Objective: This study investigated how predictors such as older onset affected the length of hospital stay in elderly psychiatric inpatients, excluding those suffering from organic diseases.
Methods: The study included 101 patients aged 65 and older hospitalized at St. Marianna University Hospital from January 2018 to December 2019. We performed a retrospective clinical chart review that examined medical information such as the patient’s social background and symptomatological factors, including older onset.
Results: A univariate analysis found that the length of hospital stay was significantly longer among those with an onset age of 60 years or older than among those under 60 years old. Other factors associated with an extended length of stay included compulsory hospitalization, gender, psychotic symptoms and suicidal ideation, and lack of insight. The results of multivariate analysis indicated that older onset and suicidal ideation at admission were predictors of a longer hospital stay.
Discussion: Suicidal ideation at admission reflects the severity of illness and may affect the length of hospital stay. Patients and their families may find it difficult to accept a mental illness diagnosis in the case of elderly onset, and they may be reluctant to consent to a discharge. Therefore, it is important to properly evaluate patients’ psychiatric symptoms and medical information at the time of admission and intervene early with an eye to making environmental adjustments.

A retrospective study was performed in 282 patients who underwent treatment with immune checkpoint inhibitors (ICI) at St. Marianna University Hospital from July 2014 to November 2020. There were 38 patients with 43 lesions that revealed cutaneous immune-related adverse events (irAEs), which were observed more frequently in female patients. The incidence rate of cutaneous irAEs was the highest in malignant melanoma (51.6%) followed by renal cell carcinoma (21.1%), and malignant pleural mesothelioma (20.0%). Cutaneous irAEs occurred in 12.8% of the patients treated with anti-PD-1 antibody, 50.0% of those treated with a combination of anti-PD-1 and anti-CTLA-4 antibodies, and 10.0% of those treated with anti-PD-L1 antibody. As for the types of rashes, maculopapular rash was observed in 21 patients, vitiligo in 11 patients, lichen planus in 3 patients, psoriasis in 3 patients, eruption in 3 patients, bullous pemphigoid in 1 patient, and alopecia in 1 patient. Psoriasis and maculopapular rash appeared early; however, vitiligo and lichen planus appeared later. The Common Terminology Criteria for Adverse Events grade of eruption was 1–2 in 93.0% of the patients, while 7.0% of the patients reported Grade 3. The use of ICI was discontinued in 5 patients. Among the 38 patients, 5 patients had a complete response, 6 had a partial response against the tumor. Seven of these 11 responders were malignant melanoma patients. Regarding malignant melanoma cases, the response rate against melanoma was higher in patients with cutaneous irAEs than those without. Cutaneous irAEs often appear earlier than other irAEs. Most cutaneous irAEs are mild; however, we need to be cautious as severe cases exist. As several points regarding cutaneous irAEs remain unanswered, it is necessary to evaluate more cases and treat those patients in cooperation with other departments.

Purpose: Cultured epithelium grafting is an effective and relatively less invasive medical technique for the treatment of extensive vitiligo. However, the results obtained after grafting are not stable because the conventional culture technique only maintains the melanocytes present in the epithelial cell culture but does not support melanocyte growth. To solve this problem, we established an epithelial cell culture technique that can regulate the melanocyte content. In this study, we investigated the viability and persistence of melanocytes in cultured epithelium cells.
Methods: Cultured epidermis was prepared at epidermal cell/pigment cell ratios of 1: 0.01, 1: 0.1, and 1:1. These cultured epithelial sheets were then grafted subcutaneously into immunodeficient mice, and the tissues were collected after periods of 2 weeks and 3 months, for histological examination.
Results: Survival of the pigmented epithelium was confirmed after 2 weeks. The grafted cultured epithelium contained Melan-A positive cells and melanin granules (as detected with Giemsa staining). The number of melanocytes in the cultured epithelium after grafting changed according to the ratio of seeded melanocytes. The viability of the cultured epithelium and melanocytes was also confirmed in the tissue collected 3 months after transplantation. Moreover, Giemsa staining demonstrated the presence of melanin granules in these pigmented cells. The melanocytes in the grafted epithelium tested positive for Dopa reaction, 3 months after the transplantation.
Conclusion: The cultured epithelium containing melanocytes was able to proliferate in vivo, and the melanocytes survived and maintained their functions, even in the long term. Therefore, this technique may provide a better color-matched treatment for vitiligo vulgaris in the future.

Osteoarthritis (OA) is a joint disease characterized by gradual loss of cartilage matrix. Recently, the increased production of MMP-1, MMP-2 and MMP-3 in synovial tissue (ST) has been considered to be involved in the loss of cartilage in OA. The pathological roles of miRNAs in various diseases have been recently highlighted. We first explored which miRNAs regulate the expression of MMP-1 and then investigated the relationship between the selected miRNAs and MMP-2/MMP-3 in OA synovium. Twenty-six synovial fluid (SF) samples were collected from 26 early- or middle-stage OA knees. In addition, 30 ST samples were prepared from 30 end-stage OA knees during prosthetic replacement arthroplasty. The concentrations of MMPs and amounts of 65 miRNAs in the SF samples were quantified by a Luminex assay and quantitative polymerase chain reaction (qPCR), respectively. The expression of MMPs and miRNAs in the ST samples were quantified by qPCR. As a result, among the 65 miRNAs, miR-21-5p and miR-195 showed a wide range of measurements that were negatively correlated with the measurements of MMP-1 in the SF samples. In the expression analysis of miR-21-5p, miR-195, and MMP1 mRNA in the ST samples, the amount of miR-21-5p but not miR-195 showed a negative correlation with the levels of MMP1 mRNA. We then investigated the relationships between miR-21-5p and MMP-2/MMP-3. As a result, the amounts of miR-21-5p were negatively correlated with the concentration of MMP-2 and MMP-3, respectively, in the SF samples. Similarly, the amounts of miR-21-5p were negatively correlated with the expression of MMP2 and MMP3 mRNA, respectively, in the ST samples. Given these data, we concluded that miR-21-5p may play a role in the increased expression of MMPs in OA synovium.