A 75-year-old man, who was under treatment for bronchial asthma and hypertension in our hospital, complained about his snoring and daytime sleepiness. Polysomnography (PSG) was indicated. He was diagnosed as having a serious obstructive sleep apnea-hypopnea syndrome in April, 2003. Continuous positive airway pressure (CPAP) treatment was effective, and his symptoms waned. The CPAP treatment was discontinued at the end of October, because the patient, chief priest of a temple Buddhist, had to serve for 100 days as acting chief priest of another temple. He ate only meals prepared at the temple, and drinking and eating out were not done at all, and the eating habits were managed. He was told he is a trrible snorer, but was not aware of daytime sleepiness. In April 2004, PSG showed his condition turned a little better with AHI being 9.9/hour. After he returned to the original temple, a diet was continued. However, the AHI rose to 12.8 in November 2004-nine months after reinstatement. It was thought that differences in everyday life were responsible for the exacerbation of OSAHS despite the fact tha the showed an improvement just after he came back to his temple.
Priest ; Sleep Apnea, Obstructive ; Continuous positive airway pressure ventilation treatment ; Syndrome ; Disease remission

A 20-years-old man was referred to our hospital in September 2003. He complained of fatigue and headache at the time of getting up, daytime sleepiness, sudden sleep attacks and dozing off at the wheel. He became aware of insomnia at night and severe sleepiness in the daytime at the age of 13. Since he was 17 years old, he had been seized with an uncontrollable desire for sleep. The total night's sleep has often been reduced to two hours at the longest, interrupted by arousal 10 times (maximal) since he got a job. His Epworth Sleepiness Scale was 13 points. In polysomnography, the first REM period occurred immediately after onset of sleep, and the apnea-hypopnea index was 1.0 per hour. In multiple sleep latency tests, his sleep latency and REM latency were less than 2 minutes. The sleep onset REM period was found in all sessions of MSLT. HLA-DR2 and HLA-DQ1 were positive. His case was diagnosed as narcolepsy, and methylphenidate was taken in the morning and at noon, and naps were taken in the morning and in the afternoon, and the sleep diary was started. The times of daytime's naps and sleep attacks decreased, and his condition was improved.
Sleep ; rapid eye movement ; Narcolepsy ; seconds ; night

It is a big problem to cope with elderly patients who are increasing in a community in Niigata which has already been heavily populated by those people over 65 years of age. Aging is not a disease. However, the actual situation of patients with hematological and solid tumors in the aging community is little known. In this communication, we analyzed 293 patients (AML/ALL: 52, NHL: 112, MDS: 75, MM: 40, and others: 14) and 127 dead with hematological malignancies treated in our hospital for the past 10 years or 80 to clarify the actual changes in the trend of patients with hematological malignancies and compared them with those of patients who died of solid tumors. The population movements over the last 20 years in the Kashiwazaki area were also studied.Our analysis showed that the number of patients who died of solid tumors increased (1.6 times) in step with the increases in the aged population for there 20 years in the Kashiwazaki area. In addition, the incidence of gastric cancer markedly decreased for the past 20 years, while that of colorectal cancer rapidly increased (5 times). The incidence of hematological malignancies also increased with its peak shiftted to the latter haf of the 7th decade of age for the past 10 years. In addition to the increased incidence, patients with NHL and MDS increased in number by 1.5 times over the last 10 years. Especially, patients with MM showed an increase of 3 times, while the incidence of AML was not changed, even decreasing in number.In conclusion, the incidence of hematological malignancies as well as solid tumors has steadily been increasing with the increases in the aged population in the Kashiwazaki area, and the number of the aged patients over 70 years of age also increased. Such aged patients, however, are not available for hematopoietic stem cell transplantation. Therefore, it is urgently necessary for us to cope with the increases in the number of aged patients with hematological malignancies.
Malignant Neoplasms ; incidence of cases ; seconds ; Solid tumor ; Aging

BACKGROUND: The free vascularized fibula flap presents many advantages such as sufficient length of the bony segment, good vascularization, better quality of the bone, and a long vascular pedicle, but it is also associated with some disadvantages with regard to prosthetic rehabilitation because of its limited height. Improvement in bone height is necessary for ideal dental implant treatment of reconstructed mandibles. CASE PRESENTATION: For two squamous cell carcinoma patients, mandibular bone reconstruction was performed secondarily with the peroneal flap after tumor resection. Since the bone height was insufficient at the time of implant treatment, occlusion reconstruction by dental implant was performed after vertical distraction osteogenesis. CONCLUSIONS: Vertical distraction osteogenesis is a suitable treatment option for alveolar ridge deficiency resulting from fibula transplantation for mandibular reconstruction following tumor surgery.
Alveolar Process ; Carcinoma, Squamous Cell ; Dental Implants ; Fibula ; Humans ; Mandible ; Mandibular Reconstruction ; Osteogenesis, Distraction ; Rehabilitation