• Sleep Medicine and Psychophysiology
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• v.8 no.2
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• pp.107-112
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• 2001

Introduction: Narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and cataplexy, is known to be closely associated with the human leukocyte antigen (HLA) DQB1*0602. Several studies have suggested that HLA-DQB1*0602 is strongly linked with narcolepsy-cataplexy. However, no studies have yet been made on whether HLA DQB1*0602 is associated with Korean patients with narcolepsy. This study was designed to investigate the frequency of HLA-DQB1*0602 of Korean patients with narcolepsy. Methods: Twenty patients were selected (mean age: $28.2{\pm}3.0$, 11 men and 9 women). The patients were confirmed to have narcolepsy by the overnight polysomnography and multiple sleep latency test (MSLT) in addition to their clinical history and symptoms at St. Vincent's Hospital and Korea University Hospital Sleep Disorders Clinic. Any subjects co-morbid with other hypersomnic sleep disorders such as sleep apnea or periodic limb movements during sleep were excluded. Clinical data was collected through a semi-structured interview for narcoleptic patients. All patients and 21 control did HLA typing for the presence of DQB1*0602. Results Obtained were as Follows: 1) Mean sleep latency was 2.4 (${\pm}2.0$ minutes) and mean frequency of sleep-onset REM period was 3.0 (${\pm}1.6$) by MSLT. 2) Characteristic symptoms of narcolepsy investigated were as follows: excessive daytime sleepiness (100%), cataplexy (100%), sleep paralysis (60%), hypnagogic hallucination (70%) and disrupted nocturnal sleep (75%). 3) Strong emotional expression such as laughing (80%) and joking (70%) triggered cataplexy which affects the knee and leg region (80%) and jaw region (30%). 4) HLA-DR2 was found in 90% of patients and 35% in controls. The frequency of HLA-DQB1*0602 in patients and controls was 90%, and 24%, respectively. Conclusions: These results, which exhibit high HLA-DQB1*0602 expression in Korean patients with narcolepsy, suggest that HLADQB1*0602 could be a strong genetic marker in narcolepsy.

• Safety and Health at Work
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• v.7 no.2
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• pp.120-123
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• 2016

Background: To assess in a laboratory setting the ability to stay awake in a sample of workers of an Italian hospital and to investigate the association between that ability and the risk of occupational injury. Methods: Nine workers at the University Hospital of Udine who reported an occupational injury in the study period (cases), and seven noninjured workers (controls) underwent a polysomnography and four 40-minute maintenance of wakefulness tests (MWT). Differences in sleep characteristics and in wakefulness maintenance were assessed using Wilcoxon's rank sums tests and Fisher's exact tests. Results: Controls had greater sleep latency, lower total sleep time, fewer leg movements, and a higher percentage ratio of cycling alternating pattern, were more likely not to fall asleep during the MWT and were less likely to have two or more sleep onsets. Although not all the differences reached statistical significance, cases had lower sleep onset times in Trials 1-3. Conclusion: In the literature, the evidence of an association between MWT results and real life risk of accidents is weak. Our results suggest a relationship between the MWT results and the risk of injury among hospital workers.

• Advances in Traditional Medicine
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• v.6 no.3
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• pp.174-178
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• 2006

The ethanolic extract of Leucas aspera root was studied for its effect on the central nervous system (CNS) using pentobarbitone induced sleeping time test, the open field test and the hole cross test in Swiss albino mice. The present investigation revealed that the extract at the doses of 250 and 500 mg/kg, significantly prolonged the pentobarbitone induced sleeping time in mice though the onset of sleep was delayed as compared to control. In open field test the depressing effect was prominent from the second observation period (30 min) and persisted throughout the entire experimental period (240 min). In the hole cross test, the depressing effect was observed significant from the third observation period (60 min) and persisted up to the seventh observation period (240 min) except at fourth observation (90 min) for 250 mg dose group and depressing effect was significant from second observation (30 min) up to seventh observation period (240 min) for 500 mg dose group. These results support the finding that Leucas aspera root may contain biologically active constituent(s) having CNS activity.

• Advances in Traditional Medicine
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• v.4 no.4
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• pp.249-252
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• 2004

The methanol extract of Diospyros peregrina bark was studied for its effect on the central nervous system (CNS) using the pentobarbitone induced sleeping time test, the open field test and the hole cross test in Swiss albino mice. The present investigation revealed that the extract, at the doses of 250 and 500 mg/kg, significantly prolonged the pentobarbitone induced sleeping time in mice though the onset of sleep was delayed as compared to the control. In open field test, the depressing effect was prominent from the second observation period (30 min) and persisted throughout the entire experimental period (240 min). In the hole cross test, the depressing effect was observed from the second observation period (30 min) and persisted up to fifth observation period (120 min) for 250 mg dose group and up to sixth observation period (180 min) for 500 mg dose group. These results support the finding that D. peregrina bark extract at the above doses has CNS depressing effects and indicate that D. peregrina bark may contain biologically active constituent(s) having CNS depressant activity.

• Asian Spine Journal
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• v.12 no.6
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• pp.1043-1052
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• 2018

Study Design: Level III retrospective cross-sectional study. Purpose: To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with 'post-decompressive neuropathy (PDN).' Overview of Literature: PDN is characterized by lower extremity radicular pain that is 'different' from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood. We hypothesize that PDN is caused by an intraoperative neuropraxic event and may develop early (within 30 days following the procedure) or late (after 30 days following the procedure) within the postoperative period. Methods: Patients who consented to undergo lumbar laminectomy with or without an instrumented fusion for degenerative lumbar spine disease were followed up prospectively from July 2013 to December 2014. Relevant data were extracted from the charts of the eligible patients. Patient demographics and surgical factors were identified. Patients completed postoperative questionnaires 3 weeks, 3 months, 6 months, and 1 year postoperatively. Questions were designed to characterize the postoperative pain that differed from preoperative pain. A diagnosis of PDN was established if the patient exhibited the following characteristics: pain different from preoperative pain, leg pain worse than back pain, a non-dermatomal pain pattern, and nocturnal pain that often disrupted sleep. A Visual Analog Scale was used to monitor the pain, and patients documented the effectiveness of the prescribed pain management modalities. Patients for whom more than one follow-up survey was missed were excluded from analysis. Results: Of the 164 eligible patients, 118 (72.0%) completed at least one follow-up survey at each time interval. Of these eligible patients, 91 (77.1%) described symptoms consistent with PDN. Additionally, 75 patients (82.4%) described early-onset symptoms, whereas 16 reported symptoms consistent with late-onset PDN. Significantly more female patients reported PDN symptoms (87% vs. 69%, p=0.03). Patients with both early and late development of PDN described their leg pain as an intermittent, constant, burning, sharp/stabbing, or dull ache. Early PDN was categorized more commonly as a dull ache than late-onset PDN (60% vs. 31%, p=0.052); however, the difference did not reach statistical significance. Opioids were significantly more effective for patients with early-onset PDN than for those with late-onset PDN (85% vs. 44%, p=0.001). Gabapentin was most commonly prescribed to patients who cited no resolution of symptoms (70% vs. 31%, p=0.003). Time to symptom resolution ranged from within 1 month to 1 year. Patients' symptoms were considered unresolved if symptoms persisted for more than 1 year postoperatively. In total, 81% of the patients with early-onset PDN reported complete symptom resolution 1 year postoperatively compared with 63% of patients with late-onset PDN (p=0.11). Conclusions: PDN is a discrete postoperative pain phenomenon that occurred in 77% of the patients who underwent lumbar laminectomy with or without instrumented fusion. Attention must be paid to the constellation and natural history of symptoms unique to PDN to effectively manage a self-limiting postoperative issue.

• Advances in Traditional Medicine
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• v.6 no.3
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• pp.208-214
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• 2006

In this study the Ayurvedic formulation Dasamularista was studied for its preliminary pharmacological properties using laboratory mice. Dasamularista showed a decrease in food intake and stool formation, while the water content of stool and water intake was higher and the volume of the urine was less. Dasamularista in a slight extent reduced the intestinal motility. This constipating effect was further supported by the significant anti-diarrhoeal property of the formulation in castor oil induced dairrhoea. The tested formulation markedly increased the latent period of diarrhoea and reduced the purging index value. Dasamularista did not alter the acetic acid induced abdominal writhing. Significant reduction on the onset of sleeping time and increased duration of sleep was observed in pentobarbital induced sleeping time test.

• Sleep Medicine and Psychophysiology
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• v.10 no.1
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• pp.52-60
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• 2003

Objectives: Stage 1 sleep provides important information regarding interpretation of nocturnal polysomnography, particularly sleep onset. It is a short transition period from wakeful consciousness to sleep. The lack of prominent sleep events characterizing stage 1 sleep is a major obstacle in automatic sleep stage scoring. In this study, utilization of simultaneous EEG and EOG processing and analyses to detect stage 1 sleep automatically were attempted. Methods: Relative powers of the alpha waves and the theta waves were calculated from spectral estimation. A relative power of alpha waves less than 50% or relative power of theta waves more than 23% was regarded as stage 1 sleep. SEM(slow eye movement) was defined as the duration of both-eye movement ranging from 1.5 to 4 seconds, and was also regarded as stage 1 sleep. If one of these three criteria was met, the epoch was regarded as stage 1 sleep. Results were compared to the manual rating results done by two polysomnography experts. Results: A total of 169 epochs were analyzed. The agreement rate for stage 1 sleep between automatic detection and manual scoring was 79.3% and Cohen’s Kappa was 0.586 (p<0.01). A significant portion (32%) of automatically detected stage 1 sleep included SEM. Conclusion: Generally, digitally-scored sleep staging shows accuracy up to 70%. Considering potential difficulty in stage 1 sleep scoring, accuracy of 79.3% in this study seems to be strong enough. Simultaneous analysis of EOG differentiates this study from previous ones which mainly depended on EEG analysis. The issue of close relationship between SEM and stage 1 sleep raised by Kinnari remains a valid one in this study.

• Sleep Medicine and Psychophysiology
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• v.19 no.1
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• pp.11-17
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• 2012

Objective: Among various methods developed to quantitatively explore electroencephalograms (EEG), we focused on a wavelet method that was known to yield robust results under nonstationary conditions. The aim of this study was thus to introduce the wavelet method and demonstrate its potential use in clinical sleep studies. Method: This study involved artificial EEG specifically designed to validate the wavelet method. The method was performed to obtain time-dependent spectral power and phase angles of the signal. Synchrony of multichannel EEG was analyzed by an order parameter of the instantaneous phase. The standard methods, such as Fourier transformation and coherence, were also performed and compared with the wavelet method. The method was further validated with clinical EEG and ERP samples available as pilot studies at academic sleep centers. Result: The time-frequency plot and phase synchrony level obtained by the wavelet method clearly showed dynamic changes in the EEG waveforms artificially fabricated. When applied to clinical samples, the method successfully detected changes in spectral power across the sleep onset period and identified differences between the target and background ERP. Conclusion: Our results suggest that the wavelet method could be an alternative and/or complementary tool to the conventional Fourier method in quantifying and identifying EEG and ERP biomarkers robustly, especially when the signals were nonstationary in a short time scale (1-100 seconds).

• Advances in Traditional Medicine
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• v.6 no.1
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• pp.21-26
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• 2006

The ethanolic extract of Fleurya interrupta Gaud, (Urticaceae) was tested for its possible neuropharmacological effects on experimental animals, For the primary neuropharmacological screening of this plant, the ethanolic extract of its aerial parts was subjected to preliminary evaluation for acute toxicity, antinociceptive activity and central nervous system (CNS) activities. At the doses of 125 and 250 mg/kg, the extract significantly (P < 0.01 and P < 0. 001) and dose-dependently increased the frequency of acetic acid induced writhing in mice. In the pentobarbitone induced sleeping time test, the extract at the above dose levels, significantly and dose-dependently decreased the pentobarbitone induced sleeping time (P < 0.001) and increased the time for onset of sleep (P < 0.001) in mice. In the open field and hole cross tests, test animals showed an increase in their movement in the both tests from the 2nd observation period (30 min) and persisted throughout the entire experimental period (240 min). These results of the extract may attribute a stimulating action on the CNS. On the basis of these findings, it can be assumed that the extract exerts its stimulating effect on the CNS in mice by interfering with the cortical function or increasing the effect of some CNS stimulating neurotransmitters.

• Journal of Biomedical Engineering Research
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• v.25 no.1
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• pp.11-19
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• 2004

Stage 1 sleep provides important information regarding interpretation of nocturnal polysomnography, particularly sleep onset. It is a short transition period from wakeful consciousness to sleep. Lack of prominent sleep events characterizing stage 1 sleep is a major obstacle in automatic sleep stage scoring. In this study, we attempted to utilize simultaneous EEC and EOG processing and analyses to detect stage 1 sleep automatically. Relative powers of the alpha waves and the theta waves were calculated from spectral estimation. Either the relative power of alpha waves less than 50％ or the relative power of theta waves more than 23％ was regarded as stage 1 sleep. SEM (slow eye movement) was defined as the duration of both eye movement ranging from 1.5 to 4 seconds and regarded also as stage 1 sleep. If one of these three criteria was met, the epoch was regarded as stage 1 sleep. Results f ere compared to the manual rating results done by two polysomnography experts. Total of 169 epochs was analyzed. Agreement rate for stage 1 sleep between automatic detection and manual scoring was 79.3％ and Cohen's Kappa was 0.586 (p＜0.01). A significant portion (32％) of automatically detected stage 1 sleep included SEM. Generally, digitally-scored sleep s1aging shows the accuracy up to 70％. Considering potential difficulties in stage 1 sleep scoring, the accuracy of 79.3％ in this study seems to be robust enough. Simultaneous analysis of EOG provides differential value to the present study from previous oneswhich mainly depended on EEG analysis. The issue of close relationship between SEM and stage 1 sleep raised by Kinnariet at. remains to be a valid one in this study.