Psychiatric symptoms and related factors in a sample of Japanese workers

A survey was conducted to investigate the presence of psychiatric symptoms and associated factors affecting psychiatric impairment among 2190 Japanese tax workers. The Japanese translated version of the General Health Questionnaire (GHQ) was used as a measure of psychiatric symptomatology. Several sociodemographic and psychosocial factors (interpersonal factors and perceived stress) were examined as being related to psychiatric impairment. As with all other language versions, the percentage distribution of the GHQ scores was considerably skewed. Females exhibited more psychiatric symptoms than males. No significant differences were found among four age-groups for both sexes. Perceived stress related to the workplace was correlated more with psychiatric impairment than with other psychosocial factors. It was also observed that the 'long-distance marriage' ('business bachelorhood') peculiar to Japanese occupations had little influence on the impairment levels.

Metabolism of 2,4-diamino-6-(2,5-dichlorophenyl)-s-triazine maleate in rats, guinea pigs, dogs and monkeys

The metabolism of 2,4-diamino-6-(2,5-dichlorophenyl)-s-triazine maleate (MN-1695) was studied in rats, guinea pigs, dogs and monkeys. MN-1695 was metabolized to more than 8 metabolites after oral administration in a dose of 3.1 mg/kg in rats. These metabolites were isolated from the urine and characterized by cochromatography with reference compounds, mass spectrometry and other instrumental analysis. The main metabolite in the urine was MN-1695 X m-OH, which was excreted as a conjugate, in rats and guinea pigs, and MN-1695 X N-oxide in dogs. In monkeys, MN-1695 X m-OH (free and conjugate) and MN-1695 X N-oxide predominated in the urine, although MN-1695 was not extensively metabolized. In rats, over 90% of the radioactivity excreted into the bile consisted of the polar metabolites. The major metabolic pathways of MN-1695 found in various animal species involved the hydroxylation at the positions of 3 and 4 of the aromatic ring and the N-oxidation at the position of 3 of the s-triazine ring. In addition, the sulfur-containing metabolites were detected in all species examined.

Sinus histiocytosis with massive lymphadenopathy. A histogenic analysis of histiocytes found in the fourth Japanese case

The present paper deals with immunohistochemical and ultrastructural study of the lymph nodes of sinus histiocytosis with massive lymphadenopathy (Rosai and Dorfman, SHML) of a 12-year-old Japanese boy. This is the fourth case in Japan. Osseous manifestation was also found in the bilateral ulnae. With hallmarks of S-100 protein and interdigitating cytoplasmic extensions, the phagocytizing histiocytes proliferating in the sinuses were considered to be derived mostly from interdigitating cells in the paracortex or T cell dependent area, which have heretofore been regarded as nonphagocytizing. Furthermore, it is most interesting that lymphoid cells bearing thymic cortical cell-antigen (OKT 6) were increasingly recognized in the patient's peripheral blood. These results suggested that SHML is a specialized reactive histiocytosis analogous to histiocytosis X and histiocytic medullary reticulosis.

Superficial carcinoma of the esophagus

Nine cases of superficial carcinoma of the esophagus were described. Although 3 patients complained of abdominal sensations on swallowing or dysphasia, 6 patients did not present with any symptoms related to the esophageal lesion. The radiologic diagnosis is particularly difficult in cases with superficial type esophageal cancer, and no definitive findings were obtained in three such cases. However, esophagoscopy using Lugol spray was far more effective for the recognition of these superficial lesions. Although surgical resection of the esophagus is technically easier in these cases, the indications of surgery should be carefully evaluated. One operative death occurred in our series. In cases that are good indications, however, wide lymph node dissection should be carried out, since metastases occur even to distant lymph nodes, particularly in cases with cancer invasion of the submucosal layer. The histopathologic diagnosis was squamous cell carcinoma in 8 cases, but in one case it was adenocarcinoma of mucus-secreting gland origin in the mid-thoracic esophagus.

[Inhibitory effect on rabbit peritoneal leukocyte and macrophage chemotaxis by sera from patients with pulmonary sarcoidosis: significance of serum chemotactic inhibitor in sarcoidosis]

Untreated 45 patients with pulmonary sarcoidosis were studied with respect to the presence of serum chemotactic inhibitor. Chemotactic assay was performed by modified Boyden chambers using polymorphonuclear leukocytes (PMNs) obtained from rabbit peritoneal exudate as indicator cells. Chemotaxis of PMNs was significantly suppressed by sera from patients with hilar lymphadenopathy and/or pulmonary infiltration compared with those from healthy subjects (P less than 0.001), whereas there was no significant difference between healthy subjects and patients who revealed complete remission on the chest X-ray films. This would be due to the serum chemotactic inhibitor rather than to the chemotactic deactivation of the cells. This inhibitor exhibited a direct inhibitory effect on the cells. In addition, the inhibitory effect remained even after serum was removed from the cells by washing. The inhibitor was heat-stable at 56 degrees C for 30 minutes in character. These features closely agreed with those of cell-directed inhibitor as described by Ward et al. Furthermore, untreated 30 patients with pulmonary sarcoidosis were examined by modified Boyden chambers using rabbit peritoneal macrophages as indicator cells. Macrophage chemotaxis was significantly suppressed by sera from patients who had tuberculin anergy compared with those from healthy subjects and patients who exhibited positive tuberculin reaction (P less than 0.001). In addition, there was close relationship between the degree of chemotactic suppression and the duration of disease (P less than 0.001), angiotensin-converting-enzyme activity (P less than 0.01). It was discussed that the cell-directed inhibitor might play a role in pathogenesis of sarcoidosis.

Infantile neuroaxonal dystrophy. Schwann cell inclusion in the peripheral nerve

Abnormal Schwann cell inclusion is reported in biopsied peripheral nerve in a case of infantile neuroaxonal dystrophy. In addition to non-specific dystrophic changes of the axons, the Schwann cells contained several distinct bodies which were composed of stacks of irregularly disposed membranes; in some instances, transformed Schwann cell cytoplasm was distined with similar bodies. This change has not been reported on this condition and its significance is briefly discussed.

Superficial esophageal carcinoma. Radiological findings in double-contrast studies

Most cases of superficial esophageal cancer have been reported in Japan and China. Radiological findings in 11 patients (13 lesions) are described. Superficial spreading cancer is difficult to detect despite widespread mucosal involvement. Double-contrast technique is essential, both to detect lesions and to demonstrate their extent. An irregular, rigid wall, mucosal abnormalities such as barium pooling and coating, and protrusions of various sizes and shapes are diagnostic features.

The studies of the attacks of abnormal eye movement in a case of infantile spasms

We observed the attacks of nystagmus in a case of infantile spasms and carried out overnight sleep polygraphy. The following findings were obtained: (1) Awake time was prolonged to 56% of TIB, while sleep time was markedly shortened to 44% of TIB. Also REM sleep time was reduced to 20% of SPT and deep slow sleep (stage N3) was absent. (2) Attacks of nystagmus were observed only during wakefulness. At first, fast wave bursts appeared in the right occipital area, and were followed by left-upward deviations of eyeballs, and then the attacks of counterclockwise right-downward rotatory nystagmus. Also the fast wave bursts were succeeded by spreading of fast waves to adjacent areas. At the same time, EMG exhibited elevated muscle action potentials of mentalis and biceps femoris. During the attacks of nystagmus, there was alteration of respiratory movements. In NREM sleep, both fast wave bursts and the attacks of nystagmus were not observed. In REM sleep, the fast wave bursts and eye movements were observed but the attacks of nystagmus did not appear. During the fast wave bursts, alteration of respiratory movements were observed. From the results of this study, it was presumed that the brain lesions of this case were extended with severe degree of damage in the great parts of brain containing cerebral cortex and brain stem.