1/6. Hypersomnia with periodic breathing (an acromegalic Pickwickian).The syndromes of Pickwickian, Ondine's curse, and primary alveolar hypoventilation are respiratory disorders manifesting increased sleepiness and irregular respiratory rhythms. These disorders are currently grouped as hypersomnia with periodic breathing (HPB). Polygraphic techniques have lead to a reasonable hypothesis as to the pathophysiology of the multiple variants of HPB. Discernible causes of HPB have been attributed to both central and peripheral factors. Peripheral factors encompass those conditions relating to upper airway obstruction. An acromegalic person suffering the HPB syndrome secondary to laryngeal stenosis is described.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
2/6. Fetal response to periodic sleep apnea: a new syndrome in obstetrics.Periodic sleep apnea, a chronic sleep deprivation state, in which marked changes in the arterial PO2 and PCO2 tensions have been recorded, is a relatively new syndrome not previously reported in pregnancy. It is characterized by episodes of apnea, prevalently obstructive, during sleep. The majority of patients with this syndrome have snored heavily for years, suggesting a causal relationship between snoring and periodic sleep apnea. The effects of prolonged snoring on alveolar ventilation and systemic pressure(s) suggest that this snoring has physiopathological implications on maternal cardio-respiratory reserve and indirectly upon the fetus, especially as there are recordable changes in fetal heart rate and also a change in the acid-base status of the fetus. The possibility that this syndrome may have an adverse effect upon the fetus is stressed.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
3/6. Hypersomnia and periodic breathing. Report of a case and review of the literature.A patient with hypersomnia and periodic breathing has been studied. Both airflow obstruction and an abnormally of the respiratory control mechanism were implicated in the pathogenesis of the ventilatory arrhythmia. It is suggested that the older terms "Pickwick" syndrome and primary alveolar hypoventilation are abandoned for more descriptive terms, e.g. "hypersomnia with periodic breathing".- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
4/6. Pulmonary function in a typical case of Pickwickian syndrome.Pulmonary function was studied in a patient with Pickwickian syndrome, before and after a weight reduction of 160 kg which was brought about by jejunoileal bypass surgery. After weight reduction, there was an increase in alveolar ventilation, lung volumes and respiratory flow rates. Arterial blood oxygen tension, arterial oxygen saturation, arterial carbon dioxide tension and pH also showed a significant improvement towards normal. These findings indicate that reduction of body weight is beneficial for Pickwickian syndrome patients. The improvement of pulmonary function was probably due to the improvement of the patient's respiratory mechanics.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
5/6. Polygraphic study of periodic breathing and hypersomnolence in a patient with severe hypothyroidism.A 67-year-old woman with primary hypothyroidism, who had Pickwickian syndrome as well, was studied electrophysiologically. A polygraphic study with simultaneous recordings of electroencephalography, actograms of the abdominal walls, the mentum and the anterior neck, and electromyogram of the intercostal muscles revealed a cyclic appearance of apnea in the sleep phase and gasping preceding arousal, which, together with macroglossia and sleep in the sitting position, suggested a cyclic obstruction of the upper airway. The obstruction appeared responsible for both alveolar hypoventilation and disturbance of consciousness.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
6/6. obesity hypoventilation [corrected] syndrome in the differential diagnosis of a pulmonary mass.dyspnea and cyanosis are common presenting manifestations of cardiopulmonary disease. When these findings occur in a cigarette smoker with an apparent pulmonary mass on chest radiograph, the differential diagnosis rapidly narrows to a short list of possibilities that include pulmonary neoplasm, pulmonary infection and pulmonary infarction. Pulmonary hypertension with pulmonary arterial enlargement and hypoxia secondary to alveolar hypoventilation should also, however, be included as a diagnostic possibility in the appropriate setting because the evaluation and treatment of this entity may differ markedly.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |