bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing sampling strategies for estimating mean water quality in lakes using geostatistical techniques with remote sensing
Authors: Hedger R. D. , Atkinson P. M. , Malthus T. J.
Published: March 2003

In planning a sampling regime, it is desirable that the sampling procedure should involve minimum estimation error for a given sample size or minimum sampling effort for a given accuracy. Two approaches for matching sampling effort to accuracy may be used: a classical approach, which ignores spatial dependence between observations, and uses a random scheme; and a geostatistical approach, which exploits spatial dependence, and uses a systematic scheme. Four Airborne Thematic Mapper images of two British lakes were processed to provide a chlorophyll index, reflecting variations in chlorophyll‐a concentration. Spatial structure was characterized using the variogram, and the modelled variogram was used in Kriging to plan sampling regimes for estimating the mean chlorophyll. For a given sample size, the systematic scheme incurred less error than the random scheme; and for a given error, the systematic scheme required smaller sample sizes than the random scheme. The relative advantage of the systematic approach over the random sampling approach increased with an increase in sample size and an increase in the proportion of variance in the data that was spatially dependent. This paper demonstrates that the sampling regime must be calibrated to the spatial dynamics of the lake under investigation, and suggests that remote sensing is the ideal means by which to determine such dynamics.
Modelling the impact of historical land uses on surface‐water quality using groundwater flow and solute‐transport models
Authors: Wayland Karen G. , Hyndman David W. , Boutt David , Pijanowski Bryan C. , Long David T.
Published: March 2003

Groundwater age, and its influence on contemporary water chemistry, needs to be accurately described to quantify the temporally varying impacts of land use on water quality. The time lags between solute inputs at the land surface and impacts on stream chemistry can be an important factor for managing land use in regional watersheds. Our approach uses a modified groundwater flow code to simulate reverse groundwater flow, regional flow and the solute‐transport model where a unit concentration of a conservative solute serves as a proxy for groundwater age. Solute‐contour lines represent groundwater travel time, which can then be coupled with Geographic Information System analyses to examine the relationship between water quality and historical land‐use patterns. The reverse flow and solute modelling produced a reasonable distribution of groundwater travel times across the watershed, given the hydrology of the system. These groundwater flow paths would be unexpected if surface topography or even surface hydrology were used to predict groundwater movement. Approximately 70% of the watershed has a groundwater lag of ≤30 years. When the temporal lags for individual drainage areas within the watershed are compared, flush times vary dramatically. This variability is related both to the size of the sourceshed and its geology. The influence of a particular land use on stream chemistry changes depending on the time scale considered, and also depending on the sourceshed in question as a result of landscape diversity. The results suggest that land‐use management practices to reduce solute loading to a watershed might not result in water‐quality improvements for many years, especially if implemented on land far from streams. The influence of long groundwater flow paths that integrate past and current land uses must be considered in the interpretation of land‐use effects on surface‐water quality.
Resuspension of bottom sediment by an internal wave in Lake Biwa
Authors: Sakai Yuji , Murase Jun , Sugimoto Atsuko , Okubo Kenji , Nakayama Eiichiro
Published: March 2003

An internal wave‐induced resuspension of bottom sediment and resultant changes in water chemistry were investigated in the sublittoral area of Lake Biwa in the late stage of the stagnant period. The thermocline was measured at between depths of 15 and 20 m at the beginning of the observation and rapidly dropped by 5 m within 3 h. The downward movement of the thermocline resulted in markedly increased turbidity at the top of the thermocline (20 m in water depth). Concentrations of dissolved methane synchronistically increased with turbidity, especially in the top of the thermocline where there was the highest turbidity. Total dissolved phosphorus and particulate phosphorus also increased in the thermocline. In contrast, the soluble reactive phosphate concentration decreased with time. An increase in the concentrations of particulate metals (aluminium, iron and titanium), which probably originated from mineral particles, was more marked in the water sample collected at 1 m above the bottom than at the peak of turbidity. The results indicated that an internal wave caused resuspension of the bottom sediment and also affected the water chemistry.
Ischemic delayed neuronal death: Role of the cysteine proteases calpain and cathepsins
Authors: Tontchev Anton B , Yamashima Tetsumori
Published: March 2003

A few days after a transient brain ischemia, the pyramidal neurons in the cornu Ammonis (CA) 1 sector of the hippocampus undergo selective death, a process named delayed neuronal death (DND). Cell death may occur as necrosis and/or apoptosis, and both have been reported to take place in DND. The cell's decision between apoptosis and necrosis may depend on the strength of the insult, the balance of downstream signal transduction systems, and the expression level of pro‐ and anti‐apoptotic or necrotic factors. Cytosolic calcium (Ca2+) overload specifically occurs in the CA1 neurons after ischemia and thus is considered a common triggering event of the death cascade. As Ca2+ activates a wide array of intracellular enzymes, many Ca2+‐targeted enzymes have been implicated in DND. Among these, the present review will focus on the cysteine proteases calpain and cathepsins (B and L). In addition, their possible interactions with another family of cysteine proteases, caspases, will be discussed in relation to the cellular fate toward apoptosis or necrosis.
Clinicopathological features of non‐atherosclerotic cerebral arterial trunk aneurysms
Authors: Mizutani Tohru , Kojima Hideaki
Published: March 2003

Internal elastic lamina (IEL) is the most vital structure of the cerebral arterial wall. Longstanding weakness of the IEL due to hemodynamic stress is compensated by adaptive intimal thickening. Formation of cerebral arterial trunk aneurysm is assumed to be the result of a break in the equilibrium between hemodynamic stress and the condition of the IEL and intima. Cerebral arterial trunk aneurysms unrelated to the branching zones have several lesional patterns of IEL and the state of intima. There is a strong relationship between the pathological features of aneur‐ ysms and their clinical courses. We attempt to delineate the concept of cerebral arterial trunk aneurysms including ‘dissecting aneurysms’ and ‘fusiform aneurysms’.
Neuropathological findings of Onuf's nucleus and its significance
Authors: Mannen Toru
Published: March 2003

Onuf's nucleus is a small group of cells which are located mainly in the anterior horn of the second sacral segment of the spinal cord. This paper describes the history of studies relating to this nucleus including a discussion of its relation with the various pathological studies which have been made.
Peripheral primitive neuroectodermal tumor within the spinal epidural space
Authors: Izycka‐Swieszewska Ewa , Stefanowicz Joanna , Debiec‐Rychter Maria , Rzepko Robert , Borowska‐Lehman Jolanta
Published: March 2003

A case of an epidural spinal peripheral primitive neuroectodermal tumor (pPNET) in a 13‐year‐old girl is presented. The tumor was disseminated at the moment of diagnosis, thus only diagnostic oligobiopsy of the epidural mass was performed. Histologically the tumor was composed of small round blue cells. The neoplastic cells expressed MIC2 and features of neural differentiation on immunohistochemical staining (neuron‐specific enolase, synaptophysin and NCAM positivity). Fluorescent in situ hybridization (FISH) analysis was performed for the final diagnosis and the translocation t(11;22)(q24;q12) was detected. The present case emphasizes the usefulness of FISH in differential diagnosis of tumors, especially when only routinely fixed material is available.
Primary extranodal marginal zone B‐cell lymphoma of the mucosa‐associated lymphoid tissue type in the CNS
Authors: Itoh Tomoo , Shimizu Michio , Kitami Koichi , Kamata Kyosuke , Mitsumori Kenji , Fujita Miri , Ohnishi Akiko , Nagashima Kazuo
Published: March 2003

Extranodal marginal zone B‐cell lymphoma of the mucosa‐associated lymphoid tissue (MALT) type has been reported in various internal organs. Here a case is reported of MALT lymphoma developing in the cerebellopontine (CP) angle in a patient with Sjögren syndrome, and the concept of MALT lymphoma of the CNS is introduced. Pathologically, the tumor showed inflammatory features of reactive lymphocytic infiltration with follicle formation, but there were slightly atypical lymphocytes and plasmacytes with B‐cell markers. These cells invaded reactive follicles, showing follicular colonization, and showed aberrant expression indicating their neoplastic nature. A review of the literature revealed eight cases of MALT lymphoma originating from the dura mater and one from the CP angle. The average age of patients was 50 years (range 28–66 years), and all patients were female. The tumors were slow to develop and the patients were cured after surgical removal and/or additional therapies. It is proposed that MALT lymphoma should be considered as a differential diagnosis of inflammatory pseudotumor of the CNS.
Apoptosis in the pathogenesis of renal disease with a focus on tubulointerstitial injury
Authors: GOBE Glenda , BUTTYAN Ralph
Published: March 2003

SUMMARY: Renal cell apoptosis is important not only in normal physiological conditions of the kidney but also in pathological processes. In normal renal development, it removes unwanted, damaged or harmful cells, and in the healthy adult kidney, it maintains cellular homeostasis by regulating the balance between cell proliferation and cell loss. the apoptotic process has now been described in the pathogenesis and prognosis of certain renal diseases with both beneficial and detrimental roles. It causes deletion of cells intrinsic to the kidney after, for example, toxic, ischaemic, immune or radiation damage, and this loss can be destructive and can cause significant reduction of renal function. In contrast, it can control and limit inflammatory processes in both the acute and chronic phases of renal disease. Information on the positive and negative outcomes of renal cell apoptosis, plus the thousands of publications on more general aspects of apoptosis mechanisms, have now presented real opportunities for the development of therapies that selectively delete or protect certain renal cell populations. This review will discuss some of the more general aspects of renal cell apoptosis and then concentrate on the detrimental or beneficial roles of apoptosis in the initiation, progression or resolution of selected, mainly tubulointerstitial, renal diseases.
Recommendations for the use of icodextrin in peritoneal dialysis patients
Authors: JOHNSON DAVID W , AGAR JOHN , COLLINS JOHN , DISNEY ALEX , HARRIS DAVID CH , IBELS LLOYD , IRISH ASHLEY , SALTISSI DAVID , SURANYI MICHAEL
Published: March 2003

SUMMARY: Icodextrin is a starch‐derived, high molecular weight glucose polymer, which has been shown to promote sustained ultrafiltration equivalent to that achieved with hypertonic (3.86%/4.25%) glucose exchanges during prolonged intraperitoneal dwells (up to 16 h). Patients with impaired ultrafiltration, particularly in the settings of acute peritonitis, high transporter status and diabetes mellitus, appear to derive the greatest benefit from icodextrin with respect to augmentation of dialytic fluid removal, amelioration of symptomatic fluid retention and possible prolongation of technique survival. Glycaemic control is also improved by substituting icodextrin for hypertonic glucose exchanges in diabetic patients. Preliminary in vitro and ex vivo studies suggest that icodextrin demonstrates greater peritoneal membrane biocompatibility than glucose‐based dialysates, but these findings need to be confirmed by long‐term clinical studies. This paper reviews the available clinical evidence pertaining to the safety and efficacy of icodextrin and makes recommendations for its use in peritonal dialysis.
Prenatal screening and women's perception of infant disability: A Sophie's Choice for every mother
Authors: Chandler Michele , Smith Angie
Published: March 2003

Prenatal screening can significantly benefit parents and the community. However, it has created a dilemma for women as it requires them to quickly decide whether to continue a pregnancy or terminate it should the test indicate a foetal abnormality. This can be psychologically traumatic for women torn between their connection to an unborn child with all its possible imperfections, and a desire to prevent its suffering as a disabled child in later life. A woman must also consider her own and her family's future welfare. Extensive research into the physical aspects of prenatal screening has not explored the meaning of the experience for women or whether termination is the most appropriate option. This article examines recent qualitative studies, concluding that women who terminate a pregnancy following prenatal screening may experience an acute grief reaction or be plagued by guilt and fear that can precipitate marital breakdown. Additionally, there is a risk that through striving to eradicate congenital disability, a community risks promoting a cult of perfectionism that may have discriminatory effects on disabled people.
Reflection as empowerment?
Authors: Johns Christopher
Published: March 2003

Reflective practice, as an ideal model, is generally espoused as a developmental process to empower practitioners to achieve and sustain effective practice. Yet when reflective practice is accommodated into the real world of everyday practice can this ideal itself be realised? Or will reflective practice be accommodated within existing norms whereby it becomes another technology of surveillance? The paper draws on dialogue taken from a guided reflection session to consider whether reflection can be empowering and to consider those factors which limit this potential.
‘I’ll tell you what suits me best if you don’t mind me saying’: ‘lay participation’ in health‐care
Authors: Allen Davina
Published: March 2003

‘I’ll tell you what suits me best if you don’t mind me saying’: ‘lay participation’ in health‐care

Increasing ‘lay participation’ in healthcare has become a popular notion in recent years and is generally considered to be a good thing in both nursing and wider policy circles. Yet despite the widespread acceptance of this overall idea, there is a dearth of theorising in this area. This has resulted in a lack of conceptual clarity which has not only hamstrung the development of empirical work in the field, but has also led to a tendency by both nurses and policy‐makers to assume that greater ‘lay participation’ in health will lead to a concomitant increase in lay power vis‐à‐vis health professionals. The data presented in this paper indicate that this is, at best, an over‐simplistic assumption and, at worst, an erroneous one. Drawing on sociological theories of the division of labour, I suggest that one way in which we might begin to clarify our thinking in this area is by differentiating between the ‘role’ and ‘task’ components of ‘lay participation’. I illustrate my argument with reference to two separate ethnographic studies undertaken between 1994 and 1998 in which participation at the level of the individual was examined.
Nurses and medication error: a discursive reading of the literature
Authors: Gibson Terri
Published: March 2003

Nurses and medication error: a discursive reading of the literature

Medication management is a part of everyday nursing practice. In carrying out this aspect of their role, nurses are subject to a range of practices and procedures, which are dictated through legal, management and medical requirements to ensure safe administration of medications. The literature addresses a range of areas related to the nurse’s role in medication management, including knowledge required by nurses, practices and procedures related to administration, procedures for identifying and reducing errors and measuring error rates, and professional and ethical issues. The literature is a part of the discursive ensemble of nursing — as a written text it contributes to how nurses and colleagues construct and view nursing practice. This paper presents a discursive reading of that literature, exploring how nurses are positioned in relation to medication errors. I argue that the voice of nursing is mostly heard through discourses of biomedical science, law and management and draw on the work of Michel Foucault to illustrate some of the ways in which these discourses shape nursing practice.
Interrater reliability of the Japanese version of the Positive and Negative Syndrome Scale and the appraisal of its training effect
Authors: IGARASHI YOSHITO , HAYASHI NAOKI , YAMASHINA MITSURU , OTSUKA NAOHISA , KUROKI NORIOMI , ANZAI NOBUO , KAZAMATSURI HAJIME
Published: March 2003

The purpose of the present study is to test interrater reliability of the Japanese version of the Positive and Negative Syndrome Scale (PANSS) and to examine factors possibly affecting the reliability. The study group conducted the PANSS rating on 20 patients with DSM‐IV schizophrenia. For the analysis of interrater reliability, intraclass correlation coefficient (ICC) was calculated. The ICC for individual items of the PANSS ranged from 0.26 to 0.92, and those for the positive, negative, and general psychopathology subscales were 0.85, 0.83 and 0.75, respectively. The Cronbach's alpha coefficient for the subscales were 0.84, 0.87 and 0.76, respectively. The interrater reliability and the internal consistency were satisfactory and similar to those obtained in the antecedent studies. No salient training effect was found in a sequential analysis of the concordance rate. It is concluded that the Japanese version of the PANSS is a reliable and efficient tool for comprehensive assessment of the schizophrenic syndrome.
Depressive disorders as psychiatric complications after obesity surgery
Authors: KODAMA KAZUHIRO , NODA SHINGO , MURAKAMI ATSUHIRO , AZUMA YUKARI , TAKEDA NAOKI , YAMANOUCHI NAOTO , OKADA SHINICHI , KOMATSU NAOYA , SATO TOSHIO , MIYAZAWA YUKIMASA , KAWAMURA ISAO
Published: March 2003

Three case reports of morbidly obese patients (two women and a man) who underwent vertical banded gastroplasty and who subsequently fell into depression, are presented here. The psychiatric diagnosis according to DSM‐III‐R (Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised), the eating pattern before obesity surgery, the past history of mental disorder, social adaptation before surgery, psychological gain from their obese state, and the presence of unrealistic expectations of obesity surgery were investigated. Case 1 was diagnosed postoperatively as having a major depressive episode without a personality disorder. Case 2 was diagnosed postoperatively as having a major depressive episode. Case 3 had a depressive disorder not otherwise specified. Cases 2 and 3 had a social phobia with comorbidity of personality disorders. Binge eating disorder was confirmed in all patients before obesity surgery. There were differences between case 1 and cases 2 and 3 based on the presence of personality disorder and the time of onset of depression. When some psychiatric characteristics are confirmed in obese patients, obesity surgery should be undertaken more prudently because the patients may manifest depression postoperatively. The pre‐operative psychiatric assessment is essential for a decision on indication of obesity surgery.
Psychological responses to disasters: Conceptualization and identification of high‐risk survivors
Authors: GREEN BONNIE L.
Published: March 2003

Disasters are often categorized as being `natural' or `technological' in origin. Natural disasters are called `acts of God' and are not seen to be alterable by human actions, while ecological disasters represent a loss of control over technology that could have been avoided. These technological events represent a breach of an implicit social contract that individuals, companies or organizations have to protect human welfare or not to cause harm. Although these differing types of events have not been directly compared, and some events may represent a combination of types, the distinction regarding responsibility may have implications for mental health. A more recently studied type of disaster involving toxic exposure, such as a nuclear radiation leak, has additional characteristics that may have implications for recovery, such as that the initial stressor may be only information. The actual level of exposure may be unknown, and later consequences may be unknown as well. In addition to describing these types of disasters, the present paper presents a conceptual model of individual risk factors for negative outcomes following disaster events. Empirical findings for a number of these risk factors are reviewed, with a focus on the importance of studying interactions among risk factors as they contribute to mental health outcomes. Future research needs include the description and accounting for comorbid disorders, and studying the trauma history of survivors, for whom the disaster is unlikely to be their only traumatic event exposure.
Skin blood flow responses during sleep by laser Doppler flowmetry
Authors: Shiihara Yasufumi , Hirota Akihisa , Kobayashi Yosinari , Nakamiya Toshiyuki , Kodama Masahisa
Published: March 2003

Skin surface blood flow at the fingertips was measured in a 21‐year‐old woman during sleep using laser Doppler flowmetry. Skin blood flow responses (SBFR) are transient reductions in skin blood flow of about 25 s in duration. In our subject, SBFR showed a delay time of 8–9 s from the onset of skin potential responses (SPR) and appeared more consistently than SPR. The frequency of SBFR decreased during non‐rapid eye movement sleep, especially when the sleep stage became deep. These findings indicate the validity of SBFR as a discrete index of autonomic function during sleep.
Gender difference of slow wave sleep in middle aged and elderly subjects
Authors: Fukuda Noriko , Honma Hiroshi , Kohsaka Masako , Kobayashi Riko , Sakakibara Satoshi , Kohsaka Shinobu , Koyama Tsukasa
Published: March 2003

Sleep EEG of eight healthy males and eight females aged 54–72 years were recorded at their homes. The electroencephalograms were visually scored and analyzed by spectral analysis using the FFT method. There were no significant differences in sleep parameters except for a higher percentage of stage 3 + 4 in females. The spectral power of the delta band EEG was classified into two frequencies: 0.5–2 Hz and 2–4 Hz. The total amount of the delta band spectral power through the night was significantly larger in females. Periodic fluctuation of delta band power was observed in females along with non‐rapid eye movement–rapid eye movement cycles.
Linear automatic detection of eye movements during the transition between wake and sleep
Authors: Hiroshige Yoshiharu
Published: March 2003

Slow eye movement (SEM) are a sensitive indicator of lowered consciousness or drowsiness in man. A new computerized method for detection of SEM was introduced. A linear regression analysis was applied in each moving window for approximation to the tangent line on the electro‐oculogram curve. The results revealed that SEM were more frequent and their duration was shorter at stage wake than at sleep stages 1 and 2. The method was practically suitable for objective detection and measurement of SEM.
Acetylcholine and glutamate release during sleep–wakefulness in the pedunculopontine tegmental nucleus and norepinephrine changes regulated by nitric oxide
Authors: Kodama Tohru , Honda Yoshiko
Published: March 2003

Cholinergic neurons in the pons appear to play a major role in generating rapid eye movement (REM) sleep. In the present study, acetylcholine and glutamate release in the pedunculopontine tegmental nucleus (PPT) during the sleep–waking cycle were investigated by in vivo microdialysis. Acetylcholine release during slow wave sleep (SWS) was significantly lower (P < 0.05) than during REM sleep and wakefulness. On the other hand, glutamate release during wakefulness was higher (P < 0.05) than during REM sleep and SWS. Furthermore, the application of N‐methyl‐D‐aspartate (1 mM) induced a significant increase of nitric oxides (NOx) for 20 min (P < 0.05) and a decrease of norepinephrine for the first 15 min (P = 0.01), indicating NOx regulation on norepinephrine release in PPT.
The effect of cytochrome P450 2D6 genotypes on haloperidol metabolism: A preliminary study in a psychiatric population
Authors: Someya Toshiyuki , Suzuki Yutaro , Shimoda Kazutaka , Hirokane Genta , Morita Sachiyo , Yokono Aya , Inoue Yoshimasa , Takahashi Saburo
Published: March 2003

We investigated the effect of cytochrome P450 (CYP2D6) genotypes on plasma levels of haloperidol (HAL) and reduced haloperidol (RHAL) in 47 Japanese male schizophrenic inpatients being treated with HAL. Mutation‐specific polymerase chain reaction (PCR) analysis was used to detect CYP2D6*10 as the C188C1T mutation in exon 1. A long‐PCR analysis method was used to detect CYP2D6*5. Allele frequencies of CYP2D6*5 and CYP2D6*10 were 4.3% and 34.0%, respectively. Plasma concentrations of HAL and RHAL were measured using high‐performance liquid chromatography. The ranges of the plasma concentration of HAL and RHAL corrected to the dose were 0.28–1.60 (mean ± SD, 0.66 ± 0.25, n = 47) ng/mL/mg and 0.03–3.00 (mean ± SD, 0.36 ± 0.46, n = 47) ng/mL, respectively. Plasma RHAL/HAL ratios (R/H ratios) ranged from 0.06 to 1.88 (mean ± SD, 0.48 ± 0.32, n = 47). The analysis was performed among the four genotype groups:CYP2D6*1/CYP2D6*1 (n = 11), CYP2D6*1/CYP2D6*10 (n = 11), CYP2D6*10/CYP2D6*10 (n = 6) and those who have CYP2D6*5 allele (CYP2D6*1/ CYP2D6*5 or CYP2D6*5/CYP2D6*10 (n = 4). We observed significant tendency in effects of CYP2D6 genotypes on plasma concentration of HAL and significant effects on plasma concentration of RHAL, and R/H ratio. These results we obtained suggested that the plasma concentration of HAL and RHAL were determined partly by CYP2D6 polymorphic activity.
Effects of gender difference and birth order on perceived parenting styles, measured by the EMBU scale, in Japanese two‐sibling subjects
Authors: Someya Toshiyuki , Uehara Toru , Kadowaki Maho , Tang Sui Wong , Takahashi Saburo
Published: March 2003

The relationship between Egna Minnen av Barndoms Uppforstran (EMBU) scaling and gender, birth order and parents’ gender was previously investigated in a large volunteer sample; significant interactions among the variables were found. In the present study, 730 Japanese volunteers with one sibling were used as subjects in order to control the number of siblings: the effect of gender of subjects and siblings and birth order on the perceived parenting style was examined. Based on gender and birth orders, 730 subjects were grouped into the following categories: (i) male with a younger brother; (ii) male with a younger sister; (iii) male with an older brother; (iv) male with an older sister; (v) female with a younger brother; (vi) female with a younger sister; (vii) female with an older brother; and (viii) female with an older sister. One‐way ANOVA was performed with each EMBU subscale used as a dependent variable and these eight groups as independent variables. The scores for rejection and emotional warmth of father were influenced significantly by the pattern of siblings (P < 0.006 and P < 0.0012, respectively), and scores for emotional warmth of mother were influenced significantly by the pattern of siblings (P < 0.0012). The elder male children strongly experienced parenting style as more rejecting than others, and female children (elder sisters with brother, or younger sisters with sister) recognized parenting style as more caring and demonstrated more warmth than others. The results confirmed a significant interaction of gender of subjects and siblings and birth order of perceived parental rearing behavior.
Declining of memory functions of normal elderly persons
Authors: Yokota Masao , Miyanaga Kazuo , Yonemura Kimie , Watanabe Hama , Nagashima Kiichi , Naito Katsuo , Yamada Saburouta , Arai Setuko , Neufeld Richard W. J
Published: March 2003

Two studies examined the declining of memory functions in normal elderly persons using the Yokota memory test (YMT), which includes 15 items concerning verbal and non‐verbal memory functions. In the first study, 552 subjects over 40 years of age in five age groups were examined. Factor analysis revealed that YMT consisted of two factors pertaining to short‐term/working memory, and two factors pertaining to long‐term memory. It is suggested that the former was more affected than the latter, with aging. In the second study, YMT was examined in relation to the revised version of Hasegawa dementia scale (HDS‐R), which was the most popular intelligence scale for the elderly in Japan. As a result, memory functions differentially declined with the decreasing score of HDS‐R, which suggests that memory functions differentially declined with progressive risk of dementia.
Assessment of psychiatric patients' competency to give informed consent: Legal safeguard of civil right to autonomous decision‐making
Authors: Kitamura Toshinori
Published: March 2003

AbstractAmendment of the Mental Health and Welfare Law in Japan will limit admission for medical care and protection only for those individuals who are incapable of giving consent to admission. This is a first in the history of the Japanese mental health legislation. By reviewing the law and psychiatric literature, it is argued that: (i) informed consent is a legal transaction that embodies the idea of an individual's right to autonomous decision‐making in medical settings; (ii) health professionals have a duty to protect those individuals who cannot decide medical matters because of lack of capacity to do so; (iii) some patients are marginally incompetent so assessment of their competency is essential in protecting patients' civil rights; (iv) in order for a competency assessment to be reliable (and hence fair) the method should be psychometrically sound; (v) at the same time, in order for a competency assessment to be valid, the structure of a competency assessment should match the patient's psychological, cultural, and social background; and (vi) because informed consent is a process rather than a cross‐sectional event, a competency assessment should be performed in everyday practice. The use of a brief and semistructured interview to assess patients' competency to give informed consent may meet all of the requirements described.
Public attitudes towards the mentally ill: A cross‐cultural study between Bali and Tokyo
Authors: Kurihara Toshiyuki , Kato Motoichiro , Sakamoto Shinji , Reverger Robert , Kitamura Toshinori
Published: March 2003

Abstract The present study investigates the differences in public attitudes towards the mentally ill in Bali (Indonesia) and Tokyo (Japan), the former being a non‐industrialized society and the latter an industrialized society in Asia. Seventy‐seven residents of Bali and 66 residents from Tokyo were examined by a devaluation‐discrimination measure and a self‐assessment questionnaire to gauge their reactions to five imaginary case study vignettes consisting of three cases of schizophrenia, one case of a depressive episode, and one case of obsessive–compulsive disorder. Balinese respondents had significantly lower devaluation‐discrimination measure scores, indicating a more favorable global attitude towards persons with a history of psychiatric treatment than did respondents in Tokyo. However, the extent to which people were prejudicial against mental patients in the two societies varied with the kinds of mental disorders, with Balinese having a more positive attitude to schizophrenics but more negative to depressive and obsessive– compulsive patients.
Lasting changes in NMDAR1 mRNA level in various regions of cerebral cortex in epileptogenesis of amygdaloid‐kindled rat
Authors: Kikuchi Shiuichi , Iwasa Hiroto , Sato Toshio
Published: March 2003

Abstract The involvement of NMDA receptor subunit, NR1, with kindling phenomenon has been reported, but the role of NR1 in epileptogenesis is still unknown. We have examined the expression levels of NR1 mRNA in the cerebral cortices of amygdaloid‐kindled rats. Northern blot analysis showed a significant increase in NR1 mRNA expression level in the ipsilateral frontal and temporal cortices at 4 weeks after the last generalized seizure. At the same time, NR1 mRNA decreased in the bilateral piriform cortices. These data suggest that NR1‐mediated transmission may have an impact in the neurobiological basis of enduring epileptogenesis.
Electroconvulsive shock regulates serotonin transporter mRNA expression in rat raphe nucleus
Authors: Shen Haowei , Numachi Yohtaro , Yoshida Sumiko , Toda Shigenobu , Awata Shuichi , Matsuoka Hiroo , Sato Mitsumoto
Published: March 2003

Abstract The antidepressive actions of electroconvulsive shock (ECS) therapy are considered to involve altered neurotransmission of serotonin. In this study, we investigated the effects of acute and chronic ECS on 5‐hydroxytryptamine (5‐HT) transporter mRNA expression in rat raphe nucleus. We found that serotonin transporter (5‐HTT) mRNA expression was decreased in 9 and 24 h after acute ECS and in 3, 9, 24 h and 2 weeks after chronic ECS in rat raphe nucleus. We presume that the adaptive change in 5‐HTT mRNA expression is possibly related to the therapeutic efficacy of electroconvulsive therapy (ECT) on medication‐resistant depression.
Restlessness related to SSRI withdrawal
Authors: Hirose Shigehiro
Published: March 2003

Abstract There are reports that abrupt withdrawal of various selective serotonin re‐uptake inhibitors, such as fluvoxamine, can elicit in patients various withdrawal symptoms. Fluvoxamine has been widely used in Japan for ~1 year. However, there have been no case reports of withdrawal symptoms following abrupt fluvoxamine discontinuation in Japan. The author reports a case where the abrupt discontinuation of fluvoxamine produced restlessness in a depressed patient. The restlessness disappeared soon after the reinstatement of treatment with fluvoxamine. This case report suggests that clinicians should carefully scrutinize a patient's compliance to fluvoxamine as the withdrawal symptoms observed following abrupt discontinuation might be regarded as a relapse of depression or side‐effects of the medicine.
Comparisons of sleep patterns between mothers in post‐partum from 9 to 12 weeks and non‐pregnant women
Authors: Nishihara Kyoko , Horiuchi Shigeko , Eto Hiromi , Uchida Sunao
Published: March 2003

In order to evaluate two patterns of interrupted and non‐interrupted sleep for the post‐partum mothers from 9 to 12 weeks after delivery, we compared them with sleep patterns of non‐pregnant women. Subjects were 10 primipara and 12 non‐pregnant women. Their polysomnographic recordings were made using a Medilog recorder at home. In interrupted sleep, low sleep efficiency, decreased total sleep time, and a decreased percentage of stage 2 were significantly observed compared with non‐pregnant women. Sleep parameters of non‐interrupted sleep, except for increased percentage of stage 4, did not show any significant differences from non‐pregnant women. Mothers’ sleep fluctuated between interrupted sleep similar to the early post‐partum sleep from 1 to 6 weeks and non‐interrupted sleep with increased stage 4.
Narcoleptic canines display periodic leg movements during sleep
Authors: Okura Mutsumi , Fujiki Nobuhiro , Ripley Beth , Takahashi Shotaro , Amitai Nurith , Mignot Emmanuel , Nishino Seiji
Published: March 2003

Periodic leg movements during sleep (PLMS) is a high prevalent sleep disorder of unknown etiology. The disease is pharmacologically treated with dopaminergic agonists (i.e. D2/D3 agonists) and opiates. Periodic leg movements during sleep often occur in narcoleptic patients. We observed that narcoleptic canines, like narcoleptic humans, also exhibit jerky, unilateral or bilateral slow leg movements during sleep. The movements in dogs are characterized by repetitive dorsiflexions of the ankle, lasting 0.5–1.5 s, and occur at regular intervals of 3–20 s, thus showing similarities to PLMS in humans. The observation that D2/D3 agonists aggravate cataplexy in narcoleptic dogs suggests that altered dopaminergic regulation in canine narcolepsy may play a critical role in both cataplexy and PLMS. Our canines may therefore be an invaluable resource in PLMS research.
Hypnotic action of melatonin during daytime administration and its comparison with triazolam
Authors: Satomura Takeshi , Sakamoto Tetsuro , ShIrakawa Shinichiro , Tsutsumi Yasumasa , Mukai Masaki , Ohyama Tetsu , Uchimura Naohisa , Maeda Hisao
Published: March 2003

The present study was conducted to assess hypnotic action, effects on rectal temperature and dose dependency by daytime administration of exogenous melatonin (MLT) at 1 mg, 3 mg or 6 mg to subjects consisting of seven healthy juvenile adults. As a result, exogenous MLT significantly increased total sleep time and sleep efficiency, and MLT 6mg was observed to demonstrate hypnotic effects that were nearly equal to those of triazolam at 0.125 mg. Rectal temperature was significantly decreased at MLT 1mg and 3 mg, there were no significant differences observed in the hypothermic effects at MLT 6mg. These results indicate that exogenous MLT had dose‐dependent hypnotic action on daytime sleep, and it is possible to consider that this hypnotic action was based on a direct‐acting mechanism.
A survey on the drug therapy for delirium
Authors: Someya Toshiyuki , Endo Taro , Hara Takashi , Yagi Gohei , Suzuki Jiro
Published: March 2003

Abstract Delirium, which is experienced by 10–30% of inpatients, is commonly seen in daily practice. A survey was conducted of the delirium medications, and results were obtained from 28 psychiatric departments and related facilities. Haloperidol was used in 67% cases for the treatment of delirium. Ninety‐seven per cent of facilities considered haloperidol as the drug of first choice, while 57% thought this drug had few side‐effects and was easy to use. However, because the use of this drug is not covered by health insurance in Japan, its use is limited. We expect that this study on medication for the treatment of delirium will be a first step in increasing the approved indications for drugs used for the treatment of delirium, and to reduce off‐label use.
Relationship between regional cerebral blood flow and verbal fluency in Alzheimer's disease
Authors: Kitabayashi Yurinosuke , Ueda Hideki , Tsuchida Hideto , Iizumi Hideyuki , Narumoto Jin , Nakamura Kaeko , Kita Hitoshi , Fukui Kenji
Published: March 2003

Abstract Category and letter verbal fluency tests are widely used for dementia detection and severity measure. Performances of these tasks have been regarded to be mainly associated with the left frontal lobe function. However, some recent studies suggest that there are different neuropsychological bases between these two tasks, and the brain region which contributes to these performances still remains unclear in Alzheimer's disease (AD). To clarify the neural basis of verbal fluency in AD, we examined the relationship between performances of these tasks and regional cerebral blood flow (rCBF). Twenty‐five AD patients were administered verbal fluency tasks and single photon emission computed tomography (SPECT) scans. Thirteen cortical regions of interest were symmetrically defined in each hemisphere. Letter fluency scores were correlated significantly only with the left prefrontal (Brodmann's area (BA) 10–46) regional cerebral blood flow (rCBF). In contrast, category fluency scores were correlated most strongly with the left temporal rCBF and also with the left prefrontal (BA 10–46) rCBF. In conclusion, the present study suggests that left prefrontal (BA 10‐46) dysfunction contributes to decline in both letter and category fluency scores in AD, while typical posterior dysfunction of AD has a closer relationship with decline in category fluency scores.
An open pilot trial of olanzapine for delirium in the Korean population
Authors: Kim Kwang‐Soo , Pae Chi‐Un , Chae Jeong‐Ho , Bahk Won‐Myong , Jun Taeyoun
Published: March 2003

Abstract This study was performed to assess the efficacy and safety of olanzapine for the treatment of delirium in a Korean population. An open trial of olanzapine was conducted in Korean patients with delirium caused by multiple medicosurgical conditions. All subjects were evaluated by Delirium Rating Scale (DRS), which is known to be one of the most sensitive scales for delirium. In addition, other data for profiles of side‐effects were collected and analyzed. Twenty patients were treated by olanzapine with doses of 5.9 ± 1.5 mg/day. The initial dose was 4.6 ± 0.9 mg/day and maximal dose of olanzapine was 8.8 ± 2.2 mg/day. The average duration of treatment was 6.6 ± 1.7 days and the day of maximal response was 3.8 ± 1.7 treated days. The scores of DRS were significantly improved from 20.0 ± 3.6 at the time of pretreatment to 9.3 ± 4.6 at the post‐treatment. All subjects showed no definite serious side‐effects including anticholinergic and extrapyramidal symptoms. Olanzapine treatment for patients with delirium was effective and safe. This newer drug may be a useful alternative agent to classical antipsychotics in the treatment of delirium.
Schizophrenic outpatient perceptions of psychiatric treatment and psychotic symptomatology: An investigation using structural equation modeling
Authors: Hayashi Naoki , Yamashina Mitsuru , Taguchi Hisako , Ishige Naoko , Igarashi Yoshito
Published: March 2003

Abstract Schizophrenic patient perceptions of treatment have clinical value and deserve detailed psychiatric investigation. The present study sought a model indicating statistically estimated cause–effect relationships of perceptions and psychotic symptomatology of outpatients with schizophrenia by applying a method of structural equation modeling. The perceptions included in this model were patient satisfaction with treatment, perceptions of their treating psychiatrists, and patient‐role perception. Scores of Positive and Negative Syndrome Scale and poor insight measures were added to the model as possible influential factors. The constructed model revealed that the poor insight exerted a major influence on the patient‐role perception that had small effects on the reliable therapist perception and the satisfaction. It was also shown that satisfaction was chiefly determined by the reliable therapist perception that was formed in the treatment relationship, rather independently of the other construct. These findings were valuable in terms of their implications for understanding the makeup of the perceptions and the strategy for interventions to improve them.
Cerebral blood flow changes in general paresis following penicillin treatment: A longitudinal single photon emission computed tomography study
Authors: Kitabayashi Yurinosuke , Ueda Hideki , Narumoto Jin , Nakamura Kaeko , Kita Hitoshi , Tsuchida Hideto , Iizumi Hideyuki , Fukui Kenji
Published: March 2003

Abstract Three cases of general paresis were successfully treated with high‐dose penicillin. In all cases, cerebrospinal fluid cell counts decreased to normal and mental status improved rapidly. Cerebrospinal fluid protein concentrations decreased and IQ scores and overall levels of functioning improved gradually over 1 year. Regional cerebral blood flow (CBF) changes were analyzed longitudinally for 1 year using single photon emission computed tomography (SPECT). Autoradiography method and region of interest (ROI) analyses were used for quantitative CBF assessment and 3D stereotactic surface projections (3D‐SSP) analyses were used for qualitative CBF pattern assessment. 3D‐SSP could not reveal remarkable CBF pattern changes through the courses. The ROI analyses showed remarkable CBF decreases in all brain regions 1 month after the treatment, which recovered to normal levels 1 year after the treatment. These results suggest that remarkable decreases of quantitative CBF counts reflect the disappearance of encephalitis, while their gradual recovery reflects the gradual improvement of cerebral functional activity. As Treponema pallidum infection affects whole brain and CBF changes globally, quantitative CBF assessment may be more efficient than qualitative CBF pattern analyses for the purpose of understanding the pathophysiology of general paresis.
Psychiatric morbidity and pregnancy outcome in a disaster area of Taiwan 921 earthquake
Authors: Chang Hseuh‐Ling , Chang Ting‐Chang , Lin Tzou‐Yien , Kuo Shian‐Shu
Published: March 2003

Abstract We investigated the prevalence of minor psychiatric morbidity in a group of women who were pregnant during or immediately after a major earthquake disaster and we investigated the prognostic factors that may have influenced the perinatal outcome of the pregnancy. The study was initiated 6 months after the earthquake and enrolled 171 women in a town near the epicentre. A Post‐Earthquake Questionnaire, Chinese Health Questionnaire (CHQ‐12) and posttraumatic stress disorder (PTSD) symptoms checklist were completed before delivery while the perinatal data were retrieved from hospital obstetrical records. The prevalence of minor psychiatric morbidity (MPM) was 29.2%. Women with starvation experience, higher negative attitude scores about the influence of earthquake on pregnancy and more casualties among relatives were significantly correlated with high CHQ. A significant positive correlation between the MPM and PTSD scores was noticed. Among the 115 pregnancies with known perinatal outcome, there were nine (7.8%) low‐birth weight neonates, defined as birth weight ≤ 2500 g. Maternal history of abdominal injury, spouse casualty and instability in living condition were significantly correlated with low birth weight. Spouse casualty was the only significant factor that predicts neonatal low birth weight.
The study of polysomnography and sleepiness the morning after administration of triazolam and brotizolam
Authors: YAMADERA HIROSHI , SUZUKI HIDEAKI , KUDO YOSHIHISA , ASAYAMA KENTARO , ITO TAKAO , ENDO SHUNKICHI
Published: March 2003

Abstract Using polysomnography, sleep effect was studied, then the sleep latency test (SLT), Stanford Sleepiness Scale (SSS), and Kwansei Gakuin Sleepiness Scale (KSS) were studied the next morning after administration of either an inactive placebo (PL), 0.125 mg triazolam (TL), 0.25 mg triazolam (TH), or 0.25 mg brotizolam (BR). Ten healthy male volunteers were used for the double‐blind crossover design. TL increased the percentage of stage 2 sleep significantly compared with PL, whereas TH decreased the number of stage shifts significantly. TH and BR increased the percentage of stage 2 sleep significantly and decreased the percentage of rapid eye movement sleep significantly. Although no drug had any effect on SSS and KSS, BR decreased the sleep latency in SLT significantly.