Japanese Journal of Psychosomatic Medicine
Online ISSN : 2189-5996
Print ISSN : 0385-0307
ISSN-L : 0385-0307
Volume 49, Issue 7
Displaying 1-30 of 30 articles from this issue
  • Article type: Cover
    2009 Volume 49 Issue 7 Pages Cover1-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Cover
    2009 Volume 49 Issue 7 Pages Cover2-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Index
    2009 Volume 49 Issue 7 Pages 773-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Index
    2009 Volume 49 Issue 7 Pages 773-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 774-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Mamoru Onishi
    Article type: Article
    2009 Volume 49 Issue 7 Pages 775-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • [in Japanese], [in Japanese]
    Article type: Article
    2009 Volume 49 Issue 7 Pages 776-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Tomotaka Shoji, Jo Morishita, Satoshi Watanabe, Yuka Endo, Yasuhiro Sa ...
    Article type: Article
    2009 Volume 49 Issue 7 Pages 777-782
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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    Background & aim: Functional dyspepsia was reclassified into meal-induced dyspepsia as postprandial distress syndrome (PDS) and epigastric pain dyspepsia as epigastric distress syndrome (PDS) in Rome III. Gastric hypersensitivity has been reported to be one of the pathogenetic mechanism of functional dyspepsia, however, it is not known whether subcategories of PDS and EPS demonstrate differencies in gastric hypersensitivity. Therefore we evaluated gastric sensation by the cerebral evoked potential and the water load test in functional dyspepsia patients. Methods: Sixteen FD subjects, fulfilling Rome III criteria for functional dyspepsia, were recruited by ad posters, and were served as functional dyspepsia non-consulters (FD-NC), and 16 healthy subjects (HS) without any dyspeptic symptoms as control participated. All subjects had gastrointestinal endoscopy, urea breath test to rule out any possible pathogenesis, and Gastrointestinal Symptoms Rating-Scale questionnaire (GSRS) for quantitative symptomatic evaluation. Study A): Visceral sensation and evoked cerebral potentials through electrical stimulation of esophageal mucosa at the level of 37cm from nostril were evaluated in 16 subjects with FD-NC and 16HSs. Study B): Water load test was performed to evaluate tolerable volume and subjective symptoms in 16 subjects with FD-NC (8 PDS, 8 EPS) and 15 HSs. Water load test was performed with rapid water drink within 5 minutes at room temperature, and subjective symptoms were evaluated in ordinate scale up to 30 minutes. Results: All subjects had no organic disease in upper GI tract nor Helicobacter pylori infection. FD-NCs showed significantly higher GSRS score than that in HSs. A): FD-NCs had lower pain threshold to the esophageal electrical stimulation than HSs (p=0.076). Latency of N2 and P2 of evoked potential were significantly shorter in FD-NCs than HSs (p<0.05). B): Consumed water volume in WLT were not remarkably different between HSs (mean 853ml), PDS subjects (863ml) and EPS subjects (800ml). However symptom scores of gastric discomfort and fullness were higher and lasted longer in PDS subjects than that in HSs. In EPS subjects, epigastric pain was not induced by WLT. Conclusions: FD-NCs small in intensity but significant symptoms in GSRS scores. Such changes might be correlated with altered brain processing for visceral perception. Subjects with PDS demonstrated significant in intensity and longer duration of symptoms provoked by WLT, which suggest that gastric hypersensitivity and/or impaired gastric accommodation are major candidates for pathogenesis of dyspeptic symptoms in PDS. As WLT did not induce epigastric pain symptom in subjects with EPS, which suggest that mechanical gastric stimulation is not the main factor for the pathogenesis of symptoms of EPS.
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  • Kazunari Tominaga, Masahiro Ochi, Tetsuya Tanigawa, Toshio Watanabe, Y ...
    Article type: Article
    2009 Volume 49 Issue 7 Pages 783-790
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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    Aim: As the pathogenesis of functional dyspepsia (FD) considering brain-gut axis, it is thought that daily stressors affect the autonomic nervous system (ANS), gastrointestinal motility, and various chemical mediators thereafter causing abdominal symptoms. We examined the effects of external stresses on gastric emptying in rats and the association of ANS with FD patients. Methods: 1. We examined various parameters: body weight, relative organ weight, catecholamine levels, and gastric emptying in 8-weeks old rats after water immersion stress restraint for 5 days. 2. We analyzed the 24hrs heart rate variability for FD patients after obtaining the questionnaire of daily stressors: component of high frequency (HF: 0.15-0.40Hz) for parasympathetic function and ratio of component of low frequency (LF: 0.04-0.15Hz) to HF component for sympathetic function. We examined 1) 24hrs balance, 2) changes after meal and cold or mental mathematical stressors, 3) effects of tofisopam, a psychovegetative regulator. Results: Stress significantly decreased body weight and relative weight of thymus, and increased relative weight of adrenal glands. Stress increased serum ACTH, corticosterone, adrenalin, and noradrenalin levels. Gastric emptying was decreased in the early phase of the stress restraint and increased in the late phase. Plasma total and inactive ghrelin levels were increased at 24hrs stress restraint and thereafter gradually decreased. Active ghrelin level began to increase at that time. Basal levels of parasympathetic tone were lower and the levels of sympathetic tone were higher in FD patients compared to those of controls. Parasympathetic tone levels of all controls during 30min after meal were higher than their basal condition. But those levels were increased in about half of FD patients. Sympathetic tone levels from 90 to 120 minutes after meal were increased in almost controls but in half of FD patients. Treatment with tofisopam ameliorated the basal imbalance to the normal balanced levels of ANS followed by improving dyspeptic symptoms of FD patients. Conclusions: Fragility of ANS and external stress may be associated with the gastric emptying and abdominal symptoms in FD patients. Treatment with tofisopam, a psychovegetative regulator, may be effective for FD patients.
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  • Koji Nakada, Motohiro Ozone, Naruo Kawasaki, Tomoko Nakayoshi, Nobuyos ...
    Article type: Article
    2009 Volume 49 Issue 7 Pages 791-797
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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    Underlying causes of symptoms in functional dyspepsia (FD) are multi-factorial, including delayed gastric emptying, impaired gastric accommodation, visceral hypersensitivity and psychiatric distress (PD). However, the impact of these abnormal gastric physiology and psychiatric distress on the severity of daily dyspeptic symptoms (DS), and the correlation among these causes are still unclear. We studied the impact of abnormal gastric physiology and psychiatric distress on the severity of daily DS, and to examine the correlation among these multi-factorial causes in FD. Thirty-three FD (Rome II) patients were evaluated by gastric emptying study (GES), and water load drink test (DT). Subjects also completed STAI, SDS, CMI and the original dyspeptic symptoms questionnaire to examine DS severity (strength and frequency). The correlation between DS severity with GES, DT, and PD were examined. The correlation among GES, DT, and PD were also examined. In FD, both DT and PD correlated significantly with DS severity, and significant correlation was noted between DT and PD. In FD, both intolerance to volume load in DT and PD enhanced DS severity, and PD may influence the gastric physiology assessed by DT.
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  • Toshihiro Konagaya, Hiroshi Kaneko, Yasushi Funaki, Akihito Iida, Masa ...
    Article type: Article
    2009 Volume 49 Issue 7 Pages 799-806
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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    Gastric physiological dysfunction such as hypersensitiyity and motility disorder play an important role in pathogenesis of functional dyspepsia. However, the mechanisms inducing bloating feeling and epigastric pain remain unclear, since the relationship between pathophisiology and symptom has not been discussed enough. Our investigation using both the barostat method as a gold standard and the drinking test as an easy method, clarified an accomplishment of gastric accommodation induced postprandial bloating feeling. It was also elucidated that a gastric acid secretion inhibitor improved dyspeptic symptom by increasing the gastric perception threshold against intragastric distention, and prokinetic drugs did by increasing the threshold volume inducing bloating feeling. The drinking test is expected as a clinical useful tool for exploring gastric perception and motor function, though there are several problems including standardization of methodology to be solved. Because this method might have a potency to investigate the effects of various stressors upon gastric function, objective analyses on the relationship between psychosocial factors and dyspeptic symptoms would be expected.
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  • Hiroshi Takeda, Shuichi Muto, Tomohisa Hattori, Chiharu Sadakane
    Article type: Article
    2009 Volume 49 Issue 7 Pages 807-813
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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    Chemotherapy with an anticancer agent generally causes gastrointestinal tract disorders such as vomiting and anorexia, but the mechanism remains unclear. Rikkunshito, a kampo preparation, is known to alleviate such adverse reactions. In this study, we attempted to clarify the mechanism. We investigated the decreases of plasma acylated-ghrelin level and food intake caused by cisplatin, serotonin (5-HT), 5-HT agonists and vagotomy as well as the decrease-suppressing effects of Rikkunshito and 5-HT antagonists. In addition, binding affinities of Rikkunshito components were determined in receptor-binding assays using 5-HT_<2B> and 5-HT_<2C> receptors. Cisplatin, 5-HT, BW723C86 (5-HT_<2B> receptor agonist), and m-chlorophenylpiperazine HCl (5-HT_<2C> agonist) markedly decreased plasma acylated-ghrelin levels, although 5-HT_3 and 5-HT_4 agonists had no effect. In contrast, 5-HT_<2B> and 5-HT_<2C> antagonists suppressed the cisplatin-induced decrease of plasma acylated-ghrelin level and food intake. Administration of rat ghrelin improved the cisplatin-induced decrease in food intake. Vagotomy decreased the plasma acylatedghrelin level, which was further decreased by cisplatin. Rikkunshito suppressed such cisplatin-induced decreases of plasma acylated-ghrelin level and food intake. The suppressive effect of Rikkunshito was blocked by a ghrelin antagonist. Components of Rikkunshito, 3,3',4',5,6,7,8-heptamethoxyflavone, hesperidin, and isoliquiritigenin showed a 5-HT_<2B>-antagonistic effect in vitro, and oraladministration of Rikkunshito suppressed the cisplatin-induced decrease in the plasma acylated-ghrelin level. The cisplatin-induced decreases of the plasma acylated-ghrelin level and food intake are mediated by 5-HT_<2B/2C> receptors and suppressed by flavonoids in Rikkunshito.
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  • [in Japanese]
    Article type: Article
    2009 Volume 49 Issue 7 Pages 816-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Ryuichiro Yamamoto, Shinobu Nomura
    Article type: Article
    2009 Volume 49 Issue 7 Pages 817-825
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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    Objective: The purpose of this study was to investigate sleep problems in undergraduates using Pittsburgh Sleep Quality Index (PSQI). Method: One thousand and one hundred eighteen undergraduates (Valid response rate: 84.50%) completed PSQI Japanese version. We analyzed 1092 undergraduates' PSQI data except for those who are using of sleeping medication (n=26: 2.3% of valid responder). Results: (a) Characteristics of PSQI data: As for undergraduates of the current study, C3 (sleep duration), C5 (sleep disturbance) and C7 (daytime dysfunction) and Global PSQI Score were higher and C4 (habitual sleep efficiency) was lower than those of participants at development and validation point in time of PSQI. (b) Sex differences: Compared with female, sleep onset time [t (1083.10)=2.27, p<0.01] and wake time [t (1068.71)=5.82, p<0.01] in male were more delayed. Similarly, total sleep time [t (1090)=4.10, p<0.01] and sleep onset latency [t (1090)=1.70, p<0.10] in male were longer than that in female. As for each PSQI component score, PSQI C2 score of men was significantly higher than that of women [t (1090)=2.19, p<0.05], however C5 [t (1075.10)=-1.83, p<0.10] and C7 [t (1075.10)=-3.72, p<0.01] scores were lower. (c) School grade differences: As a result of one-way ANOVA and post-hoc Scheffe, significant grade differences in sleep onset time [F (3,1088)=7.53, p<0.01, 1st<2nd, 3rd<4th] and wake time [F (3,1088)=7.46, p<0.01, 1st<2nd<3rd,4th] were confirmed. (d) Classification of sleep problems: Hierarchical cluster analysis (ward method) revealed five types of sleep problems: cluster 1 "Short Sleep & Sleep Maintaining Insomnia" (n=238, 21.79%); cluster 2 "Long Sleep & Sleep Maintaining Insomnia" (n=335: 30.68%); cluster 3 "Good Sleep" (n=127, 11.63%); cluster 4 "Sleep Onset Insomnia" (n=156, 14.29%) cluster 5 "Short Sleep Only" (n=236, 21.61%). As a result of one-way ANOVA [F (4,1087)=296.71, p<0.01] and post-hoc Scheffe, "Sleep Onset Insomnia" was the highest global PSQI score of these 5 clusters. Conclusion: Most of undergraduates are poor sleepers, and they have a tendency to insufficient sleep syndrome or circadian sleep rhythm disorder, especially delayed sleep phase syndrome. The sleep phase of juniors and seniors is more delayed than that of freshmen and sophomores. And the symptom of sleep onset insomnia contributes to multidimensional sleep quality in university students. Therefore it is needed to (a) widely inform undergraduates about the importance of regularized sleep-wake rhythms and prolonged sleep time and (b) perform screening test and support students with sleep onset insomnia.
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  • [in Japanese], [in Japanese]
    Article type: Article
    2009 Volume 49 Issue 7 Pages 826-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Toyohiko Kodama, Koichi Shinchi, Akiko Maekawa, Sayaka Oguri, Naruyo K ...
    Article type: Article
    2009 Volume 49 Issue 7 Pages 827-837
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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    Objectives: We examined risk factors of suicide in nursing staff for prevention of healthcare worker suicide in Saga Prefecture, Japan. Subjects: Eighty-three nurses who participated in the education program of mental health management held by Saga Nursing Association on June, 30, 2007 and 10 post-graduate students of master course in nursing in a university who had a lecture on mental health management in workplace on October, 1, 2007. Subjects were total 93 nurses. Method: We distributed self-administered questionnaires concerning suicide of medical staff colleagues to the subjects and collected them after the lectures. Results: The collection rate was 91.4% (85 nurses), and the response rate was 100%. The number of nurses who experienced the suicide of colleague nurses was eight. Eleven nurses attempted suicide, 4 nurses died, and 7 nurses survived. Most of the nurses who committed suicide were in their 20's (81.8%), and 63.6% of the nurses who committed suicide were working in the hospital less than 5 years. Ninety point nine percent of the nurses were single and 72.7% were working in the shift-work system. Among the chief reasons for suicide included problems of interpersonal relationship in job, and love affairs with opposite sex. Conclusion: Mental health management of young nurses was considered very important for prevention of suicide. Especially, young nursing staff who have been at work less than 5 years needed support for their mental health.
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 838-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 838-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Masako Hosoi, [in Japanese], [in Japanese], [in Japanese]
    Article type: Article
    2009 Volume 49 Issue 7 Pages 839-844
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Tatsuaki Inamitsu
    Article type: Article
    2009 Volume 49 Issue 7 Pages 845-849
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 851-853
    Published: July 01, 2009
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 855-
    Published: July 01, 2009
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 856-858
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 859-
    Published: July 01, 2009
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 860-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 862-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 862-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 862-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Appendix
    2009 Volume 49 Issue 7 Pages 862-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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  • Article type: Cover
    2009 Volume 49 Issue 7 Pages Cover3-
    Published: July 01, 2009
    Released on J-STAGE: August 01, 2017
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