bluuebunny/crossref_metadata_2025 huggingface dataset:
Large freshwater lakes in arid Australia: A review of their limnology and threats to their future
Authors: Timms Brian V.
Published: March 2003

Large freshwater lakes in Australia’s arid zone are episodic due to highly variable inflows from allogenic rivers. A few receive enough inflow almost yearly to be permanent, despite large losses from high evaporation. Biodiversity is high, with most taxonomic groups represented, and is largely endemic at the continental scale. There is almost no regional endemism, which is at variance with other major aquatic habitat types in Australia. Abundance fluctuates greatly, with invertebrates and fish booming and busting with floodwater input, but birds generally reach greatest numbers later in the cycle as they gather on the more persistent waters. Invertebrate assemblages are influenced by the degree of lake permanence, turbidity and salinity, providing a temporally variable mosiac of environments throughout a lake system and between systems and with time. Unlike other groups, fish are not speciose, but are important predators in most systems with breeding coinciding with flooding. This favours native species against exotics in the Coongie Lakes but, in the Paroo, exotics are common in permanent waters. Waterbirds are the very obvious components in these variable systems, using their resources for feeding and breeding. Most are extremely nomadic to take advantage of the variable habitat. Two of the most important lake systems, the Coongie Lakes on Cooper Creek and the Paroo lakes in the northwestern Murray Darling catchment, are threatened by water abstraction upstream for irrigation, so that important habitat may be lost. In addition, the lakes will become less variable and, so, possibly compromise their character with cascading effects through the ecosystem. Some smaller lakes are adversely impacted by accelerated sedimentation.
Frontotemporal dementia with motor neuron disease (amyotrophic lateral sclerosis with dementia)
Authors: Nakano Imaharu
Published: March 2003

Frontotemporal dementia (FTD) with motor neuron disease means amyotrophic lateral sclerosis (ALS) with dementia. In the cerebrum of this condition, the medial cortex of the rostral temporal lobe is constantly and most remarkably involved. Another constant and quite characteristic lesion is neuronal loss localized to the CA1‐subiculum transitional area at the level of the pes hippocampi. The rostral portion of the parahippocampal gyrus, and the amygdaloid nucleus are also involved. Ubiquitinated intracytoplasmic inclusions are seen in the dentate granule cells and parahippocampal gyrus neurons. Some cases of ALS without dementia show the identical temporal lobe degeneration as well as the cortical ubiquitinated inclusions, thus raising the possibility of overlooked dementia or premature death of the patients. Similarly, recently proposed motor neuron disease‐inclusion dementia may be a forme fruste of ALS with dementia.
Crow–Fukase syndrome
Authors: Koike Haruki , Sobue Gen
Published: March 2003

Crow–Fukase syndrome is a unique multisystem disorder that is also known as POEMS syndrome (an acronym for polyneuropathy, organomegaly, endocrinopathy, the presence of M‐protein and skin change). This syndrome is strongly associated with plasma cell dyscrasia. Circulating light chains of M component, almost invariably IgG lambda or IgA lambda, are found in 75% of patients. Neuropathologically, segmental demyelination, particularly in the proximal segment of the peripheral nerve trunk, is the primary process. Axonal degeneration and marked endoneurial edema are also characteristic. Focal excessive myelin outfolds with globular features corresponding to periodicity and paranodal enlargement of myelin are also highly characteristic of this syndrome. Vascular endothelial growth factor (VEGF) was found to be specifically and highly elevated in the serum of patients with this syndrome, suggesting a pathogenic role. M‐protein, interleukin (IL)‐1β, IL‐6 and tumor necrosis factor (TNF)‐α are also considered to be involved in the pathogenesis. Treatment consists of radiation and surgical resection of the myeloma, chemotherapy, and a high dose of intravenous immunoglobulin (IVIg).
Immunohistochemical expression and pathogenesis of BLM in the human brain and visceral organs
Authors: Hachiya Yuriko , Motonaga Kozo , Itoh Masayuki , Masuko Takashi , Enomoto Takemi , Sonobe Hiroshi , Takashima Sachio
Published: March 2003

Bloom syndrome (BS) involves the clinical features of telangiectatic erythema, immunodeficiency, and an increased risk for cancer. In order to clarify the pathogenetic significance of the responsible gene, BLM, which encodes a protein possessing homology to Escherichia coli RecQ helicase, the immunohistochemistry of BLM was examined in human brains and visceral organs from fetuses to adults and an adult with BS, using anti‐BLM antibodies. Purkinje cells exhibited positive BLM immunoreactivity from 21 gestational weeks (GW), which transiently increased at approximately 40 GW. Neurons of the pontine tegmentum were immunolabeled from the early fetal period. In visceral organs, positive BLM immunoreactivity was observed in the Hassal corpuscles in the thymus from 24 GW, in beta‐cells in the Langerhans islets of the pancreas from 36 GW, and in sperm cells and sperms of the testes from 11 years of age. But in a patient with BS, it was negative in the pancreas and testis tissues examined. The characteristic effect of BLM on specific cells in different periods suggests that the BLM gene product is closely related to neuronal development as well as immune, insulin secretory and sperm functions, which appear in different periods, and disorders of which are major symptoms of BS.
Autopsy case of autosomal recessive hereditary spastic paraplegia with reference to the muscular pathology
Authors: Nomura Hiroshi , Koike Fumihiko , Tsuruta Yuko , Iwaki Akiko , Iwaki Toru
Published: March 2003

An autopsied case of autosomal recessive hereditary spastic paraplegia with severe neurogenic muscular atrophy is described herein. This patient, a 16‐year‐old woman, presented with gait disturbance. She developed progressive spastic paralysis of the upper and lower limbs and mental deterioration. She became bedridden at approximately 40 years of age. Dysarthria worsened at 45 years of age. She died of pneumonia at 50 years of age. Her younger sister has shown similar clinical symptoms and became bedridden at 37 years of age. Their parents were second cousins. Autopsy revealed a severely atrophic brain, weighing 720 g. The cerebral cortex was thin, and the white matter was extremely reduced in volume. Microscopically, neuronal loss and variable astrogliosis with diffuse spongy changes were evident at the cerebral cortex, thalamic nuclei, basal ganglia and hippocampus. The remaining neurons were atrophied with heavy deposition of lipofuscin. In the spinal cord, the pyramidal tracts as well as the dorsal spinocerebellar tracts were degenerated. In addition, marked loss of the anterior horn cells was seen. Severe neuronal loss of the nucleus gracilis was also detected. In contrast, only mild degeneration of the ventral spinocerebellar tracts and fasciulus cuneatus in the spinal cord were observed. In the frozen sections of skeletal muscle, severe neurogenic atrophy and fatty infiltration were evident. In addition, several rimmed vacuoles were observed in the atrophic fibers, and cytochrome coxidase‐deficient fibers were present in part. Reduced nicoti‐namide adenine dinucleotide (NADH)‐tetrazolium reductase reaction revealed abnormal accumulation of mitochondria around the center of the non‐atrophic muscle fibers. It is suggested that an analysis of mitochondrial function of Japanese autosomal recessive hereditary spastic hemiplegia may provide additional information to clarify the pathogenesis.
Predicting mortality in patients with malarial acute renal failure
Authors: Westerlund Eli K , Wilairatana Polrat , Looareesuwan Sornchai , Vannaphan Suparp , Krudsood Srivicha , Treeprasertsuk Sombat , Srisuriya Pranee , Aikawa Masamichi , Gordeuk Victor R , Brittenham Gary M , Neild Guy H
Published: March 2003

SUMMARY:

Acute Physiology and Chronic Health Evaluation (APACHE) III scores, calculated within the first 24 h of admission, were analysed in 108 patients with acute renal failure due to falciparum malaria who were admitted to Bangkok Hospital for Tropical Diseases, Thailand. Twelve (11.1%) patients died. The mean APACHE III score was 82.0 ± 25.5 (range, 45–171). There was a close relation between the APACHE III score and the hospital mortality rate. The non‐survivors had significantly higher APACHE III scores than the survivors, 109.8 ± 36.7 and 75.7 ± 21.6, respectively (P < 0.001). Patients with APACHE III score ≥ 82 had a 4.2‐fold higher risk of dying compared with patients with a lower score (95% CI 1.2–14.7; P = 0.013). Haemodialysis treatment was performed in 97 (89.8%) of the patients. The mean APACHE III score for patients who were not treated with haemodialysis (95.9 ± 38.0) was not significantly higher than those who received haemodialysis (80.4 ± 23.5; P > 0.05), but the former had a 4.4‐times higher risk of dying compared with those dialysed (95% CI 1.6–12.3; P = 0.019). Using the APACHE III score and its ability to predict death, we calculated its sensitivity, specificity and accuracy to be 0.92, 0.31 and 0.41, respectively, at a cut‐off score of 67 points. The area under the receiver operating characteristic (ROC) curve was 0.75. The APACHE III scoring system correlated well with the outcome of critically ill malaria patients with acute renal failure, although it was not possible to identify individual survivors or non‐survivors. APACHE III should not be used for individual prognosis or treatment decisions.
Anaemia of renal failure: Differences between continuous ambulatory peritoneal dialysis and haemodialysis
Authors: Fernández A , Guindeo MC , Molero T , Domínguez C , Hortal L , Pérez‐Borges P , Jímenez S , Navarro M , Perdomo M , Vega N , Palop L
Published: March 2003

SUMMARY:

A cross‐sectional study was performed to assess a series of parameters, especially those related to iron status, that may account for differences in the anaemia of patients treated with continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis (HD). Patients on CAPD (n = 37) and on haemodialysis (n = 27) were selected on the basis of clinical stability and absence of factors that may interfere with iron metabolism. Parameters measured included routine haematological and biochemical profile; serum iron metabolism (serum iron, transferrin saturation capacity, transferrin saturation index, serum ferritin); erythrocyte ferritin; bone marrow erythroid components and semiqualitative analysis of iron deposits in the bone marrow. The CAPD patients showed higher levels of haemoglobin and transferrin saturation capacity as well as lower serum ferritin than patients on haemodialysis. In the bone marrow, CAPD patients had a higher percentage of red blood cells and in those with low iron‐containing macrophages a higher percentage of sideroblasts than the haemodialysis group. Erythrocyte ferritin levels were similar in both groups. These data suggest more efficient iron metabolism in CAPD patients than in patients on haemodialysis.
Studies on the effects of gentamicin on rat metanephric development in vitro
Authors: Cullen Luise A , Young Richard J , Bertram John F
Published: March 2003

SUMMARY:

Reduced nephron endowment has been associated with increased risk of developing essential hypertension and chronic renal failure. Both in vivo and in vitro exposure of developing rat metanephroi to gentamicin has been reported to inhibit metanephric development resulting in reduced nephron endowment. The aim of the present study was to confirm that gentamicin results in reduced nephron endowment in vitro, and to extend understanding of the mechanisms responsible for this reduced endowment. Embryonic day 14 (E14) rat metanephroi were cultured for up to 4 days in serum‐free medium with or without 50 μg/mL gentamicin. Metanephroi cultured in the presence of gentamicin were 25% smaller than control metanephroi after 2 days culture and 30% smaller after 4 days (P < 0.001). This decrease in total metanephric volume was reflected in reduced volumes of ureteric duct epithelium, mesenchyme/interstitium and nephron epithelia. The reduced volume of ureteric duct epithelium in gentamicin‐treated metanephroi was associated with a 30% reduction in the number of ureteric duct branch points at 2 days. Metanephroi cultured with gentamicin contained 20% fewer glomeruli than control metanephroi (P < 0.005) at 4 days. These glomeruli were 30% smaller than control glomeruli (P < 0.05). Qualitative observations of Pax‐2 immunostained mesenchymal condensates indicated no difference in condensate size, location or morphology. These results confirm that in vitro exposure of developing rat metanephroi to gentamicin results in reduced nephron endowment. The defect in nephrogenesis centres around the inhibition of ureteric duct branching.
Mechanisms of renal disease in indigenous populations: influences at work in Canadian indigenous peoples
Authors: Dyck Roland F
Published: March 2003

Canadian aboriginal people experience end‐stage renal disease at rates 2.5–4 times higher than those found in the general population. Up to 60% of cases are due to diabetic end‐stage renal disease, while most of the remainder are caused by a variety of types of glomerulonephritis. The greatest increase in cases of end‐stage renal disease among aboriginal people since 1981 has been observed in those with diabetes. There appear to be three major contributing influences to the increase in diabetic end‐stage renal disease among Canadian aboriginal people. First, the rates of type 2 diabetes mellitus have increased from virtually zero to several times those seen in the general population in less than 60 years. Second, aboriginal people with diabetes have seven times the rate of diabetic end‐stage renal disease compared with their non‐aboriginal counterparts. Finally, birth rates among aboriginal people are higher than in any other segment of the population. An epidemic of diabetic end‐stage renal disease is the most important nephrological issue facing Canadian aboriginal people and threatens to overwhelm health care resources in many parts of the country unless effective early recognition and prevention programmes are established.
Importance of renal biopsy*
Authors: Nelson CL , Mackinnon MWB , Charlesworth JA
Published: March 2003

Renal biopsy remains an essential requirement for the accurate diagnosis and treatment of several forms of renal disease. Recent advances in technique have improved the safety of the procedure. However, its use in certain categories of patients remains controversial. These include patients with diabetes or chronic renal failure and patients over the age of 60 years. This brief review addresses some of the advances in the biopsy procedure and its application to diseases of the native kidney.
From angels to handmaidens: changing constructions of nursing's public image in post‐war Britain
Authors: Parker Judith , Hallam Julia
Published: March 2003

The public image of nursing is an important barometer of how the profession is valued in society. Recent research into images of nurses tends to use content analysis to substantiate claims that the mass media misrepresent the profession, perpetuating outmoded conceptions of nursing work. Such a strategy treats the nature of nursing itself as unproblematic, an object to be more or less accurately ‘represented’. But these are assumptions that need to be questioned. The systems of belief and value that produce representations of nursing both reveal and constitute the institutional practices that regulate nursing as a profession, which in turn shape the material form and substance of representational constructs. Drawing on fictional and factual popular and official representations of nursing and nursing work on film, television and in recruitment literature, it is argued that although nursing was consistently constructed as ‘women's work’ for much of the 20th century, a noticeable shift is perceivable in the status of nursing's public image between the late 1930s and early 1970s.
Exploring Ricoeur’s hermeneutic theory of interpretation as a method of analysing research texts
Authors: Geanellos Rene
Published: March 2003

Exploring Ricoeur’s hermeneutic theory of interpretation as a method of analysing research texts

Increasingly, researchers use hermeneutic philosophy to inform the conduct of interpretive research. Congruence between the philosophical foundations of a study, and the methodological processes through which study findings are actualised, obliges hermeneutic researchers to use (or develop) hermeneutic approaches to research interviewing and textual analysis. Paul Ricoeur’s theory of interpretation provides one approach through which researchers using hermeneutics can achieve congruence between philosophy, methodology and method.

Ricoeur’s theory of interpretation acknowledges the interrelationship between epistemology (interpretation) and ontology (interpreter). Also, Ricoeur notes the way interpretation moves forward from naive understanding, where the interpreter has a superficial grasp of the whole of the text, to deeper understanding, where the interpreter understands the parts of the text in relation to the whole and the whole of the text in relation to its parts (the hermeneutic circle). In this way, Ricoeur’s theory of interpretation provides researchers with a method of developing intersubjective knowledge.

Through exposition of the concepts of Ricoeur’s theory, which include distanciation, appropriation, explanation and understanding, guess, and validation, a hermeneutic approach to textual analysis is presented, discussed and critiqued. Examples from nursing research are also used to demonstrate points under discussion. It is suggested that, in conjunction with Gadamer’s hermeneutic of understanding, Ricoeur’s theory of interpretation warrants consideration as a method of textual analysis.
Reflexivity and detachment: a discursive approach to women's depression
Authors: Crowe Marie
Published: March 2003

Reflexivity and detachment: a discursive approach to women's depression

This paper explores a discursive approach to understanding women's depression by presenting the results of research into women's narratives of their experiences. The discursive approach taken acknowledges women's immersion in cultural practices that determine the subject positions available to them and places a value on attributes of reflexivity and detachment that are not usually associated with their performance. The social and cultural context of the individual's experience is significant because if the focus is simply on the individual this supposes that the problem lies solely with the individual. An understanding of cultural expectations and their relation to mental distress is important to mental health nursing practice. The psychotherapeutic relationship that is fundamental to mental health nursing practice requires an understanding of the meaning of individual's responses in their cultural context in order to provide facilitative and meaningful care for the women that they nurse.
Vulnerability and protective factors for posttraumatic stress disorder
Authors: WEISÆTH LARS
Published: March 2003

A review is given of pre‐, peri‐ and post‐traumatic factors that increase or decrease the risk of developing posttraumatic stress disorder (PTSD). With the exception of extremely severe stressors, vulnerability and protective factors explain much of the probability of developing PTSD. The etiology of PTSD is multifactorial, and variables related to the individual, their life situation at the time of exposure, the stressor, and the recovery environment tend to interact.
Recent advances in dementia research in Japan: Alzheimer‐type dementia
Authors: Kosaka Kenji , Iseki Eizo , Arai Heii
Published: March 2003

In a previous article, recent reports by Japanese researchers on non‐Alzheimer‐type degenerative dementias were reviewed. In the present article, recent Japanese reports on Alzheimer‐type dementia (ATD) are reviewed. Alzheimer‐type dementia has received great attention and has been studied from various viewpoints in Japan as well as in Europe and the Americas. In Japan, although it was believed that vascular dementia was the most frequent dementia in the elderly, ATD has recently been shown to be the most predominant type of dementia. Such a great number of papers on ATD have been reported in Japan that mainly the clinical, neuropathological, biochemical and molecular biological research papers alone are reviewed here.
An autopsy case of myotonic dystrophy with mental disorders and various neuropathologic features
Authors: Mizukami Katsuyoshi , Sasaki Megumi , Baba Atsuomi , Suzuki Toshihito , Shiraishi Hiroyasu
Published: March 2003

An autopsy case of myotonic dystrophy (MD) is reported. The patient was a 58‐year‐old male. He presented with muscular weakness and muscular atrophy at the age of 33 and was diagnosed as having MD from myotonic symptoms (i.e. percussion and grip myotonia) at 49 years old. Mental disorders including a delusional hallucinatory state, mental slowness, indifference, and lack of spontaneity as well as visual cognitive impairments were noted at the age of 55. He showed Parkinsonism and died of septic shock. T2‐weighted magnetic resonance imaging demonstrated diffuse cortical atrophy with a marked frontal atrophy and high‐intensity signals in the white matter. Single photon emission computed tomography demonstrated hypoperfusion in the frontal cortex. Neuropathologic observation revealed neuronal loss in the superficial layer of the frontal and parietal cortices and extensive neuronal loss in the occipital cortex, intracytoplasmic inclusion body in the nerve cell of the medial thalamic nuclei, neuronal loss and presence of Lewy bodies in the substantia nigra and locus ceruleus corresponding to the pathologic features of Parkinson’s disease, as well as abnormalities of myelin in the white matter. The present case suggests that in MD brain, various neuropathologic changes may occur and they contribute to the mental disorders.
Correlation between the circadian sleep propensity rhythm and hormonal rhythms under ultra‐short sleep–wake cycle
Authors: Kudo Yoshihisa , Uchiyama Makoto , Okawa Masako , Shibui Kayo , Kamei Yuichi , Hayakawa Tatsuro , Kim Keiko , Ishibashi Kenichi
Published: March 2003

The aim of this study was to clarify effects of hormonal and temperature rhythms on circadian fluctuations of sleep propensity. Ten healthy females underwent 24‐h sleep deprivation and entered the circadian sleep propensity assessment setting under the ultra‐short sleep–wake schedule. During the experiment, sleep propensity rhythm, rectal temperature, and 24‐h serum hormone profiles (melatonin, cortisol and thyroid‐stimulating hormone) were investigated. The circadian sleep propensity rhythms had two apparent peaks (afternoon and nocturnal peaks) and a trough (nocturnal sleep gate). The timings of the nocturnal sleep gate and the nocturnal peak were correlated exclusively with temperature and melatonin rhythms (P < 0.05), while that of the afternoon peak was significantly correlated with habitual wake time and melatonin rhythm. These results indicate that the circadian sleep propensity rhythm is influenced not only by the circadian pacemaker, but also by sleep habit.
Effects of a daytime nap in the aged
Authors: Tamaki Munehisa , Shirota Ai , Tanaka Hideki , Hayashi Mitsuo , Hori Tadao
Published: March 2003

This study evaluated the effects of the daytime nap on performance, mood and physiological measures in aged individuals. Participants were six healthy aged persons (M = 72.2 years old) who habitually napped in the afternoon three or more times a week. They participated under two conditions with an interval of 1 week. In the nap condition, the subjects went to bed at 13:00 h and slept for 30 min. In the rest condition, they just watched television. In both conditions, electroencephalogram (EEG), blood pressure, mood and performance were measured before and after a nap or rest. The daytime nap improved performance, decreased subjective sleepiness and fatigue, and attenuated EEG alpha band activity. Moreover, following a nap diastolic blood pressure significantly decreased. These findings suggest that a habitual daytime nap helps aged individuals to maintain their daytime physiological, psychological and behavioral arousal at an adequate level.
Weight and shape concerns and dieting behaviours among pre‐adolescents and adolescents in Japan
Authors: Kaneko Koji , Kiriike Nobuo , Ikenaga Keiji , Miyawaki Dai , Yamagami Sakae
Published: March 2003

The attitudes towards body weight and shape, desire for thinness and dieting behaviours were investigated in pre‐adolescent and adolescent girls and boys (547 elementary school students, 615 junior high school students, and 470 senior high school students) aged 10–17 years in Osaka Prefecture, Japan, by a self‐report questionnaire.

Forty‐eight per cent of 10‐year‐old females and 84% of 17‐year‐old females categorized themselves as ‘fat’ or ‘too fat’. The fear of weight gain and desire for thinness was reported in 35% and 51% of 10‐year‐old girls, respectively, and increased progressively with ageing to 79% and 87% of 17‐year‐old girls. In contrast, these were reported by 20–30% of boys in the corresponding age groups. Some practices to be slim were found in 22% of the 10‐year‐old girls, and increased to 37% among the 17‐year‐old girls, whereas they were found in around 20% of the boys at each age. The practices to be slim were found in 32% of the girls who were 85–90% of the standard body weight (SBW) and in 14% of the girls less than 85% of the SBW. These results suggest that significant concerns about weight and shape and dieting behaviours are present in young Japanese girls and increase progressively with age. These results are compatible with those in Western society.
Lithium and clonazepam treatment of two cases with cluster headache
Authors: Takebayashi Minoru , Fujikawa Tokumi , Kagaya Ariyuki , Horiguchi Jun , Yamawaki Shigeto
Published: March 2003

Patients with cluster headache are often treated with lithium. However, there are some patients who can not be fully treated with lithium alone. Two patients with cluster headache were treated with clonazepam, one of the most potent benzodiazepines. Lithium prolonged the period of remission, and the addition of clonazepam further prolonged it in case 1. Treatment with clonazepam reduced the symptoms in case 2, and when combined with lithium, the disorder went into remission after 6 months. These findings suggest that the combination of lithium and clonazepam may be effective in patients with cluster headache.
Reliability of the 5‐min speech sample for assessing expressed emotion in Japanese patients
Authors: Uehara Toru , Yokoyama Tomoyuki , Goto Masahiro , Nakano Yasuko , Kawashima Yoshiaki , Someya Toshiyuki
Published: March 2003

Expressed emotion (EE) has been shown in various countries to be a good predictor of the clinical course of a patient’s mental illness. Because the traditional EE interview requires considerable time and effort, this study examined the reliability of a method called the five‐minute speech sample (FMSS) for assessing EE. The samples of 65 subjects were rated by the FMSS–EE coding system, and the interrater reliability among four authorized raters was investigated. Of these 65 samples, 10 (15%) were rated as high‐EE (high critical, 6%; high emotional over‐involvement (EOI), 9%), and 19 (29%) were rated as borderline (b‐)‐high‐EE (b‐critical, 15%; b‐EOI, 14%). The intraclass correlation coefficient (ICC) was 0.91 for the overall category, 0.74 for criticism, 0.85 for EOI, 0.63 for b‐critical and 0.54 for b‐EOI. The FMSS was shown to be reliable for the assessment of EE, even outside of Western countries. However, the lower agreement in the subcategories of EOI and b‐critical has to be considered as a limitation of this brief method.
Apolipoprotein E phenotypes in healthy normal controls and demented subjects with Alzheimer’s disease and vascular dementia in Mie Prefecture of Japan
Authors: Nakayama Shigeho , Kuzuhara Shigeki
Published: March 2003

In order to clarify the association between apolipoprotein E4 (ApoE4) and the pathogenesis of Alzheimer’s disease (AD), we analyzed the distribution of the apolipoprotein E (ApoE) phenotypes and the frequency of the apo E alleles ɛ2, ɛ3, and ɛ4 in Japanese healthy controls (n = 1090, an average age of 51.2 ± 12.6 years) and demented patients (n = 103, mean age of 73.6 ± 9.2 years). Demented subjects were divided into three subgroups: early‐onset AD group (EOAD; n = 25, mean age 63.0 ± 6.2 years), late‐onset AD group (LOAD; n = 33, mean age 79.3 ± 5.1 years), and vascular dementia group (VD; n = 45, mean age 75.3 ± 8.0 years). The apolipoprotein E phenotype was determined by isoelectric focusing and immunoblotting. There were no significant differences in the distribution of the apo E phenotypes by gender or age, and the estimated frequencies of ɛ2, ɛ3 and ɛ4 were 0.05, 0.86 and 0.09, respectively, in the normal controls. There was a significant difference in the distribution of the apo E phenotypes between LOAD and elderly controls aged more than 65 years (P < 0.0001). The distribution of the apo E phenotypes in EOAD was the same as that in LOAD. The frequency of the ɛ4 allele was significantly higher in LOAD (0.35, P < 0.0001) and EOAD (0.28, P < 0.0001) than that in the control subjects (0.07), but not in VD (0.12, P = 0.1630). The present findings suggest that ApoE4 is related with both EOAD and LOAD, but not with VD, and support the hypothesis that it is a genetic risk factor of AD.
Psychological effect of the Nagasaki atomic bombing on survivors after half a century
Authors: Ohta Yasuyuki , Mine Mariko , Wakasugi Masako , Yoshimine Etsuko , Himuro Yachiyo , Yoneda Megumi , Yamaguchi Sayuri , Mikita Akemi , Morikawa Tomoko
Published: March 2003

In 1997 a mental health survey using a 30‐item General Health Questionnaire (GHQ‐30) and an interview survey of an atomic bombing experience were conducted in survivors of the Nagasaki atomic bombing. Overall psychological distress measured on the basis of the GHQ‐30 was greater in the atomic bombing survivors than in the controls. As for the contents of psychological distress, those concerning emotion such as anxiety and depression were milder in survivors than in the controls, but those related to social activities such as apathy, disturbance of human relations, loss of enjoyment of living were more severe. Furthermore, recurring and distressing recollection of the experience of the atomic bombing, suspicion over the relationship between the atomic bombing and an unhealthy physical condition, and the experience of witnessing death or severe injury of close relatives due to the atomic bombing were significantly related to the degree of psychological distress of the survivors.
Sleep apnea syndrome in patients with pulmonary thromboembolism
Authors: Hasegawa Rika , Shiomi Toshiaki , Sasanabe Ryujiro , Otake Kazuo , Banno Katsuhisa , Oki Yoshitaka , Maekawa Masato , Kobayashi Tadashi , Ito Asao , Taniguchi Aki , Ozeki Kaori
Published: March 2003

Seven patients (one man and six women) with a diagnosis of pulmonary thromboembolism (PTE) were examined by polysomnography in order to clarify the relationship between sleep‐related breathing disorders and PTE. In the chronic stage of PTE, sleep apnea syndrome (SAS) was recognized in two patients (a man and a woman) among the subjects. Four of the five patients without SAS showed nocturnal hypoxemia. The female predominance was different from ordinary SAS without the disease background of PTE even though PTE is accompanied by hypoxemia and pulmonary hypertension like SAS. A pathophysiological relationship between PTE and SAS was not found in this study.
A study of the relationship between the seizure focus and 1H‐MRS in temporal lobe epilepsy and frontal lobe epilepsy
Authors: Kikuchi Senichiro , Kubota Fumio , Akata Takushiro , Shibata Nobuyoshi , Hattori Suguru , Oya Nariyuki , Takahashi Akio
Published: March 2003

Abstract Several studies of temporal lobe epilepsy (TLE) patients have investigated the relationship between the seizure focus and 1H magnetic resonance spectroscopy (1H‐MRS). There have also been a few reports in other types of partial epilepsy. We examined the relationship between the seizure focus and the reduction in N‐acetylaspartate : creatine (NAA : Cr) ratio using 1H‐MRS in both TLE and frontal lobe epilepsy (FLE) patients. We studied 21 patients with unilateral TLE and seven patients with unilateral FLE. We used a 1.5 Tesla magnetic resonance unit (Signa Horizon; General Electric). Approximately 15 × 15 × 20 mm3 voxel of interest (VOI) was placed over the anterior portion of the bilateral hippocampus in the TLE patients, and the anterodorsal position of bilateral frontal lobe in the FLE patients. The seizure focus was identified by interictal scalp electro‐encephalogram (EEG). In the TLE patients the NAA : Cr ratios were reduced in the seizure focus, while in the FLE patients they were not always reduced in the seizure focus. In the TLE patients the coincidence rate between the seizure focus and the reduction in the NAA : Cr ratio was 90% (19 of 21 patients), while in the FLE patients the coincidence rate was only 57% (four of seven patients).
Presence of human herpesvirus 6 and herpes simplex virus detected by polymerase chain reaction in surgical tissue from temporal lobe epileptic patients
Authors: Uesugi Hideji , Shimizu Hiroyuki , Maehara Taketoshi , Arai Nobutaka , Nakayama Hiroshi
Published: March 2003

Abstract We investigated the presence of human herpesvirus 6 (HHV‐6) and herpes simplex virus (HSV) in surgical tissue from temporal lobe epileptic patients. A total of 17 cases were studied, including eight males and nine females. The mean age was 24.9 ± 11.1 years and the mean age of onset was 11.1 ± 5.4 years. Five patients were diagnosed as encephalitis/meningitis and another three had a history of suspected encephalitis/meningitis, but no patient showed any obvious neurological symptom or mental handicap. Mesial and lateral temporal tissues were examined by polymerase chain reaction. Among six patients positive for HHV‐6 (35%), the mesial temporal lobe was positive in four and the lateral temporal lobe was positive in three. Herpes simplex virus was positive in only one patient. Three of the six patients positive for HHV‐6 did not show any apparent causes. Mild encephalitis/meningitis induced by HHV‐6, a condition sometimes not recognized as encephalitis/meningitis, may be one of the most frequent causes of temporal lobe epilepsy.
Extraosseous epidural IgD myeloma presenting with compression myelopathy
Authors: Watanabe Yasuhiro , Endou Akira , Ooi Shinji , Matsushima Eiji , Shimisu Yasutaka , Nakashima Kenji
Published: March 2003

Abstract An 85‐year‐old man presented with acute transverse myelopathy: flaccid paraplegia, superficial and deep sensory disturbance below Th6 and loss of urinary sensation. Spinal magnetic resonance image showed an epidural mass compressing the spinal cord at the level of C7 to Th2. Immunoelectrophoresis revealed the presence of immunoglobulin D (IgD)‐λ M protein. Chemotherapy markedly improved both the haematologic aspect and tumor size, but not the motor deficit. In IgD myeloma, extraosseous spreads occur frequently, but extraosseous epidural tumors causing compression myelopathy are relatively rare. To our knowledge, this is the fourth report of cases.
The effects of recreational underwater exercise in early evening on sleep for physically untrained male subjects
Authors: Oda Shiro
Published: March 2003

The present study investigated the effects of recreational underwater exercise (UWE; 28.9–31.5°C, 16:00–16:50, 36.2 ± 5.2 %HRres) on thermal response and nocturnal sleep. Rectal temperature (Trec) and sleep parameters of eight physically untrained male subjects were measured in both non‐exercise (NE) and UWE days. Underwater exercise consisted of aerobic exercises with various kinds of movements. During UWE, Trec raised slightly in most subjects, but declined in one subject. We could not observe a rapid decline in Trec before sleep on a UWE day. The polysomnographic and subjective sleep parameters showed no significant differences between NE and UWE nights. The quality of sleep did not improve on the night when UWE was performed, and thermal changes might be related to the results.
Age and gender difference in habitual sleep–wake rhythm
Authors: Park Young Man , Matsumoto Kazuya , Shinkoda Harumi , Nagashima Hidetoshi , Kang Min Jeung , Seo Yoo Jin
Published: March 2003

We analysed the effects of age and gender on the habitual sleep–wake rhythm in 2252 randomly selected subjects living in Shimonoseki, Japan. Subjects were divided into 21 age groups with a matching number of males and females for each. During the period from primary school to adolescence, the bedtime became delayed and sleep length decreased with age. After that period, with increasing age, bedtime became earlier and sleep length increased. The number of awakenings and the length of daytime naps increased markedly with epoch after 50 years and 70 years of age, respectively. Gender differences were considered to be due to the women’s social and domestic customs in Japan.
A longitudinal study of diurnal variation in baseline fetal heart rate in one dichorionic‐diamniotic twin pregnancy
Authors: Muro Masami , Shono Hideaki , Shono Mayumi , Ito Yuji , Iwasaka Tsuyoshi
Published: March 2003

A longitudinal study to analyse the diurnal variations in baseline fetal heart rate (FHR) and sustained fetal tachycardia (SFT) in twin pregnancy was performed on one dichorionic twin. Twenty‐four hour FHR recordings on twins were made at 32, 34 and 36 weeks of gestation simultaneously. Significant diurnal variations were found in both twins in all gestational weeks. The diurnal variations in baseline FHR of twins were highly correlated with no phase‐lag. No coincidence was recognized in the appearance of SFT between twins. These results suggest the maternal influence equally affects FHR in each fetus of dichorionic twin since 32 weeks of gestation, while the appearance of SFT might be independent from maternal influence.
Caregiver depression predicts early discontinuation of care for disabled elderly at home
Authors: Arai Yumiko , Sugiura Midori , Washio Masakazu , Miura Hiroko , Kudo Kei
Published: March 2003

Abstract This longitudinal study investigates the caregiving experiences among Japanese caregivers who provided informal care at home for disabled elderly between 1998 and 1999. Forty‐seven caregivers of the impaired elderly continued caregiving at home in Matsuyama Town, a rural area of northern Japan, while 18 caregivers discontinued it. The mean score of the Center for Epidemiologic Studies Depression Scale in 1998 among those who gave up caregiving was significantly higher than that of those who continued caregiving, indicating that depression predicts early discontinuation of care in the home. This is one of the few studies in Japan to suggest that initial caregiver depression is a factor in the decision to terminate care for the disabled elderly at home.
Eye movements during the Rorschach test in schizophrenia
Authors: HORI YASUKO , FUKUZAKO HIROSHI , SUGIMOTO YOKO , TAKIGAWA MORIKUNI
Published: March 2003

Abstract In order to understand relationships between scanning behaviors, characteristics of visual stimuli and the clinical symptoms in schizophrenia, eye movements of 37 schizophrenic patients and 36 controls were recorded using an eye‐mark recorder during a free‐response period in a Rorschach test. Four cards (I, II, V and VIII) were used. Data were analyzed during 15 s from the presentation of each card. For all cards, the number of eye fixations and the number of eye fixation areas were fewer, and total scanning length and mean scanning length were shorter for schizophrenic patients than for controls. For card II, in the non‐popular response group, eye fixation frequency upon area 5 + 6 (red) was higher for schizophrenic patients. For card VIII, in the popular response group, eye fixation frequency upon area 5 + 6 (pink) was lower for schizophrenic patients. For cards II and VIII, the number of eye fixations was inversely correlated with negative symptoms. For card II, total scanning length tended to be inversely correlated with negative symptoms, and mean eye fixation time was correlated with negative symptoms. The number of eye fixation areas was inversely correlated with positive symptoms. For card VIII, eye fixation frequency in a stimulative area tended to be correlated with positive symptoms. Scanning behaviors in schizophrenic patients are affected by characteristics of visual stimuli, and partially by clinical symptoms.
Minnesota Multiphasic Personality Inventory profile characteristics of schizotypal personality disorder
Authors: MATSUI MIÉ , SUMIYOSHI TOMIKI , NIU LISHA , KUROKAWA KENZO , KURACHI MASAYOSHI
Published: March 2003

Abstract The goal of the present study was to determine whether precursors for psychopathology can be found in personality dimensions of the general population. Two hundred and 62 university students were compared with 41 schizophrenic patients and 18 patients with schizotypal personality disorder (SPD) on the Minnesota Multiphasic Personality Inventory (MMPI). Schizotypal personality disorder patients showed significantly elevated Pt and Si scales compared with the schizophrenic patients. Schizophrenia and SPD groups generally produced two‐point codetypes of 6–8/8–6, 2–6/6–2, 7–8/8–7, and 7–8/8–7, 2–7/7–2, 6–8/8–6. A total of 77.5% of students had no codetype with a T‐value of ≥ 70, although the frequency of codetypes of spike 5, spike 0 and 2–7/7–2 was relatively high in the student group compared with the general population. Discriminant function analysis of the MMPI profiles revealed significant variance among the three groups. The overall rate of correct classification of the subjects into schizophrenia, SPD or university students was 90.3%. The first coefficient, mainly defined by a negative weight on the Sc scale, best distinguished the patients with either schizophrenia or SPD from the students. The second coefficient, defined by negative weights on the Sc and Si scales, and positive weights on the F and Ma scales identified patients with schizophrenia and SPD patients. The Harris‐Lingoes subscales, which are supposed to provide the profile patterns characteristic of schizotypy, well discriminated the three groups. These results suggest the usefulness of the MMPI subscales for the detection of subjects with the SPD trait.
Diagnostic consideration of Morita shinkeishitsu and DSM‐III‐R
Authors: KITANISHI KENJI , NAKAMURA KEI , MIYAKE YUKO , HASHIMOTO KAZUYUKI , KUBOTA MIKIKO
Published: March 2003

The purpose of the present study was to empirically and objectively clarify the diagnostic standing of Morita shinkeishitsu, the subject of Morita therapy, by comparing and contrasting it with the operational diagnosis of the Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised; DSM‐III‐R). Morita therapists’ clinical diagnoses of 88 outpatients who requested Morita therapy were compared with the results of the independently conducted operational diagnoses (structured clinical interview for DSM (SCID) for DSM‐III‐R, the Japanese version). In view of the result of axis I diagnoses, Morita shinkeishitsu corresponds to anxiety disorders, although it is a complex that also embodies mood disorders, which were found in one‐quarter of the cases, as well as personality disorders, which were found in half of the cases, especially cluster C (avoidant, obsessive–compulsive, and dependent personality disorders). Morita shinkeishitsu is almost equivalent to anxiety disorders (DSM‐III‐R, axis I), and is a complex, a part of which includes mood disorders and cluster C personality disorders.
Cenesthopathy in adolescence
Authors: Watanabe Hisashi , Takahashi Toshihiko , Tonoike Takashi , Suwa Mami , Akahori Kaoruko
Published: March 2003

Abstract Psychopathological investigation was conducted on the basis of the clinical observation of 23 subjects whose cenesthopathic symptoms began before 30 years of age. This illness is called ‘adolescent cenesthopathy’ based on the specificity of this mental condition to the adolescent period. Adolescent cenesthopathy is compared to schizophrenia, depersonalization, sensitive delusion of reference and other symptoms. Outstanding features of adolescent cenesthopathy are shown from the perspective of its difference from schizophrenia in terms of the specific characteristics of the symptoms in this disease.
Correlation between electroencephalography and heart rate variability during sleep
Authors: Ako Mina , Kawara Tokuhiro , Uchida Sunao , Miyazaki Shinichi , Nishihara Kyoko , Mukai Junko , Hirao Kenzo , Ako Junya , Okubo Yoshiro
Published: March 2003

Abstract It is known that autonomic nervous activities change in correspondence with sleep stages. However, the characteristics of continuous fluctuations in nocturnal autonomic nerve tone have not been clarified in detail. The study aimed to determine the possible correlation between the electroencephalogram (EEG) and autonomic nervous activities, and to clarify in detail the nocturnal fluctuations in autonomic nerve activities. Overnight EEGs and electrocardiograms of seven healthy males were obtained. These EEGs were analyzed by fast Fourier transformation algorithm to extract delta, sigma and beta power. Heart rate and heart rate variability (HRV) were calculated in consecutive 5‐min epochs. The HRV indices of low frequency (LF), high frequency (HF) and LF/HF ratio were calculated from the spectral analysis of R‐R intervals. The sleep stages were manually scored according to Rechtschaffen and Kales’ criteria. Low frequency and LF/HF were significantly lower during non‐rapid eye movement (NREM) than REM, and were lower in stages 3 and 4 than in stages 1 and 2. Furthermore, delta EEG showed inverse correlations with LF (r = − 0.44, P < 0.001) and LF/HF (r = − 0.41, P < 0.001). In contrast, HF differed neither between REM and NREM nor among NREM sleep stages. Detailed analysis revealed that correlation was evident from the first to third NREM, but not in the fourth and fifth NREM. Delta EEG power showed negative correlations with LF and LF/HF, suggesting that sympathetic nervous activities continuously fluctuate in accordance with sleep deepening and lightening.
Mucin histochemical analysis of minute gastric differentiated adenocarcinoma
Authors: Egashira Yutaro , Shimoda Tadakazu , Ikegami Masahiro
Published: March 2003

Fifty‐six surgically resected intramucosal differentiated adenocarcinomas (DA) of the stomach with a maximum diameter of less than 5 mm were analyzed by mucin histochemistry. Gastric type phenotypic expression was observed in 41.1% of cases, intestinal type in 28.6% and gastric–intestinal type in 28.6% of all cancers. Gastric type phenotypic expression was the most frequent. As the tumor diameter increased, the incidence of DA with gastric phenotype tended to decrease. Intestinal metaplasia of the cancer’s surrounding mucosa was absent or slight in DA with gastric phenotype, but moderate to severe in DA with gastric–intestinal phenotype and intestinal phenotype. Morphologically and mucin histochemically, intestinal metaplasia surrounding DA with gastric phenotype was immature and incomplete compared with DA with gastric– intestinal phenotype or intestinal phenotype. It is suggested that a large amount of DA with gastric phenotype is histogenetically derived from the gastric gland proper without intestinal metaplasia. However, as the tumor grows and intestinal metaplasia progresses, intestinal type phenotypic expression appears and then DA with gastric phenotype changes into DA with gastric–intestinal phenotype or intestinal phenotype.