bluuebunny/crossref_metadata_2025 huggingface dataset:
Event‐related potential correlates of functional hearing loss: Reduced P3 amplitude with preserved Nl and N2 components in a unilateral case
Authors: FUKUDA MASATO , HATA AKINOBU , NIWA SHIN‐ICHI , HIRAMATSU KEN‐ICHI , YOKOKOJI MASAFUMI , HAYASHIDA SEIKI , DENG KENJI ITOH , NAKAGOME KAZUYUKI , IWANAMI AKIRA
Published: March 2008

Abstract A female patient exhibiting functional hearing loss in her left ear demonstrated reduced amplitude of P3 component in event‐related potentials (ERP) to left monaural stimulation, with preserved N1 and N2 components to stimulation of either ear. This result suggested that stimuli in the affected ear were conducted successfully up to the auditory cortex but that further processing in higher brain regions was ‘repressed’. Event‐related potential examination for such hysterical disorders could be useful in clarifying their brain mechanism and offer a useful diagnostic clue to its nature.
Argyria and convulsive seizures caused by ingestion of silver in a patient with schizophrenia
Authors: OHBO YOSHIHIKO , FUKUZAKO HIROSHI , TAKEUCHI KOUZOU , TAKIGAWA MORIKUNI
Published: March 2008

Abstract The case study of a schizophrenic patient with argyria which resulted from the chronic and excessive ingestion of antismoking pills contain silver, is presented. Convulsive seizures developed after the patient had been addicted to the pills for 40 years. An extremely high concentration of silver was detected in serum. This case provides support for the hypothesis that silver may cause convulsive seizures as a result of systemic poisoning.
Acute polymorphic psychosis in adults with mild intellectual deficits
Authors: IWAWAKI ATSUSHI , FUJIYA KOICHI , KOBAYASHI KENICHI
Published: March 2008

Abstract This paper describes two representative cases of acute polymorphic psychotic disorder (APPD) defined in the International Classification of Diseases (ICD)‐10 in adults with mild intellectual deficits. The patients showed mild intellectual impairment but had worked diligently for many years without their impairment being noticed by others. Some displayed maladjustments in their childhood and were classified as having intellectual disabilities. With their low self‐esteem, precipitating events forced the patients to act inappropriately and, as a result, they became psychotic. Although APPD is supposed to occur without causative stress, an intellectual limitation combined with a certain personality can precipitate such a psychosis. It is noted that APPD might mask intellectual deficit and their precipitating factors and that a relapse could be prevented by advising a member of the patient's family.
Cavum septum pellucidum in schizophrenia: A magnetic resonance imaging study
Authors: FUKUZAKO TSUYOSHl , FUKUZAKO HIROSHI , KOUAMA SATOSHI , HASHIGUCHI TOMO , TAKIGAWA MORIKUNI
Published: March 2008

Abstract In order to determine if cavum septum pellucidum (CSP) is more prevalent in schizophrenic patients, we studied 72 Japanese patients who fulfilled the DSM‐III‐R criteria for schizophrenia and 41 normal controls. Sagittal, 1 mm thick magnetic resonance imaging slices of the entire cranium were obtained using a gradient‐echo pulse sequence, and coronal and axial images were reconstructed for assessment. A CSP was observed in 34 patients (47.2%) and in 16 controls (38.0%). Although the CSP appeared to be more prevalent in schizophrenic patients, this difference was not statistically significant. However, schizophrenic patients with a history of long‐term institutionalization had a higher incidence of CSP compared with patients who had not been admitted to hospital for more than 3 years (68.2 vs 38.0%). These results suggest that the CSP may be a pathophysiology that characterizes schizophrenic patients with poor prognoses.
Specificity and developmental consequences of speech loss in children with pervasive developmental disorders
Authors: KURITA HIROSHI
Published: March 2008

Speech loss (SL) was compared in 276 children who had pervasive developmental disorders (PDD) with 62 children with intellectual disabilities without PDD. Speech loss seems relatively specific to PDD because it is significantly more common in children with PDD (26.1%, 72/276) than in those with intellectual disabilities (1.6%, 1/62). In three PDD categories, speech loss occurred in all the 12 children with disintegrative psychosis, 35/149 (23.5%) children with infantile autism and 25/115 (21.7%) children with other PDD. Children with pervasive developmental disorders and speech loss had spoken significantly earlier yet developed less satisfactorily after speech loss than those without it. Speech loss seems fairly specific to PDD and is indicative of unfavorable intellectual development in children with PDD.
Effects of caffeine on event‐related potentials: Comparison of oddball with single‐tone paradigms
Authors: KAWAMURA NAOKI , MAEDA HISAO , NAKAMURA JUN , MORITA KIICHIRO , NAKAZAWA YOICHI
Published: March 2008

We investigated the acute effects of caffeine (500 mg) on event‐related potentials (ERP) in 10 healthy subjects using standard oddball and single‐tone paradigms. Event‐related potentials were recorded before oral ingestion of caffeine or placebo and 30 min and 210 min after. The oddball paradigm, but not the single‐tone paradigm, showed that the P300 amplitude and the area were significantly increased 30 min after ingestion of caffeine and significantly decreased 30 min after ingestion of placebo. The effects of caffeine disappeared at 210 min. Neither the P300 latency nor the reaction time changed significantly with the oddball paradigm. However, the reaction time was shortened 30 min after ingestion of caffeine with the single‐tone paradigm. These findings suggest that the caffeine‐induced increase in the P300 amplitude may have resulted from the increased allocation of attentional resources to the discriminating process which was not, however, accompanied by facilitation of the process and that caffeine may specifically stimulate the discriminating process involved in the oddball paradigm. In addition, the simple psychomotor performance of button‐pressing in response to a tone signal was accelerated by caffeine.
Liaison psychiatry and HIV infection (I): Avoidance coping responses associated with depressive symptoms accompanying somatic complaints
Authors: FUKUNISHI ISAO , HAYASHI MOTOKO , MATSUMOTO TOMOKO , NEGISHI MASAYOSHI , HOSAKA TAKASHI , MORIYA HIROFUMI
Published: March 2008

Abstract We examined the relationship of somatic complaints to coping behaviors and mood states among 50 HIV‐positive patients without AIDS. Although no patients fulfilled the DSM‐III‐R criteria for mood disorders including major depression, scores for depressive symptoms were significantly higher in the HIV‐positive patients than in healthy persons. Although depressive symptoms in HIV patients may not be strong enough to warrant a psychiatric diagnosis of mood disorders, these patients may be prone to depressive symptoms. The HIV patients indicated a tendency toward somatic complaints more frequently than their healthy counterparts. The scores for depressive symptoms were significantly and positively correlated with scores for avoidance coping responses. The presence or absence of six complaints (i.e., general fatigue, abdominal distress, chest pain or discomfort, and numbness or chills) could be discriminated based on the score of avoidance coping responses. The results of this study suggest that avoidance coping responses associated with depressive symptoms accompany several somatic complaints in HIV patients without AIDS.
Nocturnal melatonin profiles before and one year after beginning shift‐work
Authors: MADOKORO SHIGEKI , NAKAGAWA HIROKI , MISAKI KIWAMU , IHARA HISATAKA , ITO TATSUHIKO , ISAKI KIMINORI
Published: March 2008

Abstract Nocturnal serum melatonin profiles were determined twice for seven single women, during their time of employment as nurses (baseline), and after one year (follow up), in order to investigate the effects of shift‐work on nocturnal melatonin secretion. All subjects were working in the same hospital under an irregularly rotating three‐shift system. Five (5) mL blood samples were drawn six times at 2 h intervals between 20:00–06:00 hours under dim light conditions (< 50 lux). The same sampling procedures were repeated the following year. The results showed pronounced inter‐individual differences in melatonin concentrations. There was a trend towards increasing maximum melatonin concentration (MAX melatonin) at follow up, with a similar tendency seen in summed melatonin (the sum of six measured melatonin concentrations). A trend was also seen towards increasing melatonin ratio at 06:00 hours (the percentage of melatonin concentration at 06:00 hours by summed melatonin) at follow up. Melatonin concentration at 06:00 hours was significantly higher at follow up, and a significant correlation between Morningness‐Eveningness score (M‐E score) at baseline and increased summed melatonin at follow up was also seen. These results suggest that: nocturnal melatonin secretion does not significantly increase after beginning shift‐work; and that greater increases in melatonin secretion at follow up are found in subjects with higher M‐E scones (increased morning type). With more subjects, however, there may be significant increase in MAX melatonin and/or summed melatonin in the follow‐up study.
Significance of monitoring plasma levels of amitriptyline, and its hydroxylated and desmethylated metabolites in prediction of the clinical outcome of depressive state
Authors: SHIMODA KAZUTAKA , YASUDA SHIN , MORITA SACHIYO , SHIBASAKI MORIKAZU , SOMEYA TOSHIYUKI , BERTILSSON LEIF , MD SABURO TAKAHASHI
Published: March 2008

Abstract The clinical significance of monitoring the plasma levels of amitriptyline and its metabolites in prediction of the clinical outcome of depressive episode was investigated in 49 inpatients. Discriminant analysis of drug concentrations (at two weeks after initiation of drug treatment) and clinical outcome revealed that increasing the plasma levels of amitriptyline, cis‐isomers of hydroxylated metabolites (Z‐10‐hydroxyamitriptyline and Z‐10‐hydroxynortriptyline) predicted a better clinical outcome, while increasing of plasma levels of nortriptyline and trans‐isomers of hydroxylated metabolites (E‐10‐hydroxyamitriptyline and E‐10‐hydroxynortriptyline) were shown to predict a poor clinical outcome in the depressive episode of the subjects, and that clinical outcome of approximately 73% of the subjects could be correctly predicted.
Cultural distance and its relationship to psychological adjustment of international exchange students
Authors: FURUKAWA TOSHIAKI
Published: March 2008

Abstract This study aimed to evaluate the reliability and validity of the Japanese version of the Cultural Distance Questionnaire (CDQ), and to examine whether or not the measured cultural distance influenced the psychological adjustment of international exchange students and, if so, which aspects were most influential. Subjects were 211 Japanese high school and college students who stayed for one year with a host family in one of 23 countries around the world. They were asked to complete the Maudsley Personality Inventory before departure from Japan, the 12‐item General Health Questionnaire six months after arrival in the host country and the CDQ six months after they returned from abroad. We found that the CDQ had high internal consistency reliability. Satisfactory validity was suggested for the CDQ because it offered wide coverage of various aspects of daily lives that reflect cultural differences, because it was uncontaminated by social desirability or by personality traits and because the obtained scores by country and region were largely in accordance with the expected directions. It was found that the greater the cultural distance between Japan and the foreign community, as measured by the CDQ, the greater the psychological distress of the international student placed in that community. Furthermore, the results showed that it was the food that had the greatest impact on the intercultural adjustment.
Periodic leg movements in sleep in essential hypertension
Authors: ESPINAR‐SIERRA J. , VELA‐BUENO A. , LUQUE‐OTERO M.
Published: March 2008

Abstract The presence of periodic leg movements in sleep (PLMS) was assessed in 91 subjects diagnosed with essential hypertension. More than 18 per cent of the sample had PLMS, which is considerably higher than in normal controls. Also, the prevalence was significantly correlated with the severity of hypertension, as well as with age. Periodic leg movements in sleep were more frequent in the first few hours of the sleep period and during sleep stages 1 and 2. The arousing effect of PLMS was minimal, with only 17 per cent of all events related to an EEG arousal. Our results suggest that PLMS are common in people with essential hypertension, although they do not seem to be associated with any particular sleep disorder.
Free‐running circadian rhythm of melatonin in a sighted man despite a 24‐hour sleep pattern: A non‐24‐hour circadian syndrome
Authors: HASHIMOTO SATOKO , NAKAMURA KOUJI , HONMA SATO , HONMA KEN‐ICHI
Published: March 2008

Abstract Sleep and plasma melatonin rhythms were measured longitudinally in a sighted young man (21 years old) under a day‐night environment. At each measurement, the responsiveness of the melatonin rhythm to a single light pulse was examined in addition to the 24‐hour profile. In experiment 1, the timing of sleep was decided by the subject himself. Although most sleep episodes were observed between 21:02 h and 10:55 h, the plasma melatonin rhythm free‐ran for a period of 24.18 h. In experiment 2, the sleep‐wake schedule of the subject was strictly fixed. The subject was instructed to go to bed at 24:00 h and wake up, at the latest, before 8:00 h for 40 days. The melatonin rhythm, however, continued to free‐run for a period of 24.12 h. Nocturnal melatonin level could not be suppressed by a 3‐hour light pulse of 500 lx, but was suppressed by a pulse of 1000 lx. It is concluded that internal desynchronization occurred in this particular sighted subject where the sleep‐wake rhythm was entrained by the 24‐hour day‐night environment, whereas the plasma melatonin rhythm free ran, and that a forced sleep schedule did not act as a strong zeitgeber.
Fluctuations of rectal and tympanic temperatures with changes of ambient temperature during night sleep
Authors: HASHIZUME YUJI
Published: March 2008

Abstract Many studies have demonstrated a decline in core temperature during slow wave sleep (SWS) in animals and humans. However, there are few studies that have investigated core temperature fluctuation during rapid eye movement sleep (REM) at different ambient temperatures. This study examined the effects on core temperature of continuous hot or cold exposure during sleep. Ten male subjects were exposed to hot and cold stress from 00 h to 1:00 h, when SWS is most predominant, and from 5:00 h to 7:00 h, when REM is predominant. Rectal temperature (Tr) and tympanic temperature (Tt) were monitored for 3 days, and polysomnographies (PSG) were recorded from 23:00 h to 7:00 h. The experiments lasted 3 weeks for each subject, over 2 consecutive nights each week (including an adaptation night and an experimental night). On the experimental night, subjects were exposed to hot (29°C) or cold (21°C) ambience. The core temperature fluctuation under the hot or cold ambience were compared with under the thermoneutral ambience. Under hot ambience, Tr declined significantly in the first 2 hours of sleep, but Tt did not change. In the last 2 hours, both Tr and Tt were significantly elevated. Under cold ambience, both Tr and Tt declined significantly in the first 2 hours. However, in the last 2 hours, neither Tr nor Tt showed any change. The result that Tr and Tt rose in hot ambience during the last 2 hours when REM is predominant suggests that body temperature during REM is influenced by ambient temperature.
Polarization anatomy of a kainic acid seizure
Authors: DASHEIFF RICHARD M. , SACKS DAVID S.
Published: March 2008

Abstract Slow voltage‐sensitive dyes work by accumulating in brain tissue and report the average membrane potential of neurons and glia. The voltage‐sensitive dye diO‐C2‐5 was used to monitor the polarization state of 27 brain structures in the rat during a systemically induced, behaviorally mild, kainic acid seizure using a 20 s recording period. The effects of the anesthetic agent used in the experiment were minimized by delaying the dye injection and seizure mapping for one day. Eleven areas were depolarized during the seizure, but 16 other areas did not change their polarization state compared to controls. The effects of pentobarbital appear to have no measurable effect on seizure propagation once the animal has behaviorally recovered from the anesthesia. The technique allows for mapping areas of seizure involvement with a unique combination of spatial and temporal resolution.
Psychiatric manifestations accompanying interferon therapy for patients with chronic hepatitis C: An overview of cases in Japan
Authors: NOZAKI OSAMU , TAKAGI CHIHIRO , TAKAOKA KEN , TAKATA TOMOJI , YOSHIDA MASARU
Published: March 2008

Abstract  Thirty case reports published in Japan that refer to psychiatric symptoms accompanying interferon (IFN) therapy were examined. These papers covered a total of 49 cases. We categorized these 49 cases into 35 cases of mood disorder, 10 of delirium and four of psychotic disorder. The key findings of our study of these cases are as follows: (i) in total, 11 patients had psychiatric past histories: five patients in the mood disorders group were susceptible to the influence of social or psychological factors; (ii) whereas the symptoms of mood disorder or delirium appeared soon after IFN was administered, the symptoms of psychotic disorders appeared later. The patients with delirium displayed many neurological abnormalities, which were reduced by suspending IFN therapy. This suggests the neurological toxicity of IFN; (iii) the outcome of most patients was good; and (iv) we suspect that IFN‐induced psychiatric symptoms other than delirium are connected with psychoneuroimmunological functions.
Influenza virus and neurological diseases
Authors: HAYASE YUKIHARU , TOBITA KIYOTAKE
Published: March 2008

Abstract  Influenza viruses rarely cause acute encephalopathy. Post‐influenzal encephalitis, which occurs a few weeks after recovery from influenza is thought to be an autoimmune process associated with demyelination and vasculopathy. It has been suggested that Economo lethargic encephalitis followed by postencephalitic Parkinsonism was associated with the influenza A epidemic of 1918 (Spanish flu). The incidence of Reye's syndrome has markedly decreased due to the avoidance of salicylates in the treatment of influenza or varicella. One inactivated flu vaccine is thought to have caused Guillain Bane syndrome due to molecular mimicry between viral protein and myelin, which triggered autoimmune responses. The persistence of influenza virus genes in neural cells as one of the causes of chronic degenerative diseases of the central nervous system by inducing apoptosis of the host cells is yet to be proven.
Neurons and extracellular neurofibrillary tangles in the hippocampal subdivisions in early‐onset familial Alzheimer's disease: A case study
Authors: FUKUTANI YUKEN , SASAKI KAZUO , MUKAI MASAMI , MATSUBARA ROKURO , ISAKI KIMINORI , CAIRNS NIGEL J.
Published: March 2008

Abstract  We have investigated morphometrically unaffected neurons, intracellular neurofibrillary tangles (I‐NFT) and extracellular neurofibrillary tangles (E‐NFT) in eight subdivisions of the hippocampal cortex in two cases of early‐onset familial Alzheimer's disease (FAD) and six cases of early‐onset sporadic Alzheimer's disease (SAD). The hippocampal subdivisions examined included: CA4, CA3, CA2, CAI, prosubiculum, subiculum and presubiculum (PRE), parasubiculum (PARA) and entorhinal cortex (ENT). CA3, CA2 and CAI in the FAD cases showed more severe neuronal loss and much greater E‐NFT formation than in the SAD cases, while ENT in both the FAD cases showed less neuronal loss and less E‐NFT formation. These data suggest that the cornu ammonis is affected more severely than the ENT in the FAD cases. These observations indicate that hippocampal pathology in the FAD cases is qualitatively as well as quantitatively different from that in sporadic cases. These results provide further evidence for pathological heterogeneity in AD, although the number of FAD cases examined is very small.
Recording of electroencephalograms and electrocardiograms during daytime sleep in trained canines: Preparation of the sleeping dogs
Authors: YASUMA FUMIHIKO , HAYASHI HIROSHI , SHIMOKATA KAORU , YOKOTA MITSUHIRO , OKADA TAMOTSU , KITOH JUNZOH
Published: March 2008

Abstract  Although respiration in trained canines is well investigated, the process of preparing dogs has not been described in any great detail. Moreover, their daytime patterns of sleep and wakefulness during 1 or 2 h of electroencephalogram (EEG) and electrocardiogram (ECG) recordings are not clear. Therefore, we describe the process of selecting and training dogs, in which we recorded EEG and ECG in the laboratory. First, 14 of 1242 dogs dealt with over a 1 year period were chosen. They were trained for 2 h to lie quietly and to sleep in the laboratory; this training procedure was repeated 152 times. Three dogs were then selected and a permanent tracheostomy was performed in one. Finally, EEG and ECG were recorded with the bipolar fine needle electrodes; respiration was recorded simultaneously through a tube inserted to a tracheostomy in one dog. Wakefulness, slow wave sleep (SWS) and rapid eye movement (REM) sleep (REMS) were identified according to the EEG pattern and on the basis of the behavioral criteria. Recordings were performed 12 or 13 times in each dog. Complete sleep cycles, including wakefulness, SWS and REMS in this sequence, were observed 3.9–4.1 times. The mean duration of SWS was 2.2–4.4 min and that of REMS was 3.5–4.6 min. The REMS latency was 33.9–41.8 min. Fluctuation of heart rate with respiration, termed respiratory sinus arrhythmia, was noted in the ECG. Heart beat increased with inspiration and decreased with expiration. The present study demonstrates how to select and train sleeping dogs and shows their undisturbed daytime sleep and wakefulness patterns.
The classification of idiopathic spasmodic torticollis: Three types based on social adaptation and frustration tolerance
Authors: KASHIWASE HIROTAKA , KATO MAKOTO
Published: March 2008

Abstract  In this study, idiopathic spasmodic torticollis (ST) has been classified into three types from the opinion of social adaptation and the differences of frustration tolerance. The three types were as follows: type I (over‐adaptive type), type II (maladaptive type), and type III (compatible type). Type I is a typical psychosomatic with high frustration tolerance. Type II is personality disorder with low frustration tolerance. In type III, frustration tolerance varies depending on social circumstances (i.e., different at home and at the office). In type I, the prognosis of ST is generally unfavorable, since it is associated with recurrence and prolongation of the symptoms. In type II, the prognosis of ST is generally favorable. However, type II patients experience relationship or social difficulties. One characteristic of type III is that the onset of symptoms is usually found in an older person because of proper use of frustration tolerance at home and at the office.
Valproate lowered the amplitude of visual and somatosensory evoked potentials in two cases of untreated juvenile myoclonic epilepsy
Authors: KANAZAWA OSAMU , NAGAFUJI HIROSHI
Published: March 2008

Abstract  The amplitude of flash visual evoked potential (F‐VEP) and somatosensory evoked potential (SEP) was found to be initially slightly higher in two untreated patients with juvenile myoclonic epilepsy (JME). Patients were studied before and after complete control of seizures with valproate. In both patients valproate prolonged the latencies of the waves IV and V and lowered the amplitudes of waves V and VI of the F‐VEP. The N20–P25 amplitude in SEP in both patients was also lowered by valproate. These results may suggest that slightly higher cortical excitability in untreated JME was controlled by valproate.
A study of cognitive development and behavior problems in mentally retarded children
Authors: HASHINO KENICHI , IIDA JUNZO , IWASAKA HIDEMI , ITO NAOTO , SAKIYAMA SHINOBU , KITERA KATSUKI , MATSUMOTO HIROFUMI , TSUJIMOTO HIROKAZU , IKAWA GENRO , KISHIMOTO TOSHIFUMI
Published: March 2008

Abstract Cognitive development in seventy‐one mentally retarded children (19 autistic, 52 non‐autistic; aged 7–19 years) from a school for handicapped children was studied, using Ohta's scale for evaluating cognitive development level based on language comprehension (Ohta's stage), and other developmental scales. Behavior problems were also examined. The present study reports on the utility of Ohta's stage in non‐autistic children, and the relationship between cognitive development level and behavior problems in mentally retarded children. In non‐autistic children, there were temporal correlations between Ohta's stage and other development scales (a standard developmental test, speech development, symbolic play development, imitation development), suggesting that in non‐autistic children as well, Ohta's stage may serve well as a scale for cognitive development, and reflect symbolic representational functioning. In non‐autistic children, most behavior problems in feeding, elimination and sleeping, hyperkinesis, hypokinesis, stereotyped behaviors, self‐injurious behavior and licking were closely associated with cognitive development level, and were more often noted in children of lower cognitive development level rather than only in the severely mentally retarded children. Some behavior problems may often occur in the sensorimotor period and hardly occur in the symbolic representational period.
A comparative study of Asperger syndrome with high‐functioning atypical autism
Authors: KURITA HIROSHI
Published: March 2008

Abstract To test the validity of Asperger syndrome (AS) as defined in ICD‐10, 26 patients (age range, 3.5 to 12 years) with AS and 16 patients (age range, 3 to 11.5 years) with high‐functioning (IQ > 90) ICD‐10 atypical autism (HAA) were compared on 64 clinical variables including obstetric risk factors, early developmental landmarks, IQ, autistic symptoms on the CARS‐TV, epileptic EEG abnormalities and epilepsy. AS did not differ significantly from HAA on all but total and four item scores (i.e. imitation, visual responsiveness, auditory responsiveness and non‐verbal communication) on the CARS‐TV, in which AS scored significantly lower than HAA. A discriminant function based on imitation and auditory responsiveness predicted 76.2% of the 42 cases. The small difference from HAA indicates that AS is better to be regarded as the highest‐functioning end of the PDD spectrum, rather than a valid subtype of PDD. However, the autistic symptom profile less distorted in AS than HAA may warrant a further study on its validity. The author thanks Tomoko Nakano and Kaoru Katsuno in the Nerima Welfare Center for the Mentally and Physically Handicapped, Hiromi Ishida and Takiko Anzai in the Kawasaki Central District Center of Remedial Education, and Yoko Hayashi in the National Welfare Foundation for Disabled Children for their assistance in data collection
Characteristics and outcome of delirium in psychiatric inpatients
Authors: HUANG SHU‐CHI , TSAI SHIH‐JEN , CHAN CHIN‐HONG , HWANG JEN‐PING , SIM CHO‐BOON
Published: March 2008

Abstract Delirium, a transient organic psychiatric syndrome, is a common psychiatric diagnosis. It is associated with increased rates of morbidity and mortality in medical‐surgical inpatients. There have been few reports describing the risk factors and prevalence of delirium among psychiatric inpatients. The purpose of the present study was to investigate the rate of delirium, the reasons for admission, the clinical features, the etiologies and the mortality during a 2 year follow‐up in psychiatric inpatients admitted to a general hospital during a 3 year period. The results show that the rate of incidence of delirium in psychiatric and geriatric (age 65 years) inpatients was 1.4 and 9.6% respectively. The most common cause of delirium was adverse effects of medication. The inpatient mortality (5.9%) was lower compared with reported mortality rates in medical‐surgical inpatients. However, there was a high mortality rate during the 2 year follow‐up period (39.4%), especially in older patients. The high mortality during follow‐up stressed the importance of after‐discharge care in these patients.
A study of ring 20 chromosome karyotype with epilepsy
Authors: YAMADERA HIROSHI , KOBAYASHI KEIKO , SUGAI KENJI , SUDA HAJIME , KANEKO SUNAO
Published: March 2008

Abstract We reported a 24‐year‐old woman with moderate mental retardation and partial epilepsy. She developed complex partial seizures at 3 years of age and generalized tonic convulsions at 9 years. Chromosome analysis revealed that she had mosaicism (87%) of 46, XX, and r(20) (p13, q13.3). Her electroencephalogram showed bilateral 2–3 Hz sharp and wave complex over the bilateral frontopolar, and centro‐parieto‐occipital areas. Computed tomographic and magnetic resonance image examinations were normal. Twenty‐five cases of ring 20 chromosome karyotypes (including this case) have been reported in the literature; 19 showed epilepsy, and 18 showed moderate mental retardation. Many of the patients showed growth retardation and minor malformations. The ring 20 syndrome is associated with a high incidence of epilepsy, particularly partial epilepsy. Our findings indicate that the main features of the ring 20 syndrome are partial epilepsy and mental retardation.
Clonazepam as a therapeutic adjunct to improve the management of psychiatric disorders
Authors: MD SHIGERU MORISHITA , MD SHOZO AOKI , MD SHOSUKE WATANABE
Published: March 2008

Abstract Clonazepam, which is a benzodiazepine structurally related to chlordiazepoxide hydrochloride, diazepam and nitrazepam, has been available for the treatment of seizure disorders in the USA since 1976 and in Japan since 1981. Increasingly, clonazepam has been used in the treatment of a variety of psychiatric disorders. Six representative case studies are presented and specific guidelines for the use of clonazepam are discussed.
Cognitive deficits of mild dementia:A comparison between dementia of the Alzheimer's type and vascular dementia
Authors: MATSUDA OSAMU , SAITO MASAHIKO , SUGISHITA MORIHIRO
Published: March 2008

Abstract This study was designed to examine the profiles of cognitive deficits in 11 mildly demented patients with dementia of Alzheimer's type (DAT), five with vascular dementia with multiple subcortical lacunar infarcts (VDS), and seven with vascular dementia with extensive white matter lesions (VDW) in comparison with 23 aged individuals without dementia. Memory, attention, abstract thinking, and visuospatial function were assessed using the Japanese translation of the Wechsler Memory Scale‐Revised (WMS‐R) and the Japanese version of the Wechsler Adult Intelligence Scale‐Revised (WAIS‐R). Compared with normal aged individuals, three dementia groups were significantly impaired in the memory and abstract thinking. However, the performances on several tests on attention (i.e. Mental Control and Visual Memory Span Backward from WMS‐R) and visuospatial function (i.e. Object Assembly from WAIS‐R) differed significantly between the DAT and VDS groups, with VDS being the worst in terms of performance than was DAT. This study suggests that, in the mildly demented stage, the patients with DAT have few problems in the attention and visuospatial function, but those with VDS have impairments in these cognitive abilities.
Regional cerebral blood flow abnormalities in late‐life depression:Relation to refractoriness and chronification
Authors: AWATA SHUICHI , ITO HIROSHI , KONNO MICHIKO , ONO SHUICHI , KAWASHIMA RYUTA , FUKUDA HIROSHI , SATO AND MITSUMOTO
Published: March 2008

Abstract We examined patterns of regional cerebral blood flow (rCBF) abnormalities in 18 patients with major depressive disorder in late life using single photon emission computed tomography (SPECT) and (99mTc‐hexamethyl‐propylenamine oxime (99mTc‐HMPAO). Compared with 13 age‐matched controls, relative rCBF was significantly decreased bilaterally in the anterior cingulate gyrus, the prefrontal cortex, the temporal cortex, the parietal cortex, the hippocampus and the caudate nucleus. However, it was not correlated with the severity of depression or global cognitive dysfunction. In 10 patients with a prolonged depressive episode or prolonged residual symptoms (the refractory subgroup), robust and extensive decreases in rCBF were found compared with controls and the rCBF decreased significantly in the anterior cingulate gyrus and the prefrontal cortex compared with that in the non‐refractory subgroup. In the non‐refractory subgroup, rCBF decreased significandy in the caudate nucleus and tended to decrease in the anterior cingulate gyrus compared with controls. These findings indicate that dysfunction of the limbic system, the cerebral association cortex and the caudate nucleus may be implicated in late‐life depression and that robust and extensive hypoperfusion, especially in the anterior cingulate and the prefrontal regions, may relate to refractoriness or chronification of depression.
Increased tau protein level in postmortem cerebrospinal fluid
Authors: MORIHARA TAKASHI , KUDO TAKASHI , IKURA YASUMITSU , KASHIWAGI YUJIRO , MIYAMAE YASUYUKI , NAKAMURA YU , TANAKA TOSHIHISA , SHINOZAKI KAZUHIRO , NISHIKAWA TAKASHI , TAKEDA MASATOSHI
Published: March 2008

Abstract Microtubule‐associated protein tau has been reported to be significantly increased in cerebrospinal fluid (CSF) of the patients with Alzheimer's disease (AD), which suggests that it is possibly a biological marker for the diagnosis of AD. The underlying mechanism of the increased tau level in CSF, however, is not known. In this study, the tau levels were compared between antemortem and postmortem CSF. The postmortem tau levels in CSF were significantly increased in all groups including AD, neurological control, and nondemented control. A striking elevation of CSF tau was observed during the postmortem change with the nondemented subjects. These findings may offer some insight into the understanding of the mechanism of the increased tau level in CSF with AD and other related disorders.
Effect of frequent brief awakenings from nonREM sleep on the nonREM‐REM sleep cycle
Authors: ENDO TAKURO , ROTH CORINNE , LANDOLT HANS‐PETER , WERTH ESTHER , AESCHBACH DANIEL , ACHERMANN PETER , BORBÉLY ALEXANDER A.
Published: March 2008

Abstract In the framework of a selective sleep deprivation study, eight young men were repeatedly awakened during 3 nights from nonREM sleep (nonREMS). The mean number of awakenings per night was 27.4, 29.5 and 32.8. In order to avoid excessive suppression of slow wave sleep, no awakening occurred in the first nonREMS episode. Compared to baseline, cycle 2 was significantly prolonged in all 3 nights, and cycle 3 in night 3 only. However, after subtracting the waking intervals, the differences from baseline was eliminated. The results show that the mechanisms underlying sleep cycle control keep track of sleep time and disregard epochs of waking.
Effect of night exercise on the following partially deprived sleep
Authors: MIZUNO KOH , ASANO KATSUMI , OKAMOTO KAZUE
Published: March 2008

Abstract Six trained male athletes (aged 24.3 ± 2.9 years) performed cycling exercise from 23.00 to 23.50 h. From 00.30 to 07.00 h, the subjects followed a schedule that consisted of 30 min trying to fall asleep in bed and 60 min of being awake outside the bedroom. The control experiment was conducted without exercise under the same time schedule. An increase in rectal temperature induced by exercise was 1.9 ± 0.4. After exercise, prolongation of sleep onset latency was observed only in the sleep period from 00.30 to 01.00 h compared with the control night. Time spent in slow wave sleep throughout the night was significantly longer after exercise.
How does the distention of urinary bladder cause arousal?
Authors: KOYAMA YOSHIMASA , IMADA NAOKI , KAYAMA YUKIHIKO , KAWAUCHI AKIHIRO , WATANABE HIROKI
Published: March 2008

Abstract Under urethane anesthesia, the urinary bladder of male rats was distended by 0.3‐0.5 mL of saline. When the animals displayed large amplitude delta waves, the distention caused tonic excitation in 76% (19/25) of the noradrenergic neurons in the locus coeruleus and in 53% (16/30) of the cholinergic neurons in the laterodorsal tegmental nucleus. The response was followed by a shift of electroencephalogram (EEG) pattern to faster waves of smaller amplitude. When EEG amplitude was faster and smaller, the same stimuli caused no response. Neurons in Barrington's nucleus were excited by a small amount of bladder distention independent of EEG patterns. These results suggest that the transition of state, caused by bladder distention, from deep sleep to light sleep is mediated by noradrenergic and cholinergic neurons in the brainstem.
Comparison of event related potentials with and without hypnagogic imagery
Authors: MICHIDA NANAE , HAYASHI MITSUO , HORI TADAO
Published: March 2008

Abstract It is hypothesized that when hypnagogic imagery occurs, an appropriate attention may allocate to the imagery, resulting in the allocation of attention to the external tone stimuli being diminished. N3 amplitude of event related potentials (ERP) obtained a significant difference between the conditions with and without imagery. Arousal level of behavior and electroencephalography were not different between the conditions, therefore it is interpreted that the decrease of the N3 amplitude during imagining reflects the diminution of the allocation of attention to the external tone stimuli. Another late component of ERP, P3, did not make clear peaks in this study despite a large time constant (τ= 3.2 s) used for EEG records.
Efficacy of L‐846 in patients with insomnia:Evaluation by polysomnography
Authors: SAKAMOTO TETSURO , UCHIMURA NAOHISA , MUKAI MASAKI , MIZUMA HIKARI , SHIRAKAWA SHIN‐ICHIRO , NAKAZAWA YOICHI
Published: March 2008

Abstract The effects of L‐846, an ultra‐short‐acting pyrazolopyrimidine hypnotic, on sleep were studied in nine insomniacs and two neurotic patients with insomnia. The patients were randomly assigned to receive 5 mg (n= 6) or 10 mg (n= 5) L‐846. The study schedule comprised of one adaptation night, two baseline nights, three drug nights, and two withdrawal nights. Sleep latency and slow wave sleep (SWS) latency was largely shortened and %SWS increased in the early phase of sleep. No clear evidence of rebound insomnia was noted.
Evaluation of human activities and sleep‐wake identification using wrist actigraphy
Authors: SHINKODA HARUMI , MATSUMOTO KAZUYA , HAMASAKI JOUJI , SEO YOOJIN , PARK YOUNG MAN , PARK KWANG PAK
Published: March 2008

Abstract The purpose of this study is to investigate the count‐characteristics of wrist actigraphy in basic human activities and to discuss the agreement of Sleep‐wake identification between polysomnography (PSG) and wrist actigraphy during nocturnal sleep. There was a distinct distribution of actigraphy counts over the studied activities. The evaluation of Sleep‐wake scoring using the wrist actigraphy agreed 96.9% with the polysomnographic scoring during nocturnal sleep.
Evaluation of the Actillume® wrist actigraphy monitor in the detection of sleeping and waking
Authors: MATSUMOTO MIKI , MIYAGISHI TSUTOMU , SACK ROBERT L. , HUGHES ROD J. , BLOOD MARY L. , LEWY ALFRED J.
Published: March 2008

Abstract This study evaluated the Actillume® instrument and the modified Action 3 sleep‐wake scoring algorithm, in which the scoring factor (P) was set at 0.10, 0.14, 0.20, 0.30, 0.40 and 0.50. Fifteen subjects, each of whom underwent polysomnography with simultaneous wrist actigraphy four times, yielded a total of 60 sleep studies. The sleep data from each subject were divided into four groups. In the high sleep efficiency index groups of the calibration and validation samples, the accuracy of the algorithm significandy differed within six P‐values and was highest at P = 0.14. In the low sleep efficiency index groups of both samples, however, there were no significant differences in the accuracy. Thus, these results indicate that P = 0.14 should be most appropriate for this actigraph and algorithm.
Evaluation of sleep using ambulatory skin potential recording:Differences between morning and evening type
Authors: SHIIHARA YASUFUMI , NAKAJIMA MASAMI , MIYAZAKI YUKIHITO , NAKAMIYA TOSHIYUKI , MIYAMOTO MASANORI , MD SHIGERU TAKAHASHI , KODAMA MASAHISA
Published: March 2008

Abstract In order to validate the evaluation of sleep using cassette type ambulatory skin potential measurement system (C‐SPA), sleep duration variables extracted from 24 h recordings were compared between two groups (16 of the intermediate type and 16 of the evening type) with different sleep‐wake habits rated by Morningness and Eveningness Questionnaires (MEQ). Compared with the intermediate type, the evening type subjects go to bed and get up later, have difficulty in falling asleep and more frequently awaken during sleep. Thus, the sleep variables by C‐SPA provide valuable information about duration of sleep and differentiate the Sleep‐wake habits.
Cross‐correlation between 1/f‐like fluctuations in heartbeat and diurnal changes in the sleep‐waking stage
Authors: TSUJI YOICHI , NAGASAWA KAZUYUKI , SATOH HIDEKI
Published: March 2008

Abstract The cross‐correlation function between diurnal changes in /f‐like fluctuations of the R‐R interval and those of the sleep‐waking stage was calculated based on the data from six normal subjects in order to investigate the interactions among circadian components. Sleep stage was scored according to the standard criteria and waking stage was scored with criteria developed for the present study. Polysomnography was performed for 11 h during the daytime. The equation for 1/f was approximated using the power spectra of the R‐R interval every 10 min. Cross‐correlation analysis between sleep‐waking stage and 1/f fluctuation of the R‐R interval suggested that the neural network for 1/f fluctuation in heartbeat is influenced by the Sleep‐wake cycle with a time lag in the order of tens of minutes.
Sleep‐wake rhythm of autistic children
Authors: TAKASE MIKI , TAIRA MASAO , SASAKI HIDEO
Published: March 2008

Abstract Using a sleep log for 28 days in the summer vacation, 89 autistic children living in a suburb of Tokyo were examined. Only one girl of 13 years showed a tendency of non‐24 h Sleep‐wake syndrome. Most autistic children showed a large variation of total sleep time. Forty per cent of subjects showed 10% or more on coefficient of variation of total sleep time. In the retiring and rising time, many subjects tended to show late retiring and early rising.
Sleep problems in the aged in relation to senility
Authors: KAYUKAWA YUHEI , KOGAWA SUSUMU , TADANO FUMIMOTO , IMAI MAKOTO , HAYAKAWA TOSHIJI , OHTA TATSURO , NAKAGAWA TAKEO , SHIBAYAMA HIROTO
Published: March 2008

Abstract As a part of an epidemiologic survey of dementia in a community of aged persons, correlation between sleep complaints and physical illness and senility were studied. A total of 3302 randomly sampled aged individuals (aged 65 yean) were studied using a questionnaire. In this sample the prevalence of poor sleep and habitual snoring did not increase with age. The prevalence of excessive daytime sleepiness showed an increase with age. Male predominance of habitual snoring and female predominance of poor sleep were observed. Female predominance of excessive daytime sleepiness was noted among the aged 70 and over. Age‐related excessive daytime sleepiness was significantly correlated with senility.
The effects of a 20‐min nap before post‐lunch dip
Authors: HAYASHI MITSUO , HORI TADAO
Published: March 2008

Abstract The effects of a 20‐min nap before post‐lunch dip were studied. The subjects participated in nap and no‐nap conditions at intervals of 1 week. Their electroencephalogram (EEG) recordings of relaxed wakefulness, mood, performance, and self‐rating of performance level were measured every 20 min from 10.00 to 18.00 h. For nap condition, the subjects went to bed at 12.20 h and were awakened after they slept for 20 min. The nap improved subjective sleepiness and self‐rating of task performance, and suppressed EEG alpha activity. The results suggest a positive effect of a 20‐min nap upon the maintenance of daytime arousal level.
Night‐time hypnopompic visual hallucinations related to REM sleep disorder
Authors: TAKATA KOKICHI , INOUE YUICHI , HAZAMA HIDEBUMI , FUKUMA ETSUO
Published: March 2008

Abstract We encountered three patients who had experienced hypnopompic visual night‐time hallucinations. Their clinical manifestations resembled Charles Bonnet's syndrome and the content of their experiences were understood as attempts at wish fulfillment. However, abnormal REM findings were recognized on polysomnogram at the occurrence of visual hallucination in two cases. We speculated that dysfunction of REM sleep mechanism might contribute to the night‐time occurrence of such kind of visual hallucination and that their visual experiences might be reflected by dream content.
Changes in work performances in obstructive sleep apnea patients after dental appliance therapy
Authors: ARAI HIDEKI , FURUTA HISAKAZU , KOSAKA KAZUTO , KANEDA REIZO , KOSHINO YOSHIFUMI , SANO JO , KUMAGAI SHIGEHIRO , YAMAMOTO ETSUHIDE
Published: March 2008

Abstract The effects of dental appliances on work performances of obstructive sleep apnea syndrome (OSAS) is not well examined. This study evaluated the polysomnographic and psychological findings before and after therapy. Nine patients were diagnosed OSAS by nocturnal polysomnography. The psychological battery was performed from 13:00 to 14:00, which consisted of Uchida‐Kraepelin psychodiagnostic test (U‐K's test) and Bourdon's cancellation test (Bourdon's test). Approximately 3 months after the treatment, the examinations were performed. Apnea and desaturation index decreased significantly after the therapy. In addition, sleep architecture improved after the therapy compared with that before the therapy. Dysfunction of task performances, such as mean level of work amounts in U‐K's test, mean error, mean performance time and mean deviation in Bourdon's test improved after therapy. We conclude that dental appliances therapy is effective not only to apnea but also to work performance in OSAS.
Effects of aging on morningness‐eveningness and sleep habits in Korean and Japanese workers
Authors: PARK YOUNG MAN , MATSUMOTO KAZUYA , SEO YOO JIN , SHINKODA HARUMI , PARK KWANG PAK
Published: March 2008

Abstract The Morningness‐Eveningness Questionnaire and Life Habits Inventory were given to Korean and Japanese workers. The distributions of scores on the questionnaire for these two groups were normal and its mean slightly moved to the Morning type with aging. It is noteworthy, however, that the mean scores of Korean workers was lower than those of the Japanese workers. The self‐reported waking times and bedtimes for the two groups gradually became earlier with aging. From these results it could be said that aging was an factor that led to the difference of circadian phase.
An activity monitor study on the sleep‐wake rhythm of healthy aged people residing in their homes
Authors: SAKURAI NAOKO , SASAKI MITSUO
Published: March 2008

Abstract The aim of this preliminary study was to investigate sleep‐wake rhythm in active, healthy elderly people residing in their usual habitat. The subjects were thirty‐five male volunteers within an age range of 65–95 for 3–4 days. We measured the sleep‐wake rhythm of the subjects with an Actillume® which is a combined wrist activity monitor and illumination recorder. Analysis of the Actillume® recording showed that 24 of the 35 subjects (69%) kept continuous activity indicating good maintenance of wakefulness with high light exposure. The mean mesor of sleep‐wake rhythm, however, significantly decreased in the older subjects (aged 80–95; n= 15).