Impaired anticipatory hand movement during a loading task in patients with schizophrenia

13301甲第4122号博士（保健学）金沢大学博士論文要旨Abstract 以下に掲載：金沢大学つるま保健学会誌 38(1) pp.21-28 2014. 金沢大学つるま保健学会. 共著者：菊池 ゆひ, 米田 貢, 少作 隆

Efficacy of the New Double-Layer Stent for Unresectable Distal Malignant Biliary Obstruction: A Single-Center Retrospective Study

Background and Aims. For distal malignant biliary obstruction in cases with short life expectancy, occlusion of plastic stents (PSs) does not usually occur before death, and the application of such a procedure is considered adequate from the viewpoint of cost-effectiveness. Methods and Setting. A new commercially available DLS with side holes, a conventional DLS, and, uncovered self-expanding metal stents (SEMSs) were retrospectively evaluated in patients with jaundice due to unresectable distal malignant biliary obstruction. Results. A total of 64 patients received endoscopic biliary stenting (23 patients with the new DLS, 24 patients with conventional DLS, and 17 patients with uncovered SEMS) from December 2002 to August 2009. Median patency time was found to be 198 days for the new DLS group and 99 days for the conventional DLS group, revealing a significant difference between devices. There was, however, no significant difference in median patency time between the new DLS and the uncovered SEMS (198 days versus 344 days). Conclusion. The new DLS is efficient and safe and may be considered the first choice for unresectable distal malignant obstruction in cases with short life expectancy

Expert-Performed Endotracheal Intubation-Related Complications in Trauma Patients: Incidence, Possible Risk Factors, and Outcomes in the Prehospital Setting and Emergency Department

The aim of this study was to determine complication rates and possible risk factors of expert-performed endotracheal intubation (ETI) in patients with trauma, in both the prehospital setting and the emergency department. We also investigated how the occurrence of ETI-related complications affected the survival of trauma patients. This single-center retrospective observational study included all injured patients who underwent anesthesiologist-performed ETI from 2007 to 2017. ETI-related complications were defined as hypoxemia, unrecognized esophageal intubation, regurgitation, cardiac arrest, ETI failure rescued by emergency surgical airway, dental trauma, cuff leak, and mainstem bronchus intubation. Of the 537 patients included, 23.5% experienced at least one complication. Multivariable logistic regression analysis revealed that low Glasgow Coma Scale Score (adjusted odds ratio [AOR], 0.93; 95% confidence interval [CI], 0.88–0.98), elevated heart rate (AOR, 1.01; 95% CI, 1.00–1.02), and three or more ETI attempts (AOR, 15.71; 95% CI, 3.37–73.2) were independent predictors of ETI-related complications. We also found that ETI-related complications decreased the likelihood of survival of trauma patients (AOR, 0.60; 95% CI, 0.38–0.95), independently of age, male sex, Injury Severity Score, Glasgow Coma Scale Score, and off-hours presentation. Our results suggest that airway management in trauma patients carries a very high risk; this finding has implications for the practice of airway management in injured patients

Diagnostic approach for patients with unidentified fever according to the classical criteria of fever of unknown origin in the field of autoimmune disorders

ArticleImmunological medicine. 42(4): 176-184 (2019)journal articl

マラリア感染と治療を繰り返すことにより制御性のCD19陽性B細胞が生じ実験的脳マラリアの発症が抑制される

In African endemic area, adults are less vulnerable to cerebral malaria than children probably because of acquired partial immunity or semi-immune status. Here, we developed an experimental cerebral malaria (ECM) model for semi-immune mice. C57BL/6 (B6) mice underwent one, two and three cycles of infection and radical treatment (1-cure, 2-cure and 3-cure, respectively) before being finally challenged with 104 Plasmodium berghei ANKA without treatment. Our results showed that 100% of naive (0-cure), 67% of 1-cure, 37% of 2-cure and none of 3-cure mice succumbed to ECM within 10 days post challenge infection. In the protected 3-cure mice, significantly higher levels of plasma IL-10 and lower levels of IFN-γ than the others on day 7 post challenge infection were observed. Major increased lymphocyte subset of IL-10 positive cells in 3-cure mice was CD5(?)CD19(+) B cells. Passive transfer of splenic CD19(+) cells from 3-cure mice protected naive mice from ECM. Additionally, aged 3-cure mice were also protected from ECM 12 and 20 months after the last challenge infection. In conclusion, mice became completely resistant to ECM after three exposures to malaria. CD19(+) B cells are determinants in protective mechanism of semi-immune mice against ECM possibly via modulatory IL-10 for pathogenic IFN-γ production.長崎大学学位論文 学位記番号:博(医歯薬)甲第611号 学位授与年月日:平成25年8月7日Author： Lam Quoc Bao , Nguyen Tien Huy , Mihoko Kikuchi, Tetsuo Yanagi, Masachika Senba, Mohammed Nasir Shuaibu, Kiri Honma, Katsuyuki Yui, Kenji HirayamaCitation: PLoS ONE, 8(5), e64836; 2013Nagasaki University (長崎大学)課程博

Long-term maintenance of the mucosal healing induced by azacitidine therapy in a patient with intestinal Behçet's-like disease accompanied with myelodysplastic syndrome involving trisomy 8

ArticleImmunological medicine. 42(3): 135-141 (2019)journal articl

Effects of clozapine and N-desmethylclozapine on synaptic transmission at hippocampal inhibitory and excitatory synapses

Clozapine is the first atypical antipsychotic, and improves positive and negative symptoms of many patients with schizophrenia resistant to treatment with other antipsychotic agents. Clozapine induces minimal extrapyramidal side effects, but is more often associated with seizures. A large number of studies have been conducted to elucidate pharmacological profiles of clozapine and its major active metabolite, N-desmethylclozapine (NDMC). However, there are only a limited number of electrophysiological studies examining their effects on synaptic transmission. In this study, we examined effects of clozapine and NDMC on synaptic transmission by measuring inhibitory and excitatory postsynaptic currents in rat cultured hippocampal neurons. We found that clozapine and NDMC have qualitatively similar actions. They depressed the inhibitory transmission at 1-30 μM, and the excitatory transmission at 30 μM, the former being much more sensitive. The depression of IPSCs by 30 μM of these drugs was associated with an increase in the paired-pulse ratio. The GABA-induced currents were suppressed by these drugs, but less sensitive than IPSCs. The AMPA-induced currents were slightly potentiated by these drugs at 30 μM. At 30 μM, clozapine and NDMC slightly suppressed Ca2+ and Na+ channels. These results strongly suggest that clozapine and NMDC depress the inhibitory synaptic transmission mainly by antagonizing postsynaptic GABAA receptors, but at higher concentrations additionally by acting on presynaptic site, possibly in part through inhibition of presynaptic Ca2+ and Na+ channels. Preferential depression of inhibitory synaptic transmission by clozapine and NDMC might contribute to therapeutic actions and/or side-effects of clozapine. © 2011 Elsevier B.V. All rights reserved

若年健常女性の疲労や気分の自己評価尺度および唾液コルチゾール濃度に対する手工芸の影響

　作業療法における対象者の感情表出はポジティブな面とネガティブな面があり，セラピストが対象者に対応するうえで無視することのできない主観的評価である。作業療法では様々な作業・活動を利用し，感情表出の変化をプログラムの効果として検討することが多い。そのため，これらの効果を科学的な根拠に基づき示すことは重要である。　そこで今回，作業療法の治療手段の１ つである手工芸のうち「段通」を課題とし，若年健常女性１６ 名を対象に，疲労感や気分のVisual Analog Scale とストレスホルモンの１つコルチゾールに対する効果を検討した。作業は１ 回６０ 分とし，集団または個別の環境で各８ 回行った。集団環境では作業後に身体的疲労度は増強，気分は改善，唾液コルチゾール濃度は低下した。個別環境では身体的疲労度，気分および唾液コルチゾール濃度に有意な変化は認めなかった。また，気分と唾液コルチゾール濃度の間にやや相関関係があった。以上より，手工芸は気分の改善に有効だが，その効果は作業環境に影響される可能性が示唆された。　Craft activities are commonly used in occupational therapy, especially for patients withmental disorders. We examined the effects of the “Dantsu” craft on mood and stressusing both subjective (visual analog scale: VAS) and objective (salivary cortisol) measures.A total of 16 young healthy female volunteers participated in the experiment. The craftactivity (1 hour, once a day) was repeated eight times for groups (four persons in aroom) and individuals (one person in a room). In the group participants, the craft activitysignificantly increased physical fatigue (VAS), improved mood (VAS), and decreased thelevel of salivary cortisol. In the individual participants, the craft activity had no significanteffect on physical fatigue, mood and salivary cortisol. Mood (VAS) and salivary cortisollevels had a significant correlation. These results show that craft activities are effective inimproving the mood and stress of individuals, at least under some conditions