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Objective To identify factors affecting adherence to medication, a subjective questionnaire survey was administered to schizophrenia patients regarding the prescribed antipsychotic formulations. Methods We evaluated the patients’ satisfaction and dissatisfaction with prescribed antipsychotic formulations, and patients answered the Drug Attitude Inventory-10 Questionnaire (DAI-10). Inclusion criteria for patients are as follows age between 20 and 75 years and taking antipsychotic agents containing the same ingredients and formulations, for at least 1 month. Results In total, 301 patients answered the questionnaire survey. Tablets were found to be the most commonly used antipsychotic formulations among schizophrenia patients (n = 174, 57.8%), followed by long-acting injections (LAIs, n = 93, 30.9%). No significant differences in the formulation satisfaction level and DAI-10 scores were observed between all formulations. Formulations, except for LAI, were selected by physicians in more than half of the patients. Patients who answered “Decided by consultation with physicians” had significantly higher satisfaction levels and DAI-10 scores compared to those who answered “Decided by physicians” (4.11 ± 0.77 vs. 3.80 ± 1.00, p = 0.0073 and 6.20 ± 3.51 vs. 4.39 ± 4.56, p < 0.001, respectively). Satisfaction levels moderately correlated with DAI-10 scores (r = 0.48, p < 0.001). Conclusion No formulation had a high satisfaction level in all patients, and it is important to be reflect the patients’ individual preferences in pharmacotherapy. Shared decision-making in the selection of the formulations is seen to be useful for improving medication adherence.

Objectives: To explore what the student participants learned and how they felt about the use of three educational settings, namely, face-to-face workshop setting, asynchronous and synchronous online learning environments and interactions with outpatients in a real-world clinical setting in a hybrid interprofessional education course. Methods: This qualitative study used semi-structured in-depth interviews with healthcare undergraduate student participants in a course comprising workshops in three educational settings. A total of 15 healthcare undergraduate students, which included four medical, three pharmacy, five nursing and three nutrition students, completed this IPE course. All students agreed to participate in the study. We conducted four focus groups selected using convenient sampling. Focus group transcripts were analysed using the 'Steps for Coding and Theorization' qualitative data analysis method. We investigated the students' perception through the experience of three educational settings in the hybrid interprofessional education course. Results: The students recognised that this course had three types of educational spaces, namely, real, semi-real and unreal. Then, the positive changes in the awareness of students are trained in recognition of the patient perspective, the recognition of the roles discharged by the other professions and the recognition of the functions of their own profession after experiencing the educational spaces designated for this course. Conclusions: The repeated experience of participants to real, semi-real and unreal educational spaces promoted changes over time in the students' awareness of interprofessional competencies with respect to patient-centred care and ameliorated their readiness to undertake interprofessional tasks.

Objective The present study aimed to elucidate the effect of switching from branched-chain amino acid granules to branched-chain amino acid-enriched nutrient in patients with cirrhosis with hypoalbuminemia. Methods Twenty-six patients with cirrhosis with hypoalbuminemia despite treatment with branched-chain amino acid granules containing 12 g of branched-chain amino acid were enrolled in the prospective study. The branched-chain amino acid-enriched nutrient and control groups were composed of 16 and 10 patients, respectively. The patients in branched-chain amino acid-enriched nutrient group switched to branched-chain amino acid-enriched nutrient mixture containing 12.2 g of branched-chain amino acid and 410 kcal with a half of it consumed as a late evening snack, and the patients in the control group continued branched-chain amino acid granules. Laboratory data related to nutrition parameter were assessed at baseline, 3 months after baseline, and at 6 months after baseline. Results Two patients were withdrawn; hence, nine and 15 patients in the branched-chain amino acid granules and branched-chain amino acid-enriched nutrient groups, respectively, were subjected to full analysis. Serum albumin levels and total lymphocyte counts in both groups did not change in the study period. The branched-chain amino acid-to-tyrosine ratio in the branched-chain amino acid-enriched nutrient group significantly increased from baseline to 6 months after baseline (P = 0.030), whereas that in the control group did not increase. Conclusion Switching from branched-chain amino acid granules to branched-chain amino acid-enriched nutrients improves branched-chain amino acid-to-tyrosine ratio in patients with cirrhosis with hypoalbuminemia.

In Japan, drug therapy for schizophrenia is characterized by high-dose antipsychotic polypharmacy, which is an uncommon approach internationally. In this study, we reduced the number of antipsychotic agents in 5 patients using the Safety Correction of High-dose Antipsychotic Polypharmacy (SCAP) method and conducted a survey regarding treatment satisfaction. The switch from polypharmacy to monotherapy was achieved in all patients. There was no deterioration in psychiatric symptoms, and adverse reactions were reduced. Three of the subjects were satisfied with the decrease in the number of antipsychotic agents and dose-reduction. These results suggest that the SCAP method is a safe and useful method that can be applied in a clinical setting.

Objective To improve poor medication adherence in schizophrenic patients, long-acting injectable (LAI) antipsychotics are used. However, it has not yet become common in Japan. Recently, aripiprazole LAI was approved for alternative injection into the deltoid muscle in addition to the gluteal muscle. The acceptance for the proposal to switch from gluteal to deltoid injections of aripiprazole LAI was investigated. Methods The subjects were 32 outpatients with schizophrenia who had continuously received aripiprazole LAI administration into the gluteal muscle for ≥ 6 months. In the patients who had continued deltoid injection for 3 months after switching, the changes in the pain and shame in comparison with gluteal injections were evaluated. Results Switching to the deltoid injection was chosen by 17 out of 32 patients. Three months later, 9 patients were still receiving deltoid injections with highly rated satisfaction. The main reasons for switching to deltoid injections included the pain and shame associated with gluteal injections. The main reason for returning to the gluteal injection was the pain experienced from the injection in the deltoid. Results The option to select the injected area was based on the amount of pain in the deltoid and gluteal sites, leading to the widespread use of aripiprazole LAI.

Long-acting injection (LAI) is a drug administration method that reduces symptoms and prevents recurrence or relapse of schizophrenia. We examined factors related to the continuation of LAI treatment. The study population included patients with schizophrenia who were undergoing LAI treatment involving risperidone, paliperidone, or aripiprazole at Fujita Health University Hospital between October 2009 and June 2017. We assessed the continuation rate of LAI treatment at six months, and collected patient characteristics such as medication history. Furthermore, we classified patients into two clusters according to the reason for introducing LAI based on a previous study (Prog. Neuropsychopharmacol. Biol. Psychiatry, 2008, Heres et al.). The study included 82 patients (mean age, 44.9 ± 15.0 years); the continuation rate of LAI after six months was 63.4%. Factors that affected LAI continuation included cluster II [adjusted odds ratio (OR): 5.74, p = 0.017], switching from the same component as LAI (adjusted OR: 7.13, p < 0.001), and diazepam conversion rate (adjusted OR: 0.88, p < 0.001). LAI significantly improved the continuation rate of treatment in the patient group belonging to cluster II. Furthermore, based on other factors and reasons for discontinuation, LAI should be preferably commenced in patients with a more stable condition.

BackgroundStigma associated with mental disorders is rooted among many pharmacists, and represents a major barrier to patient support in community-based psychiatry. In the current study, we firstly developed an assessment scale that is specifically designed to assess the level of stigma that pharmacists may have toward patients with schizophrenia, and then examined the effects of reducing stigma with an educational program that focuses on communication with schizophrenic patients using a newly developed Stigma Scale towards Schizophrenia for Community Pharmacists (SSCP).MethodsSSCP was developed by exploratory factor analysis with promax rotation based on responses from 822 randomly selected community pharmacists. Furthermore, a randomized controlled trial was conducted for 115 community pharmacists to clarify the effects of reducing the stigma of schizophrenia using an educational program for them with a focus on communication with patients with schizophrenia. Participants were individually allocated to two groups: a lecture group (56; only attending a lecture on schizophrenia) or communication group (59; communicating with patients and attending the lecture). The stigma assessment using SSCP was conducted immediately before and after the educational intervention.ResultsA total of 4 factors and 27 items were extracted from the exploratory factor analysis as SSCP.Cronbach’s α of SSCP was 0.89; specifically, Cronbach’s α for social distance at work (factor I), recognition of patients with schizophrenia (factor II), self-disclosure (factor III), and social distance in daily life (factor IV) were 0.88, 0.76, 0.62, and 0.62, respectively. Educational program-related changes of the median (interquartile range) total SSCP score from baseline were −9.0 (−16.0 – −5.0) in the communication group and −3.0 (−7.0 – 1.0) in the lecture group, reflecting a significant reduction of stigma levels in the communication group. On examining the SSCP subscales, scores for factor I and factor II significantly improved. The educational program was more effective for pharmacists aged 20-39 years or with negligible experience of communicating with schizophrenic patients at work and/or in private life.ConclusionsSSCP and the educational program for community pharmacists that focuses on communication with patients were useful for assessing and reducing, respectively, the stigma attached by these pharmacists to schizophrenia.CONSORT extension for abstractNot applicableTrial registrationNot applicable

Background Stigma associated with mental disorders is rooted among many pharmacists, and represents a major barrier to patient support in community-based psychiatry. We developed an assessment scale that is specifically designed to assess the level of stigma that pharmacists may have toward schizophrenia, and then examined the effects of reducing stigma with an educational program that focuses on communication with patients diagnosed with schizophrenia (PDS) using the newly developed Stigma Scale towards Schizophrenia for Community Pharmacists (SSCP). Methods SSCP was developed by exploratory factor analysis with promax rotation based on responses from 822 randomly selected community pharmacists. Furthermore, a randomized controlled trial was conducted for 115 community pharmacists to clarify the effects of reducing the stigma of schizophrenia using an educational program for them with a focus on communication with PDS. Participants were individually allocated to two groups: educational lecture group (56; only attending a lecture on schizophrenia) or contact-based intervention group (59; communicating with PDS and attending the lecture). The stigma assessment using SSCP was conducted immediately before and after the educational intervention. Results A total of 4 factors and 27 items were extracted from the exploratory factor analysis to comprise the SSCP. Cronbach’s α of SSCP, social distance at professional pharmacy service (factor I), attitudes towards PDS (factor II), self-disclosure (factor III), and social distance in personal (factor IV) were 0.89, 0.88, 0.76, 0.62, and 0.62, respectively. Educational program-related changes of the median (interquartile range) total SSCP score from baseline were − 9.0 (− 16.0 – − 5.0) in the contact-based intervention group and − 3.0 (− 7.0–1.0) in the educational lecture group, reflecting a significant reduction of stigma levels in the contact-based intervention group. On examining the SSCP subscales, scores for factor I and factor II significantly improved. The educational program was more effective for pharmacists aged 20–39 years or with negligible experience of communicating with PDS at work and/or in private life. Conclusions SSCP and the educational program for community pharmacists that focuses on communication with PDS were useful for assessing and reducing, respectively, the stigma attached by these pharmacists to schizophrenia. Trial registration UMIN Clinical Trials Registry (UMIN000043189, registered on January 30, 2021), Retrospectively registered.

This study aims to assess the differences in adverse event profiles of long-acting injectable antipsychotics (LAIs) and oral antipsychotics (OAPs) using real-world data in the Japanese Adverse Drug Event Report database. Reporting odds ratios were determined using disproportionality analysis to estimate the risk of adverse events for LAIs and OAPs. Differences in adverse event profiles between formulations were determined after propensity score matching. Time-to-onset of adverse events was compared between LAIs and OAPs using the Weibull shape parameter. Signals were detected for approximately 50% of the adverse events (12 of 22) with LAIs and for the majority of adverse events (19 of 22) with OAPs. LAIs was associated with significantly lower reporting rate than OAPs for extrapyramidal symptom, neuroleptic malignant syndrome, and dystonia. For QT prolongation, convulsions, and hyperglycemia associated with LAIs, the 95% Confidence Interval of β included 1 in time-to-onset analysis. Real-world data suggest that LAIs tend to reduce the occurrence of extrapyramidal symptom and neuroleptic malignant syndrome, but a number of other adverse events have potential risks as well as OAPs. In addition, onset of adverse events with LAIs have been shown to be slightly delayed, requiring more careful long-term monitoring.

Collaboration with multiple healthcare professionals is important to provide safer and higher quality care. Interprofessional education (IPE) promotes the practice of team-based care. The establishment of Tsurumai-Meijo IPE, including interprofessional education and practice (IPEP) and video-teaching materials, was conducted in collaboration with school of medicine/nursing in Nagoya University and Fujita Health University, because Meijo University does not have its own clinical settings and faculties except for pharmacy. In the established Tsurumai-Meijo IPE, pharmacy, medicine, and nursing students interviewed simulated patients (SP) together or separately and practiced team-based care through Tsurumai-Meijo IPEP. Students could learn in advance and on their own about each professional's knowledge related to patient care by using video-teaching materials from the Meijo IPE homepage. Using a questionnaire survey at the end of program, this study was examined whether Tsurumai-Meijo IPEP, and video-teaching materials were useful for understanding importance of team-based care. More than 83% of students indicated that Tsurumai-Meijo IPE is useful on future clinical practice. This suggests that the program and materials are beneficial to the medical student education. In the optional survey of some clinical pharmacists, who had participated in Tsurumai-Meijo IPE before graduation, they utilized it in their work and it facilitated their work related to team-based care. Tsurumai-Meijo IPE collaborating with SP is likely to contribute to provide high quality and safe team-based care by taking advantage of specialized professional ability of healthcare professionals.

Objective The adverse effects of antipsychotic agents can have a marked influence on medication adherence. In this study, we. investigated the adverse events of antipsychotics that are less likely to be reported by patients and the reasons why such symptoms remain latent. Methods Data were collected by interviewing patients using a subjective questionnaire, and the associations between unreported symptoms and background factors were investigated. Results A total of 306 patients with schizophrenia or schizoaffective disorder were examined. Their major symptoms were daytime sleepiness (50.0%), weight gain (42.2%), and sexual dysfunction (38.9%). Sexual dysfunction was nominal significantly more common among the patients that had been treated with antipsychotic agent polypharmacy (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.07 to 4.30), and was nominal significantly more common among outpatients (OR, 1.78; 95% CI, 1.02 to 3.13). Only approximately 30% of the patients had reported their symptoms to their physicians. Conclusion Patients receiving antipsychotic treatment tolerate some symptoms and do not feel able to report them to their physicians. The most common reason for this is an insufficient patient-physician relationship. Sexual dysfunction is especially hard to identify because it is a delicate problem, and our findings demonstrate that subjective questionnaires are helpful for detecting such symptoms.

Objective It is well documented that clozapine treatment causes agranulocytosis, but it can also induce drowsiness, constipation, and hypersalivation; however, these symptoms are usually less severe. It has been reported that clozapine-treated patients with schizophrenia and psychiatric healthcare professionals consider different side effects to be important. The aim of this study was to assess current practice related to the side effects of clozapine in clozapine-treated patients with schizophrenia and psychiatric healthcare professionals in Japan. Methods Data were collected from January 2014 to August 2015 in Okehazama Hospital, Kakamigahara Hospital, and Numazu Chuo Hospital. Clozapine-treated patients with schizophrenia and psychiatric healthcare professionals (psychiatrists and pharmacists) were enrolled in this study. Results Of the 106 patients and 120 psychiatric healthcare professionals screened, 100 patients and 104 healthcare professionals were included in this study. We asked the patients what side effects caused them trouble and we asked psychiatric healthcare professionals what side effects caused them concern. The patients and psychiatrists held similarly positive views regarding the efficacy of clozapine. The healthcare professionals were concerned about agranulocytosis (92.4%), blood routines (61.3%). On the other hand, the patients experienced hypersalivation (76.0%), sleepiness (51.0%). A positive correlation (R=0.696) was found between patient satisfaction and DAI-10 score. Conclusion Patients experienced more problems than healthcare professionals expected. However, usage experience of clozapine healthcare professionals tended to have similar results to patients. It is necessary that all healthcare professionals fully understand the efficacy and potential side effects of clozapine. This is very important for promoting clozapine treatment in Japan.

The aim was to assess the relationship between muscle mass depletion and chronic hepatitis C virus (HCV) infection.We retrospectively evaluated abdominal computed tomography data for 611 patients. The participants included 302 patients with HCV infection and 309 patients with gallstones (as a control). The skeletal muscle mass at the level of the third lumber vertebra (L3) was measured from the computed tomography images and normalized for height to calculate the L3 skeletal muscle index (L3-SMI, cm/m). Statistical analysis was carried out separately for each sex, given that L3-SMI differs significantly between men and women.L3-SMI showed no significant difference between chronic hepatitis patients and gallstone patients in either sex. L3-SMI was significantly lower in male cirrhotic patients than in those with chronic hepatitis (P0.001). The Child-Pugh score was correlated negatively with L3-SMI in male patients with HCV-related cirrhosis (ρ=0.200, P=0.031). In addition, the BMI in both sexes was associated with L3-SMI in the gallstone and chronic hepatitis group, in the chronic hepatitis and liver cirrhosis group, and in the liver cirrhosis group.Skeletal muscle mass is not affected by chronic HCV infection in patients without cirrhosis and decreases in accordance with liver disease progression in male patients with chronic HCV infection.

OBJECTIVE Long-acting injectable (LAI) aripiprazole is recommended to be combined with oral aripiprazole for 2 weeks after its introduction. However, we often experience patients who require more than 2 weeks of combined use. Therefore, differences in combination periods need to be examined. METHODS This was a case-control study. We surveyed prescription profiles for oral aripiprazole administration in conjunction with LAI aripiprazole introduction and assessed the clinical course during a 12-week follow-up period. RESULTS Among 121 patients, 58 (47.9%) were administered both oral and LAI aripiprazole for more than 2 weeks. Although there was no significant difference in treatment failure (defined as psychiatric hospitalization or discontinuation of LAI aripiprazole from any cause) between the two groups, the group that was administered oral aripiprazole for more than 2 weeks received less additional benzodiazepines compared with that of the 2 weeks group (adjusted odds ratio, 0.055; 95% confidence interval [0.0060, 0.50]; p

Objective The pharmacological effects of generic (GE) donepezil are the same as Aricept, its brand-name counterpart. However, little is known as to whether these two drugs provide the same quality of life (QOL). The study subjects were patients with Alzheimer's disease who were taking donepezil hydrochloride tablets, and were selected by visiting either the local pharmacies or the patients' homes. We chose the brand-name drug Aricept and its GE form donepezil to investigate, from a long-term caregiver's perspective, the influence of both drugs on the patients' QOL. Methods An EuroQol-5 Dimension (EQ-5D) was used to assess the QOL of patients with Alzheimer's disease, before and after various Aricept and/or donepezil regimens. Patients were divided into four groups: first time users of Aricept (n=43), first time users of GE donepezil (n=45), users refilling previous prescriptions of Aricept (n=51), and users switching from Aricept to GE donepezil (n=51). Results The average change in the EQ-5D utility indices rose significantly in the patients starting a new regimen of Aricept and its GE drug. The patients continuing an existing regimen of Aricept showed no significant differences, even after Aricept was switched to a GE drug. Conclusion The QOL of patients starting a new regimen of Aricept and its GE drug improved. The QOL was maintained upon switching to the GE drug form.

Objective This study examined the utility of adenine for preventing clozapine-induced neutropenia. Methods This retrospective study examined the effect of adenine on clozapine-induced neutropenia in patients with treatment-resistant schizophrenia and was conducted at Okehazama Hospital in Japan from July 2010 to June 2013. Adenine was available for use from June 2011 onwards. Twenty-one patients started receiving clozapine treatment from July 2010 to April 2011 (the pre-adenine adoption group), and 47 patients started receiving it from May 2011 to June 2013 (the post-adenine adoption group). The effects of adenine were assessed based on changes in the patients’ leukocyte counts and the frequency of treatment discontinuation due to clozapine-induced neutropenia. Results Sixty-eight patients were treated with clozapine from July 2010 to June 2013. Of the 21 patients in the pre-adenine adoption group, 4 discontinued treatment due to clozapine-induced neutropenia, whereas only 2 of the 47 patients in the post-adenine adoption group discontinued treatment. The frequency of treatment discontinuation due to clozapine-induced neutropenia was significantly lower in post-adenine adoption group than in the pre-adenine adoption group (p=0.047). Conclusion Adenine decreased the frequency of treatment discontinuation due to clozapine-induced neutropenia. Our data suggest that combined treatment with clozapine and adenine is a safe and effective strategy against treatment-resistant schizophrenia.

Background With the development of pharmacotherapy and radiotherapy, cancer treatment is being shifted from surgical to outpatient services, consequently increasing insurance-covered pharmacies’ frequency of dealing with cancer patients. As the psychology of these patients is complex, it is necessary for pharmacists to educate them in consideration of their cognitive/medical and psychosocial aspects. This study analyzed cancer patient management by pharmacists working in such pharmacies and their communication skills before and after communication skill training based on SPIKES, a six-step protocol for delivering bad news, to confirm the usefulness of such training. Methods The study involved 20 pharmacists working in insurance-covered pharmacies within Aichi Prefecture. Before and after communication skill training, role-play sessions were held using standardized patients, whose levels of satisfaction were subsequently measured. Patient management by the pharmacists was analyzed using the Roter Interaction Analysis System as a method to analyze dialogues. Results The rate of each category, representing the pharmacists’ conversation styles when dealing with the patients, changed after communication skill training as follows: [Giving information]: decreased from 37.0 to 27.6%; [Empathy statements]: increased from 12.0 to 17.2%; and [Data gathering]: increased from 18.0 to 23.3%. The increase was particularly marked in: [Acceptance], accepting patients’ emotions and events in line with [Empathy statements]; [Promoting dialogues] as a sub-category of [Building a relationship]; and [Checks for understanding] as a sub-category of [Data gathering]. Furthermore, the results of pharmacist assessment by the patients, including their levels of overall satisfaction, showed significant correlations with [Empathy statements] and [Building a relationship]. Conclusions Communication skill training may be effective to improve pharmacists’ conversation styles to listen to patients more attentively, accept their emotions, and provide education in accordance with their needs, rather than unilaterally providing information. Trial registration The study was approved by the Ethical Review Board of Meijo University as a research activity involving humans (approval number: H26-1 ).

Ca3Co4O9 (p-type) and Zn0.98Al0.02O (n-type) pellets were prepared by conventional sintering (CS) and Spark Plasma sintering (SPS) starting from the oxides. The best p-type sample was SPS Ca3Co4O9 obtained from pre-sintered pellets, with electrical conductivity σ = 144 S/cm and Seebeck coefficient S = 172 μV/K at 800 °C, while thermal conductivity κ = 2.00 W/m×K and figure of merit ZT = 0.23. The best n-type sample was CS Zn0.98Al0.02O showing σ = 83 S/cm and S = −268 μV/K at 800 °C, while = 5.03 W/m×K and ZT = 0.127. The output power of a module based on SPS Ca3Co4O9 and CS Zn0.98Al0.02O legs was 2.26 mW (with T = 500 °C, ΔT = 248 °C).

Objective To assess the educational effectiveness of a phased educational program consisting of role-playing with simulated patients, video-based reviews of the role-playing, and creating the transcripts of the video, we analyzed how each stage of the process affected pharmacy students' awareness of their own communication skills. Methods Fourth-year pharmacy students ( n = 158) who received their preliminary education in 2010 produced written assessment portfolios of their role play performance after (1) role-playing with simulated patients including feedback, (2) reviewing videos of the role-playing, and (3) creating transcripts of the videos. The statements in the students' portfolios were then analyzed to assess the extent of their self-reflection. A questionnaire examining the utility of each stage was also conducted among the students. Results The 4665 statements extracted from the portfolios were categorized into four levels according to the depth of reflection. Reflection levels 3 and 4 (the deepest reflection levels) displayed higher frequencies during the transcription stage than during the other stages, i.e., transcription made the students more self-reflective about their communication skills. Practical implications Learning through a three-step process of role-playing, video reviews, and transcription facilitates the acquisition of both verbal and non-verbal communication skills. By reviewing transcripts of their own conversations, the students came to realize which of their communication skills needed improving. Therefore, this method is considered to be useful for communication skills training.

Collagen type IV alpha 1 (COL4A1) is a major basement membrane component. Haploinsufficiency mutations in COL4A1 interrupt the basement membrane integrity, causing hemorrhagic stroke.1 Recently, mutations causing overproduction of COL4A1 mRNA have been identified in patients with cerebral small vessel disease (CSVD), including in members of families with pontine autosomal dominant microangiopathy with leukoencephalopathy2 and multi-infarct dementia of Swedish type.3 These mutations are located in the 3′ untranslated region (UTR) of COL4A1 and disrupt the binding of miR-29 to the 3′UTR of COL4A1 .2 Both diseases are characterized by leukoencephalopathy, multiple microbleeds (MBs), and multiple lacunar infarctions (LIs) with pontine involvements.2–4 However, among these patients, only case of hemorrhagic stroke was reported.5 Thus, it is unclear whether these mutations, which increase the amount of normal COL4A1, cause hemorrhagic stroke. Here, we report a patient with hemorrhagic stroke with a novel mutation in the 3′UTR of COL4A1 .

This study investigated the efficacy of scopolamine (an anticholinergic agent) ointment against clozapine-induced hypersalivation.The patients enrolled in this study consisted of 10 clozapine-treated schizophrenia patients and 10 healthy adult men. A prospective, randomized, double-blind, crossover, placebo-controlled clinical trial was designed.A total of 10 patients and 10 healthy adult men completed the study. No significant reduction in the saliva production of the clozapine-treated patients was observed; however, that of the healthy adult men decreased significantly.Scopolamine ointment was not effective against clozapine-induced hypersalivation. A further study is necessary for confirming its effect.

Recurrent seizure activity has been shown to induce a variety of permanent structural changes in the brain. Matrix metalloproteinases (MMPs) function to promote neuronal plasticity, primarily through cleavage of extracellular matrix proteins. Here, we investigated the role of MMP-9 in the development of pentylenetetrazole (PTZ)-induced kindled seizure in mice. Repeated treatment with PTZ (40 mg/kg) produced kindled seizure, which was accompanied by enhanced MMP-9 activity and expression in the hippocampus. No change in MMP-9 activity was observed in the hippocampi of mice with generalized tonic seizure following single administration of PTZ (60 mg/kg). MMP-9 colocalized with the neuronal marker NeuN and the glial marker GFAP in the dentate gyrus of the kindled mouse hippocampus. Coadministration of diazepam or MK-801 with PTZ inhibited the development of kindling and the increased MMP-9 levels in the hippocampus. Marked suppression of kindled seizure progression in response to repeated PTZ treatment was observed in MMP-9(−/−)mice compared with wild-type mice, an observation that was accompanied by decreased hippocampal levels of mature brain-derived neurotrophic factor. Microinjecting the BDNF scavenger TrkB-Fc into the right ventricle before each PTZ treatment significantly suppressed the development of kindling in wild-type mice, whereas no effect was observed in MMP-9(−/−)mice. On the other hand, bilateral injections of pro-BDNF into the hippocampal dentate gyrus significantly enhanced kindling in wild-type mice but not MMP-9(−/−)mice. These findings suggest that MMP-9 is involved in the progression of behavioral phenotypes in kindled mice because of conversion of pro-BDNF to mature BDNF in the hippocampus.

The constructions of Giza pyramids were architectural landscape projects. Old Kingdom monarchs made effective use of Eocene limestone bedrocks, called Moqattam and Maddi Formation.

The technical committee on light application and visual science (TC-LAV) have been surveying fields of application of optical engineering and visual science; covering medical science, devices for visual information processing, light sources from teraherz wave to extreme ultraviolet, advanced lithography, and etc. This article introduces two topics from recent research activities. The first is an interesting challenge of bio-medical application of light, optically assisted ultrasonic velocity-change imaging applied to monitoring the distribution of gold nano particles for drug delivery system. The second is double patterning processes using the ArF immersion lithography.

This study aimed to interpret soil fertility around Somma Vesuviana in ancient Rome from investigation of buried paleosols developed beneath thick pumice deposits of the AD 472 Pollena eruption of Mt. Vesuvius. Two buried pedons derived mainly from phonolitic tephra deposits of the AD 79 Pompeii eruption, and ancient construction waste, were excavated and sampled at the Somma Vesuviana villa ruins on the northern flanks of Mt. Vesuvius, Italy. For comparison, a buried paleosol on equivalent Pompeii tephra deposits in a nearby forest, and a modern soil on AD 1631 tephra deposits (compositionally similar to Pompeii eruptives) in an adjacent orchard, were similarly analyzed for physical, chemical, and mineralogical properties, including phosphorus fractions and primary mineral compositions. The two buried pedons in the ruin had abundant available P and K and contained moderate amounts of exchangeable cations. Leucite was the dominant primary mineral and, with alkali feldspars, is probably the major source of K in the buried horizons. A high content of “authigenic P (Ca-bound P)” characterized all the pedons. We concluded that the buried Somma Vesuviana paleosols had a relatively high ability to supply nutrients and that they were fertile prior to the AD 472 eruption, although manuring to increase nitrogen was probably needed to maintain high productivity. Their physical properties such as water retention were probably enhanced by small but significant amounts of short-range order clays.

It has been reported that viral infection in the first and second trimesters of pregnancy in humans increases the risk of subsequently developing schizophrenia. To develop a mouse model of immune activation during the early postnatal period, neonatal ICR mice were repeatedly injected with polyriboinosinic-polyribocytidilic acid (polyI:C; an inducer of strong innate immune responses) for 5 days (postnatal day 2-6) which may correspond, in terms of brain development, to the early second trimester in human. Cognitive and emotional behavior as well as the extracellular level of glutamate in the hippocampus were analyzed at the age of 10-12 weeks old. PolyI:C-treated mice showed anxiety-like behavior, impairment of object recognition memory and social behavior, and sensorimotor gating deficits, as compared to the saline-treated control group. Depolarization-evoked glutamate release in the hippocampus was impaired in polyI:C-treated mice compared to saline-treated control mice. Furthermore, to investigate the effect of neonatal immune activation on the expression levels of schizophrenia-related genes, we analyzed mRNA levels in the hippocampus 2 and 24h after polyI:C treatment. No significant differences or only transient and marginal changes were observed between polyI:C-treated and saline-treated control mice in the expression levels of schizophrenia-related genes in the hippocampus.