Shin-ichi Yoshioka

Relationships between serum magnesium levels and clinical background factors in patients with mood disorders

We measured serum magnesium (Mg) levels in 71 in‐patients and out‐patients with mood disorders and in 30 healthy controls and investigated the relationships between serum Mg levels and clinical background factors. Serum Mg levels were found to be significantly higher in patients with mood disorders than in controls. Serum Mg levels showed no significant correlation with patient sex, age, diagnosed subtype and disease phase in the mood disorder group. Serum Mg levels in patients with major depressive disorder who were taking psychotropic drugs were not significantly different from levels seen in patients with major depressive disorder who were not taking psychotropic drugs. These results suggest that the high serum Mg levels noted in patients with mood disorder are related to the underlying disorder itself and are not influenced by clinical background factors.

Age-specific effects of noradrenergic alpha-2 agonist clonidine on the development of amygdaloid kindling in developing rats

The effects of clonidine on the development of amygdaloid kindling were studied in rats of various ages (14, 21, 28 and 70 postnatal days). Administration of clonidine (0.2, 0.5 mg/kg i.p.) caused a significant retardation of kindling development in the 28-day-old rats as well as in the adult rats, whereas, in the 14-day-old rats, the development of kindling was significantly facilitated by clonidine. No significant effect of clonidine was observed in the 21-day-old rats. These results indicate that in rats the effects of clonidine on the development of amygdaloid kindling vary during development.

Development of computerized screening system for dementia and its preliminary field test

The population of aged persons is increasing along with an extension of the average span of human life. Therefore, the number of persons who suffer from dementing disorders is also increasing. Because the various psychotic symptoms and behavioral problems are frequently observed in persons with dementia, the families taking care of such people require help to reduce their mental and physical load. Therefore, maintenance and enhancement of the social support system for aged persons are urgent issues. Early identification is important because immediate recognition of dementia people and appropriate follow up treatment can prevent the progress of the disease. Clinical interviews are one general method for detecting patients with dementing disorders, and the Hasegawa Dementia Scale is one of the most popular methods in Japan. The test takes about 10 min per person, but it requires a lot of time and burden for medical staff to screen patients with dementia from the increasing number of aged persons. Therefore, new methods for assessing cognitive functions are requested. A computerized assessment system was developed for dementia which is based on the Hasegawa Dementia Scale. This system was designed for aged persons with no previous computer experience to operate easily by making efficient use of multimedia. In this paper, the system and preliminary results of the field-test are reported.

Case of pseudo-pseudohypoparathyroidism associated with juvenile dementia

Pseudo-pseudohypoparathyroidism (PPH) is a syndrome of anatomic abnormalities similar to pseudohypoparathyroidism with normal serum levels of calcium and phosphate. In an overview of PPH, Denko and Kaelbling reported that almost half of 21 cases displayed intellectual impairment. 1 However, PPH with increasing intellectual impairment has not been previously described. Recently, we have diagnosed a 24year-old woman manifesting juvenile dementia with PPH. Ms A, a 24-year-old woman with progressive mental retardation, was brought to Tottori University Hospital by her mother. She had no remarkable family history. She completed the normal course of junior high school and entered a special school for cooking. After graduation, she obtained a cooking license and got a job. However, she began making an increasing number of mistakes, and had to leave her job 2 years later. By the age of 24, she manifested marked memory impairment and difficulty in decision-making. Physical, neurological and gynecologic examination revealed no abnormalities other than positive knuckle signs on both hands. Normal values for serum levels of calcium, phosphorus, alkaline phosphatase and cholesterol were observed. Thyroid, parathyroid, pituitary and adrenocortical hormone were within normal ranges. Chromosomal findings were normal. A parathyroid hormone infusion study (Ellsworth–Howard test) displayed normal responses to parathyroid hormone. Her full IQ was 46. Comparing her ability between that during her special school days and that at the age of 24 using the Gottfries–Brane–Steen (GBS) Scale, the point increased from 7 to 37. The patient had no emotional dysfunction and no delusional and hallucinatory symptoms. Head magnetic resonance imaging (MRI) scans revealed fibrotic dysplasia of the right frontal cranial bone, which had been present since infancy. However, no cerebral calcification or abnormal density was apparent. Furthermore, electroencephalogram and 123 IN -isopropyl-p-iodoamphetamine single-photon emission computed tomography did not reveal any abnormalities. Our patient met all five criteria, which Yamamoto et al . established, 2 and was diagnosed with PPH. Although the present patient grew up without any major difficulties, at the age of 20 she suddenly began to show progressive mental impairment, resulting in juvenile dementia. The increased score on the GBS scale revealed a marked decrease in intellectual function. It is well documented that patients with PPH often showed mental retardation from birth. 1 However, increasing intellectual impairment in young adult PPH patients has not been reported. The psychiatric symptoms of PPH were reported to be related to basal ganglia calcification. Nyland and Skre reported the late onset of encephalopathy in PPH patients in a Norway family. 3 Five of the nine members of this family suffered increasing mental retardation during middle age, with calcifications of the basal ganglia. Our patient is a youth with manifest juvenile dementia and no cerebral calcification. The dementia in this PPH case must be caused by other mechanism than basal ganglia calcification.