bluuebunny/crossref_metadata_2025 huggingface dataset:
The constitutive and inducible expression of Nurr1, a key regulator of dopaminergic neuronal differentiation, in human neural and non‐neural cell lines
Authors: Satoh Jun‐ichi , Kuroda Yasuo
Published: March 2003

Nur‐related factor 1 (Nurr1), nerve growth factor‐induced gene B (NGFI‐B) and neuron‐derived orphan receptor‐1 (NOR‐1) constitute the orphan nuclear receptor subfamily of transcription factors. Previous studies showed that midbrain dopaminergic neuronal precursor cells failed to differentiate in Nurr1‐deficient mice. To investigate a role of Nurr1 in human neuronal function, Nurr1 mRNA expression was studied in human neural cell lines by RT‐PCR and northern blot analysis. Nurr1, NGFI‐B and NOR‐1 mRNA were coexpressed in all human neural and non‐neural cell lines under the serum‐containing culture condition, except for SK‐N‐SH neuroblastoma, in which Nurr1 mRNA was undetectable. The levels of Nurr1, NGFI‐B and NOR‐1 mRNA were elevated markedly in NTera2 teratocarcinoma‐derived neurons (NTera2‐N), a model of differentiated human neurons, following a 1.5 or 3 h‐exposure to 1 mmdibutyryl cyclic AMP or 100 nmphorbol 12‐myristate 13‐acetate. NGFI‐B mRNA levels were also elevated in NTera2‐N cells by exposure to 100 ng/mL brain‐derived neurotrophic factor (BDNF). To identify Nurr1‐target genes, the mRNA expression of 27 genes potentially involved in dopaminergic neuronal differentiation and survival, including BDNF, glia‐derived neurotrophic factor, their receptors, tyrosine hydroxylase and α‐synuclein, were studied in HEK293 cells following overexpression of Nurr1. None of these genes examined, however, showed significant changes. These results indicate that Nurr1, NGFI‐B and NOR‐1 mRNA are expressed constitutively in various human neural and non‐neural cell lines under the serum‐containing culture condition, and their levels are up‐regulated in human neurons by activation of protein kinase A or protein kinase C pathway, although putative coactivators expressed in dopaminergic neuronal precursor cells might be required for efficient transcriptional activation of Nurr1‐target genes.
Understanding technology in contemporary surgical nursing: a phenomenographic examination
Authors: Barnard Alan , Gerber Rod
Published: March 2003

The purpose of this paper is to describe the result of phenomenographic research undertaken to identify the qualitatively different ways technology is understood and experienced by contemporary surgical nurses. Twenty surgical nurses were interviewed and conversations were recorded through the use of drawings and audiotape that were analysed using a series of seven analytical steps. There were two major outcomes of the research: eight categories of description were revealed and each one constitutes a conception of the experience and understanding of technology, and an outcome space portraying the logical relations between conceptions was identified. Conceptions revealed demonstrate the importance of technology to the theory, practice, research and education of nurses, and highlight the complexity and significance of technology in contemporary surgical nursing experience.
Compassionate care: a moral dimension of nursing *
Authors: Von Dietze Erich , Orb Angelica
Published: March 2003

Compassionate care: a moral dimension of nursing

This paper focuses on the concept of compassion and its meaning for nursing practice. Compassion is often considered to be an essential component of nursing care; however, it is difficult to identify what exactly comprises compassionate care. To begin with, there is a general discussion of the meaning of compassion and an examination of its common usage. An argument then is presented that compassion is more than just a natural response to suffering, rather that it is a moral choice. The paper outlines the extent to which this concept has implications for nursing care, highlighting some of the obstacles that nurses need to overcome in order to maintain this essential moral value of the caring role.
Repeating history? Public and community health nursing in Australia
Authors: Helen Keleher
Published: March 2003

Repeating history? Public and community health nursing in Australia

Despite the long history in Australia of public and community health nursing, it has never been regarded as important as hospital‐based nursing. Notwithstanding the establishment of nursing organisations in the very early years of the 20th century and subsequent efforts to develop the nursing workforce, public and community health nursing has been neglected in terms of policy, research into public health nursing practice and workforce development. Even in the present day, public and community health nurses are marginalised from mainstream nursing interests and there is a lack of conceptualisation about the value of nursing’s contribution to the primary health sector. This sector is experiencing a new wave of reforms driven by a combination of managerialism and systems change for improved responses to address health inequalities. Because there is not a strong institutionalised professional policy and support base for public and community health nurses, they are vulnerable in these reforms to increased domination and appropriation of their practice by stronger professional interests. There is an urgent need for professionally organised support from mainstream nursing to ensure that public and community health nurses are positioned as a unified force in efforts to advance the health of the community.
Embodied largeness: a significant women’s health issue
Authors: Carryer Jenny
Published: March 2003

Embodied largeness: a significant women’s health issue

This paper describes a three‐year long research project in which nine large‐bodied women have engaged in a prolonged dialogue with the researcher about the experience of being ‘obese’. The study involved an extensive review of the multidisciplinary literature that informs our understandings of body size. The literature review was shared with participants in order to support their critical understanding of their experience.

An examination of a wide range of literature pertinent to the area of study reveals widespread acceptance of the notion that to be thin is to be healthy and virtuous, and to be fat is to be unhealthy and morally deficient. The experience of participants raised questions as to how nursing could best provide health‐care for large women. According to the literature review, nurses have perpetuated an unhelpful and reductionist approach to their care of large women, in direct contradiction to nursing’s supposed allegiance to a holistic approach to health‐care. This paper suggests strategies for an improved response to women who are concerned about their large body size.
Nursing migration: global treasure hunt or disaster‐in‐the‐making?
Authors: Kingma Mireille
Published: March 2003

Nursing migration: global treasure hunt or disaster‐in‐the‐making?

International nurse migration — moving from one country to another in the search of employment — is the focus of this article. The majority of member states of the World Health Organization report a shortage, maldistribution and misutilisation of nurses. International recruitment has been seen as a solution. The negative effects of international migration on the ‘supplier’ countries may be recognised today but are not effectively addressed.

Nurse migration is motivated by the search for professional development, better quality of life and personal safety. Pay and learning opportunities continue to be the most frequently reported incentives for nurse migration, especially by nurses from less‐developed countries. Career opportunities were considered key incentives for nurses emigrating from high‐income countries. Language was reported to be a significant barrier. The positive global economic/social/professional development resulting from international migration needs to be weighed against a substantial ‘brain and skills drain’ experienced by supplier countries. The vulnerable status of migrant nurses is also of concern in certain cases. The focus on short‐term solutions as opposed to resolving the problem of a worldwide shortage of nurses causes great concern. Recent initiatives attempt to curb or channel international recruitment. The delicate balance between recognising the right of individual nurses to migrate and a collective concern for the health of a nation’s population must be achieved.
Agonizing care: care ethics, agonistic feminism and a political theory of care
Authors: Cloyes Kristin G.
Published: March 2003

Agonizing care: care ethics, agonistic feminism and a political theory of care

‘Care’ is central to nursing theory and practice, and has been described in a variety of ways. Intense conversations about care have been developing in other fields of study as well, from the social sciences to the humanities. Care ethics has grown out of intellectual exchange between feminist thought, moral theory and the critique of traditional western political philosophy. However, care ethics is not without its critics, as these accounts of care have also sparked vigorous challenges. This paper traces the construct of care through nursing theory, care ethics, feminist critiques of moral and political theory and agonistic feminism to outline a set of problematics that a political theory of care should engage. It discusses how care is conventionally posited in more or less essentialist, universalizing and naturalizing terms. It introduces the ideas of feminist theorists who resist dichotomizing care and the political, and situate care in the context of power and politics. The tensions between care feminism and agonistic feminism are highlighted in order to explore the potential of theorizing both care and nursing in political terms.
Recognising relationships: reflections on evidence‐based practice
Authors: Kitson Alison
Published: March 2003

Recognising relationships: reflections on evidence‐based practice

This paper argues for a broadening of the way evidence is developed and used in health‐care. It contends that the current political and policy imperatives and the evidence‐based practice movement are in direct tension with the other major ideological movements that promote patient‐centred healthcare services. Nursing is affected by this tension because it is more naturally focused on relationships with clients to achieve health outcomes. The unresolved and mounting tension could be alleviated by embracing a broader definition of what counts as evidence and by focusing more on patient‐centred healthcare methodologies and acknowledging the interdependency of distinct ways of generating new knowledge. A number of case studies are used to illustrate how research focusing on patient perspectives and nurses’ response to patient experiences can improve the evidence base for nursing.
Breastfeeding policies and the production of motherhood: a historical–cultural approach
Authors: Meyer Dagmar Estermann , De Oliveira Dora Lúcia
Published: March 2003

Breastfeeding policies and the production of motherhood: a historical–cultural approach

This paper revisits some of the aspects that allow us to situate historically the process that has been called the ‘politicization of women's breasts’. It is part of a broader research project being undertaken in Rio Grande do Sul, Brazil, which is studying information from the educational material used in the National Campaign for the Incentive of Breastfeeding. The methodological approach used is cultural analysis, and its theoretical basis is informed by feminist studies and cultural studies, from a poststructuralist perspective. Knowledges and practices that produce notions of maternity are problematized to argue that current political and economic arrangements have necessitated a redefinition of motherhood. This re‐signification of motherhood has transferred to women the duty of solving an array of problems that were previously considered government's responsibility, in particular those related to the physical and emotional development of infants.
Religious experiences in epileptic patients with a focus on ictus‐related episodes
Authors: Ogata Akira , Miyakawa Taihei
Published: March 2003

Two hundred thirty‐four epileptic patients were examined for ictus‐related religious experiences. Of the 234 cases, three (1.3%) were found to have had such religious experiences. All three cases had temporal lobe epilepsy with post‐ictal psychosis, while one exhibited a simple partial seizure. At the same time, interictal experiences with hyperreligiosity were recognized in all three cases. The incidence of religious experiences while in a state of post‐ictal psychosis was 27.3%, which is regarded as high, indicating some influence by the religions that the patients had faith in. Patients who had ictus‐related or interictal religious experiences did not believe solely in Buddhism, a traditional religion in Japan, but rather in a combination of Buddhism and Shintoism, new Christian sect, contemporary Japanese religions and/or other folk beliefs. This indicates that these experiences had some connection not only with the personality characteristic of temporal lobe epilepsy, but also with the general lack of religious conviction and activity in Japan. In addition, the cases having ictus‐related religious experiences also had interictal religious experiences and an interaction was seen between them. In this paper, the importance of taking bio‐psycho‐social aspects into consideration is pointed out in the discussion of epilepsy and religion.
Recent advances in dementia research in Japan: Non‐Alzheimer‐type degenerative dementias
Authors: KOSAKA KENJI , ISEKI EIZO
Published: March 2003

In this article, we review recent reports by Japanese researchers on non‐Alzheimer‐type degenerative dementias. These dementias can be classified into the following subtypes: dementias with Lewy bodies, including diffuse Lewy body disease, dementias with neurofibrillary tangles, dementias with glial tangles, including progressive supranuclear palsy and corticobasal degeneration, argyrophilic grain dementia, frontotemporal dementias including Pick's disease, dementias with degeneration of subcortical nuclei, including Huntington's disease and, last, unclassified dementias. Recently, these various forms of dementia have received much attention in Japan, as elsewhere.
Methodological issues of an epidemiological study: From the results of a study on psychological problems seen in outpatients visiting the internal medicine departments of general hospitals
Authors: Utsunomiya Hiroshi , Yoshitake Kazuyasu , Otsuka Toshihiro , Sugasakl Hiroyuki , Sata Misako , Hatada Keiko , Nakane Yoshibumi
Published: March 2003

The frequency and type of psychological problems of outpatients in general healthcare settings, the recognition and management of those problems by physicians, and the course of the problems were investigated using a two‐stage sampling design method. The subjects were outpatients visiting the department of internal medicine of two general hospitals in Nagasaki prefecture. For the first‐stage investigation, the General Health Questionnaire 12‐item version (GHQ‐12) was used. A second‐stage investigation was then conducted, which used many instruments containing the Composite International Diagnostic Interview (CIDI) and Groningen Social Disability Scale (GSDS). As a result, 1555 patients participated in the first‐stage, 483 were selected and 336 (69.5%) participated in the second‐stage investigation. No significant differences were seen in age or sex between the GHQ score groups among the 1555 subjects of the core sample. The background factors of the two hospital samples differed significantly in the distribution of age, sex and physical diseases. There were some differences in the participation between men and women in age and GHQ score. It was then suggested that variances should be considered in such an epidemiological study.
Different effect of desipramine on protein kinase C in platelets between bipolar and major depressive disorders
Authors: Morishita Shigeru , Aoki Shozo , Watanabe Shosuke
Published: March 2003

Protein kinase C (PKC) activity was investigated in platelets from affective disorder subjects and healthy volunteers. The PKC activity of platelets incubated with desipramine was determined in vitro. The PKC activity of the major depressive disorder subjects and healthy volunteers was inhibited by desipramine, whereas that of the bipolar disorder subjects showed both inhibition and activation. In addition, the base PKC activity incubation with antidepressants of the major depressive disorder patients was significantly higher than of the bipolar disorder patients. These preliminary results suggest that the function of PKC may, at least in part, be associated with the mechanism of affective disorder.
The effect of 2‐h sleep reduction by a delayed bedtime on daytime sleepiness in children
Authors: Ishihara Kaneyoshi
Published: March 2003

The purpose of the present study was to investigate the effect of acute 2 h sleep reduction by a delayed bedtime on daytime sleepiness. Three children were evaluated over three consecutive days: two control days and a 2 h sleep reduction day. A sleep latency test was conducted five times each day at 2 h intervals from 10.00 h. The results showed that the effects of sleep loss generally increased daytime sleepiness, in particular, at 10.00 h, and suggested that the intensity of morning sleepiness may become a useful measure which reflects sleep loss.
Sleep stage and skin temperature regulation during night‐sleep in winter
Authors: Kubo Hiroko , Yanase Takuko , Akagi Hiroko
Published: March 2003

To clarify the thermally comfortable environment for satisfied sleep, we investigated the relationship between skin temperatures and sleep stages during night‐sleep in winter, summer and autumn. Four healthy young females served as the subjects. The experiments were performed in a climate chamber under three conditions: at 13°C‐RH70% with futon and blanket in winter, at 20–18°C‐RH60% with futon and towelket in autumn and at 29°C‐RH70% with towelket in summer. The subjects’ skin temperature on the sole was lower until about 4 hours after lights off in winter than in autumn and summer, and the percentage of st.2 was lower and st.4 was higher in winter than in autumn and summer, although the bed climate both in winter and autumn was much the same.
Multiple cardiovascular risk factors in obstructive sleep apnea syndrome patients and an attempt at lifestyle modification using telemedicine‐based education
Authors: Oki Yoshitaka , Shiomi Toshiaki , Sasanabe Ryujiro , Maekawa Masato , Hirota Izumi , Usui Kengo , Hasegawa Rika , Kobayashi Tadashi
Published: March 2003

Severe obstructive sleep apnea syndrome (OSAS) is a typical ‘lifestyle‐related disease’ characterized by a high incidence of cardiovascular risk factors, such as obesity, smoking, hypertriglyceridemia, and diabetes mellitus. Patients with OSAS tend to have eating disorders as a result of efforts to overcome the intolerable sleepiness. Treatment of OSAS should therefore aim to improve the lifestyle through encouraging weight reduction, physical activity increase, and tobacco avoidance, in addition to direct therapy such as continuous positive airway pressure for upper airway obstruction. The telemedicine system we developed was considered to be effective for providing home‐based education on nutrition and exercise aimed at correcting multiple risk factors in OSAS patients.
What prevents Japan from establishing a clinical service of sleep medicine: Experience gained at a local hospital
Authors: Oka Yasunori , Tachibana Naoko , Takahashi Hideo , Tanabe Hirotaka
Published: March 2003

We opened a mini‐sleep disorders clinic in a local general hospital in rural Japan, and have been operating it for more than 3 years. We encountered many difficulties during this period when we tried to provide proper clinical service. Problems ranged from lack of sleep specialists and polysomnography technicians, shortage of funding, non‐existence of an educational system to obtain comprehensive knowledge about sleep medicine, and also lack of cooperation among different departments necessary for maintaining clinical service. Through our experience, we analyzed various factors that prevent Japan from establishing a clinical service of sleep medicine.
Classification of the sleeping pattern of normal adults
Authors: Fukuda Kazuhiko , Ishihara Kaneyoshi , Takeuchi Tomoka , Yamamoto Yukari , Inugami Maki
Published: March 2003

A questionnaire concerning their sleep‐related lifestyle and mental health was mailed to people aged in their twenties to fifties living in the Fukushima (North East), Tokyo (Central, Metropolitan) and Okayama (West) areas of Japan. We classified the sleeping pattern of 3642 people (1702 men, 1940 women; mean age 41.3 ± 10.67) by multivariational analyses (factor analysis and cluster analysis). They were classified into six groups and defined as ‘poor sleeper group’ (30.0%), ‘good sleeper group’ (28.3%), ‘long sleeper group’ (8.2%), ‘short sleeper group’ (18.5%), ‘irregular sleeper group’ (11.3%), and ‘Delayed Sleep Phase Syndrome group’ (3.7%) based on their characteristics of the factor pattern.
A search for a mutation in the tumour necrosis factor‐alpha gene in narcolepsy
Authors: Kato Tadafumi , Honda Makoto , Kuwata Shouji , Juji Takeo , Fukuda Masato , Honda Yutaka , Kato Nobumasa
Published: March 2003

The discovery of almost 100% association of narcolepsy with human leukocyte antigens (HLA) DR2 antigen prompted molecular biological research of this disorder. In the HLA class II gene cluster, the gene for tumour necrosis factor‐alpha (TNF‐α), which plays a role in the regulation of normal human sleep, is located. The present study searched for a mutation in the TNF‐α gene by single‐strand conformation polymorphism analysis (SSCP) in patients with narcolepsy. No mutation was detected in exons and introns of the TNF‐α gene by SSCP and sequencing.
Adult‐type metachromatic leukodystrophy with a compound heterozygote mutation showing character change and dementia
Authors: Fukutani Yuken , Noriki Yoko , Sasaki Kazuo , Isaki Kiminori , Kuriyama Masaru , Kurosawa Kenji , Ida Hiroyuki
Published: March 2003

A 26‐year‐old Japanese woman slowly developed a change of character such as hypospontaneity and blunted affect, followed by obvious mental deterioration. She was diagnosed as having a disorganized type of schizophrenia at the first examination. Brain magnetic resonance imaging demonstrated diffuse high intensity in the cerebral white matter, particularly in the frontal lobes. The single photon emission computed tomography images using 123I‐IMP disclosed diffuse cerebral hypofusion, especially in the frontal lobes. Electroencephalogram showed a moderate amount of 5–6 Hz θ waves on the background of α activity. Nerve conduction velocities in the extremities were delayed. The level of leucocyte arylsulphatase was low. In the arylsulphatase A gene analysis, a compound heterozygote having the 99Gly→Asp and 409Thr→Ile mutations was confirmed. The patient was diagnosed as having metachromatic leukodystrophy. She gradually showed obvious dementing symptoms such as memory disturbance and disorientation. The characteristics of the psychiatric symptoms in the leukodystrophy are discussed.
Progressive myoclonic epilepsies syndrome (Ramsay Hunt syndrome) with mental disorder: Report of two cases
Authors: Hsiao Mei‐Chun , Liu Chia‐Yih , Yang Yong‐Yi , Lu Chin‐Song , Yeh Eng‐Kung
Published: March 2003

Ramsay Hunt syndrome (RHS) is a rare condition within the progressive myoclonic epilepsies syndrome (PME), with a triad of action myoclonus, grand mal seizure and severe cerebellar ataxia. There are few reports about the psychiatric disturbances associated with PME or RHS. The present study examines the evidence that RHS may accompany an organic mental syndrome, ethanol’s effective suppression of myoclonus, and the possible resultant problem of alcohol dependence in RHS patients. Two brothers with the previous long‐standing diagnosis of RHS and their mental symptoms of persecutory delusion and depression are reported, as well as the additional problem of alcohol dependence in one of them. The cerebellar dysfunction found in RHS may be associated with an underlying organic condition. Determination of the relationship between cerebellar dysfunction and psychosis in RHS will require further study. Although the mechanism of the suppression of myoclonus by alcohol remains unclear, patients should be allowed to drink socially, and alcohol consumption should not be totally prohibited. However, effective treatment of the problems of alcohol tolerance, abuse, or dependence requires the cooperation of both neurologists and psychiatrists.
Dipole source localization of interictal epileptiform activity in temporal lobe epilepsy with medial temporal lesion
Authors: Mine Seiichiro , Iwasa Hiroto , Nakajima Yoshio , Yamaura Akira
Published: March 2003

Dipole sources of interictal epileptiform activities recorded by conventional electroencephalogram (EEG) were estimated using the dipole tracing method. Four cases of temporal lobe epilepsy with medial temporal lesions were studied. Two patients with hippocampal sclerosis, one patient with granulation in the hippocampus and one patient with cavernous angioma were involved in the study. Interictal epileptiform activities were classified into two patterns according to the topography of spikes. They were widespread spikes over the parasagittal electrodes (parasagittal spikes) and restricted spikes at the temporal electrodes (temporal spikes). Dipole sources of parasagittal spikes were localized in the medio‐basal temporal lobe with vertically orientated vector moment. Dipole sources of temporal spikes were localized in the medio‐basal temporal lobe with horizontally orientated vector moment. Locations of dipoles and directions of vector moments were consistent with topography and polarity of spikes. The difference in the two patterns of interictal epileptiform activities was derived from the difference in the direction of the vector moment of dipole sources. There was no difference in the location of dipole sources. Both the dipole sources and the lesions were localized in the same medio‐basal temporal lobe. Dipole tracing was very useful in localizing the dipole sources of interictal epileptiform activities and in understanding the neurophysiological background.
Chronological progression of a language deficit appearing to be postictally reversible in a patient with symptomatic localization‐related epilepsy
Authors: Kudo Tatsuya , Yagi Kazuichi
Published: March 2003

A language deficit occurring interictally, with chronological progression, and postictally in a patient with symptomatic localization‐related epilepsy, which began at 1.6 years of age, is reported. The patient was a 30‐year‐old right‐handed man whose seizures seemed to originate from the left frontal lobe and to involve the left temporal lobe. The deficit in oral language consisted mainly of features of motor aphasia, including delayed initiation of speech with great effort, echolalic and palilalic tendencies, and word‐finding difficulty, but he also showed features of sensory aphasia. Written language had agraphia observed in sensory aphasia, including well‐formed letters, paraphasias, neologisms, and paragrammatism. Postictally, the language deficit appeared to be superficially reversible, and evolved from mutism through non‐fluent jargon to the interictal level of language. Analysis of the patient’s diaries from 10 to 26 years of age disclosed chronologically progressive deterioration of language with paragrammatism, showing an increase of grammatical errors, neologismus, literal and verbal paraphasias and misconstruction of sentences. The results suggest that localization‐related epilepsy of presumably left frontal lobe origin causes not only a postictal language deficit but also a slowly progressive deficit of language function.
Post‐earthquake quality of life and psychological well‐being: Longitudinal evaluation in a rural community sample in northern China
Authors: Wang Xiangdong , Gao Lan , Zhang Huabiao , Zhao Chengzhi , Shen Yucun , Shinfuku Naotaka
Published: March 2003

Abstract This study aims to observe longitudinal change of quality of life (QOL) and psychological wellbeing in a community sample affected by an earthquake and to examine the relationship between QOL and disaster exposure, post‐disaster support and other related variables. The subjects, from two villages at different distances from the epicenter, were assessed using the brief version of the World Health Organization Quality of Life Assessment (WHOQOL‐BREF) and three subscales of a symptoms checklist at 3 months (n = 335) and 9 months (n = 253) after the earthquake, respectively. Exposure to the earthquake was associated with multidimensional impairment in QOL, including physical, psychological and environmental domains at 3 months, and psychological and environmental domains at 9 months. The victims also suffered significantly more psychological distress in terms of depression, somatization and anxiety. At both assessment points the group that experienced lower initial exposure but then received less post‐disaster help reported poorer QOL and psychological well‐being. The two victim groups also differed significantly in changing trend along time. The group that received more support showed a general improvement in post‐disaster well‐being from 3 months to 9 months. The results confirm that post‐disaster variables could be as important to post‐disaster psychosocial outcomes as variables of predisaster vulnerability and disaster per se. A comprehensive and prospective assessment of disaster effects is imperative for the better organization of disaster relief programs and psychosocial interventions.
Reliability and validity of Kasahara's scale of melancholic type of personality (Typus melancholicus) in a German sample population
Authors: Ueki Hirofumi , Holzapfel Christian , Washino Kaei , Inoue Masato , Ogawa Naoshi , Takai Akihiro
Published: March 2003

Abstract We explored the reliability and validity of Kasahara's scale of melancholic type of personality (KMT) in a German sample population. Subjects comprised 66 patients diagnosed with an affective disorder (F3, ICD‐10) and 94 controls. Concerning reliability, KMT scores showed internal consistency with Cronbach's alpha coefficients of 0.65 for patients and 0.67 for controls. The KMT items, except for number 13 in controls, showed significant item–total correlations. In a test–retest procedure, the KMT total score and individual item scores were statistically similar and correlated. These results indicate reliability of the KMT. Concerning validity, KMT scores were significantly higher in patients than in controls. By controlling the effects of age and sex, partial correlation coefficients in a comparison of KMT and Zerssen's F‐List (F‐List) scores were 0.40 in patients and 0.53 in controls. These results show both the constructive and concurrent validity of the KMT. Sufficient reliability and validity of the KMT were shown in this German sample population to encourage cross‐cultural investigation of Typus melancholicus.
Changes in fractal structure of heart rate variability during a nap in one case
Authors: Shono Hideaki , Shono Mayumi , Takasaki Mitsuhiro , Iwasaka Tsuyoshi , Sugimori Hajime
Published: March 2003

The objective of the present study was to analyze fractal structures of adult heart rate (HR) variability during a nap. Fractal analysis was carried out in one case over consecutive 10‐min time series of HR, which were simultaneously recorded with electroencephalogram. Scaling relationships showed cross‐over patterns characterized by αs and αl (i.e. slopes above and below a cross‐over point). The αs and αl were black and white noise at Stage 4 of NREM sleep, and black and 1/f noise in REM sleep. Cross‐over points changed from the first to second sleep cycle. We demonstrate the multifractal structures of HR variability during a nap in the present case.
Light conditions during sleep period and sleep‐related lifestyle in Japanese students
Authors: Takeuchi Hitomi , Hino Natsumi , Iwanaga Akira , Matsuoka Aya , Harada Tetsuo
Published: March 2003

The effects of light conditions during night sleep on sleep habits and morning–evening preference were studied in Japanese students (18–28 years old). Students who usually used fluorescent or non‐fluorescent light on the room ceiling, wall or desk preferred to have a daytime nap significantly later (Mean: 14:50 h) than those who used no light (13:34 h). Students who used no curtain or a half‐transparent lace‐curtain showed shorter sleep latency (duration from going‐to‐bed to sleep‐onset) than those who used a curtain which shuts off lights from outside. Light conditions during the middle of night and early in the morning may affect the timing of sleep in Japanese students based on the circadian system.
Melatonin therapy for REM sleep behavior disorder
Authors: Takeuchi Noboru , Uchimura Naohisa , Hashizume Yuji , Mukai Masaki , Etoh Yoshinori , Yamamoto Katsuyasu , Kotorii Tatayu , Ohshima Hiroharu , Ohshima Masachika , Maeda Hisao
Published: March 2003

Rapid eye movement sleep behavior disorder (RBD) is a parasomnia with clinical symptoms that include punching, kicking, yelling and leaping out of bed in sleep. Polysomnographic (PSG) finding showed REM sleep without muscle atonia. Clonazepam is generally used for treating RBD symptoms but melatonin was reported to be effective so we reconfirmed the effect of melatonin on RBD patients in the present study. We used melatonin (3–9 mg/day) which could ameliorate problem sleep behaviors remarkably, as well as %tonic activity in PSG variables. In the present study, melatonin was reconfirmed to be effective in RBD symptoms, especially for patients with low melatonin secretion, while its mechanism was not clearly known in the present study.
A circadian system model with feedback of cross‐correlation between sleep–wake rhythm and oscillator
Authors: Nakao Mitsuyuki , Yamamoto Keisuke , Nakamura Kazuhiro , Katayama Norihiro , Yamamoto Mitsuaki
Published: March 2003

Recent findings suggest that social entrainment factors work on an oscillator other than the temperature and melatonin rhythms. This indicates that there is a feedback loop affected on oscillators. In the present study, a circadian system model, including mutually coupled two oscillators and sleep–wake rhythm, is constructed, where cross‐correlation between a sleep–wake rhythm and an oscillator is set to modify the coupling from one oscillator to the other. Based on the model simulation, a mechanism underlying delayed sleep phase syndrome is elucidated by the reduction in the cross‐correlation resulting from dissociation between the delayed sleep phase and the oscillator.
Pitch perception shift: A rare side‐effect of carbamazepine
Authors: Kobayashi Toshiyuki , Nisijima Koichi , Ehara Yumiko , Otsuka Koichiro , Kato Satoshi
Published: March 2003

Abstract Carbamazepine‐induced pitch perception shifts have rarely been described. Two cases of shifted pitch perception developing during medication with carbamazepine are described. Case 1 possessed absolute pitch. Her pitch perception shift disappeared with the discontinuance of carbamazepine. Case 2 did not have absolute pitch. Even though he experienced a pitch perception shift, he developed a tolerance to the shift. We concluded that carbamazepine was the cause of the pitch perception shift in the first case, while the second case probably became attuned to the change in pitch perception because he did not possess absolute pitch.
Kahlbaum’s catatonia revisited
Authors: Carroll Brendan T.
Published: March 2003

Modern psychiatric nosologies separate catatonia along the lines of presumed etiology: bipolar, major depression, schizophrenia and due to a general medical condition. The presence of catatonia has always held diagnostic and prognostic value. Kahlbaum’s description of catatonia includes careful documentation of phenomenology and the course of the illness. Since there were no effective treatments in his time, Kahlbaum was documenting the natural history of the illness. A review of classic studies of the natural history of catatonia demonstrates that the syndrome is episodic, may have few other psychotic signs, may have periods of remission and may, in some cases, be associated with the disorganized subtype of schizophrenia. The literature of the past 100 years supports the validity of Kahlbaum’s description for a subset of patients with catatonia.
Effects of group musical therapy on inpatients with chronic psychoses: A controlled study
Authors: Hayashi Naoki , Tanabe Yoko , Nakagawa Seishu , Noguchi Maki , Iwata Chikako , Koubuchi Yumiko , Watanabe Michiyo , Okui Miho , Takagi Keiko , Sugita Kuniko , Horiuchi Keiko , Sasaki Aiko , Koike Izumi
Published: March 2003

Abstract The objective of the present study was to examine the efficacy of group musical therapy for inpatients with DSM‐IV schizophrenia or schizoaffective psychosis. Thirty‐four therapy group subjects in a ward for long‐stay female patients received 15 group musical therapy sessions over 4 months, while 32 waiting group subjects from another ward with the same function were to wait for the sessions until the studied course was completed. The assessment included measures of psychotic symptoms, objective quality of life and subjective musical experiences. Comparison of the groups indicated that significant advantages in the therapy group subjects were detected in some measures concerning personal relations and a subjective sense of participation in a chorus activity. However, the follow‐up evaluation suggested that the improvement might not be durable. These findings suggested that the musical therapy had some, but possibly only short‐lived, effects on personal relations and musical experiences of chronic psychotic patients.
Subjective sleep quality and suggested immobilization test in restless leg syndrome and periodic limb movement disorder
Authors: INOUE YUICHI , NANBA KAZUYOSHI , HONDA YUTAKA , TAKAHASHI YASURO , ARAI HEII
Published: March 2003

Abstract The severity of restless leg syndrome (RLS) and/or periodic limb movement disorder (PLMD) was investigated by using a suggested immobilization test (SIT) and by measuring the influence of these disorders on the subjective sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI). Patients with RLS and those with both RLS and PLMD showed remarkably high values for PSQI and SIT, whereas patients with PLMD only showed normal values for PSQI. These findings suggest that there is only a small pathological significance for periodic limb movements, and demonstrate the efficacy of SIT and PSQI for evaluating the severity of these disorders.
Physical symptoms under forced‐phase advance treatment in a patient with delayed sleep phase syndrome: A case report
Authors: YANAGIDA HIROSHI , NAKAJIMA TORU , KAJIMURA NAOFUMI , KATO MASAAKI , WATANABE TSUYOSHI , HORI TORU , TAKAHASHI KIYOHISA
Published: March 2003

Abstract The physical symptoms that are observed with forced waking in patients with delayed sleep phase syndrome (DSPS) often prevent the successful treatment of patients. Better understanding of these symptoms will assist in providing appropriate treatment in such patients. Herein, a 19‐year‐old female patient with DSPS is described, in whom headache, fatigue, and dizziness were observed under forced‐phase advance treatment. Statistical analysis showed that her headache was dependent on the therapeutic week, and her fatigue was dependent on the period of the day. There was no association between dizziness and either factor. Experience with this patient indicates that the fatigue observed with forced waking is related to the circadian system. This relationship should be explored for other physical symptoms as well.
Can olanzapine be implicated in causing serotonin syndrome?
Authors: HASLETT CHRISTOPHER DAVID , KUMAR SHAILESH
Published: March 2003

The present paper describes a case of serotonin syndrome (SS), which developed in a patient with bipolar affective disorder after the addition of olanzapine to her regimen of lithium and citalopram. This appears to be the first report that implicates olanzapine with SS. Clinicians should be aware of the risk of SS when adding atypical antipsychotics, such as olanzapine, to serotonergic agents.
Features of obsessive–compulsive disorder in patients primarily diagnosed with schizophrenia
Authors: Ohta Masayuki , Kokai Masahiro , Morita Yoshio
Published: March 2003

Abstract We investigated the prevalence of obsessive–compulsive disorder (OCD) among patients who were primarily diagnosed with schizophrenia. We investigated the differences in the neuropsychiatric features and motor symptoms between patients with schizophrenia who did or did not have OCD. Seventy‐one subjects with the DSM‐IV diagnosis of schizophrenia were evaluated by the Structured Clinical Interview for DSM‐IV Axis I Disorders, the Yale‐Brown Obsessive–compulsive Scale and the Positive and Negative Syndrome Scale. To assess their motor symptoms, the Abnormal Involuntary Movements Scale, the Barnes rating scale for drug‐induced akathisia and the Simpson and Angus extrapyramidal symptoms (EPS) rating scale were used. The 13 subjects with OCD (18.3%) had significantly more severe motor symptoms than the non‐OCD subjects. Patients with schizophrenia who exhibit moderate to severe motor symptoms as side‐effects of neuroleptics, should be examined for OCD comorbidity. Patients who are found to have OCD comorbidity must be treated with carefully chosen medications, including serotonin re‐uptake inhibitors.
A peculiar Factor VIII‐related antigen staining of an oxyphilic cell nodule within an intrathyroidal parathyroid adenoma
Authors: Altinok Gülçin , Özdamar Şükrü
Published: March 2003

A case of intrathyroidal parathyroid adenoma, which was found in the lower portion of the right thyroid lobe, is presented. The nodule in this lesion was composed of oxyphilic cells. In order to verify a possible vascular invasion, immunohistochemical study with Factor VIII‐related antigen/von Willebrand factor, which is known to be synthesized by the endothelial cells and stored in Weibel– Palade bodies, and ulex europaeus lectin 1 were applied. It was interesting to find positivity for Factor VIII‐related antigen and ulex europaeus lectin I strictly confined in the nodule of oxyphil cells, which are known to have large numbers of mitochondria. This led to investigating similar immunoreactions in different lesions of oxyphilic cells with several other markers. The possible cross‐reaction between Weibel–Palade bodies and mitochondria deserves further detailed research.
A supernumerary ovary of the omentum with cystic change: Report of two cases and review of the literature
Authors: Kuga Takayuki , Esato Kensuke , Takeda Kanae , Sase Masakatsu , Hoshii Yoshinobu
Published: March 2003

A supernumerary ovary is a rare gynecological anomaly. Particularly rare is the presence of cystic changes within the supernumerary ovary. We report two cases of neonates found to have a supernumerary ovary resembling an omental cyst. To the best of our knowledge, this report describes the first antenatal diagnosis of an omental cyst with a supernumerary ovary. To explain this unusual occurrence, it is suggested that an omental cyst becomes detached from the ovarian tissue and implants itself in the greater omentum, and that these supernumerary ovaries are of true embryologic origin, and not due to post‐surgical or post‐inflammatory implantation.
Aberrant pancreatic tissue accompanied by heterotopic gastric mucosa in the gall‐bladder
Authors: Murakami Masato , Tsutsumi Yutaka
Published: March 2003

A 5 mm pancreatic heterotopia was incidentally identified in the gall‐bladder with small cholesterol polyps following cholecystectomy in an asymptomatic 49‐year‐old female. Microscopically, inflammatory changes in the wall were minimal. The aberrant tissue consisted of acini and ducts but did not have islet formation. Heterotopic gastric mucosal tissue with a mixture of foveolar cells and pyloric glands was seen at the orifice of the pancreatic heterotopia. Islet peptide‐immunoreactive endocrine cells were scattered among the pancreatic parenchyma, and the gastric‐type gland contained cells positive for gastrin, somatostatin and glucagon. A noteworthy finding was the immunohistochemical detection of a single insulin‐containing cell in the pyloric gland.
Dermatofibrosarcoma protuberans: An analysis of proliferative activity, DNA flow cytometry and p53 overexpression with emphasis on its progression
Authors: Sasaki Manabu , Ishida Tsuyoshi , Horiuchi Hajime , Machinami Rikuo
Published: March 2003

The aim of this study is to evaluate the degree and spectrum of malignancy of dermatofibrosarcoma protuberans (DFSP) in the aspect of proliferative activity, flow cytometric DNA analysis, and p53 immunoreactivity. Twenty‐three tumors from 19 cases of DFSP including three cases of DFSP with fibrosarcomatous areas (DFSP‐FS) were studied in comparison with its allied fibrohistiocytic tumors; that is, dermatofibroma (DF; 46 cases), fibrosarcoma (FS; four cases), and malignant fibrous histiocytoma (MFH; 11 cases). MIB‐1 labeling index (LI) of DFSP was significantly higher than that of DF and was lower than those of FS and of MFH. In ordinary DFSP, the recurrent tumors exhibited significantly higher MIB‐1 LI than that of the primary tumors, whereas the primary tumors showed almost the same proliferative activity of DF. DFSP‐FS tended to have a higher proliferative activity than DFSP without FS‐area (ordinary DFSP). In five of 19 cases of DFSP, aneuploidy (near‐diploidy) was found in four recurrent and one primary tumors. Immunohistochemical p53 overexpression was found in three of 19 cases of DFSP which also showed higher proliferative activity and aneuploidy. All cases of DF were immunohistochemically negative for p53, but most of the cases of FS and MFH were positive. Although DFSP has been classified in a category of fibrohistiocytic tumor of intermediate malignancy, the recurrent DFSP, DFSP‐FS, and DFSP with aneuploidy and/or p53 overexpression could be a subgroup of DFSP with more aggressive clinical behavior than ordinary primary ones.
Molecular–pathological diagnosis of gastrointestinal tissues and its contribution to cancer histopathology
Authors: Yasui Wataru , Yokozaki Hiroshi , Shimamoto Fumio , Tahara Hidetoshi , Tahara Eiichi
Published: March 2003

Multiple genetic and epigenetic alterations of cancer‐related genes and molecules are involved in the course of the development and progression of gastrointestinal cancers. These include telomerase activation, genetic instability, and abnormalities of oncogenes, tumor suppressor genes, cell cycle regulators, cell adhesion molecules and DNA repair genes. By analyzing these alterations in pathology specimens, we can improve differential diagnosis of cancer, obtain information of grade of malignancy, and identify patients at high risk for developing multiple primary cancers. Since 1993, a system of molecular–pathological diagnosis was established, and has been performed as a routine service in collaboration with Hiroshima City Medical Association Clinical Laboratory. More than 10 000 cases of gastrointestinal biopsy and surgery have been analyzed, and additional information of differential diagnosis, biological malignancy and tumor multiplicity could be obtained. Molecular–pathological diagnosis may provide a new approach to cancer diagnosis and novel therapeutics for the 21st century. Furthermore, the analysis of the genetic and epigenetic abnormalities in clinical materials may clarify the molecular mechanism of carcinogenesis and comparative morphological changes. From the analyses of p27KIP1and telomerase in gastrointestinal adenomas, we have learned that morphological abnormality of the nucleus is an indicator for cells with immortality and malignant potential that must participate in super‐early diagnosis (detection of true precancerous lesions) of gastrointestinal cancer. Molecular–pathological diagnosis thus contributes to detailed understanding of cancer histopathology and improves the histopathological diagnosis.