[Patient's delay and doctor's delay in the pulmonary tuberculosis--the experience of the National Chiba Higashi Hospital]

Out of 1628 tuberculosis patient discharged from the to National Chiba Higashi Hospital, 537 previously untreated pulmonary tuberculosis patients were selected for the study to examine the delay in case-defection. Patient's delay were longer but doctor's delay were shorter in male than in female. The main reasons for doctor's delay were the delay in taking chest X-ray, and the error in the interpretation of initial chest X-ray findings. In 88 patients who were detected in the advanced stage, the total delay were longer than the others common cases and the doctor's delay was found in 13 cases. To avoid such an unnecessary delay, the importance of sputum examinations must be re-emphasized in all patients who show respiratory symptoms and/or abnormal chest X-ray findings.

Identification of intermediately virulent Rhodococcus equi isolates from pigs

We recently reported the existence of Rhodococcus equi isolates with at least three virulence levels, isolated from AIDS patients: virulent R. equi having 15- to 17-kDa antigens that kills mice with 10(6) cells, intermediately virulent R. equi having a 20-kDa antigen that kills mice with 10(7) cells, and avirulent R. equi that does not kill mice with 10(8) cells or more (S. Takai, Y. Imai, N. Fukunaga, Y. Uchida, K. Kamisawa, Y. Sasaki, S. Tsubaki, and T. Sekizaki, J. Infect. Dis. 172:1306-1311, 1995). Virulent R. equi having the 15- to 17-kDa antigens has been isolated frequently from horses and their environment, but the source of intermediately virulent R. equi having the 20-kDa antigen is poorly understood. There are many reports of the isolation of R. equi from the lymph nodes of pigs with and without lesions resembling those of tuberculosis. Therefore, we analyzed antigens of R. equi isolates from the submaxillary lymph nodes of pigs by immunoblotting with monoclonal antibodies against these virulence-associated antigens. Immunoblots of whole-cell antigen preparations of R. equi pig isolates revealed the presence of the 20-kDa antigen in almost all the pig isolates studied, and these isolates were intermediately virulent for mice. We also demonstrated that the expression of the 20-kDa antigen and its pathogenicity in mice were associated strongly with the presence of five large, distinct plasmids of 70 to 95 kb; two of the five plasmids from pig isolates were the same sizes as those from human isolates. These results suggest that R. equi having the 20-kDa antigen exists in the submaxillary lymph nodes of pigs and that the source of infection in some human cases might be associated with pigs and their environment.

Separation of anti-shark type I collagen antibody from anti-pig type I collagen antiserum and its partial characterization

Anti-shark type I collagen antibody (PAb-S) was successfully separated from anti-pig type I collagen antiserum. PAb-S recognized a chymotryptic peptide (29 kDa) of alpha 1 (I) chain prepared from shark skin. This result suggested that the epitope contained in this chymotryptic peptide may be well conserved during the molecular evolution of type I collagen.

Evaluation of gamma camera-based measurement of individual kidney function using iodine-123 orthoiodohippurate

Gamma camera-based clearance techniques which use the renal uptake ratio (RUR) of the radiotracer are available to estimate the effective renal plasma flow (ERPF) and glomerular filtration rate. To evaluate the accuracy of these techniques, we measured RUR by an optimized procedure and compared it with standard ERPF. Iodine-123 orthoiodohippurate (OIH) scintigraphy and simultaneous para-aminohippurate clearance study for measuring standard ERPF were performed in three hospitals in 24 patients with normal or mildly impaired renal function. 123I-OIH was injected intravenously and 10-s consecutive imaging of the kidneys was started when the abdominal aorta was seen. The attenuation coefficient for 123I was measured in each hospital using the same water-equivalent absorption materials and used for the attenuation correction. After subtracting background radioactivity, RURs were defined as the count ratios of fractional renal uptakes based on the integral from 1 to 2, 2 to 3, 1.5 to 2.5 and 1 to 3 min after the injection of 123I-OIH in relation to injected doses using the following three procedures in respect of attenuation correction: (1) RUR without attenuation correction, (2) RUR with fractional renal uptake corrected by the measured attenuation coefficient, (3) RUR with the total injected dose corrected by the absorption material. To decide upon the appropriate correction method and time interval, RURs were compared with standard ERPF. Among the three correction methods, procedure 2 showed the highest correlation between RUR and standard ERPF, but the correlation coefficient was low (r=0.75). No significant difference was observed among the RURs of each time interval. Individual kidney function measured from early renal uptake may be inaccurate even when appropriate correction is made for attenuation, background activity or time lag between injection and data acquisition. Gamma camera-based measurement of renal function using 123I-OIH is limited with regard to accuracy and reproducibility, though it is convenient and non-invasive.

Involvement of endogenous tachykinins in LTD4-induced airway responses

Leukotriene D4-(LTD4) has been reported to cause tachykinin release from airway sensory nerves. However, the functional significance of endogenously released tachykinins in LTD4-mediated airway responses has not been fully clarified. The aim of this study was to investigate whether LTD4-induced airway responses are due, in part, to tachykinin release in guinea-pigs. Airway plasma exudation and bronchoconstriction were assessed by measuring extravasation of Evans blue dye and by mean pulmonary resistance (RL) in the presence of atropine (1 mg.kg-1 i.v.) and propranolol (1 mg.kg-1 i.v.), respectively. LTD4 (5 micrograms.mL-1 for 1 min) inhalation caused increase in plasma exudation and RL. Capsaicin pretreatment of animals to deplete sensory neuropeptides significantly inhibited LTD4-induced plasma exudation in the main bronchi, but not in the central (cIPA) and peripheral intrapulmonary airways (pIPA). Pretreatment with specific tachykinin neurokinin-1 (NK1)-receptor antagonists, FK 888 (10 mg.kg-1 i.v.) and CP 96345 (4 mg.kg-1 i.v.), also significantly reduced LTD4-induced plasma exudation in the main bronchi, and in the main bronchi and cIPA, respectively. However, these antagonists did not significantly affect the LTD4-induced increase in RL. In contrast, neurokinin-2 (NK2)-receptor antagonist, SR 48968 (0.3 mg.kg-1 i.v.), significantly inhibited the bronchoconstriction after LTD4-inhalation. These results suggest that leukotriene D4-induced bronchoconstriction and plasma exudation in guinea-pigs are, in part, due to tachykinin release from airway sensory nerves.

KW-4679-induced inhibition of tachykininergic contraction in the guinea-pig bronchi by prejunctional inhibition of peripheral sensory nerves

1. Sensory mechanisms play an important role in the vagal regulation of tracheobronchial smooth muscle tone. We examined the effect of KW-4679, an anti-allergic drug, on guinea-pig tachykinin-mediated contractile responses induced by electrical field stimulation (EFS) in guinea-pig bronchial muscles. 2. EFS (8 Hz, 0.5 ms, 15 V, for 15 s) evoked biphasic contractile responses in the guinea-pig isolated main bronchus in the presence of 5 microM indomethacin. The contractions consisted of a fast phase of an atropine-sensitive transient contraction and a slow phase of a sustained contraction which was inhibited by a combination of the tachykinin NK1 receptor antagonist, (+/-)-CP-96,345 (1 microM) and the NK2 receptor antagonist, SR 48969 (0.1 microM). 3. KW-4679 preferentially inhibited the slow phase in a concentration-dependent manner by 43.2 +/- 7.7% at 10 microM, whereas the drug had no effect on the fast phase at concentrations up to 10 microM. KW-4679, at a concentration of 100 microM, inhibited not only the slow phase by 49.2 +/- 11.4%, but also the fast phase by 36.8 +/- 9.3% [corrected]. 4. KW-4679 (10 microM and 100 microM) did not affect the substance P-induced or neurokinin A-induced contraction. Against the acetylcholine-induced contractile responses, 100 microM KW-4679 had a marked effect producing a 10.2 fold shift to the right in the curve. 5. The inhibitory effect of KW-4679 (10 microM) on the slow phase contraction was not influenced by treatment with naloxone (100 nM), propranolol (1 microM), thioperamide (1 microM), saclofen (50 microM), yohimbine (1 microM), methiothepin (1 microM) or methysergide (1 microM). 6. The inhibitory effect of KW-4679 (10 microM) on the slow phase contraction was not influenced by treatment with intermediate or large conductance Ca(2+)-activated K+ channel blockers (charybdotoxin (10 nM) or iberiotoxin (10 nM)), but suppressed by treatment with small conductance Ca(2+)-activated K+ channel blockers, apamin (500 nM) or scyllatoxin (300 nM). Apamin or scyllatoxin per se did not influence the slow phase contractions. 7. The results suggest that KW-4679 preferentially inhibits the release of tachykinins from the bronchial sensory nerves through activation of small conductance Ca(2+)-activated K+ channels.

Evaluation of current sterility tests for human live viral vaccines

Current sterility tests for human viral vaccines were evaluated. A total of 43 lots of bulk suspension of live viral vaccines (measles, mumps, rubella and oral poliomyelitis) produced by six manufacturers in Japan were evaluated for bacteriostatic and mycoplasmastatic activities. Some of them showed fairly high bacteriostatic and mycoplasmastatic activities, due to antibiotics added during vaccine production. It was concluded that the current sterility test for mycoplasmas is not reliable to detect viable mycoplasmas in live viral vaccines.

Inhibition by drebrin of the actin-bundling activity of brain fascin, a protein localized in filopodia of growth cones

The purification of drebrin, an actin-binding protein that is specifically expressed in embryonic rat brain, was described previously. During the purification of drebrin, we found that an actin-binding protein of 54 kDa was also expressed at high levels in embryonic brain, and this protein was identified by immunoblotting as fascin. To explore the roles of fascin in brain development, we purified fascin from brains of infant rats and characterized it. We found that the actin-binding activity of fascin was strongly inhibited by drebrin. Fascin caused formation of actin bundles, a process that was inhibited in the presence of drebrin, as confirmed by electron microscopy and a low-speed centrifugation assay. In PC12 cells, fascin was localized in the filopodia of growth cones, whereas drebrin was localized in the basal region of growth cones. Our results suggest that fascin might play an important role in the organization of actin in filopodia and that this organization might be regulated by drebrin.

Overexpression of human insulin receptor substrate 1 induces cellular transformation with activation of mitogen-activated protein kinases

The receptor insulin substrate 1 protein (IRS-1) is a specific substrate for insulin receptor tyrosine kinase. Expression and tyrosyl phosphorylation of IRS-1 play an important role during normal hepatocyte growth, and the gene is overexpressed in hepatocellular carcinoma tissue. We determined if IRS-1 overexpression directly contributes to cellular transformation. The human IRS-1 gene was subcloned into a mammalian expression vector driven by the cytomegalovirus early promoter. NIH 3T3 cells transiently transfected with this vector subsequently developed transformed foci. Several stably transfected cell lines were established, and they grew efficiently under low-serum conditions and formed colonies when plated in soft agar. Cell lines overexpressing IRS-1 displayed increased tyrosyl phosphorylation of IRS-1 and association with Grb2 but not with the p85 subunit of phosphatidylinositol 3' kinase. Since Grb2 is a component of the son-of-sevenless-Ras pathway and upstream in the mitogen-activated protein kinase (MAPK) cascade, enzymatic activities of the major components of this cascade, such as MAPK kinase and MAPK were evaluated and found to be substantially increased in three independent cell lines with IRS-1 protein overexpression. Such cells, when injected into nude mice, were highly tumorigenic, and there may be a correlation between the degree of MAPK activation and tumor growth rate. This report describes the generation of a transformed phenotype by overexpression of a molecule without a catalytic domain far upstream in the signal transduction cascade and suggests that prolonged activation of MAPKs by this mechanism may be one of the molecular events related to hepatocellular transformation.

Recurrent breast cancer treated successfully with mitomycin-C and vinblastine after failure of both doxorubicin-containing regimen and paclitaxel--a case report

Cross-resistance is one of the chief obstacles in salvage therapy for refractory breast cancer. Although paclitaxel is one of the most promising drugs, it shows a response rate of 30% at most for patients with breast cancer resistant to doxorubicin, and no effective treatments for tumors refractory to both agents have been reported. We describe a 38-year-old woman with recurrent breast cancer, who was treated successfully with mitomycin-C and vinblastine after doxorubicin-based chemotherapy and paclitaxel failed. The combinations of mitomycin-C and microtubule inhibitors including vinca alkaloids and taxanes may have a potential application to refractory breast cancer.

Clinical features of small hepatocellular carcinomas as assessed by histologic grades

BACKGROUND

Ninety-seven patients with small hepatocellular carcinomas (HCCs) measuring 3 cm or less in size and three patients with adenomatous hyperplasia who underwent radical hepatic resection were examined in this study.

METHODS

The lesions were classified into four groups according to the following histologic grading criteria: group A, adenomatous hyperplasia (n = 3); group B, early HCC (n = 6); group C, well-differentiated HCC (wHCC) (n = 32); and group D, moderately or poorly differentiated HCC (n = 59). The involvement factors that seemed to be important or to characterize the progression of HCC and the survival rates were compared among the four histologic groups.

RESULTS

The frequency of patients with tumors larger than 2.0 cm in size and that of patients with 200 or more ng/ml serum alpha-fetoprotein increased with the progression of histologic malignancy. Tumor staining on the angiogram, capsular formation, and extranodular invasion were never seen in groups A and B, but they began to appear in group C and increased remarkably in group D. The 5-year survival rates of the patients in groups B, C, and D were 100%, 60%, and 27%, respectively, and statistically significant differences were seen among them. In comparative evaluation of the group C patients the lesions that showed no tumor staining had no capsule, and those that had no capsule had no extranodular invasion. The 5-year survival rate of patients with wHCC without extranodular invasion (81%) was significantly higher than that of patients with extranodular invasion (35%) (p < 0.05).

CONCLUSIONS

It may be recommended to provide the category of wHCC without extranodular invasion for pathologic classification of clinically early HCC (i.e., HCC of high curability).

Radiation therapy for patients with xeroderma pigmentosum

Our experience reported here, as well as a review of the literature, suggests that radiation therapy can be used in the palliative treatment of XP-related malignancy. However, radiation therapy should be used with caution in XP patients with an anticipated prolonged life expectancy, because the late side effects of ionizing radiation in XP are not well known.

Cerebral prothrombotic state in spontaneously hypertensive rats of different breeds

The thrombotic tendency in two breeds of spontaneously hypertensive rats (SHRs) was assessed by inducing occlusive thrombosis in pial blood vessels using a helium-neon laser method. A prothrombotic state was observed in the SHR of one breed as compared to the corresponding control WKY, but not in the other. Circulating platelet and erythrocyte counts and haematocrit values were significantly negatively correlated in arterioles with the number of laser pulses, which is an index of the thrombotic tendency, suggesting that the prothrombotic state was partly dependent on the counts of blood components. However, there was no correlation between the measured blood parameters and prothrombotic state in venules. The difference observed in arterioles and venules might be due to their differential haemodynamics and endothelial properties. Prothrombotic state in the SHR of one breed would be partly due to the much higher difference in blood components from its corresponding control compared to the comparatively less difference in the other breed.

Acetyl-CoA carboxylase in higher plants: most plants other than gramineae have both the prokaryotic and the eukaryotic forms of this enzyme

The presence and the absence of a prokaryote type and a eukaryote type of acetyl-CoA carboxylase (EC 6.4.1.2; ACCase) were examined in members of 28 plant families by two distinct methods: the detection of biotinylated subunits of ACCase with a streptavidin probe, and the detection of the accD gene, which encodes a subunit of the prokaryotic ACCase, by Southern hybridization analysis. The protein extracts of all the plants studied contained a biotinylated polypeptide of 220 kDa, which was probably the eukaryotic ACCase. All the plants but those belonging to Gramineae also contained a biotinylated polypeptide of ca. 35 kDa, which is a putative subunit of the prokaryotic ACCase. In all plants but those in Gramineae, the ca. 35 kDa polypeptide was found in the protein extracts of plastids, while the 220 kDa polypeptide was absent from these plastid extracts. The plastid extracts of the plants in Gramineae contained the 220 kDa polypeptide, as did the homogenates of the leaves. Southern hybridization analysis demonstrated that all the plants but those in the Gramineae contained the accD gene. These findings suggest that most higher plants have the prokaryotic ACCase in the plastids and the eukaryotic ACCase in the cytosol. Only Gramineae plants might contain the eukaryotic ACCases both in the plastids and in the cytosol. The origin of the plastid-located eukaryotic ACCase in Gramineae is discussed as the first possible example of substitution of a plastid gene by a nuclear gene for a non-ribosomal component.

[Two cases of generalized disseminated atypical mycobacterium showing multiple accumulations on bone scintigraphy]

For determining the spread of multiple bone lesions in generalized disseminated atypical mycobacteriosis a rare disease, bone scintigraphy was found useful in our two patients. They were both female, and the pathogenic microbe was M. avium intracellulare complex. The disease appeared to have been induced by defatigation. The depression of cellular immunocompetence was also suspected to be responsible. Bone scintigraphy disclosed multiple abnormal accumulations systematically. The Definitive diagnosis in these cases was established by biopsy. In differential diagnosis of this disease by bone scintigraphy, bone metastasis of a malignant tumor was considered of primary importance. Although antitubercular chemotherapy resulted in improvement of subjective symptoms and inflammation, abnormal accumulation persisted. There was necessity for taking notice that in the decision of the treatment effect of this disease, improvement of abnormal accumulations on bone scintigraphy was delayed that of inflammatory reaction.

[Usefulness of spiral CT in the detection of hypovascular, well-differentiated hepatocellular carcinoma]

Whole liver scanning during artery-dominant phase using spiral CT was performed in 14 patients with 17 histologically proven well-differentiated HCCs, which were not depicted by hepatic digital subtraction angiography but by CT during arterial portography. The density of HCC relative to the liver was evaluated with conventional precontrast CT, spiral CT, and following conventional CT during the equilibrium phase. Comparison between spiral CT and magnetic resonance (MR) imaging of dynamic contrast studies was also investigated. Four tumors of 17 HCCs (24%) were shown as a high-density area by the artery-dominant phase using spiral CT. Consequently, the total sensitivity of these three kinds of CT techniques was elevated to 82%. The sensitivity of dynamic MR imaging was slightly greater than that of spiral CT. However, spiral CT sometimes made the diagnosis more conspicuous by it's good spatial resolution. Our results indicate that spiral CT has a potential benefit in the detection of hypovascular well-differentiated HCC, and MR imaging and spiral CT may be complement each other.

A new method of intra-arterial regional chemotherapy with more selective drug delivery for locally advanced pancreatic cancer

BACKGROUND/AIMS

In order to deliver the anti-cancer drugs more selectively into the cancer tissues, we have developed a new method of intra-arterial regional chemotherapy for locally unresectable cancer of the exocrine pancreas.

MATERIALS AND METHODS

This method involved placing the catheters selectively into the splenic artery and/or into the gastroduodenal artery during laparotomy. Postoperatively, via the catheter, we infused 50-100 mg of Methotrexate mixed with 10 micrograms of Angiotensin-II with an intent of increasing the blood flow in the tumor tissue but decreasing that to the non-tumor tissues. Simultaneously, a bolus iv-infusion of 5-fluorouracil (5-Fu, 500 mg) was performed. One day after each chemotherapy, citrovorum factor (Leucovorin, 30mg) was given per orally, For 15 patients with locally non-resectable pancreatic cancer, this treatment was repeated weekly or biweekly at our out-patient clinic.

RESULTS

As a result, the toxicity was so slight that all patients could tolerate this treatment as long as the catheter was patent (11 +/- 8 postoperative months). The survival period was 16 +/- 9 months (range: 5-36 months; median: 14 months), and one-, two- and three- year survival rates were 60%, 23% and 11%, respectively. Patients could take care of themselves within 12 +/- 9 months, and either complete (50%) or partial (50%) pain-relief was obtained among the 12 patients with severe pain. Only one patient experienced local tumor regression during the chemotherapy, and the incidence of liver metastasis was as low as 13%.

CONCLUSIONS

Comparing with the previously reported data in the traditional chemo- and/or radio-therapies, we consider that our method of intra-arterial chemotherapy is quite useful not only for the prolongation of patient's survival but also for improving the quality of life. Thus, this new treatment seems worthy of entering into the prospective randomized study.

A nude mouse Wilms' tumor line (KCMC-WT-1) derived from an aniridia patient with monoalleleic partial deletion of chromosome 11p

BACKGROUND

A candidate tumor suppressor gene, WT-1, is believed to have an important role in the pathogenesis of Wilms' tumor, especially that occurring in patients with congenital aniridia.

METHODS

To obtain a stable tumor line to work with, Wilms' tumor tissue was serially transplanted in athymic nude mice. Biopsied Wilms' tumor tissue, derived from an aniridia patient, was transplanted subcutaneously to an athymic nude mouse, and then transplanted serially. Histopathologic and molecular biologic studies were performed on the xenotransplants.

RESULTS

The aniridia patient showed partial deletion in one short arm of chromosome 11, which bears the WT-1 gene. The tumor was successfully transplanted in the nude mouse. Although the tumor contained blastemic, organoid, and stromal histologic elements, the organoid element began to decrease after more than 20 passages. Cytogenetic analysis revealed an additional abbreviation of one long arm of chromosome 6. Dot blot analysis showed that the copy number of WT-1 gene was decreased to half the amount in the tumor, in spite of the WT-1 transcript with normal size detected by Northern blotting.

CONCLUSIONS

The tumor is expected to bear one WT-1 gene with minute abnormalities as well as one congenitally deleted gene. This tumor line is useful when examining the effect caused by introduction of WT-1 gene to Wilms' tumor in vivo.

[Late pericardial effusion after open-heart surgery: usefulness of pericardiocentesis under echocardiographic guidance]

Late pericardial effusion (PE) after open heart surgery has a potential for serious complications, including tamponade necessitating urgent drainage. From October 1990 to March 1995 moderate to massive PE developed following 9 of 359 (2.5%) cardiac procedures between 11 and 55 days postoperatively (mean, 18.6 days). Only one of these nine patients had evidence of cardiac tamponade; the other 8 patients had moderate symptoms including malaise, weight gain, and dyspnea on exertion. All patients except one were being treated with warfarin and anti-platelet agents. Echocardiography detected posterior PE of variable magnitude in all 9 patients; anterior PE was present in only one of these patients. Pericardiocentesis under echocardiographic guidance using an echo transducer with a built in puncture needle was performed in all patients. A flexible catheter was left in place for 24 to 72 hours for suction. In each case, 300 to 712 ml of old bloody fluid (mean, 475 ml) was evacuated, with relief of symptoms. Despite continuing anticoagulant therapy, there was no recurrence of pericardial effusion. The technique we have described simplifies pericardiocentesis and helps to avoid complications in this procedure.

Epidemiological study of Mycoplasma pneumoniae infections in japan based on PCR-restriction fragment length polymorphism of the P1 cytadhesin gene

Two hundred fifty strains of Mycoplasma pneumoniae isolated during the past 20 years in Japan were classified into two groups (I and II) based upon different PCR-restriction fragment length polymorphism patterns of their P1 cytadhesin genes. Clear shifts between the M. pneumoniae groups were observed but did not appear to be correlated with M. pneumoniae epidemic cycles. Patients' sera showed relatively higher levels of antiadhesin antibodies to M. pneumoniae strains homologous with the infecting strain.

Fusion of an ETS-family gene, EIAF, to EWS by t(17;22)(q12;q12) chromosome translocation in an undifferentiated sarcoma of infancy

EIAF is a newly isolated ETS-family gene that is located on 17q21 and codes for the adenovirus EIA enhancer-binding protein. In our chromosome analysis of 18 of the Ewing family of tumors and undifferentiated sarcomas, we found t(17;22)(q12;q12) in an MIC2 antigen-positive undifferentiated sarcoma of infancy. On Southern blot analysis, EWS and EIAF cDNA probes hybridized to the same rearranged band, indicating that an EWS-EIAF fusion gene was formed in the tumor. Further Southern blot analysis using four EIAF cDNA probes of different sizes showed that the breakpoint lies in the region upstream to the ETS domain of the EIAF gene. EIAF may be the fourth ETS-family gene to be identified forming a fusion gene with EWS. We assume that the RNA binding domain of EWS may have been replaced by the DNA binding domain of EIAF in the EWS-EIAF fusion protein as in other fusion proteins previously characterized in Ewing sarcoma and other types of sarcomas.

Echocardiography-guided pericardiocentesis with a needle attached to a probe

Pericardiocentesis with a needle attached to a probe was performed under two-dimensional echocardiographic guidance in 9 patients with pericardial effusion after cardiac operations. The first 5 mm of the tip of a puncture needle for percutaneous transhepatic cholangiodrainage is scratched with a scalpel to give the tip high echo intensity. When the probe is placed on the skin, the direction of puncture at that probe angle appears automatically on the monitor.

[The process and effect of heaviness exercise in autogenic training: factor analytical study of subjective response induced by the concentration upon and formal language of the sense of heaviness in the arm]

The present study examined the subjective response induced by the concentration upon and repetition of the formal language expressing the sense of heaviness--"The arm is heavy." As a result of the factor analysis of the experiment using 60 subjects, the following five factors emerged. (1) Overall sense of improvement; (2) awareness of the sensation of the arm; (3) change to less nervousness; (4) awareness of positive aspects; (5) understanding of the formal language. Also, those who were aware of psychosomatic symptoms felt their change to less nervousness more significantly, and their understanding of the formal language was significantly higher than those who were not aware of psychosomatic symptoms. The result of the experiment suggests one possibility that excessive concentration upon the body concerning psychosomatic symptoms may have changed to the concentration upon the sense of heaviness, or that the reduction of the stress thereof may have brought the change to less nervousness.