Sudden death due to neuroleptic malignant syndrome (NMS), which is caused by the use of psychoneurotic agents, is considered difficult to diagnose solely on the basis of autopsy examinations commonly conducted to identify the cause of death. In this study, we focused on ubiquitin (Ub); a stress protein, and ryanodine receptor (RyR); a Ca2＋ release channel protein, and investigated whether these proteins can serve as indicators useful for forensic diagnosis of death from NMS. Organs from 12 cases of NMS and 15 non-NMS cases were subjected to immunohistochemical staining with anti-Ub and anti-RyR antibodies, and expression of the two proteins were observed and compared. The percentage of Ub-positive cells was found to be high in skeletal muscle from NMS cases. However, in the case of non-NMS in psychiatric and neurological agents used, sometimes a high percentage of Ub-positive cell number in skeletal muscle, it is not a diagnostic indicator of the NMS. On the other hand, the percentage of RyR-positive cells was found to be high in psoas major and hypothalamus from NMS cases. That is, when the RyR-positive cells in the psoas muscle and hypothalamus were observed more than onethird of the observation field of view, may be able to diagnose the NMS, was considered to be one of the useful indicator for forensic diagnostics.
This study was intended to get the suggestion to relation to patient with depression, through examining an association between psychological symptoms and personality tendencies, while paying attention to the office relevance association. The Yatabe-Guilford (Y-G) personality test and the interview version of the Hamilton Depression Rating Scale (HAM-D) were used to evaluate 21 outpatients with depression at the Department of Neuropsychiatry, an University Hospital, Japan. The subjects were divided according to workplace setting into office-based and non-office based groups. HAM-D scores ranged from 1 to 28 (mean±SD, 13.5 ±6.6) in the office-based group and from 3 to 29 (mean± SD, 15.4 ± 9.8) in the non-office based group. In the office-based group, the Y-G personality test classified 5 patients as A type (38.5%), 4 as E type (30.8%), 2 as D type (15.4%), 1 as B type (7.7%), and 1 as C type (7.7%). These results revealed that the most common personality type in the office-based group was A (the standard personality type). With regard to the relationship between psychological symptoms and personality tendencies, the higher the HAM-D scores, the greater the tendency for being emotionally unstable (subfactors: Depressive and Inferiority). This suggests that despite having the average personality for living in society, the number of A-type individuals with depression is on the rise. In addition, some outpatients had E-type personality, which has a tendency for maladaptation. Psychotherapy may be needed to treat patients with this personality type.
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