Search

We propose modified versions of the line-bisection task for assessing visual bias and effect of proprioceptive feedback in unilateral neglect; that is, the verbal line-bisection (VLB) task and the VLB plus pointing task. The VLB task requires only a verbal response to assess pure visual bias. Conversely, the VLB plus pointing task requires both a verbal response and pointing to assess visual and proprioceptive bias. Ten patients with unilateral neglect were administered these tasks on a computer using presentation software. Eight participants showed obvious rightward deviation in the VLB task, and were thus classified as patients with visual neglect. Four participants showed significantly greater deviation in the VLB plus pointing task than in the VLB task, and were thus classified as patients with proprioceptive bias. Visual bias and effect of proprioceptive feedback in unilateral neglect were successfully assessed by these tasks.

Identification of the innervation zone is widely used to optimize the accuracy and precision of noninvasive surface electromyography (EMG) signals because the EMG signal is strongly influenced by innervation zones. However, simply structured fusiform muscle, such as biceps brachii muscle, has been employed mainly due to the simplicity with which the propagation from raw EMG signals can be observed. In this study, the optimum electrode location (OEL), free from innervational influence, was investigated by the propagation pattern of action potentials for brachii muscles and more complicated deltoid muscle structures using an automatized signal analysis technique. The technique employed newly developed computer software with additional clinical uses and minimized subjective differences. EMG signals were recorded using surface array electrodes during voluntary isometric contractions obtained from 12 healthy male subjects. Peaks in EMG signals were detected and averaged for each muscle. The propagation patterns and OEL were examined from biceps brachii muscles for all subjects and from deltoid muscles for seven subjects. The estimated locations were partially confirmed by comparing the root mean squares of the EMG signals. These results show that propagation patterns and OEL could be estimated simply and automatically even from the surface EMG signals of deltoid muscles.

We assessed the amount of visceral fat using ultrasonography (US) and studied its relationship to cardiovascular disease risk factors, particularly blood pressure. The subjects in the first study were 45 male and 61 female outpatients. We measured the visceral fat area (VFA) of each subject using abdominal CT and waist circumference (WC), and visceral fat distance (VFD) using US. The subjects in the second study were 353 male and 457 female inhabitants of a rural community, for whom VFD and WC were measured. We divided subjects into tertiles based on VFD and WC, and studied the relationship between each group and individual risk factors. In an analysis of outpatient subjects, the correlation coefficient between VFA and VFD was satisfactory: r=0.660 for men and r=0.643 for women. In the analysis of the rural subjects, the high VFD group had a significantly higher odds ratio than the low VFD group in high blood pressure (HBP) and hypertriglyceridemia (HTG) for men and in HBP, HTG and low high-density lipoprotein cholesterolemia (LHDL) for women. Moreover, adjusting VFD for body mass index revealed that, in comparison to WC, VFD was significantly related to risk factors. VFD was used as an independent variable in multiple regression analysis with blood pressure level as a dependent variable; no significant association between WC and blood pressure was obtained. Visceral fat assessment by US may be useful for epidemiological study and for clinics with no abdominal CT equipment for identifying high-risk individuals, such as those with metabolic syndrome.

Background The degree to which abnormal glucose tolerance contributes to the development of coronary artery disease (CAD) has not been clarified in Japanese. The relationship between abnormal glucose tolerance and severity of coronary artery stenosis, as well as the contributions of hypertension, diabetes and other risk factors for CAD to recurrence of the disease, were investigated in the present study. Methods and Results The subjects were 474 consecutive patients (mean age: 63.8±11.3 years) with suspected CAD who were admitted to Sapporo Medical University Hospital during April 1, 1997 to March 31, 2004. The coronary index and stenosis score were higher in subjects with diabetes mellitus (DM) and in subjects with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) than in subjects with normal glucose tolerance (NGT). Ischemic episodes recurred during the observation period (mean 2.5 years) in 61 of 341 patients diagnosed as having CAD. In the follow-up subjects, systolic blood pressure (SBP) was significantly higher in the recurrence group than in the non-recurrence group, and SBP was a significant variable in logistic regression analysis after adjustment for age, gender, hemoglobin A1c, total cholesterol, body mass index, smoking history, family history and stenosis score. The relative risk of recurrence became 1.7-fold higher with a rise in SBP of 10 mmHg (95% confidence interval: 1.252-2.250). Analysis of the relationship between glucose tolerance and recurrence showed that the rate of recurrence was higher in patients with IFG + IGT + DM than in those with NGT. Conclusions CAD progresses not only in patients with DM but also in those with IGT. The rate of recurrence of ischemic episodes increases in individuals with IGT or DM, and suggesting that hypertension is a risk factor for recurrence of ischemic episodes. Management of glucose tolerance and blood pressure is therefore important for prevention of CAD in Japanese. (Circ J 2007; 71: 20 - 25)

A novel modified passive line-bisection test was performed using a computer display with a moving image. In the test, the subjects were required to give verbal responses instead of limb movements. The test, consisting of two subtasks, left-to-right and right-to-left tasks, was applied to patients with unilateral neglect and controls. The patient group showed an obvious mean deviation in both tasks, and showed greater rightward deviation in the right-to-left task than in the left-to-right task. The control group showed little differences between the two tasks. This paper discusses the results obtained from the two different conditions and their correlations. This method provides useful data for the assessment of unilateral neglect.

Design: The aim of this study was to determine the association between aging and adiponectin level from the aspect of the influence of renal function and sex hormones in humans.Methods: Serum adiponectin and blood urea nitrogen (BUN) levels were measured in 964 subjects (372 males) aged 60.3±12.5 years. Testosterone and free testosterone levels were measured in 123 males, and estrone and estradiol levels were measured in 114 females. The subjects were divided into two age groups; 65 years of age or older (Age ≥65 group) and less than 65 years of age (Age Results: Adiponectin level increased linearly with aging in males, whereas it increased dramatically in females until their 50s. The patterns of changes in adiponectin were similar to those in BUN. In multiple- regression analysis using adiponectin as a dependent variable BUN was selected as a significant independent variable in all subjects and in subjects in the Age ≥65 group, whereas bioactive sex hormones were not selected.Conclusions: A decrease in adiponectin clearance in the kidney may be the cause of high levels of adiponectin in the elderly. Adiponectin level seems to be influenced more strongly by BUN than by sex hormones and to be increased by a decline in renal function with aging.

Background: The aim of the present study was to determine the correlation between the combination of hypertension and diabetes mellitus and arteriosclerosis using pulse wave velocity (PWV). Methods: The subjects were 186 men over the age of 60 years (mean age: 68.8 ± 5.8 years). PWV, systolic blood pressure (SBP), diastolic blood pressure, body mass index, fasting blood sugar (FBS), total cholesterol, triglyceride and HDL cholesterol were measured in all subjects. The subjects were divided into three groups on the basis of FBS level: a normal group (FBS

Objectives: Although it is well known that obesity is closely related to insulin resistance, the incidence of the development of insulin resistance in people with obesity is not known. In this study, we investigated the incidence of insulin resistance in citizens of two rural communities in Japan. Subjects and methods: The subjects were 102 men and 126 women over the age of 30 years selected from 1035 citizens who had undergone medical examinations in the towns of Tanno and Sobetsu, Hokkaido, in 1991 and 1998. Those who were on medication for hypertension, diabetes, hyperlipidaemia, coronary heart disease and cerebral vessel disease were excluded. The simple index to determine insulin resistance [i.e. homeostasis model assessment (HOMA-R) ≥ 1.73] was used, and subjects who were determined to be positive for insulin resistance according to this index in 1991 were also excluded in order to determine the incidence of insulin resistance in subjects who had no abnormalities other than obesity. The systolic blood pressure (SBP), diastolic blood pressure, body mass index (BMI), triglyceride level, high-density lipoprotein level, blood sugar level, serum insulin value and HOMA-R were measured in all subjects in 1991 and in 1998. Moreover, the subjects were divided into two groups according to BMI, a normal group consisting of subjects with BMI

Objectives: Since arteriosclerosis obliterance in the legs (ASO) causes deterioration of the prognosis of the elderly, prevention of ASO is important for maintenance of their quality of lives. We studied the prevalences of ASO in rural communities in Japan. Methods and results: We measured the ratio of systolic blood pressure in the leg to that in the arm (ABI) using a new device, Form PWV/ABI, in 1398 subjects of both sexes. Subjects with ABI values below 0.9 were considered to have ASO. The prevalence of ASO was 2.7% in all of the subjects, 1.0% in subjects under the age of 60 years, and 3.4% in subjects aged 65 years or more. Multiple regression analysis showed that ABI was correlated with plasma level of total cholesterol in men. There were no significant differences of the mean age, mean fasting plasma glucose level and percentage of patients who smoked between the ASO group and non-ASO group in each sex. Mean cholesterol level in our subjects is lower than the reported levels in Europeans and Americans. The prevalence of ASO increased with increase in the number of risk factors in individual subjects. Conclusions: Among the atherosclerotic risk factors, age and total cholesterol seem to be more important risk factors of ASO than others.

Left unilateral spatial neglect is caused by brain damage in the right hemisphere. Other than a subjective method such as line bisection test in which a patient is requested to draw the mark at the center of the line, recording of eye movement has been evaluated as an objective diagnostic method. As a measurement tool, electro-oculography or an eye camera has been used for recording of eye movement. However, such conventional recording systems are interrupted by head movement. The authors have developed a new head set which has two functions simultaneously, measuring eye movement and presenting visual image for both eyes. Since the relative geometrical association with each other's coordinates system for measurement and presentation is absolutely fixed, the developed head set is robust to head movement.

ラックカイガラムシより分泌される樹脂状物質はセラックと呼ばれ, 各種工業製品や食品の光沢剤として広く利用されている。本研究では, セラックが形成する被膜は耐酸性に優れ, 毒性がないとされることから, セラックで歯牙の表面をコーティングした場合の歯垢付着抑制効果と, う蝕抑制効果を塩化セチルピリジニウム (CPC) を併用した場合も含めて動物モデルを用いて検討した。その結果, 0.5%セラックの単独薬液および0.2%または0.5%セラックとCPCを併用した薬液では歯垢の付着抑制効果が, 0.5%セラックとCPCを併用した薬液ではう蝕抑制効果が, それぞれ歯種によっては認められた。以上よりセラックの長期投与は, 歯垢の付着抑制に有効であることが示唆された。一方, う蝕抑制効果についてはセラック単独では抑制力は低いが, CPCの作用を著しく増強させることが示唆された。

The effects of 0.125%, 0.25% and 0.5% timolol maleate on the opacity, thickness and hydration of isolated porcine corneas were determined. The effects of adding 0.005% benzalkonium chloride, 0.5% chlorbutanol or a combination of 0.026% methyl p-hydroxybenzoate, 0.014% propyl p-hydroxybenzoate and 0.2% chlorbutanol to the timolol solutions were also assessed. Over a 4-hour incubation period, a concentration-related opacity developed in the presence of timolol alone, and was not greatly affected by the addition of the p-hydroxybenzoate mixture. However, the addition of benzalkonium chloride or the higher concentration of chlorbutanol markedly increased opacity. Corneal thickness increased significantly in the presence of 0.25% and 0.5% timolol and even further in the presence of the preservatives, chlorbutanol being the most potent. Hydration increased slightly with time and also in the presence of each of the preservatives. The need to achieve a balance between possible corneal toxicity and effective batericidal activity is discussed.

Innervation zone (IZ) has been identified as the origin of action potential propagation in isometric contraction. However, IZ shifts with changes in muscle length during muscle activity. The IZ shift has been estimated using raw EMG signals. This study aimed to investigate the movement of IZ location during continuous dynamic muscle contraction, using a computer program. Subjects flexed their elbow joint as repetitive dynamic muscle contractions. EMG signals were recorded from the biceps brachii muscle using an eight-channel surface electrode array. Approximately 100 peaks from EMG signals were detected for each channel and summed to estimate the IZ location. For each subject, the estimated IZ locations were subtracted from the IZ location during isometric contractions with the elbow flexed at 90°. The results showed that the IZ moved significantly with elbow joint movement from 45° to 135°. However, IZ movement was biased with only a 3.9 mm IZ shift on average when the elbow angle was acute but a 16 mm IZ shift on average when it was obtuse. The movement of IZ location during continuous dynamic muscle contraction can be investigated using this signal processing procedure without subjective judgment.

We investigated the effect of the position of electrodes relative to the innervation zone (IZ) of the biceps brachii muscle during isometric elbow flexion using eight-channel surface array electrodes. We estimated the location of the IZ near the centre of the muscle in 20 male subjects. The pulse peaks from electromyogram (EMG) waveforms were detected for each channel and averaged, the triphasic pulse was determined, and the peak values of the first and third phases were compared. The results showed significantly greater pulse values for the first phase when the electrode placement was proximal to the estimated IZ, and for the third phase when the electrode placement was distal to the estimated IZ. Using this method, the positional relationship between electrodes and IZ can be determined using a surface EMG waveform recorded with a pair of bipolar electrodes. This method may be clinically useful in confirming the reliability of a recorded surface EMG.

Electromyography (EMG) is useful in investigating muscle activation; however, noninvasive evaluation of surface EMG is limited due to its complicated waveform. This study investigated muscle structure and activation using an analysis technique for surface EMG.Surface array electrodes were used in 17 healthy male subjects to record eight-channel EMGs from each biceps brachii muscle during voluntary isometric contraction with a 1-kg weight band with the subjects seated. The peaks detected by referenced EMGs were normalized and averaged as averaged pulses (APs) and the innervation zone (IZ) was estimated from the APs. Muscle fiber conduction velocities (MFCVs), estimated by the time difference of the peaks (method P) and by cross-correlation (method CC) by APs, were compared. Time periods with positive values around the central peak in AP (PP) were measured and the contribution of MFCVs by motor unit action potentials (MUAPs) was estimated.IZs were estimated in 12 subjects. Near the IZ, correlation between MFCVs by methods P and CC was lower than in other locations; MFCV was significantly larger by method P than by method CC in the vicinity of the IZ. PP of the comparison AP was significantly larger than that of the reference AP. The distribution of the MFCVs by different MUAPs was verified by computer simulation.Surface EMG was used to demonstrate the diversity of MFCVs, with some increased MFCVs, for several MUAPs in the vicinity of the IZ. This method could be applied to the evaluation of neuromuscular disorders.

Primary objective: To develop a new variant of the line-bisection task for assessing non-motor (attentional, representational, etc.) bias in unilateral neglect (UN), i.e. the exactly bisected line selection task (EBLST).Methods and procedures: Nine patients with UN were included in this study. In the EBLST, multiple horizontal lines, bisected in various proportions, were presented. The participants chose the most equally bisected line and then pointed to the bisector of the chosen line. To avoid the influence of motor bias, the participants used perceptual judgement first. The conventional line-bisection task was also performed. The deviation of the subjective midpoint was measured for each participant in both tasks.Main outcomes and results: Eight participants showed obvious rightward deviation in the EBLST, thus resulting in being classified as patients with non-motor neglect. Five participants showed greater deviation in the EBLST than in the line-bisection task.Conclusion: Non-motor function in patien...

We present a method for assessing visual neglect using oculography, the "midpoint-fixation" task. In the test, patients showed rightward deviation of the fixation point. Pure bias in visual neglect was considered to be assessed well by this method. Newly designed stimuli that lead to stable fixation and an effective calibration procedure are proposed. The method is suggested as useful in the assessment of visual neglect.

It is unclear whether the role of insulin resistance in the development of atherosclerotic cardiovascular disease is similar in populations in which the incidence of atherosclerotic diseases significantly differs from that in Western countries. The aim of this study was to determine the relationship between insulin resistance and the development of cardiovascular disease in the Japanese population. We conducted 75 g-oral glucose tolerance tests (OGTTs) on 1,928 inhabitants of two towns in Hokkaido, Japan. Subjects using antihypertensive agents and known diabetic patients were excluded from the study. Data from the remaining 1,227 subjects (540 males and 687 females; mean age 56.0 +/- 10.8 years) were used for the analysis, and 1,051 subjects were seen in a follow-up care setting for a period of 8 years. The presence of insulin resistance was defined according to the guidelines reported our previous study: insulin levels of 64.0 mU/l or higher 2 h after the 75 g-OGTT. The insulin-resistant (IR) group had several risk factors such as hypertension, diabetes, treated or untreated hypercholesterolemia, hypertriglyceridemia, low high-density-lipoprotein (HDL) cholesterol levels, and obesity. During the follow-up period of 8 years, the incidence of coronary artery disease, which was adjusted for age, body mass index, sex, systolic blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and HDL cholesterol was significantly (3.2 times) higher in the IR group than in the insulin non-resistant group. The results suggested that insulin resistance is an independent risk factor for coronary artery disease in Japanese subjects, as has also been demonstrated in the case of individuals in Europe and USA.

A variant of a line bisection test was devised. Patients with unilateral visual neglect and control subjects were asked to perform the test, which consisted of two subtasks: a verbal and a manual task. The verbal task was newly designed and did not require manual responses from the subjects. The manual task was similar to conventional line bisection tasks. This paper reports and discusses the results obtained from each task and their correlations. This technique is compatible with bedside examinations, does not require a complex apparatus, and provides useful data for the assessment of unilateral visual neglect.

According to the new International Diabetes Federation (IDF) definition of metabolic syndrome, for a person to be defined as having metabolic syndrome they must have central obesity defined by waist circumference (1). In the definition, there are some ethnic or country-specific differences in the cutoff points of waist circumference, and Japanese cutoff points have been separately established in the IDF definition (≥85 cm for men and ≥90 cm for women). The Japanese Society of Internal Medicine and eight related scientific societies have also jointly announced new Japanese criteria of metabolic syndrome using the same cutoff points of waist circumference (2). However, the impact of central obesity using the cutoff points as a risk of type 2 diabetes is not known. In this study, we investigated the incidence of type 2 diabetes in citizens of two rural communities in Japan to determine the relationship between type 2 diabetes and central obesity, and we also investigated the independent effects of central obesity compared with those of overall obesity. The subjects were 348 men and 523 women selected from 938 citizens who had undergone medical examinations in the towns of Tanno and Sobetsu, Hokkaido, both in 1994 and 2003 or 2004. The following participants in medical examinations in 1994 were excluded: those with missing data on blood …