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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
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Article type: Index
2013 Volume 53 Issue 11 Pages
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Article type: Index
2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
987-990
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Sadatoshi Tsuji
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2013 Volume 53 Issue 11 Pages
991-992
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Takakazu Oka
Article type: Article
2013 Volume 53 Issue 11 Pages
993-1000
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Low-grade fever is a common symptom in patients with chronic fatigue syndrome (CFS). The mechanisms responsible for its development are poorly understood. However, several phenomena suggest that psychological stress contributes to the development and exacerbation of low-grade fever in some CFS patients. One phenomenon is workday hyperthermia. Here some patients exhibit higher axillary temperatures on working days compared with holidays. Another phenomenon is a robust stress-induced hyperthermic response. That is, some patients develop extremely high core temperatures (e.g., up to 1.0℃ increase within one hour) during psychological stress-associated interview. This article reviews how psychological stress affect the body temperature in CFS patients and describes the treatment of CFS patients whose low-grade fever is associated with psychological stress.
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Masato Murakami
Article type: Article
2013 Volume 53 Issue 11 Pages
1001-1010
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Respiratory psychosomatic medicine in Japan has been developed since 1970's with the establishment of societies and annual meetings by many specialized physicians. In 1996, the Society of Respiratory Psychosomatic Medicine was distinguished by the newly established Japanese Society of Psychosomatic Internal Medicine (JSPIM). Because so many psychosomatic researches have been made especially in bronchial asthma, the number of presentations and papers gradually decreased along with the remarkable development of basic and clinical investigations of pathology and pharmacological treatment. However the importance of psychosomatic medicine in the field of respiratory medicine has not been diminished. Respiratory symptoms occur not only by the organic stimulation of air tract but also by emotional stress. Symbolic respiratory reactions and symptoms may develop when the human's emotion is affected by psychosocial stressors. It is important to differentiate so-called psychosomatic diseases of the respiratory system because they may easily take the chronic course and become difficult to improve unless treatment with a precise diagnosis is performed. Specific psychotherapy may be applicable when the symptom is aggravated by remarkable psychogenic factors. For the future development and perspectives of respiratory psychosomatic medicine, a more original and up-to-date view by modern scientific investigation will be expected.
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Akira Toyofuku
Article type: Article
2013 Volume 53 Issue 11 Pages
1011-1017
Published: November 01, 2013
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Psychosomatic dentistry was born in 1980's with much hope for holistic approach for dental patients. Although it became more critical to clinical dentistry, it didn't yet acquire satisfactory results. There are some progresses in diagnosis and treatments for oral psychosomatic disorders, confusing terminology and disease entity are still relate to lack of enough clinical data. We have an ideal psychosomatic dentistry that can deal with dental and oral symptoms enfolding dysfunction in the central nervous systems. Succeeding our predecessors' works, we are now searching for a new psychosomatic dentistry which meets the needs of the time. We also have to get more acclimatized to clinical dentistry and dental education for the next generation.
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Nobuyuki Kobayashi, Masahiro Takano, Yoshiaki Kanazawa, Fumihiko Hamak ...
Article type: Article
2013 Volume 53 Issue 11 Pages
1018-1024
Published: November 01, 2013
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Background : Patients with olfactory reference syndrome (ORS) erroneously believe that they emit an unpleasant smell. We attempted anorectal biofeedback (BF) therapy in ORS patients with a malodor from the anus. ORS patients were assured that although their anal sphincter muscle power was adequate to prevent an anal leak, sphincter muscle training by BF would be useful to increase patients' self-confidence to prevent flatus release. Methods : The subjects consisted of 20 patients with ORS who agreed to undergo BF therapy. This group included 9 men and 11 women with a mean age of 36.4±12.9 years. The Wexner score and anorectal manometry were evaluated before and after inpatient treatment. Results : The subjects underwent BF training 13.4±8.6 times. Subjective gas leak as determined by the Wexner score was significantly improved from 8.1±3.7 points to 5.8±3.2 (p<0.01). Although the maximum resting pressure of the anus was not significantly changed, the maximum squeeze pressure (MSP) was significantly increased from 325.2±57.6cmH_2O to 424.4±105.8 in male subjects only (p<0.05). The total subjective outcome of the treatment based on patient complaints was as follows : disappearance of symptoms in 5 patients, improvement in 11, and unchanged in 4. An increased MSP was not significantly related to a decrease in the Wexner score or total subjective outcome. Conclusion : BF therapy was effective for ORS patients and it was applicable even in delusional patients who denied psychological intervention. The therapeutic mechanism can be explained by the psychotherapeutic concept of externalization, and not by a direct effect of BF. The patients could experience ease from their fear of malodor by acceptance of the proposed treatment without a denial of their erroneous belief. This is the new therapeutic approach for patients with ORS.
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Shigetoshi Iwahashi, Hiroko Kunii, Yutaka Minatoya
Article type: Article
2013 Volume 53 Issue 11 Pages
1025-1030
Published: November 01, 2013
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Our hospital is a disaster medical center located at 44 kms from Fukushima Daiichi Nuclear Power Station (FDNPS). We report two cases of psychosomatic disorders workers at FDNPS after the nuclear accident. Case 1 : A 21-year-old male visited our hospital on April 8, 2011 complaining of headache, nausea, and malaise. There were no abnormal findings on physical examination and blood tests. After the accident, he moved to a safe area away from FDNPS, but he returned to construction work in the Seismic Isolation Building of FDNPS on March 25. His working included making a hole in the wall of the nuclear power station on April 6. He experienced a severe headache began from noon of April 7. In the evening, he rested in the J Village, the housing site for workers, and his headache subsided. However nausea and malaise persisted. The patient said that white things are scary for him since the color of radioactivity protective clothing is white. He was diagnosed as having a stress reaction, represented by migraine, due to fear of radioactivity. Considering his young age, we issued a medical certificate stating that "the patient needs to rest for three days and that his workplace should be limited to a distance of more than 30 kms away from FDNPS." Case 2 : A 45-year-old male visited the emergency room of our hospital on the evening of July 19, 2011 complaining of shortness of breath and discomfort. There was no abnormality in an ECG or blood tests, and he was directed to visit the Department of Cardiology. He revisited the emergency room the next day complaining of chest discomfort and was admitted to the department of cardiology. A coronary CT study showed no stenosis of the three coronary arteries. He was discharged on July 22. As soon as he arrived at the town he was staying in, located less than 30 kms from FDNPS, palpitations and chest discomfort recurred and he visited the emergency room again. He was prescribed an anti-anxiety drug. He also visited the emergency room on July 26 complaining of palpitations and was referred to our department on July 27. The patient was sent from Kansai district of Japan in April for debris removal work at FDNPS. Since his cardiac symptoms recurred as soon as he returned to his accommodation less than 30 kms from FDNPS, he was diagnosed as having cardiac neurosis due to fear of radioactivity. We issued a medical certificate stating that he should go back home and receive treatment. These two cases suggest that workers at FDNPS have been under intense psychological stress after the nuclear accident.
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Yutaka Matsuyama
Article type: Article
2013 Volume 53 Issue 11 Pages
1031-1038
Published: November 01, 2013
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Article type: Article
2013 Volume 53 Issue 11 Pages
1039-
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
1040-1041
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
1041-1042
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
1043-1044
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
1044-1045
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Article type: Article
2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
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Article type: Article
2013 Volume 53 Issue 11 Pages
1045-1046
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
1046-1047
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2013 Volume 53 Issue 11 Pages
1047-
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2013 Volume 53 Issue 11 Pages
1048-
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2013 Volume 53 Issue 11 Pages
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2013 Volume 53 Issue 11 Pages
1048-
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2013 Volume 53 Issue 11 Pages
1048-1049
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2013 Volume 53 Issue 11 Pages
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
1050-1058
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
1059-1061
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
1062-1063
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
1064-1066
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
1070-
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
1070-
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Article type: Appendix
2013 Volume 53 Issue 11 Pages
1070-
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