Komagino Hospital

Approximately 30% of patients with schizophrenia do not respond to antipsychotics. While schizophrenia has been primarily explained by the dopamine dysfunction hypothesis, treatment-resistant schizophrenia (TRS) may involve a different pathophysiology. Neuromelanin (NM), a product of dopamine metabolism in the substantia nigra (SN), indirectly measures long-term dopamine synthesis capacity. Few studies have examined SN NM levels in TRS. Therefore, we investigated the relationship between SN NM levels and treatment responsiveness in schizophrenia. We included age- and sex-matched TRS, patients with schizophrenia in remission of positive symptoms (SZ-R), and healthy controls (HCs). Neuromelanin-sensitive magnetic resonance imaging was used to measure SN NM signals. We also evaluated clinical symptoms and cognitive impairment. We conducted voxel-wise analyses of NM contrast-to-noise ratio (CNR) to compare groups pairwise. Correlation analyses examined relationships between NM signals and symptom severity. Seventy-two participants (n = 24 per group) completed the study. The TRS group had higher dorsal SN CNR than the HC group (510 out of 1948 voxels at p < 0.05, corrected p = 0.005, permutation test). In contrast, no significant differences were observed in the other comparisons. No significant correlations were found between NM CNR and clinical severity. Our findings contrast with previous positron emission tomography studies on dorsal striatal dopamine function. Since the dorsal SN contributes to both the mesolimbic and nigrostriatal pathways, with a relatively greater role in the former, dopamine functions in these pathways may play different roles for treatment responsiveness. Further research with multimodal imaging is needed to examine dopamine function and antipsychotic treatment responsiveness in schizophrenia.

Als Kommentatoren des Kinos können Daney und Godard im Forschungsfeld zum Verhältnis von Geschichte und Film und zur Filmgeschichte, sowie in aktuellen filmwissenschaftlichen Post-Kino-Debatten positioniert werden. Post-Kino-Diskurse fragen danach, wie Kino sich wandelt, nachdem der Kinosaal nicht mehr der einzige Ort für Filme und Bewegtbilder ist. Hier wird diskutiert, ob Kino im Kontext digitaler Medien und Technologien, neuer Produktions-und Distributionspraktiken, neuer Orte und Dispositive in seinen hybriden Verbindungen eine Fortsetzung erfährt, oder ob es ein abgegrenztes, eigenständiges Dispositiv bleibt. Die filmwissenschaftliche Debatte zur Apparatus-Theorie und zum Dispositiv habe ich bereits in I.1.4 resümiert. Traditionell bezeichnet der Dispositiv-Begriff die Anordnung technischer Elemente im Kinosaal und dabei vor allem das Verhältnis von Projektor/Projektion und Zuschauer*innen, die durch das Dispositiv einem illusorischen Realitätseindruck und damit einer Ideologie unterworfen werden. So wurde der Begriff mit Bezug auf Kino und seinen Ort, den Saal, lange ideologiekritisch und psychologisch bzw. psychoanalytisch verwendet. Mit dem Ende der Hegemonie des Kinosaals ändert sich dies. Nun verweist der Dispositiv-Begriff auf eine bestimmte ästhetische, ortsgebundene Zuschauer*innenerfahrung, die »Kino« definiert -oder eben nicht mehr. Mit meinem Ansatz, Geschichte des Kinos als Produkt eines fortlaufenden Kommentars zu denken, verschiebe ich die Post-Kino-Diskussion von der Ebene des Dispositivs auf die Ebene des Textes und konzentriere mich auf das Problem der Definition des Kinos, das als Bedeutungszusammenhang und Primärtext ebenso vollendet wie neu geöffnet, definiert wie neu definiert werden kann. Post-Kino-Debatten erweisen sich insofern als filmhistorische Debatten, als dass sie retrospektiv die Frage danach öffnen, worum es sich beim filmhistorisch untersuchten Gegenstand genau handelt, wie das »Kino« und »was« als Kino zu welchem Zeitpunkt zum Gegenstand einer (film-)historischen Untersuchung also überhaupt werden kann oder konnte. Diese Frage hat eine lange Geschichte, die so alt wie das Kino selbst. Wie Pascal Dupuy (und vor ihm Martin A. Jackson) bemerkt, hat schon 1898 Boleslaus

Migraine is a neurological disorder with recurrent headaches accompanied by burdens in social life. Primary palmar hyperhidrosis is a chronic condition with excessive sweating of the palms that can significantly impair quality of life. Primary hyperhidrosis can cause anxiety, and stress, including anxiety, is the most common inducer of migraine headaches. Recently, oxybutynin has been used for primary palmar hyperhidrosis. We herein describe a 26-year-old female migraine patient with primary palmar hyperhidrosis whose migraine attacks and burdens were attenuated after the prescription of an oxybutynin lotion formula. The patient's monthly headache days (MHD) and monthly acute medication intake days (AMD) at the first visit were 10 and 9. Headache Impact Score 6 (HIT-6) at the initial visit was 63. After the prescription of Japanese herbal kampo medicine Goreisan (TJ-17), Goshuyuto (TJ-31), and 200 mg of valproic acid, MHD, AMD, and HIT-6 decreased gradually. However, these parameters could not improve sufficiently at nine months: MHD 4, AMD 4, and HIT-6 52. We first prescribed a lotion formulation of 20% oxybutynin hydrochloride at nine months. After this, migraine was further attenuated, and stress related to primary palmar hyperhidrosis was reduced; at 12 months, the patient had achieved MHD 2, AMD 2, and HIT-6 48. She will continue receiving primary palmar hyperhidrosis treatment while tapering off migraine prophylaxis. While the exact mechanisms connecting migraine and primary hyperhidrosis remain uncertain, this case raises important questions about the potential interplay between stress, sweating, and migraine triggers.

Background: We present results of a 24-week comparative study of the effects of the sodium–glucose cotransporter 2 (SGLT2) inhibitor canagliflozin vs. the sulfonylurea glimepiride, by baseline body mass index (BMI), in patients with type 2 diabetes and chronic heart failure. Methods: We conducted a post hoc analysis of the CANDLE trial. This subanalysis evaluated NT-proBNP, BMI, and other laboratory parameters, according to the subgroups stratified by BMI ≥ 25 kg/m2 vs. BMI < 25 kg/m2. Results: A group ratio of proportional changes in the geometric means of NT-proBNP was 0.99 (p = 0.940) for the subgroup with BMI ≥ 25 kg/m2 and 0.85 (p = 0.075) for the subgroup with BMI < 25 kg/m2, respectively. When baseline BMI was modeled as a continuous variable, results for patients with BMI < 30 kg/m2 showed a slightly smaller increase in NT-proBNP in the canagliflozin group vs. the glimepiride group (p = 0.295); that difference was not seen among patients with BMI ≥30 kg/m2 (p = 0.948). Irrespective of obesity, the canagliflozin group was associated with significant reduction in BMI compared to the glimepiride group. Conclusion: There was no significant difference in the effects of canagliflozin, relative to glimepiride, on NT-proBNP concentrations irrespective of baseline obesity. UMIN clinical trial registration number: UMIN000017669.

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal-recessive hereditary neuropathy causing congenital loss of pain sensation, thermoception, and perspiration. CIPA sometimes causes destructive spondyloarthropathy, the so-called Charcot spine, because of insensitivity to pain stimuli. Herein, we report a case of CIPA with severe spinal destruction treated by multiple spinal reconstructive surgeries and over 15 years of follow-up. A 15-year-old male patient who had been diagnosed with CIPA at the age of 17 months presented to his previous spine clinic with gait disturbance due to muscle weakness in his lower extremities. Imaging studies revealed that collapsed L3 and L4 vertebral bodies involved the spinal canal, and it was treated by L3-L4 instrumented posterior fusion. Fourteen years after surgery, the patient became unable to walk again due to spinal canal stenosis at the proximal fusion segment. An L2-L3 posterior interbody fusion alleviated his gait ability for 2 years; however, he became unable to stand again because of the collapsed fusion segment that caused severe lumbar kyphosis. Subsequently, a two-staged posterior and anterior fusion surgery from the lower thoracic spine to the pelvis was performed, and spinal fusion and neurological recovery were achieved 3 years after surgery. A kyphotic deformity in patients with CIPA-associated Charcot spine could be favorably treated by a long spinal fusion in combination with a reconstruction of an anterior spinal column. This case report provides a significant lesson for a treatment of CIPA-associated Charcot spine.

Abstract In the Jinzu River Basin of Toyama Prefecture, the operation of a large-scale lead-zinc mine and smelting plant (Kamioka Mine) located upstream, from the 1890s to 1970s, released large volumes of slag and wastewater, which polluted the environment with heavy metals, such as cadmium. Rice paddies with an area of 1500 ha were contaminated with heavy metals as those soils used water from the Jinzu River for irrigation. The polluted irrigation water was also used for drinking; hence, residents of the Jinzu River Basin developed a chronic cadmium poisoning symptom, locally known as the itai-itai disease. In this chapter, we discuss the history of the mining pollution in the Jinzu River Basin that lasted for over 100 years, proceedings for the damages by the itai-itai disease intended to clarify the liability of the mining company, and history and current situation of remediation of the environment contaminated with cadmium through inspection of the mine by local residents, which was granted to them as the result of winning the case.KeywordsCadmiumCountermeasuresEnvironmental pollution from the Kamioka MineItai-itai diseaseTackling by local residents

The interzeolite conversion of AlPO4-5 gave a new zeolitic material GAM-2 and the calcination caused further structural changes, forming a new zeolite GAM-3 with a 3-dimensional 12-8-6 ring pore system. This is the first synthetic example of a zeolite formed through multistep structural changes in the metastable phase.

status: Published