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Case Report: Augmentation with Blonanserin for a Schizophrenia Patient with Insufficient Response to Clozapine

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Open Journal of Psychiatry 2018年第2期8卷 131-136页

作者： Manabu Takaki shigeru takahashi Yuji Yada Kohei Kitagawa Yoshiki Kishi Norihito Yamada Department of Neuropsychiatry Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan Sekizen Hospital Okayama Japan Department of Psychiatry Okayama Psychiatric Medical Center Okayama Japan

Background: Clozapine is the most efficacious among antipsychotics for patients with schizophrenia. Nevertheless, clozapine is not effective in more than about 50% of treatment refractory schizophrenia patients, and several pharmacological strategies are used to augment it. Several reviews including meta-analyses have been published, but the efficacy of augmentation therapy for clozapine-resistant patients is not adequately supported. Though there is a weak connection between the oral dose and plasma concentration of clozapine, there is no report of augmentation therapy considering the plasma concentration of clozapine. Blonanserin is reported to be effective in treatment of both positive and negative symptoms of schizophrenia and well tolerated. Methods: We obtained consent to evaluate clinical presentations and clozapine plasma concentrations at the Okayama Psychiatric Medical Center and had not identified the individual for ethical reasons. This is a case report. Results: This case fulfilled the diagnostic criteria of neuroleptic-induced dopamine supersensitivity psychosis. Monotherapy with blonanserin was not effective, but augmentation of blonanserin with clozapine was effective and well tolerated by a clozapine-resistant schizophrenia patient. Conclusion: Because clozapine may ameliorate dopamine supersensitivity psychosis, the addition of blonanserin to clozapine may be effective even if monotherapy with blonanserin was not.

关键词： Treatment Refractory Schizophrenia Clozapine Blonanserin Clozapine Concentration Dopamine Supersensitivity Psychosis

Application of Simple Adaptive Control to Water Hydraulic Servo Cylinder System

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Chinese Journal of Mechanical Engineering 2012年第5期25卷 882-888页

作者： ITO Kazuhisa YAMADA Tsuyoshi IKEO shigeru takahashi Koji College of Systems Engineering and Science Shibaura Institute of Technology Saitama 3378570 Japan Graduate School of Mechanical Engineering Tottori UniversityTottori 6808552 Japan Department of Mechanical Engineering Sophia UniversityTokyo 1028554 Japan

Although conventional model reference adaptive control （MRAC） achieves good tracking performance for cylinder control, the controller structure is much more complicated and has less robustness to disturbance in real applications. This paper discusses the use of simple adaptive control （SAC） for positioning a water hydraulic servo cylinder system. Compared with MRAC, SAC has a simpler and lower order structure, i.e., higher feasibility. The control performance of SAC is examined and evaluated on a water hydraulic servo cylinder system. With the recent increased concerns over global environmental problems, the water hydraulic technique using pure tap water as a pressure medium has become a new drive source comparable to electric, oil hydraulic, and pneumatic drive systems. This technique is also preferred because of its high power density, high safety against fire hazards in production plants, and easy availability. However, the main problems for precise control in a water hydraulic system are steady state errors and overshoot due to its large friction torque and considerable leakage flow. MRAC has been already applied to compensate for these effects, and better control performances have been obtained. However, there have been no reports on the application of SAC for water hydraulics. To make clear the merits of SAC, the tracking control performance and robustness are discussed based on experimental results. SAC is confirmed to give better tracking performance compared with PI control, and a control precision comparable to MRAC （within 10 μm of the reference position） and higher robustness to parameter change, despite the simple controller. The research results ensure a wider application of simple adaptive control in real mechanical systems.

关键词： water hydraulics servo cylinder system positioning control simple adaptive control

Effect of Peptidase Inhibitors on Dynorphin A (1-17) or (1-13)-Induced Antinociception and Toxicity at Spinal Level

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Pharmacology & Pharmacy 2017年第2期8卷 33-51页

作者： Mitsumasa Matsuda Masanobu Yoshikawa Takugi Kan Mariko Watanabe Junko Ajimi shigeru takahashi Masaaki Miura Kenji Ito Hiroyuki Kobayashi Toshiyasu Suzuki Department of Anesthesiology School of Medicine Tokai University Isehara Japan Department of Clinical Pharmacology School of Medicine Tokai University Isehara Japan Department of Anesthesiology Hiratsuka City Hospital Hiratsuka Japan

Our group has earlier demonstrated that three enzymes sensitive to peptidase inhibitors (PIs), amastatin (A)-, captopril (C)-, and phosphoramidon (P), played an important role in inactivation of enkephalins at the spinal level. Dynorphin-converting enzyme (DCE) hydrolyzes dynorphin (Dyn) A (1-17) or Dyn A (1-13) mainly at the Arg6-Arg7 bond. Dynorphin A and its derived peptides interact with opioid and glutamate receptors at their N- and C-terminals, respectively. The purpose of the present study was to evaluate the antinociceptive potency and toxicity of intrathecal administered Dyn A (1-17), Dyn A (1-13), or Dyn A (1-6) under pretreatment with ACP and/or the DCE inhibitor p-hydroxymercuribenzoate (PHMB). The effect of these PIs on Dyn A (1-17)-induced inhibition of electrically-evoked contractions in mouse vas deferens was also investigated. The inhibitory potency of Dyn A (1-17) on electrically-evoked contractions in mouse vas deferens under pretreatment with ACP was higher than that with AC, AP, or CP. Pretreatment with ACP augmented Dyn A (1-17) or (1-13)-induced antinociception by approximately 50- or 30-fold with no sign of allodynia when administered intrathecally at low doses. Pretreatment with ACP and PHMB induced neuropathy. These findings showed that intrathecal administration of low-dose Dyn A (1-17) or DynA (1-13) increased antinociception under pretreatment with ACP, but without signs of allodynia in rat.

关键词： Dynorphin A Peptidase Dynorphin-Converting Enzyme Antinociception Allodynia

Geostatistical Predictions Based on Block Data

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Journal of Physical Science and Application 2011年第3期1卷 175-183页

作者： shigeru Mase Kouji takahashi Nobuyuki Mochida Department of Mathematical and Computer Sciences Tokyo Institute of Technology Tokyo Japan

Present Status of the Nd:YAG Thomson Scattering System Development for Time Evolution Measurement of Plasma Profile on Heliotron J

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Plasma Science and Technology 2013年第3期15卷 240-243页

作者： Takashi MINAMI Shohei ARAI Naoki KENMOCHI Hiroaki YASHIRO Chihiro takahashi Shinji KOBAYASHI Tohru MIZUUCHI Shinsuke OHSHIMA Satoshi YAMAMOTO Hiroyuki OKADA Kazunobu NAGASAKI Yuji NAKAMURA Kiyoshi HANATANI shigeru KONOSHIMA Fumimichi SANO Institute of Advanced Energy Kyoto University Graduate School of Energy Science Kyoto University Pioneering Research Unit for Next Generation Kyoto University

A new high repetition rate Nd：YAG Thomson scattering system is developed for the Heliotron J helical device. A main purpose of installing the new system is the temporal evolution measurement of a plasma profile for improved confinement physics such as the edge transport barrier （H-mode） or the internal transport barrier of the helical plasma. The system has 25 spatial points with -10 mm resolution. Two high repetition Nd：YAG lasers （〉 550 m J@ 50 Hz） realize the measurement of the time evolution of the plasma profile with ~10 ms time intervals. Scattered light is collected by a large concave mirror （D----800 mm, f/2.25） with a solid angle of -100 mstr and transferred to interference filter polychromators by optical fiber bundles in a staircase form. The signal is amplified by newly designed fast preamplifiers with DC and AC output, which reduces the low frequency background noise. The signals are digitized with a multi-event QDC, fast gated integrators. The data acquisition is performed by a VME-based system operated by the CINOS.

关键词： plasma diagnostic Nd：YAG laser Thomson scattering measurement plasma improved confinement

characteristics of intestinal pseudo-obstruction in patients with mitochondrial diseases

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World Journal of Gastroenterology 2012年第33期18卷 4557-4562页

作者： Yusuke Sekino Masahiko Inamori Eiji Yamada Hidenori Ohkubo Eiji Sakai Takuma Higurashi Hiroshi Iida Kunihiro Hosono Hiroki Endo Takashi Nonaka Hirokazu takahashi Tomoko Koide Yasunobu Abe Eiji Gotoh shigeru Koyano Yoshiyuki Kuroiwa Shin Maeda Atsushi Nakajima Gastroenterology Division Yokohama City University School of Medicine Yokohama 236-0004 Japan Department of Medical Education Yokohama City University School of Medicine Yokohama 236-0004 Japan Department of Neurology Yokohama City University School of Medicine Yokohama 236-0004 Japan

AIM: To reveal the frequency, characteristics and prognosis of chronic intestinal pseudo-obstruction (CIP) in mitochondrial disease patients. METHODS: Between January 2000 and December 2010, 31 patients (13 males and 18 females) were di-agnosed with mitochondrial diseases at our hospital. We conducted a retrospective review of the patients' sex, subclass of mitochondrial disease, age at onset of mitochondrial disease, frequency of CIP and the age at its onset, and the duration of survival. The age at onset or at the first diagnosis of the disorder that led to the clinical suspicion of mitochondrial disease was also examined. RESULTS: Twenty patients were sub-classified with mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS), 8 with chronic progressive external ophthalmoplegia (CPEO), and 3 with myoclonus epilepsy associated with ragged-red fibers (MERRF). Nine patients were diagnosed with CIP, 8 of the 20 (40.0%) patients with MELAS, 0 of the 8 (0.0%) patients with CPEO, and 1 of the 3 (33.3%) patients with MERRF. The median age (range) at the diagnosis and the median age at onset of mitochondrial disease were 40 (17-69) and 25 (12-63) years in patients with CIP, and 49 (17-81) and 40 (11-71) years in patients without CIP. During the survey period, 5 patients (4 patients with MELAS and 1 with CPEO) died. The cause of death was cardiomyopathy in 2 patients with MELAS, cerebral infarction in 1 patient with MELAS, epilepsy and aspiration pneumonia in 1 patient with MELAS, and multiple metastases from gastric cancer and aspiration pneumonia in 1 patient with CPEO. CONCLUSION: Patients with CIP tend to have disorders that are suspected to be related to mitochondrial diseases at younger ages than are patients without CIP.

关键词：线粒体疾病肠梗阻患者假性死亡原因 CIP 心肌病生存时间

Suppressive effects of saliva against enamel demineralization caused by acid beverages

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Health 2011年第12期3卷 742-747页

作者： Shoji takahashi shigeru Watanabe Takashi Ogihara Koji Watanabe Kun Xuan Xiaojing Wang 不详

This study aimed to clarify the ability of the buffer systems of saliva to inhibit enamel demineralization after intake of an acid beverage. In the first experiment, titrable acidity tests were carried out. Ten milliliters of saliva stimulated by chewing gum base was obtained from 10 healthy adult subjects and the pH of each saliva sample was measured. The beverages used for the experiment were a carbonated soft drink (pH 2.2), a sports drink (pH 3.5), and 100% orange juice (pH 3.8). Distilled water adjusted to the pH of each saliva sample was used as a control. In the second experiment, the suppressive ability of saliva against enamel demineralization was quantitatively analyzed using quantitative light- induced fluorescence (QLF). Aliquots of stimulated saliva obtained from a subject were mixed with 15 ml of 100% orange juice in saliva:orange juice ratios of 1/30, 1/15, 1/10 and 1/5, and bovine teeth were soaked for 24 hours in the solutions. The △Q of the QLF analyses of the enamel was then measured. The lowest titrant volume which reduced the pH of the initial saliva (7.7 on average) to pH 5.4 was that of the orange juice. No relationship was found between the buffer capacity and the pH of the acid beverages. From the QLF measurement, the saliva-orange juice group showed a significantly decreased amount of enamel demineralization (p < 0.01 at 20% level) compared with the distilled water-orange juice group. In conclusion, saliva acts as a buffer to suppress enamel demineralization caused by low-pH beverages.

关键词： Erosion Acid Beverage Saliva Buffering Capacity QLF

Correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis

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World Journal of Gastroenterology 2014年第45期20卷 17065-17074页

作者： Hideaki takahashi Ryuta Shigefuku Yoshihito Yoshida Hiroki Ikeda Kotaro Matsunaga Nobuyuki Matsumoto Chiaki Okuse shigeru Sase Fumio Itoh Michihiro Suzuki Division of Gastroenterology and Hepatology Department of Internal Medicine St.Marianna University School of Medicine Division of Gastroenterology Department of Internal Medicine Sapporo Shirakabadai Hospital Department of Molecular Biology Sapporo Medical University School of Medicine Anzai Medical Co. Ltd.

AIM:To elucidate the correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis(AL-LC).METHODS:The subjects included 35 patients with ALLC(34 men,1 woman;mean age,58.9±10.7 years;median age,61 years;range:37-76 years).All patientswere enrolled in this study after obtaining written informed consent.Liver function was measured with tests measuring albumin(Alb),prothrombin time(PT),brain natriuretic peptide(BNP),branched amino acid and tyrosine ratio(BTR),branched chain amino acid(BCAA),tyrosine,ammonia(NH3),cholinesterase(Ch E),immunoreactive insulin(IRI),total bile acid(TBA),and the retention rate of indocyanine green 15 min after administration(ICG R15).Hepatic blood flow,hepatic arterial tissue blood flow(HATBF),portal venous tissue blood flow(PVTBF),and total hepatic tissue blood flow(THTBF)were simultaneously calculated using xenon computed tomography.RESULTS:PVTBF,HATBF and THTBF were 30.2±10.4,20.0±10.7,and 50.3±14.9 m L/100 m L/min,respectively.Alb,PT,BNP,BTR,BCAA,tyrosine,NH3,Ch E,IRI,TBA,and ICG R15 were 3.50±0.50 g/d L,72.0%±11.5%,63.2±56.7 pg/m L,4.06±1.24,437.5±89.4μmol/L,117.7±32.8μmol/L,59.4±22.7μg/d L,161.0±70.8 IU/L,12.8±5.0μg/d L,68.0±51.8μmol/L,and 28.6%±13.5%,respectively.PVTBF showed a significant negative correlation with ICG R15(r=-0.468,P<0.01).No significant correlation was seen between ICG 15R,HATBF and THTBF.There was a significant correlation between PVTBF and Alb(r=0.2499,P<0.05),and NH3 tended to have an inverse correlation with PVTBF(r=-0.2428,P=0.0894).There were also many significant correlations between ICG R15 and liver function parameters,including Alb,NH3,PT,BNP,TBA,BCAA,and tyrosine(r=-0.2156,P<0.05;r=0.4318,P<0.01;r=0.4140,P<0.01;r=0.3610,P<0.05;r=0.5085,P<0.001;r=0.4496,P<0.01;and r=0.4740,P<0.05,respectively).CONCLUSION:Our investigation showed that there is a close correlation between liver function and hepatic blood flow.

关键词： Alcoholic liver cirrhosis Hepatic tissue blood flo

A study on sleep architecture in patients with chronic respiratory failure under long-term oxygen therapy—Focused on the influence of ventilatory failure (high CO<sub>2</sub>) elements on the patient’s sleep architecture

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Health 2013年第8期5卷 14-20页

作者： Tsuguo Nishijima Keisuke Hosokawa Fumitaka Mito Tetsuya Kizawa Susumu takahashi Hiroshi Kagami Akira Suwabe shigeru Sakurai Department of Laboratory Medicine Iwate Medical University School of Medicine Morioka Japan Department of Respirology Hachinohe Red Cross Hospital Hachinohe Japan Division of Behavioral Sleep Medicine Iwate Medical University School of Medicine Morioka Japan

Sleep disturbance related symptoms are common in patients with long-term oxygen therapy (LTOT). Essentially, there were only few previous reports about the sleep architecture in patients with respiratory disease, such as chronic obstructive pulmonary disease (COPD). This study aims to clarify the objective sleep state and the elements that affect sleep architecture in Chronic Respiratory Failure (CRF) patients with focus on clinical cases of chronic hypercapnia. 13 subjects with chronic respiratory failure were enrolled in the study. All the subjects were pre-evaluated by pulmonary function test and Arterial blood gas analysis (ABG) including exercise testing. Polysomnography (PSG) test was performed in each subject with supplemental oxygen. The estimated base line PaCO2 value that reflects overall PaCO2 including sleep period was calculated using equation of PaCO2[2.4×(HCOˉ3)-22]from obtained ABG value just before PSG test. 6 subjects were classified as hypercapnic group (base line PaCO2 ≥ 45 mmHg) and 7 subjects were non-hypercapnic group (base line PaCO2 < 45 mmHg). Latency persistent sleep of PSG data was significant higher in patients with hypercapnic than non-hypercapnic (p < 0.01). Periodic Limb Movement was seen in 23.6% of the subjects, however there was no contribution for arousals. Other PSG data include mean SpO2 were no significant difference. This study suggests that patients with estimated hypercapnia had more disturbed sleep architecture especially significant loss of sleep latency than non-hypercapnic patient with chronic respiratory failure under LTOT. Nocturnal PaCO2 level or ventilatory function may contribute to sleep disturbance in patients with estimated hypercapnia during LTOT.

关键词： Chronic Respiratory Failure Long-Term Oxygen Therapy Sleep Architecture Periodic Leg Movement Disorder