1.Medical law education in the USA and West Germany.
Keiichi YAMAMOTO ; Masazumi OKAE ; Tatsuya FUJIMIYA ; Yoshiko YAMAMOTO
Medical Education 1988;19(3):201-205
2.A Report of a Support Program for Cancer Patients and Their Families “Cancer Salon Rainbow” at Jichi Medical University Hospital
Rie Yamamoto ; Kaori Komatsuzaki ; Yoshiko Kojima ; Miwako Inada ; Hiromi Maeda ; Yumi Oeda ; Tazuko Maehara ; Hirofumi Fujii
Palliative Care Research 2017;12(2):918-922
Objectives: A cancer salon was established at Jichi Medical University Hospital in April 2014 operated based on the plan-do-check-act (PDCA) cycle. This study aims to understand the actual situation of the cancer salon and outcomes of participants, and utilize the information for optimal administration. Methods: The cancer salon was open to the public and conducted in our hospital. The program consisted of mini-lectures, relaxation, and interaction with the participants. We conducted a questionnaire survey for the participants. Results: We held 11 sessions from April 2014 to March 2015. The total number of participants was 369, and the average number of participants per session was 34 (22-50). Participants mainly consisted of patients and families who received care in our hospital. A high percentage of participants were women in their 60’s, patients who were newly diagnosed cancer within 3 years, or patients with breast cancer. Participants’ satisfaction tended to be high in lectures and relaxation, and there was a tendency for anxiety to be alleviated in their psychological state. Discussion: We must challenge that we refine quantitative evaluation methods and develop the system of assessment of detailed needs and provide appropriate support. Furthermore, we would like to propagate this system to the area around our hospital, support the development of cancer salons at other medical institutions, collaborate with them, and contribute to the creation of an inclusive society.
3.A Case of Inflammatory Abdominal Aortic Aneurysm Associated with IgG4
Yukihiro Noda ; Susumu Fujii ; Yoshiko Shintani ; Takeshi Takagi ; Shinichiro Yamamoto ; Yasuharu Kaizaki
Japanese Journal of Cardiovascular Surgery 2008;37(1):48-52
We describe our surgical experience of inflammatory abdominal aortic aneurysm (IAAA) in a 54-year-old man. Computed tomography (CT) with contrast enhancement revealed an infrarenal abdominal aortic aneurysm with marked thickening of the aneurysmal wall (mantle core sign) and left hydronephrosis. The left ureteral stenting was performed. Preoperative laboratory findings showed high levels of serum IgG4. The IAAA was removed and replaced with a woven-Dacron graft in situ. Histological examination revealed the IgG4 positive plasma cell, and demonstrated IAAA associated with IgG4. The postoperative serum IgG4 was reduced, but remained high. The postoperative CT revealed new right hydronephrosis, and the ureteral stent was performed. The mantle sign reduced in CT scan after steroid therapy. IAAA with hydronephrosis seems to be associated with IgG4-related sclerosing disease. In this case, the levels of serum IgG4 seems to be a good index for treatment efficacy.
4.A Spontaneous Rupture of the Ascending Aorta
Hiroki Kato ; Hideyasu Ueda ; Hironari No ; Yoji Nishida ; Shintaro Takago ; Yoshitaka Yamamoto ; Yoshiko Shintani ; Kenji Iino ; Keiichi Kimura ; Hirofumi Takemura
Japanese Journal of Cardiovascular Surgery 2016;45(6):281-283
The patient was 62-year-old woman was brought to the emergency room with chest pain and dyspnea. Computed tomography revealed a hematoma around the ascending aorta, a notch in the aortic wall, pericardial effusion and a hematoma around the pulmonary artery. We diagnosed early thrombotic type of acute aortic dissection. An ascending aorta replacement was performed via median sternotomy under hypothermic circulatory arrest. Upon operation, there was a 1.0 cm intimal tear just above the left main trunk and there was no specific evidence of aortic dissection. So we diagnosed spontaneous aortic rapture. Her postoperative course was uneventful and she was discharged 18 days after surgery.
5.The association of follicular fluid volume with human oolemma stretchability during intracytoplasmic sperm injection.
Taketo INOUE ; Yoshiki YAMASHITA ; Yoshiko TSUJIMOTO ; Shuji YAMAMOTO ; Sayumi TAGUCHI ; Kayoko HIRAO ; Mikiko UEMURA ; Kayoe IKAWA ; Kazunori MIYAZAKI
Clinical and Experimental Reproductive Medicine 2017;44(3):126-131
OBJECTIVE: Oocyte degeneration often occurs after intracytoplasmic sperm injection (ICSI), and the risk factor is low-quality oocytes. The follicular fluid (FF) provides a crucial microenvironment for oocyte development. We investigated the relationships between the FF volume aspirated from individual follicles and oocyte retrieval, oocyte maturity, oolemma stretchability, fertilization, and development. METHODS: This retrospective study included data obtained from 229 ICSI cycles. Ovarian stimulation was performed according to a gonadotropin-releasing hormone antagonist protocol. Each follicle was individually aspirated and divided into six groups according to FF volume (<1.0, 1.0 to <2.0, 2.0 to <3.0, 3.0 to <4.0, 4.0 to <5.0, and ≥5.0 mL). Oolemma stretchability during ICSI was evaluated using a mechanical stimulus for oolemma penetration, that is, the stretchability was assessed by oolemma penetration with aspiration (high stretchability) or without aspiration (low stretchability). RESULTS: Oocyte retrieval rates were significantly lower in the <1.0 mL group than in the ≥1.0 mL groups (46.0% [86/187] vs. 67.5%–74.3% [172/255 to 124/167], respectively; p<0.01). Low oolemma stretchability was significantly more common in the <1.0 mL group than in the ≥1.0 mL groups during ICSI (22.0% [13/59] vs. 5.8%–9.4% [6/104 to 13/139], respectively; p=0.018). There was a relationship between FF volume and oolemma stretchability. However, there were no significant differences in the rates of fertilization, cleavage, ≥7 cells at day 3, and blastocyst development among all groups. CONCLUSION: FF volume is potentially associated with the stretchability of metaphase II oolemma during ICSI. Regarding oolemma stretchability, ensuring a uniform follicular size during ovarian stimulation is crucial to obtain good-quality oocytes.
Blastocyst
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Clothing
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Female
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Fertilization
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Follicular Fluid*
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Gonadotropin-Releasing Hormone
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Humans*
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Infertility
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Membranes
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Metaphase
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Oocyte Retrieval
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Oocytes
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Ovarian Follicle
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Ovulation Induction
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Retrospective Studies
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Risk Factors
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Sperm Injections, Intracytoplasmic*
6.¹²³I-Labeled oxLDL Is Widely Distributed Throughout the Whole Body in Mice
Atushi NAKANO ; Hidekazu KAWASHIMA ; Yoshinori MIYAKE ; Tsutomu ZENIYA ; Akihide YAMAMOTO ; Kazuhiro KOSHINO ; Takashi TEMMA ; Tetsuya FUKUDA ; Yoshiko FUJITA ; Akemi KAKINO ; Shigehiko KANAYA ; Tatsuya SAWAMURA ; Hidehiro IIDA
Nuclear Medicine and Molecular Imaging 2018;52(2):144-153
PURPOSE: Oxidized low-density lipoprotein (oxLDL) plays a key role in endothelial dysfunction, vascular inflammation, and atherogenesis. The aim of this study was to assess blood clearance and in vivo kinetics of radiolabeled oxLDL in mice.METHODS: We synthesized ¹²³I-oxLDL by the iodine monochloride method, and performed an uptake study in CHO cells transfected with lectin-like oxLDL receptor-1 (LOX-1). In addition, we evaluated the consistency between the ¹²³I-oxLDL autoradiogram and the fluorescence image of DiI-oxLDL after intravenous injection for both spleen and liver. Whole-body dynamic planar images were acquired 10 min post injection of ¹²³I-oxLDL to generate regional time-activity curves (TACs) of the liver, heart, lungs, kidney, head, and abdomen. Regional radioactivity for those excised tissues as well as the bladder, stomach, gut, and thyroid were assessed using a gamma counter, yielding percent injected dose (%ID) and dose uptake ratio (DUR). The presence of ¹²³I-oxLDL in serum was assessed by radio-HPLC.RESULTS: The cellular uptakes of ¹²³I-oxLDL were identical to those of DiI-oxLDL, and autoradiograms and fluorescence images also exhibited consistent distributions. TACs after injection of ¹²³I-oxLDL demonstrated extremely fast kinetics. The radioactivity uptake at 10 min postinjection was highest in the liver (40.8 ± 2.4% ID). Notably, radioactivity uptake was equivalent throughout the rest of the body (39.4 ± 2.7% ID). HPLC analysis revealed no remaining ¹²³I-oxLDL or its metabolites in the blood.CONCLUSION: ¹²³I-OxLDL was widely distributed not only in the liver, but also throughout the whole body, providing insight into the pathophysiological effects of oxLDL.
Abdomen
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Animals
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Atherosclerosis
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CHO Cells
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Chromatography, High Pressure Liquid
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Cricetinae
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Fluorescence
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Head Kidney
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Heart
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Inflammation
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Injections, Intravenous
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Iodine
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Kinetics
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Lipoproteins
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Liver
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Lung
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Methods
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Mice
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Radioactivity
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Spleen
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Stomach
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Thyroid Gland
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Urinary Bladder
7.¹²³I-Labeled oxLDL Is Widely Distributed Throughout the Whole Body in Mice
Atushi NAKANO ; Hidekazu KAWASHIMA ; Yoshinori MIYAKE ; Tsutomu ZENIYA ; Akihide YAMAMOTO ; Kazuhiro KOSHINO ; Takashi TEMMA ; Tetsuya FUKUDA ; Yoshiko FUJITA ; Akemi KAKINO ; Shigehiko KANAYA ; Tatsuya SAWAMURA ; Hidehiro IIDA
Nuclear Medicine and Molecular Imaging 2018;52(2):144-153
PURPOSE:
Oxidized low-density lipoprotein (oxLDL) plays a key role in endothelial dysfunction, vascular inflammation, and atherogenesis. The aim of this study was to assess blood clearance and in vivo kinetics of radiolabeled oxLDL in mice.
METHODS:
We synthesized ¹²³I-oxLDL by the iodine monochloride method, and performed an uptake study in CHO cells transfected with lectin-like oxLDL receptor-1 (LOX-1). In addition, we evaluated the consistency between the ¹²³I-oxLDL autoradiogram and the fluorescence image of DiI-oxLDL after intravenous injection for both spleen and liver. Whole-body dynamic planar images were acquired 10 min post injection of ¹²³I-oxLDL to generate regional time-activity curves (TACs) of the liver, heart, lungs, kidney, head, and abdomen. Regional radioactivity for those excised tissues as well as the bladder, stomach, gut, and thyroid were assessed using a gamma counter, yielding percent injected dose (%ID) and dose uptake ratio (DUR). The presence of ¹²³I-oxLDL in serum was assessed by radio-HPLC.
RESULTS:
The cellular uptakes of ¹²³I-oxLDL were identical to those of DiI-oxLDL, and autoradiograms and fluorescence images also exhibited consistent distributions. TACs after injection of ¹²³I-oxLDL demonstrated extremely fast kinetics. The radioactivity uptake at 10 min postinjection was highest in the liver (40.8 ± 2.4% ID). Notably, radioactivity uptake was equivalent throughout the rest of the body (39.4 ± 2.7% ID). HPLC analysis revealed no remaining ¹²³I-oxLDL or its metabolites in the blood.
CONCLUSION
¹²³I-OxLDL was widely distributed not only in the liver, but also throughout the whole body, providing insight into the pathophysiological effects of oxLDL.
8.Glycemic Control Is Associated with Histological Findings of Nonalcoholic Fatty Liver Disease
Teruki MIYAKE ; Shinya FURUKAWA ; Bunzo MATSUURA ; Osamu YOSHIDA ; Masumi MIYAZAKI ; Akihito SHIOMI ; Ayumi KANAMOTO ; Hironobu NAKAGUCHI ; Yoshiko NAKAMURA ; Yusuke IMAI ; Mitsuhito KOIZUMI ; Takao WATANABE ; Yasunori YAMAMOTO ; Yohei KOIZUMI ; Yoshio TOKUMOTO ; Masashi HIROOKA ; Teru KUMAGI ; Eiji TAKESITA ; Yoshio IKEDA ; Masanori ABE ; Yoichi HIASA
Diabetes & Metabolism Journal 2024;48(3):440-448
Background:
Poor lifestyle habits may worsen nonalcoholic fatty liver disease (NAFLD), with progression to nonalcoholic steatohepatitis (NASH) and cirrhosis. This study investigated the association between glycemic control status and hepatic histological findings to elucidate the effect of glycemic control on NAFLD.
Methods:
This observational study included 331 patients diagnosed with NAFLD by liver biopsy. Effects of the glycemic control status on histological findings of NAFLD were evaluated by comparing the following four glycemic status groups defined by the glycosylated hemoglobin (HbA1c) level at the time of NAFLD diagnosis: ≤5.4%, 5.5%–6.4%, 6.5%–7.4%, and ≥7.5%.
Results:
Compared with the lowest HbA1c group (≤5.4%), the higher HbA1c groups (5.5%–6.4%, 6.5%–7.4%, and ≥7.5%) were associated with advanced liver fibrosis and high NAFLD activity score (NAS). On multivariate analysis, an HbA1c level of 6.5%– 7.4% group was significantly associated with advanced fibrosis compared with the lowest HbA1c group after adjusting for age, sex, hemoglobin, alanine aminotransferase, and creatinine levels. When further controlling for body mass index and uric acid, total cholesterol, and triglyceride levels, the higher HbA1c groups were significantly associated with advanced fibrosis compared with the lowest HbA1c group. On the other hand, compared with the lowest HbA1c group, the higher HbA1c groups were also associated with a high NAS in both multivariate analyses.
Conclusion
Glycemic control is associated with NAFLD exacerbation, with even a mild deterioration in glycemic control, especially a HbA1c level of 6.5%–7.4%, contributing to NAFLD progression.