1.The Relation between the Number, Kind and Total Amount of Psychoactive Drugs Used and the Outcome of Dysphagia in Patients with Psychiatric Disorders
Tomoyuki NAKAMURA ; Ichiro FUJISHIMA ; Norimasa KATAGIRI ; Ritsu NISHIMURA ; Naoki KATAYAMA ; Koji WATANABE
The Japanese Journal of Rehabilitation Medicine 2013;50(9):743-750
Objective : To examine the relation between psychoactive drugs and the outcome of dysphagia in patients with psychiatric disorders. Methods : We examined 53 inpatients who were prescribed speech therapy in the psychiatry ward of our hospital from January 2011 to April 2012. We categorized the patients into a poor outcome group and a good outcome group by the necessity for alternative nutrition at discharge and analyzed the number and kind of typical antipsychotic, atypical antipsychotic, hypnotic, antidepressant and mood stabilizer, total amount of typical antipsychotic, atypical antipsychotic used at admission and at discharge, sex, psychiatric disorder, central nervous system disease, aspiration pneumonia, duration of hospitalization, psychiatric disorder disease period, speech therapy intervention period and GAF scale at admission. Results : The outcome of dysphagia had a significant relation with the number and kind of antipsychotic used, especially typical antipsychotic used at admission. The good outcome group had a higher total amount of antipsychotic use, especially atypical antipsychotics. Conclusion : Long-term practical oral intake should not comprise antipsychotic polypharmacy, especially typical antipsychotics before onset of dysphagia, but should instead consist of a monopharmacy approach with atypical antipsychotics.
2.A Case of Coronary Artery Bypass Grafting Using Arterial Grafts in a Patient with Systemic Lupus Erythematosus and Review of the Literature
Hisashi Sakaguchi ; Ryuji Kunitomo ; Ichiro Ideta ; Yukihiro Katayama ; Ryo Hirayama ; Michio Kawasuji ; Mutsuo Tanaka
Japanese Journal of Cardiovascular Surgery 2004;33(2):90-93
We report a case of coronary artery bypass grafting (CABG) in a patient with systemic lupus erythematosus (SLE). A 24-year-old woman with SLE had been treated with steroids and immunosuppressive agents for 7 years. The patient was admitted to Kumamoto University Hospital for the management of unstable angina. CABG was successfully performed using bilateral internal thoracic arteries and postoperative 3D-CT demonstrated good patency of both arterial grafts. The patient experienced no significant postoperative complications, and has remained well to date (8 months postdischarge).
3.A Case Report of Double Valve Replacement for Mucopolysaccharosis with Chest Pain Attack and Severe Heart Failure
Yukihiro Katayama ; Ryuji Kunitomo ; Kentaro Takaji ; Ryusuke Suzuki ; Hisashi Sakaguchi ; Ichiro Ideta ; Michio Kawasuji
Japanese Journal of Cardiovascular Surgery 2005;34(4):317-320
We report a successfully treated case of double valve replacement for mucopolysaccharosis in a 27-year-old woman. Mucopolysaccharosis had been suspected since she was aged 11. Symptoms of heart failure and chest pain suggested valvular disease and she was referred to us. Echocardiography, aortography and cardioangiography showed aortic regurgitation (grade IV/IV) and mitral regurgitation (grade III/IV). She received double valve replacement and was discharged on the 38th postoperative day with symptom improvement. Although urinalysis was positive for heparan-sulfate, this case could not be diagnosed definitively as mucopolysaccharosis due to normal lymphocytic enzyme-activity. However, large amounts of mucopolysaccharoid deposits were present in her removed aortic and mitral valve leaflets, and her clinical picture corresponded with mucopolysaccharosis. Thus, it was considered that her ultimate diagnosis was combined cardiac valvular disease due to mucopolysaccharosis.
4.Cardiac Tamponade due to Detachment of the Aortic Valve Commissure
Hideyuki Uesugi ; Touitsu Hirayama ; Shoichiro Hagiwara ; Ichiro Ideta ; Takashi Oshitomi ; Kentaro Takaji ; Yukihiro Katayama ; Toshiharu Sassa ; Kazufumi Omori ; Hidetaka Murata
Japanese Journal of Cardiovascular Surgery 2015;44(3):148-150
A 68-year-old man was taken to our hospital by ambulance due to syncope. He was in shock with cardiac tamponade. Pericardial drainage was performed. Aortic valve regurgitation gradually increased and surgery was performed at 25 days after onset. Surgical finding showed that there was a detachment of the commissure between the right and non coronary cusps of the aortic valve. An intimal tear was detected in the same place and aortic root replacement was required. The patient had a good recovery and he was discharged 14 days after surgery.
5.A Rare Case of Annular Pustular Psoriasis Associated with Pemphigus Foliaceus.
Kenichi KATO ; Takaaki HANAFUSA ; Ken IGAWA ; Motohiro TATSUMI ; Yuji TAKAHASHI ; Takashi YAMANAKA ; Ichiro KATAYAMA
Annals of Dermatology 2014;26(2):260-261
No abstract available.
Pemphigus*
;
Psoriasis*
6.Morphea on the Breast after a Needle Biopsy.
Noriko ARASE ; Ken IGAWA ; Satoko SENDA ; Mika TERAO ; Hiroyuki MUROTA ; Ichiro KATAYAMA
Annals of Dermatology 2011;23(Suppl 3):S408-S410
Localized scleroderma (morphea) usually develops spontaneously, but the precise mechanisms underlying disease development are obscure. However, a significant number of cases suggest that morphea is induced by external stimuli. Herein, we report a case of morphea that developed after a needle biopsy.
Biopsy, Needle
;
Breast
;
Needles
;
Scleroderma, Localized
8.Immunohistochemical Analysis of Interleukin-17 Producing T Helper Cells and Regulatory T Cells Infiltration in Annular Erythema Associated with Sjogren's Syndrome.
Saori ITOI ; Atsushi TANEMURA ; Mamori TANI ; Shun KITABA ; Mika TERAO ; Hiroyuki MUROTA ; Naoki OISO ; Ichiro KATAYAMA
Annals of Dermatology 2014;26(2):203-208
BACKGROUND: Peculiar erythema known as annular erythema associated with Sjogren's syndrome (AESS) can be differentiated from autoimmune annular erythema and subacute cutaneous lupus erythematosus, both clinically and histologically. However, there are no detailed investigations on immune competent cells infiltration. OBJECTIVE: Preferential infiltration of interleukin-17-producing T helper (Th17) cells and regulatory T (Treg) cells into the labial salivary gland is reported to play a role in maintaining mucoepithelitis in patients with Sjogren's syndrome. In this study, we evaluated Th17 and Treg cell infiltration into the lesional skin of AESS. METHODS: We analyzed the numbers and infiltration patterns of Th17 and FoxP3 (+) Treg cells in seven cases of AESS using immunohistochemistry. Seven patients with systemic lupus erythematosus (SLE), atopic dermatitis (AD) and psoriasis vulgaris (PV), which are representatives of Th17 cell-involved skin disorders, were enrolled as disease controls. RESULTS: Periappendageal and epidermal changes, such as follicular plugging and liquefaction, were evident in the annular erythema of SLE, not AESS, tissue samples. In AESS tissue samples, dense perivascular and periappendageal infiltration of lymph cells was observed in the middle-to-deep dermis, as previously described, in contrast to the superficial infiltration pattern observed in both AD and PV samples. While the total number of infiltrated lymphocytes was similar between AESS and SLE tissue samples, Th17 cells were found to be preferentially infiltrated in the middle-to-deep dermis in AESS samples. CONCLUSION: These results suggest that an increased number and distribution of infiltration of Th17 cells is a preferential feature of AESS, rather than a characteristic feature of annular erythema of SLE.
Dermatitis, Atopic
;
Dermis
;
Erythema*
;
Humans
;
Immunohistochemistry
;
Interleukin-17*
;
Lupus Erythematosus, Cutaneous
;
Lupus Erythematosus, Systemic
;
Lymphocytes
;
Psoriasis
;
Salivary Glands
;
Sjogren's Syndrome*
;
Skin
;
T-Lymphocytes, Helper-Inducer*
;
T-Lymphocytes, Regulatory*
;
Th17 Cells
9.Psoriatic Arthritis Complicating Systemic Sclerosis: Possible Involvement of M2 Macrophages.
Toshifumi YAMAOKA ; Tomoko INOUE ; Shun KITABA ; Akinori YOKOMI ; Hiroaki AZUKIZAWA ; Mika TERAO ; Hiroyuki MUROTA ; Mari HIGASHIYAMA ; Ichiro KATAYAMA
Annals of Dermatology 2015;27(5):631-632
No abstract available.
Arthritis, Psoriatic*
;
Macrophages*
;
Scleroderma, Systemic*
10.Impact of Jumihaidokuto (Shi-Wei-Bai-Du-Tang) on Treatment of Chronic Spontaneous Urticaria: A Randomized Controlled Study.
Hiroyuki MUROTA ; Hiroaki AZUKIZAWA ; Ichiro KATAYAMA
Chinese journal of integrative medicine 2019;25(11):820-824
OBJECTIVE:
To study the effect of Jumihaidokuto (Shi-Wei-Bai-Du-Tang, ) in the management of chronic spontaneous urticaria.
METHODS:
A randomized two-arm, parallel group study was conducted to compare the effect of Jumihaidokuto (6 g daily) with a control for 8 weeks. Concomitant therapy (e.g., antihistamines) was continued. Twenty-one subjects with severe chronic urticaria were enrolled in this study. The primary treatment outcome was the severity score proposed by the Japanese Dermatological Association. Secondary outcomes were quality of life (Skindex-16), itch intensity (Visual Analogue Scale), and patients' subjective disability due to wheal or itch. After the subjects were randomly assigned to groups by block randomization, 10 received Jumihaidokuto, and 11 did not. All subjects had already taken antihistamines.
RESULTS:
Improvement was significant when comparing the severity score of the Jumihaidokuto group with that of the control group (P<0.01). Skindex-16 values for both groups gradually decreased in the same fashion.
CONCLUSION
Concomitant use of Jumihaidokuto with antihistamine was more effective than antihistamine alone in the management of chronic idiopathic urticaria. (Trial Registration No. UMIN000007251).