Itsugi Nagatomo

Gender of demented patients and specific family relationship of caregiver to patients influence mental fatigue and burdens on relatives as caregivers.

To survey the burden and psychological problems of family caregivers of demented people.

A STUDY OF THE QUALITY OF LIFE IN ELDERLY PEOPLE USING PSYCHOLOGICAL TESTING

To study factors which influence the quality of life (QOL) in the elderly, we investigated the relationship between scores on the modified Philadelphia Geriatric Center (JPGC) Morale Scale and various other psychological tests in 51 elderly people residing in a long‐term care facility. The JPGC Morale Scale score correlated with the scores for all sections of the Japanese version of the Cornell Medical Index (JCMI), but not with those for the Mini Mental State Examination, the Kohs block design test, the Bender Gestalt test and the activities of daily living (ADL). Both somatic and psychotic symptoms on the JCMI were correlated with the dementia behaviour disturbance scale score and walking ability according to the ADL. Subjects were further divided into four groups according to Fukamachis neurotic discriminative diagram based on the JCMI. Scores for most sections of somatic and psychotic symptoms on the JCMI were elevated in proportion to the degree of neurotic tendencies in the elderly. These results indicate that the QOL of the elderly is influenced by subjective symptoms, but not by the degree of cognitive impairment or the ADL.

Relationships between convulsive seizures and serum and brain concentrations of phenobarbital and zonisamide in mutant inbred strain EL mouse

We evaluated the anticonvulsive effects of phenobarbital (PB) and zonisamide (ZNS) in the EL mouse, a strain that is highly susceptible to seizures. The concentration of each agent was analyzed in the serum and brain. PB suppressed the seizures dose-dependently, whereas even the higher dose of ZNS was ineffective in achieving a complete suppression. Serum and brain concentrations of these two drugs increased in proportion to the higher dose injected intraperitoneally. Brain concentration of PB was lower than the serum concentration, while the brain concentration of ZNS exceeded that in serum. Although serum concentration of ZNS was essential unchanged after the combined administration of PB and ZNS, the concentration of ZNS in brain tended to rise in proportion to the highly dose of PB. Combined administration was more effective than other treatment alone. Results indicated that brain concentration of ZNS especially after concomitant PB administration, were higher than that would be expected from the concentration of ZNS in serum.

In utero and lactational exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin decreases serotonin-immunoreactive neurons in raphe nuclei of male mouse offspring

Female ddY mice were administered 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) by gavage for 8 weeks prior to pregnancy. In the male breast-fed offspring born to the TCDD-exposed mice, serotonergic neurons in the brainstem were examined using an immunocytochemical method at 42 days of age. In all offspring, a marked decrease in the intensity of immunostaining occurred in all raphe nuclei compared with the control offspring. The number of serotonin-immunoreactive neurons in each raphe nucleus was measured by computer-assisted analysis. Approximately a quarter to half of immunoreactive neurons were detected in the TCDD-exposed offspring raphe nuclei compared with the control offspring. The present findings suggest that in utero and/or lactational TCDD exposure cause a long-lasting change in the serotonergic system in the raphe nuclei of offspring.

Deep venous thrombosis of the leg due to psychiatric stupor

Abstract  We report the cases of two patients with psychiatric stupor who developed venous thrombosis. A 29‐year‐old schizophrenic woman had been hospitalized in psychiatric institutions three times because of stupor associated with auditory hallucinations and thought blocking. These symptoms recurred and she was admitted to our hospital with deep venous thrombosis of her left leg. The other patient was a 67‐year‐old woman with depression. She had also suffered from insomnia. Following admission to our hospital, she developed a depressive stupor complicated by deep venous thrombosis of her left leg. Both cases were treated with sodium heparin and urokinase, and completely resolved. It is well known that dehydration, infection and decubitus ulcers are important physical complications of psychiatric stupor, but there have been few reports of deep venous thrombosis as a physical complication of stupor.

Effects of MK-801, dantrolene, and FK506 on convulsive seizures and brain nitric oxide production in seizure-susceptible EL mice.

To clarify the role of nitric oxide (NO) in the pathogenesis of seizures in susceptible EL mice, we investigated effects of three drugs potentially related to NO production, MK-801, dantrolene, and FK506, on convulsive seizures and brain NO metabolites (NOx). MK-801 or dantrolene, but not FK506, suppressed convulsive seizures in EL mice; only MK-801 reduced NOx in the brain. Our results suggested involvement of the N-methyl-D-aspartate receptor-channel complex and intracellular calcium mobilization, but not calcineurin, in the convulsions of EL mice.

Effects of combined administration of zonisamide and valproic acid or phenytoin to nitric oxide production, monoamines and zonisamide concentrations in the brain of seizure-susceptible EL mice.

This study was undertaken to elucidate the anticonvulsive effects of zonisamide (ZNS: 25, 50, and 75 mg/kg, intraperitoneal [i.p.]), which was coadministered with valproic acid (VPA: 25, 50, and 100 mg/kg, i.p.), or phenytoin (PHT: 10, 25, and 50 mg/kg, i.p.) to ZNS concentration, nitric oxide metabolites (NOx levels), and monoamines in the brain of the EL mouse, a strain highly susceptible to seizures. NOx levels were obtained from measuring of combined level of nitrite plus nitrate. Coadministration of ZNS with VPA or PHT suppressed convulsive seizures more effectively than with treatment of ZNS alone. Both serum and brain concentrations of ZNS tended to increase as the dose of VPA or PHT was increased. While coadministrations of ZNS (75 mg/kg) and VPA or PHT at any dose did not change brain and serum NOx levels, those altered brain monoamine contents. These results suggested that anticonvulsive effect of coadministrations of ZNS and VPA or PHT were caused by changes of monoamines rather than changes of NO metabolites.

Sparse distribution of NADPH diaphorase neurons in the hippocampal formation of the inbred mutant strain EL mouse

The number of NADPH diaphorase-positive cells in the CA1/CA2 and CA3 regions of Ammons horn and the subiculum of the hippocampal formation of EL mice, an inbred mutant strain of the ddY mouse susceptible to convulsive seizures, was fewer than that of ddY mice. These findings suggest that smaller numbers of nitric oxide producing cells in the hippocampal formations of EL mice is related to their susceptibility to convulsive seizures.

Blood flow velocity waveform in the common carotid artery and its analysis in elderly subjects

We investigated common carotid artery blood flow in 99 elderly nursing home residents using an ultrasonic quantitative blood flow measurement system. Systolic velocity and end-diastolic velocity were obtained from the waveform and classified, using the end-diastolic/systolic volume as Type A which is normal flow (>20% bilaterally), Type B which is unilateral decreased flow (<20% unilaterally), Type C which is bilateral decreased flow (<20% bilaterally), Type D which is Type C plus a saw tooth pattern and Type E which is no diastolic pattern, i.e. a value of 0 unilaterally or bilaterally. Five per cent of subjects showed Type A of blood flow velocity waveform (normal flow pattern) and about 40% showed Type E (no diastolic pattern). The subjects were divided into three groups according to blood flow velocity waveform. Groups 1, 2 and 3 showed Types A or B, C or D, and E, respectively. The total blood flow volume and mean blood flow velocity of Group 1 were significantly higher than those of Groups 2 and 3 in both the supine and sitting positions. Although both total blood flow volume and mean blood flow velocity of Group 1 decreased significantly in postural change, those of Groups 2 and 3 did not change. These results suggest that total blood flow volume and mean blood flow velocity decrease in proportion to changes in the blood flow velocity waveform.

Nitric oxide production is decreased in the brain of the seizure susceptible EL mouse.

To investigate nitric oxide production in the brain of the EL mouse, an inbred mutant strain of the ddY mouse that is susceptible to convulsive seizures, we measured whole brain nitric oxide metabolites, and counted the number of nitric oxide-producing cells in the parietal cortex and striatum. Nitric oxide metabolites in the brain and serum were determined by measuring levels of nitrite plus nitrate. Nitric oxide-producing cells were demonstrated histochemically by staining for nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase. Levels of nitrite plus nitrate in the whole brain were significantly lower than those of the control mice, although levels of nitrite plus nitrate in the serum did not differ between groups. There were significantly fewer NADPH-diaphorase-positive cells in the parietal cortex and striatum of the EL mouse compared to the ddY controls. These results suggest that lower nitric oxide production in the brain may be related to the susceptibility of the EL mouse to convulsive seizures.