Electron microscopy study of peripheral nerves in the uvulae of snorers and obstructive sleep apnoea patients

2008 ◽  
Vol 123 (2) ◽  
pp. 203-207 ◽  
Author(s):  
A Bassiouny ◽  
S Nasr ◽  
M Mashaly ◽  
E Ayad ◽  
M Qotb ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Obstructive Sleep Apnoea ◽  
Microscopy Study ◽  
Sleep Apnoea ◽  
Electron Microscopy Study ◽  
Degenerative Changes ◽  
Nerve Fibres ◽  
Airway Narrowing ◽  
Obstructive Sleep ◽  
Simple Snoring

AbstractHypothesis:The pathophysiology of snoring and obstructive sleep apnoea is still unclear. Two theories are proposed. The first is the obstructive theory, which postulates palatopharyngeal muscle hypertrophy leading to airway narrowing; there is no neural role. The second is the neurogenic theory, which postulates neural degeneration due to vibratory stretch trauma, leading to muscle atrophy and collapse. As identification of nerve fibres in the uvula and palate is difficult and time-consuming, all previous studies aiming to differentiate between these two theories have been based on indirect observation of the muscles, rather than direct study of the nerves.Methods:We conducted a prospective study to directly observe and study nerve fibres in uvular specimens from 10 cases of obstructive sleep apnoea, compared with specimens from 10 cases of simple snoring, using transmission electron microscopy. Five autopsy cases served as controls.Results:Obstructive sleep apnoea was associated with definite degenerative changes in myelinated and unmyelinated nerve endings. These degenerative changes were present to a lesser degree and in a smaller proportion of cases of simple snoring.Conclusion:The events postulated by the neurogenic theory of obstructive sleep apnoea appear to play an important role in the pathophysiology of snoring and obstructive sleep apnoea.

scholarly journals Obstructive sleep apnoea in a patient with chronic lymphocytic leukaemia

2019 ◽  
Vol 12 (7) ◽  
pp. e228763
Author(s):  
Gregory Paul Stimac ◽  
Asefa Jejaw Mekonnen
Keyword(s):  
Chronic Lymphocytic Leukaemia ◽  
Obstructive Sleep Apnoea ◽  
Lymphocytic Leukaemia ◽  
Oral Appliance ◽  
Sleep Apnoea ◽  
Caucasian Woman ◽  
Upper Airways ◽  
Airway Narrowing ◽  
Obstructive Sleep ◽  
Structural Abnormalities

A 69-year-old Caucasian woman presented with chronic lymphocytic leukaemia (CLL; stage 1-Rai System), significant oropharyngeal lymphoid enlargement, snoring and fatigue. Overnight polysomnography revealed moderately severe obstructive sleep apnoea (OSA), which was managed successfully with oral appliance therapy with resolution of snoring and daytime fatigue. Structural abnormalities of the upper airways are known to cause OSA. Airway narrowing can result from bony structural abnormalities, nasopharyngeal growth, soft tissue redundancy, macroglossia, malignant and benign growth of the upper aero-digestive tract, and adenotonsilar enlargement. Clinicians should be encouraged to consider a diagnosis of OSA in patients with CLL when they present with symptoms of worsening fatigue.

scholarly journals Difference in spectral power density of sleep EEG between patients with simple snoring and those with obstructive sleep apnoea

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jae Myeong Kang ◽  
Seon Tae Kim ◽  
Sara Mariani ◽  
Seo-Eun Cho ◽  
John W. Winkelman ◽  
...  
Keyword(s):  
Power Density ◽  
Obstructive Sleep Apnoea ◽  
Spectral Power ◽  
Spectral Power Density ◽  
Sleep Apnoea ◽  
Sleep Eeg ◽  
Obstructive Sleep ◽  
Simple Snoring

scholarly journals Flextube reflectometry for determination of sites of upper airway narrowing in sleeping obstructive sleep apnoea patients

2001 ◽  
Vol 95 (8) ◽  
pp. 639-648 ◽  
Author(s):  
C.E. FABER ◽  
O. HILBERG ◽  
F.T. JENSEN ◽  
O. NORREGAARD ◽  
L. GRYMER
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Airway Narrowing ◽  
Obstructive Sleep

scholarly journals Role of common hypnotics on the phenotypic causes of obstructive sleep apnoea: paradoxical effects of zolpidem

2017 ◽  
Vol 50 (6) ◽  
pp. 1701344 ◽  
Author(s):  
Jayne C. Carberry ◽  
Lauren P. Fisher ◽  
Ronald R. Grunstein ◽  
Simon C. Gandevia ◽  
David K. McKenzie ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Muscle Activity ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Double Blind ◽  
Genioglossus Muscle ◽  
Airway Narrowing ◽  
Arousal Threshold ◽  
Obstructive Sleep ◽  
Airway Collapsibility

Hypnotics are contraindicated in obstructive sleep apnoea (OSA) because of concerns of pharyngeal muscle relaxation and delayed arousal worsening hypoxaemia. However, human data are lacking. This study aimed to determine the effects of three common hypnotics on the respiratory arousal threshold, genioglossus muscle responsiveness and upper airway collapsibility during sleep.21 individuals with and without OSA (18–65 years) completed 84 detailed sleep studies after receiving temazepam (10 mg), zolpidem (10 mg), zopiclone (7.5 mg) and placebo on four occasions in a randomised, double-blind, placebo-controlled, crossover trial (ACTRN12612001004853).The arousal threshold increased with zolpidem and zopicloneversusplacebo (mean±sd−18.3±10 and −19.1±9versus−14.6±7 cmH2O; p=0.02 and p<0.001) but not with temazepam (−16.8±9 cmH2O; p=0.17). Genioglossus muscle activity during stable non-REM sleep and responsiveness during airway narrowing was not different with temazepam and zopicloneversusplacebo but, paradoxically, zolpidem increased median muscle responsiveness three-fold during airway narrowing (median −0.15 (interquartile range −1.01 to −0.04)versus−0.05 (−0.29 to −0.03)% maximum EMG per cmH2O epiglottic pressure; p=0.03). The upper airway critical closing pressure did not change with any of the hypnotics.These doses of common hypnotics have differential effects on the respiratory arousal threshold but do not reduce upper airway muscle activity or alter airway collapsibility during sleep. Rather, muscle activity increases during airway narrowing with zolpidem.

Sutter® bipolar radiofrequency volumetric tissue reduction of palate for snoring and mild obstructive sleep apnoea: is one treatment adequate?

2009 ◽  
Vol 123 (7) ◽  
pp. 750-754 ◽  
Author(s):  
K P Pang ◽  
J K Siow
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Randomised Trial ◽  
Sleep Apnoea ◽  
Bipolar Radiofrequency ◽  
Obstructive Sleep ◽  
Radiofrequency Volumetric Tissue Reduction ◽  
Viable Method ◽  
Tissue Reduction ◽  
Simple Snoring

AbstractObjective:To evaluate the efficacy of bipolar radiofrequency volumetric tissue reduction, using Sutter® technology, in the treatment of snoring and mild obstructive sleep apnoea.Design:Prospective, non-randomised trial.Methods:Fifty-two patients with simple snoring and mild obstructive sleep apnoea underwent bipolar radiofrequency palate reduction under local anaesthesia.Results:All patients were Friedman stage II and III, with tonsil sizes graded as zero, one or two, a mean body mass index of 22.6, and a mean age of 36.2 years. Seventy-seven per cent of patients reported improvement in their snoring; patients' mean snoring level (assessed by visual analogue scale) improved from 8.9 to 3.4 (p < 0.05). Eighty-three per cent of patients reported an improvement in their Epworth sleepiness scale score, from a mean of 14.6 to 9.5. Seven out of the 17 patients (41.2 per cent) met the surgical success criteria (i.e. at least a 50 per cent reduction of the pre-procedure apnoea–hypopnoea index, and a post-procedure apnoea–hypopnoea index of below 15). Patients' mean apnoea–hypopnoea index improved from 13.6 to 9.8, and their mean lowest oxygen saturation improved from 88.3 to 92.5 per cent. Eighty-two per cent of patients reported an improvement in their quality of life as a result of the procedure.Conclusion:One session of Sutter bipolar radiofrequency tissue volume reduction represents a viable method of treating snoring and mild obstructive sleep apnoea, with good results.

scholarly journals Acoustic analysis of snoring sound in patients with simple snoring and obstructive sleep apnoea

1996 ◽  
Vol 9 (11) ◽  
pp. 2365-2370 ◽  
Author(s):  
J.A. Fiz ◽  
J. Abad ◽  
R. Jané ◽  
M. Riera ◽  
M.A. Mañanas ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Acoustic Analysis ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
Simple Snoring

Factors influencing adhesive bonding at the bone/implant interface

1992 ◽  
Vol 50 (2) ◽  
pp. 1114-1115
Author(s):  
Julie A. Martini ◽  
Robert H. Doremus
Keyword(s):  
Electron Microscopy ◽  
Adhesive Bonding ◽  
Microscopy Study ◽  
Electron Microscopy Study ◽  
Bone Implant ◽  
Factors Influencing ◽  
Lr White ◽  
Transmission Electron ◽  
New Zealand White Rabbits ◽  
Scanning Electron

Tracy and Doremus have demonstrated chemical bonding between bone and hydroxylapatite with transmission electron microscopy. Now researchers ponder how to improve upon this bond in turn improving the life expectancy and biocompatibility of implantable orthopedic devices.This report focuses on a study of the- chemical influences on the interfacial integrity and strength. Pure hydroxylapatite (HAP), magnesium doped HAP, strontium doped HAP, bioglass and medical grade titanium cylinders were implanted into the tibial cortices of New Zealand white rabbits. After 12 weeks, the implants were retrieved for a scanning electron microscopy study coupled with energy dispersive spectroscopy.Following sacrifice and careful retrieval, the samples were dehydrated through a graduated series starting with 50% ethanol and continuing through 60, 70, 80, 90, 95, and 100% ethanol over a period of two days. The samples were embedded in LR White. Again a graduated series was used with solutions of 50, 75 and 100% LR White diluted in ethanol.

Transmission Electron Microscopy study of Bi-based superconducting phases

1990 ◽  
Vol 48 (4) ◽  
pp. 50-51
Author(s):  
J.G. Wen ◽  
K.K. Fung
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Single Crystals ◽  
Microscopy Study ◽  
Electron Microscopy Study ◽  
Space Groups ◽  
Superconducting Phases ◽  
Ceramic Samples ◽  
Transmission Electron ◽  
Modulated Structures

Bi-based superconducting phases have been found to be members of a structural series represented by Bi2Sr2Can−1Cun−1On+4, n=1,2,3, and are referred to as 2201, 2212, 2223 phases. All these phases are incommensurate modulated structures. The super space groups are P2/b, NBbmb 2201, 2212 phases respectively. Pb-doped ceramic samples and single crystals and Y-doped single crystals have been studied by transmission electron microscopy.Modulated structures of all Bi-based superconducting phases are in b-c plane, therefore, it is the best way to determine modulated structure and c parameter in diffraction pattern. FIG. 1,2,3 show diffraction patterns of three kinds of modulations in Pb-doped ceramic samples. Energy dispersive X-ray analysis (EDAX) confirms the presence of Pb in the three modulated structures. Parameters c are 3 0.06, 38.29, 30.24Å, ie 2212, 2223, 2212 phases for FIG. 1,2,3 respectively. Their average space groups are all Bbmb.

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