Dokkyo Medical University Repository / 獨協医科大学リポジトリ
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Changing patterns of pulmonary abnormalities in rheumatoid arthritis
Get PDF獨協医科大学博士（医学）令和5年度doctoral thesi
Association of Skin Autofluorescence with Serum Lipids, Insulin Secretion Ability and Diabetic Complications in Patients with Poorly Controlled Type 2 Diabetes
Get PDFAims: The current study was performed to evaluate the association between the accumulation of advanced glycation end-products (AGEs) in skin and diabetes-related metabolic markers, atherosclerosis and diabetic complications in patients with poorly-controlled type 2 diabetes.
Methods: The skin AGE levels were assessed non-invasively by measuring skin autofluorescence (SAF). The modified low-density lipoprotein (LDL) was assessed by measuring lectin-like oxidized LDL receptor-1 ligand-containing apolipoprotein B (LAB).
Results: SAF was significantly higher in patients with type 2 diabetes than in the healthy control subjects. In patients with type 2 diabetes, SAF correlated positively with age and duration of diabetes. Furthermore, SAF exhibited significant negative correlations with LDL-cholesterol (C), triglyceride (TG) and body mass index. SAF was also negatively correlated with urinary C peptide immunoreactivity (U-CPR). In addition, SAF also exhibited significant positive correlations with cardio-ankle vascular index (CAVI) and intimal medial complex thickness of the carotid artery (IMT). Furthermore, there were significant correlations between SAF and estimated glomerular filtration rate (eGFR) (negative), urinary albumin excretion (positive).
Conclusion: SAF may be negatively associated with serum lipids such as LDL-C and TG, insulin sensitivity ability and renal dysfunction evaluated by eGFR, and positively associated with aging, duration of diabetes, markers of atherosclerosis (CAVI and IMT) in patients with poorly-controlled type 2 diabetes.journal articl
A Point to Be Considered in Evaluating the Renal Function
Get PDFChronic kidney disease (CKD) is clinically important not only because it progresses to end-stage renal failure, but also because it is a major risk factor for cardiovascular disease. Appropriate evaluation of renal function is needed in the diagnosis of CKD. Although glomerular filtration rate (GFR) is commonly used to assess renal function, GFR hardly changes when renal function is mildly impaired. The measurement of renal blood or plasma flow is needed to detect the mild degree of renal dysfunction but the procedure is rather complicated and invasive to be performed as a clinical examination in general. Albuminuria may non-quantitatively reflect glomerular hypertension caused by decreased nephron number. Since there is no treatment that improves kidney function in patients with CKD, it may be important to have a management strategy to prevent further decline in kidney function with evaluating the renal function. And, to prevent future renal failure and cardiovascular disease, CKD should be recognized at an early stage through multifaceted assessment and comprehensive intervention should be initiated.journal articl
Hypertensive Disorders of Pregnancy: Pathology and Current Management Strategies in Japan
Get PDFHypertensive disorders of pregnancy, especially preeclampsia, can cause severe damage to both mothers and children. Although the cause and pathogenesis of this disease had remained unknown for many years, recent evidence revealed that failed placentation is the primary cause of preeclampsia, and statistics to predict the onset of disease have been developed. Low dose aspirin is expected to prevent the onset of this disease, and various antihypertensive drugs, which had been previously regarded as contraindicated during pregnancy, are just approved for use in Japan. In contrast, lifelong follow up of women who have experienced hypertensive disorders of pregnancy, especially in Japan, is not yet fully functional. This review focuses on current knowledge on the pathogenesis of hypertensive disorders of pregnancy and novelties regarding its prediction, prevention, and treatment, with a particular emphasis on the current situation in Japan.journal articl
Parvalbumin-positive Neurons in the Mouse A8 Region were Lesser than those in the Rat
Get PDFDopaminergic neurons play crucial roles in various physiological functions, such as reward, goal-directed behavior, memory formation, and pain sensation. One of the main dopaminergic cell groups in the brain is located in the retrorubral field (RRF, A8 region). A recent electrophysiological study using rats revealed that distinct neurons within the A8 region respond to the different degrees of the threat and aversive stimuli, and that the RRF is the origin of neural signals for threat and aversive outcomes. However, neurochemical characterization of the constituents of the A8 region is not enough. The aim of this study is to determine the neurochemical
characteristics of these A8 neurons. To examine the neurochemical cellular organization of the A8 region, we performed immunohistochemistry for two GABAergic neuronal markers, parvalbumin (PV) and neuronal nitric oxide synthase (nNOS), in relation to tyrosine hydroxylase, a marker of dopaminergic neurons. We observed that the number of PV-positive neurons in the mouse A8 region was lesser than in rats. Moreover, nNOS-positive neurons were not detected within the A8 region in either species. These results indicate that the neurochemical organization of the A8 region was distinct between mice and rats. In addition, the cellular composition of the A8 dopaminergic cell group was distinct from other dopaminergic cell groups, such as the A9 and A10 region, in both mice and rats. Understanding these differences among species and cell groups is worth noting for translating the results obtained with distinct animal models into a clinical application.journal articl
The Current State of AI-based Systems for Pathological Diagnosis and Problems with Their Introduction
Get PDF近年，医療現場における人工知能 （artificial intelligence；AI） 技術の進歩は著しく，病理診断の分野でも病理組織デジタル画像 （whole slide image；WSI） を用いて，病変の認識や定量，予後予測，特徴の抽出等を行う病理診断支援 AI システムが開発されている．本邦における病理診断の現場では，病理医数の不足と診断数の増加，報告内容の複雑化により業務の負担が増しており，将来的に AI を病理診断に導入することで，過重な診断業務の軽減や診断精度の向上，形態への情報付加が期待されている．病理診断支援 AI を導入するためには，病理診断支援 AI の医療機器承認，組織画像のデジタル化，標本の均質化や品質管理などの課題が挙げられる．また，病理診断支援 AI が患者の臨床情報や病態生理，採取条件などを併せた包括的な病理診断が可能かは不明瞭であり，病理診断支援 AI システムの進歩も必要と考えられている．病理診断支援 AI システムに対する社会的な関心は高く，病理の分野では日本病理学会を中心に，病理診断支援 AI をどのように取り入れるかの提言や様々な研究開発プロジェクトが進められている．その一方で，診断現場にいる多くの病理医にとって，AI の現場への導入は実感がなく，実際の診断にどのように役立つのかも明確ではないのが現状である．病理診断支援 AI システムの導入に向けては，組織標本をデジタル化するための設備投資やワークフローの構築など，可能な範囲で準備を進めつつ，研究の進捗や法律の整備，病理学会の動向など病理診断支援 AIを取り巻く動向を注視していく必要がある．Artificial intelligence （AI） technology for use in medical practice has made great progress, and in the field of pathology, several AI systems have been developed for lesion recognition and segmentation, prognosis, and feature extraction using whole slide images （WSI） to digitize pathological specimens. Although AI-based systems for pathological diagnosis are currently in the research phase and have yet to achieve practical application, the future introduction of AI is expected to improve the accuracy of pathological diagnosis, add other information to the morphology, and improve working conditions for pathologists. The introduction of AI-based systems for pathological diagnosis involves meeting several challenges, including gaining legal approval, digitization using WSI, pathological specimen homogenization and quality control, and making further progress on AI systems.journal articl
