Reliability and validity of the Japanese version of the Yale-Brown Obsessive-Compulsive Scale

Abstract The reliability and validity of the Japanese version of the Yale-Brown Obsessive-Compulsive Scale (JY-BOCS) were determined by 20 raters for 12 Japanese patients with obsessive compulsive disorder at four institutions. Interrater reliability for the total JY-BOCS score was excellent, and the intraclass correlation coefficient was high (ICC = 0.960). Internal consistency was also excellent (Cronbach's α= 0.889). Concurrent and discriminant validity of the JY-BOCS was examined by comparing the scores on the JY-BOCS with those on the Maudsley Obsessional Compulsive Inventory (MOCI) and scales for depression and anxiety. A slight correlation was found between scores on the JY-BOCS and MOCI, but no significant correlations were found between scores on the JY-BOCS and those on scales for depression or anxiety.     

Biopharmaceutics: Enhanced Absorption of Calcium after Oral Administration of Maltitol in the Rat Intestine

The enhancing effects of maltitol (α-D-glucopyranosyl-1,4-sorbitol) on absorption of calcium by the rat intestine have been studied by use of [⁴⁵Ca]CaCl₂ in-vivo. After intragastric administration of [⁴⁵Ca]CaCl₂ solution with maltitol, plasma ⁴⁵Ca concentration remained at the maximum level for more than 80 min, whereas for animals given [⁴⁵Ca]CaCl₂ solution without maltitol, plasma ⁴⁵Ca concentration declined sharply after the peak. Determination of ⁴⁵Ca radioactivity remaining in the various segments of the gastrointestinal tract revealed that administration of maltitol elicited slower gastric emptying and slower intestinal transit, resulting in extensive ⁴⁵Ca distribution along the small intestine throughout the experimental period. The luminal contents of the small intestine were significantly higher in rats given maltitol than in the control group. These results suggest that the enhancing action of maltitol on intestinal calcium absorption could be attributed to reduced gastrointestinal calcium transit and increased luminal fluid content, presumably because of the osmotic activity of maltitol; this would not only accelerate the dissolution of calcium into the increased luminal contents, but also enable a larger area of the small intestine to absorb calcium for a longer period of time.     

Clinical profiles of autopsy-confirmed dementia with Lewy bodies at institutionalization: Comparison with Alzheimer's disease

Background: It has been reported that Alzheimer’s disease (AD) patients with Lewy pathology have a shorter time from a given baseline to institutionalization than those with AD alone. Taking the clinical distinction between dementia with Lewy bodies (DLB) and AD into consideration, the previous findings may indicate the possibility that the clinical characteristics of DLB patients have an influence on early institutionalization. This study was carried out to clarify whether there are any differences in the symptoms that required institutionalization between patients with DLB and those with AD. Methods: Hospital records and standardized data forms completed at admission to a residential care facility were reviewed to assess the profiles in all cases with autopsy‐confirmed diagnoses for correct differential diagnosis. We examined functional, cognitive and symptomatic conditions at admission to a residential care facility of 18 DLB and 35 AD patients whose diagnoses were confirmed by autopsy. The examinations were conducted using the Gottfries‐Bråne‐Steen (GBS) scale and cognitive tests, and the results were compared between the two groups of patients. Results: Hallucinations, impaired wakefulness, disturbance of ADL and emotional disturbance, common clinical features compatible with DLB, were more frequently observed in DLB patients than in AD patients (P < 0.05). Moreover, DLB patients had higher scores on cognitive tests than did AD patients at admission to a residential care facility (P < 0.05). Conclusion: The distinctive clinical features at admission to a residential care facility may indicate that the reasons for the necessity of institutionalization are different between DLB and AD, and that the interventions specific to DLB patients and their families would be necessary to prevent or postpone institutionalization.     

Epidemiology of poliomyelitis in Karachi,Pakistan: Prospective studies during 1990–93

Between October 1989 and September 1993, 245 cases of poliomyelitis visited the Department of Pediatrics, Civil Hospital Karachi, Pakistan. The majority of them were between 6 months and 2 years of age and the epidemic occurred during the hot season. The dominant serotype was polio type 1. All of the polioviruses isolated from the patients were wild type. Virological studies also disclosed that enteroviruses other than polioviruses were prevalent among healthy children as well as diarrheal and polio patients. Serodiagnosis by poliovirus-specific immunoglobulin M antibody tests using the capture enzyme-linked immunosorbent assay method were in good agreement with the results of virus isolation. The present study demonstrated that Pakistan is a region endemic for wild poliovirus and more aggressive preventive measures are needed to eradicate poliomyelitis from the region.     

Prolonged polysomnography in a case with recurrent hypersomnia

Abstract An 18-year-old male patient with recurrent hypersomnia (RH) was evaluated using prolonged polysomnography (PSG). During symptomatic period (SMP), the patient showed both 'dissociated stage REM' (DREM), REM sleep without muscle atonia and 'dissociated stage 1' (DSt-1), and stage 1 sleep with rapid eye movement. These stages were observed in the morning or following daytime record. They decreased during asymptomatic period (ASMP). It has been said that RH is caused by dysfunction of the hypothalamus and midbrain limbic system. The present result suggests also that RH involves dysfunction of the brain stem.     

Albumin gene encoding free fatty acid and β-amyloid transporter is genetically associated with Alzheimer disease

Abstract  Alzheimer disease (AD), the major cause of dementia in the elderly, is characterized by β-amyloid deposition in senile plaques and hyperphosphorylated tau in neurofibrillary tangles. Since albumin, binding and transporting free fatty acids is also the major transporter of β-amyloid, we examined the association between the albumin ( ALB ) gene and the occurrence of late-onset AD (LOAD). We found that the allele distribution of the intron 4 microsatellite of the ALB gene showed a significant difference ( P  < 0.05) between LOAD ( n  = 285) and control group ( n  = 656). An allele with 11 CA repeat, termed (CA)₁₁ allele, was significantly predominant in the control group ( P  < 0.005), and the odds ratio carrying the (CA)₁₁ allele was 0.43 ( P  < 0.01, 95% CI = 0.24–0.79). Logistic regression indicated that this effect was independent of age and the ɛ4 dose of the apolipoprotein E gene ( P  < 0.01), while the ALB gene was supposed to be related to aging. Our results indicate that the ALB gene is genetically related with the occurrence of LOAD, supporting the link between fatty acid and β-amyloid transport in the development of LOAD.     

Complications Following Percutaneous Endoscopic Gastrostomy: Acute Respiratory Infection and Local Skin Infection

Abstract: Few studies of percutaneous endoscopic gastrostomy (PEG) have evaluated the effects of antibiotic prophylaxis, PEG placement technique and early PEG feeding on acute postoperative complications. In this retrospective study, we investigated associations between postoperative management of PEG and complications of infection. The medical records of 271 patients were included in this study. Administration of antibiotics, early and delayed enteral feeding, and PEG placement technique were analyzed as risk factors for infectious complications. The rate of local skin infection correlated with early PEG feeding, but there was no difference in the rate of local skin infection due to postoperative administration of antibiotics. Early feeding with the usual enteral formula was a strong risk factor for local skin infection. The rate of local skin infection was higher in the “Push/Pull” technique than the “Introducer” technique. As for aspiration, the rate of complication was lower in groups with postoperative administration of antibiotics than in groups without administration of antibiotics, but there was no association between aspiration and early feeding or PEG placement technique. Local skin infection correlated with early postoperative feeding and was not correlated with antibiotic prophylaxis. However, the administration of antibiotics is recommended for the prevention of aspiration.     

Preliminary early intervention study using Nursing Child Assessment Teaching Scale in Japan

Background: Mother–infant interactions have been acknowledged as one of the most important elements in measuring outcomes of parent support and infant mental health interventions. The present study was conducted to measure early intervention outcomes using the Nursing Child Assessment Teaching Scale (NCATS), and to identify factors that affected Japanese mother–infant interactions. Methods: Healthy Japanese mother–infant dyads who had lower scores on the NCATS, indicating potential problems, were assigned to an intervention group, and compared with a control group who had higher scores on NCATS. Health‐care professionals visited the intervention group dyads in their homes, and gave them positive feedback on their interactions, consultations on parenting, and health advice. The control group dyads had home visitation once every 6 months for assessment only. Results: The home visitations started at 3 months of age and continued until 18 months. NCATS scores in both groups were significantly different at baseline but differences faded by the end, which suggests that the intervention promoted improved interactions in the intervention group. Two of five factors were identified as influencing mother–infant interactions: maternal age; and personal networks, and together they significantly explained 27–30% of NCATS variance. Conclusion: The results appear to support the validity of measuring Japanese mother–infant interactions with NCATS. This study is the first to measure the outcomes of early intervention on Japanese dyads’ interactions using NCATS. Additional replication studies should be conducted elsewhere in Japan, and clinical practices for promoting mother–infant interactions should begin to assess their effectiveness with NCATS as an outcome measure.