1.Occurrence of Sleep-Disordered Breathing (SDB) in Examinees of Thorough Medical Checkup
Akemi TAKAMIZAWA ; Mitsuyo OKADA ; Toshio SHIMIZU ; Miyuki HAYASHI ; Junko KOMATSU
Journal of the Japanese Association of Rural Medicine 2005;54(6):879-886
The estimated prevalence of sleep-disordered breathing (SDB) with an apnea-hypopnea index (AHI) of 5 or higher was 24 percent for men, and 4 percent of men in the middle-aged work force meet the minimal diagnostic criteria for the sleep apnea syndrome (SAS) (SDB with daytime hypersomnolence). However, there are few published data about this problem in our country.A random sample of 208 men 30 to 76 years old who were staying overnight for a complete physical examination were the subjects of this study. A portable sleep data acquisition device was used to determine the frequency of episodes of apnea and hypa-pnea in them. The prevalence of SDB was worked out and the clinical significance was discussed.The estimated prevalence of SDB was 76.4 percent and that of SAS was 12.5 percent. Compared with subjects with lower AHI values, those with higher levels of SDB and AHI included a significantly large number of individuals of advanced age and with hypertension, although their body mass index, Epworth sleepiness scale, and values of total cholesterol and triglycerides were not significantly high.These data revealed a remarkable high incidence of SDB in our country and suggested an association of SDB with risk factors of cardio-vascular events. We need a regular screening for sleep disorders by polysomnography or the portable device at least.
percent
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Prevalence aspects
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Sleep Apnea Syndromes
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Male population group
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SAS
2.A Case of Multicentric Castleman's Disease Having Lung Lesion Successfully Treated with Humanized Anti-interleukin-6 Receptor Antibody, Tocilizumab.
Tomoaki HIGUCHI ; Takashi NAKANISHI ; Kunio TAKADA ; Mitsuyo MATSUMOTO ; Makoto OKADA ; Hideyuki HORIKOSHI ; Kimihiro SUZUKI
Journal of Korean Medical Science 2010;25(9):1364-1367
This report presents the case of a patient demonstrating multicentric Castleman's disease (MCD) with a lung lesion that was successfully treated with an anti-interleukin-6 receptor antibody, tocilizumab in combination with corticosteroid and tacrolimus. A 43-yr-old female with abnormal shadows on a chest X-ray was referred to the hospital for further examination. She was diagnosed as having MCD based on the characteristic pathology of inguinal lymph node, lung lesions, laboratory data, and undifferentiated arthritis. Corticosteroid and rituximab therapy did not fully ameliorate the symptoms; thus, the therapeutic regimen was changed to include tocilizumab, oral corticosteroid and tacrolimus. This regimen resulted in clinical remission and the dose of tocilizumab and corticosteroid could be tapered. Tocilizumab in combination with corticosteroid and tacrolimus may therefore be a beneficial treatment regimen for lung lesions associated with MCD.
Adrenal Cortex Hormones/therapeutic use
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Adult
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Antibodies, Monoclonal/*therapeutic use
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Drug Therapy, Combination
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Female
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Giant Lymph Node Hyperplasia/*diagnosis/drug therapy/radiography
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Humans
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Immunosuppressive Agents/therapeutic use
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Lung Diseases, Interstitial/*drug therapy/pathology
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Lymph Nodes/pathology
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Receptors, Interleukin-6/antagonists & inhibitors
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Tacrolimus/therapeutic use
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Tomography, X-Ray Computed