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Funayama M, Koreki A, Takata T, Hisamatsu T, Mizushima J, Ogino S, Kurose S, Oi H, Mimura Y, Shimizu Y, Kudo S, Nishi A, Mukai H, Wakisaka R, Nakano M. Pneumonia Risk Increased by Dementia-Related Daily Living Difficulties: Poor Oral Hygiene and Dysphagia as Contributing Factors. Am J Geriatr Psychiatry 2023; 31:877-885. [PMID: 37286391 DOI: 10.1016/j.jagp.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Although pneumonia is the leading cause of death among patients with dementia, the specific underlying causes remain unclear. In particular, the potential connection between pneumonia risk and dementia-related daily living difficulties, such as oral hygiene practice and mobility impairment, and the use of physical restraint as a management practice, has not been extensively studied. METHODS In our retrospective study, we included 454 admissions corresponding to 336 individual patients with dementia who were admitted to a neuropsychiatric unit due to behavioral and psychological symptoms. The admissions were divided into two groups: those who developed pneumonia while hospitalized (n=62) and those who did not (n=392). We investigated differences between the two groups in terms of dementia etiology, dementia severity, physical conditions, medical complications, medication, dementia-related difficulties in daily living, and physical restraint. To control potential confounding variables, we used mixed effects logistic regression analysis to identify risk factors for pneumonia in this cohort. RESULTS Our study found that the development of pneumonia in patients with dementia was associated with poor oral hygiene, dysphagia, and loss of consciousness. Physical restraint and mobility impairment showed a weaker, nonsignificant association with the development of pneumonia. CONCLUSIONS Our findings suggest that pneumonia in this population may be caused by two primary factors: increased pathogenic microorganisms in the oral cavity due to poor hygiene, and an inability to clear aspirated contents due to dysphagia and loss of consciousness. Further investigation is needed to clarify the relationship between physical restraint, mobility impairment, and pneumonia in this population.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan.
| | - Akihiro Koreki
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Psychiatry (AK, SK), National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Taketo Takata
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan
| | - Tetsuya Hisamatsu
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Psychiatry, Gunma Hospital (TH), Gunma, Japan
| | - Jin Mizushima
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan
| | - Satoyuki Ogino
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Trauma and Critical Care Medicine (SO, YS), Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Shin Kurose
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan; Department of Psychiatry (AK, SK), National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Hiroki Oi
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Yu Mimura
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Yusuke Shimizu
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Trauma and Critical Care Medicine (SO, YS), Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Shun Kudo
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Akira Nishi
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan; Department of Psychiatry, Sakuragaoka Kinen Hospital (AN), Tokyo, Japan
| | - Hiroo Mukai
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Riko Wakisaka
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan; Department of Emergency and Critical Care Medicine (RW), Nippon Medical School, Tokyo, Japan
| | - Masaaki Nakano
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Yamada K, Takata T, Anoushiravani A, Campos L, Graham T, Kotoku J, Farsad K. Abstract No. 53 Image Quality Improvement for Digital Subtraction Angiography (DSA) around High-Density Obstacles Using Deep Learning: A Bench-Top Study. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Milling TJ, Middeldorp S, Xu L, Koch B, Demchuk A, Eikelboom JW, Verhamme P, Cohen AT, Beyer-Westendorf J, Michael Gibson C, Lopez-Sendon J, Crowther M, Shoamanesh A, Coppens M, Schmidt J, Albaladejo P, Connolly SJ, Bastani A, Clark C, Concha M, Cornell J, Dombrowski K, Fermann G, Fulmer J, Goldstein J, Kereiakes D, Milling T, Pallin D, Patel N, Refaai M, Rehman M, Schmaier A, Schwarz E, Shillinglaw W, Spohn M, Takata T, Venkat A, Welker J, Welsby I, Wilson J, Van Keer L, Verschuren F, Blostein M, Eikelboom J, Althaus K, Berrouschot J, Braun G, Doeppner T, Dziewas R, Genth-Zotz S, Greinacher P, Hamann F, Hanses F, Heide W, Kallmuenzer B, Kermer P, Poli S, Royl G, Schellong S, Schnupp S, Schwarze J, Spies C, Thomalla G, von Mering M, Weissenborn K, Wollenweber F, Gumbinger C, Jaschinski U, Maschke M, Mochmann HC, Pfeilschifter W, Pohlmann C, Zahn R, Bouzat P, Schmidt J, Vallejo C, Floccard B, Coppens M, van Wissen S, Arellano-Rodrigo E, Valles E, Alikhan R, Breen K, Hall R, Crowther M, Albaladejo P, Cohen A, Demchuk A, Schmidt J, Wyse D, Garcia D, Prins M, Nakamya J, Büller H, Mahaffey KW, Alexander JH, Cairns J, Hart R, Joyner C, Raskob G, Schulman S, Veltkamp R, Meeks B, Zotova E, Ahmad S, Pinto T, Baker K, Dykstra A, Holadyk-Gris I, Malvaso A, Demchuk A. Final Study Report of Andexanet Alfa for Major Bleeding With Factor Xa Inhibitors. Circulation 2023; 147:1026-1038. [PMID: 36802876 DOI: 10.1161/circulationaha.121.057844] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Andexanet alfa is a modified recombinant inactive factor Xa (FXa) designed to reverse FXa inhibitors. ANNEXA-4 (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of Factor Xa Inhibitors) was a multicenter, prospective, phase-3b/4, single-group cohort study that evaluated andexanet alfa in patients with acute major bleeding. The results of the final analyses are presented. METHODS Patients with acute major bleeding within 18 hours of FXa inhibitor administration were enrolled. Co-primary end points were anti-FXa activity change from baseline during andexanet alfa treatment and excellent or good hemostatic efficacy, defined by a scale used in previous reversal studies, at 12 hours. The efficacy population included patients with baseline anti-FXa activity levels above predefined thresholds (≥75 ng/mL for apixaban and rivaroxaban, ≥40 ng/mL for edoxaban, and ≥0.25 IU/mL for enoxaparin; reported in the same units used for calibrators) who were adjudicated as meeting major bleeding criteria (modified International Society of Thrombosis and Haemostasis definition). The safety population included all patients. Major bleeding criteria, hemostatic efficacy, thrombotic events (stratified by occurring before or after restart of either prophylactic [ie, a lower dose, for prevention rather than treatment] or full-dose oral anticoagulation), and deaths were assessed by an independent adjudication committee. Median endogenous thrombin potential at baseline and across the follow-up period was a secondary outcome. RESULTS There were 479 patients enrolled (mean age, 78 years; 54% male, 86% White; 81% anticoagulated for atrial fibrillation at a median time of 11.4 hours since last dose, with 245 (51%) on apixaban, 176 (37%) on rivaroxaban, 36 (8%) on edoxaban, and 22 (5%) on enoxaparin. Bleeding was predominantly intracranial (n=331 [69%]) or gastrointestinal (n=109 [23%]). In evaluable apixaban patients (n=172), median anti-FXa activity decreased from 146.9 ng/mL to 10.0 ng/mL (reduction, 93% [95% CI, 94-93]); in rivaroxaban patients (n=132), it decreased from 214.6 ng/mL to 10.8 ng/mL (94% [95% CI, 95-93]); in edoxaban patients (n=28), it decreased from 121.1 ng/mL to 24.4 ng/mL (71% [95% CI, 82-65); and in enoxaparin patients (n=17), it decreased from 0.48 IU/mL to 0.11 IU/mL (75% [95% CI, 79-67]). Excellent or good hemostasis occurred in 274 of 342 evaluable patients (80% [95% CI, 75-84]). In the safety population, thrombotic events occurred in 50 patients (10%); in 16 patients, this occurred during treatment with prophylactic anticoagulation that began after the bleeding event. No thrombotic episodes occurred after oral anticoagulation restart. Specific to certain populations, reduction of anti-FXa activity from baseline to nadir significantly predicted hemostatic efficacy in patients with intracranial hemorrhage (area under the receiver operating characteristic curve, 0.62 [95% CI, 0.54-0.70]) and correlated with lower mortality in patients <75 years of age (adjusted P=0.022; unadjusted P=0.003). Median endogenous thrombin potential was within the normal range by the end of andexanet alfa bolus through 24 hours for all FXa inhibitors. CONCLUSIONS In patients with major bleeding associated with the use of FXa inhibitors, treatment with andexanet alfa reduced anti-FXa activity and was associated with good or excellent hemostatic efficacy in 80% of patients. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT02329327.
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Affiliation(s)
- Truman J Milling
- Seton Dell Medical School Stroke Institute, Dell Medical School, University of Texas at Austin (T.J.M.)
| | - Saskia Middeldorp
- Department of Internal Medicine and Radboud Institute of Health Sciences, Nijmegenthe Netherlands (S.M.)
| | - Lizhen Xu
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
| | - Bruce Koch
- Alexion, AstraZeneca Rare Disease, BostonMA (B.K.)
| | - Andrew Demchuk
- Departments of Clinical Neurosciences and Radiology, Cumming School of Medicine, University of Calgary, AlbertaCanada (A.D.)
| | - John W Eikelboom
- Department of Medicine, McMaster University, HamiltonOntario Canada. (J.W.E., M. Crowther)
| | - Peter Verhamme
- Center for Molecular and Vascular Biology, University of Leuven, Belgium (P.V.)
| | | | - Jan Beyer-Westendorf
- Department of Medicine I, Division of Hematology and Hemostasis, University Hospital Dresden, Germany (J.B-W.)
| | | | - Jose Lopez-Sendon
- Instituto de Investigación Hospital Universitario, La PazMadridSpain (J. L-S.)
| | - Mark Crowther
- Department of Medicine, McMaster University, HamiltonOntario Canada. (J.W.E., M. Crowther)
| | - Ashkan Shoamanesh
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, University of Amsterdam, the Netherlands (M. Coppens)
| | - Jeannot Schmidt
- Centre Hospitalier Universitaire de Clermont-Ferrand, France (J.S.)
| | | | - Stuart J Connolly
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
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Kudo S, Funayama M, Kurose S, Shimizu Y, Takata T, Mimura M. Shadowing Behavior May Be Associated with an Inability to Recognize the External World: A Case Report of Shadowing in a Patient with Posterior Cortical Atrophy. J Alzheimers Dis 2023; 94:1323-1330. [PMID: 37458035 PMCID: PMC10473056 DOI: 10.3233/jad-230257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2023] [Indexed: 07/18/2023]
Abstract
Although shadowing behavior- when one individual closely follows another- is routinely documented among patients with dementia, its mechanisms have yet to be elucidated. In particular, there have been no detailed descriptions of patients with shadowing behavior. To propose its potential backgrounds, we describe a patient with posterior cortical atrophy who exhibited prominent shadowing behavior. He also experienced severe difficulties recognizing external stimuli, including visuospatial dysfunction, several types of agnosia, difficulties in verbal comprehension, disorientation, and its associated depression. This shadowing behavior may be adaptive relative to his extreme difficulty with recognizing the world around him.
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Affiliation(s)
- Shun Kudo
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
| | - Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Yusuke Shimizu
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
- Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Shimojima Y, Kishida D, Ichikawa T, Kida T, Yajima N, Omura S, Nakagomi D, Abe Y, Masatoshi K, Takizawa N, Nomura A, Kukida Y, Kondo N, Yasuhiko Y, Yanagida T, Endo K, Hirata S, Kawahata K, Matsui K, Takeuchi T, Ichinose K, Kato M, Yanai R, Matsuo Y, Yamasaki A, Nishioka R, Takata T, Moriyama M, Takatani A, Ito T, Miyawaki Y, Ito-Ihara T, Kawaguchi T, Kawahito Y, Sekijima Y. POS0822 HYPERTROPHIC PACHYMENINGITIS IN ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS: A MULTICENTER SURVEY IN JAPAN. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundHypertrophic pachymeningitis (HP), characterized by an inflammatory disorder indicating intracranial or spinal thickening of dura mater, is found to develop as a neurological involvement in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Meanwhile, the previous studies focusing on HP in AAV have been reported as a single-institution study, and the analyses were performed in a small number of patients because HP is a rare neurological disorder. Therefore, neither etiological nor clinical characteristics of HP in AAV have been adequately elucidated.ObjectivesThis study clarified the characteristics of HP in AAV by analyzing the information of multicenter study in Japan (Japan collaborative registry of ANCA-associated vasculitis: J-CANVAS).MethodsWe analyzed the clinical information from 541 Asian patients with AAV enrolled in J-CANVAS. Of them, newly diagnosed and relapsed AAV were included in 448 and 93, respectively. The epidemiological and clinical findings were compared between patients with and without HP. Clinical manifestations related to AAV were evaluated based on the Birmingham Vasculitis Activity Score version 3. To elucidate independent factors in HP development, logistic regression analyses were additionally performed.ResultsOf the total 541 patients (mean age: 71±14 years, M:F = 1:1.2), HP was demonstrated in 28 (5.17%), including 17 (3.79%) in newly diagnosed AAV and 11 (11.8%) in relapsed AAV. The classification of granulomatosis with polyangiitis (GPA) was significantly higher in patients with HP than those without HP (50% vs. 21%, p = 0.0007). In newly diagnosed AAV, patients with HP significantly had higher GPA classification and higher positivity for PR3-ANCA than those without HP (53% vs. 17%, p = 0.001; 29% vs. 9%, p = 0.015, respectively). Conversely, positivity for MPO-ANCA was significantly higher in patients with HP than those without HP in relapsed AAV (91% vs. 55%, p = 0.025), despite not significantly different in the classification of AAV. Headache and cranial neuropathies were significant neurological symptoms in patients with HP compared to those without HP (82% vs. 6.6%, p < 0.0001; 32% vs. 2.9%, p < 0.0001, respectively). Besides, ear, nose and throat (ENT) and mucous membranes/eyes were significantly higher involvements in patients with HP than in those without HP (54% vs. 26%, p = 0.003; 29% vs. 9%, p = 0.003, respectively). Moreover, higher complications of “conjunctive hearing loss” and “sudden visual loss”, which are included in the categories of ENT and mucous membranes/eyes involvement, respectively, were significantly indicated in patients with HP than those without HP (39% vs. 7.2%, p < 0.0001; 21% vs. 1.2%, p < 0.0001, respectively). Multivariable logistic regression analysis identified that ENT (odds ratio [OR] 1.28, 95% confident interval [CI] 1.09 to 1.49, p = 0.002) and mucous membranes/eyes involvement (OR 1.37, CI 1.14 to 1.65, p = 0.0006), as well as conjunctive hearing loss (OR 4.52, CI 1.56 to 13.05, p = 0.005) and sudden visual loss (OR 1.84, CI 1.12 to 3.00, p = 0.015), were independent related factors in patients with HP.ConclusionGPA could be significantly classified in patients with HP. Notably, patients with HP significantly showed higher positivity for PR3-ANCA than those without HP in newly diagnosed AAV. Furthermore, sudden visual loss and conjunctive hearing loss might be implicated in HP development.Disclosure of InterestsNone declared
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Kawamori K, Oguro N, Kida T, Omura S, Nakagomi D, Masatoshi K, Takizawa N, Nomura A, Yuji K, Kondo N, Yasuhiko Y, Yanagida T, Endo K, Hirata S, Kawahata K, Matsui K, Takeuchi T, Ichinose K, Kato M, Yanai R, Matsuo Y, Shimojima Y, Nishioka R, Yamasaki A, Takata T, Ito T, Moriyama M, Takatani A, Miyawaki Y, Kawahito Y, Ito-Ihara T, Kawaguchi T, Yajima N. AB0625 Association between Cytomegalovirus Reactivation and Renal Prognosis during Remission Induction Therapy for ANCA-Associated Vasculitis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundCytomegalovirus (CMV) has been associated with atherosclerosis in patients with chronic renal failure, and may cause secondary nephrotic syndrome. Therefore, we hypothesized that the reactivation of CMV by immunosuppressive therapy in patients with vasculitis may affect renal function.ObjectivesThe purpose of this study was to investigate relationships between CMV infection and renal function during ANCA-associated vasculitis remission induction therapy.MethodsThis retrospective cohort study enrolled microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis patients at 25 sites in Japan who had a first or severe relapse between January 2017 and June 2020. Of these, patients with MPA or GPA who had a positive renal lesion score on BVAS (version 3) at baseline, or vasculitis findings on renal biopsy, CMV assayed by 48 weeks of treatment, were included. Patients were divided into two groups based on the presence or absence of a positive CMV antigen test during the remission induction phase (0–48 weeks of treatment). Outcomes were the rate of change in estimated glomerular filtration rate (eGFR) at 48 weeks after initiation of treatment in both groups, as determined by (eGFR at 48 weeks - eGFR at the initiation of treatment)/eGFR at the initiation of treatment; where lower values were associated with worse renal function. General linear models adjusted for age, gender, presence of diabetes or chronic kidney disease, and the use of rituximab or cyclophosphamide were generated.ResultsA total of 387 patients had CMV antigen measured during ANCA-associated vasculitis treatment, of which 164 had renal involvement and eGFR measured at 48 weeks. Seventy-seven (47.0%) were male and the median age was 75 years (range 69–80 years). CMV reactivation was observed in 44 patients (26.8%). The beta coefficient of multiple regression analysis with CMV positive as 1 and negative as 0 was 0.08 (95% confidence interval -0.13 to 0.29) (p = 0.47). The rate of change in eGFR was higher in the CMV positive group, but not statistically significantly.ConclusionContrary to our hypothesis, renal prognoses tended to be better when CMV reactivation was observed. The patients in the CMV reactivation group may have been treated more aggressively, and some patients with a poor prognosis who were not followed up for 48 weeks dropped out. Further research investigating the adjustment of treatment methods is required.Disclosure of InterestsNone declared
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Nishioka R, Mizushima I, Kida T, Omura S, Nakagomi D, Masatoshi K, Takizawa N, Nomura A, Yuji K, Kondo N, Yasuhiko Y, Yanagida T, Endo K, Hirata S, Kawahata K, Matsui K, Takeuchi T, Ichinose K, Kato M, Yanai R, Matsuo Y, Shimojima Y, Yamasaki A, Takata T, Ito T, Moriyama M, Takatani A, Miyawaki Y, Ito-Ihara T, Kawaguchi T, Yajima N, Kawahito Y, Kawano M. POS0247 GLUCOCORTICOID TAPERING STRATEGY FOR ANCA-ASSOCIATED VASCULITIS: ADDRESSING THE GAP BETWEEN RECOMMENDATIONS AND REAL-WORLD PRACTICE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAntineutrophil cytoplasmic antibody -associated vasculitis (AAV) is usually treated with combination of high-dose glucocorticoid (GC) and immunosuppressive agents, followed by tapering GC dose. Although the European League Against Rheumatism (EULAR) has specific recommendations for tapering the GC dose, clinicians often taper it slower than recommended due to concerns of potential disease relapse. However, such slower taper may prolong GC exposure for the patients, increasing the risk of adverse events, particularly infection.ObjectivesThe aims of our study were (1) to clarify GC dose tapering in the treatment of AAV in a real-world setting, in contrast to the EULAR recommendation of 2015 and (2) to compare the incidence of AAV relapse and severe infection between patients underdoing EULAR-recommended tapering and those undergoing slower tapering than the recommendation.MethodsIn this multicenter (25 sites in Japan), observational, retrospective study of AAV, 541 patients who had initial or severe relapse were enrolled between January 2017 and June 2020. Of these, 349 patients with microscopic polyangiitis (MPA) or granulomatosis with polyangiitis (GPA) who entered in GC tapering phase after successful induction treatment were included. These patients were then grouped on the pace of GC tapering, defined as the GC dose at 12 weeks after treatment initiation: (1) EULAR group: 7.5-10 mg/day of GC, according to the EULAR recommendation of 2015, and (2) SLOWER group: >10 mg/day of GC. Their baseline characteristics and clinical outcomes were compared. Primary outcome was defined as relapse-free days from treatment initiation, whereas secondary outcome included the incidence of infectious events requiring hospitalization within 48 weeks from treatment initiation. Multivariable analysis was performed to assess the relationship between tapering pace and clinical outcomes.ResultsThere were 44 patients (12.6%) in the EULAR group and 290 (83.2%) in the SLOWER group. Regarding baseline characteristics, compared with the EULAR group, the SLOWER group had significantly higher serum C-reactive protein level (EULAR, 5.89 ± 6.89 mg/dL vs SLOWER, 7.56 ± 6.01 mg/dL; p = 0.03), as well as a trend toward higher Birmingham Vasculitis Activity Score (version 3) (EULAR, 11.80 ± 7.01 SLOWER, 13.93 ± 7.06; p = 0.08) We did not observe any significant differences in the frequency of relapses between the two groups (EULAR, 8/44, 18.2% vs SLOWER, 55/290, 19.0%; p = 0.63). Multivariable Cox proportional hazard analysis revealed no relationship GC dose at 12 weeks from treatment initiation and incidence of relapse. However, upon logistic regression analysis, the SLOWER group was found to have significant higher risk of a severe infectious event within 48 weeks from treatment initiation (p = 0.046; hazard ratio, 1.27; 95% confidence interval, 1.004 – 1.601).ConclusionOur finding indicates that clinicians tended to taper GC slower for patients with higher disease activity. However, slower GC taper was not found to reduce the frequency of relapse. In addition, slower GC taper was found to increase the risk of a severe infection. Hence, clinicians should pay attention not only relapsing but also late GC taper resulting in the risk of serious infection, especially in patients with higher disease activity of AAV.References[1]Eur J Clin Invest 2015;45 (3): 346–368.[2]Rheumatology (Oxford). 2021 Dec 24;61(1):205-212.[3]Arthritis Res Ther. 2021 Mar 20;23(1):90.[4]Scand J Rheumatol. 2022 Jan 20;1-13.[5]J Rheumatol. 2018 Apr;45(4):521-528.[6]Rheumatol Adv Pract. 2021 Mar 9;5(3):rkab018.[7]Ann Rheum Dis. 2016 Sep;75(9):1583-94.Figure 1.AcknowledgementsWe would like to thank Editage (www.editage.com) for English language editing.Disclosure of InterestsNone declared
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Funayama M, Koreki A, Mimura Y, Takata T, Ogino S, Kurose S, Shimizu Y, Kudo S. Restrictive type and infectious complications might predict nadir hematological values among individuals with anorexia nervosa during the refeeding period: a retrospective study. J Eat Disord 2022; 10:64. [PMID: 35513879 PMCID: PMC9074196 DOI: 10.1186/s40337-022-00586-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although hematological abnormalities in patients with anorexia nervosa have been documented, the mechanisms involved have not been fully clarified, especially during the refeeding period when hematological values further decrease after admission prior to improving. Here we address potential mechanisms underlying the hematological abnormalities of inpatients with anorexia nervosa during the refeeding period. METHODS We recruited patients from 101 admissions corresponding to 55 individual patients with anorexia nervosa with severe malnutrition (body mass index, 13.4 ± 3.4) from the neuropsychiatry unit in Ashikaga Red Cross Hospital during the period from October 1999 to March 2018. We analyzed three hematological cell measures, i.e., hemoglobin, white cell count, and platelet count, to determine their levels at admission and their lowest levels during the refeeding period and calculated the percent decrease in those values from admission to the nadir levels. We analyzed each measure using a general mixed model with explanatory variables, including data upon admission and a treatment-related indicator, i.e., energy intake. RESULTS The initial hemoglobin value of 12.1 ± 2.7 g/dl decreased by 22.3% to 9.4 ± 2.5 g/dl; the initial white cell count was 5387 ± 3474/μl, which decreased by 33.6% to 3576 ± 1440/μl; the initial platelet count of 226 ± 101 × 103/μl decreased by 24.3% to 171 ± 80 × 103/μl. All nadir levels were observed during the refeeding period from the fifth to tenth day of hospitalization. Significant correlations among the three hematological cell measures, particularly at the nadir levels, were found. Of note, 41.7% of our patients who received red blood cell transfusion during hospitalization showed normal hemoglobin levels upon admission. The anorexia nervosa restrictive type was associated with a lower nadir level of white blood cell count. Infectious complications were related to a lower nadir level of hemoglobin and a greater percent decrease in hemoglobin level as well as to the need for red blood cell transfusion. CONCLUSIONS Nadir hematological cell measures of inpatients with anorexia nervosa might be predicted by the restrictive type and infectious complications. The anorexia nervosa restrictive type was associated with further decrease in hematological values during the refeeding period.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga, Tochigi, 326-0843, Japan.
| | - Akihiro Koreki
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Yu Mimura
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga, Tochigi, 326-0843, Japan
| | - Satoyuki Ogino
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga, Tochigi, 326-0843, Japan.,Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Yusuke Shimizu
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga, Tochigi, 326-0843, Japan.,Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Shun Kudo
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Funayama M, Nakagawa Y, Nakajima A, Kawashima H, Matsukawa I, Takata T, Kurose S. Apathy Level, Disinhibition, and Psychiatric Conditions Are Related to the Employment Status of People With Traumatic Brain Injury. Am J Occup Ther 2022; 76:23217. [PMID: 35226063 DOI: 10.5014/ajot.2022.047456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE An understanding of the potential prognostic factors as they relate to the employment status of people with traumatic brain injury (TBI) is necessary so that occupational therapy practitioners can provide the most effective treatment. OBJECTIVE To examine the impact of apathy, disinhibition, and psychiatric conditions on employment status after TBI. DESIGN An observational study conducted from March 2015 to March 2020. SETTING Cognitive dysfunction clinics associated with two general hospitals in Japan. PARTICIPANTS Japanese people of working age (N = 110, ages 18-65 yr) with TBI. Outcomes and Measures: As an outcome indicator, each participant's employment status was rated on a 3-point scale (i.e., 3 = regular employment, 2 = welfare employment [employed as a person with disabilities or undergoing vocational training in the Japanese welfare employment system, for which a worker is paid under either system], 1 = unemployment). Psychiatric, neuropsychological, and physical assessments were measured as explanatory variables. The impact of various factors on employment status was investigated using linear discriminant regression analysis. RESULTS The level of apathy, disinhibition, and incidence of psychiatric conditions after TBI, as well as age and years postinjury, were related to employment status. Conclusion and Relevance: Although this is a cross-sectional study, interventions for apathy and disinhibition, as well as management of psychiatric conditions, are recommended to help improve employment status among people with TBI. What This Article Adds: The employment status of people with TBI is related more to apathy, disinhibition, and psychiatric conditions than to intelligence, memory function, or executive function.
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Affiliation(s)
- Michitaka Funayama
- Michitaka Funayama, PhD, MD, is Doctor, Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Yobe, Ashikaga-City, Japan;
| | - Yoshitaka Nakagawa
- Yoshitaka Nakagawa, MS, is Speech-Language Pathologist, Department of Rehabilitation, Edogawa Hospital, Higashikoiwa, Edogawa-Ward, Tokyo, Japan
| | - Asuka Nakajima
- Asuka Nakajima is Speech-Language Pathologist, Department of Rehabilitation, Ashikaga Red Cross Hospital, Yobe, Ashikaga-City, Japan
| | - Hiroaki Kawashima
- Hiroaki Kawashima is Speech-Language Pathologist, Department of Rehabilitation, Ashikaga Red Cross Hospital, Yobe, Ashikaga-City, Japan
| | - Isamu Matsukawa
- Isamu Matsukawa, OTR/L, is Occupational Therapist, Department of Rehabilitation, Ashikaga Red Cross Hospital, Yobe, Ashikaga-City, Japan
| | - Taketo Takata
- Taketo Takata, MD, is Doctor, Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Yobe, Ashikaga-City, Japan
| | - Shin Kurose
- Shin Kurose, MD, is Doctor, Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Yobe, Ashikaga-City, Japan
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Kurose S, Funayama M, Takata T, Shimizu Y, Mimura Y, Kudo S, Ogino S, Mimura M. Symptom changes in patients with pre-existing psychiatric disorders in the initial phase of the COVID-19 pandemic: Vulnerability of female patients and patients with mood disorders. Asian J Psychiatr 2022; 68:102966. [PMID: 34974375 PMCID: PMC8677626 DOI: 10.1016/j.ajp.2021.102966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/05/2021] [Accepted: 12/14/2021] [Indexed: 11/02/2022]
Abstract
How patients with pre-existing psychiatric disorders are responding to the COVID-19 pandemic remains unclear, and no comprehensive studies have yet been performed. To elucidate (1) which psychiatric disorders were exacerbated during the initial phase of the COVID-19 pandemic and (2) the contributing factors, we prospectively assessed psychiatric symptoms of 1592 psychiatric outpatients in a single-center study using the Global Assessment of Functioning (GAF) before the state of emergency was declared in Japan and during two months under the state of emergency (study period: April 8 to June 7, 2020). We conducted a chi-squared test for the relationship between psychiatric diagnostic category (ICD-10) and exacerbation. To control for confounders, we conducted a logistic regression analysis using sex, age, diagnostic category, and pre-pandemic GAF score as independent variables. Exacerbation rates of patients with mood disorders (F3) and neurotic disorders (F4) were 4.32% and 5.37%, respectively, and were significantly higher than those for patients with organic disorders (F0) and schizophrenic disorders (F2) (X2 (9, N = 1592) = 27.8, p < .01). Logistic regression analysis revealed that patients with F3 and female patients were significantly more affected than patients with other disorders or male patients, respectively (odds ratio (95% confidence interval) = 2.4 (1.2-4.6), p < .01 for F3; 3.1 (1.5-6.6), p < .01 for females). These findings suggest a need for careful management of patients with mood disorders and female psychiatric patients during a pandemic.
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Affiliation(s)
- Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Department of Functional Brain Imaging, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.
| | - Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan
| | - Yusuke Shimizu
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan; Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Yu Mimura
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shun Kudo
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Department of Psychiatry, Saitama City Hospital, Saitama, Japan
| | - Satoyuki Ogino
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan; Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Funayama M, Mimura Y, Takata T, Koreki A, Ogino S, Kurose S, Shimizu Y. Hypokalemia in patients with anorexia nervosa during refeeding is associated with binge-purge behavior, lower body mass index, and hypoalbuminemia. J Eat Disord 2021; 9:95. [PMID: 34362446 PMCID: PMC8348865 DOI: 10.1186/s40337-021-00452-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/27/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Hypokalemia is frequently found in patients with anorexia nervosa and sometimes leads to life-threatening conditions. Although their serum potassium levels are considered to further decrease during refeeding, no previous studies have addressed actual changes in the serum potassium levels and potential mechanisms underlying hypokalemia during the refeeding period of patients with anorexia nervosa. In this study, we investigated factors associated with hypokalemia during refeeding of patients with anorexia nervosa. METHODS We recruited 52 independent patients from 89 admissions with anorexia nervosa (body mass index, 13.0 ± 3.3) from the psychiatry unit in Ashikaga Red Cross Hospital during the period from April 2003 to March 2018 and analyzed serum potassium levels at admission. Of the 89 admissions, 66 admissions with > 1-week hospitalization were recruited to determine the lowest potassium levels during the refeeding period. We analyzed these levels with multiple linear regression analysis with explanatory variables, including data upon admission and treatment-related indicators. RESULTS The initial serum potassium level of 3.6 ± 0.9 mg/dl decreased to 3.1 ± 0.7 mg/dl at nadir hypophosphatemia, which was observed an average of 2.5 days after admission. A lower serum potassium level at admission and a lower nadir potassium level during refeeding were associated with a lower body mass index, hypoalbuminemia, and binge-purge behavior. Similar results were obtained when the analysis included restrictive or binge-purge types as well as the independent patient group. CONCLUSIONS Lower body mass index, hypoalbuminemia, and binge-purge behavior might be used as indicators to guide clinical approaches for controlling serum potassium levels in patients with anorexia nervosa during refeeding. Hypokalemia, low levels of serum potassium, in patients with anorexia nervosa sometimes leads to life-threatening conditions. Thus, it is of great importance to predict the risk of hypokalemia in patients with anorexia nervosa during the refeeding period. Our study found that hypokalemia in patients with anorexia nervosa during refeeding is associated with a lower body mass index and hypoalbuminemia (low levels of serum albumin), in addition to binge-purge behavior.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan.
| | - Yu Mimura
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan
| | - Akihiro Koreki
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Satoyuki Ogino
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan.,Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan
| | - Yusuke Shimizu
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan.,Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
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Funayama M, Okochi R, Asada S, Shimizu Y, Kurose S, Takata T. Severe diaphoresis and fever during alcohol withdrawal cause hypovolemic shock: case report. BMC Psychiatry 2021; 21:387. [PMID: 34348698 PMCID: PMC8336347 DOI: 10.1186/s12888-021-03393-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Several fatal medical complications have been associated with alcohol withdrawal, such as seizure, cardiac arrhythmia, and takotsubo cardiomyopathy. However, there have been no reports on hypovolemic shock during alcohol withdrawal, although two physical signs of alcohol withdrawal, i.e., diaphoresis and fever, can lead to hypovolemia and its medical consequences. CASE PRESENTATION We describe a patient with alcohol use disorder who exhibited hypovolemic shock and its associated acute renal failure during alcohol withdrawal with severe diaphoresis and fever even though he had consumed almost the full amount of food he was offered. Given his excessive diaphoresis and fever that were related to alcohol withdrawal, his water intake was insufficient. Infusion with extracellular fluid resolved all these medical issues. CONCLUSIONS The increased adrenergic activity associated with alcohol withdrawal might substantially increase a patient's water-intake requirement through diaphoresis and fever and may cause severe hypovolemia and its associated medical complications.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843, Japan.
| | - Ryotaro Okochi
- grid.413981.60000 0004 0604 5736Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843 Japan
| | - Shintaro Asada
- grid.413981.60000 0004 0604 5736Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843 Japan
| | - Yusuke Shimizu
- grid.413981.60000 0004 0604 5736Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843 Japan
| | - Shin Kurose
- grid.413981.60000 0004 0604 5736Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843 Japan
| | - Taketo Takata
- grid.413981.60000 0004 0604 5736Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843 Japan
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Funayama M, Nakajima A, Kurose S, Takata T. Putative Alcohol-Related Dementia as an Early Manifestation of Right Temporal Variant of Frontotemporal Dementia. J Alzheimers Dis 2021; 83:531-537. [PMID: 34334406 DOI: 10.3233/jad-210501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Diagnosis of frontotemporal dementia is challenging in the early stages. Various psychiatric and neurological diseases are misdiagnosed as frontotemporal dementia and vice versa. Here we present a case with right temporal variant of frontotemporal dementia who presented with alcohol dependency and remarkable behavioral symptoms and was first misdiagnosed as having alcohol-related dementia. He then revealed symptoms related to right temporal variant of frontotemporal dementia, such as prosopagnosia, difficulty recognizing his housemates, loss of empathy, ritualistic behaviors, and difficulty finding and comprehending words. Retrospectively, his alcohol dependency itself was considered an early manifestation of right temporal variant of frontotemporal dementia.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
| | - Asuka Nakajima
- Department of Rehabilitation, Ashikaga Red Cross Hospital, Tochigi, Japan
| | - Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
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Funayama M, Takata T, Nakagawa Y, Sunagawa K, Nakajima A, Kawashima H, Mimura M. Visuospatial working memory dysfunction from tapping span test as a diagnostic tool for patients with mild posterior cortical atrophy. Sci Rep 2021; 11:10580. [PMID: 34012020 PMCID: PMC8134425 DOI: 10.1038/s41598-021-90159-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/07/2021] [Indexed: 12/21/2022] Open
Abstract
Posterior cortical atrophy is a rare degenerative condition with prominent visuospatial dysfunction which commonly occurs between ages 50 and 65. A diagnosis of mild posterior cortical atrophy sometimes challenging and can be delayed because there are currently no established neuropsychological examination methods that can easily be used in clinical settings. In this study, we examined whether the tapping span test is a potential diagnostic tool for posterior cortical atrophy and what impairment the tapping span test is indicative of in this condition. Eight patients with mild posterior cortical atrophy were recruited. Age- and severity-matched individuals with amnesic Alzheimer's disease (n = 9) were also recruited as a control group. The participants were subjected to the tapping span test and several visuospatial working memory tests. The results of the tapping span and visuospatial working memory tests were worse for the posterior cortical atrophy group when compared with the control group. The results from the tapping span tests were strongly correlated with those from the visuospatial working memory tests. The tapping span test is a simple and potentially useful diagnostic tool for patients with mild posterior cortical atrophy, as it reflects visuospatial working memory function.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843, Japan. .,Department of Rehabilitation, Edogawa Hospital, Tokyo, 1330052, Japan.
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, Tochigi, 3260843, Japan
| | | | - Kosaku Sunagawa
- Faculty of Rehabilitation, Kansai Medical University, Osaka, 5820026, Japan
| | - Asuka Nakajima
- Department of Rehabilitation, Ashikaga Red Cross Hospital, Tochigi, 3260843, Japan
| | - Hiroaki Kawashima
- Department of Rehabilitation, Ashikaga Red Cross Hospital, Tochigi, 3260843, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, 1608582, Japan
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Mimura Y, Shimizu Y, Oi H, Kurose S, Kudo S, Takata T, Mimura M, Funayama M. "Case series: ischemic stroke associated with dehydration and arteriosclerosis in individuals with severe anorexia nervosa". J Eat Disord 2021; 9:39. [PMID: 33743808 PMCID: PMC7981924 DOI: 10.1186/s40337-021-00393-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Numerous reports have indicated that patients with anorexia nervosa (AN) are at a relatively high risk of developing vascular diseases, including cardiovascular events and venous thromboembolism. However, there have been no previous reports of the development of ischemic stroke during refeeding therapy in patients with severe AN. This report is aimed at reporting the characteristics of an ischemic stroke in patients with AN. CASE PRESENTATIONS Our study included 29 admissions by independent 19 female patients cases (19 patients), who received thorough medical, neurological, and psychiatric examinations. Two patients were diagnosed as having developed ischemic stroke; the first patient showed multiple infarctions in the brain, while the second showed symptomatic focal infarction. Our findings suggest that dehydration and arteriosclerosis, in association with severe malnutrition, could predispose to the development of ischemic stroke in patients with severe AN. CONCLUSIONS Development of ischemic stroke in patients with AN might be overlooked. Watching out for neurological signs would help in early diagnosis of ischemic stroke in patients with AN during refeeding. Specific etiology could induce ischemic stroke in patients with AN even if they have no common risk factors of ischemia.
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Affiliation(s)
- Yu Mimura
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe-Cho, Ashikaga-shi, Tochigi, 326-0843, Japan. .,Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Yusuke Shimizu
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe-Cho, Ashikaga-shi, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hiroki Oi
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe-Cho, Ashikaga-shi, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shin Kurose
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe-Cho, Ashikaga-shi, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shun Kudo
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe-Cho, Ashikaga-shi, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe-Cho, Ashikaga-shi, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Michitaka Funayama
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe-Cho, Ashikaga-shi, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Funayama M, Mimura Y, Takata T, Koreki A, Ogino S, Kurose S. Body mass index and blood urea nitrogen to creatinine ratio predicts refeeding hypophosphatemia of anorexia nervosa patients with severe malnutrition. J Eat Disord 2021; 9:1. [PMID: 33407855 PMCID: PMC7789160 DOI: 10.1186/s40337-020-00356-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/01/2020] [Indexed: 11/10/2022] Open
Abstract
AIM To investigate development of refeeding hypophosphatemia during the refeeding period and the extent of the decrease in the serum phosphorus level among anorexia nervosa patients with severe malnutrition. OBJECTIVE The accurate prediction of the severity of refeeding hypophosphatemia in patients with anorexia nervosa during acute treatment is of great importance. Although some predictors were found in previous reports, these studies used binominal data-the presence or absence of hypophosphatemia-as an outcome indicator but not the extent of serum phosphorus level decrease. It is crucial in clinical settings to predict the extent of the serum phosphorus level decrease as well as development of refeeding hypophosphatemia, in particular, for patients with severe malnutrition, who has a higher risk of death. METHODS We investigated 63 admissions from 37 patients with anorexia nervosa who had severe malnutrition (admission body mass index 11.5 ± 1.6) and carried out a linear discriminant regression analysis for the development of refeeding hypophosphatemia. The extent of the decrease in the serum phosphorus level were investigated using multiple linear regression analysis. Explanatory variables included data upon admission (age, sex, body mass index, blood urea nitrogen to creatinine ratio, albumin, initial serum phosphorus level, anorexia nervosa type, i.e., restrictive or binge-purge) as well as treatment-related indicators (calorie intake, amount of phosphate administered, and rate of weight gain). RESULTS Development of refeeding hypophosphatemia and a change in serum phosphorus levels were predicted by body mass index and elevated blood urea nitrogen to creatinine ratio. CONCLUSIONS Our study found that refeeding hypophosphatemia among patients with severe malnutrition was predicted by a lower body mass index and elevated blood urea nitrogen to creatinine ratio.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan.
| | - Yu Mimura
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan
| | - Akihiro Koreki
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan.,Department of Neuropsychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Satoyuki Ogino
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan.,Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan
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17
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Funayama M, Kurose S, Kudo S, Shimizu Y, Takata T. New information technology (IT)-related approaches could facilitate psychiatric treatments in general hospital psychiatry during the COVID-19 pandemic. Asian J Psychiatr 2020; 54:102239. [PMID: 32593119 PMCID: PMC7301776 DOI: 10.1016/j.ajp.2020.102239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 05/31/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, 3260843, Japan.
| | - Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, 3260843, Japan
| | - Shun Kudo
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, 3260843, Japan
| | - Yusuke Shimizu
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, 3260843, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1, Yobe, Ashikaga-City, 3260843, Japan
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18
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Sakurai Y, Takata T, Tanaka H, Suzuki M. Simulation for improved collimation system of gamma-ray telescope system for boron neutron capture therapy at Kyoto University Reactor. Appl Radiat Isot 2020; 165:109256. [DOI: 10.1016/j.apradiso.2020.109256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 05/15/2020] [Accepted: 05/29/2020] [Indexed: 11/29/2022]
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19
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Hu N, Tanaka H, Takata T, Endo S, Masunaga S, Suzuki M, Sakurai Y. Evaluation of PHITS for microdosimetry in BNCT to support radiobiological research. Appl Radiat Isot 2020; 161:109148. [DOI: 10.1016/j.apradiso.2020.109148] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/14/2019] [Accepted: 03/24/2020] [Indexed: 12/01/2022]
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20
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Mimura Y, Kurose S, Takata T, Tabuchi H, Mimura M, Funayama M. Pisa syndrome induced by switching of a choline-esterase inhibitor treatment from donepezil to galantamine: a case report. BMC Neurol 2020; 20:183. [PMID: 32404068 PMCID: PMC7218485 DOI: 10.1186/s12883-020-01769-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background Pisa syndrome (PS) is characterized by an abnormally sustained posture, with flexion of the body and head to one side and slight rotation of the trunk. Although PS most commonly arises as an adverse effect of antipsychotic drugs, choline-esterase inhibitors (ChEIs) are also sometimes known to induce PS. Despite the fact that the precise mechanism remains unclear, cholinergic-dopaminergic imbalance has been considered as a possible pathophysiologic mechanism underlying the genesis of PS. Case presentation We hereby report the case of a 60-year-old woman with Alzheimer’s disease who presented with the signs of PS after her treatment was switched to galantamine, a type of ChEI, even though she had received donepezil, another type of ChEI, for 5 years without any complications. To the best of our knowledge, this is the first report of PS associated with treatment switch from one to another type of ChEI. Galantamine, but not other ChEIs, can enhance striatal dopamine release through allosteric modulation of the nicotinic acetylcholine receptor, and has weaker muscarinic effects than donepezil. Therefore, we propose two novel hypotheses to explain the development of PS, as follows; galantamine, which enhances dopamine release, can induce imbalance of dopamine levels in the striatum of patients with dementia, resulting in PS, and the weaker muscarinic effects of the drug could be one of the factors predisposing to the development of PS. Conclusion The present case suggests that treatment with galantamine is associated with a higher risk of development of PS than that with other ChEIs, such as donepezil, despite the pharmacological profile of galantamine as a dopamine modulator. Also, this report provides novel insight into another plausible mechanism underlying the development of PS, besides cholinergic-dopaminergic imbalance, namely, dopamine imbalance in the striatum with muscarinic-nicotinic imbalance.
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Affiliation(s)
- Yu Mimura
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe, Ashikaga, Tochigi, Japan. .,Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan.
| | - Shin Kurose
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe, Ashikaga, Tochigi, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe, Ashikaga, Tochigi, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan
| | - Michitaka Funayama
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe, Ashikaga, Tochigi, Japan
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21
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Mimura Y, Funayama M, Oi H, Takata T, Takeuchi H, Mimura M. Effectiveness of brexpiprazole in the treatment in a patient with Huntington's disease. Psychiatry Clin Neurosci 2020; 74:278-279. [PMID: 31930762 DOI: 10.1111/pcn.12982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/26/2019] [Accepted: 01/07/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Yu Mimura
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Michitaka Funayama
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Oi
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyoshi Takeuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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22
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Dóka É, Ida T, Dagnell M, Abiko Y, Luong NC, Balog N, Takata T, Espinosa B, Nishimura A, Cheng Q, Funato Y, Miki H, Fukuto JM, Prigge JR, Schmidt EE, Arnér ESJ, Kumagai Y, Akaike T, Nagy P. Control of protein function through oxidation and reduction of persulfidated states. Sci Adv 2020; 6:eaax8358. [PMID: 31911946 PMCID: PMC6938701 DOI: 10.1126/sciadv.aax8358] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 11/05/2019] [Indexed: 05/17/2023]
Abstract
Irreversible oxidation of Cys residues to sulfinic/sulfonic forms typically impairs protein function. We found that persulfidation (CysSSH) protects Cys from irreversible oxidative loss of function by the formation of CysSSO1-3H derivatives that can subsequently be reduced back to native thiols. Reductive reactivation of oxidized persulfides by the thioredoxin system was demonstrated in albumin, Prx2, and PTP1B. In cells, this mechanism protects and regulates key proteins of signaling pathways, including Prx2, PTEN, PTP1B, HSP90, and KEAP1. Using quantitative mass spectrometry, we show that (i) CysSSH and CysSSO3H species are abundant in mouse liver and enzymatically regulated by the glutathione and thioredoxin systems and (ii) deletion of the thioredoxin-related protein TRP14 in mice altered CysSSH levels on a subset of proteins, predicting a role for TRP14 in persulfide signaling. Furthermore, selenium supplementation, polysulfide treatment, or knockdown of TRP14 mediated cellular responses to EGF, suggesting a role for TrxR1/TRP14-regulated oxidative persulfidation in growth factor responsiveness.
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Affiliation(s)
- É. Dóka
- Department of Molecular Immunology and Toxicology, National Institute of Oncology, 1122 Budapest, Hungary
| | - T. Ida
- Department of Environmental Medicine and Molecular Toxicology, Tohoku University Graduate School of Medicine, 980-8575 Sendai, Japan
| | - M. Dagnell
- Department of Medical Biochemistry and Biophysics, Division of Biochemistry, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Y. Abiko
- Environmental Biology Section, Faculty of Medicine, University of Tsukuba, 305-8575 Tsukuba, Japan
| | - N. C. Luong
- Environmental Biology Section, Faculty of Medicine, University of Tsukuba, 305-8575 Tsukuba, Japan
- Faculty of Pharmacy, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen, Hue, Vietnam
| | - N. Balog
- Department of Molecular Immunology and Toxicology, National Institute of Oncology, 1122 Budapest, Hungary
| | - T. Takata
- Department of Environmental Medicine and Molecular Toxicology, Tohoku University Graduate School of Medicine, 980-8575 Sendai, Japan
| | - B. Espinosa
- Department of Medical Biochemistry and Biophysics, Division of Biochemistry, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - A. Nishimura
- Department of Environmental Medicine and Molecular Toxicology, Tohoku University Graduate School of Medicine, 980-8575 Sendai, Japan
| | - Q. Cheng
- Department of Medical Biochemistry and Biophysics, Division of Biochemistry, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Y. Funato
- Department of Cellular Regulation, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - H. Miki
- Department of Cellular Regulation, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - J. M. Fukuto
- Department of Chemistry, Sonoma State University, Rohnert Park, Sonoma, CA 94928, USA
| | - J. R. Prigge
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - E. E. Schmidt
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - E. S. J. Arnér
- Department of Medical Biochemistry and Biophysics, Division of Biochemistry, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Y. Kumagai
- Environmental Biology Section, Faculty of Medicine, University of Tsukuba, 305-8575 Tsukuba, Japan
| | - T. Akaike
- Department of Environmental Medicine and Molecular Toxicology, Tohoku University Graduate School of Medicine, 980-8575 Sendai, Japan
| | - P. Nagy
- Department of Molecular Immunology and Toxicology, National Institute of Oncology, 1122 Budapest, Hungary
- Corresponding author.
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23
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Funayama M, Takata T. Psychiatric inpatients subjected to physical restraint have a higher risk of deep vein thrombosis and aspiration pneumonia. Gen Hosp Psychiatry 2020; 62:1-5. [PMID: 31734627 DOI: 10.1016/j.genhosppsych.2019.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/04/2019] [Accepted: 11/08/2019] [Indexed: 12/21/2022]
Abstract
Physical restraint in clinical settings can lead to potentially lethal complications. Although this is a life-and-death issue, no comprehensive large-scale study relating medical complications to physical restraint has yet been performed. The 1308 psychiatric inpatients in our retrospective cohort study were categorized into two groups: a physical restraint group (those who had been subjected to physical restraint while hospitalized; n = 110) and a non-physical restraint group (those never subjected to physical restraint; n = 1198). We assessed differences between the two groups with respect to the occurrence of medical complications subsequent to restraint. To control for potentially confounding factors, linear discriminant regression analysis was used to identify whether physical restraint itself affected the occurrence of medical complications. The physical restraint group had a higher risk for deep vein thrombosis (P < .01, OR = 6.0, 95%CI: 2.4-13.9) and aspiration pneumonia (P < .01, OR = 4.1, 95%CI: 2.1-7.6) when compared with the non-physical restraint group. Even after controlling for potentially confounding factors, physical restraint substantially raised the risk of deep vein thrombosis and aspiration pneumonia (P < .01, P = .01, respectively). Although this study population was derived from a single psychiatric unit, physical restraint may lead to serious medical conditions. To avoid this unwanted consequence, the use of physical restraint should be minimized and physical therapy is highly recommended.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi 3260843, Japan.
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi 3260843, Japan
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24
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Fennell D, Hudka M, Darlison L, Lord K, Bzura A, Dzialo J, Pritchard C, Harber J, Takata T, Popat S, Krebs M, Nolan L, Greystoke A, Richards C, Wells-Jordan P, Branson A, Gaba A, Bhundia V, Scotland M, Mohamed S, Dawson A, Poille C, Cowley C, Walter H, King A, Thomas A. P2.06-02 Mesothelioma Stratified Therapy (MiST): A Phase IIA Umbrella Trial for Accelerating the Development of Precision Medicines. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Funayama M, Nakagawa Y, Nakajima A, Takata T, Mimura Y, Mimura M. Dementia trajectory for patients with logopenic variant primary progressive aphasia. Neurol Sci 2019; 40:2573-2579. [DOI: 10.1007/s10072-019-04013-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/16/2019] [Indexed: 11/24/2022]
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26
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Funayama M, Takata T, Koreki A. Choking incidents among patients with schizophrenia may be associated with severity illness and higher-dose antipsychotics. Gen Hosp Psychiatry 2019; 59:73-75. [PMID: 30745227 DOI: 10.1016/j.genhosppsych.2018.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/02/2018] [Accepted: 09/04/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi 3260843, Japan.
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi 3260843, Japan
| | - Akihiro Koreki
- Department of Neuropsychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, 2660007, Japan
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27
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Hoi S, Takata T, Sugihara T, Ida A, Ogawa M, Mae Y, Fukuda S, Munemura C, Isomoto H. SAT-189 PREDICTIVE VALUE OF CORTICAL THICKNESS MEASURED BY ULTRASONOGRAPHY FOR RENAL IMPAIRMENT. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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28
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Abstract
We report a new type of stimulus-bound behavior, denoted forced person-following, which we documented for a patient with hypoxic encephalopathy following a suicide attempt with carbon monoxide poisoning. The patient's brain was damaged in the bilateral frontal, parietal, and temporal lobes and in the basal ganglia. The patient was compelled to follow any person who came into his sight and would continue to do so until the person went out of his sight. The patient also exhibited certain primitive reflexes. The forced person-following exhibited by our patient appears to be a consequence of stimulus-bound behavior due to frontal lobe dysfunction and, to a lesser degree, severe cognitive dysfunctions, e.g., visuospatial deficits, which are related to damage in posterior cortices. The unique behavior exhibited by this patient might contribute to our understanding of innate human behavior.
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Affiliation(s)
- Michitaka Funayama
- a Department of Neuropsychiatry, Ashikaga Red Cross Hospital , Ashikaga-City, Tochigi , Japan
| | - Taketo Takata
- a Department of Neuropsychiatry, Ashikaga Red Cross Hospital , Ashikaga-City, Tochigi , Japan
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29
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Funayama M, Sugihara M, Takata T, Mimura M, Ikeuchi T. Remarkable behavioural signs and progressive non-fluent aphasia in a patient with adult-onset leucoencephalopathy with axonal spheroids and pigmented glia. Psychogeriatrics 2019; 19:282-285. [PMID: 30393946 DOI: 10.1111/psyg.12387] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/02/2018] [Accepted: 09/24/2018] [Indexed: 11/29/2022]
Abstract
Adult-onset leucoencephalopathy with axonal spheroids and pigmented glia (ALSP), also known as hereditary diffuse leucoencephalopathy with spheroids (HDLS), is a progressive neurocognitive disorder that predominantly affects the cerebral white matter, mainly the frontal subcortical areas and the corpus callosum. Patients with ALSP are clinically characterized by a gradual onset of cognitive and behavioural dysfunction and personality changes, followed by motor impairments such as gait disturbance and bradykinesia. Given the disease-related degenerative changes of the frontal white matter, it is no wonder that patients with ALSP present with behavioural symptoms and non-fluent aphasia, which are found in patients with frontotemporal lobar degeneration. However, behavioural symptoms and non-fluent aphasia in a patient with ALSP have rarely reported in detail. Here, we describe a patient with ALSP who initially presented with remarkable behavioural signs and non-fluent primary progressive aphasia, which resembled symptoms of frontotemporal lobar degeneration. The present case suggests that ALSP should be included in the differential diagnosis for frontotemporal lobar degeneration.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Masako Sugihara
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Japan.,Department of Psychiatry, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
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30
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Hagiwara D, Sato K, Miyazaki M, Kamada M, Moriwaki N, Nakano T, Shiotsuka S, Tokushige C, Toh H, Kamimura H, Togawa A, Takata T. The impact of earlier intervention by an antimicrobial stewardship team for specific antimicrobials in a single weekly intervention. Int J Infect Dis 2018; 77:34-39. [PMID: 30292892 DOI: 10.1016/j.ijid.2018.09.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/26/2018] [Accepted: 09/28/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the effects of earlier intervention by an antimicrobial stewardship team (AST) on antimicrobial use, antimicrobial resistance rates, and the clinical outcomes, without changing the weekly intervention schedule. METHODS A retrospective study was conducted at Fukuoka University Hospital between April 2013 and March 2016. The effects were compared among three study periods (SP): SP1 (patients receiving anti-methicillin-resistant Staphylococcus aureus agents and carbapenems for ≥14 days), SP2 (patients receiving specific antimicrobials for ≥14 days), and SP3 (patients receiving specific antimicrobials regardless of the duration of treatment). RESULTS The timing of AST intervention was shortened from an average of 15.5days after administration in SP1 to 4.2 days in SP3. The antimicrobial use density (AUD) of carbapenems and piperacillin-tazobactam decreased significantly (SP2 vs. SP3, p<0.05), and the costs of specific antimicrobials decreased (SP1, US$ 1080000; SP2, US$ 944000; SP3, US$ 763000). The rates of carbapenem resistance among Pseudomonas aeruginosa isolates showed a significant reduction from 16.2% in SP2 to 8.7% in SP3 (p<0.05). The mortality rate and length of stay did not change during the study period. CONCLUSIONS Earlier intervention by an AST could contribute to the proper use of antimicrobials without adversely affecting patient outcomes.
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Affiliation(s)
- D Hagiwara
- Department of Pharmacy, Fukuoka University Hospital, Fukuoka, Japan
| | - K Sato
- Department of Pharmacy, Fukuoka University Hospital, Fukuoka, Japan
| | - M Miyazaki
- Department of Pharmacy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - M Kamada
- Department of Pharmacy, Fukuoka University Hospital, Fukuoka, Japan
| | - N Moriwaki
- Department of Pharmacy, Fukuoka University Hospital, Fukuoka, Japan
| | - T Nakano
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan
| | - S Shiotsuka
- Department of Pharmacy, Fukuoka University Hospital, Fukuoka, Japan
| | - C Tokushige
- Department of Clinical Laboratory, Fukuoka University Hospital, Fukuoka, Japan
| | - H Toh
- Department of Clinical Laboratory, Fukuoka University Hospital, Fukuoka, Japan
| | - H Kamimura
- Department of Pharmacy, Fukuoka University Hospital, Fukuoka, Japan
| | - A Togawa
- Department of Infection Control, Fukuoka University Hospital, Fukuoka, Japan; Department of Medical Oncology, Hematology, and Infectious Diseases, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - T Takata
- Department of Infection Control, Fukuoka University Hospital, Fukuoka, Japan; Department of Medical Oncology, Hematology, and Infectious Diseases, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
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31
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Abstract
Most patients with N-methyl-D-aspartate receptor (NMDAR) encephalitis initially present with psychiatric symptoms. Although a delayed diagnosis may lead to a poor outcome, psychiatric symptoms that could differentiate anti-NMDAR encephalitis from other psychoses have not been fully investigated. We evaluated two patients with anti-NMDAR encephalitis who were observed by psychiatrists from onset throughout the course of disease. Both patients exhibited disorientation, memory deficits, perceptual disturbances, hallucinations, and mood liability. Among those, altered perceptions were most prominent - in particular, altered time perceptions without disorganization syndrome. The information obtained for these patients may help clinicians differentiate anti-NMDAR encephalitis from other psychoses, e.g., schizophrenia.
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Affiliation(s)
- Michitaka Funayama
- a Department of Neuropsychiatry , Ashikaga Red Cross Hospital , Ashikaga , Japan
| | - Jin Mizushima
- a Department of Neuropsychiatry , Ashikaga Red Cross Hospital , Ashikaga , Japan.,b Department of Neuropsychiatry , Keio University School of Medicine , Tokyo , Japan
| | - Taketo Takata
- a Department of Neuropsychiatry , Ashikaga Red Cross Hospital , Ashikaga , Japan
| | - Akihiro Koreki
- a Department of Neuropsychiatry , Ashikaga Red Cross Hospital , Ashikaga , Japan.,c Department of Neuropsychiatry , National Hospital Organization Shimofusa Psychiatric Medical Center , Chiba , Japan
| | - Masaru Mimura
- b Department of Neuropsychiatry , Keio University School of Medicine , Tokyo , Japan
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32
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Affiliation(s)
- A. Uchibori
- Japan Atomic Energy Agency, Fast Reactor Cycle System Research and Development Center, 4002 Narita, O-arai, Ibaraki 311-1393, Japan
| | - A. Watanabe
- NDD Corporation, Fast Reactor Cycle System Research and Development Center, 1-1-6 Jonan, Mito, Ibaraki 310-0803, Japan
| | - T. Takata
- Japan Atomic Energy Agency, Fast Reactor Cycle System Research and Development Center, 4002 Narita, O-arai, Ibaraki 311-1393, Japan
| | - H. Ohshima
- Japan Atomic Energy Agency, Fast Reactor Cycle System Research and Development Center, 4002 Narita, O-arai, Ibaraki 311-1393, Japan
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33
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Altwerger G, Bonazzoli E, Bellone S, Takata T, Menderes G, Pettinella F, Bianchi A, Riccio F, Feinberg J, Zammataro L, Han C, Yadav G, Dugan K, Morneault A, Ponte J, Buza N, Hui P, Litkouhi B, Ratner E, Silasi D, Huang G, Azodi M, Schwartz P, Santin A. Remarkable in vitro and in vivo activity of IMGN853, an antibody-drug conjugate targeting folate receptor alpha linked to the tubulin-disrupting maytansinoid DM4, in biologically aggressive (type II) endometrial cancers. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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34
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Funayama M, Takata T, Mimura M. Cotard's syndrome in anti-N-methyl-d-aspartate receptor encephalitis. Psychiatry Clin Neurosci 2018; 72:455-456. [PMID: 29604143 DOI: 10.1111/pcn.12658] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 03/23/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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35
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Japan.
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Japan
| | - Motoichiro Kato
- Department of Neuropsychiatry, Keio University School of Medicine, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Japan
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36
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Izumi Y, Takata T, Miyamoto R, Kawarai T, Saito Y, Murayama S, Kaji R. An autopsied case with novel mutated hereditary diffuse leukoencephalopathy with spheroid (HDLS). J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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37
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Takata T. A neuropathological report of familial amyotrophic lateral sclerosis with an R521S FUS/TLS mutation. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Tanaka H, Sakurai Y, Takata T, Watanabe T, Kawabata S, Suzuki M, Masunaga SI, Taki K, Akabori K, Watanabe K, Ono K. Note: Development of real-time epithermal neutron detector for boron neutron capture therapy. Rev Sci Instrum 2017; 88:056101. [PMID: 28571445 DOI: 10.1063/1.4982036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The real-time detection of epithermal neutrons forms an important aspect of boron neutron capture therapy. In this context, we developed an epithermal neutron detector based on the combination of a small Eu:LiCaAlF6 scintillator and a quartz fiber in order to fulfill the irradiation-field requirements for boron neutron capture therapy. The irradiation test is performed with the use of a reactor-based neutron source. The thermal and epithermal neutron sensitivities of our epithermal neutron detector are estimated to be 9.52 × 10-8 ± 1.59 × 10-8 cm2 and 1.20 × 10-6 cm2 ± 8.96 × 10-9 cm2, respectively. We also subject the developed epithermal neutron detector to actual irradiation fields, and we confirm that the epithermal neutron flux can be measured in realtime.
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Affiliation(s)
- H Tanaka
- Research Reactor Institute, Kyoto University, Asashiro-nishi 2-1010, Kumatori-cho, Osaka 590-0494, Japan
| | - Y Sakurai
- Research Reactor Institute, Kyoto University, Asashiro-nishi 2-1010, Kumatori-cho, Osaka 590-0494, Japan
| | - T Takata
- Research Reactor Institute, Kyoto University, Asashiro-nishi 2-1010, Kumatori-cho, Osaka 590-0494, Japan
| | - T Watanabe
- Research Reactor Institute, Kyoto University, Asashiro-nishi 2-1010, Kumatori-cho, Osaka 590-0494, Japan
| | - S Kawabata
- Osaka Medical College, Takatsuki, Osaka, Japan
| | - M Suzuki
- Research Reactor Institute, Kyoto University, Asashiro-nishi 2-1010, Kumatori-cho, Osaka 590-0494, Japan
| | - S-I Masunaga
- Research Reactor Institute, Kyoto University, Asashiro-nishi 2-1010, Kumatori-cho, Osaka 590-0494, Japan
| | - K Taki
- Sumitomo Heavy Industries, Osaki 2-1-1, Shinagawa, Tokyo, 141-6025, Japan
| | - K Akabori
- Sumitomo Heavy Industries, Osaki 2-1-1, Shinagawa, Tokyo, 141-6025, Japan
| | - K Watanabe
- Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Japan
| | - K Ono
- Research Reactor Institute, Kyoto University, Asashiro-nishi 2-1010, Kumatori-cho, Osaka 590-0494, Japan
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39
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Kondo N, Nakayama K, Sakurai Y, Takata T, Kume K, Miyatake S, Inoue T, Ogawa O, Suzuki M. P17.09 Lipid alteration following proton beam irradiation in mouse brain of radiation necrosis model. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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40
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Sawada J, Aoki D, Kuzume M, Nakazono K, Otsuka H, Takata T. A vinylic rotaxane cross-linker for toughened network polymers from the radical polymerization of vinyl monomers. Polym Chem 2017. [DOI: 10.1039/c7py00193b] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A [2]rotaxane cross-linker with one vinyl group in each component was synthesized as a vinylic cross-linker for highly toughened network polymers.
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Affiliation(s)
- J. Sawada
- Department of Chemical Science and Engineering
- Tokyo Institute of Technology
- Meguro-ku
- Japan
| | - D. Aoki
- Department of Chemical Science and Engineering
- Tokyo Institute of Technology
- Meguro-ku
- Japan
| | - M. Kuzume
- Department of Chemical Science and Engineering
- Tokyo Institute of Technology
- Meguro-ku
- Japan
| | - K. Nakazono
- Department of Chemical Science and Engineering
- Tokyo Institute of Technology
- Meguro-ku
- Japan
| | - H. Otsuka
- Department of Chemical Science and Engineering
- Tokyo Institute of Technology
- Meguro-ku
- Japan
| | - T. Takata
- Department of Chemical Science and Engineering
- Tokyo Institute of Technology
- Meguro-ku
- Japan
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41
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Abstract
Destruction of cementum and alveolar bone is the main causative event for the exfoliation of teeth as a consequence of periodontitis. Prostaglandin E2 (PGE2) and PGE receptor subtypes (EPs) play an important role in modulating osteoblast-mediated osteoclastogenesis; however, no information is available on the role of PGE2 and EPs in regulating cementoblast-mediated cementoclastogenesis. We hypothesized that the PGE2-EPs pathway also regulates cementoblasts’ ability to activate cementoclasts. For these studies, OCCM-30 cells (a mouse cementoblast cell line) were exposed to PGE2 and specific EP agonists. PGE2 (100 ng/mL) and EP4 agonist (1 μM) up-regulated RANKL and IL-6 mRNA levels, while they down-regulated OPG mRNA expression. The EP4 antagonist (1 μM) eliminated these effects of PGE2. PGE2 treatment of co-cultures of OCCM-30 cells with bone marrow cells induced TRAP-positive cells via the EP4 pathway. These findings suggest that PGE2 promotes cementoblast-mediated cementoclastogenesis by regulating the expression of RANKL and OPG via the EP4 pathway.
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Affiliation(s)
- H Oka
- Department of Oral and Maxillofacial Pathobiology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
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42
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Tanaka E, Kawai N, Tanaka M, Todoh M, van Eijden T, Hanaoka K, Dalla-Bona DA, Takata T, Tanne K. The Frictional Coefficient of the Temporomandibular Joint and Its Dependency on the Magnitude and Duration of Joint Loading. J Dent Res 2016; 83:404-7. [PMID: 15111633 DOI: 10.1177/154405910408300510] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In synovial joints, friction between articular surfaces leads to shear stress within the cartilaginous tissue, which might result in tissue rupture and failure. Joint friction depends on synovial lubrication of the articular surfaces, which can be altered due to compressive loading. Therefore, we hypothesized that the frictional coefficient of the temporomandibular joint (TMJ) is affected by the magnitude and duration of loading. We tested this by measuring the frictional coefficient in 20 intact porcine TMJs using a pendulum-type friction tester. The mean frictional coefficient was 0.0145 (SD 0.0027) after a constant loading of 50 N during 5 sec. The frictional coefficient increased with the length of the preceding loading duration and exceeded 0.0220 (SD 0.0014) after 1 hr. Application of larger loading (80 N) resulted in significantly larger frictional coefficients. In conclusion, the frictional coefficient in the TMJ was proportional to the magnitude and duration of joint loading.
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Affiliation(s)
- E Tanaka
- Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan.
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43
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Nishimura S, Mizuno H, Akashi T, Takata T, Nakamura F, Goda F, Mihara C, Sato H, Kurihara M, Sasaki M. MON-P192: Clinical Usefulness of New Type Formulathat Features a State Change from Liquid to Semi-Solidified in the Stomach. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30826-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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44
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Kunimatsu R, Yoshimi Y, Hirose N, Awada T, Miyauchi M, Takata T, Li W, Zhu L, Denbesten P, Tanimoto K. The C-terminus of amelogenin enhances osteogenic differentiation of human cementoblast lineage cells. J Periodontal Res 2016; 52:218-224. [DOI: 10.1111/jre.12384] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2016] [Indexed: 12/28/2022]
Affiliation(s)
- R. Kunimatsu
- Department of Orthodontics; Applied Life Sciences; Hiroshima University; Institute of Biomedical & Health Sciences; Hiroshima Japan
| | - Y. Yoshimi
- Department of Orthodontics; Applied Life Sciences; Hiroshima University; Institute of Biomedical & Health Sciences; Hiroshima Japan
| | - N. Hirose
- Department of Orthodontics; Applied Life Sciences; Hiroshima University; Institute of Biomedical & Health Sciences; Hiroshima Japan
| | - T. Awada
- Department of Orthodontics; Applied Life Sciences; Hiroshima University; Institute of Biomedical & Health Sciences; Hiroshima Japan
| | - M. Miyauchi
- Department of Oral Maxillofacial and Pathobiology; Basic Life Sciences; Hiroshima University; Institute of Biomedical & Health Sciences; Hiroshima Japan
| | - T. Takata
- Department of Oral Maxillofacial and Pathobiology; Basic Life Sciences; Hiroshima University; Institute of Biomedical & Health Sciences; Hiroshima Japan
| | - W. Li
- Department of Orofacial Sciences; University of California; San Francisco CA USA
| | - L. Zhu
- Department of Orofacial Sciences; University of California; San Francisco CA USA
| | - P.K. Denbesten
- Department of Orofacial Sciences; University of California; San Francisco CA USA
| | - K. Tanimoto
- Department of Orthodontics; Applied Life Sciences; Hiroshima University; Institute of Biomedical & Health Sciences; Hiroshima Japan
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45
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Sato T, Takata T, Nebashi T, Murakawa S, Mizuno K, Akimoto N. 696 MEK and BRAF inhibitors augment the production and accumulation of sebum in hamster sebocytes. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Fujimoto N, Tanaka H, Sakurai Y, Takata T, Kondo N, Narabayashi M, Nakagawa Y, Watanabe T, Kinashi Y, Masunaga S, Maruhashi A, Ono K, Suzuki M. Improvement of depth dose distribution using multiple-field irradiation in boron neutron capture therapy. Appl Radiat Isot 2015; 106:134-8. [PMID: 26282566 DOI: 10.1016/j.apradiso.2015.07.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/10/2015] [Accepted: 07/25/2015] [Indexed: 10/23/2022]
Abstract
It is important that improvements are made to depth dose distribution in boron neutron capture therapy, because the neutrons do not reach the innermost regions of the human body. Here, we evaluated the dose distribution obtained using multiple-field irradiation in simulation. From a dose volume histogram analysis, it was found that the mean and minimum tumor doses were increased using two-field irradiation, because of improved dose distribution for deeper-sited tumors.
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Affiliation(s)
- N Fujimoto
- Kyoto University Research Reactor Institute, Japan
| | - H Tanaka
- Kyoto University Research Reactor Institute, Japan.
| | - Y Sakurai
- Kyoto University Research Reactor Institute, Japan
| | - T Takata
- Kyoto University Research Reactor Institute, Japan
| | - N Kondo
- Kyoto University Research Reactor Institute, Japan
| | | | - Y Nakagawa
- Kyoto University Research Reactor Institute, Japan
| | - T Watanabe
- Kyoto University Research Reactor Institute, Japan
| | - Y Kinashi
- Kyoto University Research Reactor Institute, Japan
| | - S Masunaga
- Kyoto University Research Reactor Institute, Japan
| | - A Maruhashi
- Kyoto University Research Reactor Institute, Japan
| | - K Ono
- Kyoto University Research Reactor Institute, Japan
| | - M Suzuki
- Kyoto University Research Reactor Institute, Japan
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47
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Nakamura T, Ushigome H, Takata T, Nakao T, Harada S, Koshino K, Suzuki T, Ito T, Nobori S, Yoshimura N. Histopathologic Impacts of Everolimus Introduction on Kidney Transplant Recipients. Transplant Proc 2015; 47:630-4. [DOI: 10.1016/j.transproceed.2014.09.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 09/29/2014] [Indexed: 10/23/2022]
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48
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Takeuchi M, Sakasai-Sakai A, Takata T, Ueda T, Takino J, Tsutsumi M, Hyogo H, Yamagishi S. Serum levels of toxic AGEs (TAGE) may be a promising novel biomarker in development and progression of NASH. Med Hypotheses 2015; 84:490-3. [PMID: 25697114 DOI: 10.1016/j.mehy.2015.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 02/04/2015] [Indexed: 12/13/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) ranges from simple steatosis to nonalcoholic steatohepatitis (NASH), leads to fibrosis and potentially cirrhosis, liver failure, and hepatocellular carcinoma, and is one of the most common causes of liver disease worldwide. NAFLD has also been implicated in other medical conditions such as insulin resistance, obesity, metabolic syndrome, hyperlipemia, hypertension, cardiovascular disease, and diabetes. Continuous hyperglycemia has been implicated in the pathogenesis of diabetic micro- and macro-vascular complications via various metabolic pathways, and numerous hyperglycemia-induced metabolic and hemodynamic conditions exist, including the increased generation of various types of advanced glycation end-products (AGEs). We recently demonstrated that glyceraldehyde-derived AGEs (Glycer-AGEs), the predominant components of toxic AGEs (TAGE), played an important role in the pathogenesis of angiopathy in diabetic patients. Moreover, a growing body of evidence suggests that the interaction between TAGE and the receptor for AGEs may alter intracellular signaling, gene expression, and the release of pro-inflammatory molecules and also elicits the generation of oxidative stress in numerous types of cells including hepatocytes and hepatic stellate cells. Serum levels of TAGE were significantly higher in NASH patients than in those with simple steatosis and healthy controls. Moreover, serum levels of TAGE inversely correlated with adiponectin (adiponectin is produced by adipose tissue and is an anti-inflammatory adipokine that can increase insulin sensitivity). Furthermore, immunohistochemical staining of TAGE showed intense staining in the livers of patients with NASH. Serum levels of TAGE may be a useful biomarker for discriminating NASH from simple steatosis. The administration of atorvastatin (10 mg daily) for 12 months significantly improved NASH-related metabolic parameters and significantly decreased serum levels of TAGE. The steatosis grade and NAFLD activity score were also significantly improved. These results demonstrated that atorvastatin decreased the serum levels of TAGE in NASH patients with dyslipidemia and suggest the usefulness of TAGE as a biomarker for the attenuation of NASH. Serum levels of TAGE were significantly higher in non-B or non-C hepatocellular carcinoma (NBNC-HCC) patients than in NASH subjects without HCC or control subjects. TAGE may be involved in the pathogenesis of NBNC-HCC, and could, therefore, be a biomarker that could discriminate NBNC-HCC from NASH. We propose that serum levels of TAGE are promising novel targets for the diagnosis of and therapeutic interventions against NASH.
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Affiliation(s)
- M Takeuchi
- Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan.
| | - A Sakasai-Sakai
- Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | - T Takata
- Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | - T Ueda
- Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | - J Takino
- Laboratory of Biochemistry, Faculty of Pharmaceutical Sciences, Hiroshima International University, Hiroshima, Japan
| | - M Tsutsumi
- Department of Hepatology, Kanazawa Medical University, Ishikawa, Japan
| | - H Hyogo
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - S Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Fukuoka, Japan
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49
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Kimura M, Makio K, Hara K, Hiruma W, Fujita Y, Takata T, Nishio K, Ono N. A Supramolecular Substance, [2] Rotaxane, Induces Apoptosis in Human Molt-3 Acute Lymphoblastic Leukemia Cells. Drug Res (Stuttg) 2014; 65:614-6. [PMID: 25463596 DOI: 10.1055/s-0034-1395628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The antitumor effects of a supramolecular substance, the [2] rotaxane (TRO-A0001), and its molecular mechanisms were investigated. TRO-A0001 suppressed the proliferation of cultured human Molt-3 acute lymphoblastic leukemia cells for 12-72 h in a dose-dependent manner. Based on flow cytometry, TRO-A0001 clearly induced apoptosis after 24 h. The mitochondrial membrane potential disappeared after treatment with 1.0 µM of TRO-A0001. Expression of the cleaved forms of capase-9 and caspase-3 was significantly increased in cells exposed to TRO-A0001, whereas the expression of XIAP, a type of inhibitor of apoptosis family, was decreased. These results suggest that [2] rotaxane TRO-A0001 may be a highly promising new antitumor medicine.
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Affiliation(s)
- M Kimura
- Medicinal-Informatics and Research Unit, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan
| | - K Makio
- Medicinal-Informatics and Research Unit, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan
| | - K Hara
- Medicinal-Informatics and Research Unit, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan
| | - W Hiruma
- Medicinal-Informatics and Research Unit, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan
| | - Y Fujita
- Department of Genome Biology, Kinki University School of Medicine, Osaka, Japan
| | - T Takata
- Department of Organic and Polymeric Materials, Tokyo Institute of Technology, Tokyo, Japan
| | - K Nishio
- Department of Genome Biology, Kinki University School of Medicine, Osaka, Japan
| | - N Ono
- Medicinal-Informatics and Research Unit, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan
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50
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Maru S, Ishigaki Y, Shinohara N, Takata T, Tomosugi N, Nonomura K. Reply by authors. J Urol 2013; 190:1957. [PMID: 24266051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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