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Get PDFSchizophrenia is defined by operative diagnostic criteria in DSM-IV with some typical symptoms as hallucinations and duration of the disease. Huber focused on the subjective experience of patients and coined the term “basic symptoms” and created BSABS. Our study investigated the reliability and the diagnostic validity of the 5 clusters of BSABS for DSM-IV-based diagnosis of schizophrenia with a cohort of 105 patients. Good inter-rater reliability was obtained except for one item D.10. As evaluated by Spearman’s rank correlation coefficients, among the 5 clusters excluding Cluster 2, internal consistency was good. This suggests that, although each cluster is heterogeneous, cluster symptoms are the expression of physiological and biological disturbances of schizophrenia. Receiver Operating Characteristic Curve analysis was also used to show the ability of each cluster to discriminate schizophrenia. Results showed that the area representing the powers in discriminate schizophrenia of Cluster 4 “Adynamia”, which is considered related to the dynamic aspect of thinking, was highest, at 0.739. Cluster 1 “Information processing disturbances” which has a predictive ability for schizophrenia showed 0.714 and Cluster 3 “Impaired tolerance to normal stress” showed 0.711. Our findings suggest that, although these clusters symptoms differ from DSM-Ⅳ criteria, they are related to fundamental process of schizophrenia. Use of some of these three clusters with other neurophysiological markers could allow clinical evaluation of schizophrenia from a new perspective.departmental bulletin pape
Get PDFIn recent years, the increasing number of young people withdrawing from society, so called Hikikomori, has been a cause for concern in Japan. These are people who stay at home and do not work or attend school for more than 6 months. Most of them are not regarded as having any psychotic illness such as schizophrenia. With respect to college students, “student apathy” syndrome has been discussed since the 1960’s. Objectives: To evaluate the proportion of apathetic and withdrawing students among those who leave school, take off, or repeat academic years; to see how these situations have changed in the last 20 years; and to identify the characteristics of such high risk groups so as to provide them with effective psychiatric support services. Methods: First I examined the mean rates of the academic events mentioned above among students of Japanese national universities. I then compared those rates statistically between males and females, and among 6 groups according to gender and academic majors . Then the reasons for those academic events were examined. Results: The rates of each event have continually increased over the last 21 years, and a considerable number of the students were shown to have been in a state of “student apathy.” Male 4-year course students had a high risk, especially male science course students had serious problems.departmental bulletin pape
Get PDFTo elucidate whether people with hair follicles containing many Propionibacterium acnes cells are prone to acne, we developed a novel method to count the number of P. acnes in hair follicles. We sampled sebaceous material in hair follicles by aspiration at a constant negative pressure from the nose, forehead, and upper arm of 86 patients with acne vulgaris and 209 control subjects with healthy skin, including 84 subjects age-matched to the patients. Genome-equivalents of P. acnes in samples were estimated by real-time quantitative PCR (TaqMan). Numbers of P. acnes genomeequivalents were extremely low in control subjects less than 10 years of age and generally higher at greater ages, with much variation in subjects in the same decade of life. In men, the median count was highest in controls aged 15-19 years; in women, it peaked twice, in controls aged 15-19 years and again in those aged 40 years or older. P. acnes counts on the forehead and nose were higher in the acne patients aged 10-14 years than in the age-matched controls in both sexes. The counts at three sites were similar in acne patients and controls aged 15 to 29 years in both sexes. The results suggest that people with hair follicles containing many P. acnes cells are not particularly prone to acne, except for younger teenagers. Our aspiration method with estimation by real-time PCR can be used to examine the cutaneous microflora of P. acnes.departmental bulletin pape
Get PDFThe measurement of early mother-child relationship and interaction is a critical issue for infant mental health. The Nursing Child Assessment Teaching Scale (NCATS) has been regarded as one of the most effective assessment tools. A Japanese version (JNCATS) has been developed and its reliability was reported. The purpose of the present study was to show evidence for the validity of the JNCATS by utilizing micro analysis and sequential analysis of 53 mother-child interactions. Micro analysis is a second-by-second analysis of mother and child behavioral streams. Sequential analysis is a technique to detect mutual and contingent aspects of interaction. Variables obtained from these two methods were: a) probabilities of coding categories, and b) log odds ratios of contingency codes, whose correlations with JNCATS scores were examined. Some weak and medium correlations were found (p < .05). It was suggested that these two methods and the JNCATS could capture similar features of motherchild interaction, which provides evidence for the validity of the JNCATS.departmental bulletin pape
Get PDFIntroduction : The aim of the study was to investigate the association between the difference (defined as the remainder, Rm) in laboratory values determined in the upright and supine positions and the severity of obstructive sleep apnea syndrome (OSAS). Materials and Methods : Thirty-three Japanese male subjects with OSAS [apnea/hypopnea index (AHI: the number of apneas and hypopneas per hour) ≥ 5] underwent cephalometric analysis and measurements of nasal resistance in the upright and supine positions. Several parameters in a dental model and physical features were also analyzed. Results : Significant associations of the logarithmic AHI, with neck depth, Rm for the facial axis, and the minimum airway behind the tongue in the supine position were found in multiple linear regression analysis. Conclusion : Our results suggest that neck depth, Rm for the facial axis and the minimum airway behind the tongue in the supine position may be determinants of the severity of OSAS.departmental bulletin pape
Get PDFHearing loss (HL) is the most common sensory impairment occurring at birth in developed countries. Epidemiological data show that more than one child in 1000 is born with HL, while more than 50% of prelingual HL cases are found to be hereditary. Approximately 70% of hereditary HL is nonsyndromic and subdivided to autosomal dominant (20%), autosomal recessive (75%), X-linked HL (1%), and maternally-inherited HL associated with the mitochondrial DNA mutation. More than 10 deafness genes have been reported to be responsible for nonsyndromic hereditary HL in Japan. Among them, the most prevalent causative genes, GJB2 and the mitochondrial DNA 12SrRNA are introduced. In addition, this study also refers to the specific genes responsible for the unique audiogram, mainly WFS1 . Finally, the genes related to the enlargement of vestibular aqueduct of inner ear abnormality, SLC26A4, EYA1 and SIX1 are discussed. The clinical and genetic findings associated with these disorders including the results of a recent study are reviewed.departmental bulletin pape
Get PDFBackground: The clinical course of elderly patients with acute myocardial infarction (AMI) can sometimes unexpectedly result in an adverse outcome even when therapy appears to be successful. We suspect that specific factors may characterize this worsening of status during hospitalization. Purpose: This study examines whether the pre-hospital physical activity status of the elderly treated with percutaneous coronary intervention (PCI) for AMI affects their in-hospital course. Methods: We studied 110 consecutive patients, aged 80 or older, who had undergone emergent PCI for AMI. Patients were divided into two groups based on clinical presentation: Better Killip class (Killip classes I and II) and Worse Killip class (Killip classes III and IV). Patients were also divided into two groups based on pre-hospital physical activity status, determined retrospectively by review of medical records: Good physical activity (n =57) comprising those able to go out alone independently and Poor physical activity comprising those mainly confined to home (n =53). Results: The overall in-hospital mortality rate was 9.1% for the study population. The Worse Killip class group had a higher in-hospital mortality rate than the Better Killip class group (27.8% vs 5.4%, respectively; p =0.0102). In addition, the Poor physical activity group had a higher in-hospital mortality rate than the Good physical activity group (15.1% vs. 3.5%, respectively; p =0.047). Conclusion: These data suggest that pre-hospital physical activity status in elderly patients with AMI may affect in-hospital mortality as well as Killip class.departmental bulletin pape
Get PDFThis study aims to validate ultrasonic anisotropy in 2-dimensional echocardiograms by one-toone histological correlation. Thirteen echograms were obtained in vitro from 9 specimens of 2 left ventricles of healthy adult beagle dogs and were correlated with corresponding histology in regard to ultrasound orientation relative to the local fiber direction. Median value of pixel echogenicity (255- rank) was lower in areas with parallel (n = 9, 18 ± 13) than in those with oblique (n = 7, 41 ± 14, P < 0.05) and perpendicular (n = 13, 57 ± 21, P < 0.01) ultrasound orientations. Echogenicity in the proximal part within 0.5 cm from an edge was relatively high (n = 9, 33 ± 15; n = 5, 66 ± 27; n = 8, 65 ± 32, respectively) and was different between parallel and perpendicular orientations (P < 0.05). The ratio of the distal adjacent 0.5-cm part to the proximal part echogenicity was lower for either parallel or oblique orientation (0.35 ± 0.25, 0.51 ± 0.16) than for perpendicular orientation (0.95 ± 0.16, P < 0.01, respectively). Acoustic dropouts appeared beyond myocardial areas with parallel or oblique ultrasound orientation. These results disclosed precise acoustic anisotropy in the 2-dimensional echocardiograms.departmental bulletin pape
Get PDFCerebral blood flow (CBF) measurements during mild hypothermia therapy were made in 30 adult patients with severe head injuries (Glasgow Coma Scale score ≦8), by xenon enhanced computed tomography (Xe-CT). All patients but one underwent removal of hematomas and decompressive craniectomy. Immediately after surgery, hypothermia was induced by surface cooling, and a brain temperature of 32 - 35℃ was maintained for 3 days. During hypothermia therapy, CBF measurements by Xe-CT were made for all patients on post-injury days 1 to 4. From the arteriovenous-oxygen content difference and CBF values, the cerebral metabolic rate of oxygen (CMRO2) values were obtained. Outcome was assessed at discharge according to the patients’ Glasgow Outcome Scale (GOS) scores. Patients were divided into two groups based on their outcomes. Nineteen patients (63%) showed good outcomes (GOS score of 4 or 5) and 11 (37%) showed poor outcomes (GOS score of 1, 2, or 3). Statistically significant differences were obtained for the mean global CBF and CMRO2 values between the good and poor outcome groups. In this study, we demonstrated that CBF measurement may be useful to predict neurological outcomes following severe traumatic brain injury in patients undergoing hypothermia as well as to identify those who might not likely benefit from hypothermia therapy.departmental bulletin pape
Get PDFObjective: I examined the predictive value of the combination of three delayed recall tests to distinguish 1) those with probable Alzheimer’s disease (AD) from those within normal range, and 2) those with Mild cognitive impairment 1 (MCI) from those within normal range. The data from 90 visitors to a memory clinic in Tokyo was used. I first examined patients clinically, neuroradiologically, and excluded the mental and neurological illness. AD was diagnosed according to the NINCDS-ADRDA criteria 2, MCI according to the criteria of Petersen et al.1. Normal must be free from any disease examined above. Methods: After the diagnosis, the baseline neuropsychological tests were performed for all participants; the Mini Mental State Examination3, Raven’s Colored Progressive Matrices, the Stroop Test, a 10-words list learning and recall test, a story recall test, and the Rey-Osterrieth Complex Figure Test. After 10 years, all patients were reassessed and diagnosed again. Results: Of the MCI patients for follow-up (n=29), 19 were converted to AD, while 5 not. One died. 4 lost. All AD patients (n=30) remained as AD. The combination of 3 delayed recall battery provides clinically useful predictive values for both AD and MCI in a memory clinics and dementia research clinics.departmental bulletin pape