京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20283号 / 医博第4242号 / 新制||医||1021(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 湊谷 謙司, 教授 福原 俊一, 教授 横出 正之 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Thesis (M. D.)--University of Hong Kong, 2010. / Includes bibliographical references (leaves 229-273). Also available in print.

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This thesis explores the relationship between memory self-report, depression and neuropsychological performance at both baseline and six months following coronary artery bypass graft surgery (CABG). An additional important refinement on previous work included the adoption of a theoretically driven approach to calculate post-test change scores (Standardized Based Regression) in order to control measurement error, practice effects and regression-to-the-mean. A further important refinement included the analysis of different subtypes of depression and how they affect patient perceptions of memory over time. A prospective study of 64 elective CABG surgery patients (mean age 65.4 years) was undertaken pre-operatively and six months post-operatively, along with the assessment of 50 normal control participants (mean age 68.6 years). The neuropsychological test battery was selected in accordance with the Statement of Consensus on the Assessment of Neurobehavioural Outcomes after Cardiac Surgery (Murkin et al., 1995). Standardized self-report measures of depression and memory self-report were also included, namely the DASS and MAC-S. Unexpectedly, results showed that both CABG patients and controls scored in the 'normal' range for depression at both testing intervals. However, at baseline assessment, analyses showed small, significant correlations between memory self report and depression as well as between memory self-report and the CVLT variable Short Delay Free Recall. The depressive subscales of Inertia and Self-deprecation also emerged as significant predictors of memory self-report using hierarchical regression analysis. At follow-up assessment, no significant correlations were found between memory self report, depression or any neuropsychological variable. However, the DASS depression subscale of Devaluation of Life entered as a significant predictor of memory self-report. Collectively, these results provide little evidence of a relationship between subjective and objective measures of memory. However, they indicate that relatively non-depressed patients can show mild variants of the cognitive biases and symptoms classically related to clinical depression and that these symptoms correlate significantly with perceptions of memory. Although no consistent trends were found over time, excluding any inferences of causality, this study was the first to systematically examine the relationship between depressive symptoms and memory self-report, with a view to assisting clinicians to identify patients more inclined to over-report memory failure. / Thesis (PhD)--University of South Australia, 2006.

Thesis (PhD) -- University of South Australia, 1994

The objective of this thesis is to investigate the pathophysiology of the coronary slow phenomenon (CSFP). The experimental work of this thesis has taken a 'bedside to benchtop' approach with clinical observations made in the second chapter guiding the application of basic research techniques in subsequent chapters. Chapter 1 ; The CSFP is a disorder of the coronary microcirculation ; hence chapter 1 specifically reviews the current understanding of this vascular territory and concludes with a summary of the clinical disorders affecting it, concentrating on the CSFP. Chapter 2 ; investigated the angiographic response of the CSFP to a calcium channel blocking agent with antianginal efficacy in this disorder ( mibefradil ). Mibefradil administration was associated with an acute improvement of coronary flow indices which occurred despite background vasodilator therapy with conventional calcium channel antagonists. Chapter 3 ; investigated the in vitro response of human microvessels to mibefradil in comparison to conventional calcium channel blockers. Mibefradil was found to be a more potent agent both in terms of vasodilatation and the prevention of vasoconstriction. Both findings support the clinical observations and point to its selective action on the calcium T channel subtype as a potential mechanism. Chapter 4 ; examined the expression of T type calcium channels at the level of the microvasculature and compared T channel expression in CSFP patients and controls. T channels were found to be expressed at two or more orders of magnitude greater than the L channels. No difference in T channel expression between patients and controls was found. Chapter 5 ; examined the vasomotor reactivity of isolated subcutaneous arterial microvessels to various vasoactive substances between controls and CSFP patients. CSFP patients were found to have a selective hyper reactivity to endothelin. Chapter 6 ; examined plasma endothelin levels in CSFP patients and controls and the relationship between endothelin levels and angina frequency in the CSFP cohort. A small but statistically significant elevation of endothelin-1 was present in patients with the CSFP. A positive association between plasma endothelin fluctuation and angina frequency was also found in the CSFP cohort but not between absolute endothelin levels and angina symptoms. / Thesis (Ph.D.)-- The University of Adelaide, School of Medical Sciences, 2006.

The objective of this thesis is to investigate the pathophysiology of the coronary slow phenomenon (CSFP). The experimental work of this thesis has taken a 'bedside to benchtop' approach with clinical observations made in the second chapter guiding the application of basic research techniques in subsequent chapters. Chapter 1 ; The CSFP is a disorder of the coronary microcirculation ; hence chapter 1 specifically reviews the current understanding of this vascular territory and concludes with a summary of the clinical disorders affecting it, concentrating on the CSFP. Chapter 2 ; investigated the angiographic response of the CSFP to a calcium channel blocking agent with antianginal efficacy in this disorder ( mibefradil ). Mibefradil administration was associated with an acute improvement of coronary flow indices which occurred despite background vasodilator therapy with conventional calcium channel antagonists. Chapter 3 ; investigated the in vitro response of human microvessels to mibefradil in comparison to conventional calcium channel blockers. Mibefradil was found to be a more potent agent both in terms of vasodilatation and the prevention of vasoconstriction. Both findings support the clinical observations and point to its selective action on the calcium T channel subtype as a potential mechanism. Chapter 4 ; examined the expression of T type calcium channels at the level of the microvasculature and compared T channel expression in CSFP patients and controls. T channels were found to be expressed at two or more orders of magnitude greater than the L channels. No difference in T channel expression between patients and controls was found. Chapter 5 ; examined the vasomotor reactivity of isolated subcutaneous arterial microvessels to various vasoactive substances between controls and CSFP patients. CSFP patients were found to have a selective hyper reactivity to endothelin. Chapter 6 ; examined plasma endothelin levels in CSFP patients and controls and the relationship between endothelin levels and angina frequency in the CSFP cohort. A small but statistically significant elevation of endothelin-1 was present in patients with the CSFP. A positive association between plasma endothelin fluctuation and angina frequency was also found in the CSFP cohort but not between absolute endothelin levels and angina symptoms. / Thesis (Ph.D.)-- The University of Adelaide, School of Medical Sciences, 2006.

Thesis (M. Phil.)--University of Hong Kong, 2007. / Also available in print.

Thesis (M. P. H.)--University of Hong Kong, 2005. / Also available in print.

Thesis (Ph. D.)--Virginia Polytechnic Institute and State University, 1994. / Vita. Abstract. Includes bibliographical references (leaves 91-96). Also available via the Internet.