Study Objectives To evaluate the prevalence and clinical characteristics of isolated REM sleep behavior disorder (iRBD) among a general population of elderly Japanese people. Methods This epidemiological study targeted 2714 elderly residents (76.0 ± 8.0 years, 52.9% female) of a rural community. Questionnaires including the REM sleep behavior disorder single question and demographic information were distributed. All respondents with the question positive were interviewed by telephone. Respondents suspected of having iRBD proceeded to face-to-face interviews and underwent video-polysomnography and neurological/neuropsychological examination. These results were compared to those of previously diagnosed clinical iRBD patients in our sleep clinic. Results Of 1464 respondents to the questionnaire, 18 respondents were diagnosed as iRBD (1.23 [0.66–1.79]%), including eight respondents who satisfied diagnostic criteria with REM sleep without atonia (RWA) above the cut-off value (0.54 [0.17–0.92]%) and 10 respondents who had clear dream enactment behaviors but not RWA above the cut-off (provisionally diagnosed iRBD; p-iRBD) (0.69 [0.26–1.11]%). Severity of RBD and RWA of the population-based iRBD were compatible with those of the clinical iRBD. Half of the population-based iRBD showed orthostatic hypotension and they showed lower olfactory function than population-based p-iRBD and non-RBD. However, their olfactory and cognitive functions were higher than those in the clinical iRBD patients. Conclusions Prevalence of iRBD in Japanese elderly people was comparable with the rate reported from other countries. Population-based iRBD/p-iRBD showed lower neurodegenerative loading than clinical iRBD in spite of comparable disease duration of RBD, that may indicate their lower risk of future neurodegeneration.

Over half of treated patients with hypertension are not well controlled. However, little is known about physicians' prescribing behaviour for these patients.

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Few studies have reported on risk factors by blood pressure categories based on antihypertensive treatment in the general population. We examined the associations between blood pressure categories and other risk factors in Japan. Cross-sectional study, multicenter population-based study was designed. A total of 11,302 men and women were eligible. Data were obtained from April 1992 to July 1995 in 12 rural districts in Japan. Subjects were divided into three categories: normotensives (with blood pressure <140/90 mmHg), treated hypertensives (antihypertensive treatment regardless of current blood pressure), and nontreated hypertensives (blood pressure >or=140/90 mmHg without hypertensive treatment). The proportions of normotensives, treated hypertensives, and nontreated hypertensives were 63%, 10%, and 27% among men, and 67%, 13%, and 20% among women, respectively. Total cholesterol, triglyceride, blood glucose, and body mass index were higher in treated or nontreated hypertensives than in normotensives. Fibrinogen, factor VIIc, and physical activity index were higher in treated hypertensives than in normotensives. High-density lipoprotein (HDL) cholesterol was higher in normotensives than in treated or nontreated hypertensives in women; but no tendency was shown in men. The proportions of dyslipidemia, impaired glucose tolerance, and metabolic syndrome were significantly higher in treated and nontreated hypertensives than in normotensive men and women. In conclusion, cardiovascular risk factors were higher in hypertensives with or without treatment than in normotensives in a general population in Japan.

A 47-year-old man with ulcerative colitis was transferred to our hospital due to progressive dyspnea. Electrocardiography on admission showed ST elevation in leads II, III, aVF, and V5-V6. Coronary angiography revealed no remarkable coronary stenosis, and left ventriculography showed a depressed left ventricular ejection fraction (EF) of 23%. Although the patient received percutaneous cardiopulmonary support, his EF progressively decreased (7-15%), and both ventricular tachycardia (VT) and high-degree atrial-ventricular block occurred. An endomyocardial biopsy showed eosinophilic infiltration in the myocardium. Steroid therapy improved the patient's EF. However, his severe inferior wall hypokinesis and non-sustained VT remained after the abovementioned treatment.