Determining Food Allergens by Skin Sensitization in Mice.

A food allergy is a chronic inflammatory disease against dietary antigens with high prevalence in industrialized countries. Because there is currently no cure for food allergies, avoiding the allergen is crucial for the prevention of an allergic reaction. Therefore, a further understanding of the pathogenesis and risk factors that augment the sensitization to food allergens is required. We have previously developed a food allergy mouse model using transdermal sensitization, which influences the susceptibility to food allergies. In this model, mice sensitized with partially hydrolyzed wheat protein (HWP) successfully resembled the major features of HWP-sensitized and wheat allergy-induced patients. In this article, we describe transdermal sensitization of food allergens and induction of immediate-type food allergies in mice. The methodology detailed here was mainly adapted from an original work by Adachi and colleagues with some modifications to the dressing methods to reduce stress. © 2018 by John Wiley & Sons, Inc.

[Three successful cases of continuous dexmedetomidine infusion for the treatment of intractable delirium associated with cancer pain].

We report three cases of successful treatment of intractable delirium associated with cancer pain with continuous dexmedetomidine (DEX) infusion. Case 1 : An 83-year-old man receiving oral oxycodone for lung cancer pain developed delirium. He was resistant to haloperidol infusion, oral quetiapine, and opioid rotation. DEX infusion was administered at 0.4 microg kg-1 hr-1, and his delirium resolved. Case 2: A 50-year-old woman with cervical cancer of the uterus suffered from sepsis but could not take oral oxycodone. After continuous morphine infusion, she developed delirium. She was resistant to haloperidol infusion or injections of oxycodone for opioid rotation, but DEX infusion at 0.4 microg kg-1hr-1 led to disappearance of delirium symptoms. Case 3: A 71-year-old woman with advanced renal cancer was treated with epidural analgesia to alleviate cancer pain. She subsequently developed delirium but was resistant to haloperidol or chlorpromazine infusion. DEX infusion at 0.3 microg kg-1 hr-1 led to disappearance of delirium symptoms and orientation recovery. DEX infusion may be effective for the treatment of intractable delirium associated with cancer pain.

The evolution of antipsychotic switch and polypharmacy in natural practice--a longitudinal perspective.

OBJECTIVE: Most patients with schizophrenia first start with a single antipsychotic, and yet most finally end up 'switching' or using 'polypharmacy'. The objective of this study was to examine the evolution of antipsychotic switch and polypharmacy in the real-world from a longitudinal perspective. METHODS: A systematic review of longitudinal antipsychotic prescriptions in 300 patients with schizophrenia (ICD-10) for up to 2 years after their first visit to one of the 4 participating psychiatric clinics in Tokyo, Japan between January, 2007 and June, 2008, was conducted. Reasons for prescription change were also examined. The evolution of switching and polypharmacy was studied, and prescribed doses were compared to suggested dose ranges by the Texas Medication Algorithm Project (TMAP). RESULTS: 208 patients started their antipsychotic treatment with monotherapy. 34.1% of the patients gave up monotherapy with an initial antipsychotic to move to antipsychotic switch (27.4%) and/or polypharmacy (17.8%) within 2 years. The main reason for antipsychotic switch was 'ineffectiveness'; interestingly, this happened despite the fact that the monotherapy dose was below the recommended range in 47.4% of the antipsychotic switch. In a subgroup of 100 patients who started as antipsychotic-free, 2-year prevalence rates of switching and antipsychotic polypharmacy were 27.0% and 18.0%, respectively, and polypharmacy was resorted to after a median of 1 antipsychotic had been tried for 84 days (median). CONCLUSIONS: These findings raise a concern that physicians may perform an antipsychotic switch without exploring the entire dose range and resort to antipsychotic polypharmacy without trying an adequate number of antipsychotics.

Patient's trust in their psychiatrist: a cross-sectional survey.

Investigating and characterizing the degree and correlates of patient's trust in their treating psychiatrists across a range of psychiatric disorders is of a great clinical relevance to enhance our therapeutic alliance, which has not been addressed in the literature. In this study, outpatients who visited one of the participating psychiatric clinics in Tokyo, Japan between October and November, 2010 were asked to complete the Trust in Physician Scale (TPS), an 11-item self-report questionnaire. A univariate general linear model was used to examine the effects of the following variables on the TPS total score: age, sex, diagnosis, Global Assessment of Functioning score, educational background, physician's years of practice as a psychiatrist, duration of treatment with their current psychiatrists, sex concordance between patients and their psychiatrists, and whether patients were older than their psychiatrists. Five hundred and four patients were enrolled (mean ± SD age = 42.8 ± 13.6 years; 176 men; Psychiatric diagnoses (ICD-10): F0 [N = 8], F2 [N = 72], F3 [N = 252], F4 [N = 147], F6 [N = 22]). A duration of treatment with their current psychiatrist of ≥ 1 year and a duration of their physician's clinical expertise as a psychiatrist for ≥ 10 years were associated with a greater degree of patient's trust in their psychiatrist. Furthermore, patients with a F3 diagnosis showed a significantly higher TPS total score than those with F4. These findings underscore an importance of paying close attention to patients who are relatively new and are not treated by well-experienced psychiatrists in terms of subjective trust. Furthermore, this likely holds more true for patients with neurotic disorders.

[Effects of transplacental and trans-breast milk exposure to the organophosphate compound chlorpyrifos on the developing immune system of mice].

Navarro et al (2001) have reported that neonatal exposure of rat to the organophosphate compound chlorpyrifos (CPF) resulted in long-term deficits in T lymphocyte mitogenic response, although the mechanism has been unclear. In this study, pregnant BALB/c mice were exposed to 0, 2.8, 14, 70 ppm CPF via diet from gestational day 10 to postnatal day (PND) 21, and subpopulational changes in T lymphocytes of offspring were analyzed at PND21. The irreversibility of the effects was also investigated at PND77 after ceasing exposure by weaning at PND21. Serum cholinesterase activity was significantly reduced after exposure to CPF at PND21. An increase in the proportion of CD4 positive splenocytes was observed after exposure to CPF, which remained until PND77. We found that regulatory T cells were the only one CD4 positive subset which increased in the spleen of CPF-exposed mice at PND77.

[Study of radiation dose rate in air at Setagaya in Tokyo].

The great earthquake occurred at East Japan on March 11, 2011 and the following tsunami induced the accident which environmentally leaked radioactive materials from the nuclear power plant of the Fukushima Daiichi. We measured radiation dose rate in air by the NaI (Tl) scintillation and GM survey meters from March 15 to May 30 at Setagaya in Tokyo. Three measured points were at the 1m height from the ground on asphalt surfaced road, at the 5cm height from ground with weeds, and at the room of a reinforced concrete building. As a result, a transient increase was observed on March 15, a sustained rise was observed on both days of March 21 and 22. The latter was thought to be due to the radioactive rainfall. These measured values were compared with the radiation dose rate in air of the cities in Kanto area, and it was confirmed that the measured values at Setagaya are not so different from that of those cities.

Reducing the dose of antipsychotic agents ameliorates visual hypersensitivity attack: an ideal treatment option in terms of the adverse effect.

There are sporadic reports of antipsychotic-induced visual hypersensitivity attack (VHA). VHA is characterized by hypersensitivity of perception mainly in the visual modality and sometimes accompanied by an oculogyric crisis. However, some researchers regard VHA as a schizophrenia symptom. To determine whether VHA is an adverse effect of antipsychotic agents, we examined the effect of dose reduction on VHA. This was an open-label 36-week study. We randomized 34 patients with VHA to a reduced-dose group and a fixed-dose group. Primary outcome measures were the frequency and duration of VHA, assessed with patients' self-reports, and the Clinical Global Impressions (CGI). Assessment also included the Drug-induced Extrapyramidal Symptoms Scale for extrapyramidal symptoms, the Positive and Negative Syndrome Scale (PANSS) for schizophrenia, and the CGI for other diagnoses. Data were collected from August 2000 to April 2005 at 4 psychiatric hospitals in Tokyo.VHA diminished in 16 patients (94.1%) in the reduced-dose group in the CGI score, the frequency (number of episodes per week), and the duration of the episodes (from 4.06 to 1.77, P < 0.001; from 2.59 to 0.82, P = 0.001; and from 1.92 to 0.66 hours, P = 0.007, respectively), but there were no changes in the fixed-dose group. There were no changes in the underlying illness as measured by the PANSS in both groups. Reducing the dose of antipsychotic agents ameliorates VHA and represents the ideal treatment option for patients with VHA.

[Anesthetic management for Cesarean section in a patient with left ventricular noncompaction].

Left ventricular noncompaction (LVNC) is a rare disease characterized by heart failure, arrhythmia, and embolic events. We report anesthetic management of a pregnant woman with LVNC. At 24 weeks gestation of the first pregnancy, the patient was scheduled for Cesarean section. Preoperatively the patient had symptomatic heart failure, and was anesthetized with propofol and fentanyl aiming at stable intraoperative hemodynamics. About 2 years later, the patient also underwent cesarean section under spinal anesthesia at 34 weeks gestation of the second pregnancy, because her cardiac function was almost normal and she was not receiving anticoagulant therapy. Both perioperative courses were uneventful. Careful preoperative assessment and close anesthetic planning are necessary.

Relationships between temperament dimensions in personality and unconscious emotional responses.

BACKGROUND: In addition to character dimensions, personality includes temperament dimensions, defined as individual differences in implicit associative learning responses to environmental stimuli processed by unconscious memories. We examined whether temperament dimensions were associated with patterns of unconscious emotional responses of an autonomic nature. METHODS: From 70 healthy men, high and low novelty-seeking (NS) groups and high and low harm-avoidance (HA) groups were selected using scores on the Tridimensional Personality Questionnaire measuring temperament dimensions. Emotionally negative, neutral, and positive visual stimuli were presented subliminally using backward masking, and skin conductance responses (SCRs) were measured as an autonomic index of emotional responses. Skin conductance responses to the three emotional stimulus conditions were compared between groups. RESULTS: Skin conductance responses in the high NS group were significantly greater than in the low NS group when positive or negative emotional stimuli were presented but not neutral stimuli. Skin conductance responses in the high HA group were significantly greater than in the low HA group for stimuli of all three valences. CONCLUSIONS: Autonomic response patterns to unconscious emotional perception differed between NS and HA, suggesting that different dimensions of temperament may be associated with different patterns of unconscious emotional responses. Novelty seeking and HA may be associated with specificity and susceptibility of preattentive emotional perception, respectively.

Interhemispheric difference in emotional response without awareness.

To investigate interhemispheric differences concerning unconscious human emotional responses processed, we measured human skin conductance responses (SCRs) to masked (unseen) emotional stimuli presented to left or right visual fields. Backward masking was used to preclude conscious processing of emotional stimuli. Masked negative or neutral emotional pictures from the International Affective Picture System (IAPS) were presented to 11 right-handed male volunteers. Mean SCR for negative emotional stimuli presented to the left visual field was significantly greater than mean SCRs for negative emotional stimuli to the right visual field and for neutral stimuli to the left or right visual fields. Thus, the right rather than the left hemisphere appears to respond to preattentive negative emotional stimuli.