[Comparative study of different types of sutures in single or double layers in the small intestine. Experimental study in dogs].
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Biomedical subjects
Publications and source records attributed to M Mantovani.
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A case of myotonic dystrophy accompanied by alveolar hypoventilation and hypersomnia is presented. Radiological studies and EMG examination of the intercostal muscles demonstrated that the respiratory muscles were affected by the disease, while polygraphic recordings showed that the alveolar hypoventilation and pulmonary hypertension worsened during sleep. The hypersomnia preceded the appearance of clinical signs of the muscular disease by many years and persisted even after treatment when the blood gas analysis values were greatly improved. During both diurnal and nocturnal sleep, the patient frequently fell asleep directly into a REM stage. The possibility is discussed that, concomitant with the respiratory musculature involvement, there is an alteration in the central nervous system in myotonic dystrophy which is at least partially responsible for both the alveolar hypoventilation and the hypersomnia.
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Two non-obese patients suffering from hypersomnia with periodic breathing, who presented predominantly obstructive apnoea persisting throughout sleep, underwent tracheotomy with placement of a permanent tracheal cannula. Before tracheostomy there was a serious state of alveolar hypoventilation with a marked rise in pulmonary arterial pressure which appeared during sleep. After tracheostomy breathing during sleep became regular, pulmonary arterial pressure became normal, and daytime drowsiness disappeared. These observations suggest that the obstruction of the upper air tracts during sleep represents the most important factor in the pathogenesis of hypersomnia with periodic breathing.
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