Characteristics of the elderly in high - resolution computed tomography lung densitometry

To determine the characteristics of the elderly in high - resolution computed tomography (HRCT) lung densitometry, mean lung density (MLD) and relative area of the lungs showing attenuation values less than -950 HU (RA(950)) on HRCT were evaluated in nonsmoking control subjects (n = 80) and patients with asthma (n = 80) in relation to their age and pulmonary function. MLD was significantly decreased, and RAW was significantly increased with increasing age in both asthmatics and controls. The MLD values were significantly lower in asthmatics compared with controls in subjects aged between 60 and 69 years and over age 70. RAgsov alues were significantly higher in asthmatics compared with controls in subjects aged between 50 and 59 years, between 60 and 69, and over 70. % FEV(1) and FEV(1) / FVC were significantly decreased in elderly asthmatic patients over 70 years of age compared with the values in those under 49. Percent residual volume (% RV) was significantly larger in patients over 70 years of age than in those between 50 and 59, and under 49 years. RAW was significantly larger in patients with steroid-dependent intractable asthma (SDIA) between 50 and 59 years of age, and between 60 and 69 compared with RA 950 in those without SDIA. However, RAW did not differ significantly between SDIA and non-SDIA in patients over age 70. The results suggested that in % LAA of the lungs on HRCT was significantly increased in the elderly subjects with and without asthma, and it was significantly higher in the elderly asthmatics than the elderly controls.高齢者の病態的特徴を明らかにするために，健常者80例および非喫煙喘息患者80例を対象として，平均肺CT値（MLD）ならびに高分解能CT（HRCT）による－950HU以下の肺low attenuation area（RA950）を評価し，年齢及び肺機能との関連を検討した。　 1．健常者，喘息患者いずれにおいても年齢とともにMLDは有意に減少し，RA(950)は有意に増加した。MLDは，60－69歳と70歳以上の年 齢層において，健常者に比して喘息患者で有意に低値を示した。RA(950)。は，50－59歳・60－69歳・70歳以上の年齢層において，健常者に比して喘息患者で有意に高値を示した。　 2．喘息患者において，1秒量（% FEV(1)）および1秒（FEV(1)/ FVC）は，49歳以下の年齢層に比して70歳以上の年齢層で有意に低値を示した。一方，残気量（% RV）は，50－59歳ならびに49歳以下の年齢層に比して70歳以上の年齢層で有意に高値を示した。 3．50－59歳および60－69歳の年齢層では，RA(950)は，ステロイド依存性重症難治性喘息（SDIA）患者において非SDIA患者に比して有意に高値を示した。しかし，70歳以上の年齢層では両者に有意の差は認められなかった。これらの結果より，HRCT上の肺low attenuation areaは高齢者において有意に増加すること，さらに嘱息患者の方が健常者に比してより高値を示すことが示唆された

Radar-Based Automatic Detection of Sleep Apnea Using Support Vector Machine

2020 International Symposium on Antennas and Propagation (ISAP), 25-28 Jan. 2021, Osaka, JapanEarly diagnosis of sleep-apnea-related breathing problems helps to avoid the increased risk they can cause. In this study, we performed simultaneous radar measurements and polysomnography on patients with sleep apnea. A support vector machine algorithm was applied to the radar data to automatically detect sleep apnea events. Support vector machine parameters were optimized using the relationship between the radar and polysomnography data. The support vector machine was found to be effective in noncontact detection of central/mixed sleep apnea events using radar data. The proposed approach achieved an accuracy of 79.5%, a recall of 71.2%, and a precision of 71.2%

Orbital Cystic Schwannoma Originating from the Frontal Nerve

Schwannomas of the orbit are very rare benign neoplasms. Intraorbital cystic schwannomas originating from the frontal nerve are even rarer, with only 1 case reported to date. This is most likely due to the fact that, in most cases, the origin of the orbital schwannoma cannot be identified intraoperatively. The nerve origin is usually speculated from histological examination of the specimen and the postoperative neurological deficits of the patient. Here, we present the case of a 65-year-old woman with a one-month history of exophthalmos, whose orbital cystic lesion was completely removed by microsurgical transcranial operation. Intraoperatively, the continuity between the tumor and frontal nerve was seen macroscopically, leading us to confirm the frontal nerve as an origin of the tumor, which was consistent with the postoperative neurological findings. The diagnosis of the tumor was established as schwannoma from the histological examination. As a differential diagnosis of the orbital cystic lesions, the possibility of schwannomas should be kept in mind

Noncontact Detection of Sleep Apnea Using Radar and Expectation-Maximization Algorithm

Sleep apnea syndrome requires early diagnosis because this syndrome can lead to a variety of health problems. If sleep apnea events can be detected in a noncontact manner using radar, we can then avoid the discomfort caused by the contact-type sensors that are used in conventional polysomnography. This study proposes a novel radar-based method for accurate detection of sleep apnea events. The proposed method uses the expectation-maximization algorithm to extract the respiratory features that form normal and abnormal breathing patterns, resulting in an adaptive apnea detection capability without any requirement for empirical parameters. We conducted an experimental quantitative evaluation of the proposed method by performing polysomnography and radar measurements simultaneously in five patients with the symptoms of sleep apnea syndrome. Through these experiments, we show that the proposed method can detect the number of apnea and hypopnea events per hour with an error of 4.8 times/hour; this represents an improvement in the accuracy by 1.8 times when compared with the conventional threshold-based method and demonstrates the effectiveness of our proposed method.Comment: 8 pages, 12 figures, 3 tables. This work is going to be submitted to the IEEE for possible publicatio

Clinical effects of long-term spa therapy on pulmonaryemphysema. Evaluation by pulmonary function and pathological changes of terminal airspace of the lung

Clinical effects of long-term spa therapy for 4 years were estimated in 8 patients of pulmonary emphysema (4 with spa therapy and 4 without spa therapy) by pulmonary function and morphological changes of peripheral airspaces of the lung on high - resolution computed tomography (HRCT). 1 . The values of % FVC, % FEV1.0, and FEV 1.0% did not significantly change for 4year observation both in patients with spa therapy and those without spa therapy. 2. The OLco value significantly decreased from 69.9% at the initial level to 48.8% after 4-year observation in patients without spa therapy (p<O.02). However, the DLco value did not significantly decrease in patients with spa therapy. 3. The values of % RV and % LAA of the lung showed a significant increase in patients without spa therapy (% RV: p<O.05, % LAA: p<O.Ol after 4-year observation compared with the initial levels), however, a change in % RV and % LAA was not significant in patients with spa therapy. 4. The CT number also significantly decreased in patients without spa therapy, but not in those with spa therapy. The results suggest that spa therapy improves % DLco, % RV and morphological changes of peripheral airspaces, chiefly overinflation, of the lung in patients with pulmonary emphysema.肺気腫に対する4年以上にわたる温泉療法の臨床効果を,肺機能の面および末梢肺領域の形態学的変化により評価した｡ 1.FVC,% FEV1.0,およびFEV1.0%値は,温泉療法を受けた症例と受けなかった症例の間に有意の差は見られなかった｡ 2.拡散能(DLco)は,温泉療法を受けなかった症例では,観察初期の69.9%から4年後には48.8%と有意の低下を示したが,温泉療法を続 けた症例では,有意の低下は見られなかった｡ 3.% RVおよびHRCT上の-950HU以下の肺のlow attenuation area(LAA)は,いずれも温泉療法を受けなかった症例では有意の増加傾向を示したが,温泉療法を受けた症例では有意の増加傾向は見られなかった｡ 4.Crnumberは,温泉療法を受けなかった症例では有意の低下を示したが,温泉療法を続けた症例では有意の変化は見られなかった｡これらの結果より,肺気腫に対する温泉療法を続けることにより,% DLcoや % RVは改善する傾向を示し,同時に肺胞の過膨脹の部分(破壊された部分ではなく)が改善されていく可能性が示唆される

Endoscopic removal of subgaleal hematoma in a 7-year-old patient treated with anticoagulant and antiplatelet agents

Background: Subgaleal hematomas frequently occur in children after head trauma and extend over the cranial sutures. Although conservative treatment suffices in most cases, surgical removal of a subgaleal hematoma is indicated when the patient presents with anemia and headache associated with its progressive enlargement. Copyright:Case Description: We present the case of a 7-year-old boy who was medicated with warfarin and aspirin due to a hypoplastic left ventricle and fell from a rock wherein he hit his head in the frontal region. Although a computed tomography scan of the head revealed no intracranial lesion, an extracranial hematoma was found to extend over the cranial sutures, leading to the diagnosis of subgaleal hematoma. The hematoma continued to grow gradually despite the cessation of warfarin and aspirin therapy immediately after the head trauma. Since the patient\u27s headache and anemia were progressing as the hematoma enlarged, removal of the hematoma was performed 3 days after admission. Endoscopic hematoma removal was planned to enable accurate coagulation of the sites of bleeding and removal of the maximal amount of hematoma through minimal incision. The hematoma was completely removed, and the patient\u27s postoperative course was excellent with alleviation of both the anemia and the headache. No sign of hematoma recurrence could be detected during 2 years follow-up.Conclusion: An angled endoscope can allow visualization of the deep subgaleal space, and this technique enabled direct visualization of the bleeding sites and accurate coagulation to prevent recurrence of hematoma. Endoscopic techniques, such as minimally invasive techniques, can allow sufficient removal of subgaleal hematoma with minimal morbidity, especially in patients such as ours

Endocrinological Changes after Anamorelin Administration in Patients with Gastrointestinal Cancer

Changes in hormone levels in patients with cancer cachexia after anamorelin administration have not been fully investigated. This study aimed to determine how anamorelin affects the endocrine system in patients with gastrointestinal cancer and cachexia. We prospectively enrolled 13 patients and comprehensively investigated their body weight and levels of serum albumin, hemoglobin A1c (HbA1c), and hormones before (week 0) and 3 and 12 weeks after anamorelin administration. The variables were evaluated at week 3 in 9 patients and at week 12 in 5 patients. At week 3, anamorelin administration resulted in body weight gain and increased the levels of growth hormone and HbA1c, as well as insulin-like growth factor-1 standard deviation scores (IGF-1 SD scores). At the same time, negative correlations were observed between ΔIGF-1 SD score and Δthyroidstimulating hormone (TSH) and between ΔIGF-1 SD score and Δfree testosterone. ΔBody weight and ΔIGF-1 SD score correlated positively at week 12. These results suggest that TSH and free testosterone levels can be affected 3 weeks after anamorelin administration; however, those variables tend to return to a state of equilibrium, and anabolic effects of anamorelin appear in long-term (≥ 12 weeks) users

Symptomatic foramen of Magendie arachnoid cyst in an elderly patient

Background: Arachnoid cysts (ACs) are congenital anomalies of the central nervous system and arise in virtually all locations where the arachnoid membrane exists. Posterior fossa ACs are considered to develop in the posterior aspect of the rhombencephalic roof plate and do not communicate freely with the fourth ventricle or perimedullary subarachnoid space. Although posterior fossa ACs have been reported a number of times, ACs arising from the foramen of Magendie are very rare. Case Description: We report here on a 76-year-old female who presented with progressive gait disturbance. Magnetic resonance imaging of the head showed a large AC in the foramen of Magendie that was compressing the inferior vermis and medial aspects of the cerebellar hemisphere without causing hydrocephalus. Neurological examination revealed cerebellar ataxia without Romberg\u27s sign. A nearly total excision of the cyst was safely performed via a median suboccipital approach. The patient\u27s postoperative course was excellent and her neurological recovery was remarkable. Conclusion: Most cases of ACs located in the foramen of Magendie are reported in children, and it is extremely rare to observe such ACs in the elderly. In fact, to our knowledge, a symptomatic foramen Magendie AC has never been reported previously in an elderly person. Our results indicate that proper surgical intervention can yield highly positive outcomes in such cases