Polysomnography and body temperature changes by phototherapy in a delayed sleep phase syndrome case

Abstract We examined polysomnography (PSG) and body temperature in a patient with delayed sleep phase syndrome who responded to phototherapy. The patient was a 31-year-old woman whose condition had slightly improved by a vitamin B₁₂ administration. Phototherapy was administered to her in combination with the vitamin B₁₂ medication, and this combined treatment successfully advanced her delayed sleep phase. On PSG, the regimen showed shortened sleep latency, decreased total sleep time and stages 1 and 2 sleep, and increased slow wave sleep. Phototherapy also improved temporal distribution of delta half-waves (0.5-2.0 Hz, 31 µV) as well as phase relationship between sleep and body temperature.     

A Case of Multiple Ectopic Pheochromocytomas Occurring in the Urinary Bladder and the Para-Aortic Region

A patient with urinary bladder pheochromocytoma and anotherpheo-chromocytoma in the para-aortic region is presented. Also,nine cases which have already been reported in Japan are reviewed. The following conclusions are made: bladder pheochromocytomacan appear at any age in either sex. The clinical triad consistingof hypertension, gross intermittent or transient painless hematuriaand micturitional attacks typical of pheochromocytoma are seenin most cases. Attention is called to such urinary bladder     

Self-Destruction in Japan: A Crosscultural, Epidemiological Analysis of Suicide

• 1 A simple comparison of vital statistics of suicide has many biases. For example, 3.1% of the cases submitted for autopsy by the Tokyo Municipal Medical Inspection Office were difficult to attribute to suicide or accident from the legal medical standpoint. Such cases as those of children or severely psychotic patients were sometimes almost impossible to determine. Many suicides were hidden by the victims themselves or by their families, largely because of the shame associated with the act of suicide. Notwithstanding these biases, the writer carried out an epidemiological analysis of the statistical materials of suicide to discern the characteristics of suicide in Japan. By the writer's epidemiological analysis, it is believed possible to discern the characteristics of suicide in Japan and compare them with those of other countries, notwithstanding the abovementioned biases. This is because any errors could be expected to be randomized.
• 2 There are more difficulties in collecting reliable data on attempted suicide than completed suicide. The writer's survey in a city near Tokyo with 150,000 population in 1959 showed that only 92 cases of attempted suicide against 231 cases of completed suicide over a period of 8 years were obtained, notwithstanding the support of private practitioners, hospitals, health centers, and city police. However, the pattern in the attempted suicide rate of high rate in youth, low rate in the aged and higher rate in female than male, as compared with completed suicide data coincided with that for attempted suicide reported by many reliable statistics in Europe.
• 3 In this sense, it is notable that the rate of completed suicide in Japan during the last 10 years, particularly that for youth, has declined greatly. One of the characteristics of suicide in Japan, rising in youth, declining in thethe middle aged and rising in the aged, which was the same as that in Taiwan, has begun to change to the Western pattern increasing almost parallel with age.
• 4 The ratio of female-male suicide rates in Japan has risen during the past 10 years, in particular the ratio of the aged, as conipared with that among those of youth, which has declined. Consequently, the writer presumed that the fluctuation of completed suicide rates in age and sex are mainly influenced by the change of those rates and ratio in the youth of 15—25 and the aged over 65.
• 5 It was suggested that in pre-World War II times, a kind of altruistic suicide still existed in Japan, but after the war the number of anomic suicides increased to a peak in 1955-58, and both types of suicide have decrcased since 1958.
• 6 The suicide curve in Japan has been found to fluctuate with the business cycle and war; it rose in prewar time (1913, 1934) and serious depression (1932) and declined in wartime (1906, 1943) and prosperity (1917, 1960). The rise of suicide rates from 1944 to 1958 was probably connected with the financial, moral and political anomie of the postwar times. The decline of suicide rates since 1958 might be closely connected with not only financial, moral and political stability but also with the change of expressing aggression, in particular among the youth, i.e. transfer from intropunitive to extrapunitive responses. The statistics of the Young Adult and Juvenile Section of the Japanese Ministry of Justice showed that the rates of juvenile offenders decreased. It also showed that the proportion of juvenile offenders has overcome that of adult offenders since 1958 and the younger the age, the more marked the rise.
• 7 As regards the relationship between suicide and homicide, a direct relationship between suicide and homicide in the past 10 years in Japan might confirm the hypothesis that obligatory altruistic or fatalistic suicide is decreasing and anomic suicide is declining after a long rise.
• 8 Although two surveys on suicide-rates in Hawaii by Drs. Tyree and Kalish showed different data by ethnity, those rates in Japanese Hawaiian were low in youth and high in old age. The writer interpreted these data as follows: although the Japanese issei showed the same high suicide rate as Japanese Nationals, the low rate of suicide in youth might suggest that not only the suicide rate among Japanese-Hawaiians but also that of Japanese Nationals will become similar to the Western type in the future.

     

HPLC-studies on nonmercapt-mercapt conversion of human serum albumin

Human mercaptalbumin (HMA) and nonmercaptalbumin (HNA) could be separated by high-performance liquid chromatography (HPLC) at neutral pH. Using HPLC, the present authors found the nonmercapt-mercapt conversion (HNA ← HMA) during hemodialysis and the mercapt-nonmercapt conversion (HMA ← HNA) after hemodialysis in chronic renal failure, indicating HMA as the covalent carrier protein for sulfur-containing amino acids.     

Unilateral or bilateral nerve-sparing radical hysterectomy: a surgical technique to preserve the pelvic autonomic nerves while increasing radicality

We performed unilateral or bilateral nerve-sparing (UNS or BNS) radical hysterectomies combined with a parametrial excision in patients with locally advanced cervical cancer. The parametrial excision technique is characterized by a meticulous sharp dissection of the avascular plane outside the visceral fascia of the uterus and vagina under direct vision, providing an en bloc parametria and ensuring that all regional spread of the disease is contained within negative surgical margins. The aim of this study was to describe this surgical technique and to retrospectively evaluate the feasibility and the impact on early bladder function. From February 2005 to November 2006, 32 patients with FIGO stage IB-IIB cervical cancer, who had the tumor of more than 20 mm in diameter, underwent the UNS surgery or BNS surgery. A parametrial excision was performed in all the patients. The surgical procedure was safely completed in all the patients. Though 14 patients had tumor invasion to the parametria, none of the patients had a positive surgical margin in the parametrium. The bladder function of patients in the UNS group immediately after surgery was more damaged than that in the BNS group. However, all the patients in both groups recovered spontaneous voiding with no need of self-catheterization during the perioperative periods. This preliminary study showed that the surgical technique is feasible and safe. For confirmation of the efficacy of this technique, further large prospective studies are needed.     

Cyclic peptides

In order to investigate the role of the L-2-hydroxy-3-methylbutanoic acid residue at position 2 of AM-toxin I (cyclic tetradepsipeptide) on necrotic activity for apple leaves, two analogs, [L-lactic acid²] AM-toxin I and [L-2-hydroxy-4-methylpentanoic acid²] AM-toxin I, were synthesized by the conventional method for peptide synthesis. The toxic activity of the former analog was much weaker than that of the natural AM-toxin I and the latter analog. CD spectra of AM-toxin I and these analogs were correlated to those toxic activities, indicating that bulkiness of the side chain at position 2 is important for the maintenance of active conformation and the induction of necrotic activity.     

1H-n.m.r. studies on cross-relaxation phenomena in bovine mercaptalbumin (BMA) solution and partially hydrolyzed bovine plasma albumin (BPA*) gel

Bovine plasma albumin Fr. V(BPA) contains small amounts of proteolytic enzyme which catalyzes a very limited cleavage of BPA in the F-form near pH 3.8, resulting in the formation of partially hydrolyzed BPA(BPA*). BPA* had a tendency to form a transparent gel at pD 4.0 (pD range of the F-form) above 7%. Highly purified proteolytic enzyme-free bovine mercaptalbumin (BMA) was in a transparent solution at pD 4.0 even at 12.4%. after 5 days incubation at 35°. Cross-relaxation times (T_IS) between irradiated protein protons and observed protons, such as side chain and water protons, were studied on BMA solution and BPA*-gel. T_IS values of BMA solution, obtained by the saturation transfer (SATUR) and inversion recovery (INVER) methods, were a single kind of T_IS for each side chain. Those of BPA*-gel by the SATUR method indicated the presence of two kinds of T_IS, that is, short and long T_IS values for each side chain. However, those by the INVER method showed a single kind of T_IS for each side chain, corresponding to the long T_IS value by the SATUR method. The short T_IS values of BPA*-gel, observed by the SATUR method, may be due to immobile joint parts of fibrous BPA* aggregates. T_IS values from protein to water protons (T_IS(HDO)) in BPA*-gel, obtained by the INVER method, were far shorter than those in BMA solution, indicating a large amount of hydration of BPA* and rapid exchange between bound and bulk water in the gel state.     

Pigmented neurofibrosarcoma mimicking a large haemangioma

A case of solitary pigmented neurofibrosarcoma involving the lateral side of the face in a 19-year-old female is described. Clinically it resembled a haemangioma, and angiography showed hypervascularity of the tumour. Light-microscopic study revealed that the major cellular element of the tumour was composed of bizarre neoplastic cells with large pleomorphic, hyperchromatic nuclei, conspicuous nucleoli and moderate to abundant amounts of eosinophilic cytoplasm. Mitotic figures and multinucleate cells were present in most fields. Neurofibrosarcoma is one of the most highly malignant tumours; however, in the present case, there was no evidence of recurrence during a follow-up period of 5 years.