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Biomedical subjects

T Kuboki

Publications and source records attributed to T Kuboki.

At least 73 records · Page 4Linked to original sources

EEG-driven photic stimulation effect on plasma cortisol and beta-endorphin.

The effect of EEG-driven photic stimulation on stress-related endocrine function was studied. Subjects were 16 healthy males divided into a photic stimulation group (n = 8) and a control group (n = 8). Electrodermal and emotional lability measures were assessed by nonspecific skin conductance response and the Maudsley Personality Inventory, respectively. Plasma cortisol and beta-endorphin concentrations were measured both before and after EEG-driven photic stimulation as well as the resting condition. Subjects with electrodermal, emotional, or both lability showed comparable decreases of plasma beta-endorphin on photic stimulation as did the stable subjects. Under resting control conditions, however, they showed significant increases of beta-endorphin compared to both stable subjects as well as the photic stimulation condition. In addition, labile subjects showed significant alpha enhancement on photic stimulation compared to stable subjects and to the resting control condition. The data suggest that increases of plasma beta-endorphin in labile control subjects may denote a stress response to the conditions of these experiments, and that any decrease by EEG-driven photic stimulation may indicate a reduction of responsiveness to an acute stress.

Adult↗

A comparison of Japanese and American psychiatrists' attitudes towards patients wishing to die in the general hospital.

BACKGROUND: The attitudes of the psychiatrists in Japan and the US were compared in order to investigate their ideas on whether patients in general medical hospitals who have a desire to die should be allowed to do so or be assisted in this regard, and whether they require psychiatric evaluation and intervention, and the cultural influences on these attitudes. METHODS: Japanese and American general hospital psychiatrists' attitudes towards the reasonability of suicide, physician-assisted suicide, and removal of life supports under various medical and psychosocial situations were compared. Seventy-two American and 62 Japanese psychiatrists' data were collected using the Suicidal Attitudes Inventory. RESULTS: The majority of both American and Japanese psychiatrists agreed that there may be times when suicidal ideation or completed suicide in med-surg patients could be reasonable. Significantly more Japanese psychiatrists responded with some agreement to the reasonability of suicide when one is unable to fulfill social role expectations, and had more concern about causing suicidal ideation by informing terminal patients of their diagnosis. CONCLUSIONS: The results indicate that psychiatrists' attitudes towards the relationship of psychopathology with suicidal ideation, the effect of depression, and other cultural factors on the desire to die in the medically ill are issues that need better clarification among both the medical profession as well as within society. Looking at how other societies handle these matters may help to understand one's own approach to them.

Adult↗

Viscoelastic properties of the pig temporomandibular joint articular soft tissues of the condyle and disc.

It has been suggested that a sustained loading condition such as clenching could compress the temporomandibular joint (TMJ) articular soft tissues. However, there is still no clear understanding of how the TM joint articular tissues respond under compression. To answer this question, we performed in vitro indentation tests on fresh articular discs and cartilage-bone systems of the condyles of 10 Yorkshire pigs (aged 7 months) using a self-developed indentation tester. The indenter was 5 mm in diameter and was controlled by means of a computer-aided feedback mechanism. Bilateral condyles from the same mandible were uniformly prepared; one was used for measurements under sustained compression (SC) and the other for measurements under intermittent compression (IC). The displacements of the indenter induced by a SC of 10, 20, and 30 Newtons (N, units of force) for 10 min and by an IC, also of 10, 20, and 30 N, with one-second duration and two-second intervals for 10 min were measured by means of a displacement sensor with a resolution of 0.001 mm. From these data, the indentation curves of the articular discs and the cartilage-bone systems were calculated. Both the disc and the articular cartilage showed characteristic displacement vs. time curves-namely, an instantaneous deformation upon load application, followed by a time-dependent creep phase of asymptotically increasing deformation under constant load. However, the indentation curves of the two tissues were not identical: The deformation of the articular cartilage was dose-dependent, but that of the disc was not. Moreover, the articular cartilage deformed significantly less under IC than under SC. This difference was not found in the disc. It can be concluded that both the disc and the articular cartilage of the pig temporomandibular joint have viscoelastic properties against compression; however, the disc is stiffer than the articular cartilage.

Analysis of Variance↗

The effect of occlusal appliances and clenching on the temporomandibular joint space.

It has been suggested that stabilization appliances and mandibular anterior repositioning appliances work by decompressing the temporomandibular joint. To indirectly test this assumption, tomograms of right temporomandibular joints of seven subjects were taken during comfortable closure and maximum clenching in maximum intercuspation and on the two types of occlusal appliances. Outlines of the condyle and the temporal fossa were automatically determined by an edge detection protocol. Upon comfortable closure, the anterior joint space dimension was reduced with stabilization appliances and mandibular anterior repositioning appliances. Upon maximum clenching, the minimum joint space dimension on stabilization appliances was equivalent to that seen in maximum intercuspation, while that on mandibular anterior repositioning appliances was substantially less (P < .05). Findings do not indicate that these appliances induce an increase in joint space during clenching.

Adult↗

Long-term follow-up study on drop-out TMD patients with self-administered questionnaires.

Although patient attrition might be a serious threat to the validity of treatment-outcome studies on temporomandibular disorders (TMD), studies on TMD patient attrition are scarce. Of the 1405 consecutive TMD patients examined in a recent 10-year period, 367 (26.1%) drop-out patients or patients identified with a control group were sampled. A mailed questionnaire failed to reach 41 patients, and 203 (62.3%) were returned. The questionnaire elicited information on reasons for dropping out, changes in symptoms, treatment received in other clinics after dropping out, present treatment needs, and current signs and symptoms. Dropouts were divided into two groups: (1) those who failed to show up for their first scheduled appointment after the clinical examination; (2) those who failed to complete treatment. A group of patients who were judged by the examiner not to need treatment were included as a control group. The main reasons for dropping out were environmental obstacles, perceived improvement of the disease, and dissatisfaction with services. Only 21.7% considered themselves to be in need of treatment, and only 10.3% had visited other clinics after dropping out. Only 8.9% complained of the continued aggravation of symptoms, whereas 57.6% reported improvement. In addition, pain, dysfunction, and daily activity limitation tended to improve with time, although temporomandibular joint noise tended to persist. These results suggest that TMD signs and symptoms tend to decrease in patients after dropping out, and that the natural fluctuation of TMD signs and symptoms should be taken into consideration when treating TMD.

Adolescent↗

Epidemiological data on anorexia nervosa in Japan.

An epidemiological survey on anorexia nervosa was performed in Japanese hospitals in 1985 and 1992 using a questionnaire. The reported number of patients with anorexia nervosa was 2391 from 732 institutions. From these data, the total number of anorexia nervosa patients treated in 1985 in Japanese hospitals was estimated to be about 3500-4500. In 1992, the reported number of patients with AN was 2247. The total number of AN patients treated in 1992 was estimated to be about 4500-4600, which is a little higher than that in 1985 (3500-4500). The prevalence was 3.6-4.5 per 100000 among the general population, 6.3-9.7 per 10(5) among the female population, and 25.2-30.7 per 10(5) among the 13-29 year-old female population.

Adolescent↗

Treatment of a depressive disorder patient with EEG-driven photic stimulation.

This study examined the effects of electroencephalographic- (EEG-) driven photic stimulation on a case of depressive disorder, as measured by a psychometric test of mood states, EEG parameters, and several autonomic indices. The EEG-driven photic stimulation enhances the alpha rhythm of brain waves using photic signals, the brightness of which is modulated by a subject's own alpha rhythm. The patient was a 37-year-old businessman, who was treated for depression with medication during the 13 months prior to his first visit to our hospital. He underwent two sets of inpatient treatment sessions, comprising first 16 and then 18 treatment sessions. The treatments brought about the following changes: an improvement in general mood state, alpha rhythm increase, cardiac parasympathetic suppression, and increased skin conductance level. In addition, significant correlations between alpha rhythm increase and cardiac parasympathetic suppression or cardiac sympathetic predominance were observed with each inpatient treatment. Significant correlations between alpha rhythm increase, cardiac parasympathetic suppression, or cardiac sympathetic predominance and the improvement of general mood state were also observed. Thus, from these observations, it was concluded that the alpha enhancement induced by EEG-driven photic stimulation produced an improvement in the patient's depressive symptomatology connected with cardiac parasympathetic suppression and sympathetic predominance.

Adult↗

Effects of sustained unilateral molar clenching on the temporomandibular joint space.

OBJECTIVE: To measure the effect of unilateral sustained clenching on the temporomandibular joints, changes in the minimum joint space dimension were assessed. STUDY DESIGN: Ten healthy subjects performed a sustained clench on a bite force transducer in the first molar region for 5 minutes with a constant force of 170 N. Three separate sagittal tomograms were bilaterally obtained with the transducer in place before clenching and during the beginning and at the end of the contraction. Changes were quantified with a computerized image analysis system. RESULTS: The minimum joint space of the contralateral temporomandibular joint was significantly reduced both at the beginning and at the end of the contraction task. Further the minimum joint space was also significantly less at the end than at the beginning of the contraction even though bite force level was identical. The ipsilateral condyle images showed no significant shift in the minimum joint space. CONCLUSIONS: These data suggest that unilateral molar clenching induces a significant reduction of the minimum joint space in the contralateral temporomandibular joint and a sustained condition remarkably increases this change.

Adult↗

Temporomandibular disorders in the adult population of Okayama City, Japan.

In order to discover the prevalence of signs and symptoms of temporomandibular disorders (TMD) in Japan, and the difference in the prevalence among various sex and age groups in the Japanese population, 672 individuals (304 males and 368 females, age range 20-92 years) were selected randomly in Okayama City, Japan, and were investigated by means of questionnaires and clinical examinations. The reported frequency of symptoms was: TMJ sounds 24%, facial-TMJ-jaw pain 11%, headache 27%, teeth clenching 30%, and grinding 34%. The percent frequency of the following signs was: impaired mouth opening 5%, clicking 46%, reciprocal clicking 20%, crepitus 19%, TMJ tenderness 6%, and masticatory muscle tenderness 21%. The subjects with TMJ clicking were more frequently females than males. TMD signs and symptoms were found to be common in all age groups, but they were fewer in the older than in the younger age group. The younger-aged subjects with clicking appeared with significant frequency, whereas crepitus was populated with significant frequency by the oldest age group.

Adult↗

Relationship of parental bonding to child abuse and dissociation in eating disorders in Japan.

Parental bonding patterns were studied in 52 female Japanese eating disorder outpatients with and without histories of sexual or physical abuse and with dissociation. Instruments included the Parental Bonding Instrument (PBI), the Dissociative Experiences Scale (DES) and the Dissociative Disorders Interview Schedule (DDIS). Those with physical abuse history, but not sexual abuse history, had significantly different parental bonding scores and higher DES scores compared with subjects without physical abuse. DES scores and PBI scores were not correlated. Although the PBI was useful in discriminating between those with and those without abuse histories, it did not detect differences in degree of dissociation. Lack of association of sexual abuse to PBI and DES scores may have been due to mild abuse.

Adolescent↗

Dissociation and child abuse histories in an eating disorder cohort in Japan.

Dissociation and childhood abuse were studied in female eating disorder outpatients in Japan. A self-report version of the Dissociative Disorders Interview Schedule (DDIS), which includes data on physical and sexual abuse, and the Dissociative Experience Scale (DES) were used. Nine of 41 subjects who completed the DDIS reported symptoms suggesting DSM-III-R multiple personality, and 6 of the 39 subjects who completed the DES scored over 30 (reflecting a high likelihood of posttraumatic stress or multiple personality). Subjects' sexual abuse history rates were considerably greater then those in the Japanese general population. Though physical abuse history was associated with high dissociation, no difference was seen between the high and low dissociators in sexual abuse histories.

Adolescent↗

[Panic disorder].

The recent publication of the Diagnostic and Statistical Manual of Mental Disorders, third edition (D.S.M-III) has provided the basis for the separate diagnostic entity of panic disorder. A panic attack is characterized by the abrupt onset of apprehension or fear accompanied by symptoms such as dyspnea, palpitation, chest discomfort, dizziness, sweating, feeling of unreality, and fear of dying. Panic disorder, defined as four panic attacks in a four week period, has a lifetime prevalence of 1 to 2 percent of the general population. In these patients, panic disorders can be provoked by pharmacological challenge with sodium lactate, yohimbine, caffeine and carbon dioxide inhalation. Recently, the relationship between panic disorder and depression became a subject of investigation from various points of view.

Depressive Disorder↗

Multidimensional assessment of mental state in occupational health care--combined application of three questionnaires: Tokyo University Egogram (TEG), Time Structuring Scale (TSS), and Profile of Mood States (POMS).

We attempted to develop a brief test battery to assess mental state for use in occupational health care settings. As a first step, we focused on the following three psychosocial aspects: ego state, behavioral pattern, and mood state which were considered to be closely related to mental state. To evaluate these parameters, we selected three established self-rating questionnaires: the Tokyo University Egogram for ego state, the Time Structuring Scale for behavioral pattern, and the Profile of Mood States for mood state. The combination of these three questionnaires was applied on 300 healthy company employees and school teachers (170 males and 130 females). Five ego-state factors (Critical Parents, Nurturing Parents, Adult, Free Child, and Adapted Child), five behavioral pattern factors (Withdrawal, Rituals and Pastimes, Activities, Intimacy, and Games), and six mood state factors (Tension-Anxiety, Depression-Dejection, Anger-Hostility, Vigor-Activity, Fatigue-Inertia, and Confusion-Bewilderment) were scored. Of 85 correlations between test factors, 49 in males and 61 in females were not significant, indicating that each test in this battery assessed aspects of mental state rather independent of those assessed by the others. However, significant correlations (P < 0.05) were observed for remaining pairs of test factors, indicating that these three parameters were also interrelated with each other, indicating that mental state could be elucidated more comprehensively by assessing all three psychosocial parameters than by assessing only one. The possibility that this battery could be used in the future in worksite health promotion programs is discussed.

Adult↗

[Panic disorder].

Panic episodes were described as a distinct form of anxiety by Freud almost 100 years ago, and the recent publication of the Diagnostic and Statistical Manual of Mental Disorders, third edition (D.S.M.-III), has provided the basis for the separate diagnostic entity of panic disorder. In this study, we showed the historical review of research and the result of our clinical study of panic disorder in 7 patients. The following results were obtained: 1) Abnormal DSTs were observed in only two of 5 patients. 2) Five of 6 patients showed high concentration of adrenaline and noradrenaline in urine. 3) Anxiety was provoked by caffeine in two of 5 patients. 4) Depression of T-wave was shown in three of 5 patients with orthostatic E.C.G. 5) Sinus tachycardia was gained in one of 3 patients with Holter E.C.G. 6) Abnormal respiratory functions were observed in all two patients with Treadmill. 7) Only one small heart was observed on a chest radiograph. 8) Panic attacks were provoked by sodium lactate infusion in four of 7 patients.

Electrocardiography↗

Interrelationship between serum muscle enzymes and a low T3 in anorexia nervosa.

To determine the interrelationship between muscle dysfunction and a low T3 state, both seen in anorexia nervosa, we studied the relationship between the degree of muscle involvement, as assessed by the circulating concentration of the three muscle indicators (CPK, GOT and LDH), and serum T3 in thirty-three patients when they were admitted to the hospital. We also studied the malnutritional state, as assessed by their body weight or serum GH, serum potassium and the degree of hyperactivity exhibited. Additionally, another twelve patients were studied in order to explore the mounding phenomenon which is typically elicited in hypothyroidism. The logarithms of serum CPK and GOT correlated only with the serum T3 concentration (r = -0.35, p less than 0.05; r = -0.41, p less than 0.05; respectively). The logarithm of serum LDH highly correlated with serum T3, the percentage of ideal body weight, and the logarithm of serum GH (r = -0.55, p less than 0.01; r = -0.66, p less than 0.001; r = 0.43, p less than 0.05; respectively). The mounding phenomenon was elicited in ten out of twelve patients. In conclusion, it was implied that a low T3 state was associated with an increase in serum muscle indicators and thus with muscle dysfunction encountered in anorexia nervosa.

Adult↗

Two cases of anorexia nervosa associated with Graves' disease.

In this report on two cases of anorexia nervosa associated with Graves' disease, metabolism and the relationship between the two illness are considered. Case 1 was a 25-year-old female. Anorexia was associated with a stressful life situation following marriage. One year after the onset of anorexia, her condition was diagnosed as Graves' disease. In spite of high levels of serum thyroid hormone, she did not show the clinical signs and symptoms of hyperthyroidism. The hypermetabolic state of Graves' disease seems to be suppressed by the hypometabolism of anorexia. Case 2 was a 17-year-old female whose body weight, due to anorexia, at one time had decreased from 55 kg to 35.2 kg. A rebound from anorexia to bulimia increased her body weight to 80 kg in spite of an association with the hypermetabolic state of Graves' disease. In light of the abovementioned cases, it seems that the clinical picture of Graves' disease is usually hidden by the clinical symptoms of anorexia nervosa.

Adolescent↗