Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred and twenty-six patients who underwent tonsillectomy because of recurrent acute tonsillitis, tonsillar hypertrophy or sleep apnoea were evaluated by tonsillar core culturing. The sleep apnoea patients served as controls, since none of them had tonsillar hypertrophy at ENT examination or any history of recurrent acute tonsillitis, and thus their tonsillar core flora could be regarded as normal. The isolation rate of H. influenzae was much lower among sleep apnoea controls (2.7 per cent) than among either the patients with recurrent acute tonsillitis (20.3 per cent) or those with tonsillar hypertrophy (36.7 per cent) (p less than 0.05), as was that of group A streptococci, 5.4 per cent versus 16.9 and 20 per cent, respectively (though the latter differences were not statistically significant). The isolation frequencies of B. catarrhalis, pneumococci, group C and G streptococci did not differ between the three groups. The high tonsillar core recovery rates of H. influenzae and group A streptococci both in patients with recurrent acute tonsillitis and in those with tonsillar hypertrophy, as compared with normal controls, suggests the possible involvement of these bacteria in both conditions.
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PMID:High recovery of Haemophilus influenzae and group A streptococci in recurrent tonsillar infection or hypertrophy as compared with normal tonsils. 207 11

We describe two adult patients in whom acute tonsillitis resulted in the rapid development of cor pulmonale in the absence of clinically evident upper airway obstruction or diffuse obstructive airway disease. Both patients had developed symptoms of sleep apnea and all-night polysomnography confirmed the presence of severe obstructive sleep apnea. These cases emphasize the potentially severe cardiovascular consequences of acute tonsillar hypertrophy in the obese adult patient.
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PMID:Rapid development of cor pulmonale following acute tonsillitis in adults. 291 1

This report presents six cases of obstructive sleep apnea associated with discrete anatomic abnormalities of the upper airway tract. All patients were relieved of their sleep apnea by surgical correction of the airway obstruction, and therefore permanent tracheotomy was avoided. The obstructive causative factors were nasal septal deformity, adenoidal hypertrophy, nasopharyngeal stenosis, lingual cyst, lingual tonsillar hypertrophy, and laryngeal cyst. The last-named four conditions have not previously been reported as correctable causes of sleep apnea.
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PMID:Surgically correctable causes of sleep apnea syndrome. 679 97

Obstructive Sleep Apnea Syndrome (OSAS) is children is commonly caused by upper airway obstruction, such as that caused by adeno-tonsillar hypertrophy. We report a rare case of SAS due to a nasopharyngeal tumor. The patient was a 10-year-old boy who complained of snoring and sleep apnea. The tumor was found in the nasopharynx and mesopharyngeal space. We diagnosed this case as OSAS by overnight sleep study (Apnea Hypopnea Index: AHI = 19.67). The tumor was removed under general anesthesia. Histopathology revealed features of nasopharyngeal angiofibroma. After removal of the tumor, his symptoms resolved completely. A follow-up overnight sleep study confirmed resolution of OSAS. At the last follow up, conducted 17 months after the operation there were no signs of tumor recurrence.
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PMID:[A case of sleep apnea syndrome due to a nasopharyngeal tumor]. 882 49

In children with recurrent tonsillitis there may be persistent antigen deposition in tonsil tissue. even between exacerbations. If so, upregulation of immunocompetent cells should occur continuously, in contrast to tonsil tissue from children with tonsillar hypertrophy. The cytokine pattern was studied in cell suspensions prepared from tonsils obtained from 12 children undergoing tonsillectomy. The study group comprised 6 children with recurrent tonsillitis and 6 who had a history of tonsillar hypertrophy causing sleep apnea. Cytokine-producing cells (IL-1alpha, IL-1beta, TNFalpha, IL-6, IL-8, IL-2, IFNgamma, TNFbeta, IL-10 and IL-4) were characterized at the single-cell level by use of cytokine-specific monoclonal antibodies and indirect immunofluorescence technique. A constitutive production of IL-1alpha, IL-1beta, TNFalpha, and IL-8 was found in both groups (10-300/10(5) cells). However, the frequency of spontaneous IL-2, IFNgamma, TNFalpha, IL-6 and IL-10 was consistently low (10 +/- 10 cells) in both groups. Following restimulation by T-cell receptor ligation, using immobilized anti-CD3 mAb, with concentrations chosen so that it did not activate resting cells, increased frequencies of TNFalpha, IL-6, IL-8, IL-2, IFNgamma, IL-4 and 1L-10 synthesizing cells were induced in the recurrent tonsillitis group. Significantly higher incidences of IL-1beta, IL-6 and IL-2 producing cells were found in the recurrent tonsillitis group (60-200/10(5) cells, p <0.05). Microbiological evaluation in the tonsil tissue could not reveal tiny differences between the studied groups regarding bacterial or viral pathogens. However, this does not exclude persistent increased intracellular deposition of microbial antigens as a possible explanation for the elevated incidence of IL-1beta, TNF-alpha, IL-6, IL-8, IL-2, IFNgamma, IL-10 and IL-4 expressing cells noticed in patients with recurrent tonsillitis.
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PMID:Upregulated local cytokine production in recurrent tonsillitis compared with tonsillar hypertrophy. 892 44

Sleep apnea syndrome in children is usually caused by adenoidal and tonsillar hypertrophy. Here, we report on a typical case of obstructive sleep apnea syndrome, and also discuss recent indications for tonsillectomy in children. A 6-year-old boy came to our hospital suffering from serious obesity and somnolescence. He could not sleep lying down and thus started to sleep in a sitting position. Even during daytime he slept while standing, and exhibited hypersomnolescence. He was 133 cm tall and weighed 80 kg, and tonsillar hypertrophy was recognised. Consequently, tonsillectomy and a weight reducing program were undertaken. The lowest SaO(2) improved from 50% to 70%, and sleep apnea also decreased from 141 to 71 episodes. Moreover, the hypersomnolescence improved.
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PMID:Treatment of sleep apnea and snoring in children. 908 92

Among 145 patients treated with recombinant human growth hormone (GH), four developed sleep apnea (two obstructive, two mixed) associated with tonsillar and adenoidal hypertrophy in three. These four patients had no local risk factors predisposing to upper airway obstruction (i.e., frequent pharyngitis or sinusitis). Clinical and/or polysomnographic features of sleep apnea improved following cessation of GH therapy in one patient, and following tonsillectomy and adenoidectomy in all patients. The present observations indicate that, albeit rarely, obstructive and/or central sleep apnea may occur in children treated with GH. Polysomnography should be considered if symptoms of snoring, interrupted sleep, daytime somnolence-particularly if associated with tonsillar hypertrophy-appear in children during GH therapy.
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PMID:Sleep apnea in patients receiving growth hormone. 919 30

To determine the etiology of obstructive sleep apnea (OSA) in children with cerebral palsy (CP), a survey using a questionnaire was conducted on parents of 233 CP children (1-5 years old, mean age: 2.7) and on those of 343 control children during a routine medical check-up at the age of three. The prevalence of habitual snoring and nasal obstruction was 63 and 20% in CP children, which were significantly higher than in control children. Sleep apnea episodes and stridor were noted in 19.7 and 15.4% of CP children. A screening sleep study was performed using Apnomonitor II and a pulseoximeter (Pulsox 5) in 48 CP children whose questionnaires revealed habitual snoring and sleep apnea, and it was found that 27 and 58% of the children had on apnea-hypopnea index (AHI) of greater than 5 and a low level of SaO2 (LSaO2) of less than 85%, respectively. When another 10 CP children visited our hospital for treatment of severe OSA, precise evaluations including pharyngeal pressure and fiberscopic examination during sleep as well as a sleep study using an inductive prezysmograph (Respigraph) were performed. Adenoid and/or tonsillar hypertrophy were noted in only 4 children, and the main cause of sleep apnea in the other 6 children was pharyngeal collapse at the lingual base. Their OSA was successfully treated by adenotonsillectomy in 2 children, adenotomy in 2 children, UPPP and lingualplasty in 1 child, tracheostomy in 2 children, and nasal CPAP in 1 child. Before treatment of OSA in CP children, precise evaluation is recommended in order to perform appropriate treatment.
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PMID:[Obstructive sleep apnea in children with cerebral palsy]. 958 65

Predicting outcome following uvulopalatopharyngoplasty (UPPP) in obstructive sleep apnea is difficult. We hypothesized that UPPP is effective in obstructive sleep apnea patients with severe tonsillar hypertrophy. We examined the relationship between the severity of pre-operative tonsillar hypertrophy and the effect of UPPP in 38 patients with obstructive sleep apnea (oxygen desaturation index (ODI) > or = 20). The patients were classified into three groups according to the Mackenzie Classification of tonsillar hypertrophy. Ten patients were classified as grade 1 (M1) hypertrophy, i.e. tonsils just visible beyond the palatal arch. Five patients had grade 3 (M3) hypertrophy, i.e. tonsils appearing to contact each other at the midline. The remaining 23 patients had grade 2 (M2) hypertrophy, i.e. intermediate enlargement. We measured the apnea index, ODI, DST 90, and DST 85 (%time with SaO2 < or = 90% and < or = 85%, respectively) using a screening device for sleep apnea (Apnomonitor II, CHEST M. I. Co. Tokyo, Japan) before and after UPPP. Following UPPP, the mean ODI decreased significantly in all groups: 59 to 9/hr (p < 0.005) in the M3 group, 53 to 27/hr (p < 0.001) in the M2 group, and 48 to 33/hr (p < 0.05) in the M1 group. Post-UPPP ODI decreased by 83% in M3, 45% in M2, and 28% in M1 patients. Successful UPPP, defined by a post-UPPP ODI of less than 20/hr and a greater than 50% decrease in post-UPPP ODI, occurred in 80% of M3, 43% of M2, and 10% of M1 patients. We conclude that tonsillar hypertrophy can predict a successful response to UPPP in obstructive sleep apnea patients.
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PMID:[Effects of uvulopalatopharyngoplasty on patients with obstructive sleep apnea--the severity of preoperative tonsillar hypertrophy]. 961 74

Tonsillectomy was performed on 10 adult sleep apnea patients (five males, five females; average age, 39 years old; average body mass index, 24.8 kg/m2). Tonsillectomy alone was indicated if tonsillar hypertrophy was moderate to severe and the length of the soft palate was less than 35 mm according to cephalometry. Remarkable improvements were observed in all cases following surgery. The average weight of the resected tonsils was 11 g. The patients demonstrated a preoperative apnea + hypopnea index (AHI) of 14.4/h. This decreased to 2.9/h postoperatively. The intraesophageal pressure change improved from -36.6 to -15.7 cmH2O following surgery. A significant correlation between preoperative AHI and the degree of obesity (r=0.684, P < 0.05) was found. Although uvulopalatopharyngoplasty has been used extensively to treat sleep apnea, the present results suggests that certain subjects can be effectively treated through only tonsillectomy.
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PMID:Effectiveness of tonsillectomy in adult sleep apnea syndrome. 962 63


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