Relationships between the magnitude of representational momentum and the spatial and temporal anticipatory judgments of opponent's kicks in taekwondo

For successful actions in a fast, dynamic environment such as sports, a quick successful anticipation of a forthcoming environmental state is essential. However, the perceptual mechanisms involved in successful anticipation are not fully understood. This study examined the relationships between the magnitude of representational momentum (RM) as a forward displacement of the memory representation of the final position of a moving object (which implies that observers perceptually "see" a near future forthcoming dynamic environmental state) and the temporal and spatial anticipatory judgments of the opponent's high or middle kicks in taekwondo. Twenty-seven participants (university taekwondo club members and non-members) observed video clips of taekwondo kicks that vanished at one of 10 frame positions prior to the kick impact and performed three tasks consecutively: anticipatory coincidence timing (CT) with the arrival of kick impact, judgment of the kick type (high and middle kicks) by forced choice, and judgment of the vanishing frame position (measuring RM). Our results showed significant group effects for the number of correct kick-type judgments and the judgment threshold for kick-type choice (kick-typeJT), which was estimated in terms of individual psychometric function curves. A significant correlation was found between the magnitude of RM (estimated at kick-typeJT) and kick-typeJT, but not between the CT errors (estimated at kick-typeJT) and kick-typeJT. This indicates that the magnitude of RM may play an influential role in quick kick-type judgments, but not in coincidence timing while observing an opponent's kick motion. These findings suggest that subjective anticipatory perception or judgment of the future spatial state is vital to anticipatory actions under severe time constraints.

Developmental Changes in the Magnitude of Representational Momentum Among Nursery School Children: A Longitudinal Study

Representational momentum (RM) is a well-known phenomenon that occurs when a moving object vanishes suddenly and the memory of its final or vanishing position is displaced forward in the direction of its motion. Many studies have shown evidence of various perceptual and cognitive characteristics of RM in various daily aspects, sports, development, and aging. Here we examined the longitudinal developmental changes in the displacement magnitudes of RM among younger (5-year-old) and older (6-year-old) nursery school children for pointing and judging tasks. In our experiments, the children were asked to point at by their finger (pointing task) and judge the spatial location (judging task) of the vanishing point of a moving stimulus. Our results showed that the mean magnitudes of RM significantly decreased from 5- to 6-year-old children for the pointing and judging tasks, although the mean magnitude of RM was significantly greater in the 5-year-old children for the pointing task but not for the judging task. We further examined the developmental changes in RM for a wide range of ages based on data from the present study (5-year-old children) and our previous study (7- and 11-year-old children and 22-year-old adults). This ad hoc examination showed that the magnitude of RM was significantly greater in 5-year-old children than in adults for the pointing and judging tasks. Our findings suggest that the magnitude of RM was significantly greater in young children than in adults and significantly decreased in young children through adults for the pointing and judging tasks.

Exploring the Dimensions of Movement-Specific Reinvestment From Personal Characteristics Perspectives

The purposes of the present study were three-fold: to examine (a) if the movement-specific reinvestment responses should be represented as two dimensional constructs, (b) whether dichotomization of the movement-specific reinvestment responses are appropriate, and (c) how the two dimensions are associated with relevant psychological concepts. To conduct a comparative examination of the MSRS structure in two Asian samples, participants were 236 Japanese university students (136 men, 100 women; M_age = 18.0, SD = 1.6) and 328 Singaporeans (167 men, 161 women; M_age = 21.8, SD = 1.8). After examining the factor structure of the movement-specific reinvestment responses for the first purpose, latent class factor analysis was conducted for both samples for the second purpose. For the third purpose, correlation analysis and mediation analysis were conducted for a part of the Singaporean sample. Through a series of latent class factor analysis, four and three classes were identified for the Japanese and Singaporean samples, respectively. For both samples, the patterns of the item-average scores for the two movement-specific reinvestment dimensions were parallel among the classes. Conscious Motor Processing was positively associated with mental toughness, intrinsic regulation, integrated regulation, mastery-approach and task goal orientations, and dispositional flow, whereas Movement Self-Consciousness was positively related with stress and mastery-avoidance goal orientation. The findings of the study supported (a) the two-dimensional representation of the movement-specific reinvestment responses, but did not fully support (b) the practice of dichotomization of the movement-specific reinvestment responses, and indicated that (c) at the trait level, Conscious Motor Processing and Movement Self-Consciousness were associated with positive and negative psychological constructs, respectively.

Postural sway in the moving room scenario: New evidence for functional dissociation between self-motion perception and postural control

Postural control in quiet standing is often explained by a reflexive response to optical flow, the apparent motion of environmental objects in a visual scene. However, moving room experiments show that even small-amplitude body sway can evoke odd sensations or motion sickness, indicating that a consciousness factor may also be involved. Studies targeting perception of self-motion, vection, typically use rapid visual stimuli moving in a single direction to maintain a constant feeling of vection, and there are few studies of vection using low-speed sinusoidal visual stimuli similar to human pendular movement. In the present study we searched for changes in postural control during periods of vection during quiet standing. Participants (N = 19, age = 20.4 ±1.1 years) were shown dynamic visual stimuli in the form of sinusoidally expanding and contracting random dots, and the stimuli speed and visual field were manipulated. Posture was continually evaluated using Center of Pressure (CoP) measurements. Participants were also asked to report feelings of vection, both by pressing a button during the trial and through an overall rating at the end of each trial. Using repeated-measures ANOVA, we assessed changes in the CoP and vection variables between experimental conditions, as well as possible interactions between the variables. The results show that postural reaction and vection were both affected by the visual stimuli and varied with speed. The peripheral visual field was found to couple to stronger feeling of vection and better quality of postural control. However, no significant relationship between postural control and vection, nor evidence of vection interaction to the relationship between optical flow and postural control, was found. Based on our results we conclude that for postural stability during quiet standing, visual cues dominate over any potential consciousness factor arising due to vection.

Changes in self-estimated step-over ability among older adults: A 3-year follow-up study

OBJECTIVES

There is a growing body of literature examining age-related overestimation of one's own physical ability, which is a potential risk of falls in older adults, but it is unclear what leads them to overestimate. This study aimed to examine 3-year longitudinal changes in self-estimated step-over ability, along with one key risk factor: low frequency of going outdoors (FG), which is a measure of poor daily physical activity.

METHOD

This cohort study included 116 community-dwelling older adults who participated in baseline and 3-year follow-up assessments. The step-over test was used to measure both the self-estimated step-over bar height (EH) and the actual bar height (AH). Low FG was defined as going outdoors either every few days or less at baseline.

RESULTS

The number of participants who overestimated their step-over ability (EH>AH) significantly increased from 10.3% to 22.4% over the study period. AH was significantly lower at follow-up than at baseline in both participants with low and high FGs. Conversely, among participants with low FG, EH was significantly higher at follow-up than at baseline, resulting in increased self-estimation error toward overestimation. Regression model showed that low FG was independently associated with increased error in estimation (i.e., tendency to overestimate) at follow-up.

DISCUSSION

The present study indicated that self-overestimated physical ability in older adults is not only due to decreased physical ability but also due to increased self-estimation of one's ability as a function of low FG. Active lifestyle may be critical for maintaining accurate estimations of one's own physical ability.

The essential role of optical flow in the peripheral visual field for stable quiet standing: Evidence from the use of a head-mounted display

It has long been thought that vision is the most essential factor in maintaining stable quiet standing compared to other sources (i.e., vestibular and somatosensory inputs) of information. Specifically, several vision studies on postural control have shown evidence for the importance of the visual system, particularly peripheral vision rather than central vision, and optical flow. Nevertheless, to date, no study has manipulated both visual field and optical flow concurrently. In the present study, we experimentally manipulated both the visual field (the central and peripheral visual fields) and the occurrence of optical flow during quiet standing, examining the effects of the visual field and optical flow on postural sway measured in terms of the center of pressure (CoP). Stationary random dot stimuli were presented exclusively in either the central or peripheral visual field, while the occurrence of optical flow was manipulated using a desktop (DTD) or a head-mounted (HMD) display. The optical flow that occurred while using the DTD was a function of the postural sway during quiet standing, while for the HMD, no optical flow occurred even when the body/head swayed during quiet standing. Our results show that the extent of postural sway (e.g., CoP area) was smaller when visual stimuli were presented in the peripheral visual field than that in the central visual field; this was the case while using the DTD alone, with no effects of the peripheral vision on the extent of postural sway while using the HMD. It is therefore suggested that the optical flow occurring in the peripheral visual field is essential for stable quiet standing.

Older Adults with Fear of Falling Show Deficits in Motor Imagery of Gait

OBJECTIVE

Understanding of the underlying mechanisms of Fear of Falling (FoF) could help to expand potential treatments. Given the nature of motor performance, the decline in the planning stage of motor execution may be associated with an expression of FoF. The aim of this study was to assess the planning/prediction accuracy in motor execution in people with FoF using gait-related motor imagery (MI).

DESIGN

Cross-sectional case/control study.

SETTING

Three health centers in Japan.

PARTICIPANTS

Two hundred and eighty-three community-dwelling older adults were recruited and stratified by presence of FoF as FoF group (n=178) or non-FoF group (n=107).

MEASUREMENTS

Participants were tested for both imagery and execution tasks of a Timed Up and Go (TUG) test. The participants were first asked to imagine the trial (iTUG) and estimate the time it would take, and then perform the actual trial (aTUG). The difference between iTUG and aTUG (Δ TUG) was calculated.

RESULTS

The FoF group was significantly slower in aTUG, but iTUG duration was almost identical between the two groups, resulting in significant overestimation in the FoF group. The adjusted logistic regression analysis showed that increased Δ TUG (i.e., tendency to overestimate) was significantly associated with FoF (OR = 1.05; 95% CI = 1.02-1.10). Low frequency of going outdoors was also associated with FoF (OR 2.95; 95% CI: 1.16-7.44).

CONCLUSIONS

Older adults with FoF overestimate their TUG performance, reflecting impairment in motor planning. Overestimation of physical capabilities can be an additional explanation of the high risk of falls in this population.

Neural correlates of older adults' self-overestimation of stepping-over ability

A growing body of literature indicates that cognitively intact older adults tend to overestimate their physical functioning (e.g., step-over ability), which may lead to fall risk. However, the neural correlates underlying this phenomenon are still unclear. We therefore investigated the neural basis of older adults' self-overestimation of stepping-over ability. A total of 108 well-functioning community dwelling older adults (mean age = 73.9 years) performed step-over tests (SOT) in two ways: self-estimation of step-over ability and an actual step-over task. During the self-estimation task, participants observed a horizontal bar at a distance of 7 m and estimated the maximum height (EH) of successful SOT trials. The actual SOT was then performed to determine the actual maximum height (AH) of successful trials. Participants also underwent positron emission tomography with ¹⁸F-fluorodeoxyglucose at rest to assess cerebral neural activity. The SOT showed that 22.2 % of participants overestimated their step-over ability. A regression analysis adjusted for potential covariates showed that increased self-estimation error (difference between EH and AH) was correlated with lower glucose metabolism in the bilateral orbitofrontal cortex (OFC) and left frontal pole. Only the significant correlation between self-estimation error and OFC activity persisted after correcting for multiple comparisons. For well-functioning healthy older adults, overlooking one's own functional decline may be influenced by reduced metabolic activity in the anterior prefrontal cortex, particularly in the OFC. Our findings also suggest that functional decline in the OFC prevents older adults from updating the qualitative/quantitative values of their impaired physical abilities.

Motor Preparation of Manual Aiming at a Visual Target Manipulated in Size, Luminance Contrast, and Location

We conducted two experiments to investigate whether the motor preparation of manual aiming to a visual target is affected by either the physical characteristics (size or luminance contrast) or spatial characteristics (location) of the target. Reaction time (RT) of both finger lifting (ie stimulus-detection time) and manual aiming (ie movement-triggering time) to the onset of the target was measured. The difference of RT (DRT) between two tasks (ie the difference of task complexity) was examined to clarify the temporal characteristics of manual aiming per se during visuomotor integration. Results show classical characteristics: RT decreased as either the target size or luminance contrast increased. Furthermore, the task-complexity and target-location factors significantly interacted with each other, where the aiming RT was longer than the finger-lifting RT and the effects of target location on RT differed for each task. However, the task factor did not interact with either the size or luminance-contrast factor, implying that the motor preparation of manual aiming is associated with the spatial characteristics rather than the physical characteristics of the target. Inspection of DRT revealed that the time needed for motor preparation for an ipsilateral target was significantly shorter than that for a contralateral target. This was the case both for the left and for the right hand. Foveal targets required longer processing time, implying a disadvantageous function of motor preparation for the gazed target. The left-hand superiority for the target appearing in the left visual field was also observed. Such lateralised effect and left-hand advantage to the left visual field in manual aiming suggest that visuospatial information processing is activated during the preparation of aiming action, with faster processing in the right hemisphere.

Self-estimation of physical ability in stepping over an obstacle is not mediated by visual height perception: a comparison between young and older adults

Older adults tend to overestimate their step-over ability. However, it is unclear as to whether this is caused by inaccurate self-estimation of physical ability or inaccurate perception of height. We, therefore, measured both visual height perception ability and self-estimation of step-over ability among young and older adults. Forty-seven older and 16 young adults performed a height perception test (HPT) and a step-over test (SOT). Participants visually judged the height of vertical bars from distances of 7 and 1 m away in the HPT, then self-estimated and, subsequently, actually performed a step-over action in the SOT. The results showed no significant difference between young and older adults in visual height perception. In the SOT, young adults tended to underestimate their step-over ability, whereas older adults either overestimated their abilities or underestimated them to a lesser extent than did the young adults. Moreover, visual height perception was not correlated with the self-estimation of step-over ability in both young and older adults. These results suggest that the self-overestimation of step-over ability which appeared in some healthy older adults may not be caused by the nature of visual height perception, but by other factor(s), such as the likely age-related nature of self-estimation of physical ability, per se.

Age-related self-overestimation of step-over ability in healthy older adults and its relationship to fall risk

Background

Older adults could not safely step over an obstacle unless they correctly estimated their physical ability to be capable of a successful step over action. Thus, incorrect estimation (overestimation) of ability to step over an obstacle could result in severe accident such as falls in older adults. We investigated whether older adults tended to overestimate step-over ability compared with young adults and whether such overestimation in stepping over obstacles was associated with falls.

Methods

Three groups of adults, young-old (age, 60–74 years; n, 343), old-old (age, >74 years; n, 151), and young (age, 18–35 years; n, 71), performed our original step-over test (SOT). In the SOT, participants observed a horizontal bar at a 7-m distance and estimated the maximum height (EH) that they could step over. After estimation, they performed real SOT trials to measure the actual maximum height (AH). We also identified participants who had experienced falls in the 1 year period before the study.

Results

Thirty-nine young-old adults (11.4%) and 49 old-old adults (32.5%) failed to step over the bar at EH (overestimation), whereas all young adults succeeded (underestimation). There was a significant negative correlation between actual performance (AH) and self-estimation error (difference between EH and AH) in the older adults, indicating that older adults with lower AH (SOT ability) tended to overestimate actual ability (EH > AH) and vice versa. Furthermore, the percentage of participants who overestimated SOT ability in the fallers (28%) was almost double larger than that in the non-fallers (16%), with the fallers showing significantly lower SOT ability than the non-fallers.

Conclusions

Older adults appear unaware of age-related physical decline and tended to overestimate step-over ability. Both age-related decline in step-over ability, and more importantly, overestimation or decreased underestimation of this ability may raise potential risk of falls.

Athletic experience influences shoulder rotations when running through apertures

In order to pass through apertures safely and efficiently, individuals must perceive the width of the aperture relative to (1) the width of the person-plus-object system and to (2) their (anticipated) movement speed. The present study investigated whether athletes who have extensive experience playing sports that require running through narrow spaces while wearing shoulder pads control their shoulder rotations differently while performing this behavior than athletes who lack such experience. Groups of athletes with experience competing in different sports (American football, rugby, and control athletes) performed a behavioral task in which they ran or walked between two tucking dummies with or without wearing shoulder pads. They also performed a psychophysical task in which they reported perceived width of the body and shoulder pads. When running through the apertures, the athletes who played American football exhibited smaller magnitudes and later onset of shoulder rotations than control athletes. No such difference was found when walking through the apertures. There was no difference in perception of the width of the shoulder pads among three groups. These findings suggest that performance of this behavior is action-scaled and task-specific.

Reduced risk of hepatocellular carcinoma after interferon therapy in aged patients with chronic hepatitis C is limited to sustained virological responders

This study was undertaken to investigate the effect of interferon (IFN) monotherapy on the risk of hepatocellular carcinoma (HCC) in aged-patients with chronic hepatitis C. Seven hundred and twenty-five patients with histologically proven chronic hepatitis C were enrolled in this retrospective cohort study; 531 received IFN monotherapy for 6 months between 1992 and 1995, and 157 were collected as a historical control. The effect of IFN therapy on the development of HCC was compared between the patients with chronic hepatitis C under 60 years old (non-aged group, n = 531) and those 60 and over (aged group, n = 194). A stepwise Cox proportional-hazards regression analysis in the non-aged group revealed that IFN therapy (risk ratio 0.52, 95% CI 0.33-0.81, P = 0.004), older age (P = 0.001), and higher histological stage (P < 0.001) were independent factors associated with the development of HCC. In the aged-group, only higher histological stage (P = 0.002) and male gender (P = 0.011), but not IFN therapy (risk ratio 0.77, 95% CI 0.42-1.40, P = 0.386), were identified as independent risk factors for HCC, although HCC was significantly reduced when sustained virological response (SVR) was obtained (risk ratio 0.23, 95% CI 0.08-0.64, P = 0.005). In conclusion, inhibitory effect of IFN on development of HCC in the patients with chronic hepatitis C aged 60 and over was limited to the patients achieving SVR when treated with 6 months-IFN monotherapy.

Pegylated interferon alpha-2b (Peg-IFN alpha-2b) affects early virologic response dose-dependently in patients with chronic hepatitis C genotype 1 during treatment with Peg-IFN alpha-2b plus ribavirin

Chronic hepatitis C (CH-C) genotype 1 patients who achieved early virologic response have a high probability of sustained virologic response (SVR) following pegylated interferon (Peg-IFN) plus ribavirin therapy. This study was conducted to evaluate how reducing drug doses affects complete early virologic response (c-EVR) defined as hepatitis C virus (HCV) RNA negativity at week 12. Nine hundred eighty-four patients with CH-C genotype 1 were enrolled. Drug doses were evaluated independently on a body weight base from doses actually taken. From multivariate analysis, the mean dose of Peg-IFN alpha-2b during the first 12 weeks was the independent factor for c-EVR (P = 0.02), not ribavirin. The c-EVR rate was 55% in patients receiving > or = 1.2 microg/kg/week of Peg-IFN, and declined to 38% at 0.9-1.2 microg/kg/week, and 22% in patients given <0.9 microg/kg/week (P < 0.0001). Even with stratified analysis according to ribavirin dose, the dose-dependent effect of Peg-IFN on c-EVR was observed, and similar c-EVR rates were obtained if the dose categories of Peg-IFN were the same. Furthermore, the mean dose of Peg-IFN during the first 12 weeks affected HCV RNA negativity at week 24 (P < 0.0001) and SVR (P < 0.0001) in a dose-dependent manner. Our results suggest that Peg-IFN was dose-dependently correlated with c-EVR, independently of ribavirin dose. Thus, maintaining the Peg-IFN dose as high as possible during the first 12 weeks can yield HCV RNA negativity and higher c-EVR rates, leading to better SVR rates in patients with CH-C genotype 1.

Ribavirin dose reduction raises relapse rate dose-dependently in genotype 1 patients with hepatitis C responding to pegylated interferon alpha-2b plus ribavirin

The impact of ribavirin exposure on virologic relapse remains controversial in combination therapy with pegylated interferon (Peg-IFN) and ribavirin for patients with chronic hepatitis C (CH-C) genotype 1. The present study was conducted to investigate this. Nine hundred and eighty-four patients with CH-C genotype 1 were enrolled. The drug exposure of each medication was calculated by averaging the dose actually taken. For the 472 patients who were HCV RNA negative at week 24 and week 48, multivariate logistic regression analysis showed that the degree of fibrosis (P = 0.002), the timing of HCV RNA negativiation (P < 0.001) and the mean doses of ribavirin (P < 0.001) were significantly associated with relapse, but those of Peg-IFN were not. Stepwise reduction of the ribavirin dose was associated with a stepwise increase in relapse rate from 11% to 60%. For patients with complete early virologic response (c-EVR) defined as HCV RNA negativity at week 12, only 4% relapse was found in patients given > or = 12 mg/kg/day of ribavirin and ribavirin exposure affected the relapse even after treatment week 12, while Peg-IFN could be reduced to 0.6 microg/kg/week after week 12 without the increase of relapse rate. Ribavirin showed dose-dependent correlation with the relapse. Maintaining as high a ribavirin dose as possible (> or = 12 mg/kg/day) during the full treatment period can lead to suppression of the relapse in HCV genotype 1 patients responding to Peg-IFN alpha-2b plus ribavirin, especially in c-EVR patients.

Relationships among Visual Awareness, Reaction Time, and Lateralized Readiness Potential in a Simple Reaction Time Task under the Backward Masking Paradigm

The goal of the present study was to examine whether a backward masking paradigm, in which a prime and a mask stimuli were consecutively presented with a short stimulus onset asynchrony affected the time needed for either the perceptual or motor stages of processing and the simple reaction times. The times needed for the perceptual and motor stages were evaluated by measuring the stimulus-locked and response-locked lateralized readiness potentials. The results showed that the onset of the stimulus-locked lateralized readiness potentials under the backward masking paradigm took place earlier than it did under the condition of a mask stimulus presented alone, whereas the onset of the response-locked lateralized readiness potentials did not significantly differ under different stimulus conditions. These results suggested that the participants responded to the masked prime stimulus despite being unaware of the prime stimulus. This may have been mediated by facilitation of the perceptual rather than motor stages.

[Coronary malperfusion due to acute type A aortic dissection; surgical strategy and results]

Coronary malperfusion due to acute type A aortic dissection (DAA) is a lethal complication. It is especially difficult to rescue the patients with left coronary malperfusion because of acute global myocardial infarction (AMI), even with successful surgical treatments, including the replacement of the ascending aorta and coronary artery bypass grafting (CABG). We review our experience and illustrate our approach to these critically ill patients. In addition, we classify the mechanism of malperfusion into 4 types based upon perioperative findings and discuss surgical management indivisually. From January 1990 to April 2005, a total of 260 patients were operated for DAA in our institution. Twenty (7.7%) patients, 11 men and 9 women were suffering from coronary malperfusion due to DAA. The mean age was 55 (range 28-72) years. The right coronary artery was involved in 9 patients, and the left in 11. All procedures such as graft replacement and CABG were done on an emergent or urgent basis. Hospital mortality rate of right coronary malperfusion was 22% (2/9 patients), and that related to left coronary malperfusion was 5/11 (45%). Assisting device was required in 9 cases, veno-arterial bypass (VAB) in 6 cases, left ventricular assist system (LVAS) in 1, left heart bypass (LHB) in 1, LHB+right heart bypass (RHB) in 1. We lost all patients using VAB. Only 3 patients supported with strong assist device survived. Aggressive myocardial resuscitation and early operation are the key factors in the management of these critically ill patients. But once severe myocardial infarction occurs, V-A bypass (percutaneous cardiopulmonary support) is useless in treating patients with DAA who develop severe heart failure. We recommend to implant stronger assist device including LVAS immediately before exacerbation of multiple organ failure. In conclusion, surgical management is not easy for emergency patients with DAA in association with myocardial ischemia. However, reasonable surgical results can be obtained with supplemental CABG and strong mechanical support of the left ventricle.

A Topographical Study on the Event-related Potential Correlates of Scrambled Word Order in Japanese Complex Sentences

One of the most fundamental and universal properties of human language is a phenomenon called displacement. In the present study, we used multichannel event-related potentials (ERPs) to identify the nature of this phenomenon with Japanese, a subject-object-verb (SOV) language of relatively free word order. The ERPs of sentences of canonical word order (CC) were compared with those of non-canonical word order in two types of Japanese complex sentences; namely, in those which can be described as being in a middle-scrambled condition (MSC) and in those in a long-scrambled condition (LSC). The sustained anterior negativity (SAN) and the P600 in the pregap position were observed in the LSC, compared to the CC, and they are consistent with previous findings. The SAN, exhibiting a tripartite nature in morphology and scalp distribution, mainly reflected a storage cost of scrambled elements in sentence comprehension. The subsequent P600 had a left fronto-temporal maximum, distinguished from a posterior P600, taken as a reflector of the thematic role assignment in previous related studies. It is argued that the P600 in the present study reflects a cost of structural integration intensively depending on the case marker information. A compositional interpretation of sentence meanings was also observed, reflected in an anterior negativity at the postgap verbal position, which cannot be differentiated at the pregap verbal position in the languages of subject-verb-object (SVO) word order.

A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy

BACKGROUND AND STUDY AIMS

With endoscopy, there is a high rate of interobserver variability in the identification of gastric intestinal metaplasia, and the endoscopic findings correlate poorly with the histological findings. Previous studies by our group investigating the use of a narrow-band imaging system with magnifying endoscopy (NBI-ME) in the gastric mucosa suggested that the appearance of a light blue crest (LBC) on the epithelial surface may be a distinctive endoscopic finding associated with the presence of intestinal metaplasia. The aim of the present study was to clarify the value of NBI-ME for diagnosing gastric intestinal metaplasia.

PATIENTS AND METHODS

The LBC was defined as a fine, blue-white line on the crests of the epithelial surface/gyri. To investigate the histology underlying the appearance of LBC, 44 biopsy specimens were obtained from regions containing LBC and 44 from non-LBC mucosa in 34 patients with atrophic gastritis. Three endoscopists then carried out NBI-ME in 107 consecutive patients to validate the diagnostic accuracy of the novel endoscopic technique. The degree of correlation between the LBC grading and the histological parameters of intestinal metaplasia was then assessed.

RESULTS

The LBC grading correlated with cells that were positive for CD10 ( P = 0.0001) and Alcian blue ( P = 0.036). The appearance of LBC correlated with histological evidence of intestinal metaplasia with a sensitivity of 89 % (95 % CI, 83 - 96 %), a specificity of 93 % (95 % CI, 88 - 97 %), a positive predictive value of 91 % (95 % CI, 85 - 96 %), a negative predictive value of 92 % (95 % CI, 87 - 97 %), and an accuracy of 91 % (95 % CI, 88 - 95 %).

CONCLUSIONS

In narrow-band imaging with magnifying endoscopy, observation of a light blue crest on the epithelial surface in the gastric mucosa is a highly accurate sign of the presence of histological intestinal metaplasia.

Interaction between space and number representations during motor preparation in manual aiming

The existence of a spatial component in the representation of number magnitude has been repeatedly supported by the demonstration that the left hand responds faster to smaller numbers, whereas the right hand responds faster to larger numbers. These results support the view that the 'mental number line' is oriented such that smaller numbers are associated with the left side of space while larger numbers are associated with the right side. We investigated whether the link between spatial and number processing arises from a continuous or categorical mapping between space and number representations. The investigation was designed to study all aspects of the motor act, including both planning and execution phases. For this purpose we measured reaction times (RTs), movement times (MTs), spatial accuracy, and endpoint pressure of manual aiming, while subjects reached with the right hand towards the location of a visual digit target. Five different digits were equiprobably presented at five positions along the horizontal axis. A GO/NO-GO choice task paradigm was used to ensure that digit parity (i.e., odd/even) was being processed. Analyses of MT, accuracy, and pressure data showed no digit effects. However, two number-related effects were observed on RTs. First, shorter RTs were obtained for smaller digits independent of target location, despite the use of the right hand. Second, an interaction was observed between target location and number magnitude whereby relative RTs were shortest when there was a congruity between target magnitude and location. These results imply that motor preparation is contaminated both by the direct activation of number magnitude and by the congruity between the spatial location of a target number and its magnitude. We conclude that continuous mapping intervenes between mental number representation and physical space.

The functional role of central and peripheral vision in the control of posture

Three experiments were conducted to investigate the role of central and peripheral vision (CV and PV) in postural control. In Experiment 1, either the central or peripheral visual field were selectively stimulated using a circular random dot pattern that was either static or alternated at 5 Hz. Center of foot pressure (CoP) was used to examine postural sway during quiet standing under both CV and PV conditions. The results showed that, when the visual stimulus was presented in the periphery, the CoP area decreased and more so in the anterior-posterior (AP) than in the medio-lateral (ML) direction, indicating a characteristic directional specificity. There was no significant difference between the static and dynamic (alternating) conditions. Experiment 2 investigated the directional specificity of body sway found in Experiment 1 by having the trunk either be faced toward the stimulus display or perpendicularly to it, with the head always facing the display. The results showed that the stabilizing effect of peripheral vision was present in the direction of stimulus observation (i.e., the head/gaze direction), irrespective of trunk orientation. This suggested that head/gaze direction toward the stimulus presentation, rather than a biomechanical factor like greater mobility of the ankle joint in AP direction than in ML direction, was essential to postural stability. Experiment 3 further examined whether the stabilizing effect of peripheral vision found in Experiments 1 and 2 was caused because more dots (500) were presented as visual cues to the peripheral visual field than to the central visual field (20 dots) by presenting the same number of dots (20) in both conditions. It was found that, in spite of the equal number of dots, the postural sway amplitudes were larger for the central vision conditions than for the peripheral vision conditions. In conclusion, the present study showed that peripheral rather than central vision contributes to maintaining a stable standing posture, with postural sway being influenced more in the direction of stimulus observation, or head/gaze direction, than in the direction of trunk orientation, which suggests that peripheral vision operates primarily in a viewer-centered frame of reference characterized by the head/gaze direction rather than in a body-centered frame of reference characterized by the anatomical planes of the body.

Motor Strategies Responsible for Maintaining Standing Posture After Deafferentation of the Unilateral Leg

OBJECTIVE

To identify the motor strategies responsible for maintaining standing posture after deafferentation of the unilateral leg.

DESIGN

Pretest-posttest, repeated-measures design.

SETTING

A Japanese university hospital rehabilitation facility.

PARTICIPANTS

Nine healthy subjects aged 25 to 32 years.

INTERVENTION

Two separate sessions that consisted of prolonged standing (control task) and standing until the H-reflex disappeared through the application of an inflated pneumatic cuff above the right knee.

MAIN OUTCOME MEASURES

Center of pressure (COP), hip and ankle joint positions, and electromyographic activities.

RESULTS

In the control task, no time-related change during prolonged standing was found in any of the measured parameters. After deafferentation, the right soleus activity decreased significantly (P<.01), so the mean velocities of the COP in the anteroposterior and mediolateral directions were greater and the average COP position under the right foot shifted backward compared with those in the previous periods (P<.01). Also, the left tibialis anterior and soleus were activated, as was the bilateral gluteus medius.

CONCLUSIONS

The unilateral loss of leg and foot sensory information necessitated additional regulatory activities to stabilize the standing posture. The newly organized posture appeared to partly simulate the standing posture in patients with sensory disturbance of a unilateral leg.

[Aortic root remodeling and coronary artery bypass grafting for acute type A aortic dissection involving the left main coronary artery; report of a case]

A 56-year-old male was admitted for sudden chest pain followed by loss of consciousness and paraplegia. The electrocardiogram (ECG) revealed ST-elevation in leads II, III, and aVF and ST-depression in leads V3 to V6. The ultrasonic cardiography (UCG) demonstrated an intimal flap in the ascending aorta, grade III aortic regurgitation (AR), and akinesis of the posterior wall of the left ventricle. Transesophageal echocardiography directly showed dissection of the left main coronary artery. Emergency coronary artery bypass grafting (CABG) to the left anterior descending artery (LAD), obtuse marginal artery (OM) and posterolateral artery (PL) was performed using the saphenous vein. In addition, valve-sparing aortic root remodeling was performed in conjunction with replacement of the ascending aorta. The left coronary orifice was repaired and reattached to the prosthetic graft. The patient was weaned from cardiopulmonary bypass without catecholamine support. He was discharged from the hospital on foot after rehabilitation of the paraplegia. AR remains mild by UCG 3 years after surgery.

Hemodynamic infarction of the spinal cord: involvement of the gray matter plus the border-zone between the central and peripheral arteries

OBJECTIVE

Hemodynamic infarction of the spinal cord that affected an 81-year-old female having a dissecting aortic aneurysm is presented. During the graft replacement operation, systemic hypotension occurred and the patient was subsequently complicated with paraplegia of the lower limbs. The patient died 2 weeks after the surgery due to gastrointestinal bleeding. An autopsy, which did not include the brain, was performed and the spinal cord was sampled. The aim of this report is to describe the pathologic profile of the spinal cord of the patient, and to gain insight into the pathogenesis of the lesion.

METHODS

Histochemical and immunohistochemical methods were employed to study the spinal cord ranging from the lower thoracic to sacral segments.

RESULTS

The whole central areas of the spinal cord showed coagulation and/or liquefaction necroses, while the white matter on the circumference of the cord remained unaffected, thus exhibiting a 'ring-like' appearance.

CONCLUSION

This case is an example of hemodynamic infarction of the spinal cord involving the gray matter that is supplied by the central artery, plus the border-zone that is supplied by both the central and peripheral arteries. The former is probably associated with selective vulnerability of the gray matter to ischemia, while the latter is probably associated with intrinsic vulnerability of the border-zone to systemic hypotension or low blood-flow states.

Enhanced expression of suppressor of cytokine signalling-1 in the liver of chronic hepatitis C: possible involvement in resistance to interferon therapy

Interferon-alpha (IFN-alpha) is widely used in the treatment of chronic hepatitis C (CHC). The suppressor of cytokine signalling (SOCS) family has been implicated in the regulation of JAK-STAT signalling, including IFN signalling. The negative effect of SOCS expression on the response of CHC to IFN-alpha is demonstrated here. The transcriptional levels of SOCS-1 and -3 in the livers of 21 patients with CHC and eight controls were investigated by quantitative reverse transcription-polymerase chain reaction. We established stable transfectants of SOCS-1 in a human hepatoma cell line, PLC/PRF/5 and analysed the effects of SOCS-1 on the phosphorylation of IFN-alpha-induced STAT-1 tyrosine by immunoblotting and the expression of antiviral genes by Northern blot. A prospective cohort study on SOCS-1 expression and clinical outcome was carried out in 77 patients with CHC who received IFN therapy. SOCS-1, but not SOCS-3, transcripts in the livers of CHC were significantly higher than controls (P < 0.005). IFN-alpha-induced STAT-1 phosphorylation and the expression of antiviral genes were inhibited in SOCS-1-transfected cells. Patients showing high SOCS-1 expression in the liver had a significantly lower rate of sustained virological response (SVR) to IFN therapy than those with low SOCS-1 expression (P = 0.0014). A multivariate analysis performed with host factors revealed that SOCS-1 staining in the liver can serve as a significant predictor for IFN SVR (P = 0.004). SOCS-1 expression is enhanced in the livers of CHC patients and might be involved in resistance to IFN therapy.

Effects of practice on cardiorespiratory responses during postural control

The present study examined the effects of practice of a balance test on cardiorespiratory changes in response to a 1-min balance test performed by standing on one leg with eyes closed (SOLEC) in 30 females (n=15, 21+/-4 years, mean+/-SD, for the experimental group; n=15, 22+/-4 years for the control group). Blood pressure (BP), heart rate (HR), minute ventilation (VE), respiratory rate (RR), tidal volume (VT), expiratory duration (Te), inspiratory duration (Ti), and oxygen uptake (VO(2)) were measured during the balance test before and after 2 wk of daily practice. The experimental group was given a daily 15-min practice session for the balance test. In contrast, the control group was instructed not to do any special practice for the balance test. In both the experimental and control groups, SOLEC induced significant increases in BP, HR, VE, RR, and VO(2), and decreases in Te and Ti. Following the practice sessions, the balance time increased significantly in the experimental group (P<0.01). In addition, 2 wk of practice reduced the increases in BP (P<0.01), VE (P<0.05), and RR (P<0.01), and prolonged Te (P<0.01) during the SOLEC test. These results suggest that practice of a postural task affects cardiorespiratory responses to the balance test in addition to postural control.

Lateral difference and interhemispheric transfer on arm-positioning movement between right and left handers

We investigated the transfer of an arm-positioning movement between the right and left arms of right and left handers. 30 male (15 strong right handers and 15 strong left handers) subjects were asked to perform a constrained criterion movement, 12 cm in length, with right or left arm and a test movement at estimated 6-, 12-, or 24-cm length with the contralateral arm. In the right handers, the constant error of the left arm test movement was near zero, and that of the right arm indicated overshooting. In the left handers, the constant errors of the left arm test movement were farther from zero than those of right arm test movement. Left handers as well as right handers showed manual asymmetry on positioning movement. A plausible explanation for the manual asymmetry on the arm-positioning task is related to interhemispheric transfer of spatial information on positioning movement.

[Long survival with chronic ventricular fibrillation under support of uni-left-ventricular assist system]

Few minutes of suspended malignant ventricular arrhythmia may be permitted for the patient with left ventricular assist system (LVAS). However, longer and continuous ventricular arrhythmia, especially ventricular fibrillation (Vf), may induce the low output of LVAS, which leads circulatory collapse immediately. Our presenting case is a female dilated cardiomyopathy patient who has been supported with LVAS. Four months after the LVAS installation, her electrocardiogram has changed to Vf without any symptoms. Her ventricular function has never recovered, even ventricular tachycardia. She has been a candidate of heart transplantation for more than 19 months with this rare hemodynamic condition (LVAS+Vf), like the Fontan circulation. Her performance status is limited due to deceasing of the LVAS flow, which caused by the change of her position: 2.5-2.9 l/min (lie down) to 2.0 l/min (rise). Her peak VO2/W is 6.9 ml/min/kg measured by the cardio-pulmonary exercise test. However, she has developed her general status by doing rehabilitation program and is able to walk for more than 100-150 meters.

[Infective endocarditis caused by methicillin resistant Staphylococcus aureus following corticosteroid pulse therapy; report of a case]

A 51-year-old man, with a history of corticosteroid pulse therapy 3 weeks previously, developed infective endocarditis of the mitral valve due to methicillin resistant Staphylococcus aureus, and underwent mitral valve replacement. Since the second postoperative day, clinical course was seriously complicated because of recurrent abdominal pain corresponding with commencement of oral intake, unremitting spike fever, and renal and hepatic dysfunction. Various examinations except angiography failed to demonstrate the etiology. Two months later, the patient developed panperitonitis due to perforation of ischemic ulcer of the cecum and underwent ileo-cecal resection. After this operation, he convalesced very quickly. Ischemia is one of the main causes of abdominal complication following cardiac surgery. Angiography should be positively considered in cases like the present one.

Visual estimation of spatial requirements for locomotion in novice wheelchair users

Locomotion using a wheelchair requires a wider space than does walking. Two experiments were conducted to test the ability of nonhandicapped adults to estimate the spatial requirements for wheelchair use. Participants judged from a distance whether doorlike apertures of various widths were passable or not passable. Experiment 1 showed that participants underestimated the spatial requirements for wheelchair use but overestimated the spatial requirements for walking. Experiment 2 showed that their underestimation improved but was not completely eliminated after 8 days of practice passing through apertures. Analyses of wheelchair performance in the practice condition showed that the underestimation may have arisen from misperception of the positions of the hands when the participants were grasping the wheelchair hand-rims. The theoretical and practical implications of these findings are discussed.

[Resection of freely mobile atheroma in the ascending aorta under circulatory arrest during coronary artery bypass grafting surgery]

A 52-year-old male with a 13 years history of hemodialysis developed unstable angina. Preoperative examination revealed critical stenoses in 3 coronary arteries and extensive calcification in the ascending aorta. During urgent coronary artery bypass surgery, epiaortic ultrasonography demonstrated a large and markedly mobile atheroma in the ascending aorta. Therefore, he underwent resection of this atheroma using cardiopulmonary bypass and circulatory arrest. His postoperative course was fine. This aggressive strategy for a diseased aorta can be a viable option in selected cases. Epiaortic ultrasonography appeared to be indispensable during surgery for patients like a present one.

[Coronary artery aneurysm developed acute myocardial infarction: report of a case]

A 68-year-old woman without angina developed acute antero-septal myocardial infarction. Coronary angiogram revealed saccular coronary artery aneurysm at the origin of the diagonal branch and relatively mild coronary artery stenosis. Emboli from the coronary aneurysm was strongly suggested. We placed coronary bypass grafts onto left anterior descending, diagonal and obtuse marginal branches, and excluded the coronary aneurysm by ligating both its inflow and outflow. The postoperative course was uneventful. There are several treatments of choice for patients with coronary aneurysm. We believe that surgery is mandatory and that exclusion of the coronary aneurysm should be considered in every possible case.

Lateralized effects of target location on reaction times when preparing for manual aiming at a visual target

To elucidate the temporal characteristics of information processing for motor action differing in complexity in relation to both perceptual and cognitive information processing, we investigated whether the reaction times (RTs) to a visual target would be affected by task complexity (finger lifting or manual aiming), pre-cueing (with a pre-cue or without a pre-cue), or target location (five horizontal positions). Using the right hand, seven right-handed subjects performed two tasks, finger lifting and manual aiming at a target, with or without a pre-cue. The pre-cue announced the location of the target to be presented. An ANOVA showed significant interactions between task and location and between pre-cue and location with no significant interaction between task and pre-cue, indicating that the task-location interaction does not depend on whether or not a pre-cue is given. The manual-aiming RTs were longer than the finger-lifting RTs, and the effects of the target location on the RTs differed for finger lifting and manual aiming. It can be assumed that the longer RTs of manual aiming reflect the time for information processing that is needed when preparing for the aiming action per se, which is an extra movement performed in addition to the simple initiation of finger lifting. Differential RTs (DRTs) calculated by subtracting the finger-lifting RTs from the aiming RTs were therefore examined. The DRTs significantly differed for target locations (i.e., a lateralized effect), with the DRTs for an ipsilateral target appearing to be significantly shorter than those for contralateral and central targets. The lateralized effect appearing on the DRTs may be mediated by the processing of visual-spatial information about visual targets as motor preparations are made for manual aiming.

Effects of nonconscious perception on motor response

The present study reviews the literature on the empirical evidence for the dissociation between perception and action. We first review several key studies on brain-damaged patients, such as those suffering from blindsight and visual/tactile agnosia, and on experimental findings examining pointing movements in normal people in response to a nonconsciously perceived stimulus. We then describe three experiments we conducted using simple reaction time (RT) tasks with backward masking, in which the first (weak) and second (strong) electric stimuli were consecutively presented with a 40-ms interstimulus interval (ISI). First, we compared simple RTs for three stimulus conditions: weak alone, strong alone, and double, i.e., weak plus strong (Experiment 1); then, we manipulated the intensity of the first stimulus from the threshold (T) to 1.2T and 2T, with the second stimulus at 4T (Experiment 2); finally, we tested three different ISIs (20, 40, and 60 ms) with the stimulus intensities at 1.2T and 4T for the first and second stimuli (Experiment 3). These experiments showed that simple RTs were shorter for the double condition than for the strong-alone condition, indicating that motor processes under the double condition may be triggered by sensory inputs arising from the first stimulus. Our results also showed that the first stimulus was perceived without conscious awareness. These findings suggested that motor processes may be dissociated from conscious perceptual processes and that these two processes may not take place in a series but, rather, in parallel. We discussed the likely mechanisms underlying nonconscious perception and motor response to a nonconsciously perceived stimulus.

Freezing degrees of freedom under stress: kinematic evidence of constrained movement strategies

The present study investigated the effect of psychological stress imposed on movement kinematics in a computer-simulated batting task involving a backward and forward swing of the forearm. The psychological stress was imposed by a mild electric stimulus following poor performance. Fourteen participants hit a moving ball with a horizontal lever and aimed at a distant target with as much accuracy as possible. The kinematic characteristics appearing under stress were delay of movement initiation, small amplitude of movement and low variability of spatial kinematic events between trials. These features were also found in previous studies in which the experimental task required high accuracy. The characteristic kinematics evident in the present study suggested that the movement strategies adopted by the stressed participants were similar to those that appear under high accuracy demand. Moreover, a correlation analysis between the onset times of kinematic events revealed that temporally consistent movements were reproduced under stress. Taken together, the present findings demonstrated that, under psychological stress, movement strategies tend to shift toward the production of more constrained trajectories, as is seen under conditions of high accuracy demand, even though the difficulty of the task itself does not change.

The effects of different instructions for preparatory muscle tension on simple reaction time

The effects of preparatory weak muscular contraction (pre-tension) have been investigated in a number of previous studies using tasks with either simple or choice responses to measure the reaction time (RT). These studies suggested that optimal pre-tension performed prior to a motor response tends to shorten the RTs. Using a simple RT task in which participants performed a grip response to a visual stimulus, the present study compared the RTs between two pre-tension conditions (self-selection and constraint) to investigate the effects of different instructions for pre-tension. Under the self-selection condition, participants were asked to determine their optimal pre-tension levels while attempting to give responses as fast as possible. Under the constraint condition, the participants developed a pre-tension at a target force determined by the experimenter. The target force was set at the same level as the pre-tension level maintained under the self-selection. Despite the fact that the pre-tension level manipulated was the same for both conditions, the RTs were significantly shorter under self-selection than under constraint. Moreover, the present study showed a positive correlation coefficient between the proportion of shortening in RT and the variation of pre-tension level. This indicated a performance trade-off between the stability of pre-tension and RTs. The result suggests that shorter RTs that occur under self-selection are primarily mediated by mental factors, such as attention allocation, rather than by the effects of peripheral muscular preparation.