Personality and cancer survival: the Miyagi cohort study.

We tested the hypothesis that personality plays a role in cancer outcome in a population-based prospective cohort study in Japan. In July 1990, 41 442 residents of Japan completed a short form of the Eysenck Personality Questionnaire-Revised and a questionnaire on various health habits, and between January 1993 and December 1997, 890 incident cases of cancer were identified among them. These 890 cases were followed up until March 2001, and a total of 356 deaths from all causes was identified among them. Cox proportional-hazards regression was used to estimate the hazard ratio (HR) of death according to four score levels on each of four personality subscales (extraversion, neuroticism, psychoticism, and lie), with adjustment for potential confounding factors. Multivariable HRs of deaths from all causes for individuals in the highest score level on each personality subscale compared with those at the lowest level were 1.0 for extraversion (95% CI=0.8-1.4; Trend P=0.73), 1.1 for neuroticism (0.8-1.6; Trend P=0.24), 1.2 for psychoticism (0.9-1.6; Trend P=0.29), and 1.0 for lie (0.7-1.5; Trend P=0.90). The data obtained in this population-based prospective cohort study in Japan do not support the hypothesis that personality is associated with cancer survival.

Psychiatric disorders in cancer patients: descriptive analysis of 1721 psychiatric referrals at two Japanese cancer center hospitals.

BACKGROUND: Although a diagnosis of cancer today may no longer be considered to be the equivalent of a death sentence, many previous studies in Western countries have revealed that such a diagnosis places many kinds of emotional burden on a patient. However, few studies have focused on the nature of psychiatric disorders in Japanese cancer patients. METHODS: We investigated the characteristics, reason for psychiatric consultation and psychiatric diagnosis of cancer patients by analyzing the database of patients referred to the Psychiatry Divisions at the National Cancer Center Hospital and the National Cancer Center Hospital East, Japan. RESULTS: Among a total of 1721 referrals, most of the cancer patients (78%) were inpatients. Patients with lung cancer (19%) were the most common, followed by patients with breast cancer (13%) and with head and neck cancer (10%). More than half of the patients had recurrent and/or metastatic cancer and 60% of the patients had pain. The most common reason for the consultation was psychiatric evaluation (35%), followed by sleep disorders (19%), anxiety or fear (18%) and depression (18%). Regarding the psychiatric diagnosis, adjustment disorders were the most common (34%), followed by delirium (17%) and major depression (14%). The diagnosis of cancer had been disclosed to more than 99% of the patients. CONCLUSION: The common psychiatric disorders observed in Japanese cancer patients were similar to those in the Western countries provided the cancer diagnosis is disclosed.

[Psycho-oncology and its scientific background].

Psycho-oncology has two purposes corresponding to the psychosocial aspects of cancer: 1. to clarify the psychosocial impacts of cancer on the quality of life of the patient, family and staff; 2. to clarify the role that psychosocial and behavioral variables may have in cancer risk and survival. For these purposes, patient education, counseling, behavioral and psychopharmacological techniques have been applied to clinical oncology. In this paper, we review psycho-oncology and its scientific background, with respect to neuroradiology and molecular genetics, as well as psychiatry, psychology, epidemiology, pharmacology and immunology.

Impaired solute accumulation in inner medulla of Clcnk1-/- mice kidney.

The CLC-K1 chloride channel is a kidney-specific CLC chloride channel expressed in the thin ascending limb of Henle's loop (tAL). Recently, we determined that Clcnk1-/- mice show nephrogenic diabetes insipidus (NDI). To investigate the pathogenesis of impaired urinary concentrating ability, we analyzed renal functions of Clcnk1-/- mice in more detail. The osmolar clearance-to-creatinine clearance ratio was not significantly different between Clcnk1+/- and Clcnk1+/+ mice. Fractional excretion of sodium, chloride, and urea was also not significantly affected in Clcnk1-/- mice. These results indicate that the polyuria observed in Clcnk1-/- mice was water diuresis and not osmotic diuresis. The papillary osmolarity in Clcnk1-/- mice was significantly lower than that in Clcnk1+/+ mice under a hydrated condition, and it did not increase even after water deprivation. Sodium and chloride contents in the inner medulla in Clcnk1-/- mice were at about one-half the levels observed in Clcnk1+/+ mice. Furthermore, the accumulation of urea was also impaired in Clcnk1-/- mice, suggesting that the overall countercurrent system was impaired by a defect of its single component, chloride transport in the tAL. The aldose reductase mRNA abundance in Clcnk1-/- mice was decreased, further evincing that inner medullary tonicity is decreased in Clcnk1-/- mice. We concluded that NDI in Clcnk1-/- mice resulted from an impairment in the generation of inner medullary hypertonicity by a dysfunction of the countercurrent systems.

Depression after successful treatment for nonsmall cell lung carcinoma.

BACKGROUND: There have been few studies of depression in nonsmall cell lung carcinoma (NSCLC) patients after successful treatment. The purpose of the study was to clarify the prevalence and the correlated factors of depression after surgery. METHODS: A structured interview was conducted for patient characteristics and social support with NSCLC patients at baseline. One-month prevalence of depression at 1 and 3 months after surgery was obtained by follow-up interviews at 1 and 3 months after surgery, respectively, whereas that of depression at 2 months after surgery was by the latter interview retrospectively. Three-month prevalence of depression was determined as presence of depression during any month in of a period of 3 months after surgery. A logistic analysis was used to examine the correlated factors of depression during the 3 months after surgery. RESULTS: Of 223 consecutive cancer patients who participated in the study between June 1996 and April 1999, 33 (14.8%) met the criteria for major or minor depression during the 3 months after surgery. One-month prevalence of depression at 1, 2, and 3 months after surgery were 9.0%, 9.4%, and 5.8%, respectively. The results of logistic regression analysis revealed that only satisfaction with confidants before surgery, of patient characteristics and social support factors, was significantly associated with depression during the 3 months after surgery. CONCLUSIONS: These results suggest that depression is not rare after successful treatment for NSCLC and that social support may play an important role for NSCLC patients with depression after successful treatment.

Suicidal ideation in cancer patients with major depression.

BACKGROUND: Major depression is a well-documented risk factor for suicide in cancer patients as well as in the general population. However, there are no data explaining why some cancer patients suffering from major depression have suicidal ideation whereas others with the same disorder do not. METHODS: We investigated the background differences between cancer patients suffering from major depression with and without suicidal ideation by analyzing consultation data on patients referred to the Psychiatry Division, National Cancer Center Hospital, Japan. RESULTS: Univariate analysis showed that poor performance status, advanced stage and severe depression were the risk factors for suicidal ideation in these depressive cancer patients. Multivariate logistic regression analysis indicated that older age and severe depression are the final significant risk factors. CONCLUSION: These preliminary findings suggest that severe major depression may be an important indicator of suicidal ideation among cancer patients, that patients' age should be given greater attention and that closer monitoring and more intensive intervention against major depression may be needed.

Intramyocardial vascular volume distribution studied by synchrotron radiation-excited X-ray fluorescence.

We evaluated the vascular volume distribution with fine resolution (0.1-1.3 mg myocardial tissue) in the sagittal plane of the left ventricle by using the microsphere filling method in 21 dogs. The coronary arterial volume density in the sagittal plane did not exhibit normal distribution and was characterized by variability among the outer-to-inner layers and within the layers (+2SD/-2SD > 80 times), and the median values in the layers ranged from 4.7 to 22. 9 nl/mg myocardial tissue. The fractal analysis of vascular volume revealed a self-similar nature with a fractal dimension (D value) similar to that of flow distribution (1.20 +/- 0.05 and 1.24 +/- 0. 09 for vascular volume and flow distribution, respectively) and had a more marked variability than the flow. The correlation of the regional vascular volume between adjacent regions decreased as the distance increased. However, the correlation coefficients in the endocardial-to-epicardial direction were significantly higher than those in the anterior-to-posterior direction (P < 0.05 by paired t-test). In conclusion, we determined intramyocardial vascular volume density in the sagittal plane, and the distribution revealed considerable variability, self-similarity, and asymmetry in the correlation among the adjacent regions. These observations could be related to the characteristics of the intramural coronary vascular network.

Hypersensitivity pneumonitis among workers cultivating Tricholoma conglobatum (shimeji).

We report five cases of hypersensitivity pneumonitis among workers cultivating Tricholoma conglobatum (shimeji). After having worked for 5 to 20 years, they began to notice symptoms of cough, sputum, and dyspnea. They were diagnosed as having a hypersensitivity pneumonitis based on clinical features, bronchoalveolar lavage and transbronchial lung biopsy. By the double immunodiffusion test, precipitating lines between shimeji spore antigen and sera were observed in all of the patients. By enzyme-linked immunosorbent assay, the antibody activities against shimeji and three species of fungi (Cladosporium sphaerospermum, Penicillium frequentans, and Scopulariopsis species) were significantly higher in the sera of the patients than in those of normal subjects who were cultivating shimeji. Although it is not clear what causes this disease, these findings may be helpful in determining the specific antigen.

Acute lung injury after inhalation of water-proofing spray while smoking a cigarette.

A 34-year-old Japanese woman developed acute lung injury soon after inhaling a water-proofing spray which she applied onto her ski suit while smoking a cigarette at the same time. She initially demonstrated arterial hypoxemia (PaO2 = 59 mm Hg) and ground-glass opacities in both lung fields on the CT scan, which both returned to normal without any medication. Several water-proofing sprays, which are easily obtainable in Japan, contain 1,1,1-trichloroethane, liquefied petroleum gas and fluoride resin. Although these components have not been reported to be toxic to the lung yet, high concentrations of these components and/or the pyrolytic products of fluoride resin may have caused acute lung injury in this case.

[Bronchial cyst in a patient with a high serum CA19-9 concentration that fluctuated with the cyst fluid volume].

A 44-year-old woman was found to have an abnormally high concentration of CA19-9 in serum. Five years later, she underwent a right upper lobectomy for an abnormal shadow on a chest roentgenogram, because it was thought to indicate a malignant tumor. A chest CT scan revealed a cyst with fluid in the right upper lobe. During the 5 years before the lobectomy, the serum CA19-9 concentration rose when the cyst fluid volume increased, and fell when the cyst fluid volume decreased. Before the operation, the serum CA19-9 concentration was very high and the cyst was swollen. The cyst wall was found to be lined with ciliated columnar epithelial cells and to contain hyaline cartilage and smooth muscle, which led to the diagnosis of bronchial cyst. The surface epithelium and cyst fluid were positively stained by a monoclonal antibody against CA19-9. The serum CA19-9 concentration decreased and was within the normal range 3 months after the operation.

Cloning and sequence analysis of complementary DNA encoding a precursor for chicken natriuretic peptide.

Chicken alpha-natriuretic peptide (alpha-chNP) has been identified in chicken heart, which showed higher homology to brain natriuretic peptide (BNP) than to atrial natriuretic peptide (ANP). Complementary DNA (cDNA) clone encoding a chNP precursor (pre-chNP) was isolated from cardiac cDNA library and sequenced. Pre-chNP was 140-residue peptide carrying a 24-residue signal peptide at the N-terminus and alpha-chNP at the C-terminus, and did not exhibit high homology to porcine BNP except for the C-terminal region. However, a characteristic AT-rich nucleotide sequence commonly found in mammalian BNPs was also present in the 3'-untranslated region. Thus, chNP is concluded to be classified into the BNP-type.