Participation in psychosocial group intervention among Japanese women with primary breast cancer and its associated factors.

Though psychosocial group intervention is considered in the West to be an important source of support for reducing psychosocial distress in cancer patients, in Asian countries, there has been no research as yet on the needs for such intervention. This study investigated the level of participation and interest in psychosocial group intervention plus any associated factors in 151 primary breast cancer patients. All were less than 65 years old at 4-18 months post-surgery. Of the 126 subjects who responded (response rate 83%), 53 (42%) participated (participants) and 73 (58%) did not (non-participants). Participation was greater among those with a high level of anxiety measured by the Hospital Anxiety and Depression Scale (HADS) (odds ratio [OR], 3.25; 95% confidence interval [CI], 1.07-10.42), those who had undergone surgery within the last 12 months (OR, 3.10; 95% CI, 1.35-7.55), and those who were 50-65 years old (OR, 3.08; 95% CI, 1.33-7.66). Among the non-participants, 53 (73%) were interested in the intervention while 20 (27%) were not. Non-participants without any interest in the psychosocial group intervention had significantly higher anxiety levels than those with interest (t=-2.08; df=71; p=0.03). These results suggest that most Japanese breast cancer patients who need psychological support can be sought out by asking whether they are willing to participate in a psychosocial group intervention. However, the minority not interested in any psychological group intervention might need other supports such as medication or individual psychotherapy.

Lesions in lateral hypothalamic areas increase splenocyte apoptosis.

OBJECTIVE: The lateral hypothalamic area (LHa) is involved in various functions such as feeding, drinking, sexual and reward behavior, among others. Recently, we demonstrated that the LHa can regulate cellular immunity in the spleen. In experiments involving the LHa, it was noticed that the spleen shrinks noticeably after LHa destruction. To explore this phenomenon further, the effect of LHa lesioning on splenocyte apoptosis was investigated. METHODS: Male Wistar-King-Aptekman rats underwent bilateral lesioning of their LHa and consequent spleen weights, splenocyte numbers and apoptosis were measured. For the detection of splenocyte apoptosis, both ELISA, which measures DNA fragmentation within the splenocytes, and flow cytometry, which measures the percentage of apoptotic lymphocytes in the spleen, were used. RESULTS: In the LHa-lesioned rats, spleen weights and the number of splenocytes decreased significantly within 24 h. Additionally, in the spleen, lymphocyte apoptosis significantly increased compared to the control after 6 h. CONCLUSION: These results suggest that the LHa may play a role in immunoregulation by affecting lymphocytes in the spleen through apoptosis and may be relevant to the pathway of stress-induced apoptosis.

Three sets of diagnostic criteria for major depression and correlations with serotonin-induced platelet calcium mobilization in cancer patients.

OBJECTIVE: Enhanced serotonin-induced platelet calcium mobilization has been proposed to be a biological marker for the pathophysiology of major depression in physically healthy patients. To determine the most appropriate method of diagnosing major depression in cancer patients, we compared serotonin-induced platelet calcium mobilization between patients with and without major depression diagnosed according to three different sets of diagnostic criteria (inclusive, substitutive and exclusive). METHODS: Among the cancer patients referred to our institution between June 1997 and March 1998, 24 patients diagnosed as having major depression according to the inclusive approach (in which the nine traditional symptoms of major depression contribute towards the diagnosis of depression regardless of its presumed etiology) participated in the study. Serotonininduced platelet calcium mobilization was examined in these patients and in the same number of non-depressed controls matched for age, sex, cancer stage and cancer site. The depressed patients were then re-evaluated using substitutive and exclusive criteria, and calcium mobilization comparisons with the relevant controls were repeated. RESULTS: Compared with the controls, an enhanced serotonin-induced platelet calcium response was only observed in the patients with major depression according to the exclusive criteria. No significant enhancement was observed when the inclusive or substitutive approaches were used. CONCLUSION: These findings, based on the use of enhanced serotonin-induced platelet calcium mobilization as a biological marker, suggest that the exclusive approach might be the most valid and appropriate method of diagnosing major depression in cancer patients, while the inclusive and substitutive approaches might overestimate the occurrence of major depression in these patients.

Reward linked to increased natural killer cell activity in rats.

In rats splenic natural killer (NK) cell activity was found to be significantly higher following chronic uncontrollable electrical stimulation of the lateral hypothalamus in fully conscious rats, compared to sham-operated rats. In a pre-test study, all rats had demonstrated that the electrode site had self-stimulating properties, which supports the possibility that the experience of reward may be implicated in NK cell activity augmentation.

Lateral hypothalamus modulates the intrinsic splenic natural killer cell activity in rats.

Electrical stimulation of the lateral hypothalamus (LH) in rats increased splenic natural killer (NK) cell activity, whereas electrical ablation of the LH decreased it. However, the percentage of NK cells, as detected by the anti-NKR-P1 monoclonal antibody, in the spleen did not change significantly. These results suggest that the LH does not modulate the splenic NK cell activity by increasing the NK cell number but by increasing the intrinsic NK cell activity itself.

Differential effects of neuropeptides on cytokine production by mouse helper T cell subsets.

Though immune outcome is known to be determined by which helper T cell response predominates, no local mechanism has yet been established which can explain how the neuronal system may control this. It is possible that the nervous system releases neuropeptides at specific local sites of infection or challenge, which triggers lymphocytes at those points to release specific cytokine profiles. These may then influence the direction of the Th1/Th2 response and therefore immune outcome. The aim of this study was to evaluate whether and if so how neuropeptides influence cytokine production by lymphocytes, especially T cells. We investigated the effects of neuropeptide Y (NPY), calcitonin gene-related peptide (CGRP), substance P (SP) and vasoactive intestinal peptide (VIP) on the production of interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) by stimulating nonadherent splenocytes and helper T cell clones with antigens in vitro in the presence or absence of these peptides. NPY greatly enhanced IL-4 production and inhibited IFN-gamma. CGRP inhibited IFN-gamma production markedly in a dose-dependent manner, but had no effects on IL-4 production. SP and VIP had no effects on IFN-gamma production, but SP enhanced and VIP suppressed IL-4 production slightly but consistently. Therefore neuropeptides can influence cytokine production. This opens the door to speculations that these specific cytokine profiles might play a part in influencing the direction of the consequent Th1/Th2 cascade and immune outcome and possibly the pathogenesis of immune-related diseases.

Acute electrical stimulation of lateral hypothalamus increases natural killer cell activity in rats.

Natural killer cell (NK) activity in WKA and SD rats was found to be significantly higher following electrical stimulation of the lateral hypothalamus (LH) compared to sham operated. There was no such difference between sham operated rats and those receiving electrical stimulation in the frontal cortex as a control. Operations were performed under sodium pentobarbital anesthetic, and NK activity against YAC-1 target cells was measured 20 h later using 51Cr release assay. The LH area stimulated is a potent reward center and that stimulation of this point increased NK activity opens the possibility that pleasure might play a role in cellular immunity.