OBJECTIVETo examine adaptive changes in the shape of the upper airway during titrated mandibular advancement. Furthermore, to understand the mechanism of mandible-adjustable therapy to improve the ventilation.

METHODSFourteen non-apnea participated in the study. A custom-made oral device was used to keep the mandible in titrated advancement at 0% (F0), 50% (F50), 75% (F75), 100% (F100) of the maximum advancement. Magnetic resonance imaging was used to investigate the difference in the shape of upper-airway in these 4 positions. Changes in the anteroposterior direction (AP), lateral direction (Lat) and its ratio (AP/Lat) were calculated, which were transformed into the percentage of the original ones.

RESULTSThe dose-dependent decrease of AP/Lat was found when the mandible was advanced (P = 0.0001). Lateral change rate in percentage increased by degrees (P = 0.0023), while the increase of anteroposterior change rate in percentage showed no statistical significance.

CONCLUSIONThe shape of upper airway tended to be less round. The enlargement of upper airway during titrated mandibular advancement was mainly the result of enlargement in lateral direction.

Asian Continental Ancestry Group ; Humans ; Magnetic Resonance Imaging ; Male ; Mandible ; anatomy & histology ; Mandibular Advancement ; Palate, Soft ; anatomy & histology ; Pharynx ; anatomy & histology

Gastric adenocarcinoma of the fundic gland mucosa type (GA-FGM) was proposed as a new variant of gastric adenocarcinoma of the fundic gland type (GA-FG). However, at present, the influence of Helicobacter pylori and the speed of progression and degree of malignancy in GA-FGM remain unclear. Herein, we report the first case of intramucosal GA-FGM that was endoscopically observed before and after H. pylori eradication over 15 years. The lesion showed the same tumor size with no submucosal invasion and a low MIB-1 labeling index 15 years after its detection using endoscopy. The endoscopic morphology changed from 0-IIa before H. pylori eradication to 0-IIa+IIc and then 0-I after H. pylori eradication. These findings suggest that the unaltered tumor size reflects low-grade malignancy and slow growth, and that the endoscopic morphology is influenced by H. pylori eradication.