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Article type: Cover
1998 Volume 38 Issue 7 Pages
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Article type: Cover
1998 Volume 38 Issue 7 Pages
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Article type: Index
1998 Volume 38 Issue 7 Pages
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Article type: Appendix
1998 Volume 38 Issue 7 Pages
478-479
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1998 Volume 38 Issue 7 Pages
480-481
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Article type: Appendix
1998 Volume 38 Issue 7 Pages
482-
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[in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
483-
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[in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
485-493
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Katsuharu Nakazato, Yoshiko Shimonaka, Chieko Kawaai
Article type: Article
1998 Volume 38 Issue 7 Pages
495-501
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Ichirou Mashima
Article type: Article
1998 Volume 38 Issue 7 Pages
503-509
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The self-monitoring of peak expiratory flow rate (PEFR by peak flow meter) is considered to be effective in self-management of patients with bronchial asthma. However, the change in psychological factors and quality of life (QOL) by the self-monitoring of PEFR has not been reported. Therefore, we studied the efficacy of self-monitoring of PEFR for psychlogical factors and QOL in asthmatic patients. We studied 30 patients attending our outpatient clinic. They were classified into 2 groups ; PFM (+) group with PEFR monitoring and PFM (-) group without it. Sex, age, duration, severity and pulmonary function and psychological tests, such as ECL, CAI, MMPI-AS and STAI were compared before and after the self-monitoring. To evaluate the patients' QOL, "The Living with Asthma Questionnaire" was used. The study showed that CAI-Score was significantly reduced and QOL was significantly improved in PFM (+) group after monitoring of PEFR. These results suggest that the self-monitoring of PEFR may be effective in improving psychological factors associated with asthmatic attacks and QOL.
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Article type: Appendix
1998 Volume 38 Issue 7 Pages
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Mika Hadano
Article type: Article
1998 Volume 38 Issue 7 Pages
511-522
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We have investigated how each member of a family, parents and child with eating disorder, evaluate their family relationships. Twenty-one patients with eating disorder (ED group) were compared with 21 junior college students with no eating disorder (control group) using Parental Bonding Instrument (PBI), and their parents were evaluated by the Family Relationships Inventory (FRI). In the ED group, parents' attitude toward a child was also evaluated by therapists. The ED group was divided into anorexia nervosa group (AN group) and bulimia nervosa group (BN group) for comparison.A result of family relationships toward parents showed a difference in dominancy between parents. In the AN group, both parents think the father has ascendancy over the mother, while in the BN group, the relationship is reverse.The FRI showed that the parents in the ED group judged their ascendancy over child lower than those in the control group. However, the discrepancy between the parents and the children in their judgment on parents' ascendancy over child was large in the ED group : the children judged parents' ascendancy higher than their parents. The results of the PBI and the parents' attitude toward their children evaluated by therapists separated the ED group into the following four : (1)parents think that their ascendancy over their children is low, but therapists think that it is high (children does not recognize patients' ascendancy, or they recognize it), (2)parents and therapists think that parents' ascendancy over their children is high (parents are receptive and treat their children as native girls, or parents are not receptive at all and have ascendancy over their children), (3)parents and therapists think that parents' ascendancy over their children is low, and both parents have given up relating to children, (4)others.Classification of family relationships by the methods described above enables us to understand patient's family relationship and to take more careful thought in therapeutic approaches.
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Article type: Appendix
1998 Volume 38 Issue 7 Pages
522-
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Hideyo Sugahara, Gen Komaki, Sunao Matsubayashi, Hiroshi Hayakawa, Haj ...
Article type: Article
1998 Volume 38 Issue 7 Pages
523-528
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A 42-year-old man was referred and admitted to the faculty of psychosomatic Medicine of Kyushu University Hospital because of polydipsia and polyuria in April 1994. He had been healthy until December 1993,when he began to drink a kind of "ARUKARI ionic water", so called healthy beverage and had thirst, polydipsia, polyuria and palpitation. In early 1994,he could not take anything other than ice and water. He felt no taste at that time. So he began to drink more and more water because of his fiery thirst. In February 1994,he was diagnosed as having hyperthyroidism and became euthyroid under medication of thiamazole in a cartain period. However, his polydipsia and polyuria never improved and his urine volume reached 7l/day at the worst. After his admission in our hospital, the examinations showed that he suffered from partial diabetes insipidus and had Rathke's cleft cyst of 10 mm diameter in sella turcica. His polydipsia seemed to have begun because of his anxiety due to living in an isolated and having a post surgical gait disturbance. Having had an explanation of his illness and a sodium restriction dietary, he improved his hypernatremia, higher plasma osmolality and lower urine osmolality. His signs also disappeared during the hospitalization of 2 months. In about a year after his discharge, plasma ADH also improved and the Rathke's cleft cyst naturally involuted and disappeared in the image of CT scan.
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Taijiro Mukai, Kazuhiko Hitomi
Article type: Article
1998 Volume 38 Issue 7 Pages
529-533
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A 56-year old female patient, who had oral cavity pain as her chief complaint, was presented. Through the careful interview, the patient also showed depressive mood, sleeplessness, loss of appetite and agitation. She also expressed her wish to die as her secondary complaint. According to DSM-IV, the patient could be diagnosed both as somatization disease and as mood disorder at the initial interview. On the other hand, from the point of view of psychosomatic medicine, the case was diagnosed as oral-cavity psychosomatic disease. In the course of treatment, amitriptyline which is an antidepressant, had a drastic effect on the patient.When we discuss the diagnosis of the case based upon the initial symptom and the response of treatment, the case must be diagnosed as mood disorder. So we should be careful about the case of this kind, because there may be mood disorder (DSM-IV) or depression in the back of psychosomatic disease.So physicians should carefully examine not only chief complaints but also secondary complaints for the treatment.
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Mitsue Fujita, Yoshihide Nakai
Article type: Article
1998 Volume 38 Issue 7 Pages
535-541
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In post-graduate education in psychosomatic medicine, it is important to acquire not only knowledge and skills, but also to learn how to cope with actual patients in terms of the attitudes and emotions of the therapist. At Kansai Medical University, the case conference plays a central role in post-graduate education. The case conference provides an opportunity for understanding the relationship between patient and illness as well as the relationship between therapist and patient, and has the function of group work through the process of analyzing individual cases. The case conference would be even more useful for making "the therapeutic self" of the participants more concrete through activation of the educative function of group work. We will show how we actually conduct a case conference, and discuss how we should direct future case conferences in order to improve post-graduate education in psychosomatic medicine.
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[in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
541-
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[in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
543-547
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Article type: Appendix
1998 Volume 38 Issue 7 Pages
547-
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[in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
548-551
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
553-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
553-
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
553-
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[in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
554-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
554-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
554-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
554-555
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
555-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
555-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
555-556
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[in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
556-
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
556-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
556-
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[in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
556-557
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Article type: Article
1998 Volume 38 Issue 7 Pages
557-
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Article type: Article
1998 Volume 38 Issue 7 Pages
557-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
557-
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[in Japanese]
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1998 Volume 38 Issue 7 Pages
557-558
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[in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
558-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
559-
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[in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
559-
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Article type: Article
1998 Volume 38 Issue 7 Pages
559-
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Article type: Article
1998 Volume 38 Issue 7 Pages
560-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
560-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
560-
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[in Japanese], [in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
560-
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[in Japanese], [in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
560-561
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1998 Volume 38 Issue 7 Pages
561-
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
561-
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
1998 Volume 38 Issue 7 Pages
561-
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