Folia psychiatrica et neurologica japonica最新文献

Progressive mental deterioration associated with parkinsonism was observed in a 68-year-old patient in the senile period. Pathologically, evidence of senile changes was obtained consisting of degeneration of the neurons and numerous senile plaques with classical and perivascular types. Further, neuronal degeneration in the form of Lewy bodies was evidently observed in the hypothalamus, substantia nigra et innominata, locus caeruleus of the vagus nerve, some nuclei in the reticular formation of the brainstem and neurons in the cerebral cortex. The clinical and pathological manifestations were those of Alzheimer's disease and Parkinson's disease. It is suggested that some common etiological factors may cause those lesions as Alzheimer's disease and Parkinson's disease.

Phosphatidylinositol (PI)-cycle in the platelet membrane was examined in eight untreated patients with psychotic symptoms. A defect of PI-cycle in the transformation from 1,2-diacylglycerol into phosphatidic acid was found in three patients, who were diagnosed as having Schizophrenic Disorders or Schizophreniform Disorder according to the DSM-III criteria. Two out of the three patients were reexamined while undergoing neuroleptic medication, and they showed the same abnormality in PI-cycle. Further studies were required to determine the nature of the abnormality in PI-cycle in the platelets of schizophrenics.

Headache was classified, in conformity to the classification of headache as specified by the Ad Hoc Committee, into migraine, contraction and combined types and others. Tricyclic antidepressant clomipramine having pharmacological properties, which are said to relatively and uniquely inhibit the reuptake of serotonin in the synapses, was administered for headaches and the clinical effects on headaches were examined. Headaches assumed to be attributable to depression were excluded by means of quationing and Zung's self-rating depression scale. Furthermore, the MMPI, MPI and MAS mentality tests were also employed to clarify the characters and traits of these patients with headache. Also, the biochemical mechanism playing a part in the occurrence of headache was conjectured from the pharmacological action pattern of the antidepressant.

Pick's disease is a rare cause of dementia. We studied two clinical cases of Pick's disease in its early stage. A computed tomography (CT) demonstrated lobar atrophy affecting primarily the anterior portions of the frontal lobes and the inferior portions of the temporal lobes. The fact that the characteristic pattern of lobar atrophy is already apparent in the early stage of the disease was demonstrated.

The effects of attention on the auditory evoked middle latency potentials (MLPs) were examined in 23 normal subjects. Early positive-negative-positive-negative waves (about 8, 11, 15 and 18 msec peak latencies) and a late positive one (about 30 msec peak latency) were recorded from the unilateral mastoid-nose tip. The amplitudes of the early portions of MLPs to binaural 50 dB SL clicks during attention decreased as compared to those obtained when the subjects were not attending to the test stimuli. No significant difference was seen in the latency of any early wave.

A simultaneous analytical method was reported for measuring the plasma levels of amitriptyline, imipramine, clomipramine, maprotiline, nortriptyline, desipramine, desmethylclomipramine, desmethylmaprotiline and amoxapine by high performance liquid chromatography (HPLC). The total plasma levels of each parent drug plus its desmethyl metabolite were monitored in 29 depressed patients administered with amitriptyline, maprotiline or amoxapine using the present analytical method. There were significant linear correlations between the dose per kg body weight and the total plasma levels with amitriptyline and maprotiline, but no such correlation was found with amoxapine. The ratios of total plasma levels to dose per kg body weight of these three drugs were lower in outpatients than in inpatients. These results indicate that the monitoring of plasma levels of antidepressants is useful in treating depression.

The subjects were 95 medical and surgical inpatients referred to Kyushu University Hospital Psychiatric Consultation Service. The authors studied the mental status of each referred patient and elicited some Unclassified mental status cases. It was recommended, therefore, to bring in new concepts of normal condition and polymorphous condition in dealing with those Unclassified mental status cases which are often recognized as problematic both by the patient's primary physician and the psychiatric consultant. The ordinary style Single contact consultation was also compared with the Active follow-up consultation regarding the function of psychiatric consultations. The authors confirmed that most referring physicians who were supported by the Active follow-up consultation appreciated highly the evaluating function of a psychiatric consultant.

Japan is presently experiencing a second epidemic of amphetamine abuse, with methamphetamine abusers committing an increasing number of murders and injuries to ordinary citizens. As a result of the author's study of some 60 cases of amphetamine psychosis, the basic symptomatology of the disease was determined to be a paranoid hallucinatory state. Moreover, according to the contents of the paranoid hallucinatory state and the courses of the disease, amphetamine psychotics were divided into two types--the acute and the chronic. Though the former delusions were vivid, realistic and concrete, the latter were generalized, systematized and grandiose. Regarding the course of the disease, the former were episodic and the latter required longer treatments. Thus as the outline of the social background of these addicts had been made clear, it has been emphasized that the authorities must decide to solve this as a social problem.

The anticonvulsive effect of midazolam was studied in rats and mice brains. Microiontophoretically applied midazolam (0.2M, pH 3.5) potentiated the GABA effect at the single neurone level, and inhibited neuronal firing in the rat cuneate neurones. Midazolam administered intraperitoneally (15 mg/kg) increased the primary afferent depolarization for at least two hours. Three mg/kg of midazolam slightly increased the glutamate decarboxylase activities in the mice cerebrum and the increase was statistically significant (p less than 0.05). The authors reported a case of clinical application of midazolam: a status epilepticus was successfully treated with it, while intravenous diazepam of 30 mg failed to control the status.