bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation dimension of the human sleep electroencephalogram
Authors: Kobayashi Toshio , Misaki Kiwamu , Nakagawa Hiroki , Madokoro Shigeki , Ota Tadaaki , Ihara Hisataka , Tsuda Kyoko , Umezawa Yumiko , Murayama Jyunichi , Isaki Kiminori 
Published: March 2003

AbstractSleep electroencephalogram (EEG) was analyzed by nonlinear analysis. Polysomnography of a healthy male subject was analyzed and the correlation dimension was calculated. The mean correlation dimensions decreased from stage ‘awake’ to stages 1, 2 and 3, and increased during rapid eye movement (REM) sleep. These results were also seen at every sleep cycle. During each sleep cycle the correlation dimensions decreased for slow wave sleep, then increased for REM sleep. The mean correlation dimension of the sleep EEG in the second half of the night was significantly higher than those in the first half of the night. A significant change was seen both during REM sleep as well as in sleep stage 2. Nonlinear analysis may be a useful method in the analysis of the entire sleep electroencephalogram.
The central mechanism of hypothalamic–pituitary– adrenocortical system hyperfunction in depressed patients
Authors: Jiang Hann‐Kuang , Wang Jia‐Yi , Lin Jiann‐Chyun 
Published: March 2003

AbstractWhile hypercortisolemia is commonly observed in depression, exactly where in the hypothalamic–pituitary–adrenocortical (H–P–A) axis this dysfunction arises remains undefined. In attempting to distinguish between central or peripheral locus of dysfunction, we studied in 12 patients (10 females, two males) with primary major depression and eight age‐matched controls (six females, two males) in their adrenal cortisol response to infused adrenocorticotropic hormone (ACTH) (cosyntropin 0.05 μg/kg bodyweight) while endogenous ACTH was suppressed with 1 mg of dexamethasone. Compared with the control group, pre‐dexamethasone plasma baseline cortisol level was significantly higher in depressed patients while ACTH level remained normal. Post‐dexamethasone responses of both hormones were greatly non‐suppressed in the depressed group. Exogenous cosyntropin‐elicited rise in plasma cortisol was significantly lower in depressed patients while the ACTH response was not significantly different. These findings suggest that an adrenal cortisol response to ACTH was significantly decreased during depression as compared with normals in Chinese depressed patients. Therefore, the central mechanism of hyperfunctioning H–P–A axis causing hypercortisolemia should be emphasized.
Reliability of clinical judgment of patients’ competency to give informed consent: A case vignette study
Authors: Kitamura Toshinori , Kitamura Fusako 
Published: March 2003

AbstractThe competency of psychiatric patients to give informed consent is important in respecting patients’ decisions as well as protecting patients from undue exploitation. A total of 176 members of the Japanese Society of Psychiatry and Neurology gave a clinical judgment in a questionnaire of competency in five case transcriptions. Their interrater reliability of competency judgment was slight (generalized kappa 0.31). Clinicians’ global judgment of patients’ competency was not reliable, but it may be improved by the use of a structured interview.
Prevalences of periodic limb movement‐like and restless legs‐like symptoms among Japanese adults
Authors: Kageyama Takayuki , Kabuto Michinori , Nitta Hiroshi , Kurokawa Yoshika , Taira Kazuhiko , Suzuki Shosuke , Takemoto Tai‐Ichiro 
Published: March 2003

AbstractPrevalences of periodic limb movement‐like and restless legs‐like symptoms among Japanese adults were investigated. The latter symptom was significantly associated with insomnia.
Sleep stage transition and changes in autonomic function in newborn infants
Authors: Goto Kazuya , Sato Keisuke , Izumi Tatsuro 
Published: March 2003

AbstractThe relationships between sleep stage, startle response, electroencephalogram (EEG) pattern, and autonomic function in sleeping full‐term infants was examined. Using autoregressive analysis of heart rate variability (HRV), 12 infants at a mean post‐conception age of 41.1 weeks were studied. Based on HRV characteristics, the present study shows sympathetic nervous system activation during active sleep (AS) and distinct changes in autonomic function based on the startle response and EEG features during quiet sleep (QS). The findings might reflect structural and functional maturation of the central nervous system of newborn infants.
Effects of bright light on cognitive and sleep–wake (circadian) rhythm disturbances in Alzheimer‐type dementia
Authors: Yamadera Hiroshi , Ito Takao , Suzuki Hideaki , Asayama Kentaro , Ito Ritsuko , Endo Shunkichi 
Published: March 2003

AbstractTwenty‐seven patients with Alzheimer‐type dementia (ATD) were treated with bright light therapy in the morning for four consecutive weeks. The cognitive state of each patient was evaluated with the Mini‐Mental‐State Examination (MMSE) and circadian rhythm with actigram before and after therapy for all of the patients and those of two groups divided by the severity criteria of the Clinical Dementia Rating. The therapy improved the circadian rhythm disturbances. Although the therapy caused no remarkable effects on dementia severity, it improved the MMSE scores, especially in the early stages of ATD. These results suggest that bright light therapy improved the circadian rhythm disturbances and then bettered the cognitive state in early‐stage ATD.
Predisposing factors in delayed sleep phase syndrome
Authors: Takahashi Yasuro , Hohjoh Hirohiko , Matsuura Keiko 
Published: March 2003

AbstractWe classified 64 patients with chronic delayed sleep phase syndrome (DSPS) into the primary (n = 53) and secondary (n = 11) group according to presence or absence of such signs as difficulty in waking up which appeared much earlier than the onset of DSPS. The age at the onset of the early signs concentrated in adolescence. The familial occurrence of DSPS was noted in 11 patients of the primary group. In human leukocyte antigen (HLA) typing, the incidence of DR1 positivity alone was significantly higher in DSPS patients than in healthy subjects. Minnesota Multiphasic Personality Inventory revealed high scores on depression, psychoasthenia and hypochondriasis. We suggest that a predisposition to DSPS includes biological, genetic, social and psychological factors, various combinations of which may lead to DSPS.
P300 abnormalities in patients with severe sleep apnea syndrome
Authors: Inoue Yuichi , Nanba Kazuyoshi , Kojima Kazushige , Mitani Hideaki , Arai And Heii 
Published: March 2003

AbstractWe investigated the mechanism of abnormal P300 findings in the patients with severe sleep apnea syndrome (SAS). Compared with controls, SAS patients showed significantly longer latency of P300. Not the mean sleep latency in multiple sleep latency test but the percentage of total periods in which percentage desaturation time fell below 90% to total sleep time correlated with P300 latency in the patients. During nasal CPAP treatment, P300 latency was significantly shortened in the patients under 45 years, while the elderly patients did not show statistical change. We speculated that P300 latencies might be prolonged due to nocturnal hypoxia with SAS and the abnormality might be irreversible, especially in elderly patients.
Qualitative analyses of clock drawings in Alzheimer's disease and vascular dementia
Authors: Kitabayashi Yurinosuke , Ueda Hideki , Narumoto Jin , Nakamura Kaeko , Kita Hitoshi , Fukui Kenji 
Published: March 2003

AbstractAlthough quantitative analyses of clock drawings (CD) have achieved widespread clinical use as a cognitive screening, little is known about the qualitative profiles of CD in Alzheimer's disease (AD) and vascular dementia (VD). To address this issue, the present study examined the significance of qualitative analyses of CD in AD and VD. Sixty‐seven AD patients, 44 VD patients and eight controls underwent a clock drawing test and took the Mini‐Mental State Examinations (MMSE). In the dementia groups, quantitative scores significantly decreased compared with controls and were significantly correlated with MMSE scores. Qualitative analysis demonstrated that in AD patients qualitative error patterns were stable and independent of severity. In contrast, in VD patients the frequency of graphic difficulties and conceptual deficit increased, while the frequency of spatial and/or planning deficit decreased, as severity worsened. In mild dementia groups the frequency of spatial and/or planning deficit was significantly higher in VD. In moderate dementia groups, the frequency of graphic difficulties was significantly higher in VD and the difference in the frequency of spatial and/or planning deficit seen in mild dementia disappeared. The present study suggests that qualitative analyses of clock drawings could demonstrate the neuropsychological profiles of AD and VD and their differences between these dementias.
Heterogeneity of expression of cytokeratin subtypes in squamous cell carcinoma of the lung: With special reference to CK14 overexpression in cancer of high‐proliferative and lymphogenous metastatic potential
Authors: Tsubokawa Futoshi , Nishisaka Takashi , Takeshima Yukio , Inai Kouki 
Published: March 2003

In surgically resected specimens of squamous cell carcinoma (SCC) of the lung from 45 patients, we immunohistochemically examined the expression of 13 subtypes of cytokeratin (CK), the intermediate filament in cytoplasm of epithelial cells. To investigate heterogeneity of CK, its expression was compared among tumor cell nests with or without keratinization and stratification. Furthermore, the relationship between CK expression and Ki‐67 labeling index or p53 expression was investigated.The tumor cell nests with keratinization showed the expression of CK1 and CK10 as a central pattern and the expression of CK14 as a peripheral pattern. The nests with stratification showed CK14 expression as a peripheral pattern, whereas those without stratification showed the expression as a diffuse pattern. The tumor cell nests showing stromal invasion with fibrosis in the marginal zone were diffusely positive for CK14. Ki‐67 antigen labeling index was significantly higher in the nests where CK14 expression was diffuse or peripheral than in the nests where the expression was focal or negative. In lymph node metastases, the tumor cells often showed CK14 expression, like trabecular nests in the primary carcinoma. These results suggest that CK14 is a parameter of proliferative activity and metastatic potential of SCC of the lung.
Light and electron microscopic observation of Nautococcus mammilatus, a neustonic coccoid green alga from China
Authors: Zhengyu Hu , Guoxiang Liu , Xiaoming Zhang , Liu Yongding 
Published: March 2003

SUMMARYA rare neustonic green coccoid alga, Nautococcus mammilatus Korschikov from Hubei Province in P.R. China was observed in culture using light and electron microscopy. Ultrastructural observations were mainly made on the cap formation and starch accumulation around the pyrenoid matrix. Accommodation of Nautococcus in the Chlorococcales is discussed.
Corticosteroid rescue in late paediatric acute respiratory distress syndrome
Authors: Goh Adrian Yt , Sekaran D , Roziah M 
Published: March 2003

AbstractLate acute respiratory distress syndrome (ARDS) is associated with a mortality of more than 80%. Recent reports in adults have shown improved survival in late ARDS treated with prolonged course of steroids, however little data are available in children concerning its safety and efficacy. We report the successful treatment of a child dying from refractory late ARDS using a prolonged course of high‐dose methylprednisolone instituted after 12 days of advanced mechanical ventilation. Progressive improvement was seen from days 3, 7, 10 and 14 after treatment with improvement in Pa
O2/fraction of inspired oxygen (FiO2) ratios, lung injury score and chest radiographical score. Treatment was complicated by a fungal urinary tract infection that was easily controlled. There were no major metabolic side effects. Steroid therapy can be considered in the treatment of children with refractory late ARDS but larger prospective studies are needed to define indications, timing, dosing and safety of this mode of treatment in children.
Impact to lung health of haze from forest fires: The Singapore experience
Authors: Emmanuel Shanta Christina 
Published: March 2003

Objective:From late July to the beginning of October 1997, countries of Southeast Asia experienced severe smoke haze pollution from uncontrolled forest fires mainly in the Indonesian states of Kalimantan and Sumatra. In Singapore, the impact of the 1997 haze was felt in the period from the end of August to the first week of November 1997 as a result of prevailing winds. Methodology: The Ministry of the Environment monitors ambient air quality by a country‐wide telemetric air quality monitoring and management network, with 15 stations located throughout the island, linked via a public telephone network to a central control station at the Environment Building. The monitoring methods used are the United States Environmental Protection Agency (USEPA) reference methods. The Pollutant Standards Index (PSI) developed by the USEPA is used for the reporting of daily air pollution concentrations. Intervals on the PSI scale are related to the potential health effects of the daily measured concentrations of the five major air pollutants: sulfur dioxide, particulate matter (PM10), nitrogen dioxide, ozone and carbon monoxide. Public sector health facilities which come under the Ministry of Health, have computerized patient care systems which enable the routine ongoing surveillance of disease conditions for the period of the haze. Attention during the period of the haze was focused on conditions related to health effects of the haze. Data sources for the monitoring of the lung health effects of the haze included morbidity from public sector outpatient care facilities, accidents and emergency departments, public sector inpatient care facilities and national mortality data. Results: Findings from the health impact of the haze showed that there was a 30% increase in outpatient attendance for haze‐related conditions. An increase in PM10 levels from 50 μg/m3 to 150 μg/m3 was significantly associated with increases of 12% of upper respiratory tract illness, 19% asthma and 26% rhinitis. Supplementary findings from scanning the electron microscopic sizing of the haze particles showed that 94% of the particles in the haze were below 2.5 μm in diameter. This was consistent with emissions from combustion sources originating over 500 km from Singapore. This has been of some concern because particles smaller than 2.5 μm in diameter can easily bypass normal body defence metabolism and penetrate deeply into the alveoli of the lungs. During the same period, there was also an increase in accident and emergency attendance for haze‐related conditions. There was no significant increase in hospital admissions or in mortality. Conclusion: The present study found that the health effects from the 1997 smoke haze in Singapore were generally mild.
Characteristic modifications of the peripheral airways in patients with bronchial asthma in areas with air pollution
Authors: Tanaka Mitsuru 
Published: March 2003

Objective:Changes in the peripheral airways in patients with bronchial asthma who were living in the Kawasaki industrial zone, region with severe air pollution, were morphologically investigated in order to determine the pathological conditions of such bronchial asthma, in particular ascertaining the effect of air pollution. Methodology: Studies were made of the morphological characteristics of the peripheral airways in patients with bronchial asthma who had resided for long periods in an area near Tokyo affected by air pollution. Results: The endoscopic findings of the peripheral airways were distinct, consisting of reddening, stenosis, pigmentation, pallor, lustrelessness and hypersecretion. The histological findings also differed from those in usual forms of asthma. Conclusions: The bronchial asthma in the present patients appeared to be a totally different form from a morphological viewpoint, although it was quite similar to known types in its clinicophysiological features.
Diagnostic yield of bronchoscopic sampling methods in bronchial carcinoma
Authors: Lam Bing , Wong Maria P. , Ooi Clara , Lam Wah K. , Chan Kwok N. , Ho James C. , Tsang Kenneth W. 
Published: March 2003

Objectives:The aim was to study the yield of malignant or suspicious cells from bronchoalveolar lavage (BAL), endobronchial biopsy (BX) and endobronchial brushing (BR) specimens obtained at bronchoscopy.Methodology:We prospectively followed up all patients who had undergone bronchoscopy and studied those with subsequent diagnosis of bronchial carcinoma at a tertiary referral centre. Bronchoalveolar lavage, BX and BR were performed, sequentially whenever possible, by one pulmonologist. The parameters assessed were age, gender, macroscopic bronchoscopic findings, TNM staging, radiological findings, histological typing, and diagnostic yield from BAL, BX, and BR.Results:One hundred patients (31 females, 69 males; mean age ± SD, 61.8 ± 12.7 years; range 32–81 years) were studied between 1995 and 1997. Of these, BAL, BX and BR were performed on 100, 64 and 37 cases which yielded diagnostic specimens for bronchial carcinoma in 69, 78.1, and 62.2% of cases, respectively (P > 0.05). Diagnostic specimens were therefore obtained in 69, 50, and 23% of the entire patient cohort from BAL, BX, and BR, respectively (P < 0.001). The diagnostic yield of BAL was independent of patient age, gender, site of lesion, TNM staging, histological typing and macroscopic bronchoscopic findings. Addition of BX, BR and postbronchoscopic sputum sampling to BAL only increased the yield of diagnostic specimens for bronchial carcinoma by 7, 0, and 4%, respectively.Conclusion:Bronchoalveolar lavage is a highly effective sampling method to obtain cytological evidence for bronchial carcinoma. The diagnostic yield for BAL is independent of tumour or other clinical characteristics. Further studies should be performed to confirm these important and clinically relevant findings.
Subcutaneous emphysema associated with chest tube drainage
Authors: Jones Peter M. , Hewer Robert D. , Wolfenden Hugh D. , Thomas Paul S. 
Published: March 2003

Background: Subcutaneous emphysema may complicate a pneumothorax, but may also occur as a consequence of its treatment by chest tube drainage. The aim of this study was to evaluate the factors involved in the association between subcutaneous emphysema and chest tube drainage, and the clinical outcomes in these cases.Methodology: One hundred and sixty‐seven patients undergoing chest tube drainage within a 12‐month period were evaluated retrospectively. There were 30 reported cases of subcutaneous emphysema (SE). Comparisons were made between those with subcutaneous emphysema and those who did not develop this complication.Results: A total of 134 patient notes were evaluated (25 SE and 109 non‐SE). Subcutaneous emphysema was more commonly associated with trauma, bronchopleural fistulae, large and bilateral pneumothoraces, and mechanical ventilation. Subcutaneous emphysema was also associated with prolonged drainage, poor tube placement, tube blockage, side‐port migration, and a greater number of chest tubes. Importantly, those with SE had a longer length of stay and increased mortality.Conclusion:Subcutaneous emphysema can be spontaneous or traumatic, but is associated with avoidable causes such as inadequate chest tube drainage, particularly due to poor tube placement, anchorage and blockage, and also with side‐port migration into the subcutaneous tissue. It is associated with an increased morbidity and mortality, and may indicate the need for urgent chest tube replacement.
Extrathoracic staging of non‐small cell bronchogenic carcinoma: Relationship of the clinical evaluation to organ scans
Authors: BILGIN SEVINÇ , YILMAZ ADNAN , ÖZDEMIR FILIZ , AKKAYA ESEN , KARAKURT ZUHAL , POLUMAN ARMAN 
Published: March 2003

Objective: The aim of this study was to investigate the value of systemic evaluation of extrathoracic extension of non‐small cell lung cancer and to assess the value of the clinical evaluation in detecting extrathoracic metastases.Methodology: The study included 90 patients [87 men, three women; mean age 57.5 years (range 28–76)] with potentially resectable non‐small cell carcinoma. Fifty‐two were squamous cell carcinomas and 38 were adenocarcinomas. Organ‐specific and non‐organ‐specific clinical findings suggesting metastases were analysed and computed tomographic scans of the brain and abdomen and whole‐body bone scanning were performed in all patients.Results: Extrathoracic metastases were detected in 23 (25.5%) of 90 patients. The
metastases were located in the following areas: brain (n = 12, 13.3%);
bone (n = 9, 10%); liver (n = 5, 5.6%); and adrenal
gland (n = 5, 5.5%). Histological analysis revealed metastases in
21.1% (11/52) of the squamous cell carcinomas and 31.6% (12/38) of
the adenocarcinomas (P > 0.05). Eleven (47.8%) of the 23 patients with extrathoracic metastases had no organ‐specific clinical findings suggesting metastases. Eight patients with squamous cell carcinomas were intrathoracic T1N0 stage and in two (25%) of these patients extrathoracic metastases were detected. These patients had no organ‐specific or non‐organ‐specific clinical factors suggesting metastases.Conclusions: Evaluation of extrathoracic extension should be routinely performed in all patients with newly diagnosed lung cancer. This approach will prevent many unnecessary thoracotomies.
The relationship between FEV1 and PEF in the assessment of the severity of airways obstruction
Authors: LLEWELLIN PETER , SAWYER GILLIAN , LEWIS SIMON , CHENG SOO , WEATHERALL MARK , FITZHARRIS PENNY , BEASLEY RICHARD 
Published: March 2003

Objective: International consensus guidelines suggest that in asthma and chronic obstructive pulmonary disease (COPD), measurements of FEV1 and PEF are equivalent in the assessment of the degree of airflow obstruction when expressed as the per cent of predicted values.Methodology: In this retrospective study, 2587 paired measurements of PEF and FEV1 performed by 101 adult patients with asthma (n = 56) and COPD (n = 45) attending an outpatient chest clinic were obtained. The mean differences between FEV1 and PEF measurements when expressed as the percentage of predicted values was determined. The level of agreement between the two measurements in the classification of asthma severity (life‐threatening, severe, moderate and mild asthma determined by PEF or FEV1 measurements of <30%, 30–60%, 60–80%, and >80% of the predicted values, respectively) was determined.Results: There was considerable variability between measurements of FEV1 and PEF when expressed as % predicted values. In both asthma and COPD, the FEV1% predicted was smaller than the PEF % predicted, with the mean difference being –10.9% (95% CI, –12.8% to –8.9%) with limits of agreement of –35.4% to +13.6%. The weighted Kappa statistic for agreement was 0.59 (95% CI, 48–70%) in the classification of the severity of airflow obstruction.Conclusion: When expressed as percentage of predicted values, PEF and FEV1 values are not equivalent. We recommend that guidelines be modified to state that across the spectrum of the severity of airflow obstruction there is considerable variability between measurements of FEV1 and PEF when expressed as % predicted such that the FEV1 may be as much as 35% lower or up to 15% higher than the PEF for patients with obstructive lung diseases.