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(Background) Prostate biopsy is the most important examination for the diagnosis of prostate cancer and the most common test in urology. We evaluated the results of transrectal prostate biopsy performed at Kanazawa Medical University Hospital. (Materials and Methods) Prospectively collected cases of 1,935 patients was undergone transrectal prostate biopsy between January 2002 and December 2021. We looked at patients age, serum Prostate-specific antigen (PSA) level, PSA density (PSAD), total prostate volume, number of biopsy times, and number of biopsy core. We examined the positive cancer rate. (Results) The median age of patients was 70 years (range: 36-96 years), the median serum PSA level was 7.6 ng/mL (range: 0.19-15,823 ng/mL), the mean number of biopsy times was 1.3 (range: 1-6), and the mean number of total biopsy core was 8.6 (range: 2-14). There were 880 (45.5%) positive cases and 1,055 (54.5%) negative cases. Comparing the cancer-positive and cancer-negative groups, the median age was 72 years (range: 50-96 years), 68 years (range: 36-93 years), the median PSA level was 11.0 ng/mL (range: 0.19-15,823 ng/mL), 6.6 ng/mL (range: 0.24-86.0 ng/mL), median prostate volume was 29.5 mL (range: 7.4-206 mL), 39.1 mL (range: 9.6-178 mL), median PSAD 0.376 (range: 0.003-1,582), 0.177 (range: 0.016-7.513), mean number of biopsy times 1.2 (range: 1-6), 1.4 (range: 1-6), mean number of total biopsy core 8.9 (range: 2-14), 8.5 (range: 4-14), and there was a significant difference in all comparison.

In patients with prostate cancer high serum prostate specific antigen (PSA) at diagnosis was generally regarded as a strong impression of advanced disease with distant metastasis and poor prognosis. (Objective) We reported a retrospective study of prognostic factor and Overall survival (OS) in patients with prostate specific antigen (PSA) level of greater than 100 ng/ml (PSA≥100 ng/ml). (Subjects and methods) Between January 2002 and December 2015, 60 patients were diagnosed prostate cancer with PSA≥100 ng/ml and performed hormonal monotherapy at Kanazawa Medical University hospital. We evaluated initial PSA level, Gleason score, Gleason Grading Group, clinical stage, site of metastasis, PSA nadir level, Time to PSA nadir (TTN), serum Hemoglobin (Hb) level, serum C-Reactive Protein (CRP) level, serum Lactate Dehydrogenase (LDH) level, serum Alkaline Phosphatase (ALP) level, clinical passage and survival time. (Results) The median age of the patients was 73 years old (54-90) and the initial PSA levels ranged from 100 ng/ml to 15,823 ng/ml (median 390).Prognostic factors of overall survival were site of metastasis, Gleason score, Gleason Grading Group, PSA nadir level, TTN, serum CRP level, serum LDH level and serum ALP level at the diagnosis. In multivariate analysis serum LDH level remained an independent predictor of OS.

We report a retrospective study on the efficacy, adverse events and the factors for continuous docetaxel (DOC) therapy for patients with castration-resistant prostate cancer (CRPC). Between April 2007 and April 2015, 37 CRPC patients were treated with DOC therapy at Kanazawa Medical University Hospital. DOC was administered every 3 weeks at 70 mg/m2. Prostatic specific antigen (PSA) level, adverse events, cycles of DOC therapy, survival time and clinical passage were examined. Fifteen patients showed a decrease in PSA level of 50% or more, 9 patients showed less than 50% decrease in PSA level and 13 patients showed no decrease in PSA level. Adverse effect of grade 3 consisted of neutropenia in 29.7% and leukocytopenia in 10.8%. The median number of treatment cycles was 11.7 courses. The patients were divided into two groups ; the first group comprised of 26 patients who received short-term DOC therapy (≤10 cycles) and the second group comprised of 11 patients who received long-term DOC therapy (≥11 cycles). The 1-year survival rate was 59 and 100% for the short-term and long-term groups, respectively. Long-term treatment was related to pretreatment PSA nadir, time to progression of CRPC and serum lactate dehydrogenase level.

With the popularization of the internet, internet addiction among the youth has received a lot of attention in recent years. While.the internet is an effective tool for: communication, the youth, who find real-life communication difficult, reportedly overuse,this aspect of the internet However, this is more of an impression based on clinical cases, with few factual findings. Therefore, the aim of this research was to study the reality of internet addiction -among university students and to examine the multilateral relationship between internet addiction and interpersonal relationships. We conducted a questibnnaire stirvey among 221 uriiversity students, analyzing the level of internet addiction, relevant interpersonal relationships, personal "charcteristics, and other factors associated with internet use. We found that the number of students who were dependent on the internet was 10 (4.7%) and the number of students with a tendency toward dependency was 98 (45.6%). In interpersonal relationships, internet addiction was significantly correlated with parental overprotection, a sense of contentment from the present parent-child rela- tionship, relationships with friends, number of friends, and availability of free time. In personal characteristics, internet addiction was significantly correlated with social skills and feelings of self-esteem. In other factors, internet addiction was significantly correlated with typing on a message board, video browsing, online gaming, use of a personal computer, desire to escape, distraction, pleasure, and connecting with others. Furthermore, we conducted a multiple regression analysis to consider the effects of these three aspects associated with internet addiction. The results suggest that internet addictionl is promoted by parental overprotection, low self-esteem, having few friends, and passive internet service usage. Thus, education is required to promote careful use of the internet to prevent internet addiction from escalating. Further, it is important to understand and support interpersonal relationships to prevent internet addiction from making life worse.

While many Japanese nationals are considered to have problems with pachinko and pachisuro (Japanese slot machines), the factors contributing to the process by which gambling disorder-is aggravated remain unclear. Therefore, the aim of this study was to establish baseline data for measures to prevent the further escalation of this gambling disorder; To elucidate the contributing factors, a self-administered questionnaire was distributed to pathological gamblers. The survey items were composed of the following basic attributes; scores on the South Oaks Gambling Screen (SOGS); gambling motivation; matters arising, after gambling behavior; remedies for excessive gambling; the Kessler 6 (K6); the CAGE (Cut down, Annoyed, Guilty, Eye opener) questionnaire; and the 8-item Family Adaptability and Cohesion Evaluation Scale at Kwansei Gakuin IV (FACESKGIV-8). The results of hierarchical multiple regression analysis using SOGS scores as the dependent variable indicated that the variables determined to contribute to the aggravation of gambling addiction were age, sex, past employment experience in the service sector, obtaining money as a motivation for gambling, and seeing limits as a remedy for excessive gambling. Because gamblers tend to fixate on money and experience increasing difficulty devoting attention to other matters as gambling problems grow more serious, the results of this study suggest the need to provide environments that will enable affected individuals to reflect on their own style of gambling at the stage at which their gambling behavior begins to exceed the scope of their own revenue.

(Objective) Bone metastasis symptoms are complications that greatly reduce the quality of life (QOL) of cancer patients. We report a retrospective study on the efficacy of radiation therapy for patients with bone metastasis in urinary organ cancer. (Subjects and methods) Subjects are comprised of 17 patients; total irradiated areas consist of 25 sites. There are 5 patients diagnosed with renal cell carcinoma, 1 patient with bladder cancer and 11 patients with prostatic cancer. All of them have undergone radiation therapy for bone metastasis in urinary organ cancer between April 2007 and March 2014 in the Department of Urology, Kanazawa Medical University. The mean age of the patients was 66.7 years old. We looked at irradiated areas, exposure dose and changes of symptom in all patients. (Results) Irradiated areas are thoracolumbar vertebrae (14 sites), cranial base (2 sites), pubic bone (1 site), ilium bone (2 sites), sacral bone (1 site), rib bone (1 site) and hip joint (1 site). The mean exposure dose of one area is 37.5 Gy (13.5-60). 19 irradiated sites which were previously reported to have sharp pain have gained improvement at 16 sites. These 16 sites have comparatively lesser pain or no pain. 8 cases in acknowledgment of walk difficulty, it was with 7 cases walking alone possibility again. (Conclusion) This study showed that radiation therapy have significant improvement in terms of symptoms and QOL for the patients with bone metastasis in urinary organ cancer.

Purpose: The aim of this study was to evaluate the effects of inaccurate attenuation correction due to the misalignment between the computed tomography (CT)-based μ-map and the positron emission tomography (PET) data on a brain PET., Methods: CT and PET scans were performed on a 3-dimension (3D) brain phantom, in which the grey matter region was filled with 18 F-fluorodeoxyglucose ( 18 F-FDG), and the skull region was filled with/without the bone-equivalent solution. The shifted PET images relative to the CT image were generated by the software-based translation of PET data in the cephalad/caudal and right directions, with a magnitude of the shift up to 30 mm and a step size of 5 mm. The regions of interest (ROIs) were drawn on the areas of the temporal lobes, parietal lobes, thalami, and cerebellums in the no-shifted image (reference). For each ROI, the radioactivity concentrations in the shifted images were compared with those of the reference., Results: The errors in the radioactivity concentrations were increased with the increasing magnitude of the shift in all brain regions except for thalamus. For a 5 mm shift in the right direction, ± 10% errors were observed in the left/right temporal lobes. The accuracy of the radioactivity concentration in the temporal lobe was very sensitive to misalignment in the right directions., Conclusion: The misalignment between CT-based μ-map and PET data had larger effects on the surface regions of the brain rather than on deep brain structures.

In Japan, many drug addiction rehabilitation centers (DARC) provide various types of recovery programs for drug addiction. The purpose of this study was to clarify the attitudes of DARC staff and users regarding job support programs. A nationwide questionnaire survey was conducted in 2009. The staff of 46 facilities and 606 users returned questionnaires. The results indicated that many (92.1%) users had work experience before entering the recovery programs provided by DARC and about half (49.3%) of the users reported being motivated to work. Although many DARC have established various job support programs, the users faced various levels of anxieties to get employed and 60.4% of the users expected to learn more detailed and concrete methods for finding a job. Through the DARC programs, the users gradually realize the significance of basic daily living skills such as maintaining their rhythm of life or neat and presentable appearance. And the more they get recovered the more they understand the significance of "self-care" and "interpersonal relationship skills". These findings indicate that job support programs for drug addicts should also focus on these recovery processes. More extensive job supports dealing with more practical issues and covering a wide variety of anxieties would be imperative.

Here we report a case of a 56-year-old woman who presented at our hospital with a chief complaint of a red lump in her right breast. Breast cancer(Rt C, T4bN0M0; ER[-], PgR[-], HER2: 3[+]; stage IIIb)was diagnosed, and subsequent preoperative chemotherapy, mastectomy and axillary lymph node dissection were performed. Five months after surgery, bone metastasis in the thoracolumbar vertebrae developed and trastuzumab/zoledronic acid hydrate therapy was initiated. Four months after the therapy, tumor marker levels increased and docetaxel was added to the treatment regimen. Although the patient's condition temporarily improved, tumor marker levels increased again after 6 months, and the treatment regimen was switched to trastuzumab/nab-paclitaxel therapy. However, such regimen was discontinued owing to the development of liver metastasis, and lapatinib/capecitabine therapy was initiated. Two months after lapatinib/capecitabine therapy, tumor marker levels normalized and the liver metastasis markedly reduced. Side effects included paronychia(grade 3), which improved with dose reduction. The patient's therapy is being continued.

This study was designed to reveal the current status of the rehabilitation support system for patients with Illegal Substance Use Disorder (ISUD). From among 465 patients who had been admitted to a psychiatric hospital in Tokyo within the past 10 years by order of the prefectural governor, 65 patients with ISUD were selected for inclusion in this study. Based on whether or not the person was arrested at the time of discharge, whether or not urine drug monitoring was ordered, and the results of the monitoring, each subject was classified into one of the following four types: 1) Arrested; 2) Not arrested and no urine drug monitoring; 3) Not arrested and positive urine drug monitoring results; and 4) Not arrested and negative urine drug monitoring results. In Group 1, every subject underwent urine drug monitoring prior to an involuntary examination; however, even though 10 percent of the subjects in this study were found to have positive results on urine drug monitoring, none of them were arrested. Moreover, 40 percent of the study subjects were not subjected to urine drug monitoring, and about 30 percent of non-arrested subjects were shown not to have used any illegal substances. Based on these results, it appears to be ideal for patients in Group 1 to apply to a diversion program, followed by medical treatment for addiction. To avoid the elimination of patients from medical services due to the vagueness of the classifications, whether or not judicial administration is required at the time of police intervention should be clearly and appropriately clarified for patients in Groups 2 and 3. Patients in Group 4 may experience a relapse of psychiatric symptoms, even if they do not use illegal substances; therefore, it is necessary for designated hospitals to perform medical treatment interventions responsibly for both endogenous psychosis and substance abuse, and to collaborate with appropriate social support facilities within the community regarding the medical discharge of such patients.

The accident at the Tokyo Electric Power Company (TEPCO) Fukushima Daiichi nuclear power plant on March 11, 2011, released a large amount of radioactive materials resulting in the radioactive contamination of a wide area of eastern Japan. Residents of the Fukushima prefecture experienced various unavoidable damages and fear of radiation effects on their health. A reliable communication of accurate risk assessment for residents is required as a countermeasure aimed at the reconstruction of Fukushima. Here, the current status of individual dose estimation and the issues relating to the radiation risk perception are discussed.

The aim of this study was to develop a scale to evaluate characteristics of how alcohol-dependent people perceive the attitudes of their partners toward alcohol dependency. Based on previous research, we created the "Attitudes of partners toward alcohol dependency" scale, from the perspective of the alcohol dependent individual. Using the new scale, 71 alcohol-dependent people (52 men, 19 women) were surveyed after obtaining their consent, and the reliability and validity of the scale were tested. The results identified 3 factors, "indifference", "acceptance" and "hypersensitivity", and factorial validity was verified. Relatively high reliability was obtained on each sub-scale (alpha = .60-.82). Furthermore, correlations were obtained with the alcohol-dependency "Denial and Awareness Scale (for alcohol-dependent people)" and with the 13-item "Usefulness of heterosexual love relations for recovery from alcohol dependency" questionnaire, which includes content on "beneficial" or "obstructive" to recovery, and with the satisfaction and the importance of relations. This demonstrates that the "Attitudes of partners toward alcohol dependency" scale has reliability and criterion-related validity. The scale facilitates evaluation of types of attitudes of partners toward alcohol dependency, and may thus be useful as one tool for investigating the influence of partners in heterosexual love relationships for recovery, and for providing advice.

The objective of this study was to identify how staff working in institutions for the treatment of and recovery from alcoholism view the relationship between heterosexuality and recovery on the part of alcoholics, how they deal with this relationship, and issues the staff face. Data were collected from 89 staff members (36 men, 52 women, 1 unknown gender) residing in the Kanto region and working at hospitals or local institutions. Over half the staff reported dealing with the issue of heterosexuality respectfully, but in terms of their views, a large majority of the staff was highly concerned about relapse due to heterosexuality. Half of the staff believed that heterosexuality might prevent continued abstinence. They also believed that the risk of relapse was increased further if the period of abstinence was short, the person was unemployed, both partners were alcoholics, the person had yet to admit their alcoholism, or if the relationship was an extramarital affair or with someone in the early stages of recovery. Medical staffs were more likely than other staff to respect the heterosexuality of alcoholics while being highly concerned about the risk of relapse. The results also showed that as alcoholics were unlikely to refrain from heterosexuality even if advised to do so, staff would probably use an appropriate method of guidance if one were available. These findings indicate the need to develop more practical and firmly held specialist therapies for heterosexuality among alcoholics, which has been regarded negatively as frequently leading to relapse, based on studies from the perspectives of both alcoholics and staff.

The purpose of this study was to develop a scale for assessing the attributes of the heterosexual love of alcoholics. Using the characteristics and categories related to the heterosexual love of alcoholics found in previous research, we created a "Heterosexual Love Assessment Scale for Alcoholics" and conducted a survey among 110 alcoholics (80 men and 30 women). The following three factors were extracted from the results: "mutual respect", "superficial intimacy", and "fear of being disliked", A high level of reliability was obtained on the scales indicated below (alpha = 63-82), and concurrent validity was confirmed between these and the Adult Attachment Scale (ECR: Experiences in Close Relationships inventory). Further, correlations were found between "mutual respect" and the benefit of heterosexual love in recovery, and between the other two factors and the impediment of heterosexual love, and between the Denial & Awareness Scale (for alcoholic). As this scale can be used to assess the type of heterosexual love of alcoholics, we predict that it will be useful in examining the effects of heterosexual love on recovery and as a tool for offering advice.

This study aimed to compare the process of changes in the recognition of pre-alcoholism between alcoholic patients and their family members, and examine the timing and methods of intervention for patients and their families. We conducted semi-structured interviews with 15 patient-family pairs, consisting of inpatients on the alcoholism ward and their family members in the same household. Our analysis of interview data showed that the process of changes in the patients' drinking behavior, i.e., from healthy drinking to alcohol dependence, had the following 4 stages: "look to benefits of alcohol consumption", "escape reality that they found hard to bear", "manifest health-related impairment", and "have increasing difficulties in restraining themselves from drinking". Drinking problems became more serious when the patients went through several stages at one time, or when they moved back and forth between the stages. There was a time gap between patients and their families in recognizing drinking problems, which leads to the worsening of the problems. Behind this lied communication and emotional problems between patients and their family members. The findings suggest the need to take account of the pre-alcoholic stages, and adequately respond to and care for both patients and families from an early stage onward.

Purpose: The goal of the study was to examine the status, Stages of Change and motivation, alcohol dependence, and harmful use of alcohol in gastroenterological inpatients., Methods: We interviewed 141 gastroenterological inpatients and analyzed their medical charts. The interviews used the Alcohol Use Disorders Identification Test (AUDIT), CAGE questionnaire and questions pertaining to drinking behavior, diagnosis, self-awareness of drinking/alcohol dependency, physician instructions regarding abstinence, and Stages of Change. The proportion of patients who screened positive was calculated based on the AUDIT, CAGE and International Classification of Diseases (ICD)-10 alcohol dependence/harmful use criteria. Alcohol dependence was defined as a score >or= 15 on the AUDIT, and harmful use as 8-14 on the AUDIT or meeting ICD-10 criteria for harmful use. Patients with alcohol dependence or harmful use comprised the hazardous drinking group. Common disorders in this group and in patients in a non-drinking group were compared by Fisher exact test. Stages of Change were also determined in the hazardous drinking group and factors regarding motivation and Stages of Change were analyzed using logistic regression analysis., Results: Of the 141 patients, 18 (12.8%) scored >or= 15 on the AUDIT, 19 (13.5%) scored L 2 on the CAGE, and 48 (34%) scored >or= 8 on the AUDIT. Among those who met the ICD-10 criteria, 16.3% had alcohol dependence and 17.7% exhibited harmful use of alcohol. Significantly, common disorders in the hazardous drinking group included liver disease, colonic diverticulitis, gout/hyperuricemia, and pancreatitis. Of the alcohol-dependent patients, 52% were in the Preparation stage. After the Contemplation stage, instructions to abstain from alcohol were the most significant motivational factor., Conclusions: Many gastroenterological inpatients exhibited alcohol dependence and about half of these patients were able to prepare for behavioral changes related to drinking. Therefore, the gastroenterological ward may help in secondary prevention of alcohol dependence and harmful use.

Background and Aims: The aims of present study are to clarify the clinical features of patients with benzodiazepine use disorder (BZsUD), and to examine the characteristics of psychiatric treatments which may cause BZsUD., Methods: We conducted a medical chart and interview survey to 87 outpatients with benzodiazepine use disorder, who had consecutively visited the four hospitals, specialized in addiction problems, located in metropolitan area, during a month of December, 2011., Results: Consequently, 88.5% of the patients with BZsUD reported to obtain BZs to be abused from general psychiatric clinics, and 83.9% contracted BZsUD in process of general psychiatric treatment. Among the patients who contracted BZsUD in process of psychiatric treatment, 43.8% were speculated to have the other substance-related disorders such as methamphetamine or alcohol-related disorder at start of the psychiatric treatment. Further, approximately 70% of them reported that surplus BZs were prescribed without consideration of storing drugs, and over 40% also reported that BZs were prescribed without a medical examination., Conclusions: The findings of the present study may let us to propose the following four measures to be taken for prevention of BZsUD: First, latent substance-related disorders should not be overlooked, second, short-acting and high-potency BZs should not be prescribed if possible, third, storing and abusing BZs should always be considered, and finally, BZs should be prescribed with a medical examination.

In Japan, the number of patients with urolithiasis has continued to increase at a faster rate, with a lifetime morbidity in 2005 of 15.1% for males and 6.8% for females, possibly due to : 1) westernization of dietary habits and lifestyle, 2) improvement of diagnostic technologies (CT and ultrasound examination), and 3) aging of the population. Additionally, this disease has a higher recurrence rate ; for example, approximately 50% for calcium-containing calculi. The guidelines on urolithiasis consist primarily of the guidelines for treatment and recurrence prevention, and the items concerning recurrence prevention were added in the 2007 updated Guidelines on Urolithiasis by the European Association of Urology (EAU) and the American Urological Association (AUA) (EAU/AUA guidelines). These facts reflect the importance of recurrence prevention. On the other hand, the Japanese guidelines on urolithiasis are now being revised and will adopt the form of "clinical questions". This paper provides an overview of the examination methods for recurrence, lifestyle guidance, and drug therapies based on the current guidelines for diagnosis and treatment of urolithiasis as well as the points for clinical questions to be included in the revised guidelines for a deeper understanding and, consequently, return to routine clinical practice.

Seven patients who had been receiving capecitabine+oxaliplatin±bevacizumab(CapeOX±BV)therapy at our hospital between February 2010 and March 2011, had complained of angialgia during oxaliplatin(L-OHP)administration. Therefore, 3. 3 mg of dexamethasone(DEX)was added to their infusion solution. The patients were then asked to rate their angialgia severity using a numerical rating scale(NRS), when L-OHP in a 5% dextrose solution was administered with or without DEX. By changing the L-OHP in 5% dextrose solution without DEX to the solution containing 3. 3 mg of DEX, the mean NRS was improved to 2. 4 from 7. 1. These findings indicate that L-OHP in 5% dextrose solution mixed with 3. 3 mg of DEX seems to be useful in reducing angialgia during peripheral administration of L-OHP.

Objectives: Methamphetamine (MAP) is one of the most commonly abused drugs in Japan. Japan has experienced three major epidemics of MAP abuse. The characteristics of abusers have changed between the second and third epidemics; however, few epidemical studies have investigated these changes. The purpose of this study is to describe the differences in the characteristics of MAP abusers between the second and third epidemics., Methods: We surveyed the medical records of patients admitted to Tokyo Metropolitan Matsuzawa Hospital for MAP-related disorders between 1989 and 1993 (n=60; second epidemic group) and between 2004 and 2008 (n=119; third epidemic group). We compared patients' backgrounds and issues related to MAP abuse between the two groups., Results: Compared to the second epidemic group, more abusers in the third epidemic group were similar to the general population of young people in terms of education level and criminal activity; were on welfare; had dependence syndrome; smoked MAP; and co-abused legal drugs. In contrast, abusers who exhibited antisocial tendencies and injected MAP were more likely to be in the second epidemic group., Conclusions: We confirmed changes in the characteristics of MAP abusers between two of the three epidemics of MAP abuse in Japan. These findings suggested that the change of environments from the second epidemics of MAP abuse to the third one influenced the characteristics of MAP-related disorders. So, it is necessary to provide accurate and updated knowledge about MAP for the drug prevention to young people, and the treatment of dependence syndrome will become more important in the future.

In Japan, the target mental disorders of preventive strategies for suicide had been limited to be mood disorder, but recently drug abuse are known to be significant as a cause of suicide because some researches has found the association between substance use disorder and suicidal behavior in Japan. However, the preventive plans for suicide of drug abusers has not been developed yet. In this study we would like to examine the risk factors of suicide ideation in Japanese drug abusers. We analyzed the data of 445 drug addicts from the Nationwide Research of Drug Addiction Rehabilitation Centers by Tokyo DARC and compared many variables including demographic factors, drug use status, family history, psychopathologies, treatment and daily life satisfactions between people with suicide ideations and without ideations. It was found that 182 cases (43.8%) had suicide ideations in a recent month, and that addicts who had suicide ideations had significantly shorter abstinence time, higher prevalence of victimized experiences before 15 years age, and more mental symptoms such as insomnia, depression, and psychotic symptoms, and more tendencies to use prescribed psychotropic drug than those without suicide ideation. These results suggested that to prevent suicide of drug abusers, we should pay attention to family histories, insomnia and abstinence periods, and help them recovery from psychological damages caused by childhood trauma without inappropriate medications.

The present study aimed to clarify the present status of home-visit nursing for drug-dependent people and awareness among their caretakers. A questionnaire was sent to 279 stations that provide home-visit psychiatric nursing care. Among the 89 stations that responded, 24 (26.9%) are currently providing home-visit nursing for drug-dependent patients, while 36 (40.4%) had experience doing so in the past. Although many stations recognized that drug-dependent patients need home-visit nursing, their practices tended to be based on trial and error due to insufficient knowledge about the actual conditions and recovery processes of drug dependence. Compared to stations that had experience with home-visit nursing for drug-dependent patients, stations without such experience were more concerned about the safety of caretakers and their insufficient specialist knowledge about drug dependence.

The use of injectable generic antineoplastic agents has been increasing. Few studies have compared the quality and adverse reactions of generic and branded antineoplastic agents; and therefore, generic agents have not gained wide acceptance. Paclitaxel injections, which are used for treating solid cancers, are being marketed by some companies in Japan. The degree of hypersensitive reactions to these drugs may vary because of the differences in chemical properties of the polyoxyethylene castor oil that is used as a solvent in the paclitaxel preparations. Therefore, we investigated the incidence of pulmonary edema occurring as a hypersensitive reaction in rats administered branded and generic paclitaxel injections. Moreover, we compared the chemical properties of these preparations. We found that the pH of branded and generic paclitaxel preparations diluted with saline was different. This difference in pH may be attributed to a difference in chemical properties from the additive. We observed no significant differences in pulmonary vascular permeability, arterial partial pressure of oxygen, or leakage of protein in the pulmonary alveolus, between paclitaxel preparations administered to rats. These results suggest that both paclitaxel preparations induced pulmonary edema of a similar level in rats, irrespective of the differences in their chemical properties.

Urinary stones have an estimated lifetime morbidity of 15.1% in males and 6.1% in females ; in other words, one out of seven males and one out of fifteen females are affected with this disease at least once in their life. Previously, we reported a simple and easy method using microplates to measure the metastable limit (ML), which indicate the upper limit of supersaturation dissolution. In this study, we examined the usability of this microplate method. We confirmed that ML is correlated with the urinary calcium concentration in healthy subjects, single stone formers (SF), and recurrent stone formers (RSF). There was no significant difference between healthy subjects and RSF in urinary magnesium concentration, and ML was found to be correlated with urinary the concentration of oxalate and citrate acid in healthy subjects only. These results suggest that ML is a simple and easy way to measure the urinary calcium level and that ML could be a useful test item in outpatient settings as a convenient indicator for preventing recurrence of urinary stones in the future.

Background and Purpose: Substance use disorder is one of the important mental health problems related to suicide, nearly equal with depressive disorder. However, it is unclear how differences of abused substances influence the suicide risk of individuals with substance use disorder in Japan. The purpose of the present study is to compare an estimated suicide risk among patients with alcohol, amphetamine, and sedative, hypnotic or anxiolytic use disorders., Methods: Subjects were 1082 outpatients with alcohol use disorder (AUD), 191 with amphetamine-like use disorder (AMUD), and 63 with sedative, hypnotic or anxiolytic use disorder (SUD), all of whom consecutively had consulted seven medical facilities specialized for treatment of substance use disorder during a month of December 2009. A self-reporting questionnaire including the items of Kessler 10 (K10) and the Mini International Neuropsychiatric Interview (M.I.N.I.) was administered, and scores of the K10 and M.I.N.I., and the other clinical information were compared among the patients with AUD, AMUD, and SUD., Results: Patients with AMUD and SUD showed significantly higher score on the M.I.N.I. than those with AUD, while those with SUD showed highest score on the K10, followed by those with AMUD. In either of patients with AUD, AMUD, or SUD, approximately 60% of the subjects who attempted suicide within a month reported to take any psychoactive substance in the attempted suicide. Additionally, a remarkable difference was found in histories of general psychiatric treatment before consulting medical facilities specialized for treatment of substance use disorder between these three groups. Most of outpatients with SUD reported such histories., Conclusions: Outpatients with SUD appeared to involve the highest risk for suicide of all patients with substance use disorder, probably because of the comorbid-severe depression. In our speculation, SUD which our subjects suffered from might be induced or accelerated by pharmacotherapy performed in general psychiatric facilities. Education on dependency of prescribed psychotropic drugs to general psychiatrists is required.

Objective: Assessment of the degree of motivation for change in drug abusers is important in determining the optimal treatment modality for each patient. The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) is a 19 item instrument designed by Miller and Tonigan to provide quantitative assessment of the motivation for change in substance abusers. The object of the present study is to examine the factor structure and validity of the Japanese version of SOCRATES-8D (version 8 for drug abusers)., Methods: One hundred and five adolescent delinquents (81 male and 24 female) in a detention home were included in the study. The most frequently abused drug was cannabis in 43 percent of the delinquents, followed by methamphetamine in 20 percent and organic solvent in 18 percent. Exploratory factor analysis and validity analysis was performed to determine the factor structure and criterion-related validity., Results: The two factor structure of the 13 item Japanese version was confirmed, namely 6 item "Ambivalence" and 7 item "Taking steps". Internal consistency was acceptable with the value of a over 0.85. Criterion-related validity was confirmed with significant negative correlation between the Self-Efficacy Scale (Morita et al.) and "Ambivalence" factor, and significant positive correlation with "Taking steps" factor. Also, there was significant positive correlation between the Japanese version of the Drug Abuse Screening Test (Skinner) and "Ambivalence" factor. The external validity of "Recognition" factor was not confirmed. Presumably the factor related to the recognition of oneself as an addict was absorbed in "Ambivalence" factor, due to the relatively less severe degree of drug dependence that is characteristic of the juvenile delinquents in detention homes., Conclusion: The 13 item Japanese version of the SOCRATES-8D is valid and applicable to the substance abusing juvenile delinquents in detention homes. Further research with the inclusion of adult samples from addiction clinics is necessary to confirm the generalizability of the version.

Hallucinogens are drugs that cause hallucinations, which is distortions in a person s perceptions of reality. Historically they were found in some plants and mushrooms and had been used mostly during religious rituals. Various hallucinogens came to be compounded chemically in the 20th century, and have spread among the young men in West European countries. Also in Japan, use of MDMA, or other hallucinogens is increasing in the young adult and minors. In recent years, Japanese medicine-related law were revised and most hallucinogens came to be treated as illegal drugs, but even now Japanese young men have got hallucinogens through the Internet and dance clubs, and medical and educational staffs and caregivers need to implement early intervention.

The coexistence of methamphetamine use disorder (MUD) and psychotic disorder (PSD) is common in clinical settings. These cases are defined as methamphetamine concurrent disorder (MCD). It is often hard to decide which type of support is suitable for a MCD case; the one used for schizophrenics ("schizophrenia-support" model) or for drug addicts ("dependence-support" model). In the present study, we compare the courses of two MCD cases; one was supported using the "schizophrenia-support" model, and the other by the "dependence-support" model. These cases suggest that it is preferable to switch the models from one to the other, based on the severity of dependence. After stabilizing the patient's life through the use of at least three to six months of pharmacotherapy and psychiatric rehabilitation, we can recommend that the patient attend self-help meetings convenient for them. If the MCD patient has no risk of methamphetamine use, the hospital should play a major role to urge the health and the welfare facilities to support the patient. If the patient has some risk of relapse or criminal behavior, the legal system as well as medical and welfare facilities should play the major roles to present suitable services and to prepare an appropriate care-system.

Child abuse is known to correlate with drug abuse and interferes with recovery from substance-related disorders. To determine the prevalence and severity of child abuse among drug addicts, we conducted a nationwide cross-sectional survey of residents and outpatients at drug addiction rehabilitation centers (DARC) in Japan. A total of 445 participants gave informed consent and completed a self-reporting questionnaire. Sixty-eight percent of participants had experienced some kind of child abuse by the time they reached junior high school. The kinds of abuse experienced were physical (53.7%), psychological (60.4%), sexual (5.4%) abuse and neglect (24.5%). Comparison of female and male participants revealed that more female than male participants had experienced psychological (76.9% vs. 58.2%) and sexual (17.5% vs. 4.0%) abuse. Comparison of participants who had experienced some kind of child abuse ("Abused" group 68.3%) and those who had not experienced abuse ("Non-abused" group 24.3%) revealed that the "Abused" group was younger than the "Non-abused" group (35.7 SD9.0 vs. 39.7 SD10.8). Participants in the "Abused" group were found to have more severe psychological difficulties than those in the "Non-abused" group for the following: anxiety (73.0% vs. 61.1%), delusional atmosphere (48.0% vs. 28.7%), lack of energy (53.9% vs. 40.7%), ideas of persecution (48.7% vs. 29.6%), depression (62.2% vs. 43.5%) and suicidal ideation in the previous year (50.7% vs. 24.3%). The present results suggest that additional program that prepared to care the drug addicts who experienced child abuse and are experiencing suicidal ideation is needed. Furthermore, intervention for families with risk factors for child abuse should be developed in order to prevent the victim from suffering not only from post traumatic stress disorder but also from substance related disorders.

Purpose: This study aimed to compare with bone scintigraphy showed round focal accumulation and Multidetector Row CT (MDCT) findings., Methods: We obtained 101 patients (mean age 69.2 years; 75 men, 26 women) and 186 diseases. They were examined both MDCT and bone scintigraphy within a month of each other. We classified into two groups (with metastasis and spondylosis) according to their MDCT findings. Bone scintigraphy was estimated on planar image, MDCT was evaluated in three directions with 1 x 1 x 1 mm thickness., Results: We determined 20 metastases cases and 81 of spondylosis. We could not judge abnormal findings on MDCT in 4 patients (1 metastasis, 3 spondylosis); thus, detectability by MDCT was 93.5%. In the spondylosis group, the accumulation lesions were localized on the lower vertebral body in 76 patients (59%), with most showing as osteophytes. In the metastasis group, 11 patients showed more than 1 accumulations, 9 were osteoblastic changes and 10 were lytic. There was a tendency that patients who accumulated more than 1 vertebral bodies (64%) had osteoblastic and irregular distribution and those who accumulated just one body (78%) were lytic and their locations were focused on the lateral side., Conclusion: For evaluating bone scintigraphy, MDCT finding was helpful to increase the detectability in bone metastasis. Therefore, we should refer to MDCT finding positively in reading bone scintigraphy.

A survey was conducted involving 664 individuals admitted to a public psychiatric hospital in Tokyo Prefecture between July 15, 2004 and July 14, 2007 as a result of involuntary admission by order of the prefectural governor (hereafter, involuntarily admitted patients). The characteristics of patients with a focus on the effects of the Medical Treatment and Supervision Act were investigated in 656 patients, excluding eight patients for whom information at the time of involuntary admission was unclear. The proportion of patients in the present survey who had been reported by prosecutors was markedly low compared to nationwide and previous surveys. This was thought to be a result of the fact that the proportion of patients reported by the police, which tend to include emergency cases, was high due to the characteristics of the present hospital as well as the regional characteristics of Tokyo Prefecture. The characteristics of involuntarily admitted patients tended to be similar to those observed in previous surveys on involuntarily admitted patients at the present and other hospitals in Tokyo Prefecture. Comparison of the characteristics of involuntarily admitted patients and problem behaviors that instigated admission before and after implementation of the Medical Treatment and Supervision Act showed no clear differences, indicating that the act had no marked effect on involuntary admission by order of the prefectural governor. In addition, only a small proportion of patients with problem behaviors corresponding to actions described in the Medical Treatment and Supervision Act were reported by prosecutors, suggesting that such patients were mostly reported by the police. In cases where patients faced involuntary admission by order of the prefectural governor after being reported by the police, the prosecutor may have either been unaware of the patient or, if aware, had not filed a petition. Issues may include clues for investigation in addition to the roles of judicial police officers and prosecutors in investigation procedures in the former case, and the discretion of prosecutors in the latter case. While opinions on the appropriateness of actively applying the Medical Treatment and Supervision Act to these patients vary depending on the interpretation of the act's legal characteristics, it appeared that involuntary admission by order of the prefectural governor was at present not clearly distinguished from the Medical Treatment and Supervision Act. Involuntary admission by order of the prefectural governor and the Medical Treatment and Supervision Act are systems that have significant implications for patients with mental disorders, who are likely to cause injury to themselves or others. In order to facilitate the provision of appropriate medical care, it is important to clarify the systematic relationships within the legal system.

A nationwide questionnaire survey was conducted to clarify the current status of medical experts in mental health evaluation and their needs (recovery rate: 66.6%). The data were simply tabulated and then statistically analyzed with respect to past experiences of serving as expert witnesses or judges as defined by the Medical Treatment and Supervision Act and past clinical experience. The results showed that 201 respondents (53.0%) had served as medical experts an average of 2.8 +/- 2.4 times, while 173 respondents (45.6%) had not served as such experts, and that 284 respondents (74.9%) had served as judges an average of 3.0 +/- 2.5 times, while 86 respondents (22.7%) had not served as judges. Although about 70% of the respondents who had served as expert witnesses felt that their experiences were burdensome, mostly due to time-related concerns, most had favorable views of the legal process. More than 70% of the respondents indicated that they would continue to serve as expert witnesses despite their sense of burden, thus suggesting a correlation between a past experience of serving as an expert witness and a willingness to do so again in the future. Furthermore, the results indicate that medical experts in mental health evaluation who have not served as expert witnesses are more hesitant, and since physicians employed at institutions for forensic psychiatric examination are more likely to serve as expert witnesses, a relatively small group of medical experts in mental health evaluation repeatedly serve as expert witnesses. On the other hand, when compared to serving as medical experts, serving as judges was psychologically more stressful for many respondents. Since physicians are not used to being judges, they may experience feelings of resistance or burden. Also, judges are somewhat bound by expert testimony, and the fact that there is no written policy for questioning testimony adds to their stress. Therefore, it will be necessary to clarify the positioning of expert evidence and the decisions made by judges. What medical experts in mental health evaluation needed to improve their knowledge varied depending on the type and duration of work and clinical experience. Therefore, it is necessary to provide information matching the experience, skills, and information related to the practical aspect of the Medical Treatment and Supervision Act. Moreover, the results suggest the necessity for medical experts in mental health evaluation to acquire a wide range of expert knowledge in forensic psychiatry beyond that required for the Medical Treatment and Supervision Act.

Heterosexual love has many negative impacts on the process of recovery from dependency in a clinical setting; therefore, the present study investigated the characteristics of heterosexual love in alcoholics. Semi-structured interviews were conducted on 23 alcoholics and 14 healthy volunteers in order to ascertain their experiences with heterosexual love, and episodes were compared between the two groups (39 episodes for the alcoholics and 22 episodes for the healthy volunteers). When compared to the healthy volunteers, the length of time from meeting to dating was shorter for the alcoholics, and the measures to deepen relationships were more limited and tended to cause difficulties during the period. In addition, during the period of maintaining relationships, the alcoholics tended to have fewer daily conversations and had more regrets of having started dating. Furthermore, when compared to the healthy volunteers, the mean score for heterosexuality-related satisfaction and the mean score for needing the partner was significantly lower for the alcoholics. These findings suggest that among alcoholics heterosexual love has an element of instability that reflects a lower degree of self-acceptance; therefore, it is necessary to remain aware of this point when providing support.

In the West, various psychological programs have been developed to treat drug dependence. Although some programs have been performed as trials in a few facilities in Japan, there are no psychological treatment programs available in many facilities, and their effects on Japanese drug abusers have not been well studied. We developed a manualized cognitive behavior therapy (CBT) program for Japanese clients with drug dependence based on a review of the literature. The program focused on the development of relapse prevention skills through role-playing, enhancement of motivation for recovery and self-care using relaxation technique. We studied the effects of the program for Japanese drug abusers. We evaluated the change after treatment, and compared findings between an intervention group and a control group. The results indicated that the program improved self-efficacies to cope with cravings and situations that increased the risk of relapse only in the intervention group, and physical complaints were decreased in the intervention group, although such complaints were increased in the control group. Seventy percent of the intervention group members indicated satisfaction and 50% indicated that the program was useful. These findings showed that the relapse prevention program was effective for Japanese clients. However, most emotional factors relevant to craving were not adequately changed in either group. We should improve the program, allowing the clients an opportunity to try the relapse prevention skills outside the facility and focus the emotion during a trial in vivo.

The reliability and validity of the Japanese version of Structured Interview for Disorders of Extreme Stress (SIDES) were evaluated in a group of normal subjects (n=60) and a group of victims of interpersonal trauma (n= 53). SIDES was developed in the United States in 1997 and is a tool for assessing Disorders of Extreme Stress Not Otherwise Specified (DESNOS). Self-reporting and semi-structured versions of the SIDES have been developed. Cronbach's alpha coefficient for the self-reporting version was .92 for an individual's lifetime, and .85 for the present. Cronbach's alpha coefficient for the semi-structured interview version was .95 for an individual's lifetime, and .88 for the present. Using the Dissociative Experiences Scale (DES) and physical symptom scale as external standards, the validity of SIDES was confirmed. Although the present results indicate that the Japanese version of SIDES has good internal reliability and validity, it remains necessary to conduct further research on more victims of many kinds of trauma.

DARC (Drug Addiction Rehabilitation Center) is the first and largest private half-way house agency for drug addiction in Japan, in which the programs are centered on 12 step meetings and the staff is made up of only those recovered from drug dependence. The purpose of this report is to elucidate how DARC works in the recovery from drug dependence. We made two studies: staff in 30 DARC facilities and 108 users in 7 male residential facilities. The results showed that 330 clients with drug dependence were participating in DARC programs at the time of research and about 600 clients use the programs each year. According to our research, three fourths of the users could maintain sobriety. Although many users had severe mental symptoms and socioeconomic difficulties, most users evaluated DARC programs highly to help them recover from these conditions. DARC rated highly because it provides companionship for recovered addicts and flexible frameworks to enhance drug addicts' motivation to recover, such as accepting dropouts and restarting programs, the provision of facilities away from areas where users were at high risk of relapse, and various program modalities.

While the relationship between substance use disorder and suicidal behavior is well known, few studies have been conducted on this issue in Japan to date. The present study aimed to investigate the profiles of drug-dependent individuals with a history of suicide attempts not including completed suicides. A survey was conducted on 101 drug-dependent patients in 8 drug rehabilitation institutions. The survey included a questionnaire that assessed various items regarding personal profiles, such as history of suicide attempts and drug abuse, physical and mental problems. In addition, the survey included the Parental Bonding Instrument (PBI) and the Center for Epidemiological Studies Depression Scale (CES-D). The results indicated that 50 patients (49.5%) had attempted suicide, and that subjects with a history of suicide attempts were significantly younger than those without suicide attempts. It was also revealed that subjects with a history of suicide attempts had started abusing drugs at an earlier age, had more psychiatric problems, and scored higher on the CES-D and lower on both the parental and maternal care scores of the PBI. These findings suggest that early-age drug abuse, psychiatric problems, depressive symptoms, and parental rearing behaviors perceived as cold and rejecting may predispose drug-dependent individuals to suicidal behavior.

The authors conducted questionnaire surveys utilizing model cases with the aim of investigating the current views of psychiatrists regarding criminal responsibility judgments in forensic psychiatric evaluations. Six model cases-injury by a person with acute schizophrenia, indecent assault by a person with chronic schizophrenia, attempted murder by a woman with depression, arson by an alcohol abuser, burglary by an amphetamine abuser, rape and indecent assault by a person with personality disorder-were presented to 345 psychiatrists, who were asked about criminal responsibility and appropriate treatment for each of the cases. One hundred eighty-five of the psychiatrists responded. In the case of acute schizophrenia with hallucination and delusion, the case of severe depression, and the personality disorder case, there was a high level of agreement between the evaluations of criminal responsibility made by the different respondents, but in the case of chronic schizophrenia, the case of alcohol-induced psychotic disorder, and the case of amphetamine abuse, there were variations in the evaluation of criminal responsibility, with many respondents emphasizing the patient's symptoms and condition at the time of the offense, and relatively few emphasizing whether the disorder was endogenous. Regarding the form of treatment, many of the respondents recommended compulsory hospitalization for the case of acute schizophrenia with hallucination and delusion, while at the same time recommending treatment in a prison environment for the personality disorder case. In contrast, for the case of chronic schizophrenia and the case of alcohol-induced psychotic disorder, opinion was divided as to whether the subject should be handled with a medical or a judicial approach. Regarding treatment for the case of alcohol-induced psychotic disorder and the case of amphetamine abuse, there was a tendency to make a judgment based on the subject's condition at the point of psychiatric evaluation, which was not necessarily linked to the criminal responsibility.

We report a case of a 65-year-old male with stage IV gastric cancer accompanied by liver metastases, which showed a significant response after administration of TS-1. One hundred and twenty mg/body/day of TS-1 was orally administered without hospitalization. After 3 months, upper GI endoscopy showed improvement of primary gastric lesion, and cancer cells could not be detected under biopsy. After 2 months, computed tomography (CT) showed a reduction in the multiple liver metastases. Moreover, after 15 months, CT showed a complete regression of the multiple liver metastases, for a complete response (CR). The serum level of carcinoembryonic antigen (CEA) was reduced from 115 to within normal range. Noticeable critical adverse effects did not appear. Treatment on an outpatient basis, therefore, greatly contributed to his quality of life. We judged that TS-1 might be a candidate anti-cancer drug for first-line chemotherapy for advanced gastric cancer.

Therapeutic Communities (TC) have played an important role in the recovery from drug dependence around the world since the 1960s. They employ multiple and comprehensive methods which include community meeting, life training, psychoeducation, psychotherapy, medical care, and vocational coordination etc. In Japan, there is not such comprehensive rehabilitation programs for drug dependence. In order to learn the programs of TCs, we attend the programs of Walden house and Asian and American Recovery Services (AARS), which San Francisco and rehabilitation programs in Japan and how to introduce the TC methods into Japan.

Objectives: To investigate the diurnal rhythm of live births labored spontaneously, and the effects of obstetric intervention on birth time distributions., Methods: The data of live births tabulated by time (one-hour intervals), date and birthplace throughout Japan between 1981 and 1998 were obtained with permission from the former Ministry of Health and Welfare. Together with an investigation of hourly birth numbers by place in each year, an annual transition of hourly birth rates in medical institutions and the diurnal rhythm of birth numbers in maternity homes and at home were analyzed using regression analysis., Results: In every calendar year studied the hourly live birth numbers at hospitals showed a single-peak distribution pattern with maximum values at 13:00-15:00. The annual transition of hourly birth rates showed a 10% (birth numbers base) decrease in the 11:00-13:00 period in 1998 as compared with that in 1981, while there was a corresponding increase of 8% in the 13:00-15:00 period. Hourly birth numbers at clinics showed a double-peak distribution pattern with maximum values during the 11:00-12:00 and 14:00-15:00 periods in early 1980, while a single-peak distribution with a maximum value during the 13:00-15:00 period appeared in 1989 and has remained thereafter. Hourly birth rates (birth numbers base) increased by over 6% in the 13:00-15:00 and 17:00-20:00 periods over the past 18 years, while they decreased by 10% in the 9:00-13:00 period. The results at maternity homes were clearly different from those at hospitals and clinics. The live birth numbers totaled for the 18 years showed a double-phase distribution with a maximum value in the 6:00-7:00 period and a minimum value in the 19:00-20:00 period. The best-fit regression model for the obtained data was a sine curve with a maximum value at 6:00 (coefficient of determination 0.97). Hourly distributions of live births at home also fitted best to a since curve with the maximum value again at 6:00 (coefficient of determination 0.95)., Conclusions: The results suggested that the timing of spontaneous live births follows a circadian rhythm and that obstetric intervention affects time distributions of live births by shifting over 10% of births during the night and early morning to a working day service time (9:00-17:00).

Objectives: Health education for residents is now common, but only a few studies of its effects have been made. The purpose of this study was to investigate the effects of nutrition education for residents on intake of lipid-related nutrients., Methods: A total of 79 females (40-64 years) who underwent a health examination for residents in a town, Nara Prefecture and were found to have total serum cholesterol levels between 220 mg/dl and 300 mg/dl were divided into two groups. In the first group, nutrition education was performed during the first 24 weeks and no education was performed during the second 24 weeks as the self-control period. In the second group, no education was given during the first 24 weeks as the waiting period but was performed during the second 24 weeks. During the education period, dietary intervention for individual subjects was performed 3 times at intervals of 8 weeks by trained dietitians. The intake of nutrients was estimated by the food frequency questionnaire developed by Ueshima and Okayama, and changes in the intake of nutrients adjusted for total energy were used for evaluation of the effects of the education., Results: In the first group of 42 subjects, three discontinued during the education period and two during the self-control period, and in the second group of the 37 subjects, six discontinued during the waiting period and three during the education period. At the end of the education period, for the total of 67 subjects (39 and 28 in the first and second groups, respectively), the total energy adjusted intake of lipid, cholesterol and saturated fatty acid were significantly lower and the PS ratio was significantly higher than in the second group during the waiting period. During the self-control period after the education, the adjusted intake of lipid-related nutrients remained unchanged in the 37 subjects of the first group who had been given the nutrition education in the first 24 weeks, and it was significantly lower at the end of the 48-week test period than at the baseline examination. The percentage of the subjects showing a desirable intake pattern of major lipid-related nutrients increased significantly after the education period., Conclusions: These results indicate that the intake of lipid-related nutrients can be decreased by educating individual subjects about nutrition and the effects are maintained for at least 24 weeks.

Docetaxel is an excellent agent with a high antitumor effect for advanced/recurrent head and neck cancer. A 67-year-old male with advanced hypopharyngeal cancer (T3N2bM1: Stage IV) underwent two courses of superselective intra-arterial infusion of docetaxel and intravenous administration of CDDP and 5-FU. Using a coaxial technique, a microcatheter was placed in the feeding artery. Using imaging techniques docetaxel (60 mg/body and 30 mg/body) was infused into the vessels. During chemotherapy the patient received concomitant radiotherapy (50 Gy). MRI after chemoradiation showed a complete response for the primary tumor and a partial response for the neck metastasis. Grade 4 leukopenia and neutropenia and grade 3 pharyngitis/esophagitis were observed during chemoradiotherapy, but these adverse effects abated immediately and were not critical. We conclude that this superselective intra-arterial infusion of docetaxel will be useful and safe for head and neck cancer.

Unlabelled: To clarify the clinical characteristics of mental disorders in sexual assault victims, we investigated the victims focusing on PTSD, depression, physical symptoms, and their relationships., Subjects: Participants were 46 treatment-seeking female victims of sexual assault who consulted four hospitals, one clinic and one psychological services center, between February 2000 and April 2001. The mean +/- SD age of the participants was 28.0 +/- 8.9 years, the mean +/- SD period from the traumatic event was 94.5 +/- 88.0 months. PTSD was diagnosed and evaluated using a structured interview (Clinician-Administered PTSD Scale for DSM-IV: CAPS). Depressive symptoms were assessed using Self-rating Depression Scales (SDS). Physical symptoms were assessed using the Physical symptom scale developed by the authors., Results: Thirty-two participants (69.6%) met the criteria for PTSD in their current diagnosis, and 41 (89.1%) had the disorder at some point during their lives. SDS score and Physical symptom scale score of the PTSD group were significantly higher than those scores of the non-PTSD group. The SDS score correlated with the Avoidant-numbing score. The Physical symptoms scale score correlated with the Intrusion score and Hyperarousal score. We think that the PTSD group had the co-existing depression secondary to PTSD. Although previous studies have discussed the relationship between physical symptoms and Hyperarousal symptoms, this study suggested that physical symptoms were related to Intrusion symptoms as much as Hyperarousal symptoms. We found 2 patterns when PTSD patients reported physical symptoms related to Intrusion symptoms. The patterns were caused (1) by physiological reactivity on exposure to internal or external cues that symbolize an aspect of the traumatic event, and caused (2) by somatic reenactment symptoms., Conclusion: We discuss the importance for clinicians to distinguish Intrusion symptoms from physical symptoms as well as Avoidant-numbing symptoms from depressive symptoms on PTSD diagnosis. Because sexual assault victims have difficulty in talking about the traumatic experience, clinicians should pay attention to these findings in developing therapeutic plans for the victims.

The difference between the maximum and minimum QT interval measured from a 12-lead electrocardiogram was defined as an index of spatial inhomogeneous repolarization of the ventricular myocardium. The causal relationship between QT dispersion and incidence of ventricular arrhythmias has been pointed out in various heart diseases, but until now it was discussed mainly related to sinus rhythm. QT dispersion in extrasystole may be more important in the development of arrhythmias. We examined 5 cases (mean age 34 +/- 12 years) with a history of paroxysmal supraventricular tachycardia, who underwent electrophysiologic study. Both atrial and ventricular premature stimuli were given at a basic cycle length of 600 msec respectively. The QT interval and the ventricular activation time (VAT) (period from premature test stimulus to the summit of QRS) of the premature beats were measured in a simultaneously recorded 12-lead electrocardiogram. QT dispersion (the difference between the longest QT interval and the shortest QT interval) and VAT dispersion (the difference between the longest VAT and the shortest VAT) were measured. In atrial premature beats, there were no significant changes in the QT dispersion or VAT dispersion when the coupling interval of the premature beats was shortened. In the ventricular premature beats, however, both the QT dispersion and the VAT dispersion tended to increase with the shortening of the coupling interval. We concluded that only a short coupled ventricular premature beat induces greater QT and VAT dispersion. A ventricular couplet with short coupling interval may contribute to the development of ventricular tachyarrhythmias.