bluuebunny/crossref_metadata_2025 huggingface dataset:
Mid‐pregnancy maternal plasma levels of interleukin 2, 6, and 12, tumor necrosis factor‐alpha, interferon‐gamma, and granulocyte‐macrophage colony‐stimulating factor and spontaneous preterm delivery
Authors: CURRY ALLISON E. , VOGEL IDA , DREWS CAROLYN , SCHENDEL DIANA , SKOGSTRAND KRISTIN , FLANDERS W. DANA , HOUGAARD DAVID , OLSEN JØRN , THORSEN POUL
Published: August 2007

Background. Few studies have investigated the relationship between inflammation and spontaneous preterm delivery (sPTD) in women before preterm labour. The authors examine whether mid‐pregnancy plasma cytokine levels are associated with sPTD, and whether associations vary by maternal age, body mass index, prior preterm delivery, or gravidity. Methods. This case‐control study was nested within the Danish National Birth Cohort, a cohort of women with 101,042 pregnancies from 1997 to 2002. Included in this study are 61 women delivering at 24–29 weeks, 278 delivering at 30–33 weeks, 334 delivering at 34–36 weeks, and 1,125 delivering at ≥37 weeks. Maternal plasma interleukin (IL)‐2, IL‐6, tumor necrosis factor (TNF)‐α, interferon (IFN)‐γ, and granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) at 25 weeks’ gestation were measured using multiplex flow cytometry. Results. For IL‐2, TNF‐α, and GM‐CSF, the proportion of women with levels >75th or >90th percentile did not differ by gestational age at delivery. IFN‐γ >90th percentile was associated with an increased risk of delivering at 30–33 weeks (crude odds ratio (cOR): 1.56; 95% confidence interval (CI): 1.07–2.30), while IFN‐γ >75th percentile and IL‐6 >75th percentile were associated with an increased risk of delivering at 34–36 weeks (cOR: 1.32; 95% CI: 1.01–1.73); estimates changed little after adjusting for confounders. There was no effect‐measure modification by maternal factors. Conclusion. Elevated mid‐pregnancy plasma IL‐2, TNF‐α, and GM‐CSF did not appear to be associated with an increased risk of sPTD, while elevated IFN‐γ and IL‐6 levels were weakly associated with moderate and late sPTD. The value of using mid‐pregnancy cytokines in predicting spontaneous preterm delivery appears limited.
Scientific Structuralism: Presentation and Representation
Authors: Brading Katherine , Landry Elaine
Published: August 2007

This paper explores varieties of scientific structuralism. Central to our investigation is the notion of ‘shared structure’. We begin with a description of mathematical structuralism and use this to point out analogies and disanalogies with scientific structuralism. Our particular focus is the semantic structuralist's attempt to use the notion of shared structure to account for the theory-world connection, this use being crucially important to both the contemporary structural empiricist and realist. We show why minimal scientific structuralism is, at the very least, a powerful methodological standpoint. Our investigation also makes explicit what more must be added to this minimal structuralist position in order to address the theory-world connection, namely, an account of representation.
Surprised by a Nanowire: Simulation, Control, and Understanding
Authors: Lenhard Johannes
Published: August 2007

This paper starts by looking at the coincidence of surprising behavior on the nanolevel in both matter and simulation. It uses this coincidence to argue that the simulation approach opens up a pragmatic mode of understanding oriented toward design rules and based on a new instrumental access to complex models. Calculations, and their variation by means of explorative numerical experimentation and visualization, can give a feeling for a model's behavior and the ability to control phenomena, even if the model itself remains epistemically opaque. Thus, the investigation of simulation in nanoscience provides a good example of how science is adapting to a new instrument: computer simulation.
Philosophical Scrutiny of Evidence of Risks: From Bioethics to Bioevidence
Authors: Mayo Deborah G. , Spanos Aris
Published: August 2007

We argue that a responsible analysis of today's evidence-based risk assessments and risk debates in biology demands a critical or metascientific scrutiny of the uncertainties, assumptions, and threats of error along the manifold steps in risk analysis. Without an accompanying methodological critique, neither sensitivity to social and ethical values, nor conceptual clarification alone, suffices. In this view, restricting the invitation for philosophical involvement to those wearing a “bioethicist” label precludes the vitally important role philosophers of science may be able to play as bioevidentialists. The goal of this paper is to give a brief and partial sketch of how a metascientific scrutiny of risk evidence might work.
Comparing Legislators and Legislatures: The Dynamics of Legislative Gridlock Reconsidered
Authors: Chiou Fang-Yi , Rothenberg Lawrence S.
Published: August 2007

Although political methodologists are well aware of measurement issues and the problems that can be created, such concerns are not always front and center when we are doing substantive research. Here, we show how choices in measuring legislative preferences have influenced our understanding of what determines legislative outputs. Specifically, we replicate and extend Binder's highly influential analysis (Binder, Sarah A. 1999. The dynamics of legislative gridlock, 1947–96.American Political Science Review93:519–33; see also Binder, Sarah A. 2003.Stalemate: Causes and consequences of legislative gridlock. Washington, DC: Brookings Institution) of legislative gridlock, which emphasizes how partisan, electoral, and institutional characteristics generate major legislative initiatives. Binder purports to show that examining the proportion, rather than the absolute number, of key policy proposals passed leads to the inference that these features, rather than divided government, are crucial for explaining gridlock. However, we demonstrate that this finding is undermined by flaws in preference measurement. Binder's results are a function of using W-NOMINATE scores never designed for comparing Senate to House members or for analyzing multiple Congresses jointly. When preferences are more appropriately measured with common space scores (Poole, Keith T. 1998. Recovering a basic space from a set of issue scales.American Journal of Political Science42:964–93), there is no evidence that the factors that she highlights matter.
El Niño‐Southern Oscillation, rainfall, temperature and Normalized Difference Vegetation Index fluctuations in the Mara‐Serengeti ecosystem
Authors: Ogutu J. O. , Piepho H.‐P. , Dublin H. T. , Bhola N. , Reid R. S.
Published: August 2007

Understanding long‐term climatic variability is basic to wise management and conservation of biodiversity. We analysed temporal variations in the local rainfall, temperature, Normalized Difference Vegetation Index and the hemispheric El Niño‐Southern Oscillation (ENSO), using the Southern Oscillation Index and how they co varied in the Mara‐Serengeti ecosystem of Kenya and Tanzania. Local rainfall showed a striking temporal variability and an evident 5‐year quasi‐periodicity in the ecosystem. Severe droughts were a recurrent/persistent feature of the ecosystem but extreme floods were relatively infrequent. The timings of droughts and floods coincided with strong episodes in the activities of the ENSO phenomenon. Above‐average rainfall often accompanied cold ENSO episodes and below‐average rainfall warm ENSO events, contrary to past generalizations suggesting that warm ENSO events are only associated with above‐average rainfall whereas cold ENSO events with below‐average rainfall in equatorial East Africa. Both minimum and maximum temperatures were below‐normal during cold ENSO episodes and above‐normal during warm ENSO events. Rising temperatures and declining rainfall throughout the 1990s and early 2000s, with unprecedently prolonged and strong ENSO episodes, engendered progressive habitat desiccation and reduction in vegetation production in the ecosystem. This exacerbated the debilitating effects of adverse weather on local plant and animal communities, resulting in high mortalities of ungulates.
Anaesthesia: cheap at twice the price?
Authors: Bailey C. R. , Ruggier R. , Cashman J. N.
Published: August 2007

We questioned 50 anaesthetic staff about the costs of consumables used in routine anaesthetic practice. By means of a questionnaire staff were asked for estimates of the cost of 28 drugs, fluids and disposables. The responses were more accurate than in previous surveys; 47% of all the estimated costs were within 50% of the actual costs and 75% were within 100%. The costs of relatively expensive items such as blood, laryngeal mask airways, enflurane and isoflurane were consistently underestimated whereas cheaper items such as disposable syringes and electrocardiograph electrodes were consistently overestimated. Using ‘state of the art’ consumables, an hour‐long anaesthetic in 1992 cost £14.02 compared with £1.24 in 1959. However, allowing for inflation, the cost today is actually equivalent to the cost in 1959. Since 1980 there has been no consistent pattern in drug prices, with some prices remaining the same, others falling and some increasing; all are, however, cheaper in real terms. It is possible to make substantial savings by using the more expensive drugs judiciously and by encouraging the use of low‐flow, closed‐circuit anaesthetic systems.
Salvaging a tooth with a deep palatogingival groove: an endo‐perio treatment – a case report
Authors: Ballal N. V. , Jothi V. , Bhat K. S. , Bhat K. M.
Published: August 2007

Aim  To describe the diagnosis and management of tooth 22 with a necrotic pulp and severe periodontal destruction associated with a deep palatogingival groove extending to the root apex.

Summary  Palatogingival grooves are uncommon in maxillary lateral incisors, but when present may contribute to the pathogenesis of periodontal and endodontic lesions. In the present case, the prognosis was considered poor, as the patient presented with a deep probing defect, advanced bone loss and grade III mobility of tooth 22. Root canal treatment was performed, followed by periodontal surgery, during which the groove was conditioned and sealed with conventional glass–ionomer cement and the osseous defect filled with indigenously prepared hydroxyapatite. The 18 month post‐operative follow up showed substantial resolution of the osseous defect with gain in attachment and decreased tooth mobility.

Key learning points

Teeth with deep palatogingival grooves may be significantly compromised with severe periodontal and periapical bone loss.

Following thorough evaluation, the careful application of endodontic and periodontal surgical procedures may restore satisfactory function.
Fungal flora associated with Tomicus piniperda L. in an area close to a timber yard in southern Poland
Authors: Jankowiak R. , Bilański P.
Published: August 2007

Abstract:  The association between Tomicus piniperda L. (Col., Scolytinae) and fungi was studied in a Pinus sylvestris L. forest in Mielec‐Mościska. Fungi were isolated from overwintered adult beetles taken from two stands situated in different distance from timber yard. Two media were used for isolation. The results showed great diversity of fungi associated with T. piniperda: 1895 cultures, representing 64 species, were isolated. Penicillia and Hormonema dematioides were the dominant species, found in 20.2% and 17.8% of all beetles, respectively. A frequently isolated ophiostomatoid fungi was Ophiostoma minus. Qualitative and quantitative differences in the mycobiota composition of this insect between two stands were detected. The highest richness and diversity of fungal species appeared in the samples taken from the location where the trees were heavily damaged by shoot‐feeding of T. piniperda. Differences were most clear for the pathogenic O. minus, which was a common fungal associate of the insects in this stand.
Inter‐parental conflict and children's academic attainment: a longitudinal analysis
Authors: Harold Gordon T. , Aitken Jessica J. , Shelton Katherine H.
Published: August 2007

Background:  Previous research suggests a link between inter‐parental conflict and children's psychological development. Most studies, however, have tended to focus on two broad indices of children's psychological adaptation (internalizing symptoms and externalizing problems) in considering the effects of inter‐parental conflict on children's development. The present longitudinal study extends this body of research by considering the impact of inter‐parental conflict on children's low academic attainment among a sample of 230 schoolchildren (age 11–13 years) living in the United Kingdom.

Method:  Controlling for teacher reports of children's initial levels of aggression (Time 1), the proposed theoretical model linked parent and child reports of inter‐parental conflict at Time 1 (1999) to children's perceptions of negative parent–child relations, appraisals of self‐blame for marital conflict and teacher reports of children's aggressive behavior at Time 2 (2000), which in turn were linked to children's performance on standardized academic tests (English, Math, Science) at Time 3 (2001). Structural equation modeling was used to test all hypothesized relations in the proposed theoretical model.

Results:  Support was found for the role of children's self‐blaming attributions for parents’ marital arguments, not negative parenting behavior, as a mechanism through which variation in their academic attainment is explained.

Conclusions:  Contrary to the focus emphasized in most current family and school‐based intervention programs, findings suggest that the attributional processes engendered in children who live in households marked by high levels of inter‐parental conflict and hostility have important implications for their long‐term academic success.
Quantifying Dementia Care in Japan: A Discussion on the Long‐Term Care Insurance
Authors: Nandi Shivani
Published: August 2007

Abstract: The Japanese government mandated the kaigohoken, or Long Term Care Insurance (LTCI) in December 1997. In view of the pressures faced by Japan as an aged society, the aim of the LTCI is to alleviate the burden of providing care for frail older people by ensuring good quality and readily available services to everyone over 65. The LTCI is thus a high profile, age‐based entitlement program—age based for persons 65 years of age and above, and age related disability based for ages 40 to 64. Individuals 40 years and above, including foreigners living in Japan for more than a year, are responsible in bearing a part of the financial responsibility by having to pay the mandatory premium. The benefits that the insured person receives are decided after evaluating the care requirement. Care is quantified by being categorized into six levels of increasing requirement, starting from support required, through five levels of increasing care.

As is well known, caring for a person with dementia is further complicated by accompanying psychiatric disturbances which in turn increase caregiver burden. Thus the fundamental difficulty in dealing with the care of persons with dementia such as Alzheimer's disease, which is the most common form of dementia, is the evaluation procedure preceding entitlement. We find that the statistical program of the LTCI employed in the initial stage of the evaluation contains discrepancies, and tends to overemphasize bed ridden patients over people with dementia. This paper is a study of the status of people with dementia in Japan, the mechanism of the assessment method, and the problems associated with it.
Influence of Apolipoprotein E3 on the Production of Paired Helical Filament in Guamanian Parkinsonism‐dementia Complex/Amyotrophic Lateral Sclerosis and Alzheimer's Disease
Authors: Tsuda Takehide , McLachlan D.R.C. , MD Yasuto Itoyama
Published: August 2007

Background: Neuropathologically, Guamanian parkinsonism‐dementia complex (PDC) and amyotrophic lateral sclerosis (ALS) are characterized by neuronal loss and neurofibrillary tangles (NFTs). The NFTs are principally composed of paired helical filaments (PHFs) consisting of hyperphosphorylated tau and have been shown to be histopathologically similar to those in Alzheimer's disease (AD). Recent biochemical studies have suggested that the binding of apolipoprotein E3 (ApoE3) to tau may interfere with the hyperphosphorylation of tau, thus resulting in neuroprotective effects.

Methods: In order to clarify the influence of ApoE3 on the production of PHFs in various pathological conditions, the ɛ3 allele frequency in patients with Guamanian PDC and ALS, as well as AD, was examined.

Results: The results obtained in this study showed no significant differences between these affected groups and each of the controls in terms of the frequency of the ApoE3 allele.

Conclusion: Although ApoE3 has been implicated in the production of PHFs, the present study suggests that ApoE3 may not have a strong inhibitory effect on the production of NFTs in these affected patients.
Psychogeriatrics in China
Authors: Yu Xin
Published: August 2007

Abstract: Ageing is a global problem. China, which is the most populated nation in the world, became an elderly country in the beginning of this century. The unpredicted aging process brings about challenges to the Chinese society and health care system as well. Chinese psychiatrists are facing even greater challenges, since geriatric psychiatry is still at its infancy. To obtain reliable epidemiological data on mental disorders of the elderly in such a huge country like China, seems an impossible mission. However, quite a few of the epidemiological studies that were conducted with reliable diagnostic criteria and instruments may depict a broad picture only of current situations on mental health of Chinese elderly. Data about dementia are inconsistent. Prevalence rates of Alzheimer's disease (AD) and vascular dementia (VD) vary in studies. Besides the differences in methodology, the differences in residential location (north vs. south, rural vs. urban) may contribute to the etiology of dementia. Contrary to the inconsistent results of dementia, prevalence of depression is consistently low, no matter in which age group. Cultural aspects may play a role in the development of depression in elderly. We need more studies in order to understand this issue better.
Rapid Eye Movement Sleep Behavior Disorder
Authors: Kumano‐go Takayuki , Mikami Akira , Suganuma Nakamori , Adachi Hiroyoshi , Shigedo Yoshihisa , Sugita Yoshiro , Takeda Masatoshi
Published: August 2007

Abstract: Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by loss of normal voluntary muscle atonia during REM sleep, and is associated with excessive motor activity related to dreaming. The movements are often potentially harmful and may lead to repeated injuries to the patients and/or their bedpartners.

RBD is more common in the elderly and affects predominantly males. A recent survey reported an estimated prevalence of RBD of 0.38% in the elderly and 0.5% in the general population. Because the treatment of RBD is effective and safe in most cases, awareness and diagnosis of RBD is critical. Overnight polysomnography is required to differentiate accurately between RBD and other sleep disorders, even though the patients have been clinically diagnosed as RBD according to the minimal criteria of the International Classification of Sleep Disorders. Muscle tone persists during REM sleep in RBD patients, and may be frequently augmented for prolonged periods of time. The density of REMs or phasic muscle activity occurring during REM sleep significantly increases in these patients, although their overall sleep architecture is usually normal, with the expected cycles of non‐REM and REM sleep.

RBD occurs in both acute and chronic form. Acute cases are associated with intoxication and withdrawal. Chronic cases are most often either idiopathic or associated with neurological disorders—especially neurodegenerative diseases. The etiology of idiopathic RBD is still unknown, but a recent study has shown an association between some cases of idiopathic RBD and neurodegenerative disorders with parkinsonism such as Parkinson's disease, multiple system atrophy, and diffuse Lewy body disease. RBD patients thus need to be carefully followed up in terms of neurological evaluation.
Alzheimer Amyloid α‐Secretase: A Special Target for Drug Development
Authors: Ishiura Shoichi , Hotoda Nika , Szabó Beáta , Asai Masashi , Hattori Chinatsu , Tanaka Eiichiro , Koike Hisashi , Sasagawa Noboru
Published: August 2007

Abstract: Multiple lines of evidence suggest that increased production and deposition of amyloid β peptide (Aβ) contribute to Alzheimer's disease (amyloid hypothesis). Several factors regulate processing of amyloid precursor protein. Mechanisms of Aβ production and clearance from the brain have been the subject of considerable interest. Here we summarize recent advances in the identification of amyloid secretases and rational drug design.
Hippocampal Role in Cognitive Functions and Memory, and Effects of a Novel Cognitive Enhancer on Learning Deficits Due to Hippocampal Lesions
Authors: Ono Taketoshi , Nishijo Hisao
Published: August 2007

Abstract:In the 21st century, advances in basic research on higher brain functions in both system and molecular levels will proceed therapeutics to alleviate senile dementia, including Alzheimer's disease. In this review, we present our recent experimental results in the hippocampal formation (HF) in reference to human amnesia and a role of the HF in episodic memory and learning. First, we analyzed the activity of the HF neurons in both monkeys and rats. Neural activity in the monkey HF was analyzed during a spatial moving task in which the monkey could control a motorized, movable device (cab) and its route to a target location by pressing the bars. Some HF neurons responded to the occurrence of significant events (or episodes) in the place field where neuronal activity increased. This indicates that HF gating of incoming information may depend on where the monkey is located. These responses suggest representation related to episodic memory, and linkage among diverse information including both spatial and non‐spatial cues. Rats were also trained to explore a circular open‐field to obtain rewards [intracranial self‐stimulation (ICSS)]. When ICSS delivery place was changed, about 20% of the place neurons shifted place fields to locations newly associated with ICSS rewards. These neurophysiological results suggest that the HF is crucial to represent associative relations among multiple cues or factors and to learn such relations. Second, we investigated effects of the newly developed compound (T‐588), on learning and memory in rats. Treatment with the compound ameliorated deficits in learning the spatial tasks due to selective lesions of the CA1 subfield.
An Environmental Change Does Not Affect Dementia Prevalence but Affects Depressive State and Physical Activity: A Trans‐Cultural Study of Japanese Elderly Subjects and Japanese Elderly Immigrants in Brazil
Authors: Meguro Kenichi , Meguro Mitsue , Caramelli Paulo , Ishizaki Junichi , Ambo Hideo , Chubaci Rosa Y. S. , Ishii Hiroshi , Yamaguchi Satoshi , Shimada Masumi , Hamada Gerson S. , Nitrini Ricardo , Yamadori Atsushi
Published: August 2007

Background:Dementia, depressive state, and physical inactivity, are some of the main topics of geriatric medicine. We previously showed the prevalence of dementia in Tajiri, Miyagi Prefecture, Japan. To investigate the environmental effects, first‐generation immigrants are one of the best samples. Brazil is the country with the largest number of Japanese immigrants.

Objective:To evaluate the effects of environment on dementia, depressive state, and physical activity, the Tajiri subjects and the elderly Japanese emigrants from Miyagi Prefecture to Brazil were compared.

Methods:The total elderly population in Tajiri and that the elderly members of the Miyagi Association in the São Paulo metropolitan area in Brazil were compared. All data were gathered using a standardized interview covering physical status, cognitive function (Mini‐Mental State Examination, MMSE), and depressive state (Self‐reported Depressive Scale, SDS). Dementia and depression were diagnosed based on the DSM‐IV.

Results:Seventy‐six percent of the immigrants perceived their health as being excellent or relatively good, whereas only 56% of Tajiri subjects did so. The percentage of subjects with a history of diabetes mellitus, a lifestyle related disease, was 8.4% in Tajiri and 24.2% in Brazil. In spite of similar prevalences of dementia with slightly different MMSE distributions, the two groups had a different SDS distribution; the immigrants showed lower depressive scores.

Conclusion:In spite of environmental changes influencing physical activity and diabetes, cognitive function was not apparently affected. Although the immigrants lives were marked with hardship, their depressive scores were unexpectedly lower than Japanese, probably due to their stronger mental activity.
Early Onset Alzheimer Type Dementia More Rapidly Deteriorates than Late Onset Type: A Follow‐up Study on MMSE Scores in Japanese Patients
Authors: Arai Heii , Tsubaki Hiroe , Mitsuyama Yoshio , Fujimoto Naoki , Urata Yasuo , Homma Akira
Published: August 2007

Background:Cognitive function in patients with Alzheimer type dementia (ATD) changes over time, and the rate of progression varies according to reports. An aim of the study is to examine the rate of progression in patients with ATD by the onset of the disease.

Methods:Forty patients with early onset dementia at the age of 65 or less and 99 patients with late onset dementia at the age of more than 65 years in whom Mini‐Mental State Examination (MMSE) scores could be followed up for at least 12 months were enrolled and examined retrospectively for changes in MMSE scores over time.

Results:It was demonstrated that the rate of decrease in MMSE scores was significantly higher in Alzheimer disease (AD) than in senile dementia of Alzheimer type (SDAT) and that the decrease in MMSE scores was significantly slower in patients with higher initial scores.

Conclusion:ATD patients are likely to be classified into AD or SDAT for evaluation of decreased cognitive function. Initial MMSE score and the subtype according to age at onset are important predictors for the progression of intellectual impairment in ATD patients.
Prevalence of Dementia Among the Elderly in a Japanese Community Population—Comparative Study on the 1983 and 1996 Survey: The Aichi Study
Authors: Shibayama Hiroto , Kobayashi Hiroshi , Nakagawa Makoto , Marui Yasuo , Miyachi Tatsuo , Kayukawa Yuhei , Yamada Kenichi , Iwata Hiromu , Takeuchi Tohru , Iwai Kiyoshi , Kogawa Susumu , Kagawa Naoki , Imai Makoto , Mizuno Yutaka , Hashimoto Naoki , Ibuki Yasuo , Ogasawara Shunichiro , Tadano Fumiyasu , Nakagawa Takeo , Ohta Tatsuro
Published: August 2007

Background:An epidemiological survey of dementia among community residents over 65 years of age in Aichi Prefecture (Japan) was conducted in 1983 and 1996. We compared the prevalence rates of dementia in 1996, with the previously published rates of 1983.

Methods:The study employed a two‐stage design. First stage: A test based on the DSM‐III‐R criteria for dementia was administered to all participating residents, who were randomly drawn from the resident register (856,879) of Aichi Prefecture in 1995 (495,923 in 1983). Second stage: A detailed clinical and cognitive evaluation (including MMSE and neurological examination) of the subjects identified in the first stage was carried out by trained psychiatrists.

Results:The prevalence rate for dementia in 1996 was 4.8% (moderate and severe 2.1%) compared with 5.8% (2.2%) in 1983; for senile dementia of Alzheimer type (SDAT) it was 2.8% in 1996 and 2.4% in 1983; for cerebrovascular dementia (CVD), 1.8% in 1996 and 2.8% in 1983.

Conclusion:Up to this time, the cases of CVD have been more frequent than those of SDAT in Japan, especially in the urban areas. However, the relationship between CVD and SDAT has now reversed. These data suggest that SDAT is a common condition and that its public health impact will continue to increase with the increasing longevity of the population in Japan.
An Autopsy Case of Traumatic Brain Injury (TBI) Presenting as Frontotemporal Dementia with Klüver‐Bucy Syndrome
Authors: Yokota Osamu , Terada Seishi , Ishizu Hideki , Nakashima Hanae , Fujisawa Yoshikatsu , Sasaki Ken , Kuroda Shigetoshi
Published: August 2007

Abstract: We report an autopsy case of traumatic brain injury (TBI) that presented clinically as frontotemporal dementia (FTD) with Klüver‐Bucy syndrome after a one‐year latency period. The head injury was relatively slight, and clouding of consciousness was not noted at the time. Repeated CT scans demonstrated no obvious cerebral contusions. The case presented with four of six core symptoms of the Klüver‐Bucy syndrome, including hyperorality, changes in emotional behavior (aggression and impulsiveness), hypersexuality, and bulimia. Histopathological examination revealed small cerebral contusions in the bilateral temporal lobe. Loss of myelin and axons was also revealed, especially in the base of the frontotemporal lobe. The laminar structure in the frontotemporal cortex was well preserved. No Pick bodies or Pick's inflated cells were demonstrated by Bodian staining in any region. In the contusions, a small amount of hemosiderin was deposited. In the Lund and Manchester group's research criteria for frontotemporal dementia, head trauma related to the onset of dementia is one of the diagnostic exclusion features. However, 1) assessment of whether a past minor head injury is related to the onset of dementia after a long latency is controversial, and 2) a subset of the TBI cases might be difficult to distinguish from FTD. Further analysis of autopsy cases presenting as FTD following a minor head injury might provide important clues to differentiate clinically FTD from TBI.
Subcortical Haemorrhage in the Right Temporal Lobe Exhibiting only Transient Agitated Delirium
Authors: Ohnishi Jiro
Published: August 2007

Abstract: A 55‐year‐old man with cerebral haemorrhage localized in the rostral subcortical region of the right temporal lobe exhibited a transient agitated delirium (AgD) consisting of the global disorder of attention, irritation, excitation, hallucination, delusion, and excessive movement, and recovered from that without any remaining neurologically defective symptoms. As local lesions that could cause AgD, the right temporal lobe and the right parietal lobe are mainly suggested, but other neurological symptoms such as hemiplegia and hemianopsia are usually present. There has been no report on patients with local injury of the white matter in the right temporal lobe who solely exhibited AgD. Therefore, the present case appeared to be important in distinguishing the disease state exhibiting attentional disorder.
Psychogeriatrics in the New Century—Issues and Challenge —
Authors: Hasegawa Kazuo
Published: August 2007

Abstract: Many huge changes have taken place in our own field of psychogeriatrics and psychogeriatric care at the beginning of the new century. The speed of these changes has been extremely rapid, and increasingly difficult problems have emerged. We, thus, must at this juncture gather together our collective wisdom, devise an appropriate approach to the new century, and aggressively tackle those areas that need to be addressed. While predicting the future is by no means an easy task, I would like to discuss the following three points: educational issues, research activities and the psychogeriatric service. I sincerely pray for the future of our psychogeriatric society with a famous religious philosopher Dr. Reinhold Neibuhr “God, grant me the serenity to accept the things I cannot change, the coursjge to change the things I can, and the wisdom to know the difference.”
Health Economical Aspects of Alzheimer Disease and its Treatment
Authors: Wimo Anders , Winblad Bengt
Published: August 2007

Abstract: The health economics of Alzheimer disease (AD) is in a premature state, and there is a great need for methodological improvement. The scientific database is small although rapidly expanding. There is also a great interest in the pharmacoeconomics of AD amongst the drug authorities in different countries and in the pharmaceutical companies who are engaged in AD research, illustrating that it is a hot topic. In particular, aspects of quality of life among patients and caregivers, long term treatment effects and informal care should be the focus for methodological development.
Late‐Onset Depressive Episodes in the Elderly: Examination of Evidence for a Separate Nosological Entity
Authors: Artero Sylvaine , Ritchie Karen
Published: August 2007

Abstract: Depression in the elderly is common, and while sharing many of the features of early‐onset depression, differences in presenting symptomatology, family history of affective disorder, and prognosis together raise the possibility that late‐life depression may constitute a disease subtype or even a separate nosological entity.

A review of the literature over the past 30 years with relation to depression in elderly cohorts was used as the basis for examining to what extent present evidence confirmed the existence of a separate entity according to predetermined criteria.

Comparisons of clinical cohorts suggest quantitative rather than qualitative differences and are inconclusive due to disparities in methodology which preclude meta‐analysis.

Depression in the elderly appears to be commonly attributable to comorbidity, in particular ageing‐related vascular changes, rather than genetic factors. It is thus more likely to be a syndrome due to varying underlying causes rather than a separate disease entity.
Quantitative Analysis of Presenilin‐1 mRNA Expression in Sporadic Alzheimer's Disease Brain
Authors: Baba Hajime , Ohnuma Tohru , Shibata Nobuto , Takahashi Tadashi , Arai Heii
Published: August 2007

Background: The majority of familial Alzheimer's disease (FAD) is caused by mutations in the presenilin‐1 (PS‐1) or presenilin‐2 (PS‐2) genes. The neuropathological changes in both FAD and sporadic late‐onset Alzheimer's disease (AD) are similar, suggesting that they share a common etiological pathway. Despite many attempts to investigate the function of PS in sporadic AD, no consensus has been reached as to the levels of expression in sporadic AD.

Methods: PS‐1 mRNA content was measured in the frontal cortex of post‐mortem human brains from four sporadic AD cases and five controls. Real‐time quantitative polymerase chain reaction (PCR) was performed using a LightCycler rapid thermal cycler (Roche) with SYBR Green I fluorescence.

Results: The results showed that the content of PS‐1 mRNA in the frontal cortex of sporadic AD cases was higher than those in controls (p<0.05).

Conclusion: We quantified PS‐1 mRNA in the frontal cortex from sporadic AD and controls with a quantitative real‐time reverse transcriptase‐PCR (RT‐PCR) method. We found that the PS‐1 mRNA content in sporadic AD was higher than in controls suggesting that up‐regulated PS‐1 expression may be associated with some of the pathological changes found in sporadic AD.
Vascular Cognitive Impairment
Authors: Erkinjuntti Timo , Rockwood Kenneth
Published: August 2007

Abstract: The term vascular cognitive impairment (VCI) is now employed to capture the spectrum of illness and disability arising from impaired cognitive function of vascular origin. As such, it supplants the more narrowly focussed terms “Vascular dementia (VaD)” and “multi‐infarct dementia”. It is meant to include both those whose cognitive impairment is different from that assumed by the usual criteria for dementia. Traditionally, dementia criteria have been modelled on AD, a disorder with more characteristic neuropathological and clinical disease expression than is seen in VaD, which can occur in many forms. VCI is common, and is associated with many adverse outcomes, including worse cognition, institutionalization, and death.

One form of VCI is coincident AD and VaD, a category which, although it has been comparatively neglected, may be amongst the most common forms of dementia. Another common form of VCI has a predilection for subcortical ischemic lesions, and for a clinical presentation which reflects frontal and subcortical involvement.

At present, there is no specific treatment for VCI, although several agents appear to offer the hope of both treatment and prevention. Further research on the clinical, pathological and mechanistic underpinnings of this important syndrome is needed. For a long time, VaD has been recognized as the second most common cause of dementia.1,2) More recently, however, the concept of cognitive impairment in relation to cerebrovascular disease has been expanded. This paper will review the notion of “vascular cognitive impairment” (VCI) as it relates to clinical practice, and to our understanding of disease mechanisms in dementia and related disorders. It will propose that while the expanded concept has merit, within it are to be found distinct subgroups, including some of particular importance as targets for clinical trials of therapeutic and even preventive interventions.
Neuronal Ca2+ Channels and Nicotinic ACh Receptors as Functional Targets of the Nootropic Nefiracetam
Authors: Yoshii Mitsunobu , Watabe Shigeo , Murashima Yoshiya L. , Nukada Toshihide , Shiotani Tadashi , Nishizaki Tomoyuki
Published: August 2007

Abstract: Piracetam‐like nootropics (or cognitive enhancers) have been used for the treatment of various forms of dementia, including Alzheimer's disease. The underlying mechanisms of their actions, however, are largely unknown. Our recent studies have demonstrated that nefiracetam, a nootropic agent, can markedly enhance activities of neuronal L‐and N‐type (α1B) Ca2+ channels as well as those of presynaptic nicotinic acetylcholine (ACh) receptors, thereby increasing neurotransmitter release. Aniracetam exerted a slight facilitatory effect on Ca2+ channels, but no effect on nicotinic ACh receptors. Piracetam and oxiracetam have no such actions on Ca2+ channels and nicotinic ACh receptors. It is suggested that inhibitory G‐proteins (Go/Gi) and protein kinase A (PKA) mediate the nefiracetam action on Ca2+ channels, whereas protein kinase C (PKC) mediates the drug action on nicotinic ACh receptors. In the hippocampus of the rodent, nefiracetam induces a long‐lasting (>4 h) facilitation of synaptic transmission. The ‘LTP‐like’ facilitation appears to result from activation of presynaptic nicotinic ACh receptors (and Ca2+ channels as well) by nefiracetam. In conclusion, nefiracetam is distinguished from other nootropic agents for its preferential actions on both presynaptic Ca2+ channels and nicotinic ACh receptors, and could therefore be of great therapeutic importance to the neurotransmission failure that contributes to the symptoms of Alzheimer's disease and associated disorders.
ORIGINAL ARTICLE: Inter‐peak Latency of Auditory Event‐related Potentials (P300) in Cases of Aged Schizophrenia and Alzheimer‐type Dementia
Authors: Sumi Noriaki , Harada Kazuyoshi , Fujimoto Osamu , Taguchi Satoki , Ohta Yoshitaka , Nan‐no Hisashige , Hanatani Takashi , Takeda Masatoshi
Published: August 2007

Background: Both patients with schizophrenia and those with dementia show cognitive difficulties, and in many cases of schizophrenia the cognitive disturbance is progressive, as it is in dementia. Event‐related potentials have revealed cognitive impairments in patients with schizophrenia and dementia, but most studies of event‐related potentials in cases of psychiatric illness or dementia have focused on the single peak latency of the event‐related potential components. In the present study, we investigated the cognitive function in elderly patients with schizophrenia and Alzheimer‐type dementia (AID) using auditory event‐related potentials (P300).

Methods: P300 was recorded using the tone discrimination task and peak latencies for N1, P2, N2 and P3 at the Pz electrode site were measured. In addition to analyzing peak latencies of P300, we also analyzed inter‐peak latencies (IPL; N1‐P2, P2‐N2, and N2‐P3). Twenty‐two elderly residual‐type schizophrenics and 36 patients with AID were compared with 39 age‐matched healthy volunteers.

Results: The mean latencies of P3 and mean IPL of P2‐N2 in elderly schizophrenic patients were longer than those of the controls. In ATD the mean latencies of N2 and P3 and the mean IPL of P2‐N2 were longer than those of the controls. When the mean latencies of ATD patients were compared with those in patients with schizophrenia, P2, N2, and P3 latencies and N1‐P2 and P2‐N2 IPL were longer.

Conclusion: These findings suggest that a similar impairment of the cognitive process is found in elderly patients with schizophrenia and those with ATD and that the degree of the impairment of patients with ATD is more severe than that of elderly patients with schizophrenia.
Exploring the Role of the Right Temporal Lobe in Person‐specific Knowledge: A Case Study of Semantic Dementia Associated with Right Temporal Lobe Atrophy
Authors: Nakaaki Shutaro , Sato Junko , Nakamura Hikaru , Yoshida Shinichi , Furuhashi Kyoko , Furukawa Toshiaki , Takabayashi Isao
Published: August 2007

Abstract: The role of the right temporal lobe in person‐specific knowledge is not yet fully understood. We report here the case of a 66‐year old, right‐handed woman with severe right temporal lobe atrophy, who was diagnosed as having semantic dementia according to established criteria. While she had difficulty in identifying faces of famous people, family members, such as her daughter, were relatively well recognized. Brain MRI revealed asymmetrical lateral temporal lobe atrophy, involving the pole and the inferior and middle temporal gyri on the right side. We examined her knowledge of personal acquaintances and famous people using detailed autobiographical memory and famous events‐people tests. While she had lost almost all knowledge of personal acquaintances (e.g., old friends) and famous people of her past, she was able to identify personal acquaintances (e.g., grandchildren) from her recent life, not only by name, but also by face. However, famous people in recent memory could be recognized only by name, but not by face. These results suggest that knowledge regarding personal acquaintances in recent memory is supported by greater exposure, relative to that of famous persons and personal acquaintances in her past life, and the preservation of episodic memory. The right temporal lobe may play an important role in the storage of knowledge about people in past memory and accessing faces of famous people in recent memory.
Electroconvulsive Therapy: Issues in the Elderly
Authors: Das Arunava , Chiu Edmond
Published: August 2007

Abstract: The elderly psychiatrically ill constitute a high proportion of the patients who receive electroconvulsive therapy (ECT). There is evidence to say that the efficacy of ECT may be enhanced in the elderly. Clinical and biological markers are increasingly being recognised as predictors of outcome to ECT.

The doses of anticholinergic, anaesthetic and relaxant agents may need to be modified in accordance with physiological changes associated with aging. ECT stimulus and ECT technique should be selected against the background of increased seizure threshold and possibility of greater ECT‐induced cognitive dysfunction in the elderly, particularly those with pre‐existing cognitive or neurologic impairment.

New brain‐imaging techniques and biochemical measures of brain damage have proved that ECT does not cause brain damage. The physical risk with ECT is considered to be low. There is some evidence to say that cardiovascular complications reported with ECT are related to the nature of pre‐existing cardiac disease.

Although the short‐term response to ECT in the elderly is quite good, post‐ECT relapse rates are quite high. Continuation‐maintenance ECT has a definite role in minimising relapses and recurrences in the elderly, taking care not to enhance physical and cognitive risks. With increasing administration of outpatient ECT, it is important to refine methods for monitoring patients for adverse effects of treatment.

The roles of repetitive trans‐cranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS) in geriatric psychiatry are yet to be established.
Analysis of Clinical and Neuroimaging Course of Four Patients with Left Side Dominant Fronto‐temporal Lobar Atrophy
Authors: Katsuragi Toshio , Saito Atsushi , Iizuka Hiroshi , Iseki Eizo , Amano Naoji , Kosaka Kenji
Published: August 2007

Background: Patients with left side dominant fronto‐temporal lobar atrophy, as an example of primary progressive aphasia (PPA), are occasionally recognized. The concept of PPA is based on symptomatology. The aim of the present study was to investigate the clinical course and follow‐up neuroimaging in patients with left side dominant atrophy, especially, during the incipient stage.

Methods: The subjects consist of four right‐handed patients showing left side dominant fronto‐temporal lobar atrophy on brain computed tomography or magnetic resonance imaging. They were analyzed using changes in clinical symptoms, electroencephalopathy (EEG), and neuroimaging course within a few years of diagnosis.

Results: Three of four patients had symptoms of PPA incipiently. The neuroimaging of three patients revealed a reduction in the asymmetrical anterior temporal gyri including the hippocampus on the left and progressed to bilateral fronto‐temporal lobar atrophy within a few years.

Conclusion: One patient was clinically diagnosed as having Pick's disease, and three patients had probable Alzheimer's disease (AD), based on the clinical course and the findings of EEG and brain neuroimaging including single photon emission computed tomography (SPECT). These results suggest the possibilities that the patients with PPA may eventually develop AD. Moreover we confirmed that patients with left side dominant atrophy may generally progress to bilateral fronto‐temporal lobar atrophy within a few years.
The Effect of Poststroke Depression on Recovery from Stroke
Authors: Tateno Amane , Robinson Robert G.
Published: August 2007

Background: Stroke is a major health problem and poststroke depression is known to be one of the frequent and severe psychiatric complications following stroke.

Methods: Based on the results of structured psychiatric mental state exams and DSM diagnostic criteria, the prevalence of poststroke depression has been examined in numerous study populations throughout the world. Longitudinal examinations have documented the effect of poststroke depression on recovery from stroke.

Results: The mean prevalence of poststroke major depression was 21.1 % and minor depression was 17.1% among hospitalized or outpatient samples. Community samples showed a slightly lower rate of 14.1% and 9.1%, respectively. Furthermore, the existence of poststroke depression leads to poorer physical recovery, greater cognitive impairment, and worse recovery in activities of daily living compared with non‐depressed patients. Several studies have also found that poststroke depression is associated with increased mortality compared with non‐depressed patients who had comparable strokes and similar premorbid risk factors. Finally, several studies have found that successful treatment of poststroke depression improves both cognitive and physical recovery and decreases mortality.

Conclusion: The current review documents the beneficial effect of identifying and treating poststroke depression on both recovery and survival following stroke.