Background: To clarify the differences in diaphragm thickness between male and female participants in healthy young adults with ultrasonography using the mean intima media thickness (IMT) method and to investigate the relationship between diaphragm thickness and respiratory pressure. Methods: Twenty-nine healthy individuals (16 females and 13 males) participated in the study. Diaphragm thickness was measured at total lung capacity (TLC) and at functional residual capacity (FRC) in each participant. We measured the diaphragm thickness using a method for mean intima media thickness. Moreover, change ratio of diaphragm thickness was calculated with the diaphragm thickness at TLC and FRC. Results: Mean diaphragm thicknesses at FRC in males were significantly narrower than those in females (p < 0.001). The change ratio of diaphragm thickness was significantly augmented in males compared with that in females (p < 0.001). There was a positive correlation between the change ratio of diaphragm thickness and pulmonary function data and respiratory muscle strength in healthy young adults. Conclusions: The change ratio of diaphragm thickness using the IMT method can be accurately performed with a high degree of reproducibility by clinical laboratory technicians and may be a useful indicator for evaluating diaphragm muscle strength.

We report an 8-year-old girl who experienced daily episodes of visual and somesthetic distortion and was diagnosed with Alice in wonderland syndrome (AIWS). Ophthalmologic assessment revealed best-corrected visual acuity of 0.2 in both eyes, and bilateral constricted tubular or spiral visual fields. Augmented amplitude of visually evoked potentials was revealed, and treatment with lomerizine and valproate showed favorable effect on the visual/somesthetic distortion as well as the visual field and acuity. Psychogenic visual problems can co-exist with the typical sensory distortion in AIWS, similarly to the case of psychogenic pseudo-seizures in subjects with epilepsy. Otherwise, an ambiguous borderline between psychological and physical pathomechanisms in migraine may also be characteristic of the migraine-related AIWS.

Background/Objectives: Continuous positive airway pressure (CPAP) is used to treat patients with obstructive sleep apnea (OSA) and has proven clinical efficacy for this condition. However, the objective method to determine the appropriate CPAP level for treatment is still unclear. Patients with OSA typically exhibit irregular respiratory efforts due to obstruction or narrowing of the upper airway during sleep. Treatment with an adequate CPAP level alleviates airway obstruction or narrowing, leading to more regular respiratory patterns. We aimed to develop an objective CPAP titration method using the respiratory regularity index (RRI) derived from respiratory movements. Methods: We conducted daytime CPAP titration in 10 patients with OSA. Respiratory movements were recorded by inductance plethysmography in three conditions: wake, apnea, and during CPAP therapy. The RRI of respiratory movements was calculated in each condition, and the CPAP level with the lowest RRI was identified as the appropriate air pressure level in each patient. CPAP therapy at the appropriate level determined by the study method was conducted for 2 months, after which efficacy was assessed by night polysomnography in the hospital. Results: The fixed air pressure level for the CPAP device was determined as 7.8 ± 0.7 cmH₂O based on our daytime CPAP titration method using the RRI. The apnea–hypopnea index improved significantly from before CPAP therapy (43.1 ± 15.3 h⁻¹) to during CPAP therapy (3.0 ± 2.1 h⁻¹) (p < 0.006). The Epworth Sleepiness Scale score decreased significantly during CPAP therapy. The lowest percutaneous arterial oxygen saturation values in each sleep stage also improved significantly with the CPAP determined by our daytime CPAP titration method. Conclusions: The study findings showed that our daytime CPAP titration method based on the RRI is an effective method for determining individualized appropriate CPAP levels in patients with OSA. The RRI-based daytime CPAP titration method offers a simplified approach to determining the adequate CPAP level for patients with OSA.

This study aimed to determine whether more stable electroretinography parameters could be obtained in younger children using skin electrodes placed at the inner canthus and ears compared to using contact lens electrodes. The study included three Japanese patients (two girls and one boy) who presented with epileptic spasms before the age of 3 years. We compared the electroretinography parameters obtained with skin electrodes and contact lens electrodes. We could record reproducible results using skin ERG with a montage of electrodes placed at the inner canthus and the ear in children. Moreover, standard data for younger children were created, enabling the evaluation of electroretinography parameters recorded with skin electrodes in individual pediatric patients. The skin electroretinography using the new montage may be stable parameters for evaluating retinal function in younger children.

Background: To clarify the differences in diaphragm thickness between male and female participants in healthy young adults using ultrasonography and to investigate the relationship between diaphragm thickness and respiratory pressure.Methods: Twenty-nine healthy individuals (16 females and 13 males) participated in the study. Diaphragm thickness was measured at total lung capacity (TLC) and at functional residual capacity (FRC) in each participant. We measured the diaphragm thickness using a method for mean intima media thickness. Moreover, change ratio of diaphragm thickness was calculated with the diaphragm thickness at TLC and FRC.Results: Mean diaphragm thicknesses at FRC in males were significantly narrower than those in females (p<0.001). The change ratio of diaphragm thickness was significantly augmented in males compared with that in females (p<0.001). There was a significant positive correlation between the change ratio of diaphragm thickness and respiratory muscle strength in males but not in females.Conclusions: The change ratio might be an alternative to evaluate respiratory muscle strength in young adult males. The diaphragm thickness values and the change ratio of diaphragm thickness in healthy young adults, evaluated by B-mode sonography, were varied based on sex.