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When conducting experimental psychology, psychological phenomena are often described in mathematical terms and logic. How practical is the mathematical approach in experimental psychology? This paper aims to explain plain linguistic and mathematical expressions, how psychological phenomena are expressed mathematically in experimental psychology and how mathematical models are constructed, using examples of psychological phenomena related to sensation, perception, and cognition. First, it outlined the perspective, thinking, and utilization of mathematical models in experimental psychology, using some psychological phenomena. Second, it was introduced that several previous studies dealt with spatial properties of perceptual and cognitive phenomena, including the author's studies. It is hoped that this paper will increase familiarity with and opportunities to utilize mathematical models in experimental psychology. [ABSTRACT FROM AUTHOR]

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How should we define synesthesia? After more than a century of research, scientists have still not reached an agreement on what synesthesia is (and is not). The author s opinion of this condition is that the disagreement on the definition of synesthesia is essentially a disagreement on determining what sensations are normal and what are unnormaL All different versions of the definition of synesthesia state, either explicitly or implicitly, that synesthesia is an extraordinary sensation, which is caused by the activation of a second sensory or cognitive pathway that is not normally activated by the inducing stimulus. In other words, the boundary between synesthesia and non-synesthesia depends on what sensations are considered normal, and this can only be judged subjectively. In so far as we consider synesthesia as an unnormal/extraordinary phenomenon, it is illogical to hope that there could be some objective criteria to distinguish synesthesia from non-synesthesia. The remedy is to assume continuity between synesthetic and non-synesthetic experiences. [ABSTRACT FROM AUTHOR]

Epilepsy is a neurological disorder with abnormal brain activity. It causes convulsions or periods of unusual behavior, sensations, and sometimes loss of awareness. Drug-resistant epilepsy (DRE) affects an estimated 15%-20% of patients with epilepsy. Vagus nerve stimulation (VNS) is a type of neuromodulation. VNS therapy is an adjunctive neurostimulation treatment for DRE patients who are unsuitable for respective surgery or have experienced unsuccessful surgery. VNS involves the use of a device to stimulate the vagus nerve with electrical impulses. VNS is not a cure for epilepsy, and most epilepsy patients can still experience seizures or use epilepsy medication after the procedure. However, 60%-70% of patients can have over 50% reduction in seizures 5 years after the VNS procedure. Seizure intensity may also reduce. VNS is safe with tolerable side effects in most cases. The mechanism of VNS action against epilepsy is still not accurately verified. Some people believe that VNS therapy improves their mood, memory, or alertness and may also help reduce depression. VNS therapy is also expected to work in other indications, including psychiatric, gastrointestinal, endocrinological, and immunological disorders.

This article examines the status of "sensation" in the late nineteenth-century Japanese instructional theory. Through a historical comparison of the two types of instructional theories in pedagogy, this article explains how the changes in the status of "sensation," derived from experimental psychology, reorganized the relationship between the two basic concepts of mind and body and led to the logic of control through "sensation". In the 1880s, "object lessons" theorized "perception" as a medium between the mind and the knowledge acquired from external aspects. This instructional theory proposed that with regard to perception, the eyes are particularly important for the acquisition of precise knowledge. Therefore, it is essential to discipline the eyes, which mediate the mind and knowledge, and to acquire the ability of attention in order to gain precise knowledge. On the other hand, in the 1890s, it was argued in "psychological instructions" that "sensation" is aroused by the stimulation of the sensory organs. Further, this uncertain "sensation" caused by accidental stimulation forms one's ideas. Moreover, this theory postulates that the mind is a fluid wherein multifarious ideas created by sensations continually conflict. Accordingly, the incorporation of psychological knowledge in pedagogy in the late nineteenth century resulted in the understanding that ➀ the subject becomes a passive existence affected by accidental "sensation" and ➁ the subject is defined as an existence that constructs his/her own ideas by active "attention." Further, on the other hand, ➂ the psychological instructions determine in advance the set of ideas that the students should aim to gain. and the attention of the subject is thus invalidated. Consequently. ➃ this theory can become the logic of control through "sensation." Thus, with the change in the status of "sensation," the aim of using projection devices in the 1890s was to shift focus from the training of perception to the controlling and measuring of sensation. [ABSTRACT FROM AUTHOR]

Bladder afferent nerves are composed by myelinated Aδ- and unmyelinated C-fibers. During the storage phase of urine, distention of the bladder has long been considered to evoke afferent activity via Aδ-fibers connected in series with the smooth muscle fibers. In contrast, a previous study in cats revealed that more than 90% of C-fibers do not respond to normal bladder distension, being so called 〝silent〟 fibers. However, at least in rats, C-fibers can respond to normal bladder distension like Aδ-fibers, although they may also fulfill a potentially different role in the bladder sensory function in response to abnormal stimuli. The symptoms of overactive bladder (OAB) or interstitial cystitis (IC) are believed to be commonly related to the sensory (afferent) function. In addition, it has been suggested that bladder myogenic microcontractions or micromotions may partly contribute to the development of urgency in OAB related to bladder outlet obstruction (BOO), which is one of cause of benign prostatic hyperplasia (BPH). We have investigated the direct effects of drugs (anticholinergics, β3-adrenoceptor agonists, α1-adrenoceptor antagonists, PDE type5 inhibitors, etc.) on the bladder afferent function in rodents. In our results, almost all drugs may act on the bladder afferent function, and some of drug (e.g. mirabegron) inhibits the afferent activities through the suppression of the bladder myogenic microcontractions in normal or pathophysiological conditions.

The 20, 21, and 22 areas in the temporal lobe as classified by Brodmann are almost identical with Economo and Koskinas's TA, TE1, and TE2, and, generally, with the gyrus, middle temporal gyrus, and inferior temporal gyrus according to brain anatomy. Before Brodmann's classification, Flechsig published his book "Soul and Brain" in 1897, in which primary, secondary, and association areas in the brain were classified. More recently, results from research using magnetic resonance imaging (MRI) and fMRI support the parcellation of the cerebral cortex proposed by Flechsig, Brodmann, and Economo more than one century ago.

Background: We compared three combined spinal-epidural anesthesia (CSEA) techniques for cesarean delivery. Hypotension, nausea and vomiting are main problems produced by coonventional intrathecal doses. These problems were our secondary observations. Our primary observations were motor recovery and intraoperative pain., Methods: Sixty patients were randomly allocated to one of the 3 groups (n = 20 per group). Group B (conventional dose): received intrathecally 0.5% hyperbaric bupivacaine (10 mg; < 160 cm in height 11 mg ; ≥ 160 cm in height) and epidural catheter at T12-L1. Group F (low-dose and addition of fentanyl) : received intrathecally 0.5% hyperbaric bupivacaine (70% of group B) with fentanyl 20 mg and epidural catheter at T12-L1. Group E (low-dose and epidural volume extension : EVE) : received intrathecally 0.5% hyperbaric bupivacaine (70% of group B) and epidural catheter at L3-4, through which 10 ml saline was injected 3 minutes after intrathecal injection., Results: Group F and E demonstrated faster motor recovery than group B. More patients in group E than those in group B and F complained of intraoperative pain. There was no incidence of hypotension, nausea and vomiting., Conclusions: Group F and group E demonstrated similar fast motor recovery, but the former caused less intraoperative pain than the latter. Because this is an observational study, comparison of techniques such as addition of fentanyl, EVE, needs a compatative study.

The first paper on mirror neurons was published in 1992. In the span of over two decades since then, much knowledge about the relationship between social cognitive function and the motor control system has been accumulated. Direct matching of visual actions and their corresponding motor representations is the most important functional property of mirror neuron. Many studies have emphasized intrinsic simulation as a core concept for mirror neurons. Mirror neurons are thought to play a role in social cognitive function. However, the function of mirror neurons in the macaque remains unclear, because such cognitive functions are limited or lacking in macaque monkeys. It is therefore important to discuss these neurons in the context of motor function. Rizzolatti and colleagues have stressed that the most important function of mirror neurons in macaques is recognition of actions performed by other individuals. I suggest that mirror neurons in the Macaque inferior pariental lobule might be correlated with body schema. In the parieto-premotor network, matching of corollary discharge and actual sensory feedback is an essential neuronal operation. Recently, neurons showing mirror properties were found in some cortical areas outside the mirror neuron system. The current work would revisit the outcomes of mirror neuron studies to discuss the function of mirror neurons in the monkey.

This paper reviews theories and research pertaining to emotional functions of the insula--a cortical area that is located deep in the lateral sulcus and has been included in the limbic lobe because of its intimate connections with the cingulate, amygdala, and orbitofrontal cortex. The insula is known to contain the primary gustatory cortex across mammalian species, and thus, earlier studies have focused on its special role in disgust, which is an emotion closely associated with the sensation of bad taste. In recent years, more emphasis has been placed on the insular contribution to conscious experience of emotion in general. Emotional experience has been known to depend on both the perception of bodily reactions to emotion-provoking objects and the cognitive appraisal of contexts. The insula is theoretically suited for representing such emotional experience because it receives interoceptive inputs from the whole body, and its connections with the prefrontal regions can provide contextual information. In fact, many studies have shown that the activation of the insula, particularly its anterior part, covaries with subjective feelings, which reflect not only physical stimulus intensity but also cognitive factors such as prediction. Such insular activation seems to work as a so-called "as if" somatic marker that inclines us to approach or avoid the stimulus; in addictive disorders, insular activation is proposed to be the neural basis for intense urges. In addition, the insula also represents "simulated" emotional experience, including empathy with others, which may play an important role in social learning. Thus, further investigations into the emotional functions of the insula would help elucidate the still unknown role of conscious experience in regulating cognitive processes and behavior.

The purpose of this study was to investigate the relationship between subtypes of social anxiety and distorted cognition of bodily sensations. The package of questionnaires including the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) was administered to 582 undergraduate students. To identify subtypes of social anxiety, cluster analysis was conducted using scores of the SPS and SIAS. Five clusters were identified and labeled as follows: Generalized type characterized by intense anxiety in most social situations, Non-anxious type characterized by low anxiety levels in social situations, Averaged type whose anxiety levels are averaged, Interaction anxiety type who feels anxiety mainly in social interaction situations, and Performance anxiety type who feels anxiety mainly in performance situations. Results of an ANOVA indicated that individuals with interaction type fear the negative evaluation from others regarding their bodily sensations whereas individuals with performance type overestimate the visibility of their bodily sensations to others. Differences in salient aspects of cognitive distortion among social anxiety subtypes may show necessity to select intervention techniques in consideration of subtypes.

A 76-year-old man suddenly experienced floating sensation, transient vertigo, and nausea. Neurological examination was unremarkable except for hypotonia and mild ataxia in the limbs, but orthostatic nausea and vomiting forced him to take a quiet, recumbent position. Magnetic resonance imaging of the brain showed cerebellar infarction restricted to the bilateral inferior vermis. During a course of recovery, he fell down in any directions while standing unattended. He was unable to keep the center of gravity on the feet base in an upright posture. The inferior vermis may participate in maintaining the center of gravity while standing.

For 74 men and 123 women averaging 52.5 years of age with vertigo and dizziness, we recorded the age, gender, vertigo type, duration of illness, concomitant symptoms, and vestibular and psychological test results and used a 100 mm horizontal visual analog scale (VAS) to quantitatively assess sensation intensity and annoyance in vertigo or dizziness. Factors influencing these 2 quantitative assessment parameters were analyzed by stepwise multiple regression analysis. Factors influencing sensation intensity were nausea or vomiting as a concomitant symptom, duration of vertigo or dizziness (within a day), and first episode onset. Intensity of sensation to vertigo or dizziness, self-rating depression score (SDS), and gender (female) were selected as significantly influencing annoyance. These results suggest that rational care of significant factors that involve the intensity and annoyance in vertigo is essential to treating patients with vertigo or dizziness.

Formerly, hair had been analyzed mainly in the field of individual identification. Otherwise, it is known that many substances are accumulated in hair such as metals like arsenic, mercury, alkaloids like caffeine, theophylline, drugs like opiate, stimulants, other drugs and poisons. So, by qualitative and quantitative analysis of such deposits in hair. It is possible to presume one's life manner during recent several months. This is the new development of hair analysis and it is expected that it may be wide of application. The main theme of this paper is hedonics. Nobody dislike hedonic sensation. So, it can be said everybody being living always coveting hedonic sensation. There are many hedonic sensers all over the body, and hedonic sensation transmitted by A10 nerve, so A10 nerve is called the hedonic nerve. Neurotransmitter of this A10 nerve is Dopamine. Dopamine is the endogenous hedonic material. Exogeneous hedonic one is stimulant like Methamphetamine. In this paper, relation between Dopamine, Methamphetamine and Tyramine, thought to be the terminal product from two formers is examined in the aspect of hair analysis. Catecholamines including Dopamine are made of Tyrosine. They have a Benzene-ring. Compounds with a Benzene-ring made of Tyrosine are relatively rare, but all of them have very strong action. Tyramine is made of Tyrosine, too. So the structure of Tyramine is essentially resemble to Dopamine, and the skeletal structure of Methamphetamine is identical to Dopamine, so the action is identical, too. Normally, excessive release of Dopamine in brain is controlled by the negative feedback of GABA system. But extrinsic stimulus as Methamphetamine put balance of the homeostasis between Dopamine system and GABA system in to disorder, and long term administration of Methamphetamine makes long remaining degeneration of synapse of Dopamine nerve. So, abnormal state of excess releasing of Dopamine happens easily. And the morbid state named stimulant psychosis occur. The volume of Tyramine in hair changes correlatively with the volume of released Dopamine in brain. Therefore it is suggested that quantitative analysis of Tyramine in hair enable to estimate the changes of Dopamine released in brain.

We reported a 48-year-old male who showed stimulus-sensitive spinal myoclonus due to chronic toluene intoxication. He has been exposed to thinner for more than 30 years as a painter, and occasionally experienced an episode of headache, nausea and dizziness because of acute thinner intoxication. He noted tremor of his hands 10 years ago. He also noticed memory disturbance since the end of 1997. Neurological examination revealed postural tremor of his fingers on the bilateral sides and the left arm. In addition, rhythmic myoclonic jerks were induced in the right upper limb muscles by a tendon tap given on the right brachioradialis muscles. Surface EMG revealed repetitive grouping discharges in those two muscles approximately 100 msec after the tendon tap which continued for about 30-50 msec. A long loop reflex (C-reflex) and giant SEPs were not observed in his right upper limb, and EEG showed no spike. Urinary excretion of N-benzoylglycine, which was a metabolite of toluene was increased (1.17 g/l). Therefore, he was diagnosed as a case of chronic toluene intoxication. His myoclonic jerks were considered to be stimulus-sensitive spinal myoclonus, because they were induced segmentally and because cortical hyperexcitability was not seen. This is the first report to describe the occurrence of stimulus-sensitive spinal myoclonus in the case of chronic toluene intoxication.

Medial medullary infarction is characterized by ipsilateral hypoglossal nerve palsy with contralateral hemiparesis and disturbance of deep and discriminative sensory perception. We examined the extent and distribution of disturbances in deep sensation and compared the findings with the lesion location in the medial lemniscus detected by MRI in 3 patients with medial medullary infarction. We classified the lesion location into 2 groups; type I and type II. Type I was ventral to the middle medial lesion of the medial lemniscus, and type II was ventral to the dorsal medial lesion. In our series, type I (Case 1) impairment of the three kinds of deep sensations was more severe in the lower extremities than in the up-per extremities. In type II (Cases 2, 3) the severity or impairment in the upper extremities was moderate or severe and nearly equal to that in the lower extremities. There was no difference in the severity of impairment for the four kinds of discriminative sensations. In the literature, type I (8 patients) impairment of position sense in deep sensation was found in 1 of 7 patients in the upper extremities and 5 of 7 patients in the lower extremities. Impairment of vibration sense was found in 1 of 7 patients in the upper extremities and in all patients in the lower extremities. In type II (14 patients) severe impairment of position and vibration sense in deep sensation was found in 3 patients in the upper extremities equal to that in the lower extremities. There was no tendency in the severity of impairment of four kinds of discriminative sensations. Including our 3 cases and 22 in the literature, impairment of deep sensation was more severe in the lower extremities than in the upper extremities in type I (9 patients) and the extent was none (7), mild or moderate (2) in the upper extremities, mild (2), moderate (1), severe (2), obscure (4) in the lower extremities, while in type II (16 patients) the severity in the upper extremities was nearly equal to that in the lower extremities and the extent was none (1), mild or moderate (1), severe (5), obscure (9) in the upper extremities, none (2), mild or moderate (1), severe (6), obscure (7) in the lower extremities. It is concluded that hemiparesis appeared with lesions located in the pyramidal tract of the medulla, hemiparesis and disturbance of deep sensation in the upper and lower extremities, predominantly in the lower extremities with the lesion of the pyramidal tract to the middle of medial lemniscus in the medulla, hemiparesis and disturbance of the upper and lower extremities deep sensation with lesions of the pyramidal tract to the whole of the medial lemniscus in the medulla. Evaluating deep sensation of the upper and lower extremities is useful for speculation of the lesion location in the medial lemniscus in medial medullary infarction.

To assess the prevalences and neurological symptoms of destructive spondyloarthropathy (DSA) and other cervical spinal diseases in long-term hemodialysis, a questionnaire survey of the medical histories and subjective sensory-motor symptoms was taken on 191 patients undergoing dialysis for 0.2-23 years (mean 8.6 +/- 6.3) with a mean age of 56.6 +/- 11.8 years (range 23-86). Furthermore, plain radiographic examinations of the cervical spine were carried out in 90% of the patients, and neurologic examinations were also performed on 29 patients. DSA was diagnosed in 18 cases (10%): moderate narrowing of the intervertebral space (NIS-I) in 8, severe narrowing (NIS-II) in 18, ossification of posterior longitudinal ligaments (OPLL) in 6, cervical spondylosis (CS) in 12 and other abnormalities in 6; 104 cases were normal. NIS-I was considered to reflect an early stage of DSA. The age of patients with DSA (mean 61.5 +/- 10.2 years), as well as with CS, was significantly higher than the normal group (52.2 +/- 10.6; p < 0.001), but younger than CS (68.5 +/- 10.0). The duration of dialysis in DSA patients (mean 12.1 +/- 6.0 years) was the longest and significantly longer than normal (7.7 +/- 6.5; p < 0.01) and (:S patients (3.8 +/- 3.0; p < 0.001). Through comparative evaluations of prior histories of the diseases, such as diabetes mellitus, carpal tunnel syndrome, amyloid osteoarthropathy (AOA) and parathyroidectomy, along with large calcification of the nuchal soft tissues on plain films, it was found that DSA, in conjunction with NIS-I, correlated with only AOA (p < 0.05). Subjective sensory symptoms, which consisted chiefly of arthralgic type followed by polyneuritic type, were noted in 60% of all patients and 56% of DSA patients. No significant differences were evident between any two particular groups. The score of subjective motor symptoms of the lower extremities in 5 patients with myelopathy was significantly higher than that in 5 other patients without neurological disorders (p < 0.05). Thirty-eight percent of DSA patients showed myelopathy; the frequency was higher than those of previous similar studies (0 = 5%). In conclusion, this study demonstrated that 1) DSA occurred in 10% of dialysis patients, which was also evident in previous reports (9 = 10%); this prevalence was higher than those of CS or OPLL, 2) DSA correlated with the duration of dialysis and AOA, 3) subjective motor symptoms of the lower extremities could indicate presence of myelopathy whereas subjective sensory symptoms contributed little to differential diagnosis, and 4) a careful neurologic examination can more frequently disclose myelopathy in patients with DSA than so far believed.

We studied the efficacy of glutathione in the prevention of CDDP-induced neurotoxicity. Nine patients with muscle-invasive bladder cancer were treated with intra-arterial THP and CDDP chemotherapy plus radiotherapy. Glutathione was given at a dose of 1,500 mg/m2 before CDDP administration and at a dose of 600 mg/body on days 2 to 4. The CR rate of 9 patients was 89%, and 2 of the 9 patients developed grade 1 neurotoxicity. These patients were then compared with 15 patients treated with the same regiment but without glutathione. The two groups did not differ in CR rate (89% vs 87%), but the incidence of neurotoxicity of patients with glutathione was significantly lower than that of patients without glutathione (22% vs 73%).

Although lacunar syndrome is relatively commonly encountered in patients with a lacunar infarct in the deep cerebral white matter, the responsible lesions are often unidentified. By examining eight patients with lacunar syndrome who had small infarcts in the deep cerebral white matter, an attempt was made to determine the position and distribution of the sensory pathway on brain CT at the level of the splenium of the corpus callosum. When the distance from the frontal crista to the superior saggital sinus sulcus was defined as 1.0, the position of the corticospinal tract was located in the portion from 0.45 to 0.49 and that of the sensory pathway in the portion from 0.49 to 0.53. These data indicated that the position of the sensory pathway was just behind the corticospinal tract and the distribution was very narrow at this level. The results of this assessment revealed that lacunar infarcts in the deep cerebral white matter were liable to cause sensorimoter syndrome more than pure sensory stroke.

This study introduces an original testing method on facial skin sensation and describes the results obtained by its application to patients after orthognathic surgery. The alterations of skin sensation in lower lip and chin area were examined in 135 patients who had undergone orthognathic surgery, by application of electrical stimulation through an original pencil shaped probe. Detection threshold of the same area before surgery were used as control, and the location and size of the area with thresholds higher than control levels were measured. The control thresholds ranged from 0.13 mA to 0.21 mA. The higher threshold area was found in 86.3% of all the patients in 1 month after surgery, in 27.7% after 1 year. The threshold levels declined with the time, and in none of the patients the threshold level was higher than 1.0 mA more than 2 years after surgery. The patients whose threshold level was more than 1.0 mA in 1 month postoperatively showed a tendency to have the area with a threshold higher than the control level even 1 year later (p < 0.0001). The threshold of the younger patients tended to improve smoothly than the older. In addition, the patients with a shorter set-back or advance distance had a slighter sensory disturbance and recovered more smoothly than those with a longer distance.

The present study examined the subjective response induced by the concentration upon and repetition of the formal language expressing the sense of heaviness--"The arm is heavy." As a result of the factor analysis of the experiment using 60 subjects, the following five factors emerged. (1) Overall sense of improvement; (2) awareness of the sensation of the arm; (3) change to less nervousness; (4) awareness of positive aspects; (5) understanding of the formal language. Also, those who were aware of psychosomatic symptoms felt their change to less nervousness more significantly, and their understanding of the formal language was significantly higher than those who were not aware of psychosomatic symptoms. The result of the experiment suggests one possibility that excessive concentration upon the body concerning psychosomatic symptoms may have changed to the concentration upon the sense of heaviness, or that the reduction of the stress thereof may have brought the change to less nervousness.

To compare the recovery of corneal sensitivity and corneal regeneration following excimer laser and manual epithelial debridement, the corneal epithelium of the right eye of New Zealand white rabbits (n = 21) was manually debrided and the left eye was ablated with the excimer laser (47 microns depth, 5 Hz, and 160 mJ/cm2). We observed the wound healing rate and corneal sensitivity. The relative density of innervation on the intraepithelial layer was measured using gold chloride staining or right microscopic examination for 30 weeks. In the laser-ablated cornea sensitivity rapidly increased to a normal level by day 5, and then it continued to increase gradually and reached a maximum at day 42. Thereafter it remained elevated to 126 days and returned to normal at 210 days. There were significant differences in the recovery of sensitivity following excimer ablation and manual epithelial removal. The relative density of innervation on the intraepithelial layer after excimer ablation was significantly higher than manual debridement at day 35. We observed a correlation between increased sensitivity levels and increased nerve density. This result suggests that for photorefractive keratectomy or phototherapeutic keratectomy, manual debridement of the corneal epithelium should be performed before stromal excimer ablation.

Cumulative Fatigue Symptoms Index (CFSI) is used for workers' subjective assessment of feeling of fatigue and of symptoms. Until now, this index has been used in the analysis of members of the same occupation. The purpose of this study is to examine fatigue symptoms in workers and to assess by CFSI the effect of regular physical exercise. Study participants were an exercise group (n = 67) and a non-exercise group (n = 115) of older workers, aged from 30 to 69 years. The CFSI questionnaire was distributed to all participants and the former group (exercise) answered two descriptive questions concerning the aim and subjective effects of physical exercise. As a result, it was found that mental fatigue symptoms decreased in the exercise group even after considering the differences in managerial position, subjective senses on health and marital status which are related to degree of feelings of fatigue. Weakened vitality was significantly less in the exercise group than the non-exercise group. Therefore, we concluded that weakened vitality would be needed to be regarded on an assessment scale for effects caused by exercise. It has also been considered that we should investigate general fatigue in assessing physical fatigue relating to one's lifestyle.

A 55-year-old woman with known retinitis pigmentosa for 25 years was progressively clumsy in gait and activities of daily living over the past 30 years. She was able to manage house work and social activities, but she developed swallowing disturbance associated with involuntary neck muscle spasm for 2 weeks, which brought her to our clinic on September 7, 1990. General physical examination was normal except for dry skin. Neurological examination was compatible with sensory-dominant polyneuropathy, showing distal dominant sensory impairment together with absent vibration sense and areflexia in lower limbs, but no gross muscular weakness. There were neck dystonia and bilateral poor visual acuity due to secondary optic atrophy of retinitis pigmentosa. The former responded to the combination of tiapride and trihexyphenidyl. She was admitted twice for further evaluation. Complete blood count and blood chemistry tests including lipids were all within normal limits, and so was cerebrospinal fluid. Pyruvate and lactate before and after exercise loading were also normal. Malignancy workup was negative. To our surprise, serum vitamin E level turned out very low (1.89 micrograms/ml), normal range being 4.7-20.3 micrograms/ml. Oral vitamin E administration test by 2g of alpha-tocopherol showed abnormal absorption curve followed fast clearance in serum. Stool was occasionally positive for fat corpuscles by Sudan III staining, but 99Tc-HSA leakage into the intestines was not detected.(ABSTRACT TRUNCATED AT 250 WORDS)

The numb chin syndrome (NCS) is characterized by chin or lower lip numbness restricted to the distribution of the mental nerve (the distal trigeminal nerve). A case of multiple myeloma with polycythemia vera was diagnosed with NCS as the initial manifestation. A 73-year-old Japanese male was admitted to our hospital in April, 1993, because of paresthesia around the chin and lower lip. X-ray film showed multiple osteolytic lesions. According to serum and urine immunoelectrophoresis, lambda type Bence Jones protein was demonstrated. The bone marrow aspiration showed the normocellular marrow with 14.1% myeloma cells. He was diagnosed a suffering from multiple myeloma and was treated with melphalan and prednisolone. He is alive at present with resolution of NCS. We discussed pathogenesis, diagnosis, and treatment of NCS.

We adopted a visual analogue scale (VAS) to evaluate discomfort like the sensation of a choking lump in the throats of 92 patients (24 male and 68 female, 17-80 years of age) who consulted us complaining of the sensation. The VAS consisted of a 100 mm long horizontal straight line defined by anchors with verbal labels: the left end point (0 mm) indicated no throat discomfort, the right end point (100 mm) overwhelming throat discomfort. We determined the VAS score (1 mm = 1) by measuring the distance from the left end point to the mark made by the patient. On the first day of the study, the patients evaluated the sensation with the VAS alone. One, two and three weeks later they evaluated the sensation with the scale, and at the same time, they were asked to compare the strength of the existing sensation with that on the first experimental day and to express the percent change in the sensation. The latter data were used for calculation of the predicted VAS score. It was neither difficult nor time-consuming for the patients, some of whom were fairly elderly, to display the strength of the sensation on the scale. The VAS score on the first day of the study for each patient ranged from 6-92, and the mean and the standard deviation were 44.6 and 21.0, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

The purpose of this work was to confirm ocular deviation during head tilt in cases of superior oblique muscle palsy. Ocular vertical deviation and cyclodeviation under head tilt loading were examined in nine cases with superior oblique muscle palsy using a new device, celled a modified phase difference haploscope (M-PDH). The M-PDH is able to measure a quantitative head tilt loading towards both sides. Tests using the M-PDH revealed the difference in angle of head tilt at the onset of hyperdrift and the degree of vertical deviation during head tilt towards the paretic side. Among the cases of superior oblique muscle palsy tested, ocular vertical deviation was classified into three types depending on the angle of head tilt.

The swallowing function of ten patients showing marked cervical osteophytes were studied by double contrast pharyngogram and manometric examinations. In five cases in which the pharyngeal clearance was B type according to Shuzaki's classification, a significant increase in the maximal swallowing pressure value on the oral side ipsilateral to the osteophytes was often observed. In five cases in which the pharyngeal clearance showed A + A' type (marked impairment), the frequency of significantly decreased maximal swallowing pressure on the oral side ipsilateral to the osteophytes and abnormal waveforms of the swallowing pressure were high. However, no definite correlation was noted between these changes in swallowing function and osteophyte site. Therefore, there are two possible outcomes of the changes in swallowing function caused by cervical osteophytes: one is a compensatory increase in pharyngeal constriction aimed at maintaining relatively good pharyngeal clearance, the other is impaired pharyngeal constriction and the pharyngeal clearance. These changes in swallowing function would impact on globus sensation.

We examined, in 32 normal adults, the effect of hypoxia on the sensation of dyspnea during hypercapnic ventilatory response (HCVR). The tests were conducted under two different levels of inspiratory O2 content, either hyperoxia (PETO2 greater than 150 Torr) or hypoxia (PETO2 50-55 Torr), with simultaneous assessment of dyspnea sensation by visual analogue scaling (VAS). The sensation was evaluated either in relation to VE standardized by predicted MVV (the slope of VAS-VE regression line or VAS at VE 40%) or in relation to PETCO2 (the slope of VAS-PETCO2 line or VAS at PETCO2 55 Torr). Concomitant hypoxia significantly enhanced both the mean value of delta VE/delta PETCO2 and that of delta P0.1/delta PETCO2. The sensation of dyspnea did not differ between the two conditions when it was evaluated in relation to ventilation, whereas it was markedly greater during hypoxic HCVR when it was evaluated in relation to PETCO2. The hypoxic augmentation of the sensation, compared at PETCO2 55 Torr, could be explained by increase of the motor output from the respiratory center, since it was positively correlated with the relative change of VE, VTTI, and delta P0.1/delta PETCO2 (r = 0.70, p less than 0.0001; r = 0.63, p less than 0.0001; r = 0.40, p less than 0.05, respectively). From these findings, we conclude that hypoxia does not have a direct dyspnogenic effect, at least in normal subjects.