesenchymal transition in Lewis lung carcinoma model.

BACKGROUND: Epithelial mesenchymal transition (EMT) is thought to be an essential feature of malignant tumor cells when they spread into the stroma. Despite the extracellular acidity of tumor tissues, the effect of acidic extracellular pH (pH e ) on EMT in carcinoma models, including the Lewis lung carcinoma (LLC) model, remains unclear. METHODS: High and low metastatic LLC variants were generated by repeated tail vein injection of metastatic cells. DMEM/F12 medium, which has been supplemented with 15 mM HEPES, 4 mM phosphoric acid, and 1 g/L NaHCO3 and adjusted to the desire pH with HCl or NaOH, was used for cell culture. EMT marker gene expression was determined by quantitative reverse transcription-polymerase chain reaction. Migration and invasion activities were analyzed by wound healing assay and the Boyden chamber assay through Matrigel®, respectively. RESULTS: Low metastatic variant LLCm1 cells showed a cobble-stone like morphology at pH e 7.4. At pH e 6.8, however, their morphology became fibroblastic, similar in shape to high metastatic variant LLCm4 cells. Steady state levels of matrix metalloproteinase-9 (Mmp9) mRNA were induced by acidic pH e , maximizing at pH 6.8, with the levels of Mmp9 mRNA higher in LLCm4 than in LLCm1 cells. Both variants showed decreased levels of E-cadherin and increased levels of vimentin at pH e 6.8. Acidic pH e also induced expression of mRNAs encoding the E-cadherin repressors, Zeb2, Twist1 and Twist2, as well as enhancing cell motility and in vitro invasion through Matrigel®. CONCLUSIONS: Acidic pH e can induce EMT in some types of carcinoma.

Effects of a transmitted light device for pediatric peripheral venipuncture and intravenous cannulation.

Pediatric peripheral venipuncture and intravenous cannulation are difficult. However, successful venipuncture and intravenous cannulation are absolutely required for pediatric clinical risk management. This study assessed the success rate of venipuncture and intravenous cannulation when transmitted light was applied to the pediatric dorsum manus. The subjects included 100 young children who were scheduled for dental treatment or oral surgery under general anesthesia. Anesthesia was induced, and insertion of an intravenous catheter into the dorsum manus was attempted with or without using transmitted light. The patients were evaluated to determine whether the venipuncture was successful, and whether the intravenous cannulation of the external catheter was successful. The success rate of venipuncture was 100% when transmitted light was used, and 83% when the transmitted light was not used (P = 0.000016). In addition, the success rate of intravenous cannulation was 88% when transmitted light was used, and 55% when the transmitted light was not used (P = 0.0000002). The shape of the vein in the dorsum manus can be clearly recognized when transmitted light is used. The use of light significantly increased the success rate of intravenous cannulation, because it allowed direct confirmation of the direction to push the intravenous catheter forward. The use of transmitted light allows for more successful venipuncture and intravenous cannulation in young children.

Availability of a remote online hemodynamic monitoring system during treatment in a private dental office for medically high-risk patients.

The importance of systemic management to prevent accidents is increasing in dentistry because co-morbid illnesses in an aging society and invasive surgical procedures are increasing. In this prefecture, a new medical system called the remote online hemodynamic monitoring system (ROHMs) was started in 2001. Eight private dental offices participated in this trial. When dental practitioners feel the risk of a dental procedure, they can contact via ROHMs to this hospital. Then, the hemodynamic data (blood pressure, heart rate, ECG, SpO2, and RPP) of the patient in the clinic can be transmitted here via the internet, and the images and the voice can be transmitted as well. The availability of this system was assessed in 66 patients (98 cases). The most frequent complications were hypertension, heart disease, and diabetes mellitus. Systemic management included monitoring during the dental procedure (71.4%), checking vital signs after an interview (15.3%), and monitoring under sedation (13.3%). There were 35.7% of all cases where an unscheduled procedure was necessary for the systemic management. Based on a questionnaire, the majority of the patients felt relieved and safe. This system creates a situation where a specialist is almost present during the procedure. This system will provide significant assistance for future medical cooperation for risk management.