Abstract: There are two types of neurofibrillary tangles, namely, a twisted tubule and a straight or uniform tubule in the same cell in the brain with Alzheimer's disease. However, in some parts of the same fibril, both the twisted and straight tubules clearly could be seen as a continuation of each other. This finding suggests that both of the tubules have a deep relation to each other, especially at the molecular level. This might also suggest the possibility of both tubules which mutually transform into each other.
Abstract: The mental health of 70 school teachers for the mentally retarded, 60 direct care staff in social welfare facilities for the mentally retarded, 124 nurses and 369 general office workers was investigated by means of General Health Questionnaire (GHQ). The results were: 1) The incidence of mental unhealthiness was 44.6% among staff serving the mentally retarded, tending to be higher than among nurses, and significantly higher than among general office workers. 2) Among staff serving the mentally retarded, females tended to be more mentally unhealthy than males; among school teachers for the mentally retarded, the incidence among females was significantly higher than among males. 3) As to the incidence by age and experience, among staff serving the mentally retarded, the younger the age and the shorter the experience, the higher the incidence of mental unhealthiness.
Abstract: In Japan, 9 cases of severe lithium intoxication have been treated by hemodialysis so far, and the usefulness and indications of this procedure are not yet understood fully. We have recently experienced a case of lithium intoxication treated by hemodialysis. Considering this case together with those reported previously, we have prepared some preliminary guidelines for the application of hemodialysis to patients with lithium intoxication. The blood concentration of lithium, renal function, the severity of consciousness disturbance and clinical symptoms such as somatic complications are, of course, important indices for the application of this therapy. We think that the signs of intoxication and the time interval between the onset and the beginning of treatment also serve as useful indices for application of hemodialysis.
We studied the serum lipoprotein and apolipoprotein profiles in 44 patients with sporadic late-onset Alzheimer's dementia and 43 patients with vascular dementia. The levels of high-density lipoprotein (HDL) cholesterol were lower in both patient groups than in a control group. Apolipoprotein A I and A II levels have decreased in both the patient groups, especially in the vascular dementia group. The HDL-cholesterol levels correlated positively with the level of apolipoprotein A I, but not with the level of apolipoprotein A II. The ratios of apolipoprotein A I/A II have increased in both the patient groups. The apolipoprotein A II levels have disproportionally decreased in the patient groups. The serum apolipoprotein A II may involve the pathological process in the patients with senile dementia.
Psychiatry and Clinical NeurosciencesVolume 48, Issue 2 p. 265-266 Absence of Criteria for Discontinuation of Antiepileptic Drug Therapy Kazuichi Yagi M.D., Corresponding Author National Epilepsy Center, Shizuoka Higashi Hospital, ShizuokaNational Epilepsy Center, Shizuoka Higashi Hospital, 886 Urushiyama, Shizuoka 420, Japan.Search for more papers by this author Kazuichi Yagi M.D., Corresponding Author National Epilepsy Center, Shizuoka Higashi Hospital, ShizuokaNational Epilepsy Center, Shizuoka Higashi Hospital, 886 Urushiyama, Shizuoka 420, Japan.Search for more papers by this author First published: June 1994 https://doi.org/10.1111/j.1440-1819.1994.tb03064.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume48, Issue2June 1994Pages 265-266 RelatedInformation
Historical changes in forensic psychiatric evaluation on criminal responsibility and proceedings in psychopathological findings of amphetamine psychosis are reviewed at first. The classification of amphetamine related mental disorders are proposed in 6 types. Among them, the clinical characteristics and psychopathological features of ''Anxiety-situational reaction type'' (Fukushima) are described. According to some reasonable grounds, offenders diagnosed as anxiety-situational reaction type should be evaluated as diminished responsibility in place of irresponsibility. Finally, two cases of murder committed under the influence of amphetamine, are reported in detail.
It has been hypothesized that a saccade control dysfunction is one cause of a smooth pursuit eye movement (SPEM) dysfunction in schizophrenia. We studied the voluntary control of saccades in schizophrenic patients with the SPEM dysfunction using an antisaccade task. The mean error rate in the antisaccade task was significantly higher in the two schizophrenic groups with and without a SPEM dysfunction than in the normal control group. Furthermore, the schizophrenic group with the SPEM dysfunction showed significantly more errors than the schizophrenic group without the SPEM dysfunction. These findings seem to suggest a close relationship between the SPEM dysfunction and the appearance of errors which indicates an inability to inhibit reflexive saccades voluntarily in the antisaccade task. However, 4 of 10 subjects with the SPEM dysfunction showed an error rate less than the mean error rate of the schizophrenic group without the SPEM dysfunction. So, a voluntary control disorder of saccades as the main cause of the SPEM dysfunction appeared to be unlikely. An interesting finding of this study was that many schizophrenic subjects with the SPEM dysfunction showed errors with the latencies similar to those in express saccades, particularly in the rightward direction. This finding may suggest a close relationship between the SPEM dysfunction in schizophrenic patients and some pathological conditions of express saccades such as disinhibition of express saccades.
A survey was made on 502 elderly people living at home in Tokyo, and reliable data were obtained from 486 (96.8%) of them. A total of 198 persons who were judged to have dementia according to our clinical diagnostic criteria were subjected to the present study as the demented group (Group D). Other people who had no dementia or mental disorder were studied as controls (Group C); they were subdivided into two groups, i.e., a group of 83 persons who had a decline in ADL (Group C-I) and a group of 181 persons who had no decline in ADL (Group C-II). Their personalities were classified in terms of the personality trend and personality type according to SPI. 1. According to the classification by SPI, 28.2% of people who were syntonic in their younger days were in Group D, The corresponding rate was 11.6% for the nervous type, 45.3% for the immodithymic type, 1.7% for the viscous type, 5.5% for the autistic type, and 7.7% for the hysterical type, Thus, people who were syntonic, immodithymic or nervous in younger days were less likely to develop dementia, while those who were autistic or hysterical were more likely to develop dementia. The viscous type was associated with a low incidence of dementia in the present study. 2. Personality change was found more frequently in Group D (55.6%) than in Groups C-I and C-II (39.4%). 3. A personality change was either to nonadaptive personality (selfish, obstinate, suspicious or hot-tempered) or to adaptive personality (mellow or extroverted). In particular, the former four types of nonadaptive personality change were significantly more frequent in Group D. A change toward selfishness, obstinateness, suspiciousness or hot-temperedness was closely related to the development of dementia rather than to ADL. There was no consistent relationship between the severity of dementia and nonadaptive personality change. Thus, among the personality in younger days, personality change and age associated dementia, we found a certain relationship between the personality in younger days and dementia. However, a relationship between the personality in younger days and later personality change was found in only a small group of subjects. However, the personality change toward selfishness, obstinateness, suspiciousness or hot-temperedness was closely related to the development of dementia.
A Japanese version of the Eating Attitudes Test (EAT) was developed and validated using a group of anorectics and Japanese female controls. Its sensitivity was considered to be low for anorectics, especially for the fasting type anorectics. A cross-cultural comparison of the EAT scores of anorectics showed some significant differences among those found in Japan, Canada and Germany. A survey of eating disorders among 286 Japanese female students was carried out with a Japanese EAT. Three cases of bulimia nervosa were identified in this survey, although no clear case of anorexia nervosa could be identified. The EAT seemed to be useful to screen cases of bulimia nervosa and sensitive to distinguish abnormal eating attitudes among the young females in Japan.
Abstract: A case of neuro‐Behçet's disease with dementia and personality changes is described with magnetic resonance imaging (MRI), single photon emission tomography (SPECT) and neuropathological findings. MRI disclosed high signal areas in the cerebral white matter and the brain stem. SPECT showed a marked reduction of blood flow in the frontal cortex. Neuropathologically, multifocal necrotizing lesions with perivascular lymphocytic infiltration and glial proliferation were detected mainly in the brain stem, namely the midbrain and the pons. From these findings, it is suggested that mental disorders of neuro‐Behçet's disease are related to the secondary dysfunction of the frontal cortex due to the damage of the subcortical structures, mainly the brain stem.
The present study was designed to determine the clinical significance of a temporal low-voltage irregular delta wave (TLID) on EEG. Among 808 EEG records examined during one year at our hospital, the TLID was commonly detected in patients with clinically diagnosed ischemic brain diseases such as multiple infarction. Subsequently, a relation of the TLID to ischemic lesions on MRI was examined in 50 elderly depressive patients. It was found that there was a close correlation between the occurrence of the TLID and small Ischemic lesions on MRI (p<0.001). These results suggest that the TLID is a valuable indicator of minor ischemic changes of the brain.
Psychiatry and Clinical NeurosciencesVolume 48, Issue s1 p. 125-128 Reform in French Legislation Concerning Psychiatric Hospitalization 1838–1990 François Caroli M.D., Corresponding Author François Caroli M.D. Centre Médico–Psychologique, ParisCentre Médico–Psychologique, 145 bis, rue d'Alésia, 75014 Paris, France.Search for more papers by this author François Caroli M.D., Corresponding Author François Caroli M.D. Centre Médico–Psychologique, ParisCentre Médico–Psychologique, 145 bis, rue d'Alésia, 75014 Paris, France.Search for more papers by this author First published: May 1994 https://doi.org/10.1111/j.1440-1819.1994.tb03048.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume48, Issues1May 1994Pages 125-128 RelatedInformation
We report three patients with localization-related epilepsy of neonatal onset. They exhibited favourable psychomotor development and had no cerebral lesions on neuroimaging studies despite the presence of intractable partial seizures of neonatal onset. Although rare, some cases of epilepsy of neonatal onset may be cryptogenic, i.e. they belong to neither the symptomatic nor the idiopathic group.
We studied 6 patients with asymmetric spasms who comprised 16.2% of 37 patients with West syndrome (WS) who demonstrated clusters of tonic spasms on simultaneous video-EEG recordings. Neuroimaging studies showed diffuse cerebral abnormalities in 3 of 6 patients and unilateral hemispheric lesions in the remaining 3. In 3, the clusters of spasms occurred soon after a preceding partial seizure. Lateral dominance of seizures alternated in each patient, and the dominant side of the spasms also varied in relation to the preceding partial seizures. In the remaining 3, tonic spasms were constantly dominant on the side contralateral to the hemispheric lesions. In most of these 6 patients, the seizures were intractable and psychomotor outcome was poor. In particular, 3 patients had severe psychomotor retardation. These results lend support to the notion that cerebral cortex plays an important role in generating clusters of tonic spasms.
Event-related potentials were recorded in 25 abstinent alcoholics, and 25 gender- and age-matched controls during a two-tone discrimination (odd ball) task. All the subjects were free from medication and dextral. MR images were examined in the alcoholics. The amplitudes of N100, N200 and P300 in the alcoholics were reduced compared with those of the controls. In order to identify morphological changes responsible for ERP abnormalities, linear regression analyses were performed between ERP measures and MRI parameters. The amplitude of N100 was inversely correlated with ventricular size. The amplitudes of P300 were inversely correlated with both ventricular size and width of cortical sulci. It was suggested that the N100 abnormality was related to subcortical structure, and P300 alteration was related to both subcortical and cortical structures in the alcoholics.
In order to evaluate the quality-of-life (QOL) of epilepsy surgery patients, we surveyed patients' degree of life satisfaction and their families' degree of satisfaction with patient's status in a range of domains both pre- and post-operatively. Of 100 patient-family sets of surveys that were mailed out, 93 were completed and returned from patients and 91 from their families. All patients surveyed had temporal lobe epilepsy and had been followed for longer than 2 years after resective surgery. Patients and their families rated overall QOL as having markedly improved following surgery. However, they rated social domains of QOL, including role activities, financial status, and social and family relationships as having improved relatively little. Despite freedom from seizures, a few patients' families were dissatisfied with the patients' post-operative status, primarily for psychosocial reasons. Patients operated on at a later age reported little gains in life satisfaction following surgery. This study supports the conclusion that surgical intervention should occur before patients are subjected to the psychological conflicts and social handicaps associated with chronic intractable epilepsy.
When chlorpromazine (CPZ) and lithium chloride (LiCl) are compared, the former suppresses both rat's intracranial self-stimulation (ICSS) and methamphetamine (MAP)-induced hyperactivity. On the other hand, the latter suppresses only MAP-induced abnormal hyperactivity but hardly suppresses a purpose-oriented ICSS associated with the reward system. Therefore, LiCl inhibits abnormal hyperactivity induced by MAP, but it does not suppress physiological motivation. Using the two types of antipsychotic drugs, the authors propose a method of combining the ICSS and locomotor activity together with its traces. These proposals are useful indicators for evaluating and developing the new antipsychotic drugs which are used clinically for psychotic patients and for understanding the drug-induced akinesia and anhedonia.
Two hundred and ten subjects with panic disorder were studied and classified into four clinical types according to symptomatology and clinical courses. The outcomes of 181 of these subjects were categorized in three ways (good, fair, or poor). Through an examination of the relationship between these clinical types and categories of outcome, it was found that the subjects with little or no ''neurotization'' had a favorable outcome, while those with remarkable ''neurotization'' or with comorbid depressive states had an unfavorable outcome. It is suggested that concomitant ''neurotic'' symptoms, such as somatoform symptoms, as well as concomitance of depressive states, predict an unfavorable outcome of panic disorder.
Psychiatry and Clinical NeurosciencesVolume 48, Issue s1 p. 97-103 Forensic Psychiatry in England: A System in Transition John Gunn M.D., Corresponding Author John Gunn M.D. Department of Forensic Psychiatry, Institute of Psychiatry, LondonDepartment of Forensic Psychiatry Institute of Psychiatry, De Crespigny Park, London SE5 8AF, U. K.Search for more papers by this author John Gunn M.D., Corresponding Author John Gunn M.D. Department of Forensic Psychiatry, Institute of Psychiatry, LondonDepartment of Forensic Psychiatry Institute of Psychiatry, De Crespigny Park, London SE5 8AF, U. K.Search for more papers by this author First published: May 1994 https://doi.org/10.1111/j.1440-1819.1994.tb03044.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume48, Issues1May 1994Pages 97-103 RelatedInformation
