bluuebunny/crossref_metadata_2025 huggingface dataset:
Misinterpretation of facial expression: A cross‐cultural study
Authors: Shioiri Toshiki , Someya Toshiyuki , Helmeste Daiga , Tang Siu Wa
Published: March 2003

Accurately recognizing facial emotional expressions is important in psychiatrist‐versus‐patient interactions. This might be difficult when the physician and patients are from different cultures. More than two decades of research on facial expressions have documented the universality of the emotions of anger, contempt, disgust, fear, happiness, sadness, and surprise. In contrast, some research data supported the concept that there are significant cultural differences in the judgment of emotion. In this pilot study, the recognition of emotional facial expressions in 123 Japanese subjects was evaluated using the Japanese and Caucasian Facial Expression of Emotion (JACFEE) photos. The results indicated that Japanese subjects experienced difficulties in recognizing some emotional facial expressions and misunderstood others as depicted by the posers, when compared to previous studies using American subjects. Interestingly, the sex and cultural background of the poser did not appear to influence the accuracy of recognition. The data suggest that in this young Japanese sample, judgment of certain emotional facial expressions was significantly different from the Americans. Further exploration in this area is warranted due to its importance in cross‐cultural clinician–patient interactions.
Folate levels in psychiatric outpatients
Authors: Herrán A. , García‐Unzueta M. T. , Amado J. A. , López‐Cordovilla J. J. , Díez‐Manrique J. F. , Vázquez‐Barquero J. L.
Published: March 2003

This study examines folate in psychiatric outpatients. Fifty‐three outpatients with schizophrenia and 24 outpatients with depressive disorder assessed with the Schedules for Clinical Assessment in Neuropsychiatry interview are included. Patients with schizophrenia had lower serum folate levels than age‐ and sex‐matched controls, while red cell folate levels did not differ. Serum folate levels showed a negative correlation with the Clinical Global Impression, disorganized dimension, and total Positive and Negative Syndrome Scale score. Patients with depressive disorder had lower serum folate levels than healthy controls, but showed no differences in red cell folate levels. Only two patients with schizophrenia had red cell folate levels below the normal range.
Risk factors for psychopathology among Chinese children
Authors: Liu Xianchen , Kurita Hiroshi , Sun Zhenxiao , Wang Fuxi
Published: March 2003

The present study was designed to examine the family environment and child characteristics associated with psychopathology among Chinese children. A large epidemiological sample of 1695 children aged 6–11 was drawn from 12 elementary schools in Linyi Prefecture of China. Parents completed the Child Behaviour Checklist, the Family Environment Scale, and a self‐administered questionnaire including a number of items with regard to family, parental, and child characteristics. Results indicated that the overall prevalence of child psychopathology was 17.2%. Logistic regression analyses showed that a number of family and parental, as well as prenatal, perinatal and postnatal risk factors had significant association with child psychopathology. The most notable risks were derived from poor parental rearing with regard to the child’s misbehaviour, low birthweight, and poor marital relations of the parents after controlling for other factors. These findings are consistent with previously reported risk factors for child psychopathology, highlighting the importance of family and early childhood intervention as a measure to prevent child psychopathology in China.
Factors affecting disability in patients attending the internal medicine departments of general hospitals
Authors: Sata Misako , Yoshitake Kazuyasu , Utsunomiya Hiroshi , Hatada Keiko , Ohtsuka Toshihiro , Sugasaki Hiroyuki , Nakane Yoshibumi
Published: March 2003

The aim of this study was to investigate the effect of sociodemographic factors, physical factors and mental factors on the physical and social disability of patients attending outpatient clinics of general hospitals. Physical and psychiatric morbidity in 1580 consecutive patients attending the internal medicine department of general hospitals was assessed using a stratified two‐stage sampling design method. Of the total, 336 patients completed the second stage interview composed of Primary Care Version of Composite International Diagnostic Interview and Groningen Social Disability Schedule to assess sociodemographic, physical and mental factors. In this study, restricted activity days, disability days and Brief Disability Questionnaire were used for the assessment of physical disability, and Groningen Social Disability Schedule was used for social disability. Sociodemographic, physical and mental factors were all related to disability. Among sociodemographic factors, unemployment was associated with physical disability and social disability mildly. Among physical factors, the severity of physical disease was not associated with disability and medically explained somatic symptoms were associated with disability. Furthermore, the mental factor was more strongly associated with physical and social disability. It could be said that the mental factor is more strongly associated with physical and social disability than sociodemographic or physical factors. In addition, even mild mental symptoms not leading to ICD‐10 mental disorders affected disability. From the viewpoint of the patients’ burden, it is important to assess the mental symptoms as well as physical status in outpatient clinics of internal medicine or primary care.
Gender differences and reproducibility in exploratory eye movements of normal subjects
Authors: Miyahira Ayako , Morita Kiichiro , Yamaguchi Hiroshi , Morita Yoshifumi , Maeda Hisao
Published: March 2003

Exploratory eye movements were recorded using an eye‐mark recorder in 48 normal subjects (24 male and 24 female). Gender differences were examined regarding four eye movement parameters such as the mean gazing time, the total number of gazing points, and the mean eye scanning length and the total eye scanning length. The mean gazing time of women was significantly longer than that of men, and the total number of gazing points of women was significantly less than that of men. The mean eye‐scanning length of men and women did not differ. The total eye scanning length of men was significantly longer than that of women. Reproducibility between sessions of the four eye movement parameters above was expressed as Pearson correlation coefficients (r) in 24 healthy adults before and after a month interval, yielding respective coefficients of 0.65, 0.42, 0.56 and 0.61. These results suggested that differences in exploratory eye movements between men and women may reflect differences in the characteristics of visual information processing and also confirmed the reproducibility of exploratory eye movement parameters.
Age at onset of schizophrenia: Gender differences and influence of temporal socioeconomic change
Authors: Takahashi Sakae , Matsuura Masato , Tanabe Eiichi , Yara Kazuo , Nonaka Konosuke , Fukura Yoichi , Kikuchi Miho , Kojima Takuya
Published: March 2003

This study was undertaken to examine whether males develop schizophrenia at a younger age than females, and whether temporal socioeconomic change affects the age at onset of schizophrenia. The subjects were 848 ICD‐9 schizophrenics who were admitted to Nihon University Hospital, Tokyo, Japan, during the period of 1955–64 (n = 468 (214 males and 254 females), group A) or during the period of 1982–91 (n = 380 (220 males and 160 females), group B). Schizophrenic males showed an earlier age at onset than schizophrenic females. However, the mean age at onset of schizophrenia did not differ significantly between group A and group B. These results indicate that the gender difference in age at onset of schizophrenia has not been influenced by temporal socioeconomic change.
The effects of prolactin on the mesopontine tegmental neurons
Authors: Takahashi Kazumi , Koyama Yosimasa , Kayama Yukihiko , Yamamoto Mitsuaki
Published: March 2003

In urethane‐anaesthetized rats, single neuronal activity was recorded extracellularily in and around the laterodorsal tegmental nucleus, and the response to prolactin applied by pressure injection was examined. Three of six cholinergic neurons tested were excited by prolactin for more than 1 min. In two of three non‐cholinergic neurons tested, prolactin application caused excitation which lasted a shorter time than that in the cholinergic neurons. The results suggest that prolactin may have physiological influences on these mesopontine neurons to increase paradoxical sleep.
Sleep–wake habits of schoolchildren according to grade
Authors: Shinkoda Harumi , Matsumoto Kazuya , Park Young Man , Nagashima Hidetoshi
Published: March 2003

Five hundred and twelve students aged from 6 to 18 years were administered the morningness–eveningness questionnaire and a sleep log. The mean morningness–eveningness score decreased with grade; this decrease was significant around the seventh grade. The habitual waking time showed no difference among grades but the habitual bedtime became later with grade; thus, the sleep length on weekdays decreased with grade. The percentage of students falling asleep during school lessons significantly increased from the eighth to 12th grade. We found that a delay of sleep phase, reduction of sleep length, increased daytime sleep, and transition to evening type occurred at around the seventh grade.
The Koga Hospital Center for studies on sleep: Status report
Authors: Hashimoto Tsurumi , Ogino Hideo , Koga Toshihiko , Uchimura Naohisa
Published: March 2003

Abstract Between September 1996 and January 1999 we used polysomnography (PSG) to examine 473 patients (involving a total of 662 records). The diagnosis was a sleep‐related breathing disorder in 256 patients, including sleep apnea syndrome (SAS) in 194 patients, sleep hypoxicemia in 18 and insomnia in the other four. The SAS consisted of three subtypes: central apnea (CA) in 56 patients, obstructive apnea (OA) in 124 and mixed apnea (MA) in eight. The ratio of central apnea was relatively higher than the national average. Among the 473 patients, the most common complication was heart disease (133 patients) while other complications included hypertension, and respiratory and cerebrovascular diseases. Concerning the therapy for these patients, continuous positive airway pressure therapy was the most commonly applied and was effective in each type of SAS (CA, OA, MA). Other therapies included prosthetic mandibular advancement, bilevel positive airway pressure, medication and ENT operations. In Koga Hospital, there are many patients with heart disease and/or respiratory disease. We examined those patients who presented with snoring and/or apnea using PSG. Among these patients, SAS was the most common sleep disorder. The relative ratio of CA was high and the average age was higher than those with OA.
Effects of small dose of brotizolam on P300
Authors: Hayakawa Tatsuro , Uchiyama Makoto , Enomoto Tetsuro , Nakajima Tsuneo , Kim Keiko , Shibui Kayo , Kudo Yoshihisa , Ozaki Shigeru , Nakajima Toru , Suzuki Hiroyuki , Urata Jujiro , Okawa Masako
Published: March 2003

Nine healthy men (mean age, 22.2 years) participated in two experimental sessions cross‐overed randomly in a double blind manner; one with a placebo and the other with 0.125 mg of brotizolam (BTZ) administered in the morning. Resting electroencephalogram and event‐related potential under oddball paradigm was recorded before and 1, 2, 4, 6 and 8 h after the administration. Mean 30‐msec bin amplitude from 240 msec to 450 msec after the stimulus was compared between placebo and drug sessions in order to observe P300. Brotizolam reduced the amplitude of P300 at 6 h after administration. It was noted that the effects of BTZ were most marked at Fz.
The expansion of the hypopharynx by correction of glosso‐larynx
Authors: Nitta Masayoshi , Mukai Susumu , Mukai Chikako
Published: March 2003

Abstract The width of the hypopharynx and oropharynx before and after the operation correction of glosso‐larynx (CGL) was compared by cranial X‐ray film. After the operation, the hyoid bone was seen to have moved downward, and the cranial bone was observed to have rotated forward. As a result, the hypopharynx and the oropharynx were expanded. Expansion of the hypopharynx resulted in the decreased resistance of flow decreased and the increased in airflow.
Brainstem function in rapid eye movement sleep behavior disorder: The evaluation of brainstem function by proton MR spectroscopy (1H‐MRS)
Authors: Miyamoto Masayuki , Miyamoto Tomoyuki , Kubo Jin , Yokota Noritsugu , Hirata Koichi , Sato Toshihiko
Published: March 2003

Brainstem function was evaluated by proton magnetic resonance (MR) spectroscopy ( 1H‐MRS) in a 69‐year‐old man with idiopathic rapid eye movement (REM) sleep behavior disorder. An analysis of spectral peak area ratios revealed an increase in the choline/creatine ratio. This change suggests that brainstem neurons have functional impairment at the cell membrane level. Further, our results suggest that 1H‐MRS may provide for non‐invasive, metabolic evaluation of brainstem neuronal function in REM sleep behavior disorder and find application in the differentiation of secondary REM sleep behavior disorders with neurodegenerative disorders from idiopathic disorders.
Autonomic nervous function after evening bright light therapy: Spectral analysis of heart rate variability
Authors: Sakakibara Satoshi , Honma Hiroshi , Kohsaka Masako , Fukuda Noriko , Kawai Ikuko , Kobayashi Riko , Koyama Tsukasa
Published: March 2003

In order to investigate the effects of 5000 lx evening bright light on autonomic nervous function, a spectral analysis was used to assess heart rate variability in consecutive 5‐min epochs just after 60 min of bright light therapy was given to 12 young women (range: 20–21 years of age). The study revealed that a low frequency band (LF) increased in bright light conditions (BL) in comparison with controlled conditions (CL). High frequency band (HF), LF : HF ratio and the coefficient of variance (CV R‐R) were not significantly different between the two conditions. These results indicate that 5000 lx evening bright light may affect sympathetic nervous system activity in healthy women.
Low sampling rate induces high correlation dimension on electroencephalograms from healthy subjects
Authors: Jing Hongkui , Takigawa Morikuni
Published: March 2003

Abstract The aim of this paper was to elucidate the influence of sampling parameters in the non‐linear analysis of a resting electroencephalogram (EEG) in healthy subjects. Electroencephalograms in 12 healthy volunteers were recorded and the signal digitized at 128, 256, 512 and 1024 Hz, respectively, with the resolution of 8 bits, 12 bits and 16 bits for each sampling rate. Correlation dimension was calculated on each data set. Results were demonstrated on brain maps and examined by analysis of variance (
ANOVA). Correlation integral functions demonstrated four parts separated by critical points. The data showed that sampling rate significantly affected the estimation, while resolution did not influence the results. The correlation dimensions calculated with the sampling rate at or below 256 Hz were apparently higher than the results obtained at 1024 Hz. The values at 512 Hz and 1024 Hz did not differ. The data revealed that low sampling rate can severely distort the estimation of correlation dimension. The optimal sampling rate for analyzing resting EEG on normal subjects is 512 Hz. Limitation and aliasing phenomenon are discussed in the paper.
Validity of brief intelligence tests for patients with Alzheimer's disease
Authors: Nakamura Hikaru , Nakanishi Masao , Furukawa Toshiaki A. , Hamanaka Toshihiko , Tokudome Shinkan
Published: March 2003

Abstract The validity of two kinds of brief intelligence tests for patients with Alzheimer's disease (AD) was investigated. In study 1, five short forms of the Japanese Wechsler Adult Intelligence Scale‐Revised (JWAIS‐R) were administered to 102 AD patients. The results showed that the intraclass correlation coefficients (ICC) between IQ estimated with the short forms and those obtained by administration of the full JWAIS‐R were satisfactory, ranging from 0.82 to 0.98, and that the abbreviated forms took a shorter time to execute. In study 2, the Raven's Coloured Progressive Matrices (RCPM) and the Mini‐Mental State Examination (MMSE) were administered to 67 AD patients. The ICC between the IQ estimated with these tests and the full‐scale IQ of the JWAIS‐R were both acceptable at 0.57, and each test could be carried out in a very short time. It was concluded that these brief tests, particularly the WAIS‐R short forms, are highly practical for quick measurement of intelligence in AD patients, although they have their respective limitations.
A case of temporal lobe epilepsy with improvement of clinical symptoms and single photon emission computed tomography findings after treatment with clonazepam
Authors: Ide Masayuki , Mizukami Katsuyoshi , Suzuki Toshihito , Shiraishi Hiroyasu
Published: March 2003

Abstract A 26‐year‐old female presented psychomotor seizures, déjà vu and amnestic syndrome after meningitis at the age of 14 years. Repeated electroencephalograms (EEG) demonstrated occasional spikes localized in the right temporal region in addition to a considerable amount of theta waves mainly in the right fronto‐temporal region. Single photon emission computed tomography (SPECT) showed a marked hypoperfusion corresponding to the region in which the EEG showed abnormal findings, although magnetic resonance imaging (MRI) demonstrated no abnormal findings associated with the clinical features. Treatment with clonazepam in addition to sodium valproate resulted in a remarkable improvement of clinical symptoms (i.e. psychomotor seizures and déjà vu), as well as of the EEG and SPECT findings. The present study suggests that SPECT is a useful method not only to determine the localization of regions associated with temporal lobe epilepsy but also to evaluate the effect of treatment in temporal lobe epilepsy.
Predictors of severity of behavioral disturbance among community‐dwelling elderly individuals with Alzheimer's disease: A 6‐year follow‐up study
Authors: Asada Takashi , Motonaga Takuro , Kinoshita Toru
Published: March 2003

Abstract To clarify which baseline factors, including apolipoprotein E (ApoE) genotyping and caregiver characteristics, predict the future severity of behavioral disturbance among community‐dwelling elderly with Alzheimer's disease (AD), we conducted a longitudinal study for up to 6 years. Fourteen kinds of behavioral disturbance were evaluated. Analyses using data from 62 subjects with at least three annual assessments revealed that the baseline severity of behavioral disturbance was the strongest predictor of future severity, followed by baseline stage of dementia or use of support services. However, ApoE ɛ4 had only a marginal effect at most. The behavioral disturbances examined in the present study appear to be innately determined phenomena rather than merely representing stages of AD.
Absence of sleep spindles in human medial and basal temporal lobes
Authors: Nakabayashi Tetsuo , Uchida Sunao , Maehara Taketoshi , Hirai Nobuhide , Nakamura Motoaki , Arakaki Hiroshi , Shimisu Hiroyuki , Okubo Yoshiro
Published: March 2003

Abstract All‐night recordings from subdural electrocorticographic (ECoG) electrodes on the human medial and basal temporal lobes were analysed to examine spindling activities during sleep. Subjects were three males and three females who were candidates for neurosurgical treatments of partial epilepsy. Subdural electrodes were attached to the medial and basal temporal lobe cortices, allowing ECoG and electroencephalogram from the scalp vertex (Cz EEG) to be recorded simultaneously during all night sleep. In one case, subdural electrodes were attached also on the parietal lobe. Fast Fourier transformation (FFT) analyses were performed on the ECoG and Cz EEG signals. No organized sleep spindles or sigma band (12–16 Hz) peaks in FFT power spectra were observed from the medial or basal temporal lobes of the non‐epileptogenic hemispheres during non‐rapid eye movement (NREM) sleep. In a case with parietal electrodes, organized spindle bursts were observed in parietal signals synchronized with Cz spindles. Although delta band (0.3–3 Hz) power from both the medial and basal temporal lobes fluctuated across each night as expected, sigma activity changed little. However, 14 Hz oscillatory bursts were observed in the medial basal temporal lobe of epileptogenic hemisphere in two cases and bilaterally in one case during not only NREM sleep but rapid eye movement (REM) sleep and wakefulness. From the present study we conclude that sleep spindle activities are absent in the medial and basal temporal lobes. Fourteen Hz oscillatory bursts observed from the medial or basal temporal lobe in some cases were not considered to be sleep spindles since they also appeared during REM sleep and wakefulness. These waveforms could have originated due to epileptic pathology, since they frequently appeared in epileptic regions.
Restlessness in suboccipital muscles as a manifestation of akathisia
Authors: Hirose Shigehiro
Published: March 2003

Abstract Antipsychotic‐induced akathisia is primarily manifested as restlessness, particularly expressed in the legs. Consequently, rating scales and the research criteria of DSM‐IV regard restlessness in the legs as the major sign of akathisia, although it has been suggested that such restlessness may occur in other areas of the body. A case of antipsychotic‐induced akathisia is reported where the region of inner restlessness (the subjective component) was identified in posterior cervical muscles. The patient was initially suspected to be experiencing somatic delusions and the dose of antipsychotic medication was increased. This did not improve the symptoms, and upon careful questioning about his head discomfort, the patient acknowledged that he felt an inner restlessness in the suboccipital muscles. The restlessness ceased with intramuscular biperiden and subsequent discontinuation of antipsychotic medication. This case suggests that subjective restlessness may occur in muscle groups that are not usually associated with akathisia. Thus, this report may assist clinicians in the diagnosis of akathisia that could be overlooked or misdiagnosed as somatic delusions or the worsening of the patient's psychosis.
Relation of apolipoprotein E polymorphism to clinically diagnosed Alzheimer's disease in the Korean population
Authors: Kim Hee‐Cheol , Kim Dae‐Kwang , Choi In‐Jang , Kang Kyung‐Hee , Yi Sang‐Do , Park Jonghan , Park Young‐Nam
Published: March 2003

Abstract The gene for human apolipoprotein E (APOE) is found on the long arm of chromosome 19 (19q13.2) and exists in three common allelic forms, ɛ2, ɛ3, and ɛ4. The APOE ɛ4 allele is overrepresented in Alzheimer's disease (AD) and is accepted as a genetic risk factor. Some studies reported a protective effect of the APOE ɛ2 allele for AD. However, there are some ethnic variations in the proportion of different APOE alleles and their relationship to AD. We examine the distribution of APOE alleles from 30 AD patients and 158 controls in Korea. The control subjects were all cognitively intact unrelated Koreans. The frequencies of APOE alleles in AD patients were 18.3% (ɛ2), 58.3% (ɛ3), and 23.3% (ɛ4). The corresponding frequencies in controls were 13.3% (ɛ2), 72.5% (ɛ3), and 14.2% (ɛ4). The frequency of the APOE ɛ2 allele in AD patients was not significantly different from that in controls. When statistical analysis was conducted after the exclusion of the APOE ɛ2 allele, the frequency of the APOE ɛ4 allele in AD patients was significantly higher than that in controls (P < 0.05). These results support that the APOE ɛ4 allele plays a role as a risk factor for AD in Koreans and suggest that the APOE ɛ2 allele may not play a protective role in the development of AD in Koreans.
Sociomedical aspects of epileptic patients: Their employment and marital status
Authors: Wada Kazumaru , Kawata Yuko , Murakami Takuya , Kamata Akihisa , Zhu Gang , Mizuno Kazuhisa , Okada Motohiro , Kaneko Sunao
Published: March 2003

Abstract We examined the employment and marital status of adult patients with epilepsy who did not have mental retardation and who had been treated at Hirosaki University Hospital, Hirosaki, Japan, for more than 5 years. The present study included 278 patients (142 males and 136 females) ranging from 20 to 60 years of age. We investigated the occupational status of the subjects and found that 168 had permanent jobs, but 41 patients were unemployed at the time of this survey. The proportion of the patients whose seizures were controlled at the time of this survey was 68% (114/168) in the group having permanent jobs, and 22% (9/41) in the unemployed group. Forty cases answered that they had resigned from their jobs due to occurrence of epileptic seizures. Of these patients, 13 were dismissed and 27 resigned voluntarily due to the potential for seizures. As to relationship between jobs and neuropsychiatric complications, the incidence of a past history of psychotic states in the unemployed group was significantly higher than that in the employed group. As to marital status, 13 males and 16 females (n = 29) had experienced divorce. Seven cases (two males and five females) had answered that epilepsy had been the reason for their divorce. We conclude that epilepsy or epileptic seizures have various negative effects on the patient's social life.
Is the sleep initiating process affected by psychological factors?
Authors: Komada Yoko , Yamamoto Yukari , Shirakawa Schuichiro , Yamazaki Katuo
Published: March 2003

The aim of this study was to investigate the effects of psychological factors on sleep initiating process. The Y‐G personality test (Y‐G), Lazarus‐type stress coping inventory (SCI), Zung self‐rating depression scale, General health questionnaire, and Sleep health questionnaire were administered to 418 subjects (mean age = 21.13 ± 8.76 years), and the data were analyzed by multiple regression analysis (stepwise variable reduction method). Self‐rating depression scale; Co‐Em, Pla, Sel scale in SCI; C, N, O, Co scale in Y‐G were significantly included in the final model. The results showed that psychological factors, such as depression, emotion‐focused coping behaviour, prudent planning to solve problems, low self‐control, small changes of feeling, nervousness, subjectiveness, and cooperativeness are associated with difficulty initiating sleep.
Synchronization between hippocampal theta waves and PGO waves during REM sleep
Authors: Karashima Akihiro , Nakamura Kazuhiro , Watanabe Mika , Sato Naoki , Nakao Mitsuyuki , Katayama Norihiro , Yamamoto Mitsuaki
Published: March 2003

We investigated the temporal relationship between hippocampal theta waves (referred to as ‘theta waves’) and ponto‐geniculo‐occipital (PGO) waves in cats. We measured the time intervals between an occurrence of a PGO wave and the prior and posterior adjacent positive peaks of the theta wave. The unimodal distributions of these intervals suggested a close temporal relationship between PGO and theta waves (i.e. synchronization). In addition, the period of a theta wave during which a PGO wave occurred was not statistically different from that without a PGO wave. This result suggests that the synchronization found here is characterized by phase‐locking rather than phase‐resetting. Common mechanisms are suggested to underlie the generation of PGO and theta waves.
Examination of accuracy of sleep stages by means of an automatic sleep analysis system ‘Sleep Ukiha’
Authors: Hashizume Yuji , Kuwahara Hiroo , Uchimura Naohisa , Mukai Masaki , Shirakawa Shinichirou , Satomura Takeshi , Takeuchi Noboru , Tanaka Junji , Maeda Hisao
Published: March 2003

We examined the differences between the results of an automatic sleep analysis system and inspection decision. Subjects were 10 males (average age 21.6 years). One section consists of 20 s records. The sections that deviated from the algorithm could not be decided. Each sleep stage decided by automatic analysis was compared with the inspection decision. The agreement ratio of stage 3 was 91.6% in the highest, and followed by stage 2, stage 4, stage W and stage 1. The lowest was 62.5% for movement time. The total agreement ratio was 85.8%. The agreement ratios of the apnea index (AI) and the apnea hypopnea index (AHI) were relatively high, but for types of sleep apnea, agreement ratios require improvement.
Aggregated occurrence of sleep apnea syndrome in a family
Authors: Shimizu Osamu , Inoue Yuichi , Takada Kokichi , Nanba Kazuyoshi , Arai Heii
Published: March 2003

We experienced a family in whom sleep apnea syndrome (SAS) was recognized in six members and habitual snoring in seven members among 26 subjects of four generations. In all members with snoring, the disorder was noticed before the age of 20. Hypercapnic response study showed normal findings, and ultrafast magnetic resonance image of the upper airway revealed that the obstruction of the upper airway occurred at the velopharyngeal portion during apneic episodes in all SAS‐afflicted subjects. In this family, the similar craniofacial structural abnormalities were thought to cause the aggregated occurrences of the disorders at young ages, and obesity was regarded as a contributor for the aggravated symptoms.
Uvulopalatopharyngoplasty for obstructive sleep‐related breathing disorders: One‐year follow up
Authors: Itasaka Yoshiaki , Miyazaki Soichiro , Tanaka Toshihiko , Ishikawa Kazuo
Published: March 2003

The effectiveness of uvulopalatopharyngoplasty was evaluated in 28 patients (25 men and three women; mean age 47.6 years) with obstructive sleep apnea by comparing preoperative daytime polysomnography with those carried out 6 months and 1 year postoperatively. The mean apnea plus hypopnea index (AHI) in the supine position decreased from 51.0/h to 23.0/h 6 months postoperatively and 57.1% of patients showed a 50% or more reduction of AHI. By changing the sleep position from supine to lateral, 71.4% of the 28 patients indicated a 50% or more reduction in AHI before surgery, which increased to 92.3% of 26 patients 6 months postoperatively. The positive results of uvulopalatopharyngoplasty were maintained at least until 1 year after surgery.
Effect of melatonin on sleep and rectal temperature of young healthy evening types
Authors: Shirakawa Shin‐Ichiro , Sakamoto Tetsuro , Uchimura Naohisa , Tsutsumi Yasumasa , Tanaka Junji , Maeda Hisao
Published: March 2003

The present study assessed in healthy nocturnal juveniles the presence or absence of the hypnotic action of exogenous melatonin and its effect on core temperature by oral administration of exogenous melatonin at a pharmacologically low dose 15 min before going to bed at the normal time. Both sleep latency and the number of instances of waking up after falling asleep tended to decrease, while the amount of Stage 2 sleep increased significantly. However, no hypothermic action regarding the rectal temperature for changes in the circadian phase were observed. According to those results, it is possible that exogenous melatonin has some direct hypnotic action on habitual night sleep, although the extent of this action is considered to be relatively weak.
Polymorphism of CTLA‐4 gene for major depression in the Korean population
Authors: Jun Tae‐Youn , Pae Chi‐Un , Chae Jeong‐Ho , Bahk Won‐Myong , Kim Kwang‐Soo
Published: March 2003

This study was carried out to verify the relationship between major depression and cytotoxic T lymphocyte antigen‐4 (CTLA‐4), which is related to immunological function such as T‐cell regulation. Among the Korean patients diagnosed with major depression according to DSM‐IV, 77 patients without neurological illness, hormonal disorder, or comorbid mental illness were selected. The stored data on 149 normal Koreans from the Catholic Hemopoietic Stem Cell Bank of Korea, were used as a control group. The data of the Korean control group were compared with those of the studies of different ethnic groups. DNA was extracted from whole blood using proteinase K and the exon 1 region of CTLA‐4 gene was amplified by polymerase chain reaction. Gene typing was performed using single strand conformation polymorphism. The results were assessed. There were significant differences in frequencies of CTLA‐4 allele (χ2 = 56.472, d.f. = 1, P = 0.001) and genotype (χ2 = 46.132, d.f. = 2, P = 0.001) between the Korean population and the Caucasian population. However, we could not find any differences between the Korean and the Japanese population. There were no significant differences in genotype frequencies of CTLA‐4*G/G, CTLA‐4*G/A, and CTLA‐4*A/A between the patients with major depression and the control group in the Korean population (48.1%vs 46.3%, 41.6%vs 39.6%, 10.3%vs 14.1%, respectively). There were no significant differences in allelic frequencies of CTLA‐4*G and CTLA‐4*A between the patients with major depression and the control group in the Korean population (68.8%vs 66.1%, 31.2%vs 33.9%, respectively). Although the present study produced negative results for the association of exon 1 polymorphism of CTLA‐4 gene with major depression in the Korean population, further systematic research, including diverse clinical variables, would be necessary.
On the role of quantitative brain imaging in the differential diagnosis of speech disorders
Authors: Elst Ludger H. Tebartz Van , Juengling Freimut D , Kassubek Jan , Schmidtke Klaus , Thiel Thorsten , Ebert Dieter , Dykierek Petra , Hüll Michael
Published: March 2003

Abstract We present the case of a 71‐year‐old woman with an 11‐year history of slowly progressive decline of motor speech. Normal clinical investigations including routine magnetic resonance imaging (MRI) at 7, 8 and 10 years after the onset of speech dysfunction led to the suggestion of a psychogenic disorder. Extensive clinical, neuropsychological and neuroimaging investigations including 18F‐desoxyglucose‐positron emission tomography (PET), quantitative MRI and MR spectroscopy were performed to look for subtle brain pathology. Quantitative assessment of 3D‐MRI, F‐desoxyglucose‐PET and magnetic resonance spectroscopy all demonstrated clear evidence of multifocal frontotemporal brain pathology that had not been picked up on routine MRI investigations on previous admissions. This is the longest benign history of slowly progressive anarthria reported so far. It demonstrates a possible role of quantitative neuroimaging techniques in the diagnosis of complex neuropsychiatric disorders.
Elbow flexion response as another primitive reflex
Authors: Sudo Kazumasa , Matsuyama Tomokiho , Goto Yoshiro , Matsumoto Akihisa , Tashiro Kunio
Published: March 2003

Abstract In daily clinical practice we noticed that patients with intellectual impairment spontaneously flex the elbow within a few seconds of the forearm being manipulated during routine examination of spasticity of the muscles in the upper extremities. We termed this phenomenon elbow flexion response (EFR), and prospectively studied it in 229 patients who underwent in‐hospital rehabilitation following brain damage. Evaluation of each patient included EFR, patient profile, ability to communicate, scores on three parameters from various intelligence tests, scores on seven parameters testing primitive reflexes, and scores on three parameters describing personality. We investigated for relationships among these parameters. Consequently, although EFR rarely have a statistical association with the varied profiles of patients, patients with bilateral lesion or bilateral paresis demonstrated significantly more marked EFR than those with unilateral lesion or unilateral paresis. Patients with involvement of the frontal lobe showed significantly more marked EFR than those without damage in this area. Elbow flexion responses occurred significantly more frequently in relation with lower scores on intelligence and occurred with significantly higher frequency in conjunction with the more marked appearance of conventional primitive reflexes. Therefore, we conclude that EFR have a strong association with intelligence and with the existence of frontal lobe lesion, and their mode of clinical presentation parallels that of primitive reflexes particularly that of the grasp reflex. We propose that EFR could be referred as a variation of the grasp reflex occurring in the more proximal or axial part of the body.
Effects of orexin on the laterodorsal tegmental neurones
Authors: TAKAHASHI KAZUMI , KOYAMA YOSHIMASA , KAYAMA YUKIHIKO , YAMAMOTO MITSUAKI
Published: March 2003

Abstract Orexin, a hypothalamic neuropeptide, has been revealed to be involved in sleep regulation. To elucidate functions of orexin in brainstem sleep regulation mechanism, we examined the effects of orexin applied from micropipettes with air pressure on neurones in and around the laterodorsal tegmental nucleus (LDT). In five of seven cholinergic neurones and six of nine non‐cholinergic neurones orexin induced long‐lasting excitation. These results suggest that hypothalamic orexin neurones may affect the LDT neurones directly, and thereby participate in control of sleep.
Involvement of granulocyte–macrophage colony‐stimulating factor (GM‐CSF) in pregnancy‐enhanced sleep
Authors: KIMURA MAYUMI , INOUÉ SHOJIRO
Published: March 2003

Abstract Granulocyte–macrophage colony‐stimulating factor (GM‐CSF) is a crucial cytokine for establishing pregnancy. It has been demonstrated previously in rats that sleep increases during early pregnancy and that centrally administered GM‐CSF promotes both rapid eye movement (REM) and non‐REM sleep. Therefore, whether GM‐CSF is involved in pregnancy‐enhanced sleep was investigated using the anti‐GM‐CSF antibody. Female rats received an intracerebroventricular infusion of either anti‐GM‐CSF or control IgG (10 μg each) for four nights from the first day of pregnancy (PD1–PD4). Although sleep amounts on PD1 were not affected, anti‐GM‐CSF decreased non‐REM and REM sleep significantly during PD2–PD4 compared with the control baseline of the IgG group. The results demonstrated that anti‐GM‐CSF treatment suppresses pregnancy‐enhanced sleep, suggesting that GM‐CSF contributes to sleep regulation during pregnancy.
Analysis of the influence of diurnal variation in maternal movements on fetal heart rate acceleration
Authors: MURO MASAMI , SHONO HIDEAKI , SHONO MAYUMI , ITO YUJI , UCHIYAMA AKIRA , IWASAKA TSUYOSHI
Published: March 2003

Abstract To determine the influence of diurnal variation in maternal movements (MM) on fetal heart rate (FHR) accelerations, 24‐hour maternal heart rates (MHR), MM and FHR recordings were made simultaneously on nine healthy pregnant women at 36–39 weeks of gestation. Correlations between the diurnal variations in maternal factors and FHR parameters; that is, baseline FHR, amplitude, duration and hourly percentage of time spent in accelerations, were examined. Only a few cases showed a significant correlation between acceleration parameters and the diurnal variation of MHR or MM, while most cases indicated a high correlation between the diurnal variation in baseline FHR and that of maternal factors. In conclusion, the occurrence and form of accelerations might be independent of maternal activity.
Diurnal variation in daytime sleepiness of patients with sleep apnea syndrome
Authors: MIYAMOTO MASAYUKI , MIYAMOTO TOMOYUKI , IWATA KAYOKO , HIRATA KOICHI
Published: March 2003

Abstract Diurnal variations in daytime sleepiness were studied in 26 men with sleep apnea syndrome (SAS) [age, 41.7 ± 9.9 years (mean ± SD); body mass index,

30.0 ± 6.2 kg/m2; Epworth Sleepiness Score,

8.7 ± 4.1; apnea–hypopnea index, 50.2 ± 22.0]. Sleep latencies

measured at 09.00 h, 11.00 h, 13.00 h, 15.00 h, and 17.00 h were 3.4 ± 3.6

min, 4.7 ± 5.5 min, 5.2 ± 4.4 min, 5.3 ± 5.4 min, and 9.3 ±

7.2 min, respectively (ANOVA, P < 0.05). Daytime sleepiness in patients with SAS was more pronounced in the morning than in the afternoon and evening.
Analysis of onset location, laterality and propagation of cataplexy in canine narcolepsy
Authors: FUJIKI NOBUHIRO , MORRIS LUC , MIGNOT EMMANUEL , NISHINO SEIJI
Published: March 2003

Abstract Hypocretin deficiency is involved in most cases of human narcolepsy. Although cataplexy is pathognomonic of narcolepsy, mechanisms of induction of cataplexy are largely unknown. Patterns of occurrence of cataplectic attacks (i.e. onset location, laterality, and propagation of attacks) in hypocretin receptor 2‐mutated narcoleptic Dobermans were characterized in order to understand the basic mechanism of this abnormal sleep‐related atonia. Most cataplexy attacks were bilateral (98%) and were initiated in the hind legs (80%). Progression of attacks was also seen (49%) and atonia during propagation was most often bilateral (94%). Involvement of abnormal inactivation of bilateral pathways to the spinal motoneurones due to a deficiency in hypocretin neurotransmission is suggested in the occurrence of cataplexy.
Phase shift of coupled oscillator model with feedbacks in response to multiple bright light exposure
Authors: NAKAO MITSUYUKI , YAMAMOTO KEISUKE , KATAYAMA NORIHIRO , YAMAMOTO MITSUAKI
Published: March 2003

Abstract Human temperature rhythm was reported to have type 0 phase response curve (PRC) to multiple bright light exposure; however, mechanisms underlying this finding could not be clarified easily in a theoretical framework, and has not yet been confirmed by other researchers. In this paper, under reproduced photic exposure, phase response properties of a coupled three oscillator model were investigated to identify the possible mechanism underlying the experimental finding. The resulting phase shift of an oscillator reached approximately 12 h, and changed its sign acutely at the cross‐over point of an original PRC of the oscillator. This type 0‐like phase shift was produced by an accumulated phase response during the oscillator’s re‐entrainment process to the photic exposure. The organization of coupled oscillators affected the total amount of this phase shift.
Loss of circadian behavioural rhythms in rats kept in constant darkness
Authors: USUI SETSUO , OKAZAKI TERUE
Published: March 2003

Abstract Ten male Sprague–Dawley rats were exposed to 1‐h light and 1‐h dark (LD 1 : 1) cycles for 50 days. They were then released into constant darkness (DD) for 104 days. Exposure to LD 1 : 1 caused gradual disruption of circadian rhythms in their ambulatory and drinking activities until, finally, all the animals lost their circadian behavioural rhythms. After their release into DD, eight rats showed free‐running circadian behavioural rhythms, whereas the remaining two rats showed circadian arrhythmicity for approximately 50 days in DD before they restored their free‐running rhythms spontaneously.
Differences in fractal structure of adult heart rate fluctuation between successive rapid eye movement sleeps: Case report
Authors: SHONO HIDEAKI , SHONO MAYUMI , TAKASAKI MITSUHIRO , IWASAKA TSUYOSHI , SUGIMORI HAJIME
Published: March 2003

Abstract The dynamics of fractal structures of heart rate (HR) fluctuations in successive

rapid eye movement sleeps (REMS) was investigated in a healthy male. Fractal analysis

using a purposely‐devised method was carried out at 10‐min time series of HR, which

were being recorded simultaneously by an electroencephalogram at night. Scaling relationships

showed three slopes (αs). The mean αs below one cross‐over point

(< 6.0 s), mean αm between two cross‐over points, and mean α1 above another cross‐over point (> 12.0 s) during REMS changed from 2.0, 1.0, and 0.3 in the third cycle to 2.0, 0.9, and 1.2 in the fourth cycle. The present study demonstrates the differences in multiscaled fractal structures of HR fluctuations between the successive REMS in a particular case.
Relationship between amount of sleep and daytime sleepiness in three cases
Authors: ISHIHARA KANEYOSHI
Published: March 2003

Abstract The effect of sleep amount on daytime sleepiness was investigated, and the appropriate
amount of sleep for each subject was evaluated. Three children were longitudinally
evaluated for three conditions: control, sleep extension, and sleep reduction. A
sleep latency test was conducted five times for each condition at 2‐h intervals from
10.00 hours. The results showed that the effects of sleep loss increased sleepiness
at 10.00 hours and 18.00 hours, and there were positive correlations between sleep
amount and sleep latency for each subject (r = 0.590–0.903). Whether or not the amount of sleep for each subject was sufficient was evaluated from the relationship between the two measures.
A sleep disorders centre in the United Kingdom
Authors: OKA YASUNORI , HOWARD ROBIN S. , WILLIAMS ADRIAN J.
Published: March 2003

Abstract The demographic features of 296 patients who consulted a sleep disorders centre in the United Kingdom were reviewed. Diagnosis after a sleep study was mainly that of sleep‐related breathing disorders; however, various other sleep disorders were also diagnosed. Considering that most sleep disorders are diagnosed only after sleep investigations, it should be emphasized that such a facility should be well prepared in undertaking not only polysomnography but also various sleep investigations, including multiple sleep latency testing and actigraphy. In addition, several treatment options, including sleep hygiene, light therapy, and behavioural therapy, should be available. Therefore, a sleep disorders centre needs to be operated by sleep specialists.
Elicited ponto‐geniculo‐occipital waves by auditory stimuli are synchronized with hippocampal θ‐waves
Authors: KARASHIMA AKIHIRO , NAKAMURA KAZUHIRO , HORIUCHI MASAHIRO , NAKAO MITSUYUKI , KATAYAMA NORIHIRO , YAMAMOTO MITSUAKI
Published: March 2003

Abstract The study demonstrated that ponto‐geniculo‐occipital (PGO) waves are phase‐locked with hippocampal θ‐waves during rapid eye movement (REM) sleep. A possible mechanism

for influencing a PGO wave generator by hippocampal θ‐waves was hypothesized.

The generator is known to receive afferent inputs such as auditory input. To test

this hypothesis, the temporal relationship between hippocampal θ‐waves and elicited

PGO waves (PGOE) by auditory stimuli was analysed. The analysis showed

that PGOE were synchronized with θ‐waves, but did not reset the phase

of a θ‐wave. Because the occurrence of PGOE and spontaneous PGO waves shared the same phase‐dependency on θ‐waves, the results strongly suggest that the PGO wave generator was driven by θ‐waves, as originally hypothesized.
Pathological effect of seizures on the hippocampus in cases with temporal lobe epilepsy caused by brain tumors
Authors: UESUGI HIDEJI , SHIMIZU HIROYUKI , ARAI NOBUTAKA , MAEHARA TAKETOSHI , MIZUTANI TOSHIO , KAWAI KENSUKE , NAKAYAMA HIROSHI
Published: March 2003

The cause of Ammon's horn sclerosis in temporal lobe epilepsy has not yet been clarified. In the present study, the pathological effect of epileptic seizures on the hippocampus was investigated in surgically treated patients with brain tumor‐induced temporal lobe epilepsy. Tumors involving the hippocampus were identified as the foci of epilepsy in 13 patients (seven male and six female) and resected after epileptic discharges were found at the hippocampus on intraoperative electrocorticogram. The mean age at operation was 29.8 ± 11.5 years and the mean age of seizure onset was 19.9 ± 10.8 years. Because only three of the 13 patients who underwent temporal lobectomy for brain tumors involving the hippocampus had Ammon's horn sclerosis pathologically, it was concluded that it was very unlikely that the Ammon's horn sclerosis was produced by the epileptic seizures. Two of the three patients with pathological signs of Ammon's horn sclerosis had episodes of coma, covulsion, high fever and cyanosis in their past histories that might have portended the appearance of Ammon's horn sclerosis later in their lives.