The suicide rate among schizophrenics is about 10%. Suicide among such patients is one of the great problems for psychiatrists because of the incomprehensibility and unpredictability of its motivation. Numerous studies have been conducted on this issue both in Japan and around the world. The results of the studies done in the 80's and 90's are largely in agreement. We conducted a clinical comparative investigation of 80 suicides among schizophrenics and 80 living schizophrenic patient controls matched to the suicide group with respect to sex and illness duration. The findings indicated that suicide among schizophrenics must be considered a consern at all stages of the disease. A change in the environment, for example, a hospital admission or discharge, may trigger suicide. In a logistic regression analysis, the presence of suicidal ideation, degree of anxiety estimated by PANSS, and birth order (middle children) were revealed as predictors of suicide. The most important step for the prevention of suicide is to grasp the signs early through these studies and to intervene in crisis.

View full abstract

In the field of the clinical sciences, as in other disciplines, developments in information technology have provoked much discussion on how information ought to be circulated and shared and how informed consent should be obtained in this process. There will be an ever increasing need for empirical research in this domain. In this paper, the author proposes a useful method for clinical research in the form of effective research design and statistical analysis.

View full abstract

Human atrial natriuretic peptide (hANP) and brain natriuretic peptide (BNP) are released from volume everload in patients with hemodialysis (HD). But there have been few reports on the difference between type I and type II dialyzer about pre and post plasma levels of hANP and BNP.
We determined plasma hANP levels, plasma BNP levels and body weight pre and post HD in 32 patients without heart failure and pulmonary dysfunction (mean age: 59.7 years, mean duration of HD: 69.0 months).
The following results were obtained:
1) The mean plasma hANP levels of post HD was markedly lower than those levels of pre HD.
2) A positive correlation was recognized between %ΔhANP and %Δbody weight, however there was no correlation between %ΔBNP and %Δbody weight.
3) There was a significant difference in decreased levels of BNP and %ΔBNP between type I dialyzer group and type II dialyzer group.
We supposed that the levels of plasma BNP should be measured at pre-HD than post-HD.

View full abstract

We reported the medical backgrounds in patients with severe motor and intellectual disabilities syndrome (SMIDS), who died in national hospitals. 80 dead cases could be collated with the data of inpatients with SMIDS in national hospital. The most common cause of death was pneumonia. We divided patients into 2 groups, the first group was named super-SMIDS (most severely motor and intellectual disabilities syndrome: chojushozi) and second group was other SMIDS except for chojushozi. The number of patients with chojushozi, who indicated scores over 25 points with Suzuki's criteria (see table 2) for diagnosis as chojushozi, were 20 (25.0%) in 80 dead patients with SMIDS, as compared with 247 cases (4.1%) in 5965 survivors. The death rate in the abovementioned chojushozi was 7.5%, and 1.0% in non-chojushozi. Average of Suzuki's score in dead cases was significantly higher as compared to that of survivors (p=0.0003). Three in 5 cases died of asphyxia were chojushozi, however none in sudden death. The mean number of complication in dead cases was 6.8, and 4.6 in survivors (p<0.0001). In conclusion, the chojushozi was high in risk than non-chojushozi except for sudden death.

View full abstract

A eighty seven-year-old women visited our hospital complaining, erosion at the medial angle of right eye. This area was operated 4 years ago and diagnosed basal cell carcinoma. We treated successfully using photodynamic diagnosis (PDD) with 5 aminolevulinic acid (ALA) to divide the margin. The topical application of ALA induces protoporphyrin IX (Pp IX) that is restructed to the abnormal epithelium. PDD is the way to use fluorescence of Pp IX under UVA. We applied 20% ALA-O/W ointment and four hours after we observed red fluorescence under Black light. PDD is useful to divide the margin.

View full abstract

A 66 years old man was admitted because of chest pain and syncope. Echocardiogram showed a marked pressure gradient across the left ventricular (LV) outflow tract and LV hypertrophy. On 23 rd day, severe chest pain occurred, which was followed by cardiogenic shock. Because of cardiac arrest, temporary pacing is performed, Dual-chamber (DDD) pacing with pacing rate 80 bpm and atrio-ventricular (AV) delay 100 msec markedly reduced the pressure gradient of LV outflow tract from 94mmHg to 11mmHg. Follow up cardiac catheterization 5 months after showed that the pressure gradient remained abolished even when pacing was switched off. DDD pacing has been reported as a beneficial method for hypertrophic obstructive cardiomyopathy.

View full abstract

We presented brief reports on the status and problems associated with informed consent from the viewpoint of patients' relatives, particularly of those patients suffering from amyotrophic lateral sclerosis.
We believe that the process of informed consent is a very useful one in that it advances skills and techniques in the medical field and fosters a good mutual understanding of this grave disease in both the patients' kin and the medical staffs involved.
We hope that informed consent regarding ALS will be achieved to a yet much higher degree.

View full abstract