Autoimmunity-related neutrophilic dermatosis after coronavirus disease 2019 vaccination: A case report and literature review.

Autoimmune diseases triggered by coronavirus disease 2019 (COVID-19) mRNA vaccination have been emerging. Here, we report the case of a 27-year-old Japanese man with autoimmunity-related neutrophilic dermatosis, occurring as an initial cutaneous manifestation of systemic lupus erythematosus with Sjögren syndrome after the second dose of the Pfizer/BioNTech COVID-19 vaccination. The patient presented with urticarial erythema and partially annular erythema on the trunk and extremities with severe pruritus. Histopathological analysis showed vacuolar degeneration at the dermo-epidermal junction and interstitial neutrophil infiltration. We reviewed eight patients, including the aforementioned patient, with exacerbation or new-onset of SLE after COVID-19 vaccination and found the patient had relatively mild symptoms, itchy annular erythema, and positive anti-SS-A/SS-B antibodies. COVID-19 mRNA vaccination can induce the production of type-I interferon, which plays a crucial role in the pathogenesis of SLE and may cause autoimmunity-related neutrophilic dermatosis in susceptible individuals. In the case that itchy annular erythema develops approximately 2 weeks after the vaccination, the possibility of systemic or cutaneous lupus erythematosus should be considered. For an accurate diagnosis, dermatologists should obtain a recent vaccination history and perform complete antibody profiling and skin biopsy for patients presenting with annular or erythema multiforme-like lesions.

Japanese patients with psoriasis and atopic dermatitis show distinct personality profiles.

Personality and emotional factors are supposed to influence the course of skin diseases, such as psoriasis and atopic dermatitis. Few reports exist, however, showing distinct personality traits among patients with psoriasis, atopic dermatitis patients and healthy controls. The aim of the present study was to examine personality differences among psoriasis patients, atopic dermatitis patients and healthy controls in Japan. A total number of 51 psoriasis patients, 97 atopic dermatitis patients and 48 healthy individuals were enrolled in the study. Questionnaires of Yatabe-Guilford Personality Inventory were administered individually. These groups were evaluated by 12 dimensions of temperaments. According to the dimension scores, personality was defined as five groups. Atopic dermatitis patients showed significantly higher scores regarding temperaments of depression, feelings of inferiority, nervousness and lack of objectivity than psoriasis patients. Regarding a temperament of cyclic tendency and lack of cooperativeness, female atopic dermatitis patients showed significantly higher scores than female psoriasis patients. Regarding general activity, female atopic dermatitis patients showed significantly lower scores than those of female psoriasis patients. No significant difference in scores of temperaments of lack of agreeableness, rhathymia, thinking extraversion, ascendance and social extraversion were detected among psoriasis patients, atopic dermatitis patients and healthy controls. The personalities of male psoriasis patients were significantly different from those of atopic dermatitis patients and healthy controls. Female psoriasis patients showed a significantly different personality profile from that of atopic dermatitis patients, but not from healthy controls. Japanese psoriasis and atopic dermatitis patients show distinct personality profiles suggesting that specific a psychosomatic approach may be required during the treatment.

[Search for the subconsciousness of hospital pharmacists on their practices of blood drawing or injection, and etc].

The purpose of this study was to clarify the subconsciousness of hospital pharmacists regarding them practicing drip infusion or blood drawing for therapeutic drug monitoring (TDM), etc. We conducted a mail-in survey targeting 476 randomly-selected hospital pharmacists. In our survey sheet we presented our "hypothetical condition" i.e., "that medical practices such as drip infusion or blood drawing for TDM by hospital pharmacists be legally allowed" and we asked them 23 items about the pros and cons of this hypothetical condition and its influence on medical practice. Then, using factor analysis, we searched for the subconsciousness of hospital pharmacists from their answers to the 23 items. We then analyzed the causal association between the factors extracted from the survey and the pros and cons of the "hypothetical condition" using logistic regression analysis. 47.7% of respondents agreed to the "hypothetical condition". The results of this research provided 5 factors, consisting of "expectation of medical care and society", "temperament of pharmacists", "pharmacotherapy", "employment", and "medical team". We understood from the result of logistic regression analysis that hospital pharmacists subconsciously had two kinds of expectation, i.e., expectation about medical care and society, and about qualitative improvement of pharmacotherapy, as their background when they decided to agree to themselves practicing drip infusion or blood drawing for TDM, etc.

[Consciousness research and analysis on the directive pharmacists who provide pre-education prior to clinical practice--an effort in the College of Pharmacy Nihon University].

For the purpose of providing a pre-education prior to clinical practice which can be reflected in clinical practices, we researched and analyzed the consciousness, requests, and etc, for pre-education prior to clinical practice of the directive pharmacists who work in a community hospital or pharmacy. We conducted questionnaire-survey which targeted for the directive pharmacists of the on-the-job trainees in the participating institutions (including 45 community hospitals and 179 community pharmacies) of the College of Pharmacy Nihon University. The average collection rate from each institution group was 55.9% (62.2% in community hospitals and 54.2% in community pharmacies). The answers for the degrees of expectations to the pre-education showed those responding as "promising" at 50.2%, "not-promising" at 6.3%, and "neither" at 43.5%, respectively. With the presence or absence of expectation as objective variable, we analyzed the relationship between the objective variable and respondent's attributes using the logistic regression analysis. The result demonstrated that those who worked in a community pharmacy and that had shorter teaching term and more superior post tended to have greater expectation. Also, when we performed a correspondence analysis for the images of the pre-education using the text-mining approach, we could confirm that each group member who had the manager posts in hospitals and in pharmacies had the same structure of consciousness. If we reflect the study results on the pre-education, we could establish the practical education system of the pre-education, which enable trainees to successfully advance into the on-the-job training.

[Search for consciousness of hospital pharmacists on the future prospects of their practices and on their practices of blood drawing or injection].

This research intends to clarify the future prospects of hospital pharmacists and also the factors which influence on their practices of blood drawing or injection by conducting research on their consciousness. We studied it using mail-in survey targeting on randomly selected 476 hospital pharmacists. Study items were the attribution of responders, the prospects of their status in 10 years later, and the system and practices which influence on their future prospects (for example, injection, blood drawing during TDM, and etc.). The collection rate of the questionnaire/inquiry sheet was 37.0%. Regarding their future prospects in 10 years, 65.1% of responders answered they felt pessimistic. Among those system and practices which could influence on the prospects, they answered "Pharmacy specialist system" as the most optimistic and "Diagnosis related group/Prospective payment system (Japanese version; DPC)" as the most pessimistic. Regarding the above mentioned future prospects for injection and blood drawing during TDM by pharmacists, we implemented an exploratory data analysis by applying responders' attribution to a logistic model. The result of it showed that the pharmacists who work longer years, are in charge of drug information, and work in a hospital having more corresponding number of sickbeds per pharmacist had more positive consciousness to the above-mentioned practices. We hope this study results will be utilized as objective information in the discussion on the expansion of pharmacists' job categories.

[Application of text mining approach to pre-education prior to clinical practice].

We developed a new survey analysis technique to understand students' actual aims for effective pretraining prior to clinical practice. We asked third-year undergraduate students to write fixed-style complete and free sentences on "preparation of drug dispensing." Then, we converted their sentence data in to text style and performed Japanese-language morphologic analysis on the data using language analysis software. We classified key words, which were created on the basis of the word class information of the Japanese language morphologic analysis, into categories based on causes and characteristics. In addition to this, we classified the characteristics into six categories consisting of those concepts including "knowledge," "skill and attitude," "image," etc. with the KJ method technique. The results showed that the awareness of students of "preparation of drug dispensing" tended to be approximately three-fold more frequent in "skill and attitude," "risk," etc. than in "knowledge." Regarding the characteristics in the category of the "image," words like "hard," "challenging," "responsibility," "life," etc. frequently occurred. The results of corresponding analysis showed that the characteristics of the words "knowledge" and "skills and attitude" were independent. As the result of developing a cause-and-effect diagram, it was demonstrated that the phase "hanging tough" described most of the various factors. We thus could understand students' actual feelings by applying text-mining as a new survey analysis technique.

C9orf10 protein, a novel protein component of Puralpha-containing mRNA-protein particles (Puralpha-mRNPs): characterization of developmental and regional expressions in the mouse brain.

Puralpha has been implicated in mRNA transport and translation in neurons. We previously reported that Puralpha is a component of mRNA/protein complexes (Puralpha-mRNPs) with several other proteins. Among them, we found the C9orf10 (Homo sapiens chromosome 9 open reading frame 10) protein, which was recently characterized as a component of RNA-containing structures. However, C9orf10 itself remains poorly understood. To characterize C9orf10 expression at the protein level, we raised an antibody against C9orf10 and compared the spatial and developmental expressions of this protein and Puralpha in the mouse brain. C9orf10 was expressed as early as embryo stage 12, whereas Puralpha was expressed from 5 days after birth. In adults, C9orf10 expression was most prominent in the hippocampus, caudate putamen, cerebral cortex, and cerebellum, unlike the uniform distribution of Puralpha. C9orf10-positive cells also showed immunoreactivity to Puralpha. C9orf10 expression was restricted to neurons, judging by the immunoreactivity to neuron-specific nuclear protein or CaM kinase II. These observations suggest an accessory role of C9orf10 for Puralpha in a limited brain region in addition to other possible functions that have not yet been determined.

Identification of mRNA/protein (mRNP) complexes containing Puralpha, mStaufen, fragile X protein, and myosin Va and their association with rough endoplasmic reticulum equipped with a kinesin motor.

Puralpha, which is involved in diverse aspects of cellular functions, is strongly expressed in neuronal cytoplasm. Previously, we have reported that this protein controls BC1 RNA expression and its subsequent distribution within dendrites and that Puralpha is associated with polyribosomes. Here, we report that, following treatment with EDTA, Puralpha was released from polyribosomes in mRNA/protein complexes (mRNPs), which also contained mStaufen, Fragile X Mental Retardation Protein (FMRP), myosin Va, and other proteins with unknown functions. As the coimmunoprecipitation of these proteins by an anti-Puralpha antibody was abolished by RNase treatment, Puralpha may assist mRNP assembly in an RNA-dependent manner and be involved in targeting mRNPs to polyribosomes in cooperation with other RNA-binding proteins. The immunoprecipitation of mStaufen- and FMRP-containing mRNPs provided additional evidence that the anti-Puralpha detected structurally or functionally related mRNA subsets, which are distributed in the somatodendritic compartment. Furthermore, mRNPs appear to reside on rough endoplasmic reticulum equipped with a kinesin motor. Based on our present findings, we propose that this rough endoplasmic reticulum structure may form the molecular machinery that mediates and regulates multistep transport of polyribosomes along microtubules and actin filaments, as well as localized translation in the somatodendritic compartment.