bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient perceived quality‐of‐care in hospital in the context of clinical pathways: Development of an approach
Authors: Chou S‐C , Boldy D
Published: March 2003

Abstract Clinical pathways have been introduced in many hospitals with the aims of improving efficiency, reducing costs, and improving the quality and outcomes of care. However, there is a shortage of research evidence regarding the extent to which they do in fact achieve such aims. This paper describes the development and testing of a patient‐perceived quality‐of‐care questionnaire for use in relation to the assessment of clinical pathways. Issues of validity and reliability are addressed and illustrative examples of results for two pilot hospitals are presented.
A review of clinical risk management
Authors: Misson Julie Carol
Published: March 2003

Abstract Current literature has a plethora of information regarding medical errors, what causes them, how to reduce them and the impact they have on patients, staff and health‐care organisations. The objective of this paper was to give a summary of the current findings of recent studies and articles, including worldwide initiatives to reduce medical errors, the trend to identify system issues that result in medical error rather than the focus on individual blame, the impact of technological changes and current medical advances, litigation and law suits.
The application of statistical process control charts to the detection and monitoring of hospital‐acquired infections
Authors: Morton Anthony P , Whitby Michael , McLaws Mary‐Louise , Dobson Annette , McElwain Sean , Looke David , Stackelroth Jenny , Sartor Anna
Published: March 2003

Abstract The monitoring of infection control indicators including hospital‐acquired infections is an established part of quality maintenance programmes in many health‐care facilities. However, surveillance data use can be frustrated by the infrequent nature of many infections. Traditional methods of analysis often provide delayed identification of increasing infection occurrence, placing patients at preventable risk. The application of Shewhart, Cumulative Sum (CUSUM) and Exponentially Weighted Moving Average (EWMA) statistical process control charts to the monitoring of indicator infections allows continuous real‐time assessment. The Shewhart chart will detect large changes, while CUSUM and EWMA methods are more suited to recognition of small to moderate sustained change. When used together, Shewhart and EWMA methods are ideal for monitoring bacteraemia and multiresistant organism rates. Shewhart and CUSUM charts are suitable for surgical infection surveillance.
Bacteriological eutrophication indicators in four Colombian water bodies (South America)
Authors: Canosa Amparo , Pinilla Gabriel
Published: March 2003

For the first time in Colombia the relative abundance of Pseudomonas spp., Vibrio spp., Plesiomonas shigelloides, the Aeromonas hydrophila group, and the faecal and total coliforms were studied in three dams and a natural lagoon with a different trophic state. Coliforms were low in all the water bodies, but their number was greater in the dams with a greater anthropic activity. Vibrio spp. was not detected. The density of P. shigelloides was irregular. Pseudomonas spp. was always present and showed relatively high abundance. The bacteria of the A. hydrophila group were constant and their numbers increased with the trophic state, for which they could be indicators of the eutrophication phenomena. Significant correlation (P < 0.05) was established between total and faecal coliforms and pH, transparency, nitrites, nitrates, and orthophosphates. P. shigelloides was correlated with faecal coliforms and Aeromonas hydrophila with total coliforms and transparency.
Summer classification of Southern Hemisphere temperate lakes (Patagonia, Argentina)
Authors: Diaz Mónica , Pedrozo Fernando , Baccala Nora
Published: March 2003

The purpose of this paper was to synthesize observations of 21 cold temperate lakes from Patagonia, Argentina. To do this, objective limnological variables and the phytoplankton summer structure were analysed using multivariate statistical tools. The results suggest that the most important variables defined a trophic gradient based on nutrients, conductivity and phytoplanktonic attributes. Cluster analysis pointed to three groups of lakes. Steppe lakes (group III) were distinguished from mountain‐Andean lakes (groups I and II) through their higher conductivity and ammonia concentration values, higher net phytoplankton density and lower species diversity. The two groups of Andean lakes differed with regard to the biomass of Bacillariophyceae and Prymnesiophyceae, water temperature and dissolved inorganic nitrogen concentration. The influence of the biomass (as biovolume) of each taxonomic group in lakes of different trophic status was examined. Although all Andean lakes appear to be similar, as shown by their similar salt and nutrient concentration values, the phytoplankton biomass split into different taxa and clearly distinguished subgroups. The work presents original information about the phytoplanktonic community structure from all the lakes and the first limnological data on 10 of them, from a region that is poorly known.
Dioxin‐like and non‐dioxin like effects of polychlorinated biphenyls: Implications for risk assessment
Authors: Giesy John P. , Kurunthachalam Kannan
Published: March 2003

Polychlorinated biphenyls (PCBs) are persistent, bioaccumulative and toxic contaminants in the environment. Individual PCB congeners exhibit different physicochemical properties and biological activities that result in different environmental distributions and toxicity profiles. The variable composition of PCB residues in environmental matrices and their different mechanisms of toxicity complicate the development of scientifically based regulations for risk assessment. Various approaches for the assessment of risks of PCBs have been critically examined. Recent developments in the toxic equivalency factor (TEF) approach for the assessment of toxic effects due to dioxin‐like PCBs have been examined. The PCB exposure studies that describe non‐dioxin‐like toxic effects, particularly neurobehavioural effects and their effective doses in animals, were compiled. A comparative assessment of effective doses for dioxin‐like and non‐dioxin‐like effects by PCBs has been made to evaluate the relative significance of non‐ortho and ortho‐substituted PCBs in risk assessment. Using mink as an example, relative merits and implications of using TEF and total PCB approaches for assessing the potential for toxic effects in wildlife were examined. There are several advantages and limitations associated with each method used for PCB risk assessment. Toxic effects due to coplanar PCBs occur at relatively smaller concentrations than those due to non‐dioxin‐like PCBs and, therefore, the TEF approach derives the risk assessment of PCBs in the environment. The need for the refinement of the TEF approach for more accurate assessment of risks is discussed.
Autosomal recessive juvenile parkinsonism: A key to understanding nigral degeneration in sporadic Parkinson's disease
Authors: Hattori Nobutaka , Shimura Hideki , Kubo Shin‐ichiro , Kitada Tohru , Wang Mei , Asakawa Shuichi , Minashima Shinsei , Shimizu Nobuyoshi , Suzuki Toshiaki , Tanaka Keiji , Mizuno Yoshikuni
Published: March 2003

The contribution of genetic factors to the pathogenesis of Parkinson's disease (PD) is supported by the demonstration of the high concordance in twins studies using positron emission tomography (PET), the increased risk among relatives of PD patients in case–control and family studies, and the existence of familial PD and parkinsonism by single gene defect. Recently several genes have been mapped and/or identified. α‐Synuclein is involved in a rare dominant form of familial PD with dopa‐responsive parkinsonism features and Lewy body‐positive pathology. In contrast, parkin is responsible for the autosomal recessive form (AR‐JP) of early onset PD with Lewy body‐negative pathology. The clinical features of this form include early onset (in the 20s), levodopa‐responsive parkinsonism, diurnal fluctuation, and slow progression of the disease. Parkin consists of 12 exons and the estimated size is over 1.5 Mb. To date, variable mutations such as deletions or point mutations resulting in missense and nonsense changes have been reported in AR‐JP patients. In addition, the localization of parkin indicates that parkin may be involved in the axonal transport system. More recently we have found that parkin interacts with the ubiquitin‐conjugating enzyme E2 and is functionally linked to the Ub‐proteasome pathway as a ubiquitin ligase, E3. These findings fit the characteristics of a lack of Lewy bodies (these are cytoplasmic inclusions that are considered to be a pathological hallmark). Our findings should enhance the exploration of the mechanisms of neuronal death in PD as well as other neurodegenerative disorders of which variable inclusion bodies are observed.
Chronic low‐Ca/Mg high‐Al diet induces neuronal loss
Authors: Kihira Tameko , Yoshida Sohei , Yase Yoshiro , Ono Seiitsu , Kondo Tomoyoshi
Published: March 2003

To evaluate the causative role of environmental aluminum (Al) in the development of neurodegeneration in Kii‐amyotrophic lateral sclerosis (ALS), we examined how chronic exposure to a low‐Ca/Mg and high‐Al diet induced neuronal loss and tau‐related neuronal degeneration in experimental animals. Optical microscopic examination showed tau‐positive cells, atrophic neurons with darkly stained cytoplasms or swollen perikarya in the cerebrum, hippocampus and the brainstem of mice fed a low‐Ca/Mg high‐Al diet (Group 3). The neuronal loss was found in the frontal and parietal cortices of the mice and was not due to a classical apoptosis as detected by the terminal de ynucl otidyl transferase‐mediated dUTP‐digoxigenin nick end‐labeling (TUNEL) method. Neuronal degeneration and spheroid formation was also seen in the spinal cord of the Group 3 mice. The Morin fluorescence technique showed Al and Ca deposition in the cortical neurons and vessels in the basal ganglia of these mice. An electron microscopic examination showed intranuclear filamentous structures, intracytoplasmic vacuoles and/or darkly stained cytoplasm in the cortical neurons of Group 3 mice. These findings were seen in mice of the 11‐month‐experimental period and increased until the 25‐month‐experimental period. The present findings suggested that chronic exposure to a low‐Ca/Mg high Al condition induced an accumulation of hyperphosphorylated tau in the cortical neurons, swelling of the neuronal cytoplasm and loss in the cerebrum and spinal cord of mice. Environmental factors such as a low‐Ca/Mg high Al exposure might be one of the risk factors for the development of neuronal degeneration of ALS in the Kii Peninsula.
An autopsy case of amebic meningoencephalitis. The first Japanese case caused by Balamuthia mandrillaris
Authors: Shirabe Teruo , Monobe Yasumasa , Visvesvara And Govinda S.
Published: March 2003

We report here the first case of amebic meningoencephalitis caused by Balamuthia mandrillaris in a 78‐year‐old Japanese woman with Sjögren's syndrome. Fourteen days before her death, she presented with high fever and lost consciousness and later developed neck stiffness and abducens palsy. Computed tomography scans of the brain demonstrated multiple low‐density areas throughout the brain. Neuropathologically, hemorrhagic and necrotic lesions with many amebic trophozoites were scattered in the brain and spinal cord. Granulomatous lesions were only rarely found. The amebas were identified as Balamuthia mandrillaris based on immunofluorescence assay. Clinicopathologically, our case was thought to be an intermediate between primary amebic meningoencephalitis due to Negleria fowleri and granulomatous amebic encephalitis due to Acanthameba species. Essentially, the case was one of an elderly person with suspected immunodeficiency with fulminant necrotic meningoencephalitis and scanty granulomatous lesions of 14 days course.
The reaction of glial progenitor cells in remyelination following ethidium bromide‐induced demyelination in the mouse spinal cord
Authors: Fushimi Shigeko , Shirabe Teruo
Published: March 2003

The present study investigated how glial progenitor cells participated in the process of remyelination following ethidium bromide (EBr)‐induced demyelination in the adult mouse spinal cord.

In situ hybridization techniques for detecting mRNA for platelet‐derived growth factor α receptor (PDGFαR) and proteolipid protein (PLP) were employed to identify glial progenitor cells and mature oligodendrocytes, respectively.

During the demyelination stage and early stage of remyelination, large cells strongly expressing PDGFαR mRNA were observed in the border of the demyelinating lesion, and with immunohistochemistry they exhibited positive labeling of the astrocytic marker glial fibrillary acidic protein (GFAP). Other glial progenitor cells expressing PDGFαR mRNA proliferated around the lesion during the demyelination stage. During the remyelination stage, some PDGFαR mRNA‐positive cells partly expressed mRNA for PLP in the periphery of the demyelinating lesion.

These results suggest that PDGFαR mRNA‐positive glial progenitor cells may give rise to both astrocytes and oligodendrocytes, which participate in remyelination following demyelination.
Pathogenic potential of galactose‐deficient IgA1 in IgA nephropathy
Authors: Mestecky Jiri , Novak Jan , Julian Bruce A , Tomana Milan
Published: March 2003

SUMMARY:
Recent studies have demonstrated that immune complexes (IC) in the circulation and mesangial deposits in IgA nephropathy (IgAN) patients contain IgA1 molecules deficient in galactose (Gal) in their O‐linked hinge‐region‐associated glycans. Due to this Gal deficiency, terminal n‐acetylgalactosamine (GalNAc) in these side chains is recognized by naturally occurring IgG and IgA1 antibodies as an antigenic determinant responsible for the formation of IC. Thus, IgAN can be classified as one of several human autoimmune diseases in which glycan aberrancies play a pathogenic role. In a rare disease, Tn syndrome, terminal GalNAc on cell surface glycoproteins of erythrocytes, platelets, lymphocytes, and/or monocytes is recognized by GalNAc‐specific antibodies, resulting in their in vitro agglutination and in vivo manifestations (anaemia and thrombocytopenia). However, the antigenic determinants and corresponding antibodies in Tn syndrome differ from those of IgAN. The Tn antigen is composed of three adjacent GalNAc residues, a configuration not present in the IgA1 hinge region. The anti‐Tn antibodies are of the IgM isotype while GalNAc‐specific antibodies in IgAN patients are of the IgG and IgA1 isotypes. Furthermore, monoclonal antibodies to the Tn antigen and sialylated Tn antigens (NeuAcα2,6GalNAc) do not react with intact or glycan‐modified IgA1 myeloma proteins. Antibodies to GalNAc are present in cord blood (devoid of IgM and IgA1) and in purified serum IgG. The true antigen (Gal‐deficient IgA1)–antibody (IgG or IgA1) interaction, rather than non‐specific aggregation, was demonstrated by the dissociation of circulating IC from IgAN patients at acid pH but not in high‐salt concentrations, and the in vitro reassociation at neutral pH (and its inhibition by de‐galactosylated IgA1). The binding of anti‐GalNAc antibodies to Gal‐deficient IgA1 profoundly influences the catabolism and tissue distribution of the IgA1. The masking of GalNAc residues by corresponding antibodies diminishes binding to the hepatic asialoglycoprotein receptor (ASGP‐R) specific for terminal Gal and GalNAc residues of glycoproteins, and results in the deposition of IgA1‐containing IC deposit in the renal mesangium.
Nursing and motherhood constructions: implications for practice
Authors: Parker Judith , Brennan Sheryl
Published: March 2003

The present paper addresses the relationship between community based child health nursing services and social constructions of motherhood within Australia during the 1920s. Following the First World War, child health nursing services (then generally known as infant welfare or child welfare services) were established in all Australian states. The focus of the paper is mainly upon the development of the Tasmanian child health service, with some reference to similar services in other states. Within two decades of their establishment, most child‐bearing women in Tasmania were in contact with child health services and this apparent success meant that, thereafter, women in Tasmania cared for their children under the ‘expert’ guidance of nurses. As the 1920s progressed, child health nurses increasingly promoted one particular, and ultimately extremely influential, construction of motherhood, ‘scientific motherhood’, based upon the philosophy of Dr Truby King. I argue that an understanding of how nursing services have historically reinforced and promoted ideological constructions of motherhood enhances the practice of present day nurses working with women. This argument is supported by reference to present day nursing practice in relation to postnatal depression.
Poststructuralism and nursing: uncomfortable bedfellows?
Authors: Francis Becky
Published: March 2003

Poststructuralism and nursing: uncomfortable bedfellows?

The benefits and limitations of the application of poststructuralist in nursing research are discussed. The debate concerning the use of poststructuralist theory in feminist research is drawn on to argue a divergence between a deconstructionist poststructuralism and nursing aims. It is argued that there are strong parallels between nursing and social movements such as feminism. The reasons why many feminist and nursing researchers have been attracted to poststructuralist theory are explored, as are the criticisms of poststructuralism as an inadequate, even reactionary theory. It is argued that poststructuralism is useful for examining or deconstructing existing discourse and practice, but incompatible and inadequate for research which aims to develop or change such discourses or practices.
Social poetics as research and practice: living in and learning from the process of research
Authors: Aldridge Dee , Stevenson C.
Published: March 2003

Social poetics as research and practice: living in and learning from the process of research

This paper is both a report of research work carried out by one author of the paper with the other involved in a supervisory role, and a reflection on methodology that was an emergent property of the research process. The research question arose when professional preunderstandings about schizophrenia as a biological disturbance were bracketed as a Husserlian form of phenomenology was adopted. The initial study focused on the meanings three individuals attached to being diagnosed with a mental illness and being involved in psychiatric treatment systems. The exploration of meanings led to the researcher being guided by one study participant in relation to a suitable framework for making sense of her lived experience of being entangled in psychiatric systems. This involved an appreciation of the poetics of interpersonal interaction that was simultaneously fuelled by the researcher’s reading of social poetics in psychology. Thus, the research became a hermeneutic inquiry, focused upon the text of one participant (Beth)1 and the psychiatric system that she and colleagues encountered. Beth’s psychiatric predicament was described by a loss of ‘self’, psychiatric interrogation, and positive and negative features of immersion in the system. A byproduct of taking a poetic approach was that the participant found the research process therapeutic. Thus, social poetics encouraged a beneficial blurring of the boundaries between research and practice. In both arenas, social poetics can lead to a different level of understanding. This is contradictory to mainstream approaches to research that value objectivity with a strict division between the researcher and the subjects, with the aim of producing scientific knowledge.
Conserving the vitality of suffering: addressing family constraints to illness conversations
Authors: Tapp Dianne M.
Published: March 2003

Conserving the vitality of suffering: addressing family constraints to illness conversations

When persons are confronted with life‐threatening or chronic illness, there is always a possibility that family members other than the person experiencing the illness also suffer as they attempt to manage their own distress. This paper describes exemplars from a hermeneutic study that explored therapeutic conversations between nurses and families who were living with a member experiencing ischaemic heart disease. These conversations uncovered the complexity of both individual and family suffering following acute cardiac illness events, and called attention to nursing practices that addressed some of the ways that family members were constrained from having conversations about the illness. When spaces were created for these conversations to occur, possibilities for making sense of illness and suffering were revealed as vital. These understandings support the efforts of family members to sustain and conserve family relationships in the face of illness and suffering, and inform both the professional and personal lives of nurses.
IVF as lottery or investment: contesting metaphors in discourses of infertility
Authors: De Lacey Sheryl
Published: March 2003

IVF as lottery or investment: contesting metaphors in discourses of infertility

This paper reports an aspect of a poststructural feminist study in which I explored the discursive formations within which women for whom in vitro fertilisation (IVF) was unsuccessful constitute themselves. In my exploration I draw on data from interviews with women who discontinued infertility treatment, print media material and infertility self‐help books. Specifically, I highlight a metaphor of lottery in discourses of infertility, arguing that it is hegemonic and showing how when women are situated as gamblers, the metaphor is instrumental in polarising them into ‘winners’ or ‘losers’ in relation to the subjectivity of motherhood. I further deconstruct these subjectivities, showing how ‘winners’ are valorised and ‘losers’ are pathologised. But importantly, I show how infertile women who are not mothers resisted locating themselves as ‘losers’ in a metaphor of lottery and instead situated themselves in a contesting metaphor of investment as diligent ‘workers’ and as active agents in choosing the best employment of their bodily and monetary resources. This paper therefore amplifies the marginalised perspective of infertile women who are not mothers.
Men's passage to fatherhood: an analysis of the contemporary relevance of transition theory
Authors: Draper Jan
Published: March 2003

Men's passage to fatherhood: an analysis of the contemporary relevance of transition theory

This paper presents a theoretical analysis of men's experiences of pregnancy, birth and early fatherhood. It does so using a framework of ritual transition theory and argues that despite its earlier structural‐functionalist roots, transition theory remains a valuable framework, illuminating contemporary transitions across the life course. The paper discusses the historical development of transition or ritual theory and, drawing upon data generated during longitudinal ethnographic interviews with men undergoing the transition to fatherhood, analyses its relevance in understanding contemporary experiences of fatherhood.
Altered adhesion efficiency and fibronectin content in fibroblasts from schizophrenic patients
Authors: Miyamae Yasuyuki , Nakamura Yu , Kashiwagi Yujiro , Tanaka Toshihisa , Kudo Takashi , Takeda Masatoshi
Published: March 2003

Cultured fibroblasts from the cutaneous tissue of 16 schizophrenic patients were compared with 16 control cultured fibroblasts from the healthy subjects. The fibroblasts from the schizophrenic patients showed a decreased adhesion efficiency within 30 min after plating compared to that of the control subjects. However, after 90 min, there was no significant difference between the groups, where more than 90% of the cells from both groups had adhesed to the plate. By immunohistochemistry and western blotting using the antibodies against integrin (VLA5), talin, vinculin, fodrin, vimentin, ankyrin, plectin, fibronectin, and focal adhesion kinase (FAK), there was no significant difference in localization and amount between the groups. The amount of fibronectin released into the medium in which the fibroblast had already kept confluency showed no significant difference between the groups. However, the fibronectin content in cell lysate within 48 h after plating was significantly lower in the schizophrenic group.
Neuroleptic‐induced Meige's syndrome following akathisia: Pharmacologic characteristics
Authors: HAYASHI TERUO , FURUTANI MAKOTO , TANIYAMA JUNKO , KIYASU MASAHIKO , HIKASA SATOSHI , HORIGUCHI JUN , YAMAWAKI SHIGETO
Published: March 2003

A 52‐year‐old schizophrenic patient acutely showed blepharospasm and oromandibular dystonia following neuroleptic‐induced akathisia. She had suffered from schizophrenia and been treated with neuroleptics for 15 years and had manifested tardive dyskinesia 5 years ago. Following a change in her neuroleptic medication, severe akathisia developed. Two days after the appearance of akathisia, blepharospasm and oromandibular dystonia appeared. After the disappearance of akathisia, the disorder continued. The frequency of blepharospasm ranged from 30 to 40 (times/min). The oral administration of trihexyphenidyl (6 mg/day), perphenazine (12 mg/day), and fluphenazine (12 mg/day) significantly decreased the frequency of blepharospasm, whereas carbamazepine (600 mg/day) and sulpiride (1200 mg/day) did not. These results suggest that overactivity of both cholinergic and dopaminergic functions in the striatum may be involved in this patient. Our patient, who showed acute onset of Meige's syndrome following neuroleptic‐induced akathisia, is of interest to those studying the pathogenesis of Meige's syndrome.
Event‐related potentials in patients with obsessive–compulsive disorder
Authors: MIYATA  , MATSUNAGA  , KIRIIKE  , IWASAKI  , TAKEI  , YAMAGAMI
Published: March 2003

Twenty‐three unmedicated patients with obsessive–compulsive disorder (OCD) were compared with 12 unmedicated patients with social phobia (SP) and 18 age‐matched normal controls (C) using a two‐tone auditory oddball event‐related potentials (ERP) paradigm. The OCD group showed significantly shorter P300 latencies and shorter N200 latencies for target stimuli than the SP and the C groups. The OCD patients also tended to have greater N200 negativity compared with normal controls. However, there were no significant relationships between these ERP abnormalities in OCD patients and the type or severity of their OCD symptoms. In the mean ERP waveforms, increased N200 negativity for target stimuli, as well as the provocation in the later part of N200 for non‐target stimuli, were more commonly observed in the OCD and the SP groups compared with the C group. These results raise the possibility that the shorter N200 and P300 latencies in OCD patients may be an OCD‐specific phenomenon that is more closely related to the biological basis for OCD, rather than the characteristics of their OCD symptoms. On the other hand, increased negativity in the N200 region, even for non‐target stimuli, may represent the common abnormalities among anxiety disorders.
Dissociative identity disorder and childhood trauma in Japan
Authors: AN KATSUMASA , KOBAYASHI SHUNZO , TANAKA KIWAMU , KANEDA HIROYUKI , SUGIBAYASHI MINORU , OKAZAKI JUNKO
Published: March 2003

A series of 15 cases of dissociative identity disorder (DID) was reviewed using an 85‐item checklist. The cases resembled those seen in North America, particularly with respect to clinical symptoms, alter personalities and history of childhood trauma. The authors suggest that DID may be as common in Japan as in North America.
Posttraumatic stress disorder and its related factors in burn injury and digit amputation
Authors: FUKUNISHI ISAO
Published: March 2003

This study examined the relationship of physical factors including physical functioning and cosmesis to posttraumatic stress disorder (PTSD) symptoms in patients with burn injury and in patients with digit amputation; posttraumatic stress symptoms and depression in mothers of children with burn injuries from falling into bathtubs of hot water. The study comprised 56 patients with burn injury and 26 patients with digit amputation, and 16 children with burn injury and their mothers. Prevalence rates of PTSD and major depression were 33.9 and 7.1%, respectively, in burn‐injured patients and 18.5 and 7.4%, respectively, in patients with digit amputation. Regardless of the severity of the burn injury, such as percentage of total body surface burned, females with cosmetic disfigurement exhibited PTSD symptoms, in particular avoidance and emotional numbing. For digit amputation, regardless of the degree of physical functioning after replantation such as motion and sensation, females with cosmetic disfigurement exhibit PTSD symptoms, in particular avoidance and emotional numbing. These findings suggest that in female victims the degree of cosmetic disfigurement is related to the manifestation of PTSD symptoms of avoidance and emotional numbing. Prevalence rates of PTSD and major depression were 6.3 and 0%, respectively, in children with burn injury and 12.5 and 18.8%, respectively, in their mothers. For three PTS symptoms (i.e. intense distress at a similar event, restricted range of affect, and hypervigilance), prevalence rates were significantly higher for mothers than for children. The three PTS symptoms of their mothers were significantly and positively correlated with severity of guilt feelings. Compared with burn‐injured children, the mothers are prone to PTS symptoms mixed with guilt feelings.
Poor recovery sleep after sleep deprivation in delayed sleep phase syndrome
Authors: Uchiyama Makoto , Okawa Masako , Shibui Kayo , Kim Keiko , Kudo Yosihisa , Hayakawa Tatsuro , Kamei Yuichi , Urata Jujiro
Published: March 2003

To clarify disturbances in sleep regulation in patients with delayed sleep phase syndrome (DSPS), we studied three patients with DSPS and seven healthy controls. Sleep propensity and melatonin rhythms after 24‐h sleep deprivation were investigated under dim light condition by using the ultra‐short sleep–wake schedule. The sleep propensity curves displayed clear differences between DSPS patients and the controls. During the subjective day when melatonin was not produced, recovery sleep after the sleep deprivation did not occur in DSPS patients, while recovery sleep occurred during the subjective day in controls. This suggests that DSPS may involve problems related to the homeostatic regulation of sleep after sleep deprivation.
Effects of sleep deprivation: The phosphorus metabolism in the human brain measured by 31P‐magnetic resonance spectroscopy
Authors: Murashita Jun , Yamada Naoto , Kato Tadafumi , Tazaki Masayoshi , Kato Nobumasa
Published: March 2003

Sleep deprivation (SD) has an antidepressant effect in some, but not all, patients with depression, although its biological mechanisms have not yet been characterized. We previously reported altered brain phosphorus metabolism measured by phosphorus‐31 magnetic resonance spectroscopy (31P‐MRS) in patients with bipolar depression. We preliminarily examined effects of SD on phosphorus metabolism in the frontal lobes of 15 normal subjects using 31P‐MRS. No significant differences of membrane phospholipid metabolism, high‐energy phosphate metabolism and intracellular pH were found between before and after SD in these subjects. Further studies will be necessary to elucidate the physiological mechanism of SD for depressive patients.
Disappearance of rhythmic involuntary movements during sleep in a case of olivopontocerebellar atrophy
Authors: Miyamoto Masayuki , Miyamoto Tomoyuki , Yokota Noritsugu , Hirata Koichi , Katayama Soichi
Published: March 2003

We report on a 54‐year‐old woman with an 8 or so year history of olivopontocerebellar atrophy associated with the rhythmic involuntary movements of the left upper and lower limbs, and cervical region. Surface electromyogram of the left upper limb revealed rhythmicity (about 3 Hz) and reciprocity between antagonistic muscles, which disappeared on polysomnography at all sleep stages including rapid eye movement sleep without atonia. These were characterized by the co‐existence of rhythmic skeletal myoclonus and parkinsonian tremor. These findings suggest that a disturbance of the striatonigral system as well as the dentato‐rubro‐olivary circuit may be involved in these movements. It also seems that their fate is dependent on the level of wakefulness and that the ascending reticular activating system also plays a role in the development of these movements.
Transcranial magnetic stimulation in the treatment of psychiatric disorders
Authors: Pridmore Saxby , Belmaker Robert
Published: March 2003

Transcranial magnetic stimulation (TMS) is a new technology that applies the principles of electromagnetism to deliver an electrical field to the cerebral cortices. Well established in diagnostic electrophysiology, TMS is now being studied as a treatment for psychiatric disorders. Evidence suggests this technique is safe and acceptable to patients. The future may see the application of TMS in obsessive–compulsive disorder, post‐traumantic stress disorder and mania. There is strong evidence that it will become an accepted treatment of depression.
Are micturition systems influenced by sleep‐arousal system?
Authors: Yamao Yutaka , Koyama Yoshimasa , Kawauchi Akihiro , Jodo Eiichi , Kayama Yukihiko , Miki Tsuneharu
Published: March 2003

To clarify a relation between contractile condition of the urinary bladder and vigilance condition, bladder pressure was monitored simultaneously with cortical electroencephalogram (EEG) in urethane‐anesthetized rats. Slow waves of large amplitude and those of lower amplitude appeared in EEG alternately. The bladder showed no contractile activity in the former EEG condition, while it contracted intermittently or continuously to urinate in the latter EEG condition. The relative power of EEG delta waves was significantly different in these two conditions. These results suggest that activity of the micturition system changes according to vigilance conditions, which may serve to prevent enuresis during sleep.
Mothers’ wakefulness at night in the post‐partum period is related to their infants’ circadian sleep–wake rhythm
Authors: Nishihara Kyoko , Horiuchi Shigeko , Eto Hiromi , Uchida Sunao
Published: March 2003

The relationship between a post‐partum mother’s wakefulness at night and her infant’s circadian sleep–wake rhythm was examined. The subjects were seven primipara and their infants. Actigraphic recordings for the mothers and their infants were made over three to five continuous days during Weeks 3, 6, 9 and 12. A 24‐h peak of autocorrelograms of the infants’ movements appeared in two cases at Week 6, in six cases at Week 9, and in seven cases at Week 12. The mothers’ night‐time movements significantly decreased from Week 3 to Week 12. Mothers’ wakefulness during night sleep in the post‐partum period is related to their infants’ obtaining circadian sleep–wake rhythm.
A new periodogram using one‐way analysis of variance for circadian rhythms
Authors: Shono Mayumi , Shono Hideaki , Ito Yuji , Muro Masami , Maeda Yuri , Sugimori Hajime
Published: March 2003

A new periodogram was proposed using one‐way analysis of variance ( ANOVA), termed
ANOVA periodogram, in order to reveal a precise significant periodicity. Thirty 3‐day complex computer‐simulated time series with known periodicity (24 h) and three 2‐h data‐missing occurring periodically (23 h, 20 min) were used to compare the
ANOVA periodogram with Enright’s one. In results, the
ANOVA periodogram was superior to Enright’s periodogram in the accuracy of assessing the major periodicity.
Posttraumatic stress disorder among Croatian veterans: A causal model
Authors: Vukšíc‐Mihaljevíc Željka , Mandíc Nikola , Benšíc Mirta , Mihaljevíc Silvio
Published: March 2003

Abstract The present study investigates the etiological roles of premilitary risk factors, military entry conditions, war zone experiences, dissociative reactions to war zone experiences and homecoming reception in the development of chronic posttraumatic stress disorder (PTSD) among Croatian veterans. A total of 150 Croatian war veterans with the diagnosis of chronic combat‐related PTSD, who sought treatment at Psychiatric Clinic, Osijek, Croatia, in the period 1993–1998, and who provided complete data, were selected as the sample for the present study from the treatment‐seeking group of the ex‐soldier population. Structural equation modeling is used to develop an etiological model concerning the relationships of premilitary risk factors, military entry conditions, war zone experiences, dissociative reactions, and homecoming reception with current symptoms of PTSD. An etiological model with satisfactory fit and parsimony was developed. In terms of the magnitude of variables' total contributions to the development of PTSD, war zone experiences are the most influential contributor which is followed by dissociative reactions, homecoming reception, military entry conditions and premilitary risk factors. Statistical significant direct effects to the development of PTSD were found for dissociative reactions and low family postwar support. The etiology of combat‐related PTSD among Croatian veterans remains largely unexplained. Partial explanations are omission of other etiological factors, retrospective nature of the data and small study sample. The results are the source of questions for further research.
Executive function in traumatic brain injury and obsessive–compulsive disorder: An overlap?
Authors: Coetzer Rudolf , Stein Dan J. , Toit Pieter L. Du
Published: March 2003

Abstract Thirteen individuals with traumatic brain injury, 13 individuals with obsessive–compulsive disorder (OCD) and 10 normal controls were compared on neuropsychological measures of executive function. Individuals with a traumatic brain injury performed significantly poorer than the other two groups on a test measuring visuo‐spatial strategy. Although the traumatic brain injury group made more errors on a test of maze learning and the OCD group less than the control group, this did not reach statistical significance. No support for an overlap in executive dysfunction in traumatic brain injury and OCD was found. It may be that the ‘error prevention system’ in the brain was influenced in a contrasting way by executive dysfunction in these disorders. This difference may reveal itself clinically in impulsivity/perseveration and slowness, respectively. Further studies were needed to test this hypothesis.
No evidence of an association between CYP2D6 polymorphisms among Japanese and dementia with Lewy bodies
Authors: Furuno Taku , Kawanishi Chiaki , Iseki Eizo , Onishi Hideki , Sugiyama Naoya , Suzuki Kyoko , Kosaka Kenji
Published: March 2003

Abstract Dementia with Lewy bodies (DLB) is the second most frequent degenerative dementia among the elderly, following Alzheimer‐type dementia (ATD). An association of DLB with CYP2D6*4, one of the cytochrome P450IID6 (debrisoquine 4‐hydroxylase; CYP2D6) gene polymorphisms, was reported previously, but this is controversial. Moreover, these reports have been restricted to Caucasian populations. Therefore, we compared frequencies of CYP2D6*3, *4, and *10 mutant alleles in 17 Japanese DLB patients to those among Alzheimer‐type dementia (ATD) patients and healthy controls. Polymerase chain reaction amplification and restriction fragment length polymorphism analyses were used for genotyping. No significant difference of genotype or mutant allele frequencies was detected between DLB, ATD, and healthy controls. The present results do not support the suggestion that the CYP2D6 gene is related to DLB susceptibility, at least in the Japanese population.
Quantitative characteristics of alpha and theta EEG activities during sensory deprivation
Authors: Iwata Kazuki , Nakao Mitsuyuki , Yamamoto Mitsuaki , Kimura Masayuki
Published: March 2003

Our previous study showed that theta and alpha electroencephalographic (EEG) activities occurred together during sensory deprivations (SD). The respective activities are expected to manifest different physiological states. In this study, we investigate statistical properties of both types of EEG activities during SD. Wavelet analyses of the original EEG activities during SD and the corresponding surrogation data can distinguish meaningful alpha and theta activities in the original data from accidentally detected ones. As a result, the mean duration of the theta wave is found to be longer than that of the alpha wave. This result could be useful to disclose physiological processes during SD.
Comparison in symptoms between aged and younger patients with narcolepsy
Authors: Furuta Hisakazu , Thorpy Michael J. , Temple Helen M.
Published: March 2003

We investigated the age‐related changes in symptoms in narcolepsy. Fifty patients, 65‐year‐old and over (aged group), were recruited from the National Narcolepsy Registry. Thirty‐four patients, younger than 65 (younger group), were selected by random sampling. Although there was no difference in the age of disease onset between the two groups, the age of diagnosis was significantly earlier for the younger group. Methylphenidate was used significantly more in the aged group, and modafinil in the younger group. The aged group had lower total scores on the Ullanlinna Narcolepsy Scale, because the scores for cataplexy were significantly less for the aged group. There was no significant difference in excessive daytime sleepiness between the two groups.
CYP2D6*4 polymorphism is not associated with Parkinson's disease and has no protective role against Alzheimer's disease in the Korean population
Authors: Woo Sung Il , Kim Jae Woo , Seo Han Gil , Park Chang Hwan , Han Seol Heui , Kim Seung Hyun , Kim Ki Woong , Jhoo Jin Hyung , Woo Jong Inn
Published: March 2003

AbstractCYP2D6*4 polymorphism is reported to be associated with Parkinson's disease (PD) and to have protective role against Alzheimer's disease (AD). Such findings are not extensively studied in the Oriental population, especially Koreans. The effects of CYP2D6*4 polymorphism on AD and PD were investigated by polymerase chain reaction‐restriction fragment length polymorphism in Korean subjects. Heterozygous mutant allele was found in four of 93 patients with PD, 0 of 32 patients with AD and one of 121 control subjects (59 stroke, 59 normal controls and four other psychiatric disorders), but no homozygous mutant allele was found. There were no statistically significant differences between the AD group and controls, and between the PD group and controls. In conclusion, we suggest that CYP2D6*4 polymorphism does not confer susceptibility to PD in the Korean population. Also, due to such a rare occurrence of the CYP2D6*4 polymorphism, we can not confirm the protective role of the polymorphism against AD in the Korean population.
Abnormalities of auditory event‐related potentials in students with schizotypal personality disorder
Authors: Mannan Md Rakibul , Hiramatsu Ken‐Ichi , Hokama Hiroto , Ohta Hirokazu
Published: March 2003

Abstract Biological, phenomenological and cognitive similarities are known to exist between schizophrenia and schizotypal personality disorder (SPD). This study examined whether, and to what extent, abnormalities in event‐related potentials (ERPs) already extensively reported in schizophrenia can also be observed in persons psychometrically identified with SPD. Event‐related potentials were examined in nine SPD subjects and nine controls recruited from among 1693 college students, using the Schizotypal Personality Questionnaire (SPQ) and the Structured Clinical Interview for DSM‐III‐R (SCID I and II). Event‐related potentials were recorded during an auditory oddball task. Smaller P300 amplitude and prolonged P300 latency were found in SPD subjects as compared with controls. Our findings indicate that such individuals do have deficits in information processing similar to that found in schizophrenia. We can conclude that P300 abnormalities may not be specific for SPD but that abnormalities shown in SPD are possibly a vulnerability marker for developing schizophrenia.
Muscle dysmorphia: A South African sample
Authors: Hitzeroth Volker , Wessels Charmaine , Zungu‐Dirwayi Nompumelelo , Oosthuizen Piet , Stein Dan J.
Published: March 2003

Abstract It has recently been suggested that muscle dysmorphia, a pathological preoccupation with muscularity, is a subtype of body dysmorphic disorder (BDD). There are, however, few studies of the phenomenology of this putative entity. Twenty‐eight amateur competitive body builders in the Western Cape, South Africa, were studied using a structured diagnostic interview that incorporated demographic data, body‐building activities and clinical questions focusing on muscle dysmorphia and BDD. There was a high rate of muscle dysmorphia in the sample (53.6%). Those with muscle dysmorphia were significantly more likely to have comorbid BDD based on preoccupations other than muscularity (33%). Use of the proposed diagnostic criteria for muscle dysmorphia indicated that this is a common and relevant entity. Its conceptualization as a subtype of BDD seems valid. The disorder deserves additional attention from both clinicians and researchers.
The characteristics of side‐effects of bromperidol in schizophrenic patients
Authors: Yasui‐Furukori Norio , Kondo Tsuyoshi , Ishida Masayuki , Tanaka Osamu , Mihara Kazuo , Kaneko Sunao , Otani Koichi
Published: March 2003

Abstract The characteristics of the side‐effects of bromperidol was investigated in 33 acutely
exacerbated schizophrenic patients. The most frequently observed side‐effects were
extrapyramidal symptoms. Acute dystonia developed in 10 of 33 patients, and the mean
age was significantly lower (P < 0.05) in patients with dystonia (27.3 ± 6.2 years) than that in patients without dystonia (41.5 ± 12.9 years). Plasma drug concentrations were not associated with side‐effects. These findings suggest that acute dystonia is affected by age factor, and that daily dosage or monitoring of drug concentration is unlikely to be a useful marker for the prediction of side‐effects during bromperidol treatment.
Self‐esteem and mental health characteristics especially among lean students surveyed by University Personality Inventory
Authors: Kajita Miwako , Takahashi Toshihiko , Hayashi Kimiko , Fukuharu Michitaro , Sato Juichi , Sato Yuzo
Published: March 2003

Abstract In recent years, various investigators have indicated an increase in the number of eating disorders. A similar tendency has been observed among university students. The purpose of the present study is to clarify the self‐esteem and mental health characteristics of the lean students who suffer from latent eating disorders. We examined 2132 responses to the University Personality Inventory obtained from students who entered Nagoya University in 1995. We analyzed the mental health conditions of the lean students after categorizing the subjects into lean, normal and obese group by body mass index. As a result, the following results were obtained. Lean male students presented with more subjective symptoms than normal and obese students, and extremely lean male students had more subjective symptoms. Lean female students had fewer subjective symptoms than lean male students and no particular differences from normal female students. It is suggested that male and female students had different criteria for self‐esteem with regard to body shape. The lean female students were medically ill and formed a latent or borderline latent group with anorexia nervosa. However, they had a similar degree of health awareness as normal students.