Brain structural changes as vulnerability factors and acquired signs of post-earthquake stress.

Many survivors of severe disasters, even those without posttraumatic stress disorder (PTSD), need psychological support. To understand the pathogenesis of PTSD symptoms and prevent the development of PTSD, the critical issue is to distinguish neurological abnormalities as vulnerability factors from acquired signs of PTSD symptoms in the early stage of adaptation to the trauma in the normal population. The neurological underpinnings of PTSD have been well characterized, but the causal relationships with the traumatic event are still unclear. We examined 42 non-PTSD subjects to find brain morphometric changes related to the severity of PTSD symptoms in a longitudinal magnetic resonance imaging study extending through the Great East Japan Earthquake. We found that regional grey matter volume (rGMV) in the right ventral anterior cingulate cortex (ACC) before the earthquake, and decreased rGMV in the left orbitofrontal cortex (OFC) through the earthquake were negatively associated with PTSD symptoms. Our results indicate that subjects with smaller GMV in the ACC before the earthquake, and subjects with decreased GMV in the OFC through the earthquake were likely to have PTSD symptoms. As the ACC is involved in processing of fear and anxiety, our results indicate that these processing are related to vulnerability for PTSD symptoms. In addition, decreased OFC volume was induced by failing to extinct conditioned fear soon after the traumatic event. These findings provide a better understanding of posttraumatic responses in early stage of adaptation to the trauma and may contribute to the development of effective methods to prevent PTSD.

Long-lived ultrafast spin precession in manganese alloys films with a large perpendicular magnetic anisotropy.

Spin precession with frequencies up to 280 GHz is observed in Mn(3-δ)Ga alloy films with a perpendicular magnetic anisotropy constant K(u)∼15 M erg/cm(3). The damping constant α, characterizing macroscopic spin relaxation and being a key factor in spin-transfer-torque systems, is not larger than 0.008 (0.015) for the δ=1.46 (0.88) film. Those are about one-tenth of α values for known materials with large K(u). First-principles calculations well describe both low α and large K(u) for these alloys.

Assessing age-related change in Japanese mental foramen opening direction using multidetector computed tomography.

OBJECTIVE: The purpose of this study was to investigate how the opening direction of the mental foramen (MF) changes with age in a Japanese population using multi-detector computed tomography (MDCT). METHODS: Post-mortem MDCT scans of 121 Japanese subjects (66 males and 55 females) were carried out where all subjects possessed at least twenty teeth, including molar teeth, in the upper and lower jaws. Two angles of the mental foramen opening were measured, namely the superior-inferior angle in the coronal plane and anterior-posterior angle in the transverse plane, on the CT reconstructed images. The associations between age and these two angles were evaluated using a multiple regression analysis. RESULTS: For male subjects, the relationship between the superior-inferior angle and age was a quadratic curve (p < 0.001). This angle increased until the subject reached their early 50s and then the angle decreased with age. In the transverse plane, there was a linear relation between the anterior-posterior angle and age (p=0.002).It was noted also that the angle decreased with age. By contrast, however, no significant associations between the two angles and age for either measurement were noted for female subjects. This study demonstrated that the opening direction of the mental foramen changes with age in Japanese male subjects. By contrast this change in the opening direction of the mental foramen was not demonstrated in Japanese female subjects. In male subjects, the opening direction moves superiorly until the individual reaches their early 50s, and then moves inferiorly with advancing age. It also shifts from a posterior to an anterior position with age. CONCLUSION: These observed change differ from the results of previous studies. The findings could be useful for forensic science as they demonstrate a change in the position of mental foramen in a sample of contemporaneous male Japanese subjects.

Recombinant tissue-type plasminogen activator ameliorates ischemic derangements induced by thrombotic occlusion in closed chest anesthetized dogs.

Effects of thrombotic coronary occlusion followed by thrombolytic reperfusion with recombinant tissue-type plasminogen activator (rt-PA) on infarct size and left ventricular function were studied in anesthetized closed chest dogs. After thrombotic occlusion of the left anterior descending coronary artery was produced by a copper coil technique, 74 dogs were randomly alloted to three groups; dogs treated with rt-PA at 90 min (n = 23) (group I) and at 180 min (n = 25) (group II) of the thrombotic occlusion, and 26 dogs treated with saline solution (permanent thrombotic occlusion, group III). The loading dose of intravenous rt-PA was 8,160 IU/kg body weight per min at the initial 60 min and the maintenance dose was 2,450 IU/kg per min continuously infused for 24 h. Thrombolytic recanalization was achieved at 15 +/- 4 and 18 +/- 6 min after rt-PA infusion in groups I and II, respectively. Infarct size and area at risk were determined by triphenyltetrazolium chloride staining and postmortem angiography; infarct size/area at risk ratio was 10 +/- 3% (n = 10), 33 +/- 7% (n = 9) and 63 +/- 3% (n = 10) in groups I, II and III, respectively (difference significant among groups). To examine whether infarct size and left ventricular function after thrombolytic reperfusion differ from those after mechanical reperfusion, 39 other dogs (group IV) underwent mechanical coronary occlusion for 106 +/- 1 min (occlusion period comparable with that of group I) and reperfusion using a balloon catheter.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of efficacy of lithium carbonate and chlorpromazine in mania. Report of collaborative study group on treatment of mania in Japan.

A multi-institutional cooperative study comparing lithium carbonate with chlorpromazine was conducted, using a controlled double-blind design in a series of 80 cases of endogenous manic psychosis, to evaluate the drugs' clinical utility and efficacy, characteristics of therapeutic effect, and side-effects. Dosages employed were consistently at an equipotent ratio of 4:1 (lithium carbonate:chlorpromazine). Physicians' overall ratings showed lithium carbonate as significantly superior to chlorpromazine in efficacy for manic psychosis. Improvements of basic mood and of disturbance in speech and voice were prominent with lithium carbonate. Onset of the therapeutic effect of lithium carbonate was within ten days of medication in 65% of the patients, significantly faster than with chlorpromazine. Side-effects encountered with lithium carbonate therapy at dose levels not higher than 1,800 mg/day were milder and less frequent compared with those seen with chlorpromazine.

Evaluation of a personal identification method using the fusion function of CT images and dental radiographs.

OBJECTIVES: We applied the fusion function of dental analysis software to examine whether the anatomical relationships of tooth roots when compared between reconstructed post-mortem CT (PMCT) and dental radiographs can aid dental identification. METHODS: One PMCT image taken from a cadaver (43-year-old male; Cadaver 1) was compared with 64 digital dental radiographs of the left and right upper and lower molars from Cadaver 1 and 30 other cadavers. Five corresponding anatomical reference points were marked on each image. After adjusting the angle and magnification using the fusion function, the automatically calculated error in pixels was determined five times for each of four sites on the images. RESULTS: Comparison of the PMCT image with the dental radiographs from the other cadavers revealed obvious discrepancies in the anatomical positioning of the teeth. When t-tests were applied to the data from any of the four sites, the error in pixels was found to be significantly smaller (p < 0.001) between Cadaver 1 and the other cadaver images. The average error in pixels between the PMCT and dental radiographs was smaller in the lower jaw than in the upper jaw. CONCLUSIONS: This method uses corresponding reference points on two images to calculate the error between the regions that contain all points. This feature also makes it possible to compare images taken with different modalities. The demand for a dental identification method involving PMCT is likely to increase, and we expect that the accuracy of dental identification will improve by using radiological images.

Regulatory differences and similarities: systems in Japan.

The historic steps that led up to the present federal drug regulations in the United States are outlined as a background to the development of the current drug regulatory system in Japan, consisting of the procedures for approval of new drugs, of double-brand naming, by which the same drug under different names can be sold as ethical or over-the-counter (OTC). The more recent provisions for re-evaluation of drugs, the mechanism for monitoring adverse reactions, and the dissemination of the collected information are described. The prescription habits of physicians, the influence of the health insurance systems on these, and the strikingly high level of drug consumption in Japan, as compared with those in other industrial countries, are discussed and illustrated graphically.

Age-related decreases in the reconstituting ability of hemopoietic cells and the ability of hemopoietic microenvironment to support hemopoietic reconstitution in senescence accelerated (SAM-P) mice.

The effect of the aging process on the hemopoietic system in senescence-accelerated (SAM-P) mice with respect to the reconstituting ability of hemopoietic cells and the ability of the microenvironment to support hemopoietic reconstitution was investigated by bone marrow transplantation (reconstitution assay). When the bone marrow cells, obtained from young or old mice, were transplanted to lethally irradiated young SAM-P mice no difference in the reconstituting pattern of femoral spleen colony-forming units (CFU-S), splenic CFU-S and splenic granulocyte macrophage colony-forming units (CFU-GM) was observed between the mice transplanted with young and old donor cells. However, the reconstitution of femoral CFU-GM in mice transplanted with old donor cells was delayed compared to that in mice transplanted with young donor cells. Moreover, the recovery of WBC in mice transplanted with old donor cells was noticeably delayed. When the bone marrow cells obtained from young mice were transplanted to young or old recipient mice, no difference in the reconstituting pattern of femoral CFU-S and CFU-GM as well as splenic CFU-S and CPU-GM was observed between young and old recipient mice. However, the recovery of WBC in old recipient mice was noticeably delayed. These data indicate that the functions of both the hemopoietic cells and the hemopoietic microenvironment deteriorated with age in SAM-P mice.

Effects of enoximone on exercise tolerance in patients with mild to moderate heart failure.

To evaluate the efficacy of enoximone on exercise tolerance in patients with mild to moderate heart failure, 33 patients underwent cardiopulmonary exercise tests before and 3 hours after placebo or after receiving 25 or 100 mg of enoximone administered randomly in a double-blind manner. The electrocardiogram was monitored and blood pressure measured every minute throughout cycle ergometer exercise testing with a ramp protocol in which the work rate increased 1 W every 6 seconds after a 4-minute 20-W warm-up. Minute ventilation, oxygen uptake (VO2), and carbon dioxide output were measured every 10 seconds in order to determine anaerobic threshold (AT) and peak VO2. Five patients were excluded from evaluation before breaking the double-blind key because of insufficient data. Heart rate increased and systolic blood pressure decreased throughout the testing only in the group taking 100 mg (n = 10). Significant increases in AT (14.4 to 16.2 ml/min/kg) and peak VO2 (20.8 to 22.9 ml/min/kg) were observed in the group taking 100 mg. The increases in AT showed a dose response, namely +0.7% in the placebo (n = 9), +6.9% in the 25-mg (n = 9) and 12.5% in the 100-mg group. The work rates at the AT point increased in the 25- and 100-mg groups. These results indicate that a single oral administration of enoximone improves exercise tolerance in patients with mild to moderate heart failure.

In vivo effect of a large amount of allogeneic granulocytes on reconstitution of hemopoietic cells of irradiated mice.

The in vivo effects of allogeneic granulocytes on the reconstitution of splenic and bone marrow CFUs and CFUc numbers were investigated using irradiated mice. When allogeneic granulocytes were intraperitoneally injected into irradiated BDF1 mice (260 rads), the reconstitution of CFUs in both spleen and bone marrow as well as the hematocrit were enhanced, while the reconstitution of splenic or bone marrow CFUc numbers was transiently suppressed and then enhanced. The magnitude of enhancement was dose-dependent. These results suggest that granulocytes injected into irradiated mice might act as enhancing effectors on the in vivo reconstitution of hemopoietic cells.

A long term follow-up of a randomized trial comparing interferon-alpha with busulfan for chronic myelogenous leukemia. The Kouseisho Leukemia Study Group.

To evaluate the long-term effectiveness of interferon-alpha (IFN-alpha) therapy in patients with chronic myelogenous leukemia (CML) in chronic phase, we examined the updated outcomes of 159 patients who had been enrolled between 1988 and 1991 into a randomized trial comparing IFN-alpha with busulfan. At a median follow-up of 73 months, the median survival was 71 months in the IFN-alpha group and 55 months in the busulfan group (P=0.0563), and the median time of remaining in chronic phase was 58 months in the IFN-alpha group and 39 months in the busulfan group (P=0.4676). Landmark analysis showed a significant advantage in survival (P=0.009) and duration of chronic phase (P=0.0001) in patients with any cytogenetic response among the IFN-alpha group. About half patients were discontinued IFN-alpha administration in spite of cytogenetic response in this study. It appears that continuation of IFN-alpha might possibly confer a survival advantage. Pretreatment factors associated with cytogenetic response included high hemoglobin level, low percentage of peripheral basophils and low leukocyte counts. Multivariate analysis identified lower percentage of bone marrow basophilia (P=0.007) for survival advantage. If a group with a very good prognosis is predicted by a new prognostic model, it might be an option to wait for bone marrow transplantation.

A phase II study of vinorelbine, a new derivative of vinca alkaloid, for previously untreated advanced non-small cell lung cancer. Japan Vinorelbine Lung Cancer Study Group.

To evaluate the effectiveness of vinorelbine (NVB) in patients with non-small cell lung cancer (NSCLC), a late Phase II study was conducted. A total of 80 patients with Stage III or IV NSCLC who had no previous therapy were entered into the study. Seventy-nine patients were eligible for response and toxicity. NVB was administered weekly by intravenous injection at a dose of 25 mg/m2 in 20 ml of saline and was generally administered in four cycles or more, unless patients had disease progression. Of the 79 eligible patients, 23 (29.1%) showed a partial response (95% confidence interval, 19.1-40.4%). The median duration of partial responses was 14.7+ weeks. The median survival time for all patients was 40.1+ weeks. The major toxicity was leukopenia. Grade 3 and 4 leukopenia occurred in 48 patients (60.8%). Other toxicities of grade 3 or more included anemia (6.3%), local cutaneous reaction (3.8%), pneumonitis (1.3%), nausea and vomiting (1.3%), mucositis (1.3%) and constipation (1.3%). The absolute dose-intensity of NVB was 22.33 mg/m2/week. A weekly schedule of intravenous administration of 25 mg/m2/week of NVB was reasonable for maintenance of activity, and acceptable for toxicity in the chemotherapy of advanced NSCLC.

The effects of topical diazoxide on hair follicular growth and physiology of the stumptailed macaque.

Diazoxide, an anti-hypertensive agent, has diverse pharmacologic effects; hypertrichosis, hyperglycemia associated with suppression of insulin release, and elevation of serum levels of androgens. Taking advantage of the hypertrichotic side effects of diazoxide, we examined the effect of topical application of the drug on hair regrowth in the bald frontal scalp of stumptailed macaques (Macaca arctoides); we also monitored systemic side effects. Using 7 adult stumptails, we applied diazoxide (5% solution in a vehicle) topically on the bald frontal scalp, once a day, 5 days per week. Two of seven macaques had vehicle alone applied. Hair growth was monitored by photographic recording (once every month) and by sequential analysis of folliculograms from biopsied skin (once every 4 months). We also examined body weight, hematology, blood pressure, heart rate, serum levels of testosterone and dihydrotestosterone, and glucose tolerance for a 4-month period. All 5 diazoxide-treated animals showed thickening and maintenance of the frontal hair during the entire treatment period (16 months). Analysis of folliculograms showed progressive enlargement of hair follicular size and acceleration of its cyclic growth from telogen to anagen phase and prolongation of anagen phase in all treated animals. Controls showed no consistent progressive changes of follicular growth. None of the animals treated with diazoxide showed abnormal changes in physical growth, cardiovascular function, serum levels of androgens, glucose tolerance (including insulin levels), or hematology.

Treatment of diffuse non-Hodgkin's lymphoma with combined chemotherapy using methotrexate, adriamycin, cyclophosphamide, vincristine, prednisolone and bleomycin (MACOP-B).

Forty-nine previously untreated adult patients with diffuse non-Hodgkin's lymphoma were treated with MACOP-B (methotrexate, adriamycin, cyclophosphamide, vincristine, prednisolone and bleomycin) between December 1986 and December 1990. Forty patients (82%) achieved a complete response (CR), three (6%) a partial response (PR), while four (8%) had either no response or progression of disease, one (2%) patient ceased MACOP-B therapy and received other chemotherapy because of sustained neutropenia, and one patient (2%) died of sepsis during therapy. The factors that adversely affected the CR rate were by stage IV, the presence of B symptoms, the presence of a large mass (greater than 5 cm), and low serum total protein level. The 4-year survival for all 49 patients was 70% and the 4-year disease-free survival (DFS) for the 40 CR patients was 77%. Relapses were higher in patients whose initial serum lactic dehydrogenase (LDH) level was higher than 660 IU/1 (DSF 89% vs. 49%). Toxicity was substantial but acceptable, with neutropenia and mucositis proving to be the most frequent severe side-effects. These preliminary results confirmed the effectiveness of MACOP-B therapy for diffuse non-Hodgkin's lymphoma.

Localization and synaptic effects of inhibitory vestibulocollic neurons activated by the posterior semicircular canal nerve in the cat.

Cellular locations, axonal projections, and synaptic effects of inhibitory vestibulocollic (VC) neurons activated by the ampullary nerve of the posterior semicircular canal (PCN) were studied in anesthetized cats. The inhibitory VC neurons were identified by their monosynaptic responses to PCN stimulation and by their antidromic responses to stimulation of the ipsilateral (i-) and contralateral (c-) neck extensor motoneuron pools, which are inhibitory targets of the PCN. They were classified as VCi (vestibulocollic neuron sending an axon to the i-neck extensor motoneuron pool) and VCc (vestibulocollic neuron sending an axon to the c-neck extensor motoneuron pool) neurons. Neither VCi nor VCc neurons were activated antidromically by localized stimulation of the ascending medial longitudinal fasciculus (asc. MLF) or the 3rd nuclei. Their cell somata were localized in the rostral part of the descending vestibular nucleus and the ventral part of the lateral vestibular nucleus. VCi and VCc neurons produced unitary IPSPs in neck extensor motoneurons in the C1 segment.

Extracellular recording of vestibulo-thalamic neurons projecting to the spinal cord in the cat.

Forty vestibulo-thalamic (VT) neurons were recorded extracellularly in the vestibular nuclei of the anesthetized cat. More than half of the VT neurons responded monosynaptically to vestibular nerve stimulation; the others responded polysynaptically. The VT neurons were activated antidromically from one or two sites in the contralateral VPL, VPM, VL, VM, SG, and PO in the thalamus. Their axonal arborizations in the thalamus were likely restricted in narrow areas. About three quarters of the VT neurons were also activated antidromically from the ventral funiculus in the C1 segment. Axonal branchings were found in the contralateral C1 gray matter. The VT neurons were mainly localized in the descending vestibular nucleus.

Spontaneous luxation of encapsulated intraocular lens onto the retina after a triple procedure of vitrectomy, phacoemulsification, and intraocular lens implantation.

PURPOSE: To report the clinical and histological findings of a luxated intraocular lens (IOL) in the capsular bag. METHODS: Review of a case. RESULTS: Twenty-three months after a triple procedure of vitrectomy, phacoemulsification, and IOL implantation for diabetic vitreous hemorrhage and cataract, the encapsulated IOL spontaneously luxated. Scanning electron microscopy showed sparsely distributed anterior and equatorial zonules, with only a few posterior zonules on the surface of the removed capusular bag. CONCLUSION: The absence of the anterior hyaloid membrane and posterior zonules and contraction of the lens capsule may cause dialysis of the zonules. Therefore, the anterior hyaloid membrane should be left in place in patients at low risk for the development of postoperative proliferation to maintain the long-term stability of the IOL.

Myotonic dystrophy with alveolar hypoventilation and hypersomnia: a clinicopathological study.

We present a case of myotonic dystrophy accompanied by alveolar hypoventilation and hypersomnia. Case history, pulmonary function tests, polygraphic recording, and multiple sleep latency test, concomitant with a restrictive ventilatory abnormality, suggested a central origin of alveolar hypoventilation and hypersomnia in our case. The most significant neuropathological findings were in the tegmentum of the brain stem. Severe neuronal loss and gliosis were observed in the midbrain and pontine raphe, particularly in dorsal raphe nucleus and superior central nucleus. Pontine and medullary reticular formation also showed a marked cell loss and fibrillary gliosis. The alveolar hypoventilation and the hypersomnia in our case may be attributed to these morphological abnormalities, and would appear to be central in nature.

Intra-abdominal hemorrhage due to rupture of a splenic vein aneurysm: a case report.

Splenic vein aneurysm (SVA) is extremely rare. Most patients with an SVA have portal hypertension. In this report we describe the first recorded case of intra-abdominal hemorrhage due to rupture of an SVA in a patient without evidence of portal hypertension. A 72-year-old man was admitted to our medical center in a state of shock, with complaints of acute abdominal pain and abdominal distention. Preoperatively, abdominal ultrasonography demonstrated an echo-free space in the abdomen, suggesting the presence of a fluid collection. In addition, computed tomography revealed an enhanced lesion with contrast material in the pancreatic tail. An emergency operation showed bleeding from the SVA near the pancreatic tail. Consequently, a distal pancreatectomy with splenectomy was performed. Histologically the lesion was diagnosed as an SVA surrounded by pancreatic tissue with chronic inflammatory changes. The patient's postoperative course was uneventful.