Inter--rater and test--retest reliability of the Japanese version of the subjective deficit syndrome scale.

The subjective deficit syndrome scale (SDSS) was established in 1990 by Jaeger et al. to assess systematically subjective experiences of schizophrenic patients. It was translated into Japanese in 1999 by this paper's second author (T.I.). In this study, the inter-rater reliability of this Japanese version (SDSS-J) was examined. The subjects studied were 13 schizophrenic patients (male 6, female 7; respective average ages at study entry and disease onset: 41 and 25 years), who were being followed up at the outpatients' service of the Department of Neuropsychiatry, Hyogo College of Medicine. Four psychiatrists attended together, the systematic interview with each subject to rate the SDSS-J and independently rated 19 items. The severity scales of the items assessed by these raters ranged from 0 to 4 for 12 items and from 0 to 3 for 7. The ANOVA ICC inter-rater reliability values for the 19 individual items ranged from 0.67 to 0.96. The ANOVA ICC test-retest reliability values achieved by two raters were also high overall, ranging from 0.72 to 1.00, except for one item (item 13) assessed by one rater. Our results suggest that the SDSS-J is a potentially useful rating scale for evaluating subjective experiences of schizophrenic subjects.

[Malignant syndrome caused by a combination of bromperidol and donepezil hydrochloride in a patient with probable dementia with Lewy bodies].

The patient was a 68-year-old man with a 1-year history of delusions related to well-formed and detailed visual hallucinations. Bromperidol 12 mg was prescribed to treat his symptoms. After a diagnosis of dementia of Alzheimer's type was suspected, the patient received donepezil hydrochloride 5 mg. One week later, the patient's Parkinsonism deteriorated. One month later, the patient developed radical edema of the eyelids and the anterior neck, hypoproteinemia, and severe anteflexion of the body. One and a half months later, the patient developed malignant syndrome. His medication was discontinued and parenteral nutrition was started. The patient recovered from his malignant syndrome. However, 1 month later, his Parkinsonism had not improved. The patient received levodopa to treat his Parkinsonism and his symptoms subsequently improved. The hallucinations and systematized delusions returned. The patient's cognitive impairment deteriorated on one side. The aggravation of extrapyramidal symptoms and the development of malignant syndrome were believed to have been caused by the combination of bromperidol and donepezil hydrochloride and poor nutrition. Caution should be exercised when prescribing an antipsychotic drugs with donepezil hydrochloride.

Ubiquitous presence of mutagenic and antimutagenic components in air-borne particulates of two Japanese cities.

Previous studies on several samples of urban air-borne particulates showed that the long-chain fatty acids present in these samples can interfere with the measurement of mutagenicity of the particulates with the Salmonella assay. To explore whether this phenomenon is a general, fatty acid contents and the mutagenicity (with Salmonella typhimurium TA98 without S9) were measured for 34 particulate samples collected in the cities of Okayama and Tokyo over a period of 1 year. Palmitic, stearic, oleic and linoleic acids were found in all these samples in this order of amount, and their interference on mutagenicity measurement was eminent, particularly at high doses of the sample. With the use of blue cotton extraction, the mutagenic components can be freed from most of these antimutagenic factors. Significant correlation was found between the number of particulates and the mutagenicity per unit volume of the air. Eight polycyclic aromatic hydrocarbon compounds, including benzo[alpha]pyrene were quantified for these 34 particulate samples. Their contents were too small to account for the observed mutagenicity, suggesting that other polycyclic compounds, possibly involving nitro aromatics, were responsible for the mutagenicity observed. No remarkable differences were noted between Okayama and Tokyo in fatty acid contents, mutagenicity or polycyclic aromatic-hydrocarbon contents of the samples.

Mutagenicity and antimutagenicity of air-borne particulates.

A methanol extract of air-borne particulates collected in a suburban area of Okayama City showed not only mutagenicity but also antimutagenicity in the Ames test. Thus, when the mutagenicity of this preparation in Salmonella typhimurium TA98 (with metabolic activation) was measured, we observed that the dose response reached a plateau at 27 m3 air equivalent of the particulate, showing approximately equal numbers of revertants in the dose range 27-270 m3 equivalent. This plateau formation was not seen in the dose response of a blue-cotton extract of this preparation: the extract gave a linearly increasing dose response up to 270 m3 equivalent. This finding suggests that some factors that inhibit the mutagenicity were present in this methanol extract and that these inhibitors were not adsorbable to blue cotton, an adsorbent selective for compounds having 3 or more fused rings. From the portion unadsorbed to blue cotton, we isolated the antimutagenic factors and identified them as long-chain fatty acids: palmitic, stearic, oleic and linoleic acids. Analysis of several samples, including those from other parts of Japan, has suggested that these antimutagenic fatty acids are ubiquitous in air-borne particulates.