Immunohistochemical study on androgen receptors in the anterior cruciate ligament in dogs.

Androgen is closely involved as the cause of rupture of anterior cruciate ligament (ACL) in human. In dogs, however, factors contributing to rupture of ACL remain unknown. In this study, expression of androgen receptor (AR) and histological distribution of blood vessels in ACL, and serum testosterone concentration were investigated in relation with age and sex to confirm whether canine ACL is an androgen-responsive tissue. Materials of ACL were obtained from 26 dogs: 12 young female Beagles, 2 old female mixed breeds, 9 young male Beagles, and 3 old male mixed breeds. In all canine ACL, positive AR expression was recognized in the nuclei of the fibrocytes, fibroblasts, synovial cells, and vascular endothelial cells of ACL. Expressions of AR were lesser in old males compared to the young males; however, females had no age difference in expression. Distributions of blood vessels in the synovial membrane of the ligament were fewer in old dogs both of males and females than youngs. Although distributions of vessels in the interstitium were apparently fewer in young females. Serum testosterone concentration was significantly higher in young males. Females had no age difference in the levels. From these results, it is suggested that canine ACL is an androgen-responsive tissue, and this consideration seems to closely relate to the epidemiological background that the incidence of rupture of ACL of dogs is higher in females than in males.

Effects of androgens on cultured cells derived from canine anterior cruciate ligament.

Anterior cruciate ligament (ACL) fibroblasts obtained from beagle dogs were cultured in basal medium containing different concentrations of 1 to 10(-3) µM 5α-dihydrotestosterone (DHT) and in basal medium itself as a control. It was demonstrated that DHT promoted cell proliferation activity, expression of androgen receptor, and collagen synthesis in ACL fibroblasts as compared with control. These results suggest that sex hormones are involved in the sex difference seen in ACL rupture of dogs.

[A call for immediate abolishment of the Medical Treatment and Supervision Act].

The author demonstrates that Japan's Medical Treatment and Supervision Act of 2005 is meaningless and harmful from the perspective of psychiatric treatment, and worthless in terms of enhancing public safety. He goes on to propose a step-by-step process for reforming both the practice of psychiatry in general and that branch of the justice system that deals with defendants who have psychiatric disorders. The author suggests that the cost of reforms can be offset by abolishing the law in question and reducing the number of psychiatric hospital beds, and argues that it is possible to immediately halve the number of those beds. The author emphasizes that, while it is possible to immediately abolish the law, there will be anxiety associated with the progression of reforms.

[Investigation of verdicts in lawsuits involving competency to stand trial].

In Japan, few discuss the issues concerning competency to stand trial in criminal cases. The author investigated 24 verdicts of Japanese courts addressing this issue. The definition of such competency by the Supreme Court is not sufficiently explicit. Some verdicts have held defendants incompetent for their lack of ability to: communicate; comprehend their situation; understand the details and ramifications of acts of litigation; or comprehend the abstract concept of their right to silence/right against self-incrimination. Others found that the accused had life skills and understood the issues surrounding the lawsuit in both practical and general terms, making the person competent to stand trial. The author examined how the cases were dealt with when the defendants were found incompetent--whether they were suspended or dismissed; how and where defendants were treated psychiatrically--; what was done when the accused dismissed the appeal in a capital case, was suffering from mental disorder induced by detainment; as well as how competency should be regarded before charges are brought, when the transcript of indictment is sent, at the appellate court level, etc. The author also introduced some assessment tools used for assessing competency to stand trial in the United States.

Volumetric perfusion CT using prototype 256-detector row CT scanner: preliminary study with healthy porcine model.

This is a preliminary demonstration of volumetric perfusion CT of the brain in domestic pigs by using a prototype 256-detector row CT. Scan range is approximately 100 mm in the craniocaudal direction with 0.5-mm section thickness. The 256-detector row CT is an easily available imaging technique that can provide volumetric cine imaging, CT angiography, and perfusion CT in a wide craniocaudal coverage simultaneously.

[Preliminary reports on psychiatric practice in correctional facilities].

In October 2001, Nanashakon, a council composed of seven psychiatry-related organizations in Japan, decided to launch an investigation into forensic psychiatry in Japan, and established a working team (WT) for this purpose. From its establishment to March 2004, the WT performed surveys and analyses of the current situation of preliminary reports by psychiatric experts (preliminary reports) and of psychiatric practice in correctional facilities. Based on the results, the WT has presented proposals including guidelines for preliminary reports. In January 2002, the WT conducted an awareness survey on the status quo of testimony by psychiatric experts and forensic psychiatry, targeting the members of the Japanese Society of Psychiatry and Neurology, and obtained 666 replies. The survey revealed various critical opinions such as skepticism over the current punishment imposed on criminal patients with mental disorders. In February 2002, the WT obtained data on preliminary reports (2,042 cases) compiled prior to prosecution in FY2000 from the Japanese Ministry of Justice. Reviewing the details and differences between the evaluation by psychiatrists and the decision by public prosecutors, the WT pointed out the ambiguity of criteria used for the evaluation of competency of weak-minded persons and the criteria for criminal punishment. Around the same time, the WT was also asked by a news agency to analyze the preliminary reports of 50 district public prosecutor offices. The results revealed marked regional differences in the operation of the preliminary evaluation system for competency. In January 2003, the WT collected 146 preliminary reports from around the country for comparison and review, and again found conspicuous individual and regional discrepancies in the format and content. Based on these results, the WT conducted a hearing of 41 expert opinions on preliminary reports, and in January 2004, proposed guidelines outlining a format model of preliminary reports, and a training and authorizing system for forensic psychiatrists, to standardize preliminary reports and enhance their reliability. In February 2004, the WT conducted a questionnaire survey on the current situation of psychiatry in correctional facilities, targeting doctors with experience working under these circumstances. Fifty-one replies were obtained. Most of the respondents approved of the current system. However, to incite arguments in this area, attempts were made to draw critical responses and discussion by presenting data on the current situation of psychiatric practice in correctional facilities.

[Role of psychiatrists in capital punishment cases : a review].

Many medical organizations have passed resolutions banning participation of psychiatrists in legal executions, such as the Madrid Declaration of World Psychiatric Association. The Criminal Procedure Act of Japan prohibits the execution of the insane. Although the USA and Japan are both among the few so-called developed countries that have a system of capital punishment, many disputes about psychiatrists' participation in death penalty cases have occurred in the US, but few in Japan. This author has reviewed papers addressing this issue. The U.S. Supreme Court decided in Ford v. Wainwright that the execution of an "insane" inmate was not constitutional. The rationale for excluding the mentally incompetent from execution, however, is not completely clear. The most compelling reason is that execution does not satisfy the requirement for "effective retribution," since the insane criminal is not capable of understanding the implications of the death penalty. Nonetheless, there are those who dispute this interpretation and offer other explanations. Psychiatrists may be called upon to assess a criminal's competency for execution. Some find no problem with this practice, while others object to it stating that it conflicts with the ethical tenet to "first do no harm." Those who argue from a middle position insist on assessing competency while recognizing the existence of problems in making such an assessment. Furthermore, there is controversy over which factors exactly constitutes "competency to be executed." Usually, it is thought to be one's capacity to understand the nature of the death penalty and the reasons why the penalty is to be inflicted, but other arguments exist, including the capacity to assist legal counsel in last minute appeals. The question of whether to offer treatment to death row inmates who have been found incompetent to be executed is also under debate. The first position argues that they should "never be treated", because such prisoners would be executed when treatment restores competency. The second, always-treat-position, asserts that psychiatrists are responsible for treating severe mental illness whenever possible. The third, intermediate position, insists upon treatment with several conditions, which entail, for example, respecting the prisoner's autonomy and/or selecting forms of treatment that are unlikely to restore competency. When treatment is given, assessment as to whether competency has been restored is then required. This is still a troublesome issue. The decision in Perry v. Louisiana dealt with the question of whether the state may forcibly treat prisoners incompetent for execution. There were reports about ambivalence and anger among the staff of a psychiatric hospital where an inmate found incompetent for execution was treated. More than a few disputes insist that the ethical dilemma can only be resolved by commuting the sentences of incompetent death row prisoners to life imprisonment. This author further asserts that the secretiveness with which the Ministry of Justice of Japan handles these types of cases should be abolished as soon as possible.