In our previous communicaiton on an analysis of dizzy patients, we reported that there was a significant difference between patients with dizziness of indeterminate etiology and age-matched healthy control subjects in the incidence of positivity on the Schellong test, while no significant difference was observed between dizzy patients with peripheral vestibular disorder and healthy controls. We speculated that these results may be explained by the fact that a substantial number of patients with orthostatic dysregulation or autonomic imbalance were included among dizzy patients of indeterminate etiology. We further attempted to analyze data obtained exclusively from 149 adult patients with dizziness of indeterminate etiology (34 males and 115 females), who were not diagnosed with either peripheral or central vestibular dysfunction, conforming to the procedure using the Schellong test to determine whether their symptoms were directly related to autonomic nervous system dysfunction. Ninety age-matched healthy individuals without a history of dizziness or vertigo were selected as controls (42 males and 48 females). The results obtained in the present study were as follows: 1) Patients with dizziness of indeterminate etiology showed a higher incidence of positivity on the Schellong test than healthy control subjects. The difference between the two groups was statistically significant. Our previous data reported elsewhere were thus confirmed by the present study. 2) Since the five major and six minor items listed in the questionnaire for orthostatic dysregulation are known to be composed entirely of so-called autonomic imbalance symptoms, patients were divided into two groups based on responses to a questionnaire; one having subjective symptoms of autonomic imbalance (6 males and 29 females for a total of 35) and the other not (28 males and 86females for a total of 114). Patients with autonomic imbalance disclosed a higher incidence of positivity on the Schellong test as compared to patients without symptoms. Among the former patients, a decrease of systolic pressure on standing, in particular, was more prominent than that among the latter.

Diseases associated with the Eustachian tube include Eustachian tube stenosis, Eustachian tube opening, and otitis media with effusion. The Eustachian tube insufflation method is used both for examining and treating Eustachian tubes and is clinically performed on patients with Eustachian tube diseases. However, the Eustachian tube insufflation sounds that are produced by this method are only auscultated by the doctor. Therefore, there is a disadvantage that the sound is not saved as data, and diagnosis is based on the auditory judgment of doctors, leading to weak objectivity. The purpose of this study is to improve the objectivity of diagnosis by developing a system that quantitatively evaluates the severity of the Eustachian tube insufflation sounds. We collected Eustachian tube insufflation sounds from patients with the Eustachian tube disease. The acoustic characteristics of the collected data were analyzed in order to quantify the difference in the Eustachian tube insufflation sound, depending on the degree of the Eustachian tube disease. In addition, spectrum analysis was performed using the maximum entropy method (MEM), and the abnormal sound was extracted from the cross-correlation function with the template of the abnormal sound. The change of the frequency spectrum with time was expressed. As a result, the time taken to open the Eustachian tube was recorded and an index indicating the severity of normal and stenotic sounds was proposed.

Periodontitis is a common chronic infection and is associated with cardiovascular disease. This study evaluated whether basic oral care for periodontal disease could improve endothelial function in patients with acute coronary syndrome (ACS).This study enrolled 54 patients with acute coronary syndrome admitted to Kagoshima City Hospital and who had undergone percutaneous coronary intervention. Flow-mediated endothelium-dependent dilatation (FMD) was measured before discharge (initial FMD) and at 8 months after percutaneous coronary intervention (follow-up FMD). The following periodontal characteristics were measured: periodontal pocket depth (PPD, mm), plaque control record (%), and bleeding on probing (%). All patients received basic oral care instructions from dentists. The oral health condition was generally poor in the participants and there were 24 patients (44.4%) who had severe PPD. Despite the intervention of basic oral care, the periodontal characteristics did not improve during the study period; initial FMD and follow-up FMD did not significantly differ (4.38 ± 2.74% versus 4.56 ± 2.51%, P = 0.562). However, the follow-up FMD was significantly lower in patients with severe PPD (≥ 6.0 mm, n = 24) than in patients without severe PPD (≤ 5.0 mm, n = 30) (FMD: 3.58 ± 1.91% versus 5.37 ± 2.67%, P = 0.007). FMD tended to be worse in patients with severe PPD than in patients without severe PPD (ΔFMD: -0.55 ± 2.12 versus 0.81 ± 2.77 %, P = 0.055). In conclusion, during the use of basic oral care, endothelial function improved in patients without severe PPD, while it worsened in patients with severe PPD.