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音響放射力インパルス(Acoustic Radiation Force Impulse)を伴う超音波により引き起こされる肺胞出血についての研究
Get PDF自治医科大学博士（医学）令和6年度doctoral thesi
Direct Action of Celastrol on Hypothalamic ARC Neurons to Increase Leptin Sensitivity
Get PDFLeptin is an adipocyte-derived hormone that is involved in the regulation of food intake and energy expenditure. Individuals with obesity generally exhibit hyperleptinemia and leptin resistance. Leptin sensitizers, rather than leptin, are expected to act as anti-obesity drugs. Recently, celastrol was identified as a leptin sensitizer. Celastrol alleviated endoplasmic reticulum (ER) stress and restored leptin sensitivity in the hypothalamus. However, the molecular mechanisms and sites of action of celastrol remain poorly understood. In this study, after confirming the effect of celastrol on body weight, food intake, and leptin sensitivity in lean and diet-induced obese (DIO) mice, we investigated the direct effect of celastrol on arcuate nucleus (ARC) neurons isolated from the hypothalamus by monitoring the intracellular calcium concentrations ([Ca2+]i). Celastrol treatment significantly decreased body weight gain and food intake, and significantly augmented leptin actions on food intake and hypothalamic signal transducer and activator of transcription 3 (STAT3) phosphorylation in both lean and DIO mice. In accordance with these results, celastrol treatment enhanced [Ca2+]i response to leptin in the ARC neurons of both lean and DIO mice. To our knowledge, this is the first report to demonstrate the direct effect of celastrol on ARC neurons. This knowledge might shed light on the molecular mechanisms underlying celastrol-induced leptin sensitization and resistance.departmental bulletin pape
Retroperitoneoscopy-assisted sigmoid colostomy after abdominoperineal resection for rectal cancer
Get PDF今回我々は，腹腔鏡下直腸切断術において鏡視下に後腹膜経路で結腸ストーマを作成する方法を導入したので報告する。ストーマ造設予定部皮膚を切開し，ラッププロテクターミニ®を留置する。５mmポート３本を付けたE・Zアクセス®を装着し，気嚢を開始する。左側半月状線の正中側で腹直筋後鞘を切開し，腹膜前腔に入る。腹膜と腹膜前脂肪（flank pad）との間を丁寧に剥離し，腹腔内と交通させる。気腹状態が維持されるので，腹腔内観察を行いながら，腹腔鏡用鉗子で結腸断端を把持し体外に導出する。鏡視下後腹膜経路ストーマ造設法は，完全腹膜外修復法Totally Extraperitoneal repair（TEP）や腹横筋リリースTransversus Abdominis Release（TAR）などの腹壁ヘルニア修復技術を応用することで，腹壁構造を確認しながら正確な後腹膜経路を作成できる安全な方法と考えられる。departmental bulletin pape
低位前方切除後症候群（Low Anterior Resection Syndrome：LARS）の発生率・リスクファクター・生活の質に関する調査研究
Get PDF自治医科大学博士（医学）令和6年度doctoral thesi