bluuebunny/crossref_metadata_2025 huggingface dataset:
Competitive mechanisms underlying synapse elimination in the lumbrical muscle of the rat
Authors: Betz W. J. , Ribchester R. R. , Ridge R. M. A. P.
Published: March 2003

The process of neuromuscular synapse elimination has been studied in the fourth deep lumbrical (4DL) muscle of the rat, a preparation which offers technical advantages for some types of experimental work. Studies have been performed both during development and in adult denervated muscles undergiong reinnervation. Results indicate that synapse elimination is dependent upon competition between motoneurons. Cellular mechanisms underlying this competition have also been explored. Both neuromuscular activity and muscle fiber type recognition appear to play a role, but positional cues appear unimportant in this small muscle.
Relationship of calbindin D28K‐immunoreactive cells and neuropathological changes in the hippocampal formation of Alzheimer's disease
Authors: Iritani Shuji , Niizato Kazuhiro , Emson Piers C
Published: March 2003

Previous studies have reported that calcium binding proteins, which have important functions in regulating the intracellular ion concentration, may influence the vulnerability of neurons in neurodegenerative disease. It has been observed that the neurons containing calbindin D28K (CB) may in certain circumstances be more resistant to excitotoxic and ischemic injury. In the present study the susceptibility of hippocampal neurons containing CB to develop NFT was studied, and the distribution of CB cells was compared with hippocampal plaque density in the Alzheimer's disease (AD) brain. Interestingly CB‐positive hippocampal neurons did not contain tangles and could be seen next to degenerating tau‐positive pyramidal cells. Comparison of the hippocampal plaque distribution with that of CB neurons showed that in general CB‐positive neurons were found in areas with a low plaque burden. Further comparison of cases with differing degrees of severity indicated that CB‐positive neurons were relatively preserved in cases with moderate plaque and tangle content but that in severe cases the CB‐positive pyramidal cells were lost. These findings indicate that CB cells may be protected in the earlier stages of the disease but that this resistance ability is lost in the late stages of AD. The observation that CB‐positive pyramidal cells do not accumulate NFT suggests that proteolysis of tau differs in CB‐negative and CB‐positive cells.
Ultrasound assessment of large joint amyloidosis in haemodialysis
Authors: Lanteri Marc , Ptasznik Ronnie , Hennesy Oliver , Constable Leonie , Dawborn John Kenneth
Published: March 2003

SUMMARY:

Dialysis‐related amyloidosis (DRA), associated with beta‐2 microglobulin deposition, is a common cause of morbidity in patients with renal failure undergoing chronic dialysis. The non‐invasive diagnosis of DRA in its early stages is difficult. High resolution ultrasound (US) was used to examine the shoulder, hip and knee joints of 25 chronic haemodialysis patients, and features distinctive of DRA were determined. Distinctive US features were associated with increased total duration of dialysis (15 ± 5 vs 4 ± 2 years), carpal tunnel syndrome (9/10 cases) and shoulder joint discomfort (19 vs three joints). These features include altered rotator cuff echogenicity (hyperechoic and hypoechoic areas; 20/48 joints), hypoechoic material in the biceps sheath (16/48), erosions of bone (15/48) and reduced biceps tendon fibril echogenicity (12/48). These changes are unique in the experience of the current authors, but histological proof that they are definitely the result of DRA has not yet been possible. Tears of the rotator cuff tendons (14/50) were not consistently associated with symptoms (7/14). Tendon thickness was also increased (as has been described previously). The hip capsule thickness was increased in patients with signs of DRA in the shoulder, but no specific changes in texture were seen. Asymptomatic knee joint effusions were present in 40/50 joints (80%). These features detectable on high resolution US allow the non‐invasive early detection of DRA and are useful in the diagnosis and management of this condition.
Increased angiotensin‐converting enzyme and type 1 angiotensin receptors in cortical vasculature and tubulointerstitium of chronically rejected human kidney allografts
Authors: Ohishi Mitsuru , Ueda Makiko , Tanabe Shigeru , Han Young‐Sin , Mendelsohn Frederick Ao , Zhuo Jia L
Published: March 2003

SUMMARY: Chronic rejection of human renal allografts after transplantation is characterized by interstitial infiltration, arteriosclerosis and glomerulosclerosis in the grafts. Apart from tissue HLA compatibility, angiotensin II (AII) may be implicated in accelerating the processes of chronic rejection. In the present study, the cellular distribution of angiotensin‐converting enzyme (ACE) and type 1 AII (AT1) receptors was mapped and compared in non‐rejected human kidneys (n = 8) and chronically rejected renal allografts (n = 9) using complementary immunohistochemistry and quantitative in vitro autoradiography. Chronically rejected allografts showed typical histopathological characteristics of tissue rejection, including concentric intimal thickening of intrarenal arteries, extensive or focal glomerulosclerosis, tubular atrophy and severe tubulointerstitial fibrosis. In rejected allografts, total ACE binding in the cortex was decreased to 46% of that in non‐rejected kidneys (P < 0.01), whereas AT1 receptor binding in the glomeruli and the inner stripe of the outer medulla was maintained. However, ACE and AT1 receptor binding were increased in the cortical tubulointerstitium of chronically rejected allografts. In non‐rejected kidneys, strong ACE immunostaining occurred in proximal tubules and vascular endothelium, whereas AT1 receptors occurred in vascular smooth muscle cells, as expected. In rejected allografts, intense ACE and AT1 receptor immunostaining were detected not only in the same sites as those non‐rejected kidneys, but also in cortical tubulointerstitium between atrophied tubules and surrounding the glomeruli. AT1 receptors were markedly up‐regulated in vascular smooth muscle cells of thickened atherosclerotic vessels. These results provide novel morphological evidence that increased expression and/or altered distribution of ACE and AT1 receptors in cortical tubulointerstitium and in the neointima of intrarenal arteries may play an important role in the progression of chronic rejection of human renal allografts after transplantation.
Variable toxicity of dyes used in micropuncture studies
Authors: Nikolic‐Paterson David J , Hurst Lynette A , Comper Wayne D
Published: March 2003

SUMMARY: This study evaluated the potential toxicity of Fast green and Lissamine green, the two dyes commonly used for visualizing tubular fluid flow in micropuncture studies. In both the in vitro perfused kidney and cultured tubular epithelial cells, Fast green exhibited a profound, dose‐dependent toxicity. In contrast, Lissamine green was non‐toxic. In conclusion, we recommend that Fast green not be used in micropuncture studies.
Rheumatoid arthritis and membranoproliferative glomerulonephritis: an unusual case
Authors: DERICI Ulver , KAN Erdal , ERTOY Dilek , ARINSOY Turgay , DURSUN Ayse , BICIK Zerrin , SINDEL Sukru
Published: March 2003

SUMMARY: Renal involvement is not uncommon in rheumatoid arthritis (RA). Many RA patients have renal dysfunction either secondary to the drugs used to treat arthritis or because of the chronic inflammation. Renal pathologies have often included amyloidosis, drug‐related renal disease and mesangial glomerulonephritis. However, membranoproliferative glomerulonephritis has only been rarely reported. We report a case of rheumatoid arthritis associated with membranoproliferative glomerulonephritis that rapidly progressed to end‐stage renal disease.
Glycosaminoglycans and the peritoneaum
Authors: YUNG Susan , CHAN Tak‐Mao
Published: March 2003

SUMMARY: The introduction of peritoneal dialysis (PD) over two decades ago has allowed us to manipulate the peritoneal membrane to perform as a continuous dialysing organ. to maximize the efficacy of solute transport and waste removal, conventional PD fluids require unphysiological concentrations of glucose to provide the osmotic drive, lactate to alleviate metabolic acidosis, and a low pH to prevent the caramelization of glucose during the preparation of the solutions. These factors either alone or in combination, are irritants to the peritoneal membrane. Thus, continuous exposure of the peritoneum to PD solutions, together with frequent episodes of peritonitis confers a chronic inflammatory response within the peritoneum. It is, therefore, not unexpected that with time, long‐term PD patients develop structural and functional changes within the peritoneum, which in many cases develop into peritoneal fibrosis of varying degrees and compromises the peritoneal membrane as a dialysing organ. to date, numerous studies have investigated methods to improve the efficiency of PD and preserve the structure of the peritoneal membrane. Recently, a number of reports have documented the beneficial effects of intraperitoneal administration of glycosaminoglycans (GAGs) on both the structural and functional qualities of the peritoneum. In this context, GAGs have been demonstrated to inhibit collagen synthesis within the peritoneum, decrease peritoneal advanced glycosylated end‐products (AGE) deposition, and modulate cytokine and growth factor synthesis. This review will examine the available data with regards to the potential role of GAGs in maintaining ultrafiltration, solute transport and the structural integrity of the peritoneum.
Role of transforming growth factor beta in peritoneal fibrosis
Authors: AL‐JAYYOUSI Reem H , MEDCALF James F , HARRIS Kevin PG
Published: March 2003

SUMMARY: Technique survival of peritoneal dialysis is seriously limited by the development of peritoneal fibrosis. the mesothelial cell layer lining the peritoneum is important in the pathogenesis of peritoneal fibrosis. Mesothelial cells are able to produce transforming growth factor beta (TGF‐β), and respond to stimulation by this cytokine. In this review, we will detail the evidence available so far for the role of the complex interaction between TGF‐β and mesothelial cells in the development of peritoneal fibrosis.
Predialysis factors related to prognosis in type 2 diabetic patients on chronic dialysis in Japan
Authors: OKADA Tomonari , NAKAO Toshiyuki , MATSUMOTO Hiroshi , HIDAKA Hirgmi , YOSHINO Maki , SHINO Tamami , NAGAOKA Yume , TAKEGUCHI Humihiro , IWASAWA Hideaki , TOMARU Ryo
Published: March 2003

SUMMARY: We investigated to clarify the predialysis factors associated with prognosis in type 2 diabetic patients entering chronic dialysis. One hundred and twenty‐four type 2 diabetic patients who started chronic dialysis in our department between January 1992 and November 2000 were studied. the variables in the predialysis period and those at initiation of dialysis were collected and evaluated in association with prognosis after a mean follow up of 37 ± 23 months from initiation of dialysis by using Cox's proportional‐hazards model. the 1‐, 3‐, and 5‐year survival rates after initiating chronic dialysis were 92.7, 74.6, and 56.5%, respectively. During follow up, 40 patients died. Univariate analysis demonstrated that serum albumin (Alb) levels, haemoglobin A1c, and no preparation for permanent vascular or peritoneal access at initiation of dialysis were significantly associated with prognosis. In multivariate analysis, Alb levels (hazard ratio, 2.09, per decrease of 1 g/dL; confidence interval, 1.05–4.19), and age (1.54, per decrease of 10 years; 1.06–2.22) at initiation of dialysis remained significant predictors of mortality. In conclusion, Alb levels and age at initiation of dialysis are associated with prognosis in type 2 diabetic patients on chronic dialysis. It should be elucidated whether improvement of Alb levels at initiation of dialysis would have a favourable influence on survival after diabetic patients with renal failure are entered into chronic dialysis.
Truth, virtue and beauty: midwifery and philosophy
Authors: Parker Judith M. , Gibbs Martin
Published: March 2003

In this paper, we outline three moments in the history of Western philosophy—Classical Greek, Modernity, Postmodernity—and the ways in which issues of truth, virtue and beauty have been understood within these philosophical formations. In particular, we investigate the ways in which notions of truth, virtue and beauty influenced the orthodoxy of birthing practices at these different moments. Finally, we examine current, critical reflections on the role of the intellectual in postmodern society and use these reflections as a heuristic for understanding the role of the contemporary midwife. We suggest that midwifery must reconcile two divergent demands. The first is to mobilise the positive, instrumental benefits of Western medical science to improve mortality and morbidity outcomes. The second is to remain sensitive to the cultural and social meanings attached to traditional birthing practices and to understand the roles these play in the well‐being of mother and child.
Defining relationships and limiting power: two leaders of Australian nursing, 1868–1904*
Authors: Godden Judith , Forsyth Sue
Published: March 2003

Defining relationships and limiting power: two leaders of Australian nursing, 1868–1904

This paper analyses aspects of the relationship between nursing and medicine during 1868–1904, in terms of power, gender and authority. A biographical approach is used with a focus on two leading nurses in Australia and their relationship with two leading medical practitioners. The first nurse is Lucy Osburn, the figurehead of the first generation of Nightingale nursing in Australia. The second nurse represents the second generation when Nightingale nursing had largely won acceptance and was firmly established in Australian hospitals: she is Susan McGahey. Their main medical antagonists were Dr Alfred Roberts and Dr Anderson Stuart. A struggle over the control of nursing is evident in these relationships. The outcome transcended personalities, greatly influenced the structure of modern nursing, and marked the rising tide of medical domination in Australia.
The social production of an enterprise clinic: nurses, clinical pathway guidelines and contemporary healthcare practices
Authors: Barnes Lynne
Published: March 2003

The social production of an enterprise clinic: nurses, clinical pathway guidelines and contemporary healthcare practices

In this paper I critically engage with the forming of contemporary nursing practice with/in an ‘enterprise clinic’ in order to discuss the practical potential of developing a mode of reflective practice that is a critical ontology of self. Critical engagement in the paper is secured through a ‘troubling’ of the relationship between the contemporary practices of both the self and governance, without the reduction of one to the other. The paper draws on my doctoral study in which I combined the techniques of ethnography and discourse analysis in order to critically examine registered nurses’ employment of clinical pathway guidelines through an analysis of the political technologies through which that engagement was constituted. This critical purchase was applied because of the influence of the contemporary ‘problematisation’ of healthcare provision in western society on the formation and deployment of the professional identities of nurses.
Exploring the dynamics of power: a Foucauldian analysis of care planning in learning disabilities services
Authors: Gilbert Tony
Published: March 2003

Exploring the dynamics of power: A Foucauldian analysis of care planning in learning disabilities services

This paper draws upon a study completed in 2000 that focused upon health and welfare provision for people with learning disabilities in one English county. This study drew upon the theoretical insights of Michel Foucault to provide an analysis of the micro politics of care planning. This involved the analysis of text from two sources: the academic literature and interview material gained from a number of professionals working in health and welfare services for people with learning disabilities. Drawing upon this research material, the first part of this paper briefly explores the relationship between policy, professional practice and the people who are the subjects of that practice. The discussion then moves on to consider Foucault's five methodological precautions and the way power produces a localised web of activity that identifies specific targets for management. In this process power draws into the web a range of informal and formal practices that initially lie outside of the web. The discourse produced through the activity surrounding care planning provides the evidence of this flow of power. This discourse then takes on the status of science (truth), which reproduces this activity.
Nurses’ bodywork: is there a body of work?
Authors: Shakespeare Pam
Published: March 2003

Nurses’ bodywork: is there a body of work?

The work that many nurses do involves the use of their own body as one of the tools of their occupation. Being a nurse, in many cases, means controlled, purposeful use of her or his own body oriented to the patient. This paper discusses some of the ways in which nurses’ bodies and the work that those bodies do are represented in professional and academic research accounts and made relevant in literature. Using instances of bodies and bodily activity mentioned in a variety of literature, the paper discusses three categories of accounts of nursing bodywork: those which are problematised and where the nurse's body is seen as a topic for investigation, and those which are unproblematised either explicitly discussing bodily activity (for example, touch) or implicitly dealing with bodywork (for example, taking blood pressure). Four ways in which nurses’ bodies are made relevant in accounts are proposed: relational, corporate, instrumental and human.

The paper discusses the prominence (or not) nurses’ bodies are given in professional and academic accounts, as a contribution to preliminary work of generating a topic for investigation and concludes with some suggestions as to how this investigative project might be taken forward, focusing primarily on an examination of methodic practices, or how bodywork is brought off and executed as a skilled but taken‐for‐granted activity.
Clerical frames for nursing practice: missionary nurses at Rehoboth*
Authors: Lagerwey Mary D.
Published: March 2003

Clerical frames for nursing practice: missionary nurses at Rehoboth

This paper presents a discourse analysis of publications of the Christian Reformed Church regarding its Rehoboth Mission near Gallup, New Mexico, among the Navajo. All issues of The Banner, Acts of Synod of the Christian Reformed Church, the Rehoboth Hospital Bulletin, and the Annual Report of the Rehoboth Mission from 1880 to the present were reviewed for references to health‐care at Rehoboth from 1903 to 1943. Four religiously framed discourses were identified: discourses justifying provision of health‐care at the mission, discourses of the Navajos as immature and potentially dangerous, needing to be civilized, discourses of cleanliness, and discourses of calling. This paper adds to a growing body of knowledge about religious frames within which nurses have practiced in North America.
A case of depressive disorder with neuronal heterotopia
Authors: Maruyama Yasuko , Onishi Hideki , Miura Toru , Kosaka Kenji
Published: March 2003

We describe a case of depressive disorder with neuronal heterotopia. The patient, a 55‐year‐old woman, had a history of depressive episodes since the age of 53. Magnetic resonance imaging (MRI) disclosed bilateral periventricular heterotopia. The patient had not experienced any epileptic episodes, and an electroencephalogram did not reveal any epileptic discharge. Single photon emission computed tomography (SPECT) disclosed diffuse cerebral hypoperfusion. This is the first report on a case of depression with neural migration disorder. Patients with neural migration disorders can be detected more frequently with the increasing use of MRI.
Interictal change in cardiac autonomic function associated with EEG abnormalities and clinical symptoms: A longitudinal study following acute deterioration in two patients with temporal lobe epilepsy
Authors: TOICHI  , MURAI  , SENGOKU  , MIYOSHI
Published: March 2003

The purpose of the present study was to investigate the ictal and interictal changes in cardiac autonomic function (CAF), and the relationship between the interictal change in CAF to the electroencephalogram (EEG) and clinical findings. In two patients with temporal lobe epilepsy (TLE) showing acute deterioration, a quantitative evaluation of their interictal CAF based on heart rate variability and their EEG using spectral analysis was conducted, and the findings compared with repeated clinical evaluations during the recovery period. The ictal heart rate changes and their temporal relationship to ictal discharge were investigated using simultaneous EEG/electrocardiogram (ECG) monitoring in one of the patients. Interictal parasympathetic function was decreased during the period of acute deterioration, but was increased in association with improvements in the EEG and clinical findings. In contrast, the sympathetic function showed no specific changes. The ictal discharges were preceded by a brief bradycardia, with a long delay of up to 40 s. The results demonstrated that this decrease in parasympathetic function was closely related to the interictal changes in central nervous system function. On the other hand, the ictal discharges in one of the patients were thought to have caused a transient elevation of parasympathetic function. It is strongly suggested that patients with TLE have interictal as well as ictal changes in CAF that are mediated mainly through the parasympathetic nervous system.
Effects of prolactin on sleep in cyclic rats
Authors: Zhang Shi‐Qing , Kimura Mayumi , Inoué Shojiro
Published: March 2003

We previously demonstrated that pregnancy‐associated sleep enhancement is correlated with the daily surges of prolactin (PRL). However, in spite of a surge of PRL in the proestrous night, a reduction of nocturnal sleep occurs in phase with proestrus. Therefore, to clarify the physiological role of PRL in sleep regulation during the estrous cycle, time‐course changes in sleep were analyzed in bromocriptine (CB‐154)‐treated and/or PRL‐supplemented female rats. Sleep patterns characteristic of proestrus‐to‐estrus were not affected by the CB‐154 treatment. In contrast, nocturnal rapid eye movement sleep (REMS) was significantly increased after the PRL supplementation. The CB‐154 treatment diminished the REMS‐enhancing effect of PRL. Thus, the results suggest that the endogenous PRL is not crucial for the regulation of sleep during the estrous cycle, while exogenous PRL can enhance REMS.
Topographic mapping of EEG spectral power and coherence in delta activity during the transition from wakefulness to sleep
Authors: Tanaka Hideki , Hayashi Mitsuo , Hori Tadao
Published: March 2003

The present study examined the topographic characteristics in delta band activity during the transition from wakefulness to sleep, using topographic mapping of electroencephalogram (EEG) power and coherence corresponding to nine EEG stages. The dominant topographic components of delta band activity increased clearly from the vertex sharp‐wave stage EEG stage 6) in the anterior‐central area. Principal component maps revealed the scalp distribution of EEG. Delta activity in the sleep onset period were composed of two covariant components. One is a diffuse component widely distributed on the scalp and the other is a local component at the temporo‐occipital area.
A study on polysomnographic observations and subjective experiences under sensory deprivation
Authors: Iwata Kazuki , Yamamoto Mitsuaki , Nakao Mitsuyuki , Kimura Masayuki
Published: March 2003

We investigated the relationship between subjective experiences and polysomnographic observations under sensory deprivation (SD). The results can be divided into two types: (i) visual images were perceived frequently, accompanied by alpha waves or theta waves in electroencephalogram and frequent rapid eye movements (REM); (ii) the subjects fell in deep sleep without perception of visual images. The perceptions of visual images with alpha waves or theta waves and REM are supposed to be different from those in usual wakefulness and sleep. These results suggest that the SD could disclose different aspects of consciousness from the conventionally categorized states such as wakefulness and sleep.
Systematic treatment for nocturnal urinary frequency following a sleep–micturition chart
Authors: Yamao Y. , Kawauchi A. , Tanaka Y. , Watanabe H. , Kitamori T. , Imada N. , Shirakawa S.
Published: March 2003

Seven patients complaining of nocturnal urinary frequency were treated following a sleep–micturition chart. By clinical analysis of the data, the causes of nocturnal urinary frequency were divided into three diagnostic categories: a small bladder capacity group, a sleep disorder group and a large nocturnal urinary volume group. The three groups were treated by anti‐cholinergic agents, sleeping pills and restriction of water intake at night respectively. With the administration of anti‐cholinergic agents or sleeping pills nocturnal bladder capacity increased. By restriction of water intake at night nocturnal urinary volume decreased. In all patients nocturnal urinary frequency decreased and sleep efficiency was improved.
Neuropsychological measures in women with obsessive–compulsive disorder and trichotillomania
Authors: Coetzer Rudi , Stein Dan J
Published: March 2003

Women with obsessive–compulsive disorder (OCD), trichotillomania (TTM) and normal controls completed a neuropsychological battery which was designed to test executive and visuospatial dysfunctions. Differences between the combined patient group and normal controls on the Rey–Osterreith Copy Test were consistent with previous work demonstrating similar neuropsychological dysfunctions in OCD and TTM.
The Montgomery Asberg Depression Rating Scale in bipolar II and unipolar out‐patients: A 405‐patient case study
Authors: Benazzi Franco
Published: March 2003

The aim of the present study was to find if the Montgomery Asberg Depression Rating Scale (MADRS) can identify symptom differences between bipolar II and unipolar depression. Four hundred and five consecutive bipolar II and unipolar depressed out‐patients were interviewed with the Comprehensive Assessment of Symptoms and History structured interview, following DSM‐IV criteria, the MADRS, and the Global Assessment of Functioning scale. The Montgomery Asberg Depression Rating Scale items were not significantly different between bipolar II and unipolar patients. Comparisons among atypical and non‐atypical bipolar II and unipolar patients showed that only MADRS items of ‘reduced sleep’ and ‘reduced appetite’ were significantly different between atypical and non‐atypical patients.
Application of telepsychiatry: A preliminary study
Authors: Matsuura Shinsuke , Hosaka Takashi , Yukiyama Takeshi , Ogushi Yoichi , Okada Yoshikazu , Haruki Yasuo , Nakamura Masahiko
Published: March 2003

Telemedicine is the provision of professional medical services from sites removed from the patient. This study was conducted in order to assess the reliability of psychiatric evaluations via video‐consultation. The inter‐rater reliability was determined for each interviewing condition by employing the reliability‐testing paradigm in which the brief psychiatric rating scale (BPRS) and the interclass correlation coefficient (ICC) are used. The inter‐rater reliability scores between face‐to‐face interviews and interviews conducted by video at two different levels of image qualities were compared by the authors. Reliability was found to be in perfect agreement in each of the interviewing conditions. This study verifies that telepsychiatry is a reliable method of assessing patient conditions. It may be used to provide much needed mental health‐care services to patients whose access to them is restricted.
A short daytime nap modulates levels of emotions objectively evaluated by the emotion spectrum analysis method
Authors: Luo Zili , Inoué Shojiro
Published: March 2003

A novel objective technique, the emotion spectrum analysis method, was first applied to investigate emotional fluctuations before, during and after a daytime nap in eight healthy young adults (four males and four females). The subjects were allowed to freely nap between 13.00 and 14.00 h, in which stages 1 and 2 non‐rapid eye movement sleep occurred on average for 5.9 and 20.8 min, respectively. Emotional components such as anger, joy, relaxation and sadness were numerically estimated on the basis of spatio‐temporal behavior of 21‐channel electroencephalogram and analyzed statistically. In comparison with the prenap waking level, the magnitudes of the anger, joy and relaxation components remained stably unchanged during the nap but elevated significantly during the postnap waking period. The sadness component exhibited little significant change throughout the observation period. From the results, we suggest that a short daytime nap modulates the emotions to improve the postnap mental states.
Prevalence of nocturia among Japanese adults
Authors: Kageyama Takayuki , Kabuto Michinori , Nitta Hiroshi , Kurokawa Yoshika , Taira Kazuhiko , Suzuki Shosuke , Takemoto Tai‐Ichiro
Published: March 2003

Abstract The prevalence of nocturia among Japanese community‐dwelling adults was associated with insomnia, taking into account other correlates of insomnia.
Effects of aniracetam on impaired sleep patterns in stroke‐prone spontaneously hypertensive rats
Authors: Kimura Mayumi , Okano Shukan , InouÉ Shojiro
Published: March 2003

The aim of the present study was to determine the pattern of sleep disturbances and the effects on sleep of aniracetam, a cognitive enhancer, in stroke‐prone spontaneously hypertensive rats (SHRSP). Compared with normotensive control rats, SHRSP exhibited an impaired sleep pattern characterized by suppressed diurnal rapid eye movement (REM) sleep and excessive nocturnal non‐REM sleep. At a dose of 30 mg/kg per day p.o., aniracetam increased REM sleep in the light period after administration for 5 consecutive days. Consequently, suppressed REM sleep in SHRSP was restored by repeated treatment with aniracetam. Aniracetam could be useful in improving REM sleep impairment associated with vascular dementia.
Changes in subjective sleepiness, subjective fatigue and nocturnal sleep after anaesthesia with propofol
Authors: Ozone Motohiro , Itoh Hiroshi , Yamadera Wataru , Ohbuchi Keita , Hayashida Kenichi , Sasaki Mitsuo , Ushijima Sadanobu , Toriumi Kazuhiro , Takinami Masanori , Tanifuji Yasuhasa
Published: March 2003

The purpose of this study was to clarify the changes in psycho‐physiological functions after anaesthesia with propofol (PF). The subjects were seven healthy male volunteers and the duration of the anaesthesia was 1 h (14:00–15:00 h). The plasma concentration of PF immediately decreased after the anaesthesia. The subjective sleepiness and VAS (visual liner analogue scale) scores (i.e. effort to do something) increased significantly at 20 min after the anaesthesia. However, these changes were improved at 80 min after the anaesthesia. The sleep latency at the nocturnal sleep 8 h after the anaesthesia was prolonged significantly, but the other parameters including the distributions of stage 3 + 4 and the rapid eye movement ‘REM’ stage were not changed.
Influence of alcohol on respiratory disturbance during sleep
Authors: Tsutsumi Wakako , Miyazaki Soichiro , Itasaka Yoshiaki , Togawa Kiyoshi
Published: March 2003

Oxygen saturation was measured in 37 patients with sleep‐related breathing disorders over 2 nights: after alcohol intake and under control conditions. Both the number of 3% oxygen desaturation per hour (ODI3) and the lowest saturation (LSAT) were significantly aggravated after alcohol ingestion. Oxygen saturation was degraded in 28 cases after alcohol intake. In 69% of the cases in which ODI3 increased after alcohol ingestion, the aggravation during the alcohol metabolism time was noted. No correlation was found between the quantity of alcohol and oxygen desaturation following alcohol ingestion. Our study revealed that alcohol aggravates sleep‐related breathing disorders.
A new method to analyze basic rest–activity cycle
Authors: Shono Mayumi , Shono Hideaki , Takasaki Mitsuhiro , Ito Yuji , Muro Masami , Iwasaka Tsuyoshi , Sugimori Hajime
Published: March 2003

A new method was proposed to analyze a basic rest–activity cycle (BRAC), termed BRAC‐A. This method calculates a significant cycle length by chi‐squared method and the starting points of a resting phase and an active one by analysis of the array consisting of the segmented time series in the same length. Using 20 3‐day computer‐simulated time series of standard deviation in fetal heart rate fluctuation with known periodicity of the BRAC, we demonstrated that the BRAC‐A was a useful tool to reveal the characteristics of the BRAC.
A trial study of RhinoSleep for the diagnosis of sleep apnea
Authors: Miyazaki Soichiro , Tanaka Toshihiko , Itasaka Yoshiaki , Ishikawa Kazuo
Published: March 2003

RhinoSleep was developed to diagnose obstructive sleep apnea (OSA). The RhinoSleep consists of a soft catheter, a measuring probe, and a computer. The soft catheter is inserted through the naris into the esophagus. The catheter is connected to the measuring probe, which creates and sends a continuous noise signal into the catheter. When the catheter is compressed during an obstruction, the sound reflections change, making it possible to identify both the level and the duration of the obstruction. Sixteen OSA patients were examined using RhinoSleep and daytime polysomnography simultaneously. With RhinoSleep, we successfully examined 13 cases. This trial study identified problems with RhinoSleep, such as vomiting of the catheter, hardware instability, and the criteria decision for the analysis of OSA.
Alterations of nitric oxide and monoamines in the brain of the EL mouse treated with phenobarbital and zonisamide
Authors: Tominaga Masataka , Nagatomo Itsugi , Uchida Masahiro , Hashiguchi Wataru , Akasaki Yasuaki , Takigawa Morikuni
Published: March 2003

Abstract The effects of phenobarbital (PB; doses, 5, 10, and 25 mg/kg, intraperitoneally (i.p.)) and zonisamide (ZNS; doses, 30, 75, and 150 mg/kg, i.p.) on nitric oxide (NO) production, and those of coadministration of PB (5 mg/kg, i.p.) and ZNS (75 mg/kg, i.p.) on monoamines in the brain of the seizure‐susceptible EL mouse were investigated. Nitric oxide production was obtained by measuring the combined level of nitrite plus nitrate (NOx). Zonisamide and PB dose‐dependently suppressed the seizure of the EL mouse, and coadministration of PB (5 mg/kg) and ZNS (75 mg/kg) induced a greater degree of seizure suppression than treatment with ZNS or PB alone. Although PB (5 mg/kg) had no effect on brain NOx levels, ZNS (150 mg/kg) and coadministration of ZNS (75 mg/kg) and PB (5 mg/kg) decreased NOx levels significantly. Phenobarbital (5 mg/kg) did not influence monoamines, while coadministration of PB (5 mg/kg) and ZNS (75 mg/kg) decreased dihydroxyphenylacetic acid and increased 5‐HT concentrations. The effect of the coadministration of two drugs on monoamines were similar to that of ZNS alone. These results suggest that one of the anticonvulsant effects of coadministration of PB and ZNS may be caused by changes in NOx levels.
Correlation of panic attacks and hostility in chronic schizophrenia
Authors: Chen Ching‐Yen , Liu Chia‐Yih , Yang Yong‐Yi
Published: March 2003

Abstract The aim of this study was to investigate the relationship between panic attacks and hostility in patients with chronic schizophrenia. Thirty‐two patients with a minimum 2‐year history of treatment for schizophrenia were interviewed. The patients took mood stablizers lithium, carbamazepine and valproate adjunctively for hostility and anger attacks. Panic attacks were defined by Structure Clinical Interview of DSM‐IV. Severity of psychopathology was assessed by the Hamilton Depression Rating Scale (HDRS) and Brief Psychiatric Rating Scale (BPRS). Functional level was assessed by the Global Assessment of Functioning Scale (GAF). Eight (25%) patients met the diagnostic criteria for panic attacks (DSM‐IV) with affective symptoms including hostility and sudden spells of anger. Their HDRS scores were significantly higher (P < 0.01), and GAF scores were significantly lower (P < 0.05) than those of patients without panic attacks. Patients with panic attacks displayed significantly higher hostility in the score of the BPRS (P = 0.01). Those who received higher doses of neuroleptics were more likely to be considered hostile. Multivariate analysis revealed that panic attacks were correlated with more severe depression, greater hostility and lower GAF scores. The results suggest that increased hostility and anger spells may be symptoms of panic attacks, which are overlooked by psychiatrists.
The effects of continuous positive air pressure treatment on anxiety and depression levels in apnea patients
Authors: SÁNCHEZ ANA ISABEL , BUELA‐CASAL GUALBERTO , BERMÚDEZ MARIA PAZ , CASAS‐MALDONADO FRANCISCO
Published: March 2003

Abstract Various studies have focused on understanding how the continuous positive air pressure (CPAP) treatment improves the emotional state of obstructive sleep apnea patients, as well as factors that determine improvement. Yet the results are contradictory. The objective of the present study was to evaluate the changes in depression levels, anxiety state and anxiety trait levels of patients with obstructive sleep apnea after 1 month and again after 3 months of CPAP treatment. The sample consisted of 51 obstructive sleep apnea patients. The Beck Depression Inventory (BDI) standardized spanish version was used to assess depressive symptoms. The State‐Trait Anxiety Inventory (STAI) was used to assess two elements of the response to anxiety: anxiety‐state and anxiety‐trait. The results indicate that there exist statistically significant differences in depression levels after 1 month and after 3 months of treatment (P < 0.05). In specific, a drop in depression symptomatology was observed in both experimental conditions. With respect to anxiety state‐trait levels, the obtained results show statistically significant differences in anxiety‐trait levels after 1 month and after 3 months of treatment (P < 0.05) and in anxiety state after 3 months of treatment (P < 0.01). Both variables experienced a decrease after CPAP treatment.
Changes in regional cerebral blood flow abnormalities in late‐life depression following response to electroconvulsive therapy
Authors: Awata Shuichi , Konno Michiko , Kawashima Ryuta , Suzuki Kazumasa , Sato Toshimitsu , Matsuoka Hiro , Fukuda Hiroshi , Sato Mitsumoto
Published: March 2003

Abstract The impact of electroconvulsive therapy (ECT) on the regional cerebral blood flow (rCBF) abnormalities in late‐life depression is still unknown and the clinical significance of these findings in late‐life depression has not been fully discussed. Using single photon emission computed tomography (SPECT) with 99mTc‐hexamethylpropylene
amine oxime (99mTc‐HMPAO), we examined the changes of rCBF patterns in nine late‐life patients with major depressive episodes before and following response to ECT compared with nine age‐ and sex‐matched healthy volunteers. Statistical comparisons were made on both region‐of‐interest (ROI) and voxel‐by‐voxel bases. In ROI‐based analyses, a mean rCBF was significantly decreased in the patients before ECT compared with the control, significantly increased (normalized) in the patients 2 weeks after ECT compared with that before ECT, and still increased in the patients 12 weeks after ECT compared with that before ECT. In voxel‐by‐voxel analyses, a significant rCBF reduction was found in the bilateral pre‐ and subcallosal anterior cingulate cortex, the bilateral caudal orbitofrontal cortex, the right insular cortex and the right posterior middle frontal gyrus in patients before ECT compared with the control, and similar rCBF patterns were shown at 2 weeks and 12 weeks after ECT. We propose the hypothesis that a mean rCBF reduction may have a state‐related property while persistent anterior paralimbic hypoperfusion may have a trait‐like property, which relates to the relapse vulnerability as well as a tendency toward medication failure and illness chronicity in late‐life depression.
A naturalistic study of risperidone treatment in seven affiliated university hospitals in Korea
Authors: Bahk Won‐Myong , Pae Chi‐Un , Chae Jeong‐Ho , Kim Kwang‐Soo , Jun Tae‐Youn , Tsoh Joshua , Kim Dai‐Jin , Lee Chung‐Tai , Lee Chul , Han Sang‐Ick , Choi Bo‐Moon , Han Jin‐Hee , Go Hyo‐Jin
Published: March 2003

Abstract This retrospective naturalistic study, conducted on patients with schizophrenia, was undertaken to examine the differences in the clinical characteristics of subjects who were treated with risperidone, but who were discontinued soon after administration, and those who were maintained on the drug for a long‐term period. Data on 210 of 580 inpatients with schizophrenia who were treated with risperidone and whose complete medical records were available, were analyzed. Patients maintained on risperidone for at least 2 years were assigned to a ‘long‐term maintenance’ (LTM) group and those who were discontinued within 6 months of risperidone administration were assigned to an ‘early drop‐out’ (ED) group. The parameters used for comparisons included the patients’ demographic characteristics, the presence/absence of physical or psychiatric comorbidities, the severity of the psychopathology, the typology of the schizophrenia, the nature and subjects’ responses to previous antipsychotic treatments (if any) and dosages of risperidone treatment. Of the 210 subjects, 67 (31.9%) belonged to the ED group, whereas 143 (68.1%) were maintained on risperidone at 2 years. There were no significant differences in the demographics, nor in the severity of the psychopathology, nor were there significant differences in the starting or maximal dosages of risperidone administered between the two groups. Exposure to any previous antipsychotic and the longest maintained final dosage of risperidone were significantly different in the two groups. We believed that a multicenter‐based retrospective naturalistic study would provide useful information about the efficacy and other practical aspects of antipsychotic administration.
Primary liver carcinoma complicating membranous obstruction of the inferior vena cava
Authors: Katoh Masahiro , Shigematsu Hidekazu
Published: March 2003

A rare autopsy case of primary liver carcinoma complicating a pre‐existing, incomplete membranous obstruction of the inferior vena cava (MOVC) is reported. The patient, a 67‐year‐old Japanese male, was admitted to hospital following a 2 year illness of a left chest wall tumor and a 3 month illness with progressive abdominal pain. Computed tomography scans of the abdomen displayed space‐occupying lesions in the third and seventh hepatic segments, respectively. One month later, the patient developed edema of the lower extremities and marked venous dilatation of the abdominal trunk. At that time, Doppler examination revealed the presence of intrahepatic large venovenous collaterals. The patient subsequently succumbed 82 days after hospitalization. At subsequent autopsy, the inferior vena cava was completely obstructed by tumor thrombus, which was formed caudally and cranially to a thin membrane and mimicked the valve, with calcification and elastic lamina, at the phrenic portion. Intrahepatic large collateral pathways were found between submembranous and supramembranous hepatic veins. Anomalous absence of the ostia of the middle hepatic vein was found. In addition, the portal venous trunk was occluded by tumor thrombus. Histology of hepatic tumors revealed a combined hepatocellular and cholangiocellular carcinoma in the non‐cirrhotic liver with severe acute centrilobular congestion. In MOVC patients such as the case presented, malignancy‐induced thrombosis was deemed to be an important factor in prognosis.
Synovitis in rheumatoid arthritis: Scoring of characteristic histopathological features
Authors: Koizumi Fumitomo , Matsuno Hiroaki , Wakaki Kunihiko , Ishii Yoko , Kurashige Yoichi , Nakamura Hiroshi
Published: March 2003

Synovial tissue specimens obtained from the knee joints of 40 patients with rheumatoid arthritis (RA) and from 22 patients with osteoarthritis (OA) were examined histologically. The histopathological features of RA synovitis and OA synovitis were then compared. Seven criteria items of histopathological features characteristic to RA synovitis were given a score of 1–3 points each in order to evaluate the histological severity of the seven items. Their total scores were then calculated. A comparison of the total RA synovitis score and the total OA synovitis score revealed that RA synovitis showed more than 11 points (maximum 20 points), while OA synovitis showed less than 10 points in all but two cases. Furthermore, the total scores of RA synovitis were then determined in the same manner for other joints, where it was confirmed that five other joints had scores of more than 11 points as well; that is, the intercarpal, wrist, elbow, ankle and hip joints in 52 patients with RA. From these results, it was concluded that in the histological examination of biopsied synovial tissue of RA, if the total score for synovitis is more than 11 points (maximum 20 points), an histological diagnosis of RA synovitis can be confirmed.
Paracortical hyperplasia of superficial lymph nodes in a new mutant strain of hairless rats (ISh): A lesion similar to human dermatopathic lymphadenopathy
Authors: Shamoto Mikihiro , Shinzato Masanori , Qian Bin , Hosokawa Satoru , Ishibashi Masahiko
Published: March 2003

The dermal histology and the regional draining superficial lymph node of a new mutant strain of hairless rats (ISh) were investigated. The homozygote ISh rat was characterized as having naked and wrinkled skin. The comedo‐like cysts in the skin resembled human acne and vulgaris. Histopathologically, many Langerhans’ cells positive for anti‐protein kinase C type II antibody (PKC‐II) were recognized in the epidermis. The superficial lymph nodes were significantly larger than those of the heterozygote. The paracortex of these lymph nodes was expanded and the number of Langerhans’ cells mainly increased in these areas. These lymph node lesions were similar to those of human dermatopathic lymphadenopathy. The ISh rats should be a very useful animal model for studying dermatopathic lymphadenopathy in humans. Furthermore, they may be a valuable animal model for investigating the mechanisms of not only maturation, movement and migration of Langerhans’ cells, but also of their function for antigen presentation.
Why couldn’t an accurate diagnosis be made? An analysis of 1044 consecutive autopsy cases
Authors: Tsujimura Takahiro , Yamada Yuya , Kubo Masaharu , Fushimi Hisako , Kameyama Masakuni
Published: March 2003

The protocols of 1044 consecutive patients autopsied between 1983 and 1997 at Sumitomo Hospital (Osaka, Japan) were retrospectively analyzed and the findings were compared with clinical diagnoses. In 73 cases, the clinical diagnosis apparently differed from the autopsy findings, and in six cases the origin of a malignant neoplasm remained unsolved even at autopsy. Of the 73 discrepant cases, 24 were a result of clinician misjudgment and a neglect to conduct further examinations. Missed diagnosis due to an erroneous pathological report, technical error of endoscopy, and misleading results obtained by new non‐invasive technologies accounted for seven, nine, and 11 cases, respectively. Twenty‐two cases were missed because the clinician could not carry out precise examination. It is concluded that advances in diagnostic technology and medical knowledge have not reduced the value of an autopsy.