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Naoko Tachibana

Publications and source records attributed to Naoko Tachibana.

18 recordsLinked to original sources
PubMed2006

A case report and review of the literature.

Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare central nervous system neoplasm in which gliomatous tissue is diffusely identified in the subarachnoid space with no evidence of a primary intraparenchymal tumor. A 52-year-old man presented low back pain followed by sudden unconsciousness and had also cognitive dysfunction and meningeal sign. Examinations of cerebrospinal fluid (CSF) did not show malignant cells but increased protein and pleocytosis. Magnetic resonance (MR) imaging demonstrated diffuse leptomeningeal enhancement without any source of intraparenchymal lesion. Fluid-attenuated inversion recovery (FLAIR) also demonstrated individual diffuse high intensity area in the subarachnoid space. A biopsy disclosed wide spreading of anaplastic glial cells within the leptomeninges. He died 3 months later because of disease progression despite both radiotherapy and chemotherapy. Post-mortem examination identified PDLG and several neuropathological features of glioblastoma as well. Reviewing previous cases of PDLG instructs that this entity is rare, resembles meningitis in clinical pictures, usually occurs in a relatively younger population and has more progressive clinical course than the ordinary form of malignant gliomas.

Fatal Outcome↗
PubMed2006

Sleep-disordered breathing and blood pressure levels among shift and day workers.

BACKGROUND: Sleep-disordered breathing (SDB) can be one of the major determinants of high blood pressure (BP), but there has been no study on SDB with an emphasis on shift workers. The objective of this study was to examine whether a relationship between SDB and blood pressure/hypertension is more evident among shift workers than among day workers. METHODS: In this cross-sectional study, we measured BP levels and oxygen desaturation index (by nocturnal pulse oximetry) among 253 male shift workers and 206 male day workers aged 30 to 62 years at nuclear power plants in Japan. RESULTS: The prevalence of SDB (3% oxygen desaturation index >or=10 and >or=15 per hour) in all subjects was 11.3% (95% confidence interval [95% CI] 8.4-14.2) and 6.1% (95% CI 3.9-8.3), respectively, with no statistical difference between shift and day workers. Systolic and diastolic BP levels were correlated with 3% oxygen desaturation index in all subjects after adjustment for potential confounding variables. This association was primarily observed among workers aged >or=40 years, more specifically older shift workers. CONCLUSIONS: A correlation between SDB severity and diastolic BP levels among shift workers aged >or=40 years suggests the importance of screening for SDB among shift workers for BP control.

Adult↗
PubMed2006

The relationship between sleep-disordered breathing and high-sensitivity C-reactive protein in Japanese men.

STUDY OBJECTIVES: Elevated C-reactive protein (CRP), an inflammatory marker and emerging risk factor for atherosclerosis and coronary heart disease, has been reported in overweight patients with sleep-disordered breathing (SDB). However, the contribution of C-reactive protein to this disease among non-overweight individuals is uncertain. We thus examined the relationship between serum C-reactive protein levels and nocturnal arterial oxygen desaturation, stratified by category of body mass index (BMI). DESIGN: Cross-sectional study. PARTICIPANTS: Subjects were 316 men with a mean BMI of 25.4 kg/m2, aged 20-79 years, who attended a sleep clinic at Osaka, Japan. MEASUREMENTS AND RESULTS: SDB was assessed by oxygen desaturation index (ODI) measured by pulse oximetry during sleep. We used 3% oxygen desaturations per hour (3% ODI), as the indicator of SDB. We also measured serum levels of C-reactive protein (CRP). After adjustment for age, BMI, hypertension, diabetes mellitus, hypercholesterolemia, smoking status, alcohol consumption, and daily sleep duration, mean high-sensitivity CRP levels were 0.63, 0.65, and 0.96 mg/L for SDB severity levels of 3%ODI<5, 5 to 19.9, and >=20, respectively (p for trend=0.015). This association with SDB tended to be stronger in non-overweight men (BMI<25 kg/m2) (0.47, 0.48 and 1.02 mg/L, p for trend=0.017) than in overweight men (BMI > or = 25 kg/m2) (0.92, 0.87 and 1.21 mg/L, p for trend=0.11). CONCLUSION: SDB is associated with increased levels of CRP, especially in non-overweight men. Our results suggest the importance of follow-up and control of SDB in the prevention of cardiovascular disease even in non-overweight SDB patients.

Adult↗
PubMed2005

Hypersomnolence and increased REM sleep with low cerebrospinal fluid hypocretin level in a patient after removal of craniopharyngioma.

Here we report a hypersomnolent girl with extensive hypothalamic damage after removal of a craniopharyngioma. The presence of a short sleep latency, sleep onset REM periods during a multiple sleep latency test (MSLT) and negative HLA DQB1*0602 typing suggested a diagnosis of symptomatic narcolepsy. Low cerebrospinal fluid hypocretin-1 level indicated destruction of hypocretin-producing neurons in the hypothalamus. An increased amount of REM sleep and a lack of REM sleep cyclicity documented by all-night polysomnography were different findings from previous reports of hypocretin-deficient idiopathic symptomatic narcolepsy. A more global hypothalamic lesion demonstrated by brain magnetic resonance imaging (MRI) after surgery seemed to cause marked disinhibition of REM sleep as well as hypersomnolence in this patient.

Child↗
PubMed2005

Shiftwork locus of control, situational and behavioural effects on sleepiness and fatigue in shiftworkers.

A number of situational and behavioural individual differences moderate the impact of shift and night work. The aims of this study were to identify individual differences correlates of sleep and fatigue-related shiftwork outcomes and examine their potential relative causal impact. Power company shiftworkers completed a questionnaire that measured age/experience, number of dependents, shiftwork locus of control, morningness-eveningness, workload and sleep/health-related behaviours. Shiftwork sleep and fatigue outcome variables were also measured. Hierarchical multiple regression was used to examine predictive contributions of the individual difference variables and to generate path coefficients from situational and psychological predictors through behavioural variables to the outcome variables. Shiftwork-specific internality showed the most systematic significant causal relationships with sleep and fatigue outcomes. While not having as strong a direct causal influence on sleep and fatigue outcomes as internality, the other predictors did show more significant causal effects upon sleep-related behaviours than did internality. Behavioural variables made little contribution to the total causal effects of the predictors on the outcome variables. The results suggest control beliefs to be a moderating factor in shiftwork exposure and the potential utility of this construct in aiding more effective targeting of interventions.

Adult↗
PubMed2005

Modifying effects of perceived adaptation to shift work on health, wellbeing, and alertness on the job among nuclear power plant operators.

This study examined the relationship between perceived adaptation to shift work and shift-related problems. A total of 608 male operators at nuclear power plants completed a set of validated questionnaires including a modified version of the Standard Shiftwork Index, which covered adaptation to shift work, fit to job content, chronotypes, chronic fatigue, sleep, naps, shift work locus of control (SHLOC), psychological health, social/family life, daytime sleepiness, workload, alertness on the job, and lifestyle factors. Participants were divided into two groups according to their perceived level of adaptation to shift work. The good adaptation group showed better outcomes than the poor adaptation group in terms of fit to job content, chronic fatigue, daytime sleep before night shifts, social and family disruption, SHLOC, psychological health, and alertness during night shifts (ps<0.001). Operators who reported good adaptation also took a more frequent, longer nap and more cigarettes during night shifts (ps<0.05). The cross-sectional study design cannot determine a causal relationship between perceived adaptation and shift work problems, yet the present results suggest that the effects of working shifts may be modified by perceptions of shift work adaptation.

Adaptation, Psychological↗
PubMed2005

Imbalance between the reality of sleep specialists and the demands of society in Japan.

In contrast to the fruitful achievements of sleep research, sleep medicine has never been properly defined and recognized in Japan. Therefore, it is difficult for any clinician to have a united view as to what constitutes a sleep specialist. The United States (US) has set up sleep medicine as a comprehensive clinical specialty connected with various medical, psychological, scientific and social fields, having sleep physiology that is methodologically represented by polysomnography as a common language. The US system around a core of sleep disorders centers and sleep specialists armed with a comprehensive knowledge of sleep and sleep disorders can not only diagnose and treat patients with sleep disorders, but are also sensitive to the various sleep-related problems at the work place such as circadian related safety issues and productivity. Daytime sleepiness is dangerous in some situations for the individual as well as society. Although this safety issue is an urgent demand in every workplace, sleep medicine has not matured nor established enough to respond to it in Japan. Together with advancement of sleep research, the sleep medicine community should do everything in its power to establish sleep medicine as a practical patient-based clinical field.

Humans↗
PubMed2004

Longitudinal change in REM sleep components in a patient with multiple system atrophy associated with REM sleep behavior disorder: paradoxical improvement of nocturnal behaviors in a progressive neurodegenerative disease.

A 60-year-old patient with multiple system atrophy (MSA) who presented with rapid eye movement (REM) sleep behavior disorder was investigated longitudinally by all-night polysomnography. REM sleep components, i.e. rapid eye movements and chin muscle activity, were analyzed together with the frequency of behaviors/movements on the videorecording. Decreased frequency of elaborate motor activity during REM sleep with time in this patient was compatible with the observation by his wife, and this change seemed to correlate with predominant tonic chin electromyogram with relatively suppressed phasic chin muscle activity, but the reduction of the REM sleep behavior disorder (RBD) episodes could be interpreted as being due to the increased rigidity along with MSA progression. The chronological change in REM sleep components in RBD with neurological disorders is worth studying in large follow-up series to enlarge our knowledge about the mechanism of behavioral manifestation of RBD in humans.

Brain Stem↗
PubMed2004

Relationships of craniofacial morphology and body mass index with sleep-disordered breathing in Japanese men.

OBJECTIVE/HYPOTHESIS: Obesity is an established risk factor for sleep-disordered breathing, but the impact of craniofacial morphology is uncertain. The aim of this study was to assess the impact of craniofacial morphology and body weight on sleep-disordered breathing in Japanese men. STUDY DESIGN: A cross-sectional study. METHODS: We measured body mass index, seven cephalometric variables, and 3% oxygen desaturation index recorded by a pulse oximeter in 313 Japanese men aged 20 to 65 years who attended a sleep clinic. We defined craniofacial score as the sums of quartile points (0-3) for distance from sella to nasion and that from hyoid bone to mandibular plane. RESULTS: The mean value of 3% oxygen desaturation index and odds ratios of 3% oxygen desaturation index 15 or greater progressively increased with craniofacial score as well as body mass index. Multivariate odds ratios associated with craniofacial score were higher in men with body mass index 25.0 kg/m or greater (odds ratio = 4.2, 95% confidence interval [CI] = 2.1-8.6) than in men with lower body mass index (odds ratio = 1.6, 95% CI = 0.7-3.6). CONCLUSIONS: Our results imply the importance of cephalometric assessment in overweight patients.

Adult↗
PubMed2004

Sleep characteristics of menopausal insomnia: a polysomnographic study.

Although menopausal insomnia is of clinical significance, the essential features of this form of disrupted sleep are poorly understood. The aim of the present study was to identify the sleep characteristics of menopausal insomnia by using overnight polysomnography (PSG). Twenty-one subjects with menopausal insomnia (MI) and 13 sex- and age-matched normal control (NC) subjects without sleep complaints took part in the present study. All MI and NC subjects underwent PSG on two consecutive nights. In comparison with NC, MI subjects had non-specific findings such as significantly shorter total sleep time, longer sleep latency, higher wake time after sleep onset, and lower sleep efficiency. As for rapid eye movement (REM) sleep variables, MI subjects had significantly shorter total REM sleep time, fewer numbers of REM sleep periods, longer REM latency, and higher REM density than did the NC subjects. As for the time course of REM density, REM density during the first 3 h period of nocturnal sleep was significantly higher for MI than for NC subjects. Unlike NC subjects, REM density for MI subjects did not tend to rise progressively during nocturnal sleep. The MI subjects had objective evidence of disrupted sleep and the most striking characteristics of this dysfunction were observed in REM sleep variables. The sleep characteristics of MI subjects were found to differ in REM sleep variables from those of patients with major depression (except for REM density). Menopausal insomnia patients appear to be similar to patients with generalized anxiety disorder accompanied by severe sleep disruption. These data lend support to the clinical distinction between menopausal insomnia and insomnia associated with major psychiatric disorders.

Adult↗
PubMed2004

Relationship between sleep-disordered breathing and blood pressure levels in community-based samples of Japanese men.

To examine the relationship between sleep-disordered breathing (SDB) and blood pressure levels among Japanese men, we conducted a population-based cross-sectional study of 1,424 men aged 40-69 years in rural and urban communities. The 3% oxygen desaturation index (ODI) was selected as the indicator of SDB, representing the number of desaturation events per hour of recording time in which blood oxygen fell by > or = 3% according to overnight pulse oximetry. To estimate the associations of 3% ODI levels with blood pressure levels and hypertension, multiple linear regression and logistic regression analyses were performed. The 3% ODI level was positively associated with systolic and diastolic blood pressure levels (SBP/DBP); a 5 event per hour increment of the 3% ODI level was associated with 0.8 mmHg (95% confidence interval [CI], 0.0-1.6) greater SBP and 0.7 mmHg (95% CI, 0.3-1.1) greater DBP after adjustment for age, body mass index, ethanol intake, smoking category and community. The multivariate odds ratio of hypertension for the low vs. high category of 3% ODI level was 1.63 (95% CI, 1.1-2.5). These associations were more evident among overweight than non-overweight individuals. The significant association of nocturnal oxygen desaturation with high blood pressure levels suggests that SDB plays a role in the development of hypertension among Japanese men.

Adult↗
PubMed2004

[Clinical availability of the herbal medicine, SYOUSAIKOTOU, as a gargling agent for prevention and treatment of chemotherapy-induced stomatitis].

The stomatitis accompanying chemotherapy reduces a patient's QOL. Many reports have suggested that some kinds of gargling agents for oral mucositis shorten the duration and severity of symptoms. This study tested the prevention and efficacy against stomatitis of a herbal medicine (Syousaikotou) as a gargling agent for patients receiving chemotherapy. Compared to gargling with providone-iodine and amphotericin B, the Syousaikotou gargle showed a significantly decreased incidence of stomatitis, and a painkilling effect. Stomatitis occurred in about 17.4% among 23 chemotherapy cycles with the Syousaikotou gargle, against about 40.8% among 71 chemotherapy cycles without the Syousaikotou gargle. Among the patients suffering stomatitis pain after 22 chemotherapy cycles, the painkilling effect was seen to be 76.2%, and continues for about 2 hours. Critical side effects were not seen, but in 4 cases there were complaints about foul smells, such as oil and grass smells. Syousaikotou gargle was considered to be one of the useful methods against the stomatitis prevention and sharp pain mitigation from the chemotherapy.

Adult↗
PubMed2002

Rhythmic movement disorder: polysomnographic study and summary of reported cases.

Rhythmic movement disorder (RMD) is classified as a sleep-wake transition disorder. However, some RMD patients show rhythmic movements during rapid-eye-movement (REM) sleep, during which muscle activity is completely absent. In order to determine the sleep stages in which episodes of RMD occur, we investigated two children with RMD by means of polysomnography, and also summarized the polysomnographic reports on patients with RMD. We also quantified the REM sleep atonia in our patients using the tonic and phasic inhibition indices (TII and PII). In addition, to examine the involvement of the basal ganglia in RMD patients, we studied the frequency of gross movements (GMs) during sleep in each sleep stage. Both patients showed rhythmic movements in all sleep stages, i.e. including REM sleep. Few rhythmic movements occurred during sleep-wake transition periods. Both patients showed normal TII and PII scores as well as a normal pattern for the sleep stage-dependent modulation of GMs during sleep. Eighteen of the 33 reported RMD patients, including ours, experienced episodes during REM sleep, while the other 15 patients had no episodes during REM sleep. Among the 18 patients who had episodes during REM sleep, eight experienced the episodes exclusively during REM sleep. It is unlikely that the neuronal mechanisms that underlie RMD episodes were the same in the 15 patients who had no RMD episodes during REM sleep and the eight who had them only during REM sleep. We propose that RMD can be divided into several subgroups according to the differences in the underlying neuronal mechanisms.

Adolescent↗
PubMed2002

Eye movements in REM sleep could be controlled by the same conjugate system while awake.

We describe the impairment of eye movements during REM sleep in a patient with internuclear ophthalmoplegia. A 75-year-old woman, complaining of acute unsteady gait and diplopia, was diagnosed to have right medial longitudinal fasciculus (MLF) syndrome with limited adduction of the right eye. Overnight polysomnography revealed the same impairment of right adductive ocular movement during REM sleep. Our findings suggest that the MLF mediates lateral conjugation of eye movements during REM sleep as well as voluntary lateral conjugate eye movements during wakefulness.

Journal Article↗