Background : The contraction of the genioglossus muscle is realized by the binding of serotonin with serotonin 2A receptor through modulating the hypoglossal motor output. When the genioglossus muscle relaxes, it causes glossoptosis and upper airway obstruction. Therefore, the variations of the serotonin 2A receptor gene (HTR2A) are hypothesized to be associated with obstructive sleep apnea syndrome (OSAS) according to the pathogenesis of OSAS. To investigate the association of the HTR2A gene with OSAS in the Japanese population, we conducted the current case-control association study.
Methods : The subjects included 145 male patients with OSAS who were diagnosed by overnight polysomnography (PSG) and 133 male controls who were normal in PSG. All the subjects were of Japanese origin with respect to ethnicity. Ten tag single nucleotide polymorphisms (SNPs) in the HTR2A gene were genotyped with TaqMan SNP genotyping. A multivariate logistic regression analysis was applied with adjustments of age and body mass index (BMI).
Results : There were no significant differences of allelic frequencies of the ten tag SNPs between patient and control groups. In addition, in sub-analyses among the patients with OSAS, we did not detect any associations of these SNPs with the severity of OSAS (apnea hypopnea index cutoff : 40 events/h) and with the degree of obesity (BMI cut off : 25kg/m²).
Conclusions : This study did not prove the hypothesis regarding the association of variations of the serotonin 2A receptor gene (HTR2A) with OSAS. The HTR2A gene variations were less likely to participate in the pathogenesis of OSAS in Japanese.

Background : Pneumothorax with interstitial pneumonia (IP) is a refractory and life-threatening disease. The aim of the study was to clarify the benefits of surgical treatment of initial-onset pneumothorax in patients with IP.
Methods : The medical records of 37 patients with IP who developed initial-onset pneumothorax were retrospectively reviewed. Two groups of patients were analyzed : a surgical treatment group (n＝20) and a non-surgical treatment group (n＝17). The clinical characteristics of the two groups were compared. Risk factors for respiratory complications in hospital were assessed by univariate and multivariate logistic regression analyses.
Results : A Respiratory complications in hospital in the surgical treatment group included two patients who developed bacterial pneumonia ; however, no patient developed acute exacerbation of IP. The location of air leakage was determined during surgery in 19 of the 20 (95%) patients. Air leakage developed from the bulla in 18 patients and from a crack of the lung parenchyma in one patient. Univariate and multivariate logistic regression analyses showed that surgery was independently associated with a significantly lower risk of respiratory complications in hospital (hazard ratio [HR]＝0.115, p＝0.022).
Conclusion : Surgical treatment yielded relatively better results than non-surgical treatment in patients with IP who develop initial-onset pneumothorax. Surgical treatment should be considered for IP patients who develop pneumothorax.

We evaluated the nutritional status of 77 patients hospitalized for respite care in the Integrated Community Care ward of our hospital. As a nutrition index, BMI (Body Mass Index), the Hb value, serum Alb value, TLC (total lymphocyte count), MNA® (Mini Nutritional Assessment®) and the CONUT (controlling nutritional status) method were chosen, and the group of patients for respite care was compared with a control group (77 patients more than 75 years old before operative surgery). We also examined the change in the nutritional status of 20 people hospitalized more than once for respite care. In the respite care patients, BMI and Alb were significantly lower than in the control group, but Hb and TLC were not significantly different between the two groups. In respite patients, there were also significant differences in many hypoalimentation patients with the MNA® and CONUT method. BMI, Hb, Alb, and TLC of the 20 people hospitalized more than once were significantly decreased at the time of the last hospitalization, but there were no significant changes with the modal MNA® and CONUT method. The nutritional condition of the respite patients was poor, and it was suggested that there is a risk of nutritional status deterioration with repeated hospitalization. It is necessary to do appropriate nutritional assessment and nutritional management during hospitalization and make an effort toward maintenance of the nutritional status.