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Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder in Patients with Chronic Pain

Open Journal of Psychiatry 2017年第4期7卷 261-275页

作者： Satoshi Kasahara Yumiko Okamura Ko Matsudaira Hiroyuki Oka Yoshie Suzuki Yasuko Murakami Toshiharu Tazawa Hayato Shimazaki shin-ichi niwa Yoshitsugu Yamada Anesthesiology and Pain Relief Center Faculty of Medicine University of Tokyo Tokyo Japan Department of Neuropsychiatry Faculty of Medicine University of Tokyo Tokyo Japan Department of Medical Research and Management for Musculoskeletal Pain 22nd Century Medical and Research Center Faculty of Medicine University of Tokyo Tokyo Japan Department of Anesthesiology and Pain Medicine Faculty of Medicine Juntendo University Tokyo Japan Department of Anesthesiology and Pain Medicine Yokohama City University Medical Center Yokohama Japan Department of Psychiatry Jikei University School of Medicine Tokyo Japan Department of Psychiatry Aizu Medical Center Fukushima Medical University Fukushima Japan

Aims: To investigate rates of attention-deficit hyperactivity disorder (ADHD) in patients with chronic pain attending a pain clinic, the effects of a screening measure for ADHD in patients with chronic pain, and the effects of ADHD drugs on both pain and ADHD symptoms. Methods: We retrospectively surveyed 110 patients with chronic pain visiting the Anesthesiology and Pain Relief Center at the University of Tokyo in Japan, who had also consulted a psychiatrist, between April 2012 and July 2015. Results: Of the total of 110 patients with chronic pain, 35 (31.8%) were also diagnosed with ADHD, and the average Wender Utah Rating Scale (WURS) score among the ADHD patients was 39.0 ± 22.1 (n = 25). Only 36.0% of these patients exceeded the cutoff value, suggesting that 64.0% of the patients with ADHD were not identified by screening with the WURS. Twenty-six patients initiated treatment with ADHD medication, with dosage adjustment completed in 21. Of these 21 patients 20 (95.0%) had improved ADHD symptoms. Improved pain symptoms were observed in 14 patients (66.6%), with a reduction in the pain numerical rating scale of 64.7% ± 30.1%. Conclusions: This is the first study investigating the comorbidity of ADHD and chronic pain at pain clinics showing a high level of comorbidity and amelioration of pain and ADHD symptoms with treatment. Careful interpretation is required when the WURS is used to screen patients with chronic pain.

关键词： Atomoxetine Attention Deficit Hyperactivity Disorder Chronic Pain Methylphenidate Wender Utah Rating Scale

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Newly Admitted Psychiatric Inpatients after the 3.11 Disaster in Fukushima, Japan

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Open Journal of Psychiatry 2017年第3期7卷 131-146页

作者： Masaki Hisamura Arinobu Hori Akira Wada Itaru Miura Hiroshi Hoshino Shuntaro Itagaki Yasuto Kunii Junya Matsumoto Hirobumi Mashiko Craig Katz shin-ichi niwa Department of Emergency Medicine Saitama Medical Center Saitama Medical University Saitama Japan Department of Disaster and Comprehensive Medicine Fukushima Medical University Fukushima Japan Department of Neuropsychiatry Fukushima Medical University Fukushima Japan Departments of Psychiatry and Medical Education Icahn School of Medicine at Mount Sinai New York USA Department of Psychiatry Aizu Medical Center Fukushima Medical University Fukushima Japan

Background: After the March 2011 “triple” disaster in Japan, the residents of Fukushima Prefecture suffered from serious psychological stress. Aims: This study aimed to elucidate the influence of stressful conditions on psychiatric disorders, as reflected in new psychiatric admissions. Methods: Diagnoses and background conditions among new psychiatric admissions during the 3 months immediately after the disaster in 2011 and the corresponding time periods of 2010 and 2012 were surveyed. Results: In 2011, more patients were admitted in confusional, manic, neurasthenic, and delirious states, whereas there were fewer admissions for depression. In 2012, more admissions pertained to depression. Twenty-four percent of the new admissions in 2011 were associated with concerns about radiation contamination and hospitalization, which declined to 4% in 2012. Conclusions: The diagnoses and background conditions among new psychiatric admissions were affected by the disaster;with the influence differing according to the time elapsed after the disaster.

关键词： Depression Fear of Radiation Fukushima Disaster Manic State Psychiatric Inpatients

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Attention-Deficit/Hyperactivity Disorder in Adults with High-Functioning Pervasive Developmental Disorders in Japan

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Open Journal of Psychiatry 2014年第4期4卷 372-380页

作者： Yasuko Takanashi Hirobumi Mashiko Hirohide Yokokawa Yoko Kawasaki Shuntaro Itagaki Hiromichi Ishikawa Norihiro Miyashita Yasuaki Hayashi Asako Kudo Kentaro Oga Rieko Matsuura shin-ichi niwa Department of Neuropsychiatry Fukushima Medical University School of Medicine Fukushima Japan Fukushima General Health and Welfare Center Fukushima Japan Department of Public Health Fukushima Medical University School of Medicine Fukushima Japan Department of General Medicine Juntendo University School of Medicine Tokyo Japan Musasino Child Development Clinic Tokyo Japan Hanawakousei Hospital Fukushima Japan Landic Nihonbashi Clinic Tokyo Japan Hoshigaoka Hospital Fukushima Japan Surugadai Nihon University Hospital Tokyo Japan Shiba Clinic Tokyo Japan

Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Furthermore, we examined to what extent adults with PDD think that they exhibit ADHD symptoms. Methods: We developed an original Japanese self-report questionnaire to determine the presence or absence of 18 symptoms from the diagnostic criteria for ADHD in the DSM-IV-TR. We administered the questionnaire to 64 adults with high-functioning PDD (45 men and 19 women) and 21 adults with ADHD (10 men and 11 women), aged 18 to 59 years, with a full-scale intelligence quotient ≥75. Target patients were evaluated for ADHD by their psychiatrists. Results: Twenty-nine (45.3%) adults with PDD also had ADHD. The percentage of these adults who had over six perceived inattention symptoms from the DSM-IV-TR was 96.6%. The percentage of these adults who had over six perceived hyperactivity-impulsivity symptoms was 65.5%. Thirty-five (55.6%) adults with PDD responded that they were aware of having ADHD symptoms at the level of the relevant diagnostic criteria. Conclusions: The present study is the first to examine the frequency of objective and perceived ADHD symptoms in adults with PDD in Japan. Our results show that both objective and perceived ADHD symptoms frequently appear in a large number of adults with PDD. This suggests that it is necessary to attend to concomitant ADHD symptoms in the medical care of adults with PDD.

关键词： Adults Attention-Deficit/Hyperactivity Disorder (ADHD) High-Functioning Pervasive Developmental Disorders (PDD) Self-Report

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A rare presentation of appendiceal diverticulitis associated with pelvic pseudocyst

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World Journal of Gastroenterology 2008年第8期14卷 1293-1295页

作者： Hirotaka niwa Takeyuki Hiramatsu Department of Surgery Yaizu City Hospital Yaizu-City Shizuoka Japan

We report a case of a 32-year-old woman with episodic right lower quadrant abdominal pain. With the diagnosis of either acute appendicitis or tubo-ovarian abscess, she was treated with antibiotics, which successfully relieved the pain and the inflammatory findings. She repeated the clinical condition a few times and antibiotics worked each time. In a year, her subjective symptoms became milder, however, a giant pelvic cyst appeared. She had an exploratory laparotomy to confirm this diagnosis. Histopathological studies revealed herniated appendiceal mucosa through the muscular layer associated with chronic inflammation and marked fibrosis. Gynecological disorders such as endometriosis or lutein cyst rupture was denied. These findings represent appendiceal diverticulitis. We discuss the clinical features of the disease and its relation with the pelvic pseudocyst.

关键词： Appendiceal diverticulitis Perforation Pelvic pseudocyst

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Autonomic and cardiovascular effects of pentobarbital anesthesia during trigeminal stimulation in cats

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International Journal of Oral Science 2012年第1期4卷 24-29页

作者： Hiroshi Hanamoto Hitoshi niwa Mitsutaka Sugimura Yoshinari Morimoto Department of Dental Anesthesiology Osaka University Graduate School of DentistryOsakaJapan

Stimulation of the trigeminal nerve can elicit various cardiovascular and autonomic responses;however,the effects of anesthesia with pentobarbital sodium on these responses are *** sodium was infused intravenously at a nominal rate and the lingual nerve was electrically stimulated at each infusion *** in systolic blood pressure（SBP） and heart rate（HR） were evoked by lingual nerve stimulation at an infusion rate between 5 and 7 mg？kg 21 ？h *** response was associated with an increase in the low-frequency band of SBP variability（SBP-LF）.As the infusion rate increased to 10 mg？kg 21 ？h 21 or more,decreases in SBP and HR were *** response was associated with the reduction of *** conclusion,lingual nerve stimulation has both sympathomimetic and sympathoinhibitory effects,depending on the depth of pentobarbital *** reaction pattern seems to be closely related to the autonomic balance produced by pentobarbital anesthesia.

关键词： autonomic nervous system blood pressure and heart rate variability hemodynamics trigeminal depressor response

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Risk of ileal pouch neoplasms in patients with familial adenomatous polyposis

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World Journal of Gastroenterology 2013年第40期19卷 6774-6783页

作者： Masahiro Tajika Yasumasa niwa Vikram Bhatia Tsutomu Tanaka Makoto Ishihara Kenji Yamao Department of Endoscopy Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Medical Hepatology Institute of Liver and Biliary SciencesNew Delhi 110070India Department of Gastroenterology Aichi Cancer Center HospitalNagoya 464-8681Japan

Restorative proctocolectomy is the most common surgical option for patients with familial adenomatous polyposis(FAP). However,adenomas may develop in the ileal pouch mucosa over time,and even carcinoma in the pouch has been reported. We therefore reviewed the prevalence,nature,and treatment of adenomas and carcinoma that develop after proctocolectomy in the ileal pouch mucosa in patients with FAP. In 25 reports that were reviewed,the incidence of adenomas in the ileal pouch varied from 6.7% to 73.9%. Several potential factors that favor the development of pouch polyposis have been investigated,but many remain controversial. Nevertheless,it seems certain that the age of the pouch is important. The risk appears to be 7%to 16% after 5 years,35% to 42% after 10 years,and75% after 15 years. On the other hand,only 21 cases of ileal pouch carcinoma have been recorded in the literature to date. The diagnosis of pouch carcinoma was made between 3 to 20 years(median,10 years) after pouch construction. Although the risk of malignant transformation in ileal pouches is probably low,it is not negligible,and the long-term risk cannot presently be well quantified. Regular endoscopic surveillance,especially using chromoendoscopy,is recommended.

关键词： Familial adenomatous polyposis Restorative proctocolectomy Ileal pouch Ileal pouch-anal anastomosis Ileo-rectal anastomosis Adenoma Adenocarcinoma Pouch polyp Pouch neoplasm

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Development of a digital zenith telescope for advanced astrometry

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Science China(Physics,Mechanics & Astronomy) 2012年第4期55卷 723-732页

作者： HANADA Hideo ARAKI Hiroshi TAZAWA Seiichi TSURUTA Seiitsu NODA Hirotomo ASARI Kazuyoshi SASAKI Sho FUNAZAKI Ken'ichi SATOH Atsushi TANIGUCHI Hideo KIKUCHI Mamoru TAKAHASHI Tomoe YAMAZAKI Atsumu PING JinSong KAWANO Nobuyuki PETROVA Natalia GOUDA Naoteru YANO Taihei YAMADA Yoshiyuki niwa Yoshito KONO Yusuke IWATA Takahiro National Astronomical Observatory of Japan Iwate-ken 0230861Japan Department of Engineering Department Iwate UniversityIwate 0208550Japan National Astronomical Observatory Chinese Academy of SciencesBeijing 100012China Oshu Space&Astronomy Museum Iwate-ken 0230861Japan Department of Astronomy Kazan State UniversityKazan 420008Russia Section of Graduate School of Science Division of Physics and Astronomy Kyoto UniversityKyoto 6068501Japan Japan Aerospace Exploration Agency Kanagawa 2525210Japan

Like other optical astrometric techniques,the Photographic Zenith Tube(PZT) has played a key role in the past observations of the Earth rotation,and it also has a potential to be applied to several other observations by taking advantage of automatic observations with self compensation of tilt of the *** here propose In-situ Lunar Orientation Measurement(ILOM) to study lunar rotational dynamics by direct observations of the lunar rotation from the lunar surface by using a small telescope like PZT with an accuracy of 1 milli-seconds of arc(1 mas) in the post-SELENE *** second application is to obtain local gravity field on the Earth by combining deflection of the vertical measured by PZT and the position measured by Global Positioning System(GPS) or Global Navigation Satellite System(GNSS).The accuracy required for this purpose is not as strict as *** have already developed a Bread Board Model(BBM) of the telescope for ILOM and made some experiments in order to know the performance of the driving mechanism under a similar condition to the lunar environment showing high vacuum,large temperature change and dusty *** have also shown that it is possible to correct the effects of uniform temperature change upon the optical system by using a simple model with an accuracy of better than 1 *** model has the potential to attain the accuracy of 1 mas,based on the results of the experiments and the simulations.

关键词： high accuracy orbit determination SAR LRS SELENE

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Improvement of a Real Gas-Sensor for the Origin of Methane Selectivity Degradation by l-XAFS Investigation

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Nano-Micro Letters 2015年第3期7卷 255-260页

作者： Takahiro Wada Naoyoshi Murata Takuya Suzuki Hiromitsu Uehara Hiroaki Nitani Yasuhiro niwa Motohiro Uo Kiyotaka Asakura Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Corporate R&D Headquarters Fuji Electric Co. Ltd Catalysis Research Center Hokkaido University Photon Factory Institute of Materials Structure Science

We have directly investigated the chemical state of the Pd species in a real l-gas sensor device by examining the l-fluorescence X-ray absorption fine structure. The l-gas sensor device was heavily damaged by a heating process in which the temperature was ill-controlled, resulting in decrease of methane selectivity. We found that the Pd O in the fresh l-gas sensor was reduced to Pd metal particles as the methane selectivity decreased. Based on the investigation results, we modified the device structure so as to heat up homogeneously. The lifetime of the sensor was then successfully increased by more than 5 years.

关键词： Micro gas sensor Micro-XAFS Pd/Al2O3 Deactivation

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Closed-Loop Control of an XYZ Micro-Stage and Designing of Mechanical Structure for Reduction in Motion Errors

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Nanomanufacturing and Metrology 2021年第1期4卷 53-66页

作者： Hiraku Matsukuma Keisuke Adachi Takuma Sugawara Yuki Shimizu Wei Gao Eiji niwa Yoshihiro Sasaki Department of Finemechanics Graduate School of EngineeringTohoku UniversityMiyagiSendai 980-8579Japan Research Institute for Electromagnetic Materials 9-5-1 NaritaMiyagiTomiya 981-3341.Japan

This paper presents a compact XYZ micro-stage driven by an impact driving mechanism.A moving body is translationally actuated along the X-,Y-,and Z-axes in millimeter-scale range and with nanometer-scale ***-N thin-film strain sensors are integrated into the micro-stage for closed-loop ***-loop control is also carried *** motion errors in six degrees of freedom are also investigated for this *** is clarified by analysis of finite element method that rotational motion errors around the driving axis are caused by torques due to tensions from the elastic hinges of *** mechanical structure of XYZ micro-stage to cancel out the torque generated is proposed and the second prototype is *** the rotational motion error is successfully suppressed in the second prototype,a rotational motion error of more than 0.1°remains due to remaining torque and assembly error of the elastic ***,in order to reduce the rotational motion error,the prototype is designed in which the location of elastic hinges is *** designing a mechanical structure in which torque is suppressed,all rotational motion errors are successfully reduced to less than 0.05°in the prototype with single-layer hinges.

关键词： XYZ micro-stage Cr-N thin-film displacement sensor Closed-loop positioning Impact drive Friction drive

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Autonomic nervous system network and liver regeneration

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World Journal of Gastroenterology 2018年第15期24卷 1616-1621页

作者： Kenya Kamimura Ryosuke Inoue Takuro Nagoya Norihiro Sakai Ryo Goto Masayoshi Ko Yusuke niwa Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University

To date, various signal transducers, cytokines, growth factors, and hormones have been reported to play an important role in homeostasis of various organs. Various cells and organs are involved in the hepatic regeneration process, which proceeds as a result of the coordination of many factors. While these factors are well known to be involved in the liver regeneration after the liver injury, however, as the details of such mechanisms have not been sufficiently elucidated, the practical applicability of hepatic regeneration based on the action of these and cytokines growth factors is still unclear. In terms of the involvement of the autonomic nervous system in hepatic regeneration, cell proliferation resulting from direct signal transduction to the liver has also been reported and recent studies focusing on the inter-organ communication via neural network opened a novel aspect of this field for therapeutic applicability. Therefore, the appropriate understanding of the relationship between autonomic neural network and liver regeneration through various organs including brain, afferent nerve, efferent nerve, etc. is essential. This mini-review explains the principle of neural system involved in the inter-organ communication and its contribution on the liver regeneration upon the liver injury reviewing recent progress in this field.

关键词： Autonomic nerve Neural network Liver regeneration Hormone

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