Combination of Radiation Therapy, Wim's Tumor 1 (WT1) Dendritic Cell Vaccine Therapy, and α-Galactosylceramide-Pulsed Dendritic Cell Vaccine Therapy for End-Stage Small Bowel Cancer.

There is no established treatment for terminal cancer patients who no longer respond to surgery, radiotherapy, or chemotherapy, and palliative care is the standard worldwide. We performed intensity-modulated radiation therapy for pain relief in a 40-year-old male patient with end-stage small intestinal cancer who had been diagnosed with a life expectancy of two months after chemotherapy had been ineffective. Subsequent administration of seven doses of dendritic cell vaccine recognizing Wim's tumor 1 (WT1) and α-galactosylceramide antigens resulted in significant shrinkage of the cancer and marked improvement of the patient's general condition. The combination therapy of radiotherapy and dendritic cell vaccine therapy may suppress cancer progression and prolong survival, even in patients with chemotherapy-refractory terminal cancer. In particular, double dendritic cell vaccine therapy with WT1 and α-galactosylceramide-pulsed dendritic cell may provide an anti-tumor immune effect that is superior to that of the respective monotherapy.

Utility of a shortened Hasegawa Dementia Scale Revised questionnaire to rapidly screen and diagnose Alzheimer's disease.

AIMS: The aim of this study was to analyze the sensitivity and specificity of a shortened Hasegawa Dementia Scale Revised (shortened HDS-R) questionnaire and explore its utility for the rapid screening and diagnosis of Alzheimer's disease (AD). METHODS: We included 113 patients over the age of 60 years who visited our hospital from June 2018 to January 2021 including 70 subjects with AD and 43 healthy subjects. AD was diagnosed in accordance with the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and the standard HDS-R questionnaire was used as a neuropsychological examination. The shortened HDS-R questionnaire was composed of the first seven subdomains (1 to 7) of the HDS-R questionnaire and excluded subdomains 8 and 9. Magnetic resonance imaging (MRI) was performed to calculate the degree of atrophy of the whole brain, hippocampus, and parahippocampal gyrus. RESULTS: The cumulative contribution ratio of subdomains 1 to 7 of the HDS-R questionnaire was as high as 94%, indicating that the construct validity of the shortened HDS-R was very good. The correlation coefficient of the total scores of the shortened HDS-R and the HDS-R was 0.96, indicating that the criterion-related validity was also very good. Furthermore, the shortened HDS-R was significantly negatively correlated with the degree of atrophy in the whole brain, hippocampus, and parahippocampal gyrus, indicating that its concurrent validity was very good in relation to imaging parameters. Cronbach's α coefficient of the shortened HDS-R was 0.76, and the correlation coefficient of the item-total correlation analysis was between 0.68 and 0.76, indicating that this questionnaire has high internal consistency and reliability. The total shortened HDS-R score of the normal group (17.0 ± 1.9) was significantly higher than that of the AD group (8.6 ± 3.8), demonstrating that the total shortened HDS-R score can be used to identify healthy individuals and patients with AD. When the cutoff score was 14 of 15, the sensitivity was 92.9% and the specificity was 88.4%. The diagnostic ability of the shortened HDS-R was 91.2%, which indicates that it is similar to the full HDS-R questionnaire as an AD screening tool. CONCLUSION: As a neuropsychological examination questionnaire for the screening and diagnosis of AD, the shortened HDS-R had very high validity and reliability. Its sensitivity, specificity, and diagnostic ability were similar to those of the gold standard HDS-R; therefore, it can be considered a concise and useful questionnaire for AD screening and diagnosis in the older population.