bluuebunny/crossref_metadata_2025 huggingface dataset:
Thalamic retrograde degeneration in the congenitally hydrocephalic rat is attributable to apoptotic cell death
Authors: Mori Fumiaki , Tanji Kunikazu , Yoshida Yasuji , Wakabayashi Koichi
Published: March 2003

Congenitally hydrocephalic HTX rats develop ventricular dilatation with extensive damage of the cerebral white matter. Recently, we have reported that neuronal cell death also occurs in the thalamus of HTX rats. To investigate the mechanism underlying this thalamic degeneration in these animals, we carried out a histopathological study of the brain at different phases of postnatal development. Eosinophilic neurons with condensed chromatin or fragmented nuclei were observed in the thalamus from postnatal day 17 onward. The incidence of cell death in the thalamus increased with the progression of hydrocephalus. Ultrastructurally, thalamic neurons occasionally had apoptotic features including nuclear chromatin condensation and marginalization. Immunohistochemically, single‐stranded DNA‐positive neuronal nuclei were found in the thalamus. They were also positively stained with the TUNEL method. Marked loss of myelin and axons with many TUNEL‐positive oligodendrocytes were found in the cerebral white matter. These findings suggest that the neuronal cell death observed in the thalamus in hydrocephalic HTX rats is retrograde degeneration due to extensive damage of axons in the cerebral white matter and that the thalamic retrograde degeneration is attributable to apoptotic cell death.
Basal ganglia lesions in ‘Pick complex’: A topographic neuropathological study of 19 autopsy cases
Authors: Tsuchiya Kuniaki , Ikeda Kenji
Published: March 2003

The distribution of basal ganglia lesions, including the amygdala, striatum (caudate nucleus, putamen), pallidum, and substantia nigra, were reinvestigated in 19 Japanese autopsy cases of ‘Pick complex’, consisting of five patients with corticobasal degeneration (CBD), 10 patients with Pick's disease with Pick bodies (PDPB), and four patients with generalized variant of Pick's disease (gvPD). The lesions in the amygdala, striatum, and pallidum were classified into three categories (severe, moderate, and slight). The lesions in the substantia nigra were qualitatively judged, compared with normal controls. In CBD, basal ganglia lesions in all five cases were uniform: the pallidum showed severe lesions, the striatum moderate lesions, the amygdala slight lesions, and obvious neuronal loss of the substantia nigra was verified in all five cases. Basal ganglia lesions in 10 cases of PDPB were also uniform: the amygdala disclosed severe to moderate lesions, the striatum moderate to slight lesions, the pallidum slight lesions, while obvious neuronal loss of the substantia nigra was found in only two of nine cases in which this structure was examined. Furthermore, basal ganglia lesions in all four cases of gvPD were uniform: the caudate nucleus showed severe lesions, the putamen and amygdala severe to moderate lesions, the pallidum moderate to slight lesions, and obvious neuronal loss of the substantia nigra was confirmed in all four cases. This study, using conventional staining such as hematoxylin‐eosin and Holzer, clarified that there were prominent lesions in the pallidum in CBD, in the amygdala in PDPB, and in the caudate nucleus in gvPD, respectively. In addition, nigral involvement was usually found in CBD and gvPD, but was rarely seen in PDPB. These neuropathological findings may help to elucidate the pathological heterogeneity of basal ganglia lesions in ‘Pick complex’.
Vitamin E as a protective antioxidant in progressive renal failure
Authors: Fryer Michael J
Published: March 2003

SUMMARY:

Progression to renal failure is significantly worsened by oxidative stress in chronic inflammatory kidney disease (IgA nephropathy, antiglomerular basement membrane nephritis, focal segmental glomerulosclerosis), rhabdomyolysis (myoglobinic acute renal failure), diabetic nephropathy and in poisoning by nephrotoxic compounds such as transition metals, paraquat and drugs such as cyclosporine A and cisplatin. The membrane antioxidant vitamin E (α‐tocopherol) is examined as a potential therapeutic intervention that may help to slow the rate of decline of kidney function in such conditions. An impaired plasma antioxidant defence system is characteristic of chronic renal failure and the uremic state. Vitamin E therapy is also considered as a means of correcting plasma antioxidant status and attenuating the cardiovascular disease that accompanies kidney failure.
Relationship between increased interdialytic body weight and left ventricular hypertrophy in maintenance dialysis patients
Authors: Wu San‐Chiang , Jeng Fu‐Rong
Published: March 2003

SUMMARY:Interdialytic weight gain (IDWG) has been reported to contribute to cardiovascular mortality in haemodialysis patients. In order to determine the relationship of IDWG to the pre‐dialysis blood pressure and left ventricular hypertrophy, 168 patients on maintenance haemodialysis were initially evaluated. The IDWG was estimated as the current pre‐dialysis weight minus the preceding post‐dialytic weight and expressed as a proportion (%) of the current dry weight. Patients were divided into two groups: group I consisted of patients with a mean IDWG > 5% each month for 6 months and group II consisted of patients with a mean IDWG < 5% each month for 6 months. As 51 patients had increased IDWG > 5% on more than one occasion, but fewer than six times, they were not included in the above two groups. Thus, 117 patients (33 men, 84 women) were enrolled in this study. All patients received haemodialysis three times a week, with a duration of 4.6 ± 0.5 h per dialysis session. Pre‐dialysis systolic and diastolic blood pressure (SBP, DBP) and left ventricular mass index (LVMI), as determined by echocardiography, were studied regularly. The results demonstrated that the IDWG correlated significantly with age (r= −0.209,P= 0.024) and solute removal index (Kt/V) (r= 0.254,P= 0.006), but did not correlate with pre‐dialysis systolic or diastolic blood pressure. In contrast, LVMI correlated with SBP (r= 0.816,P< 0.001), DBP (r= 0.377,P< 0.001) and age (r= 0.458,P< 0.001). Left ventricular hypertrophy presented in 18 group I subjects (81%) and 68 group II subjects (72%) respectively (P< 0.001). In conclusion, this study shows that excessive IDWG in patients maintained on haemodialysis does not correlate with pre‐dialysis blood pressure, emphasizing that additional factors other than fluid volume may play a role in the control of blood pressure in uraemic patients.
Polymorphonuclear leucocyte rheology and cytosolic Ca2+ content after activation in chronic renal failure
Authors: Caimi G , Canino B , Vaccaro F , Montana M , Carollo C , Oddo1 G , Presti1 R Lo
Published: March 2003

SUMMARY: We evaluated polymorphonuclear leucocyte (PMN) flow properties in patients with clinically stable chronic renal failure (CRF) and in control subjects at baseline and after activation with 4‐phorbol 12‐myristate 13‐acetate (PMA) and N‐formyl‐methionyl‐leucyl‐phenylalanine (fMLP). Initial relative flow rate (IRFR) and clogging particles (CPs) were obtained using the St. George's Filtrometer, and PMN membrane fluidity was assessed by marking PMNs with 1‐(4‐(trimethylamino)phenyl)‐6‐phenyl‐1,3,5‐hexatriene (TMA‐DPH). PMN cytosolic Ca2+ concentration was determined by marking PMNs with Fura 2‐AM. At baseline, CRF patients showed a significant increase only in PMN cytosolic Ca2+ content. After activation with PMA and fMLP, a decrease in IRFR and an increase in CP were observed in both control subjects and CRF patients, although the variation in IRFR present in the group of CRF patients was greater than in the control group. After activation with PMA and fMLP, we found a decrease in PMN membrane fluidity only in CRF patients, but no variation in PMN cytosolic Ca2+ concentration in either group was observed. These results provide evidence for PMN dysfunction in chronic renal failure.
Combined interleukin 1 and tumour necrosis factor α blockade in rat crescentic anti‐glomerular basement membrane glomerulonephritis
Authors: Lan Hui Y , Song Qing , Nikolic‐Paterson David J , Tesch Greg H , Mu Wei , Atkins Robert C
Published: March 2003

SUMMARY: Studies in experimental models have established that blockade of either interleukin 1 (IL‐1) or tumour necrosis factor α (TNF‐α) is effective in suppressing crescentic glomerulonephritis. However, it is not known whether simultaneous blockade of both cytokines will provide additional disease suppression compared with that produced by single cytokine blockade. We have addressed this question in a study of accelerated crescentic anti‐glomerular basement membrane (GBM) glomerulonephritis in the rat. Groups of six animals were treated with an IL‐1 receptor antagonist (IL‐1ra), TNF‐α‐binding protein (TNFbp), IL‐1ra + TNFbp (combined) or saline (control) from the time of anti‐GBM serum injection until being killed, 10 days later. Saline‐treated animals developed crescentic glomerulonephritis with tubulointerstitial damage, heavy proteinuria and renal impairment. Compared with saline, treatment with either IL‐1ra or TNFbp alone resulted in significant suppression of crescent formation (3.0% and 3.3%, respectively, vs. 21.0%; both P < 0.001 vs. control), tubulointerstitial leucocytic infiltration (262 ± 31 and 282 ± 32 cells/mm2 vs. 481 ± 71 cells/mm2; both P < 0.001 vs. control) and proteinuria (167 ± 44 and 164 ± 23 mg/24 h vs. 279 ± 36 mg/24 h; both P < 0.001 vs. control) and prevented the loss of renal function. Combined IL‐1ra and TNFbp treatment resulted in a virtually identical degree of disease suppression as individual cytokine blockade in terms of crescent formation (2.7%), interstitial leucocytic infiltration (274 ± 45 cells/mm2), proteinuria (190 ± 18 mg/24 h) and renal function preservation. In conclusion, this study has demonstrated that blockade of either IL‐1 or TNF‐α alone substantial suppresses experimental crescentic glomerulonephritis to a similar extent to that achieved by simultaneous blockade of both cytokines. These findings provide a rationale for the use of cytokine monotherapy, rather than multiple cytokine blockade, in the treatment of human crescentic glomerulonephritis.
Modelling nursing activities: electronic patient records and their discontents
Authors: Goorman Els , Berg Marc
Published: March 2003

Modelling nursing activities: electronic patient records and their discontents

A fully integrated and operating EPR in a clinical setting is hard to find: most applications can be found in outpatient or general practice settings or in isolated hospital wards. In clinical work practice problems with the electronic patient record (EPR) are frequent. These problems are at least partially due to the models of health care work embedded in EPRs. In this paper we will argue that these problems are at least partially due to the models of health care work embedded in current EPRs. We suggest that these models often contain projections of nurses’ and doctors’ work as it should be performed on the ward, rather than depicting how work is actually performed. We draw upon sociological insights to elucidate the fluid and pragmatic nature of healthcare work and give recommendations for the development of an empirically based EPR, which can support the work of nurses and other health care providers. We argue that these issues are of great importance to the nursing profession, since the EPR will help define the worksettings of the future. Since it is a tool that will impact the development of the nursing profession, nurses have and should have a stake in its development.
Frequent observation: sexualities, self‐surveillance, confession and the construction of the active patient
Authors: Pryce Anthony
Published: March 2003

Frequent observation: sexualities, self‐surveillance, confession and the construction of the active patient

Following Foucault’s analyses of the development of the disciplinary power of the medical gaze, this paper describes the themes that are relocating the ‘active patient’ as the central object of health scrutiny by professionals. A key element in these discourses has been the deployment of power through disciplinary knowledge and techniques of social control through ritual forms of confession, thereby positing the patient/client as the subject of self‐surveillance. The individual is also engaged their own sexuality, performativity and ‘truths’ of sexual experience. These Foucauldian insights have constructed the notion of surveillance medicine, whereby with the assistance of professional technologies, not only the patient’s body but also the ‘self’ can be probed through incitement to confess. However, the actor is not docile; resistances to disciplinary techniques are evident and within the professional practices of the clinic, there is resistance to the power of the erotic. The paper draws on recent research on the social construction of male sexualities in the fields of genitourinary practice, and explores how the ceremonial practices of the clinic engage with the rise of surveillance medicine and the medicalisation of everyday life. The individual actor is exhorted to engage in increased sexual and medical self‐surveillance and to be recruited in the project of becoming an ‘active patient’. It concludes with an examination of some of the implications this surveillance of self may have for practitioners in terms of power and the professional lens through which the sexualised, symbolic body is viewed.
The impact of recent changes in public health insurance on community‐based health‐care in the USA
Authors: Milio Nancy
Published: March 2003

The impact of recent changes in public health insurance on community‐based health‐care in the USA

Recent changes in US government‐funded healthcare insurance are having profound impacts on all types of community‐based health‐care, reducing access to care by vulnerable populations. This article traces the impacts of recent policies on a range of community institutions in which nurses play a critical role, such as health centers, highlighting the effects on access to care and the survival of non‐profit services in less‐advantaged communities. In general, the new policies shifted revenues into fixed payment per client contracts (capitation) paid to for‐profit managed care organizations and away from non‐profit community services. The full impact of this competitive, market‐oriented system of health services has just begun to be felt. The uncertainties and dissatisfactions assure continued activity to change current conditions, including efforts by groups that seek greater access to health services for all populations and security for committed providers and personnel, including nurses.
The externality of the inside: body images of pregnancy
Authors: Schmied Virginia , Lupton Deborah
Published: March 2003

The externality of the inside: body images of pregnancy

This paper draws on literature, empirical data and a range of theoretical perspectives on the maternal body to examine understandings of the relationship between a pregnant woman and her foetus, with a particular focus on the body images used by women to represent this relationship. Psychoanalytic and nursing accounts of the relationship between mother and foetus have often described a symbiotic ‘oneness’ or unity during pregnancy. Such accounts, however, stress the temporary nature of this unity and identify a series of ‘stages’ of separation or ‘polarisation’ between mother and foetus during pregnancy. In contrast, many of the 25 women who participated in our interview study of new motherhood described a confusion of the boundary between self and foetus. For many women the experience of pregnancy and the relationship with the unborn baby was ambiguous and uncertain. Importantly, none of these women described her relationship with the foetus as a series of developmental stages, but rather saw it as fluctuating throughout pregnancy. These findings are more consistent with the work of feminist theorists who describe pregnancy as a dynamic and fluid merging of the inside and the outside of the body/self.
Hermeneutics and narration: a way to deal with qualitative data
Authors: Wiklund Lena , Lindholm Lisbet , Lindström Unni Å.
Published: March 2003

Hermeneutics and narration: a way to deal with qualitative data

This article focuses a hermeneutic approach on the interpretation of narratives. It is based on the French philosopher Paul Ricoeur's theory of interpretation but modified and used within a caring science paradigm. The article begins with a presentation of the theoretical underpinnings of hermeneutic philosophy and narration, as well as Ricoeur's theory of interpretation, before going on to describe the interpretation process as modified by the authors. The interpretation process, which consists of several stages, is exemplified and discussed using a single case from a larger study on suffering. The results of that study indicate that the struggle of suffering is perceived as a struggle formed between shame and dignity, and that nurses must engage in the process of preserving and restoring the dignity of their suffering patients. The authors suggest that Ricoeur's theory of interpretation is useful when trying to understand narrative data if the researcher realises that the process of distanciation, although central in Ricoeur's thinking, is not the goal of the process but rather a means to deal with the researcher's pre‐understandings. According to Ricoeur, distanciation is accomplished by putting the context aside and dealing with the text ‘as text’ and thereby explaining its meaning. Explanation thus becomes the dialectic counterpart to understanding in the interpretation process. The researchers further argue that distanciation must be followed by reflection, where the interpretations are linked back to the empirical context.
Clinical features of circadian rhythm sleep disorders in outpatients
Authors: Yamadera Wataru , Sasaki Mitsuo , Itoh Hiroshi , Ozone Motohiro , Ushijima Sadanobu
Published: March 2003

The clinical data of 86 cases of primary circadian rhythm sleep disorder (primary CRSD) were retrospectively examined and compared to 40 cases of secondary circadian rhythm sleep disorder (secondary CRSD), who had presented with some kind of psychiatric or medical disorder, and had exhibited sleep‐wake rhythm disorders that were judged to be secondary CRSD based on sleep logs. The comparison of cases found that: (i) the mean age at first presentation to the clinic was significantly younger for primary CRSD compared to secondary CRSD; (ii) more secondary CRSD cases were unemployed than were Primary CRSD cases; (iii) more cases in the secondary CRSD group had a clear trigger for sleep‐wake rhythm disorder onset than cases in the primary CRSD group; and (iv) the types of sleep‐wake rhythm disorders in the primary CRSD group consisted of delayed sleep phase syndrome (DSPS), 72 (83.7%), non‐24 pattern, 11 (12.8%), and irregular, 3 (3.5%). In the secondary CRSD group there were 25 (62.5%) cases of DSPS pattern, 1 (2.5%) of non‐24 pattern and 14 (35.0%) with irregular pattern. The 56 (65.1%) cases with primary CRSD showed good response to vitamin B12 and bright light therapy; however, 28 (70.0%) cases with secondary CRSD did not respond to such therapies.
P300 in response to the subject's own face
Authors: NINOMIYA HIDEAKI , ONITSUKA TOSHIAKI , CHEN CHUNG‐HO , SATO EIGO , TASHIRO NOBUTADA
Published: March 2003

The P300 event‐related potentials in response to self‐relevant stimuli has been reported to be different from those to non‐target stimuli under a passive attention condition. In the present study the P300 in response to the subject's own face was examined. Twelve right‐handed volunteers served as subjects. In two separate conditions, deviant (subject's own face and red square; 30%), non‐target (two unfamiliar faces; 30% each), and target (famous face; 10%) stimuli were randomly presented on a computer screen. P300 amplitudes in response to the red square were larger than those to the unfamiliar faces, but were significantly lower than those to the subject's own face. The subject's own face in normal population may have an intense relevance to the subjects which has an additional effect over the simple orienting response.
Laterality of delta waves during all‐night sleep
Authors: Sekimoto Masanori , Kajimura Naofumi , Kato Masaaki , Watanabe Tsuyoshi , Nakabayashi Tetsuo , Takahashi Kiyohisa , Okuma Teruo
Published: March 2003

In order to clarify the functional asymmetry of the brain function during sleep, period‐amplitude analysis of delta electroencephalogram activity was performed on polysomnograms in 12 right‐handed healthy males. Electroencephalograms were recorded from disc electrodes placed at C3, C4, O1 and O2 (10–20 electrode system), using A1 + A2 for reference. Although there were no significant differences in delta counts between O1 and O2, delta counts of C3 were significantly larger than those of C4. These results suggest that there exists distinct laterality in the number of delta waves in the central region, reflecting the functional asymmetry of the brain during sleep.
Intensity of snoring in patients with sleep‐related breathing disorders
Authors: Itasaka Yoshiaki , Miyazaki Soichiro , Ishikawa Kazuo , Togawa Kiyoshi
Published: March 2003

The intensity of snoring was measured in 73 patients with snoring or sleep apnea using a noise meter. The mean intensity of snoring at 50 cm in front of the mouth was 61.7 dB in the supine position and 53.7 dB in the lateral position. There existed a definite correlation between the logarithmic transformation of the intra‐esophageal pressure amplitude and the intensity of snoring in the supine and lateral decubitus positions. These findings suggest that the intensity of snoring may be a useful index for sleep‐related breathing disorders.
Treatment of periodic leg movement disorder and restless leg syndrome with talipexole
Authors: Inoue Yuichi , Mitani Hideaki , Nanba Kazuyoshi , Kawahara Ryuzo
Published: March 2003

In order to investigate the bedtime dose of talipexole, a D2 and α2 stimulant, on patients with periodic leg movement disorder (PLMD) and restless leg syndrome (RLS), we made a comparison of polysomnographic findings and subjective symptom ratings before and during 4 weeks of the treatment on five cases with RLS and PLMD. A significant decrease in both the frequencies of periodic leg movements and subjective symptom ratings and significant improvement of sleep composition were recognized during the treatment. We speculate that the combination of the agonistic action of D2 and α2 receptor with the drug might not only suppress PLMD and RLS but also improve sleep quality.
Lifestyles and sleep disorders among the Japanese adult population
Authors: Kim Keiko , Uchiyama Makoto , Okawa Masako , Doi Yuriko , Oida Takashi , Minowa Masumi , Ogihara Ryuji
Published: March 2003

To clarify the effects of daily stress, habitual exercise, drinking and smoking on the prevalence of sleep disorders, we selected 4000 residents (≥ 20 years) in Japan by stratified random sampling and carried out structured interviews (response rate 75.8%). Frequencies of sleep disorders (difficulty initiating sleep: DIS; difficulty maintaining sleep: DMS; early morning awakening and hypnotic medication use) were treated as dependent variables. Significant effects of stress were prevalent in all sleep disorders. Habitual exercise had significant negative association with DIS and DMS. Drinking and smoking did not affect sleep disorders.
Schizophrenia: Is it time to replace the term?
Authors: Ono Yutaka , Satsumi Yuki , Kim Yoshiharu , Iwadate Toshiharu , Moriyama Kimio , Nakane Yoshibumi , Nakata Teruo , Okagami Kazuo , Sakai Toshiaki , Sato Mitsumoto , Someya Toshiyuki , Takagi Shunsuke , Ushijima Sadanobu , Yamauchi Keita , Yoshimura Kimio
Published: March 2003

The attitudes of Japanese psychiatrists toward their patients who suffer from schizophrenia were investigated. We were concerned specifically with whether the psychiatrists inform their patients of the suspected diagnosis. We discuss how the term ‘schizophrenia’ may influence a psychiatrist’s decision to inform his patients of the diagnosis. A self‐reported questionnaire was distributed to 150 executive board members of the Japanese Society of Psychiatry and Neurology and analysis of the data obtained from 110 respondents was carried out. The results showed that the concepts that psychiatrists use when they give a diagnosis of schizophrenia vary considerably. Fifty‐nine per cent of the respondents informed their patients of a diagnosis of schizophrenia on a case‐by‐case basis, while 37% informed only the patients’ families. A tree analysis showed that the most important predictors for informing the patients of the diagnosis were assumptions about the public image of schizophrenia and a negative impression of the term schizophrenia, translated as ‘Seishin Bunretsu Byou’ in Japanese. The results revealed that the Japanese term for schizophrenia influences a psychiatrist’s decision to inform patients of the diagnosis and that, by changing the term to a less stigmatized one, the disclosure of information about schizophrenia to patients would be promoted.
White matter hyperintensity detected by magnetic resonance imaging and lithium response in bipolar disorder: A preliminary observation
Authors: Kato Tadafumi , Fujii Kumiko , Kamiya Atsushi , Kato Nobumasa
Published: March 2003

The possible relationship between deep white matter hyperintensity (WMHI) lesions detected by magnetic resonance imaging and response to lithium was examined in 16 patients with bipolar disorder who had been under maintenance treatment with lithium for more than 1 year. Bipolar patients who had higher scores of WMHI responded significantly better to lithium (r = 0.57, P < 0.05) than did those who had lower scores. This preliminary result suggests that the presence of WMHI may be associated with a better response to lithium.
Does smoking cessation improve mental health?
Authors: Mino Yoshio , Shigemi Jun , Otsu Tadahiro , Tsuda Toshihide , Babazono Akir
Published: March 2003

There is a possibility that cessation of smoking improves mental health, but there are no studies that have demonstrated this. A cohort study was performed for 1 year in 18 males who spontaneously stopped smoking (cessation group) and 173 who continued to smoke (smoking group). The mental health state was evaluated using the Japanese version of the 30‐item General Health Questionnaire (GHQ‐30) before the cessation of smoking and 6 months and 1 year after smoking cessation. Changes in the GHQ score were compared between the cessation and smoking groups. In order to control the effects of confounding factors, multiple regression analyses were performed using the GHQ score after 6 months and 1 year as dependent variables. The GHQ score in the cessation group significantly decreased 6 months and 1 year after smoking cessation (P < 0.04 and 0.01, respectively, by paired t‐test). In the smoking group, the GHQ score slightly decreased. Repeated measure analysis of variance revealed that the decrease in the GHQ score in the cessation group was significantly larger than in the smoking group. Multiple regression analysis revealed significant effects of smoking cessation on mental health after controlling for other confounding factors. It can be concluded that smoking cessation may improve mental health.
Obsession of hearing music: From the viewpoint of Morita theory
Authors: Gomibuchi Takashi , Gomibuchi Kumiko , Akiyama Tsuyoshi , Tsuda Hitoshi , Hayakawa Tohsaku
Published: March 2003

We present two typical cases among five Japanese students who have complained of hearing music. They were found among 638 student case reports during 4 years at the mental health service center of a preparatory school. We diagnosed the complaint of hearing music as a symptom of obsession. Morita therapy was an effective treatment for this symptom. We discuss the characteristics of the symptom as an obsession and the therapy in the light of Morita theory.
Automatic detection of rapid eye movements by discrete wavelet transform
Authors: Tsuji Yoichi , Satoh Hideki , Itoh Nobuyuki , Sekiguchi Yuuki , Nagasawa Kazuyuki
Published: March 2003

In order to detect rapid eye movements (REM) automatically, the Discrete Wavelet Transform was applied to each 8‐s segment of electrooculogram (EOG) data for 30 min of 8 h of normal sleep. The Haar function was used as an analysing wavelet because this function is similar to the REM waveform. By shifting the phase of the analysing wavelet by π/4 of the function, 96% of REM could be detected. The artifacts caused by body movements could be detected simultaneously by this method. Computing time required for the detection of REM was only 11 s for 30 min EOG data.
The influence of sleep position and obesity on sleep apnea
Authors: Itasaka Yoshiaki , Miyazaki Soichiro , Ishikawa Kazuo , Togawa Kiyoshi
Published: March 2003

The influence of sleep position and the degree of obesity were examined in 257 subjects with sleep apnea. Subjects were divided into three groups according to obesity: normal weight (body mass index (BMI) under 24.0 kg/m 2), mild obese (BMI 24.0–26.4 kg/m
2) and obese group (BMI 26.4 kg/m
2 and heavier). The apnea + hypopnea index (AHI), the intraesophageal pressure and the lowest oxygen saturation became significantly worse according to the degree of obesity. The subjects were also divided into two groups according to the reduction in the AHI by lateral position: good responders showed 50% or more reduction of AHI in lateral position and poor responders indicated less than 50% reduction. The percentage of good responders to sleep position change was 90.9% in normal weight group, 74.0% in mild obese group and 57.4% in the obese group. The ratio of the subjects who had indicated two or more obstructive sites in normal weight group was 36.0% in good responders and 40.0% in poor responders. The ratio in the mild obese group was 51.8% in good responders and 66.7% in poor responders. In the obese group, the ratio was 59.4% in good responders and 78.9% in poor responders.
Habitual snoring in an outpatient population in Japan
Authors: Kayukawa Yuhei , Shirakawa Syuichiro , Hayakawa Toshiji , Imai Makoto , Iwata Nakao , Ozaki Norio , Ohta Tatsuro
Published: March 2003

Abstract In order to investigate the occurrence and history of sleep problems in Japan, the 11‐Centre Collaborative Study on Sleep Problems (COSP) project was carried out. Complaints of snoring are examined, and its prevalence, risk factors and screening reliability are discussed. The subjects who participated in the study were 6445 new outpatients from a general hospital. They were asked to answer a sleep questionnaire that consisted of 34 items with seven demographic items; each item was composed of four grades of frequency. In order to offset possible seasonal variations in sleep habits, data were collected across four seasons. Sleep patterns, insomnia, hypersomnia, parasomnia and circadian rhythm sleep disorders were covered. Habitual snoring was seen in 16.0% of males and 6.5% of females. Male predominance was noted. From these data, the relationship between habitual snoring and sleep complaints was statistically analyzed. Habitual snorers (HS) were observed to wake up more frequently during sleep (17.8% of males, 21.5% of females) than were non‐habitual snorers (NHS; 6.6% of males, 9.7% of females). Mid‐sleep awakening of HS was also more frequent than it was for NHS; however, there were no differences in difficulty in falling asleep and early morning awakening. Body mass index, cigarette smoking and alcohol consumption were also correlated with habitual snoring.
Neurocutaneous melanosis and psychosis: A case report
Authors: Azzoni Antonella , Argentieri Raffaele , Raja Michele
Published: March 2003

Abstract The paper describes a case of neurocutaneous melanosis (NM), with mental retardation, chronic psychosis, and epilepsy possibly due to a temporal focus. This is the first report of NM associated with a severe and chronic psychosis. It is likely that such an association has not previously been described because of the ominous prognosis of most cases of NM with early involvement of the central nervous system.
Characteristics of patients with hypnotic‐related psychiatric disorders in the nationwide mental hospital survey
Authors: Ozaki Shigeru , Kikuchi Shuichi , Wada Kiyoshi
Published: March 2003

We investigated the characteristics of patients with hypnotic‐related psychiatric disorders. Subjects were 90 patients reported in the nationwide Mental Hospital Survey in 1998, who were divided into three groups according to their history of substances use. Group A (patients without history of any illicit substance use) was estimated to be the most common and core group with iatrogenic characteristics. Hypnotic use in Group B (patients with history of any illicit substance use) was recognized as one of behavioral disorders in the psychosocial context. Patients in Group C (patients with multiple‐substance use and without history of any illicit substance use) showed the most serious disorders in the context of addiction. More specified treatment programs would be required considering patients’ characteristics.
Development of body temperature rhythm: 6 years follow up of three cases
Authors: Ishihara Kaneyoshi
Published: March 2003

The present study was conducted to evaluate longitudinally the relationship between phase of temperature rhythm and sleep habits. Sleep‐logs were recorded from three children for 3 weeks during school term and 1 week before the experiment, and oral temperature was recorded for 2 consecutive days during summer vacations for 6 years. Although previous studies have reported that phase of temperature rhythm was established by 5 years old, phase delay of temperature was found in all subjects even after 5 years old. These results suggest that the establishment of temperature phase is after 5 years old.
Questionnaire relating to sleep paralysis
Authors: Kotorii Tsuyoshi , Kotorii Tatayu , Uchimura Naohisa , Hashizume Yuji , Shirakawa Shinichirou , Satomura Takeshi , Tanaka Junji , Nakazawa Youichi , Maeda Hisao
Published: March 2003

A sleep survey was conducted on 8162 citizens. The cumulative experience rate of sleep paralysis was 39.6%. The initial occurrence of sleep paralysis peaked at age 16 years. In addition to being higher in young people than in older subjects, the incidence of sleep paralysis was also higher among women than among men, and was significantly higher among shift worker than non‐shift worker, and among persons engaged in the nursing profession than those not engaged in the nursing profession. The experience rate of sleep paralysis demonstrated a strong correlation with the frequency of dreaming, the experience rate of nightmares, times and regularity of going to bed and waking up, and particularly with the degree of insomnia.
Parasomnia as an occasion for the diagnosis of Parkinson’s disease
Authors: Miyamoto Masayuki , Miyamoto Tomoyuki , Takekawa Hidehiro , Kubo Jin , Hirata Koichi
Published: March 2003

We report a case of Parkinson’s disease (PD) diagnosed by REM sleep behavior disorder (RBD). The patient was a 68‐year‐old man. On admission, rigidity in the left upper and lower extremities, bradykinesia, and gait disturbance were noted. In addition, polysomnography revealed REM sleep without atonia (RWA), and a diagnosis of untreated PD associated with RBD was made. Polysomnographic data showed that REM density decreased and RWA tended to increase after administration of a combination of L‐DOPA and DCI (L‐DOPA/DCI). Thus, we considered that the pathophysiological mechanism of RBD in this case was based not only on the dysfunction of the brainstem mechanism of RWA, but also on the impairment of dopaminergic neuron.
Re‐entrainment of the circadian rhythms of plasma melatonin in an 11‐h eastward bound flight
Authors: Takahashi Toshiharu , Sasaki Mitsuo , Itoh Hiroshi , Yamadera Wataru , Ozone Motohiro , Obuchi Keita , Matsunaga Naoki , Sano Hidetaka , Hayashida Ken‐Ichi
Published: March 2003

We investigated the re‐entrainment of melatonin rhythm in an 11‐h eastward‐bound flight. Eight male subjects participated in the present study. Blood sampling was carried out once before the flight and twice after the flight. During the daytime the subjects were exposed to natural zeitgeber outdoors on the day except the blood sampling. Seven of eight subjects showed antidromic re‐entrainment, and the other subject showed orthodromic re‐entrainment. The intensity of natural day light in New York amounted to 20 000 lx. As for the direction of the re‐entrainment in New York the antidromic re‐entrainment is naturally dominant.
Effects of vitamin B12 on bright light on cognitive and sleep–wake rhythm in Alzheimer‐type dementia
Authors: Ito Takao , Yamadera Hiroshi , Ito Ritsuko , Suzuki Hideaki , Asayama Kentaro , Endo Shunkichi
Published: March 2003

The present study investigated the effects of vitamin B12 (VB12) on circadian rhythm in Alzheimer‐type dementia (ATD). Twenty‐eight ATD patients were treated with bright light therapy (BLT) for 8 weeks. For the latter 4 weeks, half were treated with VB12 with BLT (BLT + VB12). We evaluated the cognitive state with Mini‐Mental State Examination and the circadian rhythm with actigraphy after the fourth and eighth week. After the first 4 weeks BLT improved the circadian rhythm disturbances and cognitive state especially in the early stage of ATD. Although the latter 4 week‐BLT caused no significant effects on the circadian rhythm; BLT + VB12 improved the vigilance level during the daytime. These results suggest that VB12 has some efficiency to enhance vigilance for ATD patients.
A negative component superimposed on event‐related potentials during light drowsiness
Authors: Sekine Atsushi , Niiyama Yoshitsugu , Kutsuzawa Osamu , Shimizu Tetsuo
Published: March 2003

The present study examined the nature of the negative shift of event‐related potential (ERP) recorded during the fully awake state, wakefulness with minor awareness deficit (light drowsiness) and stage 1 of NREM sleep. The cortical responses evoked by two types of auditory stimuli were recorded in nine subjects at the different levels of consciousness described above. A negative component with peak latency of 250–350 msec, N300, was identified in ERP during light drowsiness but not in the fully awake state. In stage 1a (stage 1 without vertex sharp waves), the amplitude of N300 was higher than that in light drowsiness, and it was higher in stage 1b than in stage 1a. The scalp distribution of N300 was predominantly on the vertex. It also confirmed that the vertex sharp wave evoked during stage 1 is maximal on the vertex and its peak latency is approximately 300 msec. Considering the similarity in scalp distribution and peak latency between N300 and vertex sharp wave, it is possible that these electroencephalogram phenomena are generated by an identical synchronizing mechanism in the brain. We assumed that N300 observed during light drowsiness may be an incomplete product of vertex sharp wave.
Long‐term synaptic alteration in the rat hippocampal CA3 field following an entorhinal cortex lesion
Authors: Miwa Chitoku , Ueki Akinori , Shinjo Hidetaka , Simode Hiroko , Morita Yoshio
Published: March 2003

Abstract The entorhinal cortex is a key initial relay for cortical input to the hippocampus. To better understand hippocampal dysfunction resulting from early entorhinal cortex involvement in Alzheimer’s disease, we stereotaxically injected ibotenic acid to produce unilateral entorhinal cortex lesions in rats. We then serially examined the CA3 hippocampal region by neuronal counts, histochemistry for acetylcholinesterase, and synaptophysin immunohistochemistry. Over 12 months, the neuronal counts did not change. Acetylcholinesterase‐positive fibers were persistently but non‐progressively beginning at 3 months. Synaptophysin immunoreactivity progressively declined over 12 months. Since much of the entorhinal cortex output proceeds to CA3 via the dentate gyrus, transsynaptic degeneration is suspected.
Long‐term outcome in 306 males with alcoholism
Authors: Noda Tetsuro , Imamichi Hiroyuki , Kawata Akira , Hirano Kenji , Ando Tatsuo , Iwata Yasuo , Yoneda Hiroshi
Published: March 2003

Abstract The subjects of this study were 306 male alcoholics who lived in Osaka, Japan, and who were initially diagnosed with alcoholism at a psychiatric institution between 1972 and 1983. Follow‐up studies were done on three occasions: 1 March 1985 (Time 1), 1 November 1988 (Time 2) and 1 March 1992 (Time 3). We followed up 232 (75.8%) of the 306 male alcoholics. By the end of the study period 110 (35.9%) of the subjects were deceased. Regarding cross‐sectional sobriety status, from Time 1 to Time 3 the complete abstinence rate changed from 16.0 to 18.6%, excessive drinking rate was from 13.1 to 9.8%, and controlled drinking rate was from 6.9 to 9.8%. The longitudinal sobriety status of 122 living patients during the 5 years before the close of this study were: rate of stable abstinence, 28.7%; unstable abstinence, 21.3%; controlled drinking, 12.3%; and relapse 37.7%. Such variables as being without public assistance at the time of the initial diagnosis of alcoholism and attending a self‐help group soon after the initial treatment were associated with stable abstinence. Age (20–39 years) and receiving outpatient treatment at the time of the initial treatment also emerged as predictors of survival. However, those variables, except attending a self‐help group soon after the initial treatment, might merely indicate severity of alcoholism. For improving treatment results, it may be most important to provide a treatment environment within the residential area so that alcoholics may receive treatment at an early stage of alcoholism and attend a self‐help group.
Phenomenology of obsessive–compulsive disorder in Taiwan
Authors: Juang Yeong‐Yuh , Liu Chia‐Yih
Published: March 2003

This study was designed to assess the phenomenology, comorbidities, correlation with depressive disorders, and gender differences in obsessive–compulsive disorder (OCD) in Taiwan. Two hundred outpatients who fulfilled the diagnostic criteria of OCD according to DSM‐IV were included. Patient characteristics, age at onset, symptom profile, and Axis I comorbidity were recorded. Gender differences, age at onset, and comorbidity of depressive disorders among different subtypes of OCD were compared. The most common obsession was contamination, followed by pathological doubt, and need for symmetry. The most common compulsion was checking, followed by washing, and orderliness compulsions. More men than women presented with the obsession of need for symmetry. Eighty‐three (41.5%) subjects had comorbid depressive disorders. Women had more major depressive disorder. Patients with somatic obsessions were more likely to have major depressive disorder. Most clinical characteristics of OCD in Taiwan were similar to that of previous studies in other countries.
Validation study of the Japanese version of the Obsessive–Compulsive Drinking Scale
Authors: Tatsuzawa Yasutaka , Yoshimasu Haruo , Moriyama Yasushi , Furusawa Teruyuki , Yoshino Aihide
Published: March 2003

Abstract The Obsessive–Compulsive Drinking Scale (OCDS) is a self‐rating questionnaire that measures cognitive and behavioral aspects of craving for alcohol. The OCDS consists of two subscales: the obsessive thoughts of drinking subscale (OS) and the compulsive drinking subscale (CS). This study aims to validate the Japanese version of the OCDS. First, internal consistency and discriminant validity were evaluated. Second, a prospective longitudinal 3‐month outcome study of 67 patients with alcohol dependence who participated in a relapse prevention program was designed to assess the concurrent and predictive validity of the OCDS. The OCDS demonstrated high internal consistency. The OS had high discriminant validity, while the CS did not. Twenty‐three patients (34.3%) dropped out of treatment. These patients had significantly higher OS scores than those who completed the program. At 3 months, the relapse group had significantly higher OCDS scores than the no relapse group. Also, the OCDS score was higher in subjects who had early‐onset alcohol dependence than late‐onset dependence. The OCDS is useful for evaluating cognitive aspect of craving and predicts dropout and relapse.
Beneficial effects of tandospirone on ataxia of a patient with Machado‐Joseph disease
Authors: Takei Asako , Honma Sanae , Kawashima Atushi , Yabe Ichiro , Fukazawa Toshiyuki , Hamada Keiko , Hamada Takeshi , Tashiro Kunio
Published: March 2003

Abstract Tandospirone citrate (tandospirone) is an anti‐anxiety drug that acts by combining with serotonin receptor (5‐hydroxytryptamine‐1 A [5‐HT1A]). Recently, there have been a few reports of its potential role in the treatment of cerebellar ataxia. We report the first case of a patient with Machado‐Joseph disease in which we successfully treated cerebellar ataxia. In addition, his leg pain, insomnia, anorexia, and depression, which are thought to be related to 5‐HT1A receptors, were also remarkably alleviated by treatment with tandospirone.
Comparison of sleep/wake habits of university students with or without a habit of self‐awakening
Authors: MATSUURA NORIKO , HAYASHI MITSUO , HORI TADAO
Published: March 2003

Abstract Several studies have reported that some people have the ability to awaken from sleep without using external means. This ability is called ‘self‐awakening’.

The present study investigated the sleep/wake habits of university students with

or without a habit of self‐awakening. Of the 643 university students, 66 students

(10.3%) habitually self‐awakened in daily life. In comparison with those

who did not self‐awaken (n = 577, 89.7%), self‐awakening students went to bed and woke up approximately 30 min earlier, felt better when they woke up in the morning, and dozed off less in the daytime. Moreover, self‐awakening students showed a higher morningness score.
Longitudinal study for sleep–wake behaviours of mothers from pre‐partum to post‐partum using actigraph and sleep logs
Authors: KANG MIN JEONG , MATSUMOTO KAZUYA , SHINKODA HARUMI , MISHIMA MIDORI , SEO YOO JIN
Published: March 2003

Abstract To understand the sleep–wake behaviours from the fifth pre‐partum week to the 15th post‐partum week by the number of actigraphic activities and sleep logs were evaluated in 10 women. It was found that total sleep time shortened, sleep efficiency decreased, and wake after sleep onset (WASO) increased in the weeks immediately after delivery. Compared with late pregnancy, total sleep time and sleep efficiency deteriorated significantly from the delivery week to the 12th post‐partum week and there was a longer period of WASO until the 11th postpartum week. The after‐delivery sleep parameters estimated by the actigraph were worse than those estimated from sleep logs.
Effectiveness of a tongue‐retaining device
Authors: HIGURASHI NAOKI , KIKUCHI MAKOTO , MIYAZAKI SOICHIRO , ITASAKA YOSHIAKI
Published: March 2003

Abstract The effectiveness of a tongue‐retaining device (TRD) was examined at the baseline
without any TRD [TRD(–)] and then with a TRD [TRD(+)] in eight patients with
obstructive sleep apnea (OSA). In terms of the 3+ % oxygen desaturation index
(ODI3), lowest percutaneous oxygen saturation (SpO2), and time spent SpO2
< 90%, there were significant differences (P < 0.01–0.05) between the findings for TRD(–) and TRD(+). The ODI3 dropped below the baseline by more than 50% in five patients (63%) and dropped to fewer than 10 events/ h in six patients (75%). The results indicate that oral appliances help patients with mild to moderate OSA; however, patients with more severe OSA may also be treated effectively with a TRD.