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1

Studies on the mechanism of obstructive sleep apnea

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Kukwa A. , Gromysz H. , Jernajczyk U. , Karczewski W. A.

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nr 5-6

EN

Kukwa, A., Gromysz, H., Jernajczyk, U. and Karczewski, W. A.: Studies on the mechanism of obstructive sleep apnea. Acta physiol, pol., 1989, 40(5-6): 473-478. Several observations indicate that the mylohyoid nerve (NV) may play a crucial part in the mechanisms of obstructive sleep apnea (OSA). The activity of this nerve normally counteracts the collapse of the upper airways during inspiration. Any reduction in this activity may thus facilitate the occurrence of apnoeic spells. We have studied the effects of ethanol and lung inflations on the activity of NV recorded along with the activities of phrenic and facial nerve in rabbits anaesthetised with chloralose-urethan, paralyzed with curare and artificially ventilated. Under the control conditions the NV exhibited phasic expiratory activity; after vagotomy and additional, inspiratory component was observed. Lung inflation strongly enhanced the expiratory activity of NV whereas both the phrenic and facial nerve activities (both phasic-inspiratory) were typically inhibited. An injection of 5 ml of 20% ethanol very strongly inhibited the NV activity. The results may confirm the importance of NV in the mechanism of OSA. The well-known fact that OSA patients are particularly sensitive to alcohol finds support in the response of NV activity to ethanol injection. The analysis of the patterns of discharges of the three outputs from the respiratory controller may additionally suggest that the Vth nerve nucleus is involved in the control of respiratory pattern.

2

Topography of the lymphati network of the laryngeal mucosa

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Skarzynska B. , Kukwa A. , Skarzynski H.

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nr 1

3

Breuer-Hering reflexes in ketamine-induced apneustic breathing in the rabbit

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Gromysz H. , Karczewski W. A. , Kukwa A. , Jernajczyk U.

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nr 7

EN

Gromysz H., Karczewski W. A., Kukwa A., Jernajczyk U.: Breuer-Hering reflexes in ketamine-induced apneustic breathing in the rabbit. Acta Physiol. Pol. The effects of ketamine on the activities of the mylohyoid nerve (a branch of the Vth nerve) and of both phrenic nerves were investigated in rabbits anaesthetized with halothane, paralyzed and artificially ventilated. Intravenous administration of ketamine elicited a marked prolongation of the phrenic inspiratory discharge [without] not significantly affecting its amplitude) and a depression of the mylohyoid expiratory activity. An elimination of the volume-related input from the lungs (“no inflation manoeuvre” or deflation) elicited under these conditions typical apneustic pattern of breathing. The response to tracheal occlusion at peak-inspiration was “classical”. We conclude that ketamine inhibits the Vth nerve motor nucleus which is not only an important component of the central inspiratory-inhibitory neurones but also a “relay station” between the vagal and the central inspiratory “off-switch” mechanisms.

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Wielostopniowa procedura monitorowania zaburzeń oddychania podczas snu (ZOPS)

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Hatliński G. , Kornacki W. , Kukwa A.

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tom Vol. 12, nr 1

4-8

PL

Diagnostyka zaburzeń oddychania podczas snu (ZOPS) jest młodą i trudną dziedziną kliniczną, ale już obecnie ocenia się, że przypadłość związaną z nieprawidłowym oddychaniem podczas snu dotyka ponad 5% populacji ludzkiej. Chrakterystyczną cechą tych zaburzeń jest ograniczenie lub brak przepływu powietrza przez górne drogi oddechowe w czasie snu. Skrajnym przypadkiem ZOPS jest zespół snu z bezdechami (ZSzB, Sleep Apnea Syndrome). Podstawowym narzędziem do diagnostyki ZOPS jest polisomnografia. Opracowane i wdrożone przez nasz zespół systemy polisomnograficzne, które tworzą wielostopniową (czterostopniową) procedurę monitorowania ZOPS, składają się w kolejności z: a)pulsoksymetrii, b)małej polisomnografii (mPSG), c)dużej polisomnografii (PSG), d)hiperpolisomnografii (HPSG). Oryginalnym rozwiązaniem jest równoczesne monitorowanie ZOPS i zaburzeń sercowo-naczyniowych w ramach HPSG. Omówione również zostały nowe metody analizy danych oraz specyfika biopomiarów w poszczególnych procedurach monitorowania ZOPS.

EN

The diagnostic of respiratory disorders during a sleep (RDDS) is a quite new and difficult branch of clincial medicine. It is estimated now that ca. 5% of population suffers from incorrect respiratory process during a sleep. The charracteristic for these disorders is limitation or a complete obstacle to air flow through upper airways in a sleeping patient. The most severe case of the disorders is a Sleep Apnea Syndrome (SAS). The basic method for the diagnosis of RDDS is polysomnography. The developed by our team polysomnography systems base on multistage (four stage) monitoring procedure consisting of: a)pulsoximetry, b)small polysomnography (SPSG), c)large polysomnography (PSG), d)hiperpolysomnography (HPSG). The original idea behind this methodology is simultaneous monitoring of respiratory and cardiovascular disorders in HPSG. The paper also presents new methods of data analysis and biomeasurements specificity in particular monitoring procedures of RDDS.

5

Horseradish peroxidase localization of the mylohyoid motoneurones in the rabbit

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Gromysz H. , Karczewski W. A. , Kosmal A. , Kukwa A.

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nr 2

6

Influence of vagal input on cerebral blood flow in monkeys and dogs after experimental cerebral vasospasm

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Ryba M. , Glowicki K. , Zalewski W. , Januszewski S. , Kukwa A.

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tom 45

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nr 5-6