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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
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Article type: Index
2013 Volume 53 Issue 7 Pages
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Article type: Index
2013 Volume 53 Issue 7 Pages
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Article type: Appendix
2013 Volume 53 Issue 7 Pages
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Yoko Sagara
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2013 Volume 53 Issue 7 Pages
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Tsutomu Douchi
Article type: Article
2013 Volume 53 Issue 7 Pages
640-645
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The maintenance of the hypothalamic-pituitary-ovarian function requires an appropriate body weight. Both excessive weight reduction for cosmetic reasons and excess weight gain induce ovarian dysfunction. However, after returning to the original body weight, the ovarian function is usually restored. Underlying mechanisms of obesity-associated ovarian dysfunction have been explained by peripheral endocrine abnormality, endocrine disorder due to excess visceral adipose tissue, and hypothalamic derangement. In general, the severity of obesity-associated ovarian dysfunction is milder than that of excess weight reduction. Thus, we sometimes encounter pregnant women with morbid obesity. However, ovarian dysfunction due to stress-related obesity or eating disorder (bulimia nervosa) is frequently severe. The most important treatment modality for obesity-associated ovarian dysfunction is weight control through a psychosomatic approach, including counseling. Second, to prevent the development of endometrial cancer due to unopposed estrogen, it is important to regularly control uterine bleeding with the use of estrogen and progesterone.
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Yasuhisa Shinomura
Article type: Article
2013 Volume 53 Issue 7 Pages
646-651
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Recent development of endoscopic treatments and targeted therapies has improved treatment outcomes in gastrointestinal cancers. Superficial gastrointestinal neoplasms, including early cancers with no risk of metastasis, can be removed by endoscopic resection. Endoscopic submucosal dissection (ESD), a new method of endoscopic resection, has enabled en bloc resection of large neoplasms. Moreover, targeted therapies have been approved for the treatment of advanced gastrointestinal stromal tumors (GIST), colorectal cancers, and gastric cancers. Targeted therapy drugs target specific molecules involved in tumor cell growth signaling or tumor blood vessel development. The targeted therapies can induce dramatic clinical responses with fewer side effects and prolong the overall survival of patients with gastrointestinal cancers, including GISTs. The effectiveness of targeted therapies is, however, limited because most patients develop drug resistance. Further studies should aim at overcoming drug resistance.
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2013 Volume 53 Issue 7 Pages
652-
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Tomoharu Watabe
Article type: Article
2013 Volume 53 Issue 7 Pages
653-659
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It is important that the children confront and express their experiences after the disaster for mental health support at school in mid and long-term phases. The expressive activities are effective in coping with traumatic reactions, forwarding mourning work, and lessening anniversary reactions. It is necessary that the expressive activities be conducted in appropriate time with adequate considerations. The most appropriate time is a mid and long-term, approximately 3 or 6 months after disaster. It is also necessary to take each stage into consideration, such as before introduction, preparation, the day of the activity, and after the activity. It is important that the activities are conducted by initiative of the teachers who have gone through hardships with children during the past years. As a result, at schools where expressive activities were conducted, a few children had stress reactions, but teachers dealt with them calmly and appropriately, so many could grow out of their painful experiences and stress reactions. From the 2^<nd> years on, the purpose of expressive activities are not only to process and organize emotions, but also to convey children's experiences to other areas and future generations.
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Kenji Suzuki, Aya Takeda
Article type: Article
2013 Volume 53 Issue 7 Pages
660-669
Published: July 01, 2013
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Objective : Recently, the number of women with clinical eating disorders who also have children has been increasing in Japan. The purpose of this study is to indicate problems of marriage, pregnancy, delivery and childcare of women with eating disorders. Methods : This study compared concerns regarding marriage, pregnancy, delivery and childcare between women with eating disorders and control women. The subjects were 20 women with eating disorders who also had children and were being treated by the authors at the Kurihama Medical Center. Twenty volunteer women who had children were used as controls. The mean age of the subjects was 32 years old and that of the controls was 34 years old. Both the subject women and the control women were interviewed by the authors. Results: During pregnancy, the subjects continued their abnormal eating behaviors, such as bulimia and purging, and they had higher rates of depression, alcohol drinking, and smoking than the controls. The percentage of abnormal deliveries was similar between the two groups, but the subjects had a significantly higher incidence of postnatal depression than the controls. The symptoms of the eating disorders and the feelings of the subjects tended to worsen during the childcare period. Anxiety and difficulties with childcare were significantly more common in the subjects than the controls. The subjects had a higher incidence of child abuse than the controls. Thirty percent of the subjects experienced a relapse of their eating disorders during pregnancy or the childcare period. Conclusion : Women with eating disorders should receive long-term treatment.
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Tadashi Kiba, Kenji Kanbara, Kazumi Yamamoto, Ikumi Ban, Yuko Oka, Fum ...
Article type: Article
2013 Volume 53 Issue 7 Pages
670-681
Published: July 01, 2013
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Objectives: The aim of this study was to examine the relationship between pre-stress salivary α-amylase levels and psychological characteristics of patients with functional somatic syndrome (FSS). Method: Pre-arithmetic test stress levels in 27 patients with FSS and 22 healthy controls were measured and compared with salivary α-amylase levels and psychological characteristics of mood, anxiety, depression and alexithymia, as measured by psychological tests. Result: The pre-stress salivary α-amylase levels of patients with FSS were significantly greater than those of healthy controls and were highly related to tension, anxiety and persistent depression. The results of the healthy controls showed that the pre-stress salivary α-amylase levels were highly related to temporal depression and alexithymia. Salivary α-amylase levels and alexithymia were negatively correlated in FSS patients, but positively correlated in healthy controls. Conclusion: Pre-stress sympathetic nerve responses in FSS patients may be higher and related to tension, anxiety and persistent depression, compared with healthy controls. Autonomic function and alexithymia showed opposite correlations between FSS patients and healthy controls.
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Yuki Nishimura
Article type: Article
2013 Volume 53 Issue 7 Pages
682-686
Published: July 01, 2013
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Although clinicians examine patients with chronic pain on a primary care basis, they have difficulty in its treatment, even if they use antidepressants. The author reported a patient suspected as chronic fatigue syndrome, who had symptoms of general pain and fatigue, but no clinical findings on detailed examination. He was unable to continue milnacipran, recommended for chronic pain in Japan, for nausea even at lower dose. Switching to 15 mg of mirtazapine remarkably improved the patient's symptoms as well as sleep disorder and appetite loss. On stopping the mirtazapine, chronic pain had relapsed and on taking the mirtazapine, pain was alleviated. As the prior study indicated, the antinociceptive effect of mirtazapine was found faster and at lower dose than its antidepressant effect in this case report. Some studies suggested that antinociceptive mechanisms of mirtazapine might relate to multiplier effect of the racemic compound of S(+)/R(-)-mirtazapine, reduction of inflammatory cytokines' activities in the brain and endogenous opioid system, as well as dual action. Mirtazapine is considered as a clinically and pharmacologically potential antinociceptor.
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[in Japanese]
Article type: Article
2013 Volume 53 Issue 7 Pages
687-693
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2013 Volume 53 Issue 7 Pages
694-695
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
696-697
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
697-698
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
699-700
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
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Article type: Article
2013 Volume 53 Issue 7 Pages
700-701
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2013 Volume 53 Issue 7 Pages
701-
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2013 Volume 53 Issue 7 Pages
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Article type: Article
2013 Volume 53 Issue 7 Pages
701-702
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
703-704
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2013 Volume 53 Issue 7 Pages
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Article type: Appendix
2013 Volume 53 Issue 7 Pages
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Article type: Appendix
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2013 Volume 53 Issue 7 Pages
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2013 Volume 53 Issue 7 Pages
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