Ultrastructure of quick-frozen secretory ameloblasts of the rat molar tooth

Ameloblasts in molar tooth germs from 4 to 12-day-old neonatal rats were quick-frozen and then freeze-substituted in acetone-tannic acid and acetone-osmium tetroxide. Following quick freezing and freeze-substitution, the preservation of ameloblasts was principally the same as seen in conventionally-fixed ones. Several differences, however, became apparent between two methods. Concerning enamel formation, the quick-freezing procedure greatly improved the preservation including that of the extrusion of secretory granules into the extracellular space. The exocytosis is a type of merocrine secretion. The precursor stippled material was demonstrated at the front of Tomes' processes and in the intercellular space of the distal terminal junction. In the more advanced stage, the stippled material tended to decrease gradually in amount. Prior to the formation of the typical Tomes' process, large secretory granules fused directly with the distal plasma membrane, which plays a role in the formation of prismless enamel. After the typical Tomes' process had formed, secretory granules containing electron-dense material instead of the large secretory granules accumulated in the distal portion of the Tomes' process. These latter secretory granules had two different destinations; i.e. the granules discharged their contents into the infoldings of the distal part of Tomes' process and into the infoldings of the lateral cell membrane. These types of secretion seem to have a functional role in the rod or inter-rod enamel formation. The ultrastructure of the stippled material consisted of 3-dimensionally interconnected strands after quick freezing, which is different from the appearance of granules embedded in amorphous material after conventional fixation. The stippled material was seen in the intercrystal space among the newly formed crystals. Also, an extensive tubulo-vesicular structure was preserved in both the cell body and Tomes' process. The present data suggest that the membrane of this structure showed a smooth contour opening to the extracellular space, and also an intimate relationship with the secretory granules.

[Two cases of elderly people diagnosed with acute tuberculous pneumonia possibly succeeded by the perforation of lymph nodes in the bronchus]

The report is a study of the cases in which elderly people (83 years-old male and 81 years-old female) diagnosed has having acute tuberculous pneumonia possibly suffered from subsequent perforation of lymph nodes in the bronchus. Neither of the patients had a prior history of tuberculosis treatment. Both patients were admitted to the hospital after being diagnosed with pneumonia. After the administration of antibiotics, the symptoms of illness improved, but chest roentgenograms were taken failed to show improvement. The patients were then transferred to our hospital, because sputa smear tests for Mycobacteria (Ziehl-Neelsen stain) were performed, and the results were positive. Case I (male) was suspected of having endobronchial tuberculosis, since rhonchi was audible in the left-front upper chest during expiration when performing auscultation. A bronchoscopy was conducted at which time ulcer lesions on the left upper lobe of the bronchus and perforated lymph node of the upper bronchus were detected. Case II (female) was suspected of having lung cancer and a bronchoscopy was performed due to the findings of a chest roentgenogram taken after one month of chemotherapy. A perforated lymph node in right truncus intermedius was detected. In this report, we discussed the early diagnosis of tuberculous pneumonia and the perforation of caseous lymph nodes in the bronchus, which was the main cause of tuberculous pneumonia.

Usefulness of narrow pedicled intercostal cutaneous perforator flap for coverage of the burned hand

A narrow pedicled intercostal cutaneous perforator (np-ICP) flap is used for reconstruction of hand scar contractures after burns. This flap is designed with a narrow pedicle which includes some intercostal cutaneous perforators of 4-7th intercostal spaces, and with a wide distal area which lies over the costal cage and upper abdomen. Additionally the flap is thinned until only the subdermal vascular network is preserved in most of the wide distal area. It seems that this flap is more useful, not only functionally but also aesthetically, than conventional methods. This report describes the technique and concept, with a demonstration of some clinical examples.

Diabetes-induced reduction of neuronal survival in hypotonic environments in culture

Dorsal root ganglion (DRG) neurons from streptozotocin (STZ)-induced diabetic and normal C57BL mice were exposed to three different hypotonic environments (1/2, 1/4, and 1/8 osmolar solutions). After rapid applications of these hypotonic solutions to the neurons, the cell volume autoregulatory mechanism operated in 1/2 osmolar solution but was disrupted in superhypotonic solutions below 1/4 osmolar in both kinds of mice. None of the neurons could survive 12 h after treatment with superhypotonic solutions. On the other hand, a gradual reduction of osmolarity of the culture medium enabled neurons in the normal mice to survive in 1/2 and 1/4 osmolar solutions as well as in an isotonic solution. However, this reduction of osmolarity increased neuronal cell death in the diabetic mice. These results suggest that the ability of DRG neurons to survive in hypotonic environments in culture may be lost in diabetes.

A soundproof pressure chamber

For neurotological research we designed a soundproof pressure chamber in which pressure can be adjusted +/- 1000 mmH2O at the rate of less than 100 mmH2O per second. Noise in the chamber can be maintained under 30-35 dB while pressure is kept at a given level.

Test for pressure control capacity of the Eustachian tube

Because of Eustachian tube controls middle ear pressure to maintain the best hearing level, we tested the equilibration capacity of the Eustachian tube by measuring hearing levels in a soundproof pressure chamber. The number of swallows to recover normal hearing after the chamber pressure reached -200 mm H2O (an index of equilibration capacity for the static pressure differences across the eardrum) was less than 9 in normal subjects. The worst level of hearing and the time required to recover normal hearing from the beginning of alteration in the chamber pressure to -700 mm H2O (indexes of equilibration capacity for dynamic pressure differences across the eardrum) were 0-17 dB and within 120s in normal subjects. It was difficult to determine definitive normal ranges of the equilibrium capacity of the Eustachian tube when positive pressure was applied.

Effect of atmospheric pressure on hearing in normal subjects

Hearing is assumed to be altered during or immediately after a change in atmospheric pressure, although this has not been tested experimentally. We used a soundproof pressure chamber to examine the effect of alterations in atmospheric pressure on hearing in 26 normal healthy subjects. The subjects were placed in the soundproof pressure chamber in a supine position and instructed to actively equilibrate middle ear pressure or to abstain from doing so. When the pressure was changed to +/- 500 mmH2O at 33 mmH2O/s the results were as follows: When subjects did not equilibrate middle ear pressure, air conduction at low frequency tones increased more than bone conduction. The degree of deterioration in hearing was greater when the chamber pressure was increased (descent) than where pressure was decreased (ascent). When the subjects equilibrated middle ear pressure, little change in the levels of air or bone conduction was observed. Most of the deterioration in bone conduction was considered to reflect functional loss due to increased stiffness and damping of the sound transmission mechanism.

Fibromyxoma of the trachea

A 53-year-old male with a small cell carcinoma of the lung was admitted to the Department of Respiratory Diseases, Nikko Memorial Hospital. During bronchofiberoptic examination of the cancer, a small nodule was discovered on the anterior wall of the trachea, about 8 cm below the vocal cord. Histopathologically, it was diagnosed as fibromyxoma of the trachea. Primary tumors of the trachea are very rare and fibromyxoma of the trachea is extremely rare. This is only the second report of a fibromyxoma on the tracheal wall. In this report its clinical manifestations were compared with those reported in the first case.

Genomic binding-site cloning reveals an estrogen-responsive gene that encodes a RING finger protein

Estrogen receptor (ER)-binding fragments were isolated from human genomic DNA by using a recombinant ER protein. Using one of these fragments as a probe, we have identified an estrogen-responsive gene that encodes a putative zinc finger protein. It has a RING finger motif present in a family of apparent DNA-binding proteins and is designated estrogen-responsive finger protein (efp). efp cDNA contains a consensus estrogen-responsive element at the 3' untranslated region that can act as a downstream estrogen-dependent enhancer. Moreover, efp is regulated by estrogen as demonstrated at both the mRNA and the protein level in ER-positive cells derived from mammary gland. These data suggest that efp may represent an estrogen-responsive transcription factor that mediates phenotypic expression of the diverse estrogen action. Thus, the genomic binding-site cloning may be applicable for isolation of the target genes of other transcription factors.

[Postoperative pain therapy: a survey of patient attitudes to postoperative pain relief]

We surveyed the attitudes of general surgical patients to the management of their postoperative pain relief. Elective surgical patients (n = 232) were asked postoperatively about their experienced pain which was expressed according to verbal pain scale, the duration of experienced pain, satisfaction with pain relief and medication, and expectations of pain on the 5th to 7th postoperative day. Thirteen percent of the patients had no pain, 47% of whom had no rest pain but pain on moving or coughing, 32% of whom had rest and moving pain, and 0.4% of whom experienced horrible and excruciating pain. Duration of postoperative pain was 2.5 +/- 1.9 days, and 76% of the patients experienced pain only for 3 postoperative days. Results of the interviews indicated that 80% of these patients were satisfied with their postoperative pain relief. Although 80% expressed satisfaction, 39% of whom did have rest pain. In the patients with continuous epidural infusion of buprenorphine and 0.25% bupivacaine, incidence of complained rest pain was significantly low compared with those with intermittent i.v. and/or im injection of analgesics on demands of patients. Lag between patient's demand and nurse's response concerning medication correlated significantly to the satisfaction. There was no relation between satisfaction and age, the nature of operation or sex. Fifty-two percent of the patients reported that degree of experienced pain had been less than expected preoperatively. In conclusion, 80% of the patients were satisfied, but our postoperative pain therapy was still insufficient because 39% of them had rest pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Expression of follistatin, an activin-binding protein, in vascular smooth muscle cells and arteriosclerotic lesions

Activin-A has a mitogenic effect on vascular smooth muscle cells (SMCs) and is produced by monocyte/macrophage lineage cells. Here, we studied the expression of follistatin, an activin-binding protein, in both A10 cells, a rat aortic SMC line, and vascular SMCs derived from adult rat aorta. Follistatin mRNA was detected in these cells by Northern blot analysis. Ligand blot and immunoblot analyses demonstrated that follistatin was produced in the conditioned medium at a higher level by A10 cells than by SMCs. Furthermore, immunostaining and in situ hybridization of the arteriosclerotic lesions showed that follistatin was highly expressed in the diseased artery, where abnormal proliferation of SMCs occurred. We suggest that follistatin is produced by vascular SMCs and is involved in the course of atherogenesis.

An evaluation of the effects of cytokines on intracellular oxidative production in normal neutrophils by flow cytometry

To evaluate the effects of inflammatory cytokines on oxidative production in normal neutrophils, seven kinds of cytokines such as granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor (G-CSF), interleukin-2 (IL-2), IL-6, IL-1 alpha, IL-1 beta, and interferon-beta (IFN-beta) were tested. The intracellular hydrogen peroxide (H2O2) in individual cells was determined by flow cytometry. According to the levels of intracellular H2O2 enhanced by cytokines, these seven cytokines were classified into three types: (1) prominently effective--GM-CSF; (2) moderately effective--G-CSF, IL-6, and IL-2; (3) weakly or ineffective--IFN-beta, IL-1 alpha, and IL-1 beta. Changes in cell size and cell surface structure after stimulation of those seven cytokines were simultaneously measured by flow cytometry. The most prominently effective cytokine, GM-CSF, initially caused enlargement of cell size and irregularity of the cell surface and subsequently increased H2O2 production by neutrophils. In contrast, the weakly or ineffective cytokines, like IL-1 beta, had no effects on cell size or cell surface. Our study indicates that some kinds of cytokines enhance oxidative production and cause morphological changes in neutrophils.

Structural diversity in the alpha 2-->8-linked polysialic acid chains in salmonid fish egg glycoproteins. Occurrence of poly(Neu5Ac), poly(Neu5Gc), poly(Neu5Ac, Neu5Gc), poly(KDN), and their partially acetylated forms

alpha 2-->8-Linked polysialic acid (polySia) chains terminate O-linked oligosaccharide chains on Salmonidae fish egg polysialoglycoproteins (PSGPs). Expression of these surface PSGPs are developmentally regulated and the polySia epitope is functionally implicated in a number of distinct species-specific cell-cell recognition events during fertilization and early embryogenesis. To better understand the functional diversity of these PSGPs, structural studies of the polySia chains isolated from three genera and eight species of Salmonidae fish eggs were carried out by chemical, immunochemical, enzymatic, and 1H NMR methods. A remarkable degree of structural diversity was found, including differences in the N-acyl groups, i.e. N-acetylneuraminic acid (Neu5Ac) or N-glycolylneuraminic acid (Neu5Gc), and in the presence of either O-acetyl substitution at C4, C7, or C9 or O-lactyl substitution at C9. The presence of heteropolymers containing both Neu5Ac and Neu5Gc residues was also an unexpected finding. Accordingly, the different forms of alpha 2-->8-linked homo- and heteropolymers of these polySia structures include: poly(Neu5Ac), poly(Neu5Gc), poly(Neu5,chi Ac2), poly(Neu5Gc chi Ac), poly(Neu5Ac, Neu5Gc), poly-(Neu5Ac, Neu5,chi Ac2), poly(Neu5Ac, Neu5Gc chi Ac), poly(Neu5Gc,Neu5,chi Ac2), and poly(Neu5Gc, Neu5-Gc chi Ac), where chi represents the site of acetylation at carbon atom 4, 7, or 9. The significance of this new structural information, together with our recent finding of alpha 2-->8-linked polydeaminoneuraminic acid, poly(KDN), in the rainbow trout egg vitelline envelope, is that it demonstrates the natural occurrence of multiple forms of alpha 2-->8-linked polySia chains in Salmonidae fish glycoproteins that have not been previously described. The results also predict that a remarkable array of polysialylated glycoconjugates is yet to be discovered in animals other than teleost fishes.

Impaired immunity in obesity: suppressed but reversible lymphocyte responsiveness

Although obese people have been reported to have a higher incidence of infections and some types of cancer, the immunocompetence of obese subjects remains poorly understood. To investigate whether obesity affects immunity, we studied obese subjects (BMI > 30 kg/m2) whose health was uncomplicated by any other disorder, including hyperglycemia. We compared mitogen-induced blastogenic response of peripheral blood lymphocytes in 34 obese subjects (mean +/- s.e. BMI: 38.4 +/- 2.0 kg/m2) and 35 non-obese controls (BMI: 21.3 +/- 0.4 kg/m2) who were matched for age and sex. The effects of weight reduction were also evaluated in 19 obese persons (BMI: 36.4 +/- 1.8 kg/m2) on a very low calorie diet. Mean (+/- s.e.) intracellular incorporation of [3H]-thymidine, on stimulation of T lymphocytes with either phytohaemagglutinin (PHA) or concanavalin A (Con A), and B lymphocytes with pokeweed mitogen, was significantly diminished in obese subjects compared to non-obese controls (47552 +/- 6917 vs. 83720 +/- 6252 cpm, P < 0.001; 30301 +/- 6018 vs. 45942 +/- 3723 cpm, P < 0.05; 13669 +/- 2971 vs. 23735 +/- 2048 cpm, P < 0.01, respectively). After weight reduction (BMI: 27.8 +/- 1.2 kg/m2), the mean T lymphocyte responses to PHA and Con A were increased significantly vs. baseline (98404 +/- 2444 vs. 50337 +/- 9516 cpm, P < 0.05 and 69523 +/- 15480 vs. 36695 +/- 8006 cpm, P < 0.05, respectively). Depressed blastogenesis of B lymphocytes was also augmented but was not statistically significant. The results suggest that obese subjects have underlying immune impairment in responsiveness of lymphocytes and that these impairments are reversible with adequate weight reduction.

A case of perianal Paget's disease associated with a sigmoid colon carcinoma

A case of perianal invasive Paget's disease associated with a sigmoid colon carcinoma is presented. The chief complaint was perianal irritation for a year. Histologic examination yielded a correct diagnosis and abdominosacral resection with wide excision of the cutaneous component was performed. Histology of the resected specimen revealed the Paget's disease to be invasive of the dermis, the sigmoid colon carcinoma to be in Dukes' A stage and the two lesions to be different. The patient has been disease-free for more than 5 years after the operation.

Depressive states in workers using computers

There have been few reports investigating the depressive states in workers using computers. We describe the depressive states observed in workers using computers and discuss the sources of their occupational stresses. The first subject is a 34-year-old male manager of a manufacturing company who had customarily worked until 9 PM. In 1985, it become necessary for him to work until midnight; symptoms of depression began to appear during this period, exacerbated after trouble with a computer. In 1986, he visited a psychiatrist and his condition was diagnosed as Major Depression according to DSM-III. The second subject is a 26-year-old male VDT (visual display terminal) operator in a general hospital. Before the onset, he had had to work until 8 PM and, at the end of each month, until midnight. Two months later, he became depressed and his condition was diagnosed as Major Depression according to DSM-III. The third subject is a 32-year-old male chief in the computer programming section of a bank. He had had to work until 8 PM, became depressed, and visited a psychiatrist who diagnosed his condition as Major Depression according to DSM-III. The authors discuss these cases from the standpoint of occupational stresses, as they are associated with work overload, and the important role these stresses played in the onset of the workers' depressive states.

Determinants of fasting hypertriglyceridemia in ventromedial hypothalamic obesity in rats

The present study investigated the mechanism of fasting hypertriglyceridemia in ventromedial hypothalamic (VMH) obesity by measurement of post-heparin plasma lipoprotein lipase (LPL) activity, triglyceride secretion rate (TGSR), and plasma insulin. One week after VMH lesions, when the lesioned rats were gaining weight rapidly (the dynamic phase), they showed normal plasma triglyceride levels with increased plasma LPL activity and TGSR. There was a positive correlation between hyperinsulinemia and elevated plasma LPL activity or TGSR in VMH-lesioned rats, while no correlation was observed in control rats. Ten weeks after VMH lesions, when the rats had become obese and reached a steady-state weight gain (the static phase), they showed hypertriglyceridemia with increased plasma LPL activity and TGSR. There was, again, a positive correlation between hyperinsulinemia and elevated plasma LPL activity or TGSR in VMH-lesioned rats. These results suggest a possible mechanism of fasting hypertriglyceridemia in these rats; in the dynamic phase adipose tissue adequately takes up circulating triglyceride because the tissue has sufficient take-up capacity and hence hypertriglyceridemia does not develop. In the static phase the tissue cannot adequately take up circulating triglyceride because of a limitation of its capacity, resulting in hypertriglycemia despite enhanced triglyceride secretion and increased LPL activity in both phases.

Autopsy findings in 47 cases of adult T-cell leukemia/lymphoma in Miyazaki prefecture, Japan

To identify factors that might improve the prognosis of adult T-cell leukemia/lymphoma (ATL), we reviewed data on 47 autopsied cases of ATL with reference to the complications and cause of death. The primary cause of death was respiratory insufficiency due to pulmonary infection. Respiratory insufficiency was also attributed to the diffuse alveolar damage and pulmonary fibrosis resulting from chemotherapy given and oxygen. About 90% of the cases had infections with one or more pathogens. Cytomegalovirus (CMV) was the most frequent pathogen involved in 35/47 (74.5%) while fungal infections were also commonly seen in 25 of the 47 cases (53.2%). Of these, 17 (70%) had pulmonary aspergillosis. Other neoplasias were present in 10 of the 47 cases, while hypercalcemia was evident in 21 patients. These findings suggest that the prevention and treatment of nosocomial infections and of drug-induced pulmonary toxicity may improve the prognosis and quality of life of ATL patients.

Changes in plasma 5-S-cysteinyldopa concentration in B16 melanoma-bearing mice treated with interferon-beta or dacarbazine

We have previously shown that the urinary excretion of 5-S-cysteinyldopa (5-S-CD) reflects well the progression of B16 mouse melanoma. We examined the usefulness of plasma concentration of 5-S-CD in following the progression of melanoma and evaluating the efficacy of immuno- and chemotherapeutic agents in the B16 mouse model. Murine interferon-beta (MuINF-beta; 3 x 10(5) U) or dacarbazine (DTIC; 50 mg/kg) was administered once a day for 10 or 5 consecutive days starting 8 days after subcutaneous inoculation of B16 melanoma cells in C57BL/6 mice. Blood samples were collected from the tail vein and tumour volumes were measured every other day until day 24. Levels of 5-S-CD in plasma were determined by high-performance liquid chromatography. Tumours became palpable on day 6-8 and grew exponentially thereafter in the control mice. Tumours in INF-beta-treated mice also grew exponentially, although at a reduced rate. However, the growth of tumours in the DTIC-treated mice was almost suppressed between days 12 and 18. Mean values of tumour volume on day 16 were 1.45, 1.05, and 0.83 cm3 in the control, INF-beta-treated, and DTIC-treated groups, respectively. The plasma concentration of 5-S-CD began to increase on day 8, at much slower rates in the experimental groups than those in the control group. Mean values of plasma 5-S-CD on day 16 were 14.3, 5.9, and 5.6 nmol/l in the control, INF-beta-treated, and DTIC-treated groups; 5-S-CD level on day -2 was 1.8 nmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Antimelanoma activity of chloroquine, an antimalarial agent with high affinity for melanin

The antimalarial agent chloroquine is known for high affinity for melanin. This 4-aminoquinoline derivative was examined for anti-melanoma activity and uptake into melanoma cells. Chloroquine inhibited growth of cultured melanoma cells; the effect was much greater to a moderately pigmented cell line HMV-II than to a nonpigmented HMV-I. Treatment with chloroquine at a dose of 62 mg/kg i.p. for 12 days prolonged by 71% the life span of mice bearing B16 melanoma, while 24-day treatment at 31 mg/kg resulted in a 81% increase in life span. HMV-II cells showed a two-fold increase in uptake of chloroquine as compared with HMV-I cells. Chloroquine, 24 hr after administration to mice implanted s.c. with B16 melanoma, was selectively accumulated in the pigmented tissues, melanoma and eyes. Other nonpigmented tissues such as the liver, lung, and kidney showed rapid uptake (within 1 hr) and release. These results suggest that chloroquine is toxic to pigmented melanoma cells, the process being partly mediated by binding to melanin.

Vascular smooth muscle cells as target for estrogen

ER mRNA was detected as 6.0 kb band by Northern blot analysis in vascular smooth muscle cells (VSMC) derived from rat aorta. The presence of ER mRNA in VSMC was confirmed by reverse transcriptase-polymerase chain reaction using specific primers for rat ER cDNA. In addition, the immunocytochemistry of ER was performed in VSMC using a monoclonal anti-ER antibody which recognizes DNA-binding domain of ER. The immunoreactivity was distributed in the cytoplasm as well as in the nuclei. Thus, the expression of ER in VSMC was demonstrated at both the protein and the mRNA level. Furthermore, the expression of c-fos mRNA in VSMC was found up-regulated by 17 beta-estradiol treatment within 30 min. The observation that VSMC possess ER and respond to estrogen supports the idea that estrogen may directly influence vascular cell system through the ER.

Structure of novel gangliosides, deaminated neuraminic acid (KDN)-containing glycosphingolipids, isolated from rainbow trout ovarian fluid

Two acidic glycosphingolipids were isolated and purified from rainbow trout ovarian fluid. They were designated as ovarian fluid gangliosides ofg-2a and ofg-2b. Both of these glycolipids were found to contain glucose, galactose, and N-acetylgalactosamine in a molar ratio of 1:2:1, but they differ by the presence of 2 mol of deaminated neuraminic acid (KDN; 2-keto-3-deoxy-D-glycero-D-galacto-nononic acid) in ofg-2a and 1 mol each of KDN and 9-O-acetyl-KDN in ofg-2b. On the basis of composition analysis, methylation analysis, mild acid hydrolysis, fast atom bombardment mass spectrometry (FABMS), 400-MHz 1H nuclear magnetic resonance spectroscopy, and immunochemical analysis using a monoclonal antibody (mAb.kdn3G), the complete structures of these gangliosides were determined to be KDN alpha 2-->3Gal beta 1-->3GalNAc beta 1-->4(KDN alpha 2-->3)Gal beta 1-->4Glc beta 1-->Cer for ofg-2a [(KDN)GD1a] and 9-O-AcKDN alpha 2-->3Gal beta 1-->3GalNAc beta 1-->4(KDN alpha 2-->3)Gal beta 1-->4Glc beta 1-->Cer for ofg-2b [(KDN)GD1a(OAc+)]. The ceramide moieties (Cer) in both ofg-2a [(KDN)GD1a] and ofg-2b [(KDN)GD1a(OAc+)] were found by combining of the results from fatty acid analysis and FABMS measurements to be made up of 4-sphingenine and mainly a C24:1 fatty acyl chain (nervonate). The structures of ofg-2a and ofg-2b are novel, and they represent the second example of naturally occurring KDN-gangliosides. Mild acid hydrolysis of both ofg-2a and ofg-2b resulted in formation of (KDN)GM1a.

Hebephrenia as the most prevalent subtype of schizophrenia in Japan

The author reviewed the frequency of the hebephrenic subtype compared to the paranoid subtype diagnosis of schizophrenia in Japan, using research papers and statistical reports that have been published during this century. It was found that the reported rates for the hebephrenic subtype ranged from a low of 23% to a high of 68% with the majority falling between 30% and 50%. These rates had not varied significantly over a long period of time or across wide geographical areas. It was discussed that Japanese psychiatrists were so sensitive to the negative symptoms of schizophrenia that they had a broader concept of hebephrenia as compared to other Kraepelian subtypes in schizophrenia.