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[Approach to the Development of Mind and Persona]. [心灵和人格发展的方法]。
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1265/jjh.73.67
Toshiko Sawaguchi

Objectives: To access medical specialists by health specialists working in the regional health field, the possibility of utilizing the voice approach for dissociative identity disorder (DID) patients as a health assessment for medical access (HAMA) was investigated. The first step is to investigate whether the plural personae in a single DID patient can be discriminated by voice analysis.

Methods: Voices of DID patients including these with different personae were extracted from YouTube and were analysed using the software PRAAT with basic frequency, oral factors, chin factors and tongue factors. In addition, RAKUGO story teller voices made artificially and dramatically were analysed in the same manner. Quantitive and qualitative analysis method were carried out and nested logistic regression and a nested generalized linear model was developed.

Results: The voice from different personae in one DID patient could be visually and easily distinquished using basic frequency curve, cluster analysis and factor analysis. In the canonical analysis, only Roy's maximum root was <0.01. In the nested generalized linear model, the model using a standard deviation (SD) indicator fit best and some other possibilities are shown here.

Conclusions: In DID patients, the short transition time among plural personae could guide to the risky situation such as suicide. So if the voice approach can show the time threshold of changes between the different personae, it would be useful as an Access Assessment in the form of a simple HAMA.

目的:通过在区域卫生领域工作的卫生专家访问医学专家,调查了对分离性身份认同障碍(DID)患者使用语音方法作为医疗访问健康评估(HAMA)的可能性。第一步是研究是否可以通过语音分析来区分单个DID患者的复数人称。方法:从YouTube上提取DID患者包括不同人格患者的声音,使用PRAAT软件对基本频率、口腔因素、下巴因素和舌头因素进行分析。此外,还以同样的方法分析了人工和戏剧性制作的RAKUGO说书人的声音。采用定量和定性分析方法,建立了嵌套逻辑回归模型和嵌套广义线性模型。结果:通过基本频率曲线、聚类分析和因子分析,可以直观、方便地区分1例DID患者不同人物的声音。在规范分析中,只有Roy的最大根是结论:DID患者在多重人格之间的短暂过渡时间可能导致自杀等危险情况。因此,如果语音方法可以显示不同角色之间变化的时间阈值,那么它将以简单的HAMA形式作为访问评估。
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引用次数: 0
[Editor's Note]. [编者按]。
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1265/jjh.73.96
Teruomi Tsukahara
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引用次数: 0
[Recent Trends of Trace Element Studies in Clinical Medicine in Japan]. [日本临床医学微量元素研究的新动向]。
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1265/jjh.73.75
Hiroko Kodama

The deficiency or excess intake of trace elements, including zinc, copper, selenium and iodine, has often been reported. Zinc deficiency is often observed in infants fed breast milk with low zinc concentration, individuals administered chelating medicines, athletes and patients with diabetes mellitus, hepatic cirrhosis or nephrosis syndrome. Menkes disease is associated with severe copper deficiency, and there is no effective treatment. Deficiencies of selenium and iodine are observed in patients who receive special formulas of milk and enteral formula with low selenium and iodine concentrations, respectively. In contrast, neonatal transient hypothyroidism due to excess intake of iodine in pregnant women has also reported in Japan. It is expected that collaborative studies by researchers and clinicians will contribute to clarify the detail mechanism, diagnosis and treatment of these abnormalities.

缺乏或过量摄入微量元素,包括锌、铜、硒和碘,经常被报道。锌缺乏症常见于低锌母乳喂养的婴儿、服用螯合药物的个人、运动员和糖尿病、肝硬化或肾病综合征患者。门克斯病与严重缺铜有关,目前尚无有效的治疗方法。硒和碘缺乏症分别发生在服用特殊配方奶和低硒低碘肠内配方奶的患者中。相比之下,日本也有孕妇因过量摄入碘而导致的新生儿短暂性甲状腺功能减退的报道。期望研究人员和临床医生的合作研究将有助于阐明这些异常的详细机制,诊断和治疗。
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引用次数: 0
[New Approach to the Investigation of DOHaD Using X-inactivation Gene Expression System]. 用x -失活基因表达系统研究DOHaD的新方法
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1265/jjh.73.101
Takayuki Kumamoto, Shigeru Oshio

X-chromosome inactivation (XCI) occurs during the gestation period to compensate for the dosage of X-linked genes in female mammals. Xist RNA is a long noncoding RNA with a global epigenetic function and is indispensable for XCI from the initiation to establishment and maintenance phases. The X chromosome contains over 1,000 genes that are essential for proper development, especially that of the brain, immune system, metabolism and reproductive functions. We found that exposure to bisphenol A or folate deficiency during the fetal period changes the expressions of Xist, Tsix (the antisense repressor of Xist), and many X chromosome linked genes widely in newborn mice. This finding suggests that this X-chromosome mediated effect is considered one of the mechanisms of various problems encountered in the fetal environment. The Developmental Origins of Health and Disease (DOHaD) hypothesis states that nutrition and other environmental stimuli during critical periods affect developmental pathways with epigenetics and induce metabolism and chronic disease susceptibility. The XCI process has some similarities to this hypothesis and it may become one of the approaches to reveal the DOHaD mechanisms.

雌性哺乳动物在妊娠期发生x染色体失活(XCI),以补偿x连锁基因的剂量。Xist RNA是一种具有全局表观遗传功能的长链非编码RNA,是XCI从起始到建立和维持阶段不可或缺的RNA。X染色体包含1000多个基因,这些基因对正常发育至关重要,尤其是大脑、免疫系统、新陈代谢和生殖功能。我们发现,在胎儿期暴露于双酚A或叶酸缺乏会改变新生小鼠Xist, Tsix (Xist的反义抑制因子)和许多X染色体相关基因的表达。这一发现表明,这种x染色体介导的作用被认为是胎儿环境中遇到的各种问题的机制之一。健康与疾病的发育起源(DOHaD)假说认为,关键时期的营养和其他环境刺激通过表观遗传学影响发育途径,诱导代谢和慢性疾病易感性。XCI过程与这个假设有一些相似之处,它可能成为揭示DOHaD机制的方法之一。
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引用次数: 0
[Nonregular Employment in a Society with a Decreasing Birthrate: Workers' Marriage, Childbirth, and Childcare]. [低出生率社会中的非正规就业:劳动者的婚姻、生育和育儿]。
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1265/jjh.73.215
Mariko Nishikitani, Mariko Inoue, Shinobu Tsurugano

In this paper, we examine the trend in Japan towards nonregular employment and its effects on marriage, childbirth, and childcare from the viewpoint of a decreasing societal birthrate. Although the decision to marry includes personal values and preferences, socioeconomic status factors such as income and employment type are also associated with the determinants of marriage. Nonregular employment workers have a lower rate and motivation for marriage than regular workers. Thus, socioeconomic disparity caused by employment needs to be minimized through governmental measures and policies. Nonregular employment is increasing among younger generations, and for them, maternity and childcare leave are especially vital. Employee insurance coverage should be expanded to function as a form of income security during these leaves of absence, such that nonregular workers are also covered. During the childcare period, which lasts more than 10 years, it is necessary to cover childrearing costs and also the time required to spend with children. If a single working parent is involved in childcare alone, there is the burden of both work and childcare. Additionally, long work hours can also impact workers that are not involved in childcare. This is a dilemma: a stable and regular employment is often necessary to achieve a higher education; however, it is difficult for nonregular employees to take care of and prepare children for higher education owing to limited financial means. Properly designed measures and policies are necessary to break this chain. Importantly, considerations about life and work are important for all workers, including nonregular workers, who are especially affected in terms of marriage, childbirth, and childcare.

在本文中,我们从社会出生率下降的角度研究了日本非正规就业的趋势及其对婚姻、生育和儿童保育的影响。虽然结婚的决定包括个人价值观和偏好,但收入和就业类型等社会经济地位因素也与婚姻的决定因素有关。非正式就业者的结婚率和结婚动机都低于正式就业者。因此,需要通过政府的措施和政策来尽量减少就业造成的社会经济差距。在年轻一代中,非正规就业正在增加,对他们来说,产假和育儿假尤为重要。雇员的保险范围应该扩大,作为休假期间收入保障的一种形式,这样非正式工人也能得到保障。在长达10年以上的育儿期间,不仅需要支付育儿费用,还需要支付与孩子相处的时间。如果单亲父母独自照顾孩子,就会有工作和照顾孩子的负担。此外,长时间的工作也会影响到那些没有照顾孩子的人。这是一个进退两难的问题:要获得高等教育,稳定而有规律的工作往往是必要的;然而,由于经济条件有限,非正规职员工很难照顾子女并为子女接受高等教育做好准备。要打破这一链条,必须采取适当的措施和政策。重要的是,考虑生活和工作对所有工人都很重要,包括非正式工人,他们在婚姻、生育和育儿方面尤其受影响。
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引用次数: 3
[To the memory of the late Dr. Hideyasu Aoyama]. [纪念已故的青山秀康博士]。
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1265/jjh.73.243
Akira Babazono
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引用次数: 0
[Environmental Impact Assessment of Wind Power Generation Facilities]. [风力发电设施环境影响评价]。
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1265/jjh.73.284
Kunio Hara

Impacts of wind power generation facilities on neighborhood residents, animals, plants, water environment and landscape are a concern. Therefore, in 2010, wind turbine facilities were targeted to be covered by the environmental impact assessment law, which was enacted in 1999, and was amended with the environmental impact statement procedure in 2013. A guidance level of noise produced by wind turbines in quiet residential areas was set in 2017. In the environmental impact statement procedure at the planning stage of targeted projects, the trust of precedent users should be obtained and consensus building should be implemented. Projects of wind turbine facilities are accepted in accordance with the environmental impact assessment law using the new guidance noise level and the procedure of the environmental impact statement.

风力发电设施对周边居民、动植物、水环境和景观的影响是人们关注的问题。因此,2010年,风力发电设施被纳入1999年制定的《环境影响评价法》,并于2013年修订为《环境影响报告书程序》。2017年制定了安静住宅区风力涡轮机产生的噪音指导水平。在目标项目规划阶段的环境影响评价程序中,应取得先行用户的信任,并实现共识的建立。风电设施项目按照《环境影响评价法》的规定,采用新的指导噪声级和环境影响报告书程序进行验收。
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引用次数: 0
[Political Measures against Declining Birthrate-Implication of Good Family Policies and Practice in Sweden or France]. [应对出生率下降的政治措施——瑞典和法国良好家庭政策和实践的影响]。
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1265/jjh.73.322
Kanae Karita, Mari Kitada

Although the birthrate greatly declined from the 1960s to the mid-1970s amongst many developed countries, the downturn has steadily been reversed by promoting women's rights and reviewing family policies in some European countries such as Sweden and France. The current total fertility rate in Sweden or France is approximately around 1.9 children per woman. The favorable state can be partly explained by the active family policies of these countries. The government of Sweden has implemented a wide range of measures including tax allowances, childcare services, and other subsidies, as well as an18 month parental leave to be shared between mothers and fathers. The government of France has expanded childcare and provided incentives by increasing childcare/family benefits with each subsequent child.In Japan, the fertility rate has changed from a downward trend to an upward trend, but only very slightly over the last decade. The legislative systems and enforcement remain totally inadequate to maintain stable a fertility rate. The Japanese government should try to change the social security/labor policies into more active and generous ones, with enhancement of economic support and promotion of work-life balance. Other attempts including removing barriers to encourage the youth to start a family are needed to overcome declining birth rates in Japan.

虽然从20世纪60年代到70年代中期,许多发达国家的出生率大幅下降,但在一些欧洲国家,如瑞典和法国,通过促进妇女权利和审查家庭政策,这种下降趋势已经稳步扭转。目前瑞典或法国的总生育率大约是每名妇女生育1.9个孩子。这些国家积极的家庭政策可以部分解释这种有利的状态。瑞典政府实施了广泛的措施,包括税收补贴、托儿服务和其他补贴,以及18个月的父母共享育儿假。法国政府扩大了托儿服务,并通过增加每个后续孩子的托儿/家庭福利来提供激励。在日本,生育率从下降趋势变为上升趋势,但在过去十年中变化很小。立法制度和执法仍然完全不足以维持稳定的生育率。日本政府应该努力改变社会保障/劳动政策,使其更加积极和慷慨,加强经济支持,促进工作与生活的平衡。日本还需要采取其他措施,包括消除鼓励年轻人组建家庭的障碍,以克服日本不断下降的出生率。
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引用次数: 1
[Some Attentional Points in the Clinical Aspects of Trauma Care]. [创伤护理的临床注意事项]。
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1265/jjh.73.57
Toshiko Sawaguchi, Toshiko Kamo

Almost all patients requiring care for a combination of sexual, physiological, and psychological trauma, suffer from psychological or mental illness. Mental symptoms are well known to be associated with the violence very well and assailants have a violence dependency but it is not a well known mental disease. Changing of roles between being an assailant and being a victim is observed in half of the patients. In patients with trauma, hyperarousal and apathy appears simultaneously, and avoidance symptoms, intrusion symptoms, and crashed sleep, dissociation are also recognized. In addition, symptoms of orality are observed in patients requiring trauma care. However, hyperarousal, disturbance of sleep, and suicidal ideation improve quickly and the symptoms of a pair of a mother-child pair are well correlated. In organic non-temporary hyper psychogenic diseases (physiological diseases and surgery, and so on), non-organic psychogenic diseases (psychiatric diseases), and diseases on the border line between organic and non-organic diseases (psychosomatic diseases and may be unknown to non-medical professionals knowledge of such characteristic symptoms) is important information for health and medical care in the regional comprehensive care setting.

几乎所有需要治疗性、生理和心理创伤的患者都患有心理或精神疾病。众所周知,精神症状与暴力有着密切的联系,攻击者也有暴力依赖,但这并不是一种众所周知的精神疾病。在一半的病人身上可以观察到在攻击者和受害者之间角色的转变。在有创伤的患者中,亢奋和冷漠同时出现,并可识别出逃避症状、侵入症状和睡眠崩溃、分离。此外,在需要创伤护理的患者中观察到口腔症状。然而,过度觉醒、睡眠障碍和自杀意念改善迅速,母子对的症状有很好的相关性。在器质性非暂时性高心因性疾病(生理疾病和外科疾病等)中,非器质性心因性疾病(精神疾病)以及介于器质性和非器质性疾病之间的疾病(心身疾病,非医疗专业人员可能不知道这些特征症状的知识)是区域综合保健机构卫生和医疗保健的重要信息。
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引用次数: 1
[Underlying Mechanisms of Methamphetamine-Induced Self-Injurious Behavior and Lethal Effects in Mice]. [甲基苯丙胺诱导小鼠自伤行为和致死效应的潜在机制]。
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1265/jjh.73.51
Tomohisa Mori, Toshiko Sawaguchi

Relatively high doses of psychostimulants induce neurotoxicity on the dopaminergic system and self-injurious behavior (SIB) in rodents. However the underlying neuronal mechanisms of SIB remains unclear. Dopamine receptor antagonists, N-methyl-D-aspartic acid (NMDA) receptor antagonists, Nitric Oxide Synthase (NOS) inhibitors and free radical scavengers significantly attenuate methamphetamine-induced SIB. These findings indicate that activation of dopamine as well as NMDA receptors followed by radical formation and oxidative stress, especially when mediated by NOS activation, is associated with methamphetamine-induced SIB. On the other hand, an increase in the incidence of polydrug abuse is a major problem worldwide. Coadministered methamphetamine and morphine induced lethality in more than 80% in mice, accompanied by an increase in the number of poly (ADP-ribose) polymerase (PARP)-immunoreactive cells in the heart, kidney and liver. The lethal effect and the increase in the incidence of rupture or PARP-immunoreactive cells induced by the coadministration of methamphetamine and morphine were significantly attenuated by pretreatment with a phospholipase A2 inhibitor or a radical scavenger, or by cooling of body from 30 to 90 min after drug administration. These results suggest that free radicals play an important role in the increased lethality induced by the coadministration of methamphetamine and morphine. Therefore, free radical scavengers and cooling are beneficial for preventing death that is induced by the coadministration of methamphetamine and morphine. These findings may help us better understand for masochistic behavior, which is a clinical phenomenon on SIB, as well as polydrug-abuse-induced acute toxicity.

相对高剂量的精神兴奋剂可诱导啮齿动物多巴胺能系统的神经毒性和自残行为。然而,SIB的潜在神经元机制尚不清楚。多巴胺受体拮抗剂、n -甲基- d -天冬氨酸(NMDA)受体拮抗剂、一氧化氮合酶(NOS)抑制剂和自由基清除剂可显著减弱甲基苯丙胺诱导的SIB。这些发现表明,多巴胺和NMDA受体的激活,随后自由基形成和氧化应激,特别是当NOS激活介导时,与甲基苯丙胺诱导的SIB有关。另一方面,多种药物滥用发生率的增加是全世界的一个主要问题。同时给药甲基苯丙胺和吗啡导致小鼠80%以上的死亡率,同时心脏、肾脏和肝脏中聚(adp -核糖)聚合酶(PARP)免疫反应细胞的数量增加。经磷脂酶A2抑制剂或自由基清除剂预处理,或在给药后30 ~ 90 min冷却,甲基苯丙胺和吗啡联合给药可显著减弱甲基苯丙胺和吗啡联合给药引起的致死性作用和破裂或parp免疫反应细胞发生率的增加。这些结果表明,自由基在甲基苯丙胺和吗啡共同给药引起的致死率增加中起重要作用。因此,自由基清除剂和冷却剂对预防甲基苯丙胺和吗啡联合使用引起的死亡是有益的。这些发现可能有助于我们更好地理解SIB的临床现象——受虐行为,以及多种药物滥用引起的急性毒性。
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引用次数: 1
期刊
Japanese Journal of Hygiene
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