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.Understanding of epigenetics and dna methylation
Jung Hwan OH ; Nishimura ICHIRO
Journal of the Korean Association of Maxillofacial Plastic and Reconstructive Surgeons 2008;30(2):205-212
Coat Protein Complex I
;
Comparative Genomic Hybridization
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Diabetes Mellitus, Type 1
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DNA
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DNA Methylation
;
DNA Transposable Elements
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Epigenomics
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Fluorescence
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Genetic Variation
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Genome, Human
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Heart Diseases
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Humans
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In Situ Hybridization
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Polymorphism, Single Nucleotide
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Segmental Duplications, Genomic
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Tandem Repeat Sequences
3.Combined Treatment With Radiotherapy and Immunotherapy for Isocitrate Dehydrogenase Mutant Brainstem Glioma in Adult: A Case Report
Takayuki MORIMOTO ; Ryosuke MATSUDA ; Tsutomu NAKAZAWA ; Fumihiko NISHIMURA ; Ichiro NAKAGAWA
Brain Tumor Research and Treatment 2022;10(2):129-133
Brainstem gliomas are not common in adults, and the treatment strategies and their outcomes are limited. Immunotherapy is emerging as a promising new modality for the treatment of these gliomas. Here, we report the first case of brainstem glioma treated with a combination of radiotherapy and autologous formalin-fixed tumor vaccine (AFTV). A 32-year-old man presented with left facial numbness and right hemiparesis, and was referred to our department. MRI and open biopsy indicated brainstem glioma, and he was specifically diagnosed with isocitrate dehydrogenase 1-mutant diffuse astrocytoma of WHO grade II. He was treated with stereotactic radiotherapy followed by AFTV three months later. MRI conducted at 42 months after the combination therapy showed a 91% decrease in tumor volume, and the regression was maintained for 5 years. Thus, combination treatment with radiotherapy and immunotherapy may prove to be a promising alternative for the treatment of brainstem glioma.
4.A case of autoimmune enteropathy with CTLA4 haploinsufficiency
Haruka MIYAZAKI ; Namiko HOSHI ; Michitaka KOHASHI ; Eri TOKUNAGA ; Yuna KU ; Haruka TAKENAKA ; Makoto OOI ; Nobuyuki YAMAMOTO ; Suguru UEMURA ; Noriyuki NISHIMURA ; Kazumoto IIJIMA ; Keisuke JIMBO ; Tsubasa OKANO ; Akihiro HOSHINO ; Kohsuke IMAI ; Hirokazu KANEGANE ; Ichiro KOBAYASHI ; Yuzo KODAMA
Intestinal Research 2022;20(1):144-149
Autoimmune enteropathy (AIE) is a rare disease, characterized by intractable diarrhea, villous atrophy of the small intestine, and the presence of circulating anti-enterocyte autoantibodies. Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome, and mutations in FOXP3, which is a master gene of regulatory T cells (Tregs), are major causes of AIE. Recent studies have demonstrated that mutations in other Treg-associated genes, such as CD25 and CTLA4, show an IPEX-like phenotype. We present the case of a 13-year-old girl with CTLA4 haploinsufficiency, suffering from recurrent immune thrombocytopenic purpura and intractable diarrhea. We detected an autoantibody to the AIE-related 75 kDa antigen (AIE-75), a hallmark of the IPEX syndrome, in her serum. She responded well to a medium dose of prednisolone and a controlled dose of 6-mercaptopurine (6-MP), even after the cessation of prednisolone administration. Serum levels of the soluble interleukin-2 receptor and immunoglobulin G (IgG) were useful in monitoring disease activity during 6-MP therapy. In conclusion, autoimmune-mediated mechanisms, similar to the IPEX syndrome, may be involved in the development of enteropathy in CTLA4 haploinsufficiency. Treatment with 6-MP and monitoring of disease activity using serum levels of soluble interleukin-2 receptor and IgG is suggested for such cases.