Effect of pregabalin on sleep structure of rats with temporal lobe epilepsy / 中华行为医学与脑科学杂志

Objective:To explore the effect of pregabalin on sleep structure in rats with temporal lobe epilepsy induced by pilocarpine.Methods:Twelve adult SD rats (half male and half female) were injected intraperitoneally with pilocarpine to establish a chronic temporal lobe epilepsy model.According to the principle of gender matching, they were divided into model group and pregabalin group, with 6 rats in each group(half male and half female). Another 6 SD rats (half male and half female) were taken as the control group.The skull electrodes were placed in the brain areas of rats to monitor the cerebral electrical activity, then recorded the data after resting for 1 week.Rats in pregabalin group were intraperitoneally injected with 50 mg/kg pregabalin while the rats in model group and control group were intraperitoneally injected with equal volume of normal saline.Fifteen minutes later, video electroencephalogram(EEG) and electromyogram(EMG) of rats in each group were recorded.The recording time was from 10∶00 to 17∶00 for 2 consecutive days.The seizure frequency, EEG and EMG were obtained.SPSS 25.0 was used for data analysis, one-way ANOVA was used for multi group comparison, and Tukey test and Games-Howell test were used for further pairwise comparison.Results:(1)The frequency of seizures in the pregabalin group (0.0(0.0, 1.0)times) were significantly lower than that in the model group(2.5(1.0, 4.8)times)( Z=-3.0, P<0.05). (2)During the 7 h recording period, the analyzed data showed that there were significant differences in the sleep-wake transition frequency, slow-wave sleep(SWS) phase duration, rapid eye movement (REM) sleep phase duration, total SWS time, total REM time and total sleep time among the three groups( F=10.5, 4.1, 13.0, 7.8, 4.4, 9.3, all P<0.05). The frequency of sleep-wake transitions in the pregabalin group ((66.3±18.0) times) and the control group ((87.8±14.1) times) were less than that in the model group ((106.7±20.8) times) (both P<0.05). The duration of SWS phase ((11.2±4.0) min) in pregabalin group was significantly longer than that in model group ((5.9±1.8) min) ( P<0.05), while that in model group was shorter than that in control group ((7.7±1.2) min) ( P<0.05). The duration of REM phase in the model group ((1.9±0.4) min) was shorter than that in the control group ((2.5±0.4) min) ( P<0.05). There was no significant difference in the duration of REM phase between the pregabalin group and the model group ( P>0.05). Within 7 h of observation, the total SWS time ((296.5±37.1) min) and total sleep time ((338.4±33.3) min) in pregabalin group were longer than those in model group ((258.1±38.4) min, (288.9±41.0) min) (both P<0.05). The total REM time ((30.4±11.1) min) and total sleep time ((288.9±41.0) min) in the model group were significantly shorter than those in the control group ((50.2±8.5) min, (339.0±19.6) min) (both P<0.05). Conclusion:Pregabalin alone can reduce seizures and change the sleep structure disorder caused by epilepsy, which is mainly manifested in reducing the number of sleep-wake transitions, prolonging the duration of SWS, increasing sleep duration, increasing SWS and total sleep time and improving sleep quality.

Evaluation of sleep slow wave activity in children′s neurocognitive development / 中华实用儿科临床杂志

Childhood is an important period of the development of attention, memory, intelligence and other neurocognitive functions in life.A normal neurocognitive development can have a positive impact on children′s long-term learning and life.Therefore, it is very important to concern the development process of neurocognition in children, which is challenging to be objectively assessed without an accurate and efficient index.Sleep slow wave activity, as a kind of electroencephalogram measurement index, is of great significance to the evaluation of brain structure and function in children, and it is also a high-quality index to evaluate children′s neurocognitive development.This study mainly reviews the evaluation of sleep slow wave activity in children′s neurocognitive development, aiming to provide refe-rence for exploring the normal and abnormal process of children′s neurocognitive development.

Alteraciones en el sueño por el consumo de cannabis / Sleep disturbances from the use of cannabis

RESUMEN Esta es una revisión de algunos ensayos clínicos realizados acerca de las repercusiones en la estructura, arquitectura y percepción del sueño en los consumidores de cannabis. Para la búsqueda bibliográfica se consultó bases de datos, con especial énfasis en revisiones sistemáticas, metaanálisis, estudios de cohortes, ensayos controlados aleatorios y estudios de casos y controles. Las palabras claves incluyeron términos que describen el uso del cannabis combinado con otros que se refieren al sueño o anormalidades del sueño (por ejemplo: sueño, insomnio, polisomnografía, tiempo total de sueño, latencia del sueño, sueño de onda lenta, sueño de movimiento ocular rápido y su latencia). Se extrajeron datos relevantes de cada uno de los artículos consultados. Se resumió la literatura disponible sobre mediciones subjetivas y objetivas, correlaciones clínicas y paraclínicas, diferencias entre el consumo agudo, crónico y la abstinencia, y otros puntos de discusión. Se realizaron varias correlaciones moleculares y anatómicas que explican los cambios en el sueño desde el punto de vista del sistema nervioso central. Finalmente, los resultados demuestran una disminución de la latencia del sueño con el uso agudo a dosis bajas, además menor tiempo de vigilia luego del inicio del sueño, aumento del sueño de ondas lentas y disminución del sueño de movimientos oculares rápidos; estos efectos no permanecen con el uso crónico, ya que posteriormente se presenta una peor calidad del sueño; el escenario también varía con la abstinencia, puede presentarse insomnio, disminución del tiempo total del sueño de onda lenta y del sueño total.

ABSTRACT This is a review of some clinical trials conducted on the impact on sleep structure, architecture and perception in cannabis users. For the literature search, consult database queries with special emphasis on systematic reviews, meta-analyzes, cohort studies, randomized controlled trials, and case-control studies. Keywords include terms that describe cannabis use combined with others that specify sleep or sleep abnormalities (for example: sleep, insomnia, polysomnography, total sleep time, sleep latency, slow wave sleep, motion sleep fast eyepiece and its latency). Relevant data was extracted in each of the articles consulted. The available literature is summarized on: subjective and objective measurements, clinical and paraclinical correlations, differences between acute and chronic consumption and abstinence, and other points of discussion. Tese are various molecular and anatomical correlations that explain changes in sleep from the point of view of the central nervous system. Finally, results frequently decrease sleep latency with acute use at low doses, plus shorter waking time after sleep onset, increased slow wave sleep and decreased rapid eye movement sleep, these effects do not persist with chronic use since later there is a worse quality of sleep; The setting also changes with abstinence where insomnia may occur, decreased total time for slow wave sleep and total sleep.

Features of quantitative EEG in patients with amyotrophic lateral sclerosis and their relationship with cognitive impairment / 西安交通大学学报(医学版)

Objective: To investigate the characteristics of quantitative electroencephalogram (EEG) in patients with amyotrophic lateral sclerosis (ALS) and their relationship with cognitive impairment. Methods: We recruited 38 patients with ALS and 26 healthy controls. All the patients underwent quantitative EEG examination to obtain the relative power of each frequency band and calculate the slow wave ratio (δ+θ)/(α+β) as comparison indexes. Among them, 27 patients with ALS underwent the ECAS scale examination to assess their cognitive function. At the same time, 25 healthy controls underwent the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) to determine the cut-off of scale score. We compared the slow wave ratio in ALS patients with and without cognitive impairment according to the cut-off score. Results: The relative powers of δ and θ bands and slow wave ratios of quantitative EEG in ALS patients were significantly higher than those in healthy controls, and there was no significant difference in relative powers of α and β bands. In the comparison of slow wave ratios in different brain regions, the proportion of slow waves in the bilateral temporal-occipital regions and the right parietal areas was significantly higher than that in healthy controls. The slow wave ratio in the left temporal area was positively correlated with the course of ALS (correlation coefficient 0.405, P=0.05). The ECAS scale screening revealed that 33.3% of ALS patients had cognitive impairment. ALS patients with cognitive impairment had higher slow wave ratios in the frontal and temporal areas than patients without cognitive impairment. The ALS specific item score, ALS non-specific item score and the total score of ECAS were all negatively correlated with the slow wave ratios in the frontal and temporal areas. Conclusion: The changes of EEG activity in patients with ALS are mainly the increase of slow wave activity, which is significant in the temporal, parietal and occipital areas. The slow wave ratios in frontal and temporal areas of ALS patients are correlated with cognitive impairment.

Sleep in the crustacean crayfish

Sleep is defined as a state of unconsciousness, reduced locomotive activity and rapid awakening, and is well established in mammals, birds, reptiles and teleosts. Commonly, it is also defined with electrical records (electroencephalogram), which are only well established in mammals and to some extent in birds. However, sleep states similar to those of mammals, except for electrical criteria, appear to occur in some invertebrates. Currently, the most compelling evidence of sleep in invertebrates has been obtained in the crayfish. In mammals, sleep is characterized by a brain state that is different from that of wakefulness, which includes a change to slow waves that has not been observed in insects. Herein, we show that the crayfish enters a brain state with a high threshold to vibratory stimuli, accompanied by a form of slow wave activity in the brain, quite different from that of wakefulness. Therefore, the crayfish can enter a state of sleep that is comparable to that of mammals.

Does Rapid Eye Movement Sleep Aggravate Obstructive Sleep Apnea?

OBJECTIVES.: To investigate the apnea-hypopnea index (AHI) according to the sleep stage in more detail after control of posture. METHODS.: Patients who underwent nocturnal polysomnography between December 2007 and July 2018 were retrospectively evaluated. Inclusion criteria were as follows: age >18 years, sleep efficacy >80%, and patients who underwent polysomnography only in the supine position (100% of the time). Patients were classified into different groups according to the methods: the first, rapid eye movement (REM)-dominant group (AHIREM/AHINREM >2), non-rapid eye movement (NREM)-dominant group (AHINREM/AHIREM >2), and non-dominant group; and the second, light sleep group (AHIN1N2>AHISWS) and slow wave sleep (SWS) group (AHISWS>AHIN1N2). RESULTS.: A total of 234 patients (mean age, 47.4±13.9 years) were included in the study. There were 108 patients (46.2%) in the REM-dominant group, 88 (37.6%) in the non-dominant group, and 38 (16.2%) in the NREM-dominant group. The AHI was significantly higher in the NREM-dominant group than in the REM-dominant group (32.9±22.9 events/hr vs. 18.3±9.5 events/hr, respectively). There were improvements in the AHI from stage 1 to SWS in NREM sleep with the highest level in REM sleep. A higher AHISWS than AHIN1N2 was found in 16 of 234 patients (6.8%); however, there were no significant predictors of these unexpected results except AHI. CONCLUSION.: Our results demonstrated the highest AHI during REM sleep stage in total participants after control of posture. However, there were 16.2% of patients showed NREM-dominant pattern (AHINREM/AHIREM >2) and 6.8% of patients showed higher AHISWS than AHIN1N2. Therefore, each group might have a different pathophysiology of obstructive sleep apnea (OSA), and we need to consider this point when we treat the patients with OSA.

Effect of long-term deep slow-wave sleep deprivation on the reproductive system in male rats / 中华劳动卫生职业病杂志

Objective@#To investigate the effect of long-term deep slow-wave sleep deprivation on the gonad axis, sperm abnormality rate, and structure of the testis in male rats and possible mechanisms.@*Methods@#A total of 30 specific pathogen-free male Wistar rats aged 5 weeks were randomly divided into slow-wave sleep deprivation group 1 (SD1 group) , slow-wave sleep and sleep time deprivation group 2 (SD2 group) , and control group, with 10 rats in each group. The flower pot method was used to establish a model of sleep deprivation. In addition to 12-hour sleep deprivation at night, the rats in the SD1 group were given interference once every 24 minutes, and those in the SD2 group were deprived of sleep for 8 minutes every 24 minutes; the rats in the control group were given 12-hour light illumination and then placed in dark environment for 12 hours. All rats were sacrificed by exsanguination from the femoral artery, and the testis, the epididymis, and blood were collected for analysis. Sperm abnormality rate and sperm motility rate were measured, and cauda epididymal sperm counting was performed. ELISA was used to measure the serum levels of testosterone (T) , follicle-stimulating hormone (FSH) , and luteinizing hormone (LH) .@*Results@#Compared with the control group, the SD2 group had a significant increase in organ coefficient of the epididymis (P<0.05) and a significant reduction in sperm motility rate (P<0.05) . There were significant differences between the SD1 group and the SD2 group in the increase in sperm abnormality rate (P<0.05) and the reduction in cauda epididymal sperm count (P<0.05) . The levels of FSH and T tended to increase, and the level of LH tended to decrease. Pathological examination showed degeneration and vacuolization of a small amount of spermatogenic cells in the SD1 group; in the SD2 group, there were significant degeneration, edema, and vacuolization of most spermatogenic cells, some spermatogenic cells were observed in the lumen, and there were no sperms in the lumen.@*Conclusion@#Long-term deep slow-wave sleep deprivation impairs the structure of the testis, affects sperm motility rate and sex hormones, and increases the risk of sperm abnormality.

A Critical Time-Window for the Selective Induction of Hippocampal Memory Consolidation by a Brief Episode of Slow-Wave Sleep / 神经科学通报·英文版

Although extensively studied, the exact role of sleep in learning and memory is still not very clear. Sleep deprivation has been most frequently used to explore the effects of sleep on learning and memory, but the results from such studies are inevitably complicated by concurrent stress and distress. Furthermore, it is not clear whether there is a strict time-window between sleep and memory consolidation. In the present study we were able to induce time-locked slow-wave sleep (SWS) in mice by optogenetically stimulating GABAergic neurons in the parafacial zone (PZ), providing a direct approach to analyze the influences of SWS on learning and memory with precise time-windows. We found that SWS induced by light for 30 min immediately or 15 min after the training phase of the object-in-place task significantly prolonged the memory from 30 min to 6 h. However, induction of SWS 30 min after the training phase did not improve memory, suggesting a critical time-window between the induction of a brief episode of SWS and learning for memory consolidation. Application of a gentle touch to the mice during light stimulation to prevent SWS induction also failed to improve memory, indicating the specific role of SWS, but not the activation of PZ GABAergic neurons itself, in memory consolidation. Similar influences of light-induced SWS on memory consolidation also occurred for Y-maze spatial memory and contextual fear memory, but not for cued fear memory. SWS induction immediately before the test phase had no effect on memory performance, indicating that SWS does not affect memory retrieval. Thus, by induction of a brief-episode SWS we have revealed a critical time window for the consolidation of hippocampus-dependent memory.

Preliminary study on high resolution mapping in human gastric electrical activities / 中华消化杂志

Objective To investigate the spatio-temporal characteristics of normal gastric electrical activity.Methods From January 1st to February 29th,2016,fasting gastric electric slow wave signal was collected by high resolution mapping (HRM) under anesthesia before operation in patients without gastric lesions but needed laparoscopic surgery.Parameters of slow wave signal activity was calculated,gastric activity map and velocities was drawn and then spatio-temporal characteristics of gastric electrical activity of different part of the stomach were obtained.Independent sample t test was performed for comparison of two groups and one-way analysis of variance was used for multiple group comparisons.Results The normal gastric pacing zone located in the upper middle part of gastric body near greater curvature.Electrical activity of gastric body spread to gastric antrum along the long axis of the stomach.No slow signal was recorded in the gastric fundus and the gastric cardia.The frequencies of slow waves of different parts of gastric was same and the mean value was 2.61 ±0.11 cycle per minute.Compared with that of gastric body,the slow wave amplitude of gastric pacing zone was higher ((4.19±0.73) mV vs (1.67± 0.89) mV) and the speed was faster (7.24± 1.37) mm/s vs (4.94± 0.20) mm/s);the differences were statistically significant (t=18.89 and 4.95,both P＜0.01).The slow wave amplitude of gastric antrum was higher than that of gastric body ((3.21±0.49) mV vs (1.67±0.89) mV) and the speed was also faster ((6.44±0.82) mm/s vs (4.94±0.20) mm/s);the differences were statistically significant (t=4.85 and 4.95,both P＜0.05).The slow wave amplitude of gastric antrum was lower than that of pacemaker area ((3.21±0.49) mV vs (4.19±0.73) mV),and the difference was statistically significant (t =-3.67,P＜0.05);however,there was no significant difference in wave velocity ((6.44±0.82) mm/s vs (7.24±1.37) mm/s,P＞0.05).Conclusions The normal human gastric pacemaker is located in mid and upper corpus near the greater curvature,which produces slow wave and control whole gastric electrical activity.The amplitude and velocity of slow waves are in gradient changes in different gastric regions.HRM is a mature and reliable research method to study the spatio-temporal characteristics of gastric electrical activity,which provides the possibility for the study of abnormal gastric electrical activity.

Preliminary study on high resolution mapping in human gastric electrical activities / 中华消化杂志

Objective To investigate the spatio-temporal characteristics of normal gastric electrical activity.Methods From January 1st to February 29th,2016,fasting gastric electric slow wave signal was collected by high resolution mapping (HRM) under anesthesia before operation in patients without gastric lesions but needed laparoscopic surgery.Parameters of slow wave signal activity was calculated,gastric activity map and velocities was drawn and then spatio-temporal characteristics of gastric electrical activity of different part of the stomach were obtained.Independent sample t test was performed for comparison of two groups and one-way analysis of variance was used for multiple group comparisons.Results The normal gastric pacing zone located in the upper middle part of gastric body near greater curvature.Electrical activity of gastric body spread to gastric antrum along the long axis of the stomach.No slow signal was recorded in the gastric fundus and the gastric cardia.The frequencies of slow waves of different parts of gastric was same and the mean value was 2.61 ±0.11 cycle per minute.Compared with that of gastric body,the slow wave amplitude of gastric pacing zone was higher ((4.19±0.73) mV vs (1.67± 0.89) mV) and the speed was faster (7.24± 1.37) mm/s vs (4.94± 0.20) mm/s);the differences were statistically significant (t=18.89 and 4.95,both P＜0.01).The slow wave amplitude of gastric antrum was higher than that of gastric body ((3.21±0.49) mV vs (1.67±0.89) mV) and the speed was also faster ((6.44±0.82) mm/s vs (4.94±0.20) mm/s);the differences were statistically significant (t=4.85 and 4.95,both P＜0.05).The slow wave amplitude of gastric antrum was lower than that of pacemaker area ((3.21±0.49) mV vs (4.19±0.73) mV),and the difference was statistically significant (t =-3.67,P＜0.05);however,there was no significant difference in wave velocity ((6.44±0.82) mm/s vs (7.24±1.37) mm/s,P＞0.05).Conclusions The normal human gastric pacemaker is located in mid and upper corpus near the greater curvature,which produces slow wave and control whole gastric electrical activity.The amplitude and velocity of slow waves are in gradient changes in different gastric regions.HRM is a mature and reliable research method to study the spatio-temporal characteristics of gastric electrical activity,which provides the possibility for the study of abnormal gastric electrical activity.

Sleep architecture in drug naive patients with schizophrenia: A meta-analysis / 中国心理卫生杂志

Objective:To assess the characteristics change of sleep architecture in drug naive patients with schizophrenia,compared with healthy control.Methods:The key words including schizophrenia and sleep architecture (or sleep structure or sleep disturbance or polysomnogram and so on) were used to search literatures in MEDLINE,Embase,Springer,PsychINFO,google scholar,Wanfang data,published from 1980 to 2015.Fifteen studies that compared sleep architecture in drug naive patients with schizophrenia and healthy control were included.Literature quality evaluation was performed with the Newcastle-Ottawa Scale.The meta-analysis was performed by using Stata13.0 software.Results:Compared to healthy control,the total sleep time decreased (P ＜ 0.01),the sleep latency increased (P ＜ 0.01),the sleep efficiency decreased (P ＜ 0.01),and the rapid-eye-movemem (REM) sleep latency increased (P ＜ 0.01) significantly in drug naive patients with schizophrenia.The proportion of stage1 was increased,and the proportions of stage4 and slow wave sleep stage were decreased,the differences between case and control were statistically significant.Conclusion:In the control of drug effects,patients with schizophrenia may have poorer sleep quality of be poorer than healthy controls,such as the decreased total sleep time,specifically slow wave sleep,prolonged sleep latency and decreased sleep efficiency.

The Video-electroencephalography Analysis of 120 Healthy Elderly / 中国医科大学学报

Objective To investigate the Video?Electroencephalography(VEEG)characteristics and abnormal rate among healthy elderly. Meth?ods According to the age,120 healthy elders were divided into groups A,B,and C. Group A has 57 subjects,aged 60?69 years old;group B has 42 people,aged 70?79 years;group C has 21 individuals,aged≥80 years. Chi square and Rank sum test were used to calculate abnormal rate of VEEG. Additionally,characteristics of alpha、slow wave and Iconic sleep wave were analyzed. Result The total abnormal rate of VEEG was 42.5%, and it was particularly high(76.2%)among elderly over 80s. Frequency,amplitude,reactivity of Alpha wave and alpha index decreased as age in?creased. Theta slow wave increased as age increased,abnormal frontal area theta showed an increase among elderly over 80 s. Each sleep cycle iconic sleep wave was gradually decreased in the elderly. No statistical difference was found about sleep spindles and vertex sharp among different groups . Positive occipital sharp transients of sleep(POSTS)decreased as age increased. There was no POSTS among elderly over 80 s. Conclusion Our re?sults showed that abnormal rate is increased in the elderly,while reactivity variation,slow alpha frequency,alpha amplitude,alpha index are de?creased. In addition,the slow waves in frontal area is increased,. sleep cycles becomes less distinct,and the typical wave are decreased.

Electrophysiological and Mechanical Characteristics in Human Ileal Motility: Recordings of Slow Waves Conductions and Contractions, In vitro

Little human tissue data are available for slow waves and migrating motor complexes, which are the main components of small bowel motility. We investigated the electrophysiological and mechanical characteristics of human ileal motility, in vitro. Ileum was obtained from patients undergoing bowel resection. Electrophysiological microelectrode recordings for membrane potential changes and mechanical tension recordings for contraction from smooth muscle strips and ileal segments were performed. Drugs affecting the enteric nervous system were applied to measure the changes in activity. Slow waves were detected with a frequency of 9~10/min. There were no cross-sectional differences in resting membrane potential (RMP), amplitude or frequency between outer and inner circular muscle (CM), suggesting that electrical activities could be effectively transmitted from outer to inner CM. The presence of the interstitial cell of Cajal (ICC) at the linia septa was verified by immunohistochemistry. Contractions of strips and segments occurred at a frequency of 3~4/min and 1~2/min, respectively. The frequency, amplitude and area under the curve were similar between CM and LM. In segments, contractions of CM were associated with LM, but propagation varied with antegrade and retrograde directions. Atropine, NW-oxide-L-arginine, and sodium nitroprusside exhibited different effects on RMP and contractions. There were no cross-sectional differences with regard to the characteristics of slow waves in CM. The frequency of contractions in smooth muscle strips and ileal segments was lower than slow waves. The directions of propagation were diverse, indicating both mixing and transport functions of the ileum.

Regulation of Gastric Electrical and Mechanical Activity by Cholinesterases in Mice

BACKGROUND/AIMS: Gastric peristalsis begins in the orad corpus and propagates to the pylorus. Directionality of peristalsis depends upon orderly generation and propagation of electrical slow waves and a frequency gradient between proximal and distal pacemakers. We sought to understand how chronotropic agonists affect coupling between corpus and antrum. METHODS: Electrophysiological and imaging techniques were used to investigate regulation of gastric slow wave frequency by muscarinic agonists in mice. We also investigated the expression and role of cholinesterases in regulating slow wave frequency and motor patterns in the stomach. RESULTS: Both acetycholinesterase (Ache) and butyrylcholine esterase (Bche) are expressed in gastric muscles and AChE is localized to varicose processes of motor neurons. Inhibition of AChE in the absence of stimulation increased slow wave frequency in corpus and throughout muscle strips containing corpus and antrum. CCh caused depolarization and increased slow wave frequency. Stimulation of cholinergic neurons increased slow wave frequency but did not cause depolarization. Neostigmine (1 muM) increased slow wave frequency, but uncoupling between corpus and antrum was not detected. Motility mapping of contractile activity in gastric muscles showed similar effects of enteric nerve stimulation on the frequency and propagation of slow waves, but neostigmine (> 1 muM) caused aberrant contractile frequency and propagation and ectopic pacemaking. CONCLUSIONS: Our data show that slow wave uncoupling is difficult to assess with electrical recording from a single or double sites and suggest that efficient metabolism of ACh released from motor neurons is an extremely important regulator of slow wave frequency and propagation and gastric motility patterns.

Comparative Study between Slow Shock Wave Lithotripsy and Fast Shock Wave Lithotripsy in the Management of Renal Stone.

Background: Renal calculi are frequent causes of ureteric colic. Extracorporeal shock wave lithotripsy is the most common treatment of these stones. It uses focused sound waves to break up stones externally. Objective: To compare the efficiency of slow and fast delivery rate of shock waves on stone fragmentation and treatment outcome in patients with renal calculi. Materials and Methods: This prospective study was done in the department of Urology, National Institute of Kidney diseases and Urology, Sher-e-Bangla Nagar, Dhaka from July 2006 to June 2007. Total 90 patients were treated using the Storz Medical Modulith ® SLX lithotripter. Patients were divided into Group A, Group B and Group C – each group having 30 subjects. Group A was selected for extracorporeal shockwave lithotripsy (ESWL) by 60 shock waves per minute, Group B by 90 shock waves per minute and Group C by 120 shock waves per minute. Results: Complete clearance of stone was observed in 24 patients in Group A and 13 patients in both Group B and Group C in first session. In Group A only 3 patients needed second session but in Group B and Group C, 12 and 8 patients needed second session. In Group A only one patient needed third session but third session was required for 3 patients in Group B and 5 patients in Group C for complete clearance of stone. In Group A, subsequent sessions were performed under spinal anesthesia and in Group B under sedation and analgesia (p>0.001). Mean number of sessions for full clearance of stones in group A was 1.37 ± 0.85, in Group B was 1.8 ± 0.887 and in Group C was 2.0 ± 1.083. Significant difference was observed in term of sessions among groups (p>0.05). In first follow-up, complete clearance of stones was seen in 24 patients in Group A and 13 in both Group B and Group C. In second follow-up, 3 patients in Group A, 12 in Group B and 8 in Group C showed complete clearance of stones. It was observed that rate of stone clearance was higher in Group A than in Group B and Group C. Multiple logistic regression analyses revealed that slow delivery rate (60 SW/min) as well as age (younger), symptom (painful) at onset, stone location (upper and middle calyx) and size (small) were independent prognostic factors determining stone clearance after ESWL of renal stone. Conclusion: Slow rate shock wave delivery improves efficacy of ESWL treatments of renal stone and decreased number of sessions, shock waves and treatment time.

Effects of Isoflurane Anesthesia on Post-Anesthetic Sleep-Wake Architectures in Rats

The sleep homeostatic response significantly affects the state of anesthesia. In addition, sleep recovery may occur during anesthesia, either via a natural sleep-like process to occur or via a direct restorative effect. Little is known about the effects of isoflurane anesthesia on sleep homeostasis. We investigated whether 1) isoflurane anesthesia could provide a sleep-like process, and 2) the depth of anesthesia could differently affect the post-anesthesia sleep response. Nine rats were treated for 2 hours with ad libitum sleep (Control), sleep deprivation (SD), and isoflurane anesthesia with delta-wave-predominant state (ISO-1) or burst suppression pattern-predominant state (ISO-2) with at least a 1-week interval. Electroencephalogram and electromyogram were recorded and sleep-wake architecture was evaluated for 4 hours after each treatment. In the post-treatment period, the duration of transition to slow-wave-sleep decreased but slow wave sleep (SWS) increased in the SD group, but no sleep stages were significantly changed in ISO-1 and ISO-2 groups compared to Control. Different levels of anesthesia did not significantly affect the post-anesthesia sleep responses, but the deep level of anesthesia significantly delayed the latency to sleep compared to Control. The present results indicate that a natural sleep-like process likely occurs during isoflurane anesthesia and that the post-anesthesia sleep response occurs irrespective to the level of anesthesia.

Electrophysiological Characteristics of Human Colon Circular Muscle

PURPOSE: Interstitial cells of Cajal (ICC) play a core function in colonic motility as a pacemaker by regulating the slow wave. We intended to investigate the electrophysiological characteristics of the circular smooth muscle in the human colon, especially in Koreans. METHODS: Colon tissues were obtained from patients undergoing an elective colectomy for non-obstructive lesions. Tissues were immediately stored in oxygenated Krebs-Ringer's bicarbonate solution, and conventional microelectrode recordings of the colonic circular muscle were done from muscle cells. RESULTS: The trans-membrane potentials from 100 tissues were recorded. Regular slow-wave patterns were observed in 36 patients, and 64 patients showed irregular wave patterns. In the tissues exhibiting regular slow-wave patterns, 20 tissues were recorded from the proximal colon and 16 from the distal colon. The frequency of the slow wave from the proximal part was significantly higher than that from the distal part. The resting membrane potential, the upstroke amplitude, the spike amplitude, and the maximal rate of rise showed no significant difference between the two parts, but the time to reach half amplitude did show a significant difference between the two parts. No significant differences in parameters were observed based on the patients' demographics such as sex and age (younger or older than 60). We were able to divide the irregular waves into 3 groups. Irregular slow waves were observed in 35 tissues, irregular slow waves mixed with spike waves were observed in 26 tissues, and spike waves alone were observed in 3 tissues. CONCLUSION: We analyzed the electrophysiological characteristics of the human colonic circular smooth muscle, especially those of the slow wave originating from ICC of patients who had not been pretreated with drugs.

Sleep, ageing and night work

Studies have shown that the frequency or worsening of sleep disorders tends to increase with age and that the ability to perform circadian adjustments tends to decrease in individuals who work the night shift. This condition can cause consequences such as excessive sleepiness, which are often a factor in accidents that occur at work. The present study investigated the effects of age on the daytime and nighttime sleep patterns using polysomnography (PSG) of long-haul bus drivers working fixed night or day shifts. A total of 124 drivers, free of sleep disorders and grouped according to age (<45 years, N = 85, and ≥45 years, N = 39) and PSG timing (daytime (D) PSG, N = 60; nighttime (N) PSG, N = 64) participated in the study. We observed a significant effect of bedtime (D vs N) and found that the length of daytime sleep was shorter [D: <45 years (336.10 ± 73.75 min) vs N: <45 years (398 ± 78.79 min) and D: ≥45 years (346.57 ± 43.17 min) vs N: ≥45 years (386.44 ± 52.92 min); P ≤ 0.05]. Daytime sleep was less efficient compared to nighttime sleep [D: <45 years (78.86 ± 13.30 percent) vs N: <45 years (86.45 ± 9.77 percent) and D: ≥45 years (79.89 ± 9.45 percent) and N: ≥45 years (83.13 ± 9.13 percent); P ≤ 0.05]. An effect of age was observed for rapid eye movement sleep [D: <45 years (18.05 ± 6.12 percent) vs D: ≥45 years (15.48 ± 7.11 percent) and N: <45 years (23.88 ± 6.75 percent) vs N: ≥45 years (20.77 ± 5.64 percent); P ≤ 0.05], which was greater in younger drivers. These findings are inconsistent with the notion that older night workers are more adversely affected than younger night workers by the challenge of attempting to rest during the day.

Effect of vincristine on the myoelectric activity and motility of the small intestine in rats / 中华消化杂志

Objective To investigate the effects of vincristine on myoelectric activity and motility of the small intestine in conscious rats and its mechanism. Methods Seventy-two SD rats were divided into six groups. The rats in control group were received 0.9% NaCl solution (n=18). The rats in group B were injected with vincristine and subdivided into 0.25 mg/kg(n=6) ,0.5 mg/kg(n=6)and 0.75 mg/kg groups. The group C and D was false operation (n=6)and false operation plus injection with 0.75 mg/kg of vincristine(n=6), respectively. The group E and F was subdiaphragmatic vagotomy plus 0.9% NaCl (n=6) or subdiaphragmatic vagotomy plus 0.75 mg/kg of vincristine (n=6), respectively. The myoelectric activity and motility of the small intestine were recorded. The frequency and area under the curve of slow wave, the periodicity of the migrating myoelectrie complex (MMC) and the duration of MMC Ⅲ were analyzed. The expressions of the myenteric neurons and interstitial cells of Cajal were evaluated by immunofluorescence stain. Results The myoelectric activity in 0.25mg/kg group was not different from the controls, but it changed in 0.5 mg/kg and 0.75 mg/kg groups which correlated with the time of vincristine injection. The irregular spike activity arose and accompanied with disruption of the MMC at (51±14.27) minutes,but recovered at (78.33±13.08) minutes. The periodicity was shorter in 0.5mg/kg [(343.17±142.93)s]and 0.75 mg/kg groups [(302.67±66.67)s] compared with controls [(740.22± 98.92) s, F=31.325, P<0.01]. Three days after vincristine administration, the area under the curve of slow wave decreased to (2.56±0.30) mV·s in 0.5 mg/kg group and (2.57±0.56) mV·s in 0.75 mg/kg group compared with the controls ((4.10±0.80) mV·s , F = 11.442, P<0.01). The intestinal propulsive rate was lower in 0.75 mg/kg group compared with the controls [(33.59±1.43) vs(60.34±2.41)%,t= 23.36, P<0.01]. The expression of the interstitial cells of Cajal was less than those in controls. Three days later, the area under the curve of slow wave in F group was less than that in controls. Conclusions Vincristine provokes alterations of myoelectric activity and motility of the small intestine. The early vincristine-induced escalating in myoelctric activity of the small intestine is through vagus nerve pathway. The decreased motility is contributed to the damage of the interstitial cells of Cajal.

Childhood Parasomnia / 수면정신생리

Parasomnias are characterized by undesirable physical events or experiences during sleep. They occur alone or combined with other parasomnias. Parasomnias in childhood are more common than those of adulthood. Most of them are mild, benign and self remitted. Careful history takings from the patients and their parents, videotaped recordings of the episodes are invaluable to diagnose parasomnias. Sometimes polysomnographic recordings are helpful to differentiate ambiguous conditions and to diagnose comorbid conditions. Even many parasomnias do not need treatment, some conditions need therapeutic interventions. Medication, cognitive behavioral treatment, biofeedback, and oral appliance are helpful to reduce frequency and complexity of certain kinds of parasomnias.