bluuebunny/crossref_metadata_2025 huggingface dataset:
1996 Korean Renal Registry Report
Authors: Choi Euy‐Jin , Ahn Seog‐Ju , Jin Dong‐Chan ,   The Korean Society of Nephrology, ESRD Registry Committee
Published: March 2003

SUMMARY:

This report was based on data from the ESRD (End‐Stage Renal Disease) Registry Committee of the Korean Society of Nephrology and accounts for 60% of all patients on renal replacement therapy (RRT) in Korea. The data are from 31 December 1996. There were 208 centres providing dialysis (4.76 centres per million population [p.m.p.]) and 36 renal transplant centres. There were 18 161 (391.1 p.m.p.) patients on RRT of which 53% were on haemodialysis (HD), 16.4% on peritoneal dialysis (PD) and 30.6% with functioning renal transplants (TX). There was a 14% increase in the number of patients over the previous year (HD 12.3%, PD 8.5%, TX 20.4%). The incidence of treated ESRD was 5058 (108.9 p.m.p.). The mean age of existing patients was 48.3 years (HD, 48.4; PD, 50.2; KT, 37.5) and sex ratio was M:F 57:43 (HD, 55:45; PD, 54:46; KT, 67:33). The primary renal diseases were glomerulonephritis (21.6%), diabetic nephropathy (30.8%), hypertension (18.3%) and others (34.2%). Sixty‐five per cent of patients on HD and 35% on PD were treated with erythropoietin. Eleven per cent of patients on RRT (HD 11.4%, PD 8%) were serologically positive for hepatitis B infection and another 10% (HD 10.3%, PD 3.3%) were positive for hepatitis C infection. The rate of peritonitis was 0.78 episodes per patient year. There were 941 renal transplants in 1996 and the annual transplantation rate was 20.3 p.m.p. Eighty‐eight per cent of transplants were from live donors (65.5% living‐related and 34.5% living‐unrelated) and the other 12% were from cadaveric donors. The causes of death were cardiac (31.6%), vascular (24.5%), infection (19.4%), liver disease (3.1%), social (8.2%), miscellaneous (6.1%) and uncertain (7.1%). The annual mortality rate of RRT patients was 8.9% according to the report from Korean National Statistical Office.
Recurrent lupus nephritis in a rejected renal allograft
Authors: MENGEL Michael , KREIPE Hans , HALLER Hermann , SCHWARZ Anke
Published: March 2003

SUMMARY: The case of a 48‐year‐old female patient who underwent renal transplantation because of an end‐stage renal disease after membranous glomerulonephritis (WHO class V) in systemic lupus erythematosus (SLE) is presented. the patient lost one cadaveric allograft immediately after transplantation because of renal vein thrombosis, presumably caused by anti‐Cardiolipin antibodies. A second cadaveric allograft showed a stable function for several years before slowly deteriorating. an abrupt increase of serum creatinine led to the suspicion of a final episode of acute rejection. A biopsy was performed, which showed an overlap of rejection and recurrent iupus nephritis in an advanced chronically damaged allograft. the lupus nephritis recurred as the same WHO class V as in the native kidney, but without significant predictive clinical or serological signs of SLE activity. the case presented and a review of the literature indicate that the frequency of recurrent lupus nephritis might be underestimated, and earlier surveillance biopsies in transplanted SLE patients should be considered.
Abnormalities of IgA1 production in IgA nephropathy
Authors: Feehally John , Allen Alice
Published: March 2003

SUMMARY:
IgA nephropathy (IgAN) is characterized by the mesangial deposition of polymeric IgA1 (pIgA1). The original view that this pIgA1 is derived from the mucosal immune system can no longer be sustained. Studies of duodenal mucosa and marrow indicate increased production of pIgA1 in the marrow and decreased production in the mucosa. These changes are consistent with immunization studies showing exaggerated and prolonged pIgA responses to systemic immunization, and reduced mucosal responses to mucosal neoantigens. However, the IgA1 and IgG systemic responses to mucosal antigen are increased in IgAN, a finding consistent with impairment in oral tolerance, the process by which systemic immune responses to mucosal antigen challenge are normally suppressed. Both IgA1 production and the induction of oral tolerance are under T‐cell control. T‐cell populations involved in these processes include γδ T cells, Tr cells and T‐helper (Th)3 cells; cytokines with a key role in the control of IgA production include interleukin (IL)‐10 and transforming growth factor (TGF)‐β. There is evidence of abnormal γδ T‐cell V region usage in both mucosa and marrow in IgAN. Increased expression of relevant cytokines has also been reported in circulating T cells in IgAN. The increased O‐glycosylation of circulating IgA1 in IgAN may also be further evidence of a shift in the production of mucosal‐type pIgA1 from the mucosa to marrow. These findings suggest that the specific lymphocyte homing mechanisms that normally maintain oral tolerance and control the site of IgA production require further study in IgAN.
Differential expression of platelet‐derived growth factor and transforming growth factor‐β in relation to progression of IgA nephropathy
Authors: Kim Hwal Woong , Moon Kyung Chul , Park So Yeon , Hong Hye Kyoung , Lee Hyun Soon
Published: March 2003

SUMMARY:
The role of platelet‐derived growth factor (PDGF) and transforming growth factor‐β1 (TGF‐β1) in relation to mesangial matrix expansion and progressive glomerulosclerosis in IgA nephropathy (IgAN) is not clearly defined. Expression of PDGF B, TGF‐β1, and extracellular matrix proteins in glomeruli was assessed by immunohistochemistry in 42 biopsies with IgAN and six renal biopsies with no detectable abnormalities. The mRNA expression of PDGF B, TGF‐β1, α1(IV) collagen, laminin B1 and fibronectin genes was further evaluated by in situ hybridization in 25 biopsies with IgAN and six controls. In IgAN, the intensity of immunostaining for PDGF B, type IV collagen, laminin and fibronectin, but not for TGF‐β1, was increased in the mesangium compared with controls. The immunoreactivity of PDGF B was closely correlated with that of type IV collagen and laminin. The number of PDGF B mRNA‐, α1(IV) collagen mRNA‐, laminin B1 mRNA‐, and TGF‐β1 mRNA‐expressing cells/glomerular section, but not the number of fibronectin mRNA‐expressing cells, was increased in IgAN compared with controls. The number of PDGF B mRNA‐expressing cells correlated significantly with the percentage of glomerulosclerosis. In the cellular lesions of focal segmental glomerulosclerosis (FSGS), expression of TGF‐β1 protein and mRNA was markedly increased in visceral glomerular epithelial cells (GEC). These results suggest that PDGF B mainly overproduced by mesangial cells may cause mesangial matrix expansion, whereas TGF‐β1 produced by GEC may be related to the formation of FSGS in IgAN. Thus, PDGF B and TGF‐β1 may play differential roles in the pathogenesis of renal fibrosis and the progression of IgAN.
Environmental influences on the experiences of people with Parkinson’s disease
Authors: Sunvisson Helena , Ekman Sirkka‐Liisa
Published: March 2003

Environmental influences on the experiences of people with Parkinson’s disease

This study elucidates environmental influences on lived illness experiences. For two consecutive years, persons with Parkinson’s disease (PD) participated in 1 week of daily walking in the Swedish mountains. Daily, low‐intensive walking that is free of intense effort or time pressures associated with group interaction characterized the week. Participants were interviewed 3 months after the mountain stay regarding experiences in the mountains, daily living, and how their experience in the mountains influenced their daily living after returning home. A phenomenological method was used for data analysis. Results point to the close connection between mind, body, and environment. The connection becomes highlighted when people are afflicted with sickness, such as PD, which causes impaired control of body language, impaired voluntary mobility, and lowered energy levels. The results also show how a social context in an environment with suitable physical challenges led to a change in individuals’ perceptions of the manageability of their experienced sicknesses. These results provide a deepened understanding of how individuals with PD experience illness, its influences on daily life, and how a suitable environment opens opportunities for managing daily issues.
Tangled ruptures: discursive changes in Danish psychiatric nursing 1965–75
Authors: Buus Niels
Published: March 2003

Tangled ruptures: discursive changes in Danish psychiatric nursing 1965–75

Psychiatric nursing and psychiatric nurses have been referred to in various ways over the course of history. These articulations reflect and constitute the ways in which nursing is comprehended during specific periods. A rupture in these descriptions and conceptions of Danish psychiatric nursing over the period 1965–75 is identified using a discourse analytical framework, inspired primarily by Foucault. This rupture influenced all aspects of psychiatric nursing: the perception of the psychiatric patient, the expertise and knowledge of the nurse and the care given by the nurse. The study raises questions about the cultural and social changes that occurred prior to the discursive rupture.
Governing nursing conduct: the rise of evidence‐based practice
Authors: Winch Sarah , Creedy Debra , Chaboyer And Wendy
Published: March 2003

Governing nursing conduct: the rise of evidence‐based practice

Drawing on the Foucauldian concept of ‘governmentality’ to analyse the evidence‐based movement in nursing, we argue that it is possible to identify the governance of nursing practice and hence nurses across two distinct axes; that of the political (governance through political and economic means) and the personal (governance of the self through the cultivation of the practices required by nurses to put evidence into practice). The evaluation of nursing work through evidence‐based reviews provides detailed information that may enable governments to target and instruct nurses regarding their work in the interest of preserving the health of the population as a whole. Political governance of the nursing population becomes possible through centralised discursive mechanisms, such as evidence‐based reviews that present nursing practice as an intelligible field whose elements are connected in a more or less systematic manner. The identity of the evidence‐based nurse requires the modern nurse to develop new skills and attitudes. Evidence‐based nursing is an emerging technology of government that judges nursing research and knowledge and has the capacity to direct nursing practice at both the political and personal level.
Are young women in Japan at high risk for eating disorders?: Decreased BMI in young females from 1960 to 1995
Authors: Kiriike Nobuo , Nagata Toshihiko , Sirata Kumiko , Yamamoto Naoki
Published: March 2003

The height, weight and body mass index (BMI) of Japanese males and females aged from 6 to 24 years between 1960 and 1995 were studied. From 1960 to 1995 in males of all ages and in females aged 6–14 years height, weight and BMI increased. In females aged 15–24 years, the height increased and the weight slightly increased, but the BMI gradually decreased from 21.5 in 1960 to 20.5 in 1995. Over the last 35 years adolescent and young adult women have become thinner. Dieting to be slim has become much more prevalent among young women. These findings suggest that young females in Japan have decreased their BMI by dieting in order to become slim. If this tendency persists, with regard to a close relationship between restrained eating or dieting and eating disorders, Japanese young women have a much greater risk of developing eating disorders.
Demographic features of patients seeking cosmetic surgery
Authors: Ishigooka Jun , Iwao Mitsuhiro , Suzuki Makihiko , Fukuyama Yoshitsuna , Murasaki Mitsukuni , Miura Sadanori
Published: March 2003

The demographic features of 415 patients seeking cosmetic surgery were investigated from a psychiatric point of view. Of the 415 patients, 198 (47.7%) were found to have mental disorders according to ICD‐10 including: 17 with schizophrenia, 20 with other persistent delusional disorders, 33 with depressive episode, 47 with neurotic disorders, 42 with hypochondriacal disorder, five with paranoid personality disorder and 14 with histrionic personality disorder. The rate of subjects with poor social adjustment was 56.0%. It was noteworthy that such a considerable number of patients with mental disorders or with poor social adjustment had sought cosmetic surgery. Distinct gender differences were found: male subjects were characterized to have a greater number of mental disorders, especially dysmorphophobia (other persistent delusional disorders plus hypochondriacal disorder) and showed the narrow age range between teenage and young adult age when they were preoccupied with their ‘deformity’, and poor social function. A history of frequent operations was not considered to be an indicator for mental abnormality. The diagnostic issue in dysmorphophobia is briefly described.
The influence of obsessive‐compulsive neurosis patients’ premorbid personality on obsessive‐compulsive symptoms and efficacy of medication
Authors: Nishimura Ryoji , Hosoba Tatsuya , Ide Masaaki , Seiwa Hidetoshi
Published: March 2003

We conducted a survey with the Lynfield obsessive‐compulsive symptom questionnaire (revised version) on 48 obsessive‐compulsive neurotic patients as the survey subjects. In the factor analysis five factors of obsessions, were identified: (i) the desire for perfection; (ii) compulsive checking; (iii) washing; (iv) feelings of uncleanliness; and (v) anthropophobia. High correlations were noted between these factors. We also investigated the premorbid personalities of obsessive‐compulsive neurotic patients with a multidimensional personality scale and obtained an extroversion dimension and neuroticism dimension. The influence of these premorbid personality dimensions on obsessive‐compulsive symptoms became clear; (i) neuroticism is related to the levels of obsession after onset, but not related to compulsive behaviors; and (ii) No differences in premorbid personality dimensions were noted between compulsive checking and compulsive washing behaviors. We also studied whether it was possible to predict the efficacy of pharmacotherapy upon obsessive‐compulsive symptoms. It was elucidated that the obsessions of those whose premorbid personalities are emotionally stable and extroversive are susceptible to antidepressants. Based on these results, we discussed the usefulness of premorbid personalities in predicting diversity of obsessive‐compulsive symptoms, as well as in prediction the efficacy of medication.
Survival analytic approach to long‐term prescription of benzodiazepine hypnotics
Authors: ISHIGOOKA JUN , SUGIYAMA TAKESHI , SUZUKI MAKIHIKO , KOBAYASHI KAZUHIRO , TAKEUCHI HISAKO , MURASAKI MITSUKUNI
Published: March 2003

Eight hundred and sixty‐two patients who visited the department of neuropsychiatry and who were prescribed benzodiazepine (BZ) hypnotics were investigated to evaluate the actual state of their use, in terms of age, gender, diagnostic categories according to ICD‐9, duration of prescription and dose equivalent to diazepam prescribed. The frequency of prescriptions in subjects were surveyed using Kaplan–Meier survival analysis at every 3 months. Mean survival time to discontinuation was 8.5 months. A total of 60% of the subjects did not receive BZ hypnotics at the end of the third month, but 20% remained to be prescribed after 1 year. Moreover, 7.9% of the subjects were prescribed BZ hypnotics even after 3 years. The results indicated that 20% of patients who had started prescriptions for BZ hypnotics had the potential to induce dependence. The following variables were found in the long‐term prescription: male patients; aged patients over 60; and affective psychoses (which mainly consisted of depression) including neurotic depression, in the present study. A low dose was considered to be associated with an ability to be free from BZ hypnotics in an early period.
Amplitude reduction of plasma melatonin rhythm in association with an internal desynchronization in a subject with non‐24‐hour sleep–wake syndrome
Authors: Masubuchi Satoru , Hashimoto Satoko , Endo Takuro , Honma Sato , Honma Ken‐Ichi
Published: March 2003

The plasma melatonin rhythm was measured longitudinally in a subject with non‐24‐h sleep–wake syndrome, and the amplitude and area under the curve (AUC) of the melatonin rhythm were investigated in relation to the sleep–wake cycle. When the melatonin rhythm and sleep–wake rhythm were internally desynchronized, the amplitude and the AUC were reduced significantly. These parameters were not influenced by external melatonin administration. These results suggest that a causal relationship between the reduction of circadian oscillation and internal desynchronization exists in this subject.
Capgras syndrome: Analysis of nine cases
Authors: Huang Tiao‐Lai , Liu Chia‐Yih , Yang Yong‐Yi
Published: March 2003

Three hundred and sixty‐four patients, 158 males and 206 females, were admitted to an acute psychiatric ward between November 1994 and October 1995, and only 9 patients (2 males and 7 females) fulfilled the clinical criteria for Capgras syndrome. The crude prevalence of Capgras syndrome in the acute psychiatric ward was 2.5% (1.3% for men and 3.4% for women), which is not uncommon. Medical records and laboratory examinations, including brain images and electroencephalographic examinations (EEG), were reviewed in the nine patients with Capgras syndrome. Four cases were proven to have apparently abnormal anatomical lesions on EEG, brain computed tomography, magnetic resonance imaging or single photon emission computed tomography (99mTc–HMPAO) examinations and five cases were associated with major physical illness. These findings support that organic factors could be important in the pathogenesis of Capgras syndrome.
Patient satisfaction with polypharmacy reduction in chronic epileptics
Authors: Matsuura Masato
Published: March 2003

The effects of polypharmacy reduction on patient satisfaction and subjective seizure severity were assessed prospectively in adult out‐patients with chronic epilepsy using Japanese versions of the Side effects and Life Satisfaction (SEALS) and the Seizure Severity Questionnaires (SSQ). Antiepileptic drugs (AED) were withdrawn using a 1‐year reduction schedule. The SSQ score was not aggravated and total SEALS score improved significantly. Moreover, temper subscore was also improved in the sedative AED reduction group. Similar to previous studies from the physician’s viewpoint, the present study confirms that from the perspective of the patient, polypharmacy reduction, especially withdrawal of sedative AED, has a favorable effect on patient satisfaction.
Sleep–wake behavior of shift workers using wrist actigraph
Authors: Park Young Man , Matsumoto Kazuya , Seo Yoo Jin , Cho Yong Rai , Noh Tae Jeong
Published: March 2003

Abstract The sleep–wake behavior and the effects of aging on the tolerance of night shift were investigated using wrist actigraph for 12 Korean male workers of a continuous full‐day three‐team three‐shift system. The wrist actigraph data were obtained for about 21 days (1 shift cycle) for each subject. During night duty, total sleep time decreased, the number of naps and nap length during on‐duty or off‐duty periods increased, and the level of activity decreased with increasing age. These results suggest that the tolerance to night shift becomes weaker with increasing age.
Tardive dystonia provoked by concomitantly administered risperidone
Authors: Tachikawa Hirokazu , Suzuki Toshihito , Kawanishi Yoichi , Hori Masashi , Hori Takafumi , Shiraishi Hiroyasu
Published: March 2003

Abstract Two cases of tardive dystonia are reported. The first case was an 18‐year‐old schizophrenic woman suffering from parkinsonism and hypotension induced by antipsychotic drugs. Risperidone (4 mg/day) was added to her drug regimen and after increasing the dosage to 6 mg/day, she began to exhibit retrocollis. The second case was a 61‐year‐old woman who had schizophrenia and tardive dyskinesia. After replacing chlorpromazine (75 mg/day) with risperidone (4 mg/day), she began to exhibit retrocollis. The retrocollis in both cases was considered to be tardive dystonia provoked by risperidone administered concomitantly with other antipsychotics. Risperidone is reported to produce few extrapyramidal symptoms, but these cases suggested that changing from other drugs to risperidone, or rapidly increasing risperidone dosage, may provoke tardive syndrome.
A case report of refractory obsessive–compulsive disorder improved by risperidone augmentation of clomipramine treatment
Authors: Kawahara Takashi , Ueda Yuto , Mitsuyama Yoshio
Published: March 2003

Abstract A male patient aged 43 years, suffering from symptoms of obsessive–compulsive disorder (OCD), such as washing hands and feet frequently and checking documents compulsively, had received intensive pharmacotherapeutic and behavior therapy. Although the administration of anxiolytic drugs and/or clomipramine did not show curative effects, a combination of clomipramine and risperidone showed much greater effect in improving these symptoms.
Sociodemographic and clinical characteristics of psychiatric patients coercively brought to hospitals
Authors: Ishizuka Chiaki , Nakatani Yoji , Morita Nobuaki , Satoh Shinji
Published: March 2003

Abstract In order to clarify the sociodemographic and clinical characteristics of psychiatric patients with poor motivation for treatment, we examined patients who were coercively brought to hospitals. Sociodemographic and clinical data on 287 inpatients from two private psychiatric hospitals in Japan were retrospectively analyzed. All patients were in the hospitals on 1 April 1997 and had received treatment prior to this admission. Of these inpatients, 67 (23.3%) were coercively brought to hospitals. Multiple logistic regression was performed on the data of these patients to identify the factors associated with their resistance to visiting the hospital. From the results of multivariate analysis, four characteristics were associated with patients coercively brought to hospitals, namely medication compliance, receiving regular outpatient treatment or not, a history of self‐aggression or aggressive behavior towards others, and living arrangements. For patients who had lived with relatives before hospitalization, the primary caregiver being a parental caregiver was associated with patients coercively brought to hospitals, although it was not statistically significant. In addition, agitation was associated with patients not coercively brought to the hospital according to multivariate analysis. The present results suggest that psychiatric patients with poor motivation are more likely to have poor medication compliance, to have not received regular outpatient treatment, to have a history of aggressive behavior and to live alone. For patients who lived with their caregivers prior to hospitalization, poorly motivated patients tended to have parental caregivers and were less likely to be agitated.
Effects of physiological cardiac pacing on sleep‐disordered breathing in patients with chronic bradydysrhythmias
Authors: Kato Isao , Shiomi Toshiaki , Sasanabe Ryujiro , Hasegawa Rika , Otake Kazuo , Banno Katsuhisa , Yamakawa Hiroki , Mizutani Noboru , Kobayashi Tadashi
Published: March 2003

In six patients with chronic bradydysrhythmias, polysomnographies were performed before cardiac pacemaker implantation and over the week following implantation. A patient with third‐degree atrioventricular block (AVB) and two patients with sinus node dysfunction (SND) were associated with sleep‐disordered breathing (SDB). Their cardiac pacemaker therapies, with the increase in the average heart rate, led to a reduction of apnea–hypopnea index and/or an improvement of Cheyne‐Stokes breathing. It seems that chronic bradydysrhythmia is one of the causative factors leading to SDB.
Association analysis of the 5‐HT6 receptor polymorphism C267T with depression in patients with Alzheimer's disease
Authors: Liu Hsiu‐Chih , Hong Chen‐Jee , Liu Chia‐Yih , Lin Ker‐Neng , Tsai Shih‐Jen , Liu Tsung‐Yun , Chi Chin‐Wen , Wang Pei‐Ning
Published: March 2003

Abstract A significant increase of 267C allele of the 5‐HT6 receptor gene has been reported in patients with Alzheimer's disease (AD). Because a deficit in serotonergic neurotransmission is involved in major depression, we tried to find out whether 267C allele is associated with depressive disorders in AD. A psychiatrist interviewed all AD patients and their caregivers for evidence of depression using a Chinese version of the Standard Clinical Interview for DSM‐III‐R. The difference in the 5‐HT6 genotype or allele distributions between the AD patients with depressive disorders (n = 25) and those without (n = 120) was not significant.
The event‐related potentials elicited by content and function words during the reading of sentences by patients with schizophrenia
Authors: Takashima Atsuko , Ohta Katsuya , Matsushima Eisuke , Toru Michio
Published: March 2003

Abstract Thought disorder is one of the main symptoms observed in schizophrenia and has been investigated in terms of language dysfunction. The purpose of the present study was to find whether there were any differences in identifying and processing between content (semantic) and function (syntax) words, and to elucidate whether semantic or syntax is more impaired for the schizophrenics. Event‐related potentials were recorded in 13 patients with schizophrenia and 14 healthy controls, while they silently read three sets of passages. Event‐related potentials were recorded for content words (noun, verb) and function words (auxiliary verb, particle) separately. For the healthy control group, the mean amplitude of P200 for the content word class was greater than for the function word class with fronto‐central dominancy. In contrast, no such difference was found for the schizophrenics mainly due to the reduction of P200 amplitude of the content words. Larger P200 for the content than the function word class suggests that greater resources were used to identify the content words. Lack of this difference found in patients with schizophrenia suggested that the disturbances in the semantics may be more attributable to the linguistic impairment than those in the syntax.
Hoarding in obsessive–compulsive disorder and related disorders: A preliminary report of 15 cases
Authors: Seedat Soraya , Stein Dan J
Published: March 2003

Abstract Hoarding, the repetitive collection of excessive quantities of poorly useable items of little or no value with failure to discard these items over time, is characterized in DSM‐IV as a symptom of obsessive–compulsive disorder (OCD) and obsessive–compulsive personality disorder (OCPD) but has, until recently, received scant empirical investigation. We describe the demographics, phenomenology, associated psychopathology and family history in 15 subjects presenting with hoarding behavior. Fifteen subjects were recruited from an OCD clinic and newspaper advertisement and assessed with the comprehensive Structured Clinical Interview for DSM‐IV (SCID I and II), the Yale‐Brown Obsessive Compulsive Scale (Y‐BOCS), and a hoarding questionnaire (devised by the authors). The sample comprised 11 women and four men who hoarded a mean of seven item types, with a mean duration of 13.2 ± 3.9 years (range 2–15 years). Their mean age was 41.8 ± 14.3 years (range 20–65 years). The most common motive for hoarding was the fear of discarding items of practical value. Nine subjects met DSM‐IV criteria for OCD, 9 met criteria for OCPD, for symptoms and behaviors other than hoarding, while six subjects met criteria for a putative OCD spectrum disorder (Tourette's, body dysmorphic disorder, trichotillomania). Six subjects reported little or no control over their hoarding, but only one subject saw her symptoms as an ‘illness’ warranting treatment. Pathological hoarding is usually a covert and chronic behavior causing distress and/or impairment, and may be related to OCD and OCPD. Hoarding may meet the criterion for a compulsion in DSM‐IV, yet there is evidence to suggest that hoarding may manifest in a variety of other psychiatric conditions. While a range of pharmacologic and behavioral treatments have been tried, their effectiveness in managing hoarding behaviors requires additional research.
The influence on the schizophrenic symptoms by the DRD2Ser/Cys311 and −141C Ins/Del polymorphisms
Authors: Himei Akio , Koh Jun , Sakai Jun , Inada Yasushi , Akabame Kazuyo , Yoneda Hiroshi
Published: March 2003

Abstract The hyperactivity of dopaminergic systems is one of the major etiological hypotheses of schizophrenia. The major support for this hypothesis is that effective antipsychotic drugs bind to dopamine receptors and improve acute schizophrenic symptoms. For this reason, we investigated the allelic association between schizophrenia and polymorphisms of the DRD2 genes for the Ser/Cys311 and –141C Ins/Del. The subjects were 190 schizophrenics (120 males and 70 females) and 103 normal controls (53 males and 50 females). There were no significant differences between the patients and controls in the allele frequencies and the frequencies of the genotypes. We found no statistical association between schizophrenia and polymorphisms of the DRD2 genes for the Ser/Cys311 and –141C Ins/Del. These results indicate that the DRD2 gene may not develop schizophrenia. Next, we examined whether the genotypes influence the symptoms of schizophrenia the using Positive and Negative Symptom Scale scores. The Ser/Cys patients exhibited significantly lower positive and negative symptom scores than Ser/Ser patients. Patients with Del/Del, Ins/Del, or Ins/Ins showed higher positive symptom scores in descending order. This result suggested that the Del allele worsens the positive symptoms. We concluded that the DRD2 receptor gene may not influence the onset of schizophrenia, but there is a strong possibility that the Cys311 and –141C Del have a significant influence on the symptoms of schizophrenia.
Evaluating mental fatigue in patients with obstructive sleep apnea syndrome by the Maastricht Questionnaire
Authors: HAYAKAWA TOSHIJI , FUJITA OSAMU , ISHIDA KAZUYA , USAMI TAKESHI , SUGIURA SYOUICHI , KAYUKAWA YUHEI , TERASHIMA MASAYOSHI , OHTA TATSURO , OKADA TAMOTSU
Published: March 2003

Abstract Mental fatigue in patients with obstructive sleep apnea syndrome (OSAS) was investigated and compared with subjects without OSAS. The study series comprised 189 habitual snoring patients and 75 controls. To measure subjective mental fatigue and somnolence, subjects were asked to complete the Maastricht Questionnaire (MQ) and the Epworth Sleepiness Scale (ESS), respectively, and patients also underwent diagnostic polysomnography. According to the apnea and hypopnea index, patients were classified into the following groups: primary snorers, or having mild, moderate, or severe OSAS. The lowest MQ and highest ESS scores were found in those patients with severe OSAS. It is proposed that the lowest MQ score is due to mental fatigue impairing awareness in patients with severe OSAS, probably because of attention loss.
Study of image findings in rapid eye movement sleep behavioural disorder
Authors: SHIRAKAWA SHIN‐ICHIRO , TAKEUCHI NOBORU , UCHIMURA NAOHISA , OHYAMA TETU , MAEDA HISAO , ABE TOSHI , ISHIBASHI MASATOSHI , OHSHIMA YUUKI , OHSHIMA HIROHARU
Published: March 2003

Abstract To elucidate the cause of idiopathic rapid eye movement (REM) sleep behavior disorder (RBD), magnetic resonance imaging and single‐photon emission computed tomography of the brain were conducted on 20 patients with RBD. Blood flow in the upper portion of both sides of the frontal lobe and pons was significantly lower in patients with RBD than in the normal elderly group. Among the patients with RBD, decreased blood flow in the frontal lobe showed no correlation with the extent of frontal lobe atrophy. Decreased blood flow in the upper portion of the frontal lobe and pons might be associated with the pathogenesis of idiopathic RBD.
Clinical significance of sleep‐related breathing disorder in narcolepsy
Authors: INOUE YUICHI , NANBA KAZUYOSHI , HIGAMI SHIGERU , HONDA YUTAKA , TAKAHASHI YASURO , ARAI HEII
Published: March 2003

Abstract Both the influence of comorbid obstructive sleep apnea–hypopnea syndrome (OSAHS) on daytime sleepiness and its pathological mechanism in 10 narcoleptic patients was studied. Mild elevation of esophageal negative pressure and obstruction in the velopharyngeal area, as observed by upper airway magnetic resonance imaging, during apneic episodes was observed in the subjects. Severity of the disorder was correlated positively with body mass index, and the latencies of the multiple sleep latency tests were not improved with nasal continuous positive airway pressure treatment in subjects. Pathogenesis of OSAHS in narcolepsy was thought to be almost similar to typical OSAHS, and that the disorder seemed to lack a pathological influence on daytime sleepiness.
Case of head banging that continued to adolescence
Authors: HASHIZUME YUJI , YOSHIJIMA HIDEKAZU , UCHIMURA NAOHISA , MAEDA HISAO
Published: March 2003

Abstract Head banging is a rhythmic movement disorder (RMD) along with headrolling and bodyrolling. The average age of onset is 9 months, and by 10 years of age the majority of subjects no longer complain of head banging. A case of head banging in which the symptoms continued to adolescence is reported. The RMD involved the patient abnormally rolling his body or head and hitting his head on walls during sleep. His head bangings were observed during sleep stage 2 and REM sleep. Doses of clonazepam ranging from 0.5 mg to 2 mg were administered for the RMD, which diminished when treated with 2 mg of clonazepam.
Effects of Yoku‐kan‐san‐ka‐chimpi‐hange on the sleep of normal healthy adult subjects
Authors: AIZAWA RIKA , KANBAYASHI TAKASHI , SAITO YASUSHI , OGAWA YURIKO , SUGIYAMA TOMONARI , KITAJIMA TSUYOSHI , KANEKO YOSHIHIKO , ABE MASAHITO , SHIMIZU TETSUO
Published: March 2003

Abstract Yoku‐kan‐san‐ka‐chimpi‐hange (YKCH) is a drug used for insomnia in Japanese traditional herbal medicine. The present study evaluated the effects of YKCH on sleep by all‐night polysomnography using the double‐blind method. Yoku‐kan‐san‐ka‐chimpi‐hange increased the total sleep time significantly, and tended to cause an increase in sleep efficiency and of stage 2 sleep, as well as a decrease of sleep latency and of stage 3 + 4 sleep. There was no apparent influence on rapid eye movement (REM) sleep. In terms of non‐REM sleep, the effects of YKCH exhibit a profile similar to those of benzodiazepines.
Psychosocial problems in attention‐deficit hyperactivity disorder with oppositional defiant disorder
Authors: HARADA YUZURU , YAMAZAKI TOHRU , SAITOH KAZUHIKO
Published: March 2003

Abstract The purpose of this study is to clarify psychosocial characteristics of the comorbidity of attention‐deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in comparison with ADHD or ODD alone. Thirty‐one patients with ADHD comorbid with ODD were compared with 23 ADHD alone and 10 with ODD alone, in terms of various examination items including objective assessment scales. The comorbid group demonstrated higher Children Depression Inventory score and State‐Trait Anxiety Inventory for Children (state‐anxiety) score than the ADHD or the ODD group, possessing more problems in the relationship with teachers than the ADHD group, with friends more than the ADHD or the ODD group, and with their mothers more than the ADHD group and less than the ODD group. School refusal occurred more frequently in the comorbid group than the ADHD group and less than the ODD group. The comorbid group had more psychosocial problems than the ADHD group and the ODD group. These problems could be classified into three types: (i) those derived from ODD, problems in the relationship with teachers; (ii) those derived from ODD but reduced by the coexistence of ADHD, problems in the relationship with their mothers; and (iii) those resulting from the comorbidity of ADHD and ODD, problems in the relationship with friends and anxious and depressive tendency. The difficulties in the relationship with teachers and friends observed in the comorbid group may lead to school refusal.
Long‐term rectal temperature measurements in a patient with menstrual‐associated sleep disorder
Authors: SUZUKI HIROYUKI , UCHIYAMA MAKOTO , SHIBUI KAYO , KIM KYUJA , TAGAYA HIROKUNI , SHINOHARA KAZUYUKI
Published: March 2003

Abstract The international classification of sleep disorders has proposed menstrual‐associated sleep disorder. However, few studies have investigated its pathophysiological mechanism. A 34‐year‐old woman complaining of insomnia in the late luteal phase underwent continuous rectal temperature measurements and simultaneous actigraphic monitoring for 146 days. The acrophase of rectal temperature rhythm was delayed in the luteal phase, compared with that in the follicular phase. Her bedtime and risetime did not differ across the menstrual cycle. These results suggest that her insomnia in the luteal phase may have been a consequence of desynchronization between her temperature rhythm and sleep phase in the luteal phase.
Relationships between seizure duration and seizure threshold and stimulus dosage at electroconvulsive therapy: Implications for electroconvulsive therapy practice
Authors: CHUNG KA‐FAI
Published: March 2003

Recent studies cast doubt on the usefulness of seizure duration as an index for stimulus dosage adjustment at electroconvulsive therapy (ECT). A retrospective analysis on the relationships between seizure duration and seizure threshold and stimulus dosage was performed for 54 patients who received a standardized ECT dose titration and treatment protocol. Subjects receiving stimulus dosage at seizure threshold had a highly variable motor seizure duration, ranging from 15 to 89 s, and 7.4% of subjects had seizures longer than 60 s. Regression analysis showed that initial seizure threshold and height were independent predictors of motor seizure duration during dose titration and accounted for 34% of its variance. Stimulus dosage was increased by 40–67% between the first and second ECT session; however, 60% of subjects had no lengthening of seizures and motor seizure duration was significantly shorter at the second treatment (mean ± SD: 35.7 ± 12.3 vs 31.0 ± 10.6 s; paired t = 2.9, d.f. = 34, P = 0.006). At the first and second ECT treatment, motor seizure duration was significantly related to stimulus dosage (r = –0.45 and r = –0.41, respectively). Given the negative correlation between seizure duration and stimulus intensity, a policy that recommends an increase of stimulus dosage and its reduction for patients with short and long seizures, respectively, does not necessarily result in ‘optimal’ seizure duration. A better dosing policy that places less emphasis on seizure duration is proposed.
Retroperitoneal bronchogenic cyst: Report of a case and literature review
Authors: Itoh Hiroshi , Shitamura Takahiro , Kataoka Hiroaki , Ide Hisamitsu , Akiyama Yutaka , Hamasuna Ryoichi , Hasui Yoshihiro , Osada Yukio , Koono Masashi
Published: March 2003

A large cystic mass was found in the subdiaphragmatic region of a 46‐year‐old woman who had complained of continuous pain in the left flank . The cyst was located in the retroperitoneum just below the diaphragm and was adhered to the diaphragmatic skeletal muscle and abdominal aorta, but was separate from the spleen, pancreas, left adrenal gland and left kidney. The surgically resected cyst measured 8 × 8 × 7 cm and was filled with protein‐rich fluid, which contained amylase and embryonal proteins such as carcinoembryonic antigen, CA125 and CA19‐9. Histologically, the cyst wall was composed of a fibrovascular connective tissue containing thin smooth muscle layers and mucus‐secreting glands and was lined by a ciliated pseudostratified or tall columnar epithelium without dysplastic changes. Thus, a diagnosis of bronchogenic cyst, which is usually discovered in the posterior part of the mediastinum, was made. A rare case of bronchogenic cyst and a literature review is presented.
Extracranial metastasis of anaplastic ganglioglioma through a ventriculoperitoneal shunt: A case report
Authors: Araki Masahiro , Fan Jianglin , Haraoka Seiji , Moritake Takashi , Yoshii Yoshihiko , Watanabe Teruo
Published: March 2003

Extracranial metastasis of an intracranial anaplastic ganglioglioma through a ventriculoperitoneal shunt is reported. A 53‐year‐old woman was treated by surgery, radiation and chemotherapy and died 2 years later. At autopsy, multiple metastatic lesions were found in the spinal cord, and the abdominal and pleural cavities. Histologically, all the metastatic lesions were composed of atypical cells which resembled primitive glial elements found in intracranial anaplastic ganglioglioma, suggesting that anaplastic glial elements have a metastatic potential. Extracranial metastasis of ganglioglioma is a rare occurrence; however, the spread of glial elements through the shunt further suggests that caution is required in therapy and indicates a need for protective filters in the shunt system.
Sarcomatoid carcinoma of the pancreas: A case report with immunohistochemical study
Authors: Higashi Michiyo , Takao Sonshin , Sato Eiichi
Published: March 2003

Sarcomatoid carcinoma of the pancreas is an uncommon neoplasm. The immunohistochemical characteristics of this unique type of pancreatic tumor were studied. Histologically, there was diffuse proliferation of atypical spindle cells that had hyperchromatic, short, spindle‐shaped nuclei and pale cytoplasm. A few tiny foci of small tubular structures were seen in connection with the atypical spindle‐shaped cells. Immunohistochemical examination showed that the spindle cells were positive for epithelial cell markers (cytokeratin AE3, cytokeratin AE1, epithelial membrane antigen) and DF3 (MUC1 apomucin‐related antigen (ARA)), and were negative for markers such as vimentin, desmin, neuron‐specific enolase, and myoglobin. DF3 antigen is known to be expressed in invasive ductal carcinoma of the pancreas and liver, as well as of the breast. Other MUC1‐ARA (MY.1E12, MUC1 glycoprotein, HMFG‐1, HMFG‐2) and anti‐CA19‐9 were also detected in the present case. Thus, this tumor was diagnosed as anaplastic carcinoma (sarcomatoid carcinoma).
Transgenic rabbit models for biomedical research: Current status, basic methods and future perspectives
Authors: Fan Jianglin , Challah Mireille , Watanabe Teruo
Published: March 2003

The creation of genetically modified laboratory and livestock animals is one of the most dramatic advances derived from recombinant DNA technology. Over the past decade, the development of a large mammal transgenic model, transgenic rabbits, has provided unprecedented opportunities for investigators to study the mechanisms of human diseases and has also provided a novel way to produce foreign proteins for both therapeutic and commercial purposes. Recent progress in gene targeting and animal cloning has opened new avenues for production of transgenic rabbits. In this review, we will introduce the reader to the progress that has been achieved in transgenic rabbits with emphasis on the application of these rabbits as human disease models and bioproducers of human therapeutic proteins.
Expression profile of extracellular matrix and its regulatory proteins during the process of interstitial fibrosis after anti‐glomerular basement membrane antibody‐induced glomerular sclerosis in Sprague‐Dawley rats
Authors: Adhikary Laxman P. , Yamamoto Tadashi , Isome Masato , Nakano Yoshimasa , Kawasaki Katsutoshi , Yaoita Eishin , Kihara Itaru
Published: March 2003

Anti‐glomerular basement membrane (GBM) nephritis in Sprague‐Dawley (SD) rats was characterized by development of marked glomerular sclerosis and tubulointerstitial fibrosis. To elucidate sequential change of the glomerular sclerosis and tubulointerstitial fibrosis, accumulation and mRNA expression of extracellular matrix (ECM) components and transforming growth factor (TGF)‐β were examined in the glomerulus and cortex during the disease course by histology, immunostaining and ribonuclease protection assay. Mild proliferative and degenerative lesions appeared in the glomeruli by day 15 after anti‐GBM antibody binding to GBM and progressed to glomerular sclerotic lesion thereafter. Conversely, interstitial change was first recognized by infiltration of mononuclear cells after day 20, followed by marked accumulation of ECM and tubular degeneration. The interstitial fibrosis was induced without apparent binding of anti‐GBM antibody to tubular basement membrane. Accumulation of fibronectin, collagen type I and type IV was noted in the interstitium by immunofluorescence microscopy in association with enhanced expression of mRNA for these ECM components and their regulatory molecules such as matrix metalloproteinase (MMP2), tissue inhibitor of metalloproteinase (TIMP)‐1 and TGF‐β1 both in glomeruli and cortex. The glomerular expression of these mRNA increased apparently by day 15 and reached a plateau or a peak at day 20. The expression of the same mRNA increased gradually from day 15 to day 29 in the cortex. These observations show that interstitial fibrosis follows glomerular sclerosis after anti‐GBM antibody injection in SD rats, suggesting that at least a part of the mechanism for ECM accumulation in the glomerulus and interstitium is essentially the same in terms of composition of ECM and expression of its regulatory molecules.
Micropapillary variant of transitional cell carcinoma of the ureter
Authors: Oh Young Lyun , Kim Kyu Rae
Published: March 2003

Micropapillary variant of transitional cell carcinoma (TCC) is a rare entity, having a distinct micropapillary component mimicking papillary serous carcinoma of the ovary and has been reported exclusively in the urinary bladder. We experienced a case of micropapillary variant of TCC in the ureter. The tumor showed a predominant proportion of micropapillary component and accompanied a TCC in situ lesion and a high‐grade TCC. A metastatic lesion in the regional lymph node also showed an entirely micropapillary pattern. Initially, our case was confused with adenocarcinoma, especially metastatic, because the micropapillary architecture resembled an abortive glandular structure and tumor cell nests were predominantly located in empty spaces mimicking vascular invasion. The patient died with peritoneal metastases 20 months after the initial diagnosis. We report the first case of a micropapillary variant of TCC occurring in the ureter.