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I was dispatched to Okinawa Ishigaki Island in 1976 and, then after about thirty years, to Touhoku to provide medical aid due to a shortage of psychiatrists. On Ishigaki, I participated in outreach activities for local islands and was deeply impressed by the public health nurses and community mental health services. I also recognized important points of view about culture and psychiatry. I spent five years in Touhoku and then the East Japan Disaster hit area. At that time, many psychiatrists from throughout Japan supported our hospital, and we supported the disaster area. I describe my experiences in both places. I hope someday that young psychiatrists will join medical dispatch programs to such areas.

In 2014, Japanese Ministry of Health, Labour and Welfare published the guideline on the policy of the psychiatric hospitals. We executed a survey to the members of "The Japanese Society of Psychiatry and Neurology" about the impression of this guideline, especially about "The functional differentiation of psychiatric hospital beds". Nine questions were notified on the home page of the society. 862 answers (5.3% of the members) were corrected by website from 1st to 30th of May in 2015. Attribution of the answers : doctors working at the psychiatric hospitals (70.9%), the psychiatric clinics (20%), the others (9.1%). The questions which more than 80% of the answers agreed were "The reduction of the psychiatric beds should be stepwise under the rule of checkbalance in the improvement of the psychiatric community treatment", "Improve the function of the recovery phase treatment" and "The adequate treat- ment for the patients of the severe and chronic phases". The questions more than 55% of the answers agreed were "The reduction of the chronic phase beds for the improvement of the function of the acute phase beds". The questions which opposites exceeded (almost 47%) were "The assessment of the psychiatric symptoms in the patients of the chronic phase should be done by the third party" and "The facility for social skill treatment should be placed in the community". We could know the mind of the members about the revolution of the psychiatric.

A sugar-carrying polymer chain with a disulfide group (DTPA−PMEGlc) was prepared by the coupling of poly(2-methacryloyloxyethyl d-glucopyranoside) (PMEGlc), which carried an amino group at its end, with 3,3‘-dithiodipropionic acid di-p-nitrophenyl ester. The polymer obtained was incubated with colloidal silver, and a self-assembled monolayer (SAM) of the polymer chain (PMEGlc) was formed on the surface of the colloid as evidenced by surface-enhanced Raman spectroscopy, cyclic voltammetry, dynamic light scattering, and ellipsometry. The silver colloid was largely stabilized by the modification with PMEGlc chains due to the formation of a thick diffuse layer on the surface. The critical flocculation concentration (CFC) of the modified colloid was not detectable, which is a contrast to the presence of CFC for the starting silver colloid dispersion (0.1 M NaCl at 25 °C). The polymer-coated colloids obtained (“sugar balls”) were aggregated when a solution of lectin (concanavalin A (Con A) from Canavalia ensifo...

糸球体濾過機能や糸球体の荒廃につながる癒着や半月体の形成に重要な役割をもつ糸球体上皮細胞 (GEC) の障害を評価するために，GECに対するマーカーを用いて腎組織での免疫染色性の変化，および尿沈渣を蛍光抗体法により検討した。GECに対するマーカーはポドカリキシン，C3b Receptor，PP44に対するモノクローナル抗体を用いた。腎組織レベルではC3b Receptorが組織障害の強い腎炎で減弱しており，障害のマーカーとしての有用性が示された。尿沈渣ではポドカリキシン，次いでC3b ReceptorがCasts，Granules，Cellsの形態で検出され，GEC障害のマーカーとしての有用性が示された。GEC障害の検出率は尿ポドカリキシン，尿C3b Receptor，組織C3bRの順に高かった。実際のGEC障害の評価にはこれらを総合して考える必要がある。

We applied an American medical necessity scale, Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS), to psychiatric practice in Japan. This is an exploratory analysis of empirical data of 272 patients. We examined the relationships between levels of care of LOCUS and clinical variables, contribution of care levels on admission decision, and changes in care levels over time. Inpatients showed significantly higher levels of care than outpatients. Levels of care showed significant strong inverse correlations to Global Assessment Scale (GAS) scores, and significant moderate correlations to admission types, care environment, and diagnostic subgroups in almost all groups. Levels of care contributed as much to the admission decision as GAS scores. Levels of care significantly decreased from the time of admission to discharge. Our preliminary evidence indicates that LOCUS is valid and sensitive to change, and applicable for clinical use in Japan.

Macroinitiators were prepared by coupling disuccinimidyl ester of 4,4'-azobis(cyanovaleric acid) with poly(N-isopropylacrylamide) (PIPA), which had an amino group at its end. Styrene was telomerized with the initiators in THF. When the styrene content in the A-B-A block telomer obtained (PIPA-b-PSt-b-PIPA) was high, the telomer formed an irreversible aggregation resulting in microspheres, whereas the telomer with a much shorter styrene block could be dispersed monomolecularly. The telomers dispersed in water were aggregated by raising the temperature above 32 degrees C due to a coil-globule transition of PIPA moieties. The PIPA-b-PSt-b-PIPA could be strongly adsorbed to polystyrene (PSt) solid surfaces to form a layer, and the PSt blocks might lay on the PSt surface and the PIPA blocks might direct to the solution phase. The contact angle of air bubbles on the surface of telomer-coated PSt in the air-in-water system was dependent on temperature; that is, with the increase in temperature the contact angle of air bubbles largely decreased and leveled off above the coil-globule transition temperature (Tc). Correspondingly, the amount of protein Concanavalin A adsorbed to the telomer layer deposited on the PSt surface increased gradually with an increase in temperature and leveled off above the Tc. These phenomena were attributed to the changes in hydrophobicity of the telomer layer below and above the Tc. The usefulness of macroinitiators in preparing various kinds of block telomers which have responsiveness to external stimuli was strongly suggested. Copyright 1999 Academic Press.

In Japan, new legislation regarding forensic mental health, namely, the Act on Medical Care and Treatment for Persons Who Have Caused Serious Cases under the Condition of Insanity (Medical Treatment and Supervision Act (MTS Act)) was enforced in 2005, although community mental health care remains largely unchanged. We surveyed local clinical psychiatrists by questionnaire to gather information on the influence of the MTS Act on clinical mental health practice. We sent a paper questionnaire to almost all the psychiatrists in the Chiba prefecture, 56% of whom (N = 306) responded. The participants felt that the MTS Act had minimal direct impact on community mental health care. However, some relatively new schemes such as a multiple disciplinary team approach or supervised outpatient care are given more attention than before. These results suggest that this new forensic mental health legislation may assist in the spread of new paradigms into clinical practice.