bluuebunny/crossref_metadata_2025 huggingface dataset:
Measurement of glomerular filtration rate in renal transplant recipients: A comparison of methods
Authors: MOURAD ADNAN , CARNEY SHANE , GILLIES ALASTAIR , HIBBERD ADRIAN , TREVILLIAN PAUL , NANRA RANJIT
Published: March 2003

SUMMARY: While single injection radionuclide and radio‐contrast glomerular filtration rate (GFR) clearance methods are widely used, the relative accuracy of single versus multiple sample techniques continues to be debated. In addition, GFR calculated from the serum creatinine concentration is considered by some to produce results comparable to clearance methods. In this study, 109 patients with stable renal transplant fraction were prospectively evaluated by yearly 51Cr EDTA clearance as well as by three published formulae used to predict GFR from serum creatinine. Analysis of 362 measurements demonstrated a highly significant correlation between multiple and single point clearance results, as well as the serum creatinine nomograms using least squares regression analysis (P<0.001). the mean GFR was, however, significantly higher using the Cockcroft and Gault formula; 64 ± 18 compared with 47 ± 14 and 50 ± 14 with other serum creatinine formulae, and 46 ± 21–50 ± 17mL/min per 1.73m2 with the three 51Cr EDTA methods (P<0.01). However, further statistical analysis using more appropriate methods, including an analysis of difference and least product regression analysis did not support any of the methods tested as reliable alternatives to multiple sample 51Cr EDTA clearance, because both fixed and proportional bias was noted. In a subgroup of 29 patients evaluated yearly over the 7‐year study period, serum creatinine derivations all demonstrated a greater year to year mean fluctuation compared with clearance methods. It is oncluded that while each GFR method has similarities, they are not interchangeable. Until clearance methods and serum creatinine formulae are directly compared with inulin clearance with the use of appropriate statistical evaluation, it is recommended that the Chantler 3 sample 51Cr EDTA method be the method of choice in clinical laboratories.
Effects of fluid intake on urinary protein excretion and haematuria during and after a 25‐km march
Authors: KRÄMER Bernhard K , MÜLLER Reinhold , KAMMERL Martin C , BARNER Caroline , STUBANUS Mike , LACKNER Karl J , FISCHEREDER Michael
Published: March 2003

SUMMARY: The purpose of this study was to investigate the effect of high fluid intake for the prevention of march‐induced proteinuria and haematuria. Thirty‐six male soldiers participated in two 25 km marches in a comfortable environment (outside temperature 13°C, cloudy weather), achieving a moderate average marching time of 3.5 h. Fluid intake during march 1 was not restricted (= habitual intake), whereas during march 2, the participants were asked to achieve a fluid intake of 1 L before and 2 L during the march. Urinary excretion of protein and albumin, haematuria, and various serum parameters were assessed before, during and after both marches. Unexpectedly, urinary albumin and protein excretion was higher during march 2 (with a high fluid intake), whereas haematuria was unaffected. the haemoconcentration, as judged from haemoglobin levels, was more intense in group 1 (with usual fluid intake) in accordance with the higher decrease of bodyweight during the march, and probably accounted for most of the serum creatinine concentration increases observed. A standardized (high) fluid intake of 2.5 L before and during a moderate exercise failed to confer any prevention against mild exercise‐induced renal abnormalities.
Predicting vascular access failure: A collective review
Authors: POLKINGHORNE Kevan R , KERR Peter G
Published: March 2003

SUMMARY: The maintenance of vascular access for haemodialysis contributes a large burden of morbidity and cost to any dialysis unit. Identifying vascular access at risk of thrombosis is an evolving and important aspect to the management of any haemodialysis patient. Haemodynamic profiles of native fistulas and arteriovenous grafts differ significantly, and, as such, the sensitivity of the specific monitoring techniques to detect dysfunction varies depending on access type. Multiple strategies are now available for monitoring vascular access including measuring intra‐access pressure and access blood flow, or screening for significant stenoses with Doppler ultrasonography. the ability of each strategy to detect significant stenosis is reviewed by looking at the evidence for both arteriovenous fistula (AVF) and arteriovenous grafts (AVG), separately. the majority of published literature involves AVG, and measuring access blood flow is the modality of choice. the best method for measuring flow is not known. For AVF, much less is known, and it is not clear whether monitoring will decrease the thrombosis risk and prolong access life. Recommendations for AVF cannot be made until more evidence becomes available.
Caring through a reflective lens: giving meaning to being a reflective practitioner
Authors: Parker Judith , Johns Christopher
Published: March 2003

Who is a reflective practitioner? It is assumed that a reflective practitioner is someone who views and responds to practice through an appropriate reflective lens. The present paper is a reflective account that gives meaning to being a reflective practitioner within everyday practice whereby the reflective lens is structured through the Burford Nursing Development Unit (NDU) Model: Caring in Practice.
Ethics and nursing research: meeting the needs of indigenous peoples
Authors: Parker Judith , Williams Leonie Mosel
Published: March 2003

Identifying an appropriate ethical approach to guide research with historically exploited peoples, indigenous or disadvantaged, places the nurse researcher in an unenviable position. Conventional ethical procedures may be appropriate for the predominant society and academia; however, these have the potential to further disable the aspirations and integrity of those who are the focus of the research. The present paper examines a number of ethical guidelines designed by and in collaboration with Australia's indigenous peoples. The guidelines of the National Health and Medical Research Council (1991) are used as the benchmark for the discussion as these are the most frequently referred to and used in the approval of nursing and health research. The concepts and approaches discussed may be considered in other contexts where nursing research is conducted with or about historically disadvantaged peoples.
Student experiences of nursing health promotion practice in hospital settings
Authors: Hills Marcia
Published: March 2003

It has become evident that the current approaches to health care are inadequate for the changing needs of the world. Health promotion has gained recognition as a preferred option and many nursing programmes throughout the world have reoriented their curricula to incorporate this approach. This paper describes a study that was conducted to explicate student experiences of the practice of health promotion. Twenty‐four students participated in the study; qualitative methods, narrative accounts and reflective journals were used to collect the data and the data was analysed using van Manen's recommendations for thematic analysis. Three major themes emerged: the centrality of caring; empowerment—power, participation and partnerships; and the primacy of people. Student narratives are used to illustrate the themes.
Nursing on paper: therapeutic letters in nursing practice
Authors: Moules Nancy J.
Published: March 2003

Nursing on paper: therapeutic letters in nursing practice

This paper offers a selected piece of interpretive research extracted from the context of a larger research study. The hermeneutic research inquiry described in this paper involved the examination of the nursing and family therapy intervention of therapeutic letters. It incorporated the textual interpretation of 11 therapeutic letters, clinical sessions with three families, clinical team discussions, and research interviews with four family members and three nurse clinicians who participated in the writing of the letters. This particular paper extracts segments of the research related to the letters received by two participants, as well as some general findings, with a focus on the possibilities and influences of therapeutic letters in nursing practice. The findings of this research offer suggestions, not as a template, but as an inspiration and evocation to write therapeutic letters that address the obligation of meeting people experiencing illness at the point of their suffering, with words and questions that invite relationship, reflection, and are large enough to sustain a meeting.
The art of loving and the therapeutic relationship
Authors: Stickley Theodore , Freshwater Dawn
Published: March 2003

Contemporary developments in nursing and health‐care, which emphasise evidence‐based and outcome‐oriented practice often fail to recognise the centrality of the caring relationship in everyday practice. This paper aims to examine the therapeutic role of the nurse within the context of an increasingly technicalized and bureaucratic healthcare system. Focusing on the importance of love and its healing potential, we intend to raise awareness of some difficult and often polemic arguments pertaining to the concept of clinical caritas. We return to the fundamental question: why do people enter nursing? In doing so we explore the concept of caring utilising theoretical and experiential examples to illustrate ways in which healthcare systems can both drain and nurture the practitioners’ capacity to care. A framework for developing the art of loving within nursing care is presented, which emphasises the balance between discipline, concentration, patience, concern and activity. We conclude by outlining the boundaries in which genuine love may be expressed within the parameters of a professional role.
Widespread expression of Fos protein induced by acute haloperidol administration in the rat brain
Authors: Suzuki Michio , Sun Yue‐Ji , Murata Masahiko , Kurachi Masayoshi
Published: March 2003

The effect of acute haloperidol administration on Fos protein expression was examined immunohistochemically in discrete regions of the rat brain. Male Wistar rats were injected subcutaneously (s.c.) with 0.1, 0.25, or 1.0 mg/kg of haloperidol. Two h after the injection, the rats were perfused, and the numbers of Fos immunoreactive neurons were counted in 24 brain regions. In contrast to the limited changes in Fos immunoreactivity at the low dose of haloperidol (0.1 mg/kg), the moderate dose (0.25 mg/kg) induced widespread increases in Fos‐positive neurons in the rat brain. Large increases were produced in the caudate‐putamen, nucleus accumbens, central amygdaloid nucleus, dorsomedial hypothalamic nucleus, hippocampus CA1 and substantia nigra pars compacta. Moderate increases were observed in the entorhinal cortex, lateral septum, lateral habenula, lateral amygdaloid nucleus, dentate gyrus, and mesencephalic central grey. Mild increases were induced in the anterior cingulate, temporal, occipital and perirhinal cortex, and central medial thalamic nucleus. The distribution of changes in Fos immunoreactivity at the high dose of haloperidol (1.0 mg/kg) were comparable to their distribution at the moderate dose. These findings indicate that the effect of acute haloperidol on Fos expression is widely distributed in the rat brain beyond the previously known dopamine‐rich areas at the dose which produces plasma levels equivalent to those within the therapeutic range used clinically in humans. Further studies on the effects of chronic antipsychotic treatment are needed in order to identify the sites of the therapeutic action of antipsychotic drugs.
Anticonvulsant effects of dipotassium clorazepate on hippocampal kindled seizures in rats
Authors: Amano Kouichiro , Takamatu Junichi , Kaneyama Hisakazu , Chihirommazaki  , Deshimaru Motonori , Sumiyoshi Shiro , Ogata Akira , Miyakawa Taihei
Published: March 2003

We examined the anticonvulsant properties of dipotassium clorazepate (DC) against hippocampal kindled seizures in rats. Adult male Wistar rats were subjected to kindling 1 week after the implantation of electrodes. After five stage 5 seizures were induced, the generalized convulsion triggering threshold (GST) was determined. Dipotassium clorazepate was administered intraperitoneally in rats that showed two stable stage 5 seizures induced at the GST current intensity. Dipotassium clorazepate at doses of 1 mg/kg or more produced an anticonvulsant effect, but did not readily suppress limbic seizures. Dipotassium clorazepate did not completely suppress after‐discharges (AD) even at the highest dose, which was 5 mg/kg. Moreover, raised stimulus intensity failed to affect its efficacy as an anticonvulsant. The results of the present study suggest that DC has a modest anticonvulsant potency. It is reasonable to assume that its anticonvulsant efficacy is primarily due to attenuation of AD propagation rather than the raising of the seizure triggering threshold at the kindling focus.
Psychological trauma and longitudinal course of psychiatric problems among evacuees of a volcanic eruption
Authors: OHTA YASUYUKI , ARAKI KEN‐ICHI , KAWASAKI NAOMI , NAKANE YOSHIBUMI , HONDA SUMIHISA , MINE MARIKO
Published: March 2003

The percentage of evacuees showing a high score (≥8), the mean General Health Questionnaire (GHQ) scores and the scores of the five subscales derived from the GHQ‐30 in evacuees of the Mt Unzen volcanic eruptions were obtained at three intervals, 6 months, 12 months and 24 months after evacuation. The percentage of evacuees showing a high score as well as mean GHQ scores had significantly improved by the second investigation, and this trend was continued at the third investigation. However, at the third investigation the percentage of evacuees with a high score was 57.3%, and the mean GHQ score was still 11.21, representing extremely high values. Factor 1 (Anxiety, Tension, Insomnia) was significantly improved in both males and females at the second investigation. A difference by sex was seen in Factor 2 (Anergia, Social Dysfunction), which had improved significantly in females, whereas no improvement was seen in males. There were no remarkable changes in Factor 3 (Depression) or Factor 4 (Anhedonia), but Factor 5 (Interpersonal Dysfunction) had significantly worsened in both males and females over the course of time. It is suggested that these results are due to the disruption of community functions and weakened community consciousness induced by prolonged evacuation to a temporary dwelling despite escaping from a potentially fatal situation.
Childhood sexual abuse and dissociation in Japan: A clinical overview from an outpatient clinic standpoint
Authors: SAITO SATORU
Published: March 2003

Having a history of sexual abuse in one's childhood is not an exceptional case in Japanese society. In the present paper we describe a recent case of child sexual abuse actually treated by our clinic.
Posttraumatic symptoms among victims of the Great Hanshin–Awaji Earthquake in Japan
Authors: KATO HIROSHI
Published: March 2003

Two comparative studies conducted in the early and reconstruction stages following the 1995 Hanshin–Awaji earthquake in Japan are presented. In the first study, posttraumatic symptoms among younger evacuees (<60 years) were compared with the symptoms among the elderly evacuees (≥ 60 years) in the same shelter. In the first study, though most of the symptoms remained unchanged among the younger subjects from the time of the third‐week assessment to that of the eighth week, the symptoms improved among the elderly subjects. In the second study, the psychological effects of those who were living in temporary housing and those who were not were compared during the reconstruction stage. That study demonstrated that the temporary housing residents had high exposure to the traumatic event, poor socioeconomic status, and various secondary stressors. The result of these factors is that they have a higher chance of facing various types of mental health problems. By examining the data obtained from these studies, the characteristics of psychological distress and coping among survivors at the different stages after the earthquake, and matters of future concern relating to the kind of mental health care required at each stage, are discussed.
Bright light treatment for sleep–wake disturbances in aged individuals with dementia
Authors: Koyama Emi , Matsubara Hozumi , Nakano Toshio
Published: March 2003

Treatment using bright light exposure was carried out on six aged subjects with dementia in two nursing homes. Sleep logs were recorded by the staff. Bright light treatment was applied in the late morning every day. The %sleep in the lights‐out period and/or the %wake in daytime increased in three subjects. In the other three subjects, sleep onset time was advanced. In all subjects abnormal behavior episodes around the lights‐out time tended to be reduced. These results suggest that bright light treatment is effective in improving the sleep–wake disturbances of aged individuals with dementia.
Double‐blind test on the efficacy of methylcobalamin on sleep–wake rhythm disorders
Authors: Takahashi K. , Okawa M. , Matsumoto M. , Mishima K. , Yamadera H. , Sasaki M. , Ishizuka Y. , Yamada K. , Higuchi T. , Okamoto N. , Furuta H. , Nakagawa H. , Ohta T. , Kuroda K. , Sugita Y. , Inoue Y. , Uchimura N. , Nagayama H. , Miike T. , Kamei K.
Published: March 2003

The therapeutic effect of methylcobalamin (Met‐12) on sleep–wake rhythm disorders was examined in a double‐blind test. In the test group which was given a large dosage, a higher percentage of improvement was found compared to the control group with a small dosage, although the difference was not significant. The test group inconsistently showed significant improvement in both the sleep–wake cycle parameters and in clinical symptoms. The tendency was for the results to show a beneficial effect of Met‐12 on rhythm disorders. However, because the percentage of improvement was low and significant improvement was inconsistent, Met‐12 might be considered to have a low therapeutic potency and possible use as a booster for other treatment methods of the disorders.
Symptom structure and psychiatric comorbidity of combat‐related post‐traumatic stress disorder
Authors: Vukšíc‐Mihaljevíc Željka , Mandíc Nikola , Mihaljevíc Silvio , Ivandíc Ante
Published: March 2003

The placement of the diagnostic category of post‐traumatic stress disorder (PTSD) among anxiety disorders reflects the recognition that anxiety is a predominant reaction to trauma. Indeed, the symptoms of PTSD overlap considerably with those of other anxiety disorders. The nosological criteria render PTSD as quite a heterogeneous diagnosis. Two individuals with no common symptoms can be diagnosed as having PTSD. In this report we provide information on the phenomenology and psychiatric comorbidity in a sample of 33 patients with combat‐related PTSD. The finding of clinical heterogeneity in subjects with combat‐related PTSD and the therapy implications are discussed.
Temporal order of sleepiness, performance and physiological indices during 19‐h sleep deprivation
Authors: Nakano Toshio , Araki Kazunori , Michimori Akihiro , Inbe Hiroyuki , Hagiwara Hiroshi , Koyama Emi
Published: March 2003

Nineteen‐hour variation of subjective sleepiness, performance and physiological indices were assessed during sleep deprivation. Longitudinal data of each index had its characteristic curve through which the values changed from day level to night level. A comparison of the time when each curve crossed its mid‐range (50% value of its range) showed that those of subjective sleepiness and heart rate were significantly earlier than those of tracking error and coefficient of variation of R‐R interval (CVR‐R), P < 0.01. That of rectal temperature was located at between 1:00 and 4:00 am. These temporal relationships were reproducible under two lighting conditions. These results will be useful in considering the occurrence of human errors by night‐time workers in the early morning.
Effects of daytime activity on nocturnal sleep in the elderly
Authors: Shirota Ai , Tamaki Munehisa , Hayashi Mitsuo , Hori Tadao
Published: March 2003

This study investigates the relationship between the level of daytime activities and nocturnal sleep in the elderly using the wrist actigraph and ambulatory polysomnograph system. Five male and five female subjects (mean age = 73.8 ± 3.05 years; range 69–77 years) participated in this study. The level of daytime activity was positively correlated with the sleep efficiency of the subsequent night only for male subjects, who were shown to be less active during the daytime. The results imply that increments in the time spent on physical activities may improve the quality of nocturnal sleep in elderly male subjects.
Localization of a novel type trypsin‐like serine protease, neurosin, in brain tissues of Alzheimer's disease and Parkinson's disease
Authors: Ogawa Kenichi , Yamada Tatsuo , Tsujioka Yasumi , Taguchi Junichi , Takahashi Mitsuo , Tsuboi Yoshio , Fujino Yasuhiro , Nakajima Masashi , Yamamoto Takashi , Akatsu Hiroyasu , Mitsui Sinichi , Yamaguchi Nozomi
Published: March 2003

Abstract Neurosin, a novel type of trypsin‐like serine protease, has been shown to be preferentially expressed in human brain by northern blotting. We examined neurosin immunolabeling in the brains of neurologically normal persons and patients with Alzheimer's disease (AD) and with Parkinson's disease. We also identified the expression of the mRNA for neurosin by in situ hybridization histochemistry and reverse transcription–polymerase chain reaction (RT‐PCR). The neurosin antibody stained all of the nuclei of various cell types. In neurons, there was also staining of neuronal cytoplasm, nucleoli and their processes. In AD, staining of neurons with processes was rare in the damaged areas. Some senile plaques, extracellular tangles and Lewy bodies were also positive for neurosin. Expression of the mRNA for neurosin was seen in neurons in the gray matter, and in microglial cells in the white matter. In AD, the intensity of the signal for neurosin mRNA in the gray matter was decreased compared with normal control brains. The relative levels of neurosin mRNA in AD brains, measured by RT‐PCR, were lower than those in controls. These results suggest that in human brain neurosin plays various physiological roles, and that in AD this molecule, like other serine proteases, may have a role in the degradation of such substances as β‐amyloid protein.
Effectiveness of the Kampo kami‐shoyo‐san (TJ‐24) for tremor of antipsychotic‐induced parkinsonism
Authors: Ishikawa Toshihiro , Funahashi Tatsuhide , Kudo Junichiro
Published: March 2003

Abstract The aim of the present study was to evaluate the effectiveness of the Kampo medication kami‐shoyo‐san against tremor due to antipsychotic‐induced parkinsonism. Kami‐shoyo‐san consists of several medicinal herbs that are known in traditional Chinese medicine to be effective in treating Parkinson's disease and convulsions. We gave kami‐shoyo‐san to eight patients at Higashiowari National Hospital who were exhibiting tremor, a symptom of antipsychotic‐induced parkinsonism. The tremor was evaluated on a five‐point scale before and after the administration of kami‐shoyo‐san, and the findings were compared statistically. The results showed a stastistically significant reduction in the tremor after the administration of kami‐shoyo‐san (P < 0.01), with 62.5% of patients showing an improvement of one point or more. The tremor did not worsen in any of the patients, and none complained of side‐effects. Thus, kami‐shoyo‐san appears to be effective against the tremor from parkinsonism. Kami‐shoyo‐san consists of 10 medicinal herbs, including Radix Bulpleuri, Radix Paeoniae, Radix Angelicae Sinensis, and Radix Glycyrrhizae, which are effective in treating disturbances in muscular movement according to TCM theory. Of the 10 herbs contained in kami‐shoyo‐san, we believe the abovementioned ones are particularly effective in helping to reduce the tremor associated with parkinsonism.
Quantitative single photon emission tomography analysis for the diagnosis of transient global amnesia: Adaptation of statistical parametric mapping
Authors: Asada Takashi , Matsuda Hiroshi , Morooka Tomoyuki , Nakano Seigo , Kimura Michihiro , Uno Masatake
Published: March 2003

Abstract We report two cases of transient global amnesia (TGA) diagnosed using a clinical criteria and single photon emission tomography (SPECT) with the aid of Statistical Parametric Mapping (SPM). Both patients underwent an initial SPECT study about 20 h after the disappearance of the amnesic episode, and a second study 3 weeks after the episode. We conducted quantitative cerebral blood flow (CBF) analyses using SPM on Matlab. This revealed regions with abnormal CBF in the first studies but not in the second. This method appears to be useful for diagnosis of TGA, especially in patients with suspected TGA in whom the amnesic episode disappears within a few days.
Early sexual abuse and low cortisol
Authors: King Jean A. , Mandansky Deborah , King Susie , Fletcher Kennethe E. , Brewer Judith
Published: March 2003

Abstract Post‐traumatic stress disorder (PTSD) is a mental health disorder precipitated by a stressful event that produces fear or terror in the individual. Post‐traumatic stress disorder studies, particularly in early sexual abuse, have been associated with neuroendocrine dysfunction, most notably the hypothalamic–pituitary–adrenal (HPA) axis. Since the literature on PTSD and neuroendocrine factors in young subjects has been sparse, the present studies were designed to look at the basal functioning of the HPA axis in response to early sexual abuse in girls aged 5 to 7 years. Morning salivary samples were collected for cortisol determination from subjects and controls who were scheduled for a physical exam by their pediatrician. The present study shows that subjects who had been abused within the last couple of months had significantly lower cortisol in comparison to control subjects (age, social economic status and race matched). The data suggest that children may have an impaired HPA axis after early trauma.
Age‐related changes of sleeping pattern during adolescence
Authors: Fukuda Kazuhiko , Ishihara Kaneyoshi
Published: March 2003

A questionnaire concerning sleep‐related lifestyle, and physical and mental health was administered to the students of junior high schools (12–15 years), high schools (15–18 years), and universities. While bedtime linearly delayed with age throughout the adolescence (from junior high school to university age), rise time remained constant until high school ages. As a result, total nocturnal sleep time considerably decreased during this period. Rise time then delayed with age in the university sample. Daytime sleepiness increased with age peaking at high school age, then decreased gradually during university age. Several physical and mental health conditions got worse during high school and university ages. Compared with the adolescent samples, daytime sleepiness and mental health complaints were very low in the adult samples.
The Chinese version of the Davidson Trauma Scale: A practice test for validation
Authors: Chen Chin‐Hung , Lin Shih‐Ku , Tang Hwa‐Sheng , Shen Winston W. , Lu Mong‐Liang
Published: March 2003

Abstract The Chinese version of the Davidson Trauma Scale (DTS‐C) was developed to respond to the need of Chinese‐speaking individuals. The DTS is a validated self‐rating scale used in the diagnosis of posttraumatic stress disorder (PTSD). The DTS‐C is translated from DTS through a two‐stage translation. Subjects were drawn from a sample of 210 survivors of the 21 September 1999, Chi‐Chi Earthquake. The scale showed good internal consistency (Cronbach's α = 0.97) and test–retest reliability (r = 0.88). Concurrent validity was obtained against the clinical diagnostic interview, with a diagnostic accuracy of 0.85 at DTS‐C score of 44. It showed that the sensitivity was 0.9, specificity 0.81, positive likelihood ratio 4.74, and negative likelihood ratio 0.12. The recommended stratum‐specific likelihood ratios were 0.10 (95% CI: 0.05–0.20) for the score range 0–39, 4 (2.22–7.23) for the score range of 40–59, and 6.14 (3.42–11.02) for the scores above 60. In PTSD diagnosed subjects, the factor structures closely resembled the DSM‐IV grouping of PTSD symptoms. The psychometric strength of DTS‐C is reliable for its future use, particularly for screening for subjects with possible diagnosis of PTSD.
Report on IL‐10 gene polymorphism at position –819 for major depression and schizophrenia in Korean population
Authors: Jun Tae‐Youn , Pae Chi‐Un , Chae Jeong‐Ho , Bahk Won‐Myong , Kim Kwang‐Soo , Han Hoon
Published: March 2003

Abstract The present study was carried out to examine the relationship of interleukin (IL)‐10 gene polymorphism at position –819 for major depression and schizophrenia in the Korean population. DNA was extracted from 92 Korean patients with major depression, 141 Korean patients with schizophrenia, and 146 ethnically matched controls. DNA was amplified by a polymerase chain reaction‐based method and digested by MaeIII, and the restriction fragment length polymorphism of two alleles, IL‐10*C and IL‐10*T, were assessed. There were no significant differences in genotype frequencies of IL‐10*T/T, IL‐10*T/C, and IL‐10*C/C as well as allelic frequencies of IL‐10*T and IL‐10*C between patients with major depression and controls in the Korean population. Comparison of genotype and allelic frequencies of IL‐10 gene between patients with schizophrenia and controls were also not significant. The present study suggests that IL‐10 gene polymorphism at position –819 does not confer susceptibility to major depression and schizophrenia, at least in the Korean population. Further systematic studies including various clinical variables would be required.
An examination of sleep health, lifestyle and mental health in junior high school students
Authors: TANAKA HIDEKI , TAIRA KAZUHIKO , ARAKAWA MASASHI , MASUDA ATUSHI , YAMAMOTO YUKARI , KOMODA YOKO , KADEGARU HATHUKO , SHIRAKAWA SHUICHIRO
Published: March 2003

Abstract The factors that influence sleep health and mental health in junior high school students’ lifestyles was examined. The proportion of students who replied that they feel bad in the morning, and who do not have breakfast was significantly higher in poor sleepers. The proportion of students who regularly take exercise was significantly lower among poor sleepers. Compared with good sleepers, poor sleepers had a higher number of illnesses and their General Health Questionnaire score was worse. The study’s results suggest that sleep health is closely related to both physical and mental health, and that habits such as exercise, and regular sleeping and eating, are important for maintaining and improving students’ sleep health.
Interhemispheric differences of the correlation dimension in a human sleep electroencephalogram
Authors: KOBAYASHI TOSHIO , MADOKORO SHIGEKI , MISAKI KIWAMU , MURAYAMA JYUNICHI , NAKAGAWA HIROKI , WADA YUJI
Published: March 2003

Abstract The interhemispheric differences of the correlation dimension (D2) in
the sleep electroencephalogram (EEG) of eight healthy right‐handed students was investigated.
During slow wave sleep (SWS) the D2 of the central EEG and the temporal
left hemisphere (LH) EEG were significantly higher than those in the right hemisphere
(RH) EEG; but during rapid eye movement (REM) sleep, the D2 of the central
EEG and the occipital RH EEG were significantly higher. The D2 of EEG in the left temporal site during REM sleep were significantly higher than in the right during the first and third sleep cycles, but these were significantly lower during the fourth and fifth sleep cycles. During REM sleep, temporal brain activity may shift from the LH to the RH as morning approaches.
Supporting by a nurse teacher in a school infirmary using collage therapy
Authors: TAKATA YURIKO
Published: March 2003

Abstract The objective of this study is to verify the effects of collage therapy when applied in the school infirmary, without time restriction, to children with problems such as school refusal. Collage therapy was used with two students who refused to attend school for a period of 1 year and 2 months to 1 year and 7 months. The results showed that both cases were successful in recovering self‐insight and starting to pursue a course leading to the establishment of their identity. For students with various mental health problems, the school, as a community of school friends of the same generation, has been suggested to be one of the most important places for the recovery of energy. The performance in the school infirmary of collage therapy without any time restraints makes use of this environment, and appears to foster self‐insight and self‐understanding, and hence promote recovery from mental health problems.
Behavioral and developmental disorders among conduct disorder
Authors: HARADA YUZURU , SATOH YURI , SAKUMA AYAKO , IMAI JUNKO , TAMARU TUNEMI , TAKAHASHI TOHRU , AMANO NAOJI
Published: March 2003

The purpose of the present study was to clarify the percentage of children with conduct disorder (CD) who also have behavioral and developmental disorders. A survey of comorbidity observed in children with CD, was carried out on 33 subjects from a disciplinary facility for children. Female teachers as the mother were interviewed as regards the subjects’ condition using the semistructured interview, and male teachers as the father were interviewed for their psychosocial problems. The subjects underwent the Wechsler Intelligence Scale for Children (WISC)‐III and their conditions were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM‐IV). Of the 33 children, 27 were diagnosed as having CD. Of the 27 CD children, 18 (67%) were diagnosed as having attention deficit hyperactivity disorder (ADHD), and 19 (70%) had oppositional defiant feature (ODF). Eight children (30%) were diagnosed as having mental retardation and in seven children (26%), the verbal IQ was significantly lower than the performance IQ. Two (7%) were diagnosed as having pervasive developmental disorders (PDD). Of 27 children diagnosed with CD, 23 (85%) had some behavioral and developmental disorders. The classification of these behavioral and developmental disorders into the following three types appeared to be clinically useful: type 1, ADHD and ODF; type 2, low intelligence, especially low verbal intelligence; and type 3, PDD. To understand and treat children with CD, the accurate diagnosis of these underlying behavioral and developmental disorders is indispensable.
Childhood Autism Rating Scale − Tokyo Version for screening pervasive developmental disorders
Authors: Tachimori Hisateru , Osada Hirokazu , Kurita Hiroshi
Published: March 2003

Abstract To assess the utility of the Childhood Autism Rating Scale − Tokyo Version (CARS‐TV), its total score was compared among 430 children with DSM‐IV per subgroup (i.e. autistic disorder (AD), childhood disintegrative disorder (CDD), Asperger's disorder, and pervasive developmental disorders (PDD) not otherwise specified (PDDNOS)). Values of Cronbach's alpha were 0.91 for the PDD group and 0.89 for the non‐PDD mental retardation (MR) group, and 0.93 for both groups combined. The total score was significantly higher in PDD (mean = 30.1, SD = 4.5) than in non‐PDD MR (mean = 22.9, SD = 3.3), t(503) = 13.7, P< 0.0001. The cut‐off to distinguish PDD from non‐PDD MR was 25.5/26, with sensitivity, specificity, positive predictive value and negative predictive value of 0.86, 0.83, 0.97 and 0.50, respectively. The total score differed significantly among the four groups, with CDD and AD being significantly higher than both PDDNOS and Asperger's disorder, PDDNOS being significantly higher than Asperger's disorder and no significant difference between CDD and AD. The cut‐off to distinguish AD from PDDNOS was 30/30.5, with sensitivity, specificity, positive predictive value and negative predictive value of 0.71, 0.75, 0.77 and 0.69, respectively. CARS‐TV seems to be a useful instrument for differentiating between PDD and non‐PDD MR and between AD and PDDNOS, although further replication is needed.
Malignant peripheral nerve sheath tumor with perineurial cell differentiation (malignant perineurioma)
Authors: Zámečník Michal , Michal Michal
Published: March 2003

A unique case of malignant peripheral nerve sheath tumor (MPNST) with perineurial cell differentiation occurring in a 63‐year‐old woman in a subcutis of the forearm is described. The tumor contained cellular and myxoid areas. The neoplastic cells were fusiform with distinct cell borders. They were arranged in storiform pattern and in wavy parallel cell cords in the cellular areas. Focally, a pleomorphism and mitotic activity (including atypical mitoses) similar to those of malignant fibrous histiocytoma were seen. The myxoid parts contained haphazardly oriented cells and scarce lipoblast‐like multivacuolated cells mimicking a liposarcoma. In the differential diagnosis, myxoid liposarcoma, dermatofibrosarcoma protuberans, malignant fibrous histiocytoma and low‐grade fibromyxoid sarcoma were considered. Immunohistochemically, perineurial differentiation was indicated by the diffuse expression of epithelial membrane antigen and focal reactivity for CD34. The tumor was negative with antibodies to S‐100 protein, Leu‐7, CD68 (KP1), vimentin and cytokeratin AE1/AE3. Ultrastructure of tumor cells revealed features of MPNST. No recurrence occurred in the patient during 2 years follow up.
Expression of MUC2, MUC5AC and MUC6 apomucins in carcinoma, dysplasia and non‐dysplastic epithelia of the gallbladder
Authors: Sasaki Motoko , Yamato Taro , Nakanuma Yasuni , Ho Samuel , Kim Young
Published: March 2003

To date, nine apomucins have been characterized and their expression in malignant and premalignant lesions is under evaluation. The purpose of this study was to characterize immunohistochemically the expression of MUC2 (colonic/ intestinal type), MUC5AC (gastric surface type), and MUC6 (pyloric gland type) apomucins in 55 patients with gallbladder carcinoma (10 with in situ carcinoma, 45 with invasive carcinoma), 20 patients with gallbladder dysplasia, and 15 patients with non‐dysplastic gallbladder. MUC2 was expressed mainly in ‘goblet type’ cells. The frequency was increased in non‐dysplastic gallbladder (47%), dysplasia (75%), and in situ carcinoma (100%), and decreased in invasive carcinoma (58%). Carcinoma cells expressing MUC2, which were usually distributed at superficial areas, and well‐differentiated carcinoma expressed MUC2 more extensively than moderately and poorly differentiated ones. MUC5AC was frequently expressed in gallbladder irrespective of non‐dysplastic epithelia, dysplasia and carcinoma. MUC5AC was expressed also in carcinoma cells at deeply invasive sites. MUC6 was expressed frequently in pseudopyloric gland metaplasia as well as dysplasia and carcinoma. In conclusion, non‐dysplastic gallbladder has a similar phenotype to gastric pyloric mucosa. Gallbladder carcinoma exhibits both intestinal and gastric surface phenotypes in the early stage of carcinogenesis, with the gastric surface phenotype dominant in invasive carcinoma.
Poorly differentiated adenocarcinoma with extensive rhabdoid differentiation: Clinicopathological features of two cases arising in the gastrointestinal tract
Authors: Al‐Nafussi A. , O’Donnell M.
Published: March 2003

This paper describes the pathological features of two cases of composite extra‐renal rhabdoid tumor; that is, poorly differentiated carcinoma with extensive rhabdoid differentiation, arising in the small intestine of a 64‐year‐old man and in the pancreas of a 77‐year‐old woman. In both cases the tumor behaved aggressively and the patients died from disseminated malignancy within 3 months of original presentation and diagnosis. To the best of our knowledge these are the first examples of such tumors in the small intestine and pancreas.
An immunohistochemical study of hepatic atypical adenomatous hyperplasia, hepatocellular carcinoma, and cholangiocarcinoma with α‐fetoprotein, carcinoembryonic antigen, CA19‐9, epithelial membrane antigen, and cytokeratins 18 and 19
Authors: Tsuji Motomu , Kashihara Takeshi , Terada Nobuyuki , Mori Hiroshi
Published: March 2003

Eight hepatic atypical adenomatous hyperplasias (AH), 30 hepatocellular carcinomas (HCC) consisting of 11 well‐, 13 moderately and six poorly differentiated HCC, and 10 intrahepatic cholangiocarcinomas (CC) were investigated immunohistochemically with anti‐α‐fetoprotein (AFP), carcinoembryonic antigen (CEA), CA19‐9, epithelial membrane antigen (EMA), and cytokeratins (CK) 18 and 19 antibodies. Immunostaining was regarded as positive when more than 5% of cells were stained. α‐Fetoprotein was positive, although focally, in five (17%) of 30 HCC but negative in all AH and CC. Carcinoembryonic antigen (polyclonal antibody) did not stain the cytoplasm of all AH and HCC, but stained two (25%) of eight AH and 10 (33%) of 30 HCC in a bile canalicular staining manner. Carcinoembryonic antigen showed intracytoplasmic or luminal border staining in six (60%) of 10 CC. CA19‐9 was negative in all AH and HCC, while six (60%) of 10 CC were positive for CA19‐9. Epithelial membrane antigen was positive in one (13%) of eight AH, seven (23%) of 30 HCC and in all 10 cases of CC. Cytokeratin 18 was positive in all AH, HCC and CC. Cytokeratin 19 was negative in both AH and HCC, whereas it stained the cytoplasm of tumor cells in all CC diffusely and intensely. These results suggest that immunostaining of AFP, CEA, CA19‐9, EMA, CK18 and CK19 are not useful in the differential diagnosis between AH and well‐differentiated HCC, and that CK19 is the most suitable reagent for the differential diagnosis between HCC and CC.
A case of large cell calcifying Sertoli cell tumor in a child with a history of nasal myxoid tumor in infancy
Authors: Tanaka Yukichi , Sano Katsuyuki , Ijiri Rieko , Tachibana Katsuhiko , Kato Keisuke , Terashima Kazumitsu
Published: March 2003

A case of an 8‐year‐old Japanese boy with a testicular large cell calcifying Sertoli cell tumor (LCCSCT) is presented. This report appears to be the first Japanese case of LCCSCT. The patient presented with left testicular swelling and gynecomastia. His family history was not contributory; however, his past history was remarkable for a benign myxoid tumor in the nasal cavity, which was removed at the age of 2 months. After removal of the testicular tumor, the gynecomastia disappeared gradually and no recurrence or metastasis developed during a 15 month follow‐up period. Although the tumor was initially interpreted as a Leydig cell tumor, a review of the slides after the patient’s past history of nasal myxoid tumor was revealed led us to the diagnosis of LCCSCT. An accurate diagnosis of LCCSCT is crucial because this tumor is occasionally associated with Carney complex, which can comprise various pathological conditions, including cardiac myxoma, that may be life‐ threatening. Myxoma of Carney complex has been described to occur in the heart, skin, oral cavity and breast in a wide age range, but there have been no reports referring to nasal myxoid tumor associated with Carney complex.
Rectal adenocarcinoid with lymph node metastasis
Authors: Yagihashi Norito , Koyama Motoi , Yagihashi Soroku
Published: March 2003

We describe a case of a rare variant of a rectal carcinoid tumor that showed mucous gland differentiation accompanied by a lymph node metastasis with a histological appearance similar to that of the primary site. The tumor consisted of a typical argyrophilic carcinoid component and of goblet cell glands. The carcinoid component was positive for neuron‐specific enolase, chromogranin A and synaptophysin. The goblet cells stained positively with periodic acid‐Schiff (PAS) and alcian blue, and expressed carcinoembryonic antigen, but were negative for neuroendocrine markers. This case suggests that carcinoid tumor can differentiate towards mucus glands, which can also be found in the metastatic site.
Neoplastic non‐papillary thyroid carcinoma lesions with a fine chromatin pattern
Authors: Mai Kien T. , Yazdi Hossein M. , Commons A. Susan , Perkins D. Garth , MacDonald Laurie
Published: March 2003

In papillary thyroid carcinoma (PTC) in cytological and surgical specimens, fine chromatin, nuclear grooves and nuclear pseudoinclusions are the hallmarks of diagnosis. We investigated the significance of these nuclear changes in neoplastic non‐PTC lesions. Fine needle aspiration biopsies (FNAB) of thyroid lesions were reviewed with histologic correlation. Twenty‐five low‐grade PTC and 35 neoplastic non‐PTC lesions with a fine chromatin pattern in cytology specimens were identified. These lesions were studied along with five multinodular goiters and five follicular adenomas with a coarse chromatin pattern. The neoplastic non‐PTC lesions were selected from cases with a histopathologic diagnosis of follicular neoplasm (accompanied by cytopathologic examination) but lacking a coarse chromatin pattern. The nuclear changes were separated into three grades of nuclear atypia with a fine chromatin pattern, depending on the degree of nuclear enlargement and nuclear membrane thickening, or the presence of nuclear grooves or pseudoinclusions. Thyroid lesions with a higher grade of nuclear atypia with a fine chromatin pattern were associated with larger nuclei and more readily visible nucleoli. These lesions correlated histologically with PTC and follicular adenomas with a fine chromatin pattern. The latter could be divided into three grades: grade 1 lesions having a fine chromatin pattern similar to that of nuclei with open chromatin seen in areas of nodular goiter; grade 3 lesions having nuclear features closest to those of PTC; and grade 2 lesions showing intermediate changes. In conclusion, there is a spectrum of nuclear changes in neoplastic non‐PTC lesions with a fine chromatin pattern. These lesions are often diagnosed as follicular adenomas in surgical pathology and pose cytopathologic diagnostic problems between nodular goiter, follicular adenoma and PTC. The significance of follicular adenomas with a fine chromatin pattern will be discussed.
Long‐term follow up of pure myxoid liposarcomas with special reference to local recurrence and progression to round cell lesions
Authors: Fukuda Toshiro , Oshiro Yumi , Yamamoto Ichiro , Tsuneyoshi Masazumi
Published: March 2003

Myxoid and round cell liposarcomas cytogenetically share the t(12;16)(q13;p11) translocation, and represent a continuous morphological spectrum including pure myxoid liposarcoma (PML), mixed (myxoid/round cell) liposarcoma (MXL) and pure round cell liposarcoma (RCL). It has been documented that a critical amount of RC lesion in low‐grade, MXL is associated with poor prognosis. The present long‐term follow‐up study examined the factors that influence the progression of PML to RCL and several other prognostic factors and compared the results with those of liposarcomas initially diagnosed as MXL. Using 34 primary PML and their local recurrences after curative resection, and two initially diagnosed MXL, the appearance of RC lesion in PML was examined, and the prognostic significance of the local recurrence rate (times/month), tumor size, infiltrative proliferation (defined as entrapping of striated muscle fibers in the tumor), tumor necrosis and mitotic figures. The follow‐up period ranged from 19 to 378 months (mean, 173.4 months). Based on Cox’s proportional hazards regression model, a recurrence rate ≥ 0.01 in 24 PML with recurrences (P = 0.037) and the presence of infiltrative proliferation in 34 PML (P = 0.043) were significant independent factors associated with poor prognosis. Round cell lesions were detected in the last recurrences of two surviving PML. These results indicate that through their recurrence, PML might potentially become malignant, independent of the proportion of RC lesions in the tumor. The appearance of RC lesions in subsequent recurrences may indicate a progression from PML to MXL.