広角光干渉断層血管撮影における糖尿病網膜症の臨床的に重要な無灌流領域

京都大学新制・課程博士博士(医学)甲第24498号医博第4940号新制||医||1064(附属図書館)京都大学大学院医学研究科医学専攻(主査)教授 中本 裕士, 教授 森本 尚樹, 教授 大森 孝一学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDFA

Horizontal distribution and annual fluctuations in abundance of settled juveniles of the black sea bream Acanthopagrus schlegelii in Hiroshima Bay, Japan

広島湾においてクロダイ稚魚の着底・成育に適した環境条件を把握する目的で，同湾沿岸の稚魚の生息密度を明らかにした。稚魚は2006–2009年6–7月に広島湾内18定点で採集した（n=2,488）。さらに，調査定点のうち最も高い稚魚密度（35.83 inds./100m2）を観測した能美島鹿田において，2013–2016年の7–9月にかけて稚魚を採集し（n=1,588），密度の年変動を観察した。その結果，広島湾の全平均密度は3.78 inds./100m2となり，密度の高い4定点はいずれも厳島，能美島西岸であった。密度が高い定点の特徴として，潮流が物理的に遮られた静穏域の砂浜帯で，淡水流入があることが挙げられた。密度には年変動があり，近年は減少傾向にあることが判明した。広島湾クロダイの資源加入量が低下している可能性が示唆された。To obtain basic information on the optimal nursery grounds for black sea bream Acanthopagrus schlegelii recruits, juvenile density in Hiroshima Bay was calculated. Juveniles (n=2,488) were collected from 18 sampling stations around Hiroshima Bay using surf zone nets during the early summer from 2006 to 2009. to assess the annual fluctuations of juvenile density, samples were continuously caught from one station (St. 1) on the western side of Noumishima Island from 2013 to 2016. Relatively high densities were recorded from four stations (St. 1, 2, 6 and 10) located along the Ohno Seto Strait and the western side of Noumishima Island. These sampling stations shared three common characteristics that likely explain the observed higher juvenile density, namely (1) moderate currents with calm areas protected by physical barrier, (2) sandy muddy beaches (tidal flats) and (3) freshwater inflows or run-off. Juvenile density showed an annual decreasing trend, suggesting that fish stock levels of black sea bream are declining in Hiroshima Bay

Unilateral transient high myopization after pediatric strabismus surgery: Observation by anterior segment optical coherence tomography

[Purpose] To describe an unusual case of unilateral transient high myopization after pediatric strabismus surgery. [Observations] A 6-year-old girl with intermittent exotropia had undergone strabismus surgery and experienced a transient decrease in best-corrected visual acuity (BCVA, from 20/20 to 20/33) with high myopization (from +0.25 D to −9.00 D). Slit-lamp microscopy showed anterior chamber inflammation and a narrow angle only in the affected eye. Anterior segment optical coherence tomography (AS-OCT) revealed ciliary body detachment, a narrow angle, a shallow anterior chamber, and an anteroposterior elongation of the crystalline lens in the affected eye. Her symptoms of blurry vision and high myopization improved 8 weeks postoperatively. AS-OCT revealed the resolution of the ciliary body detachment, an open angle, and a deep anterior chamber, with normalization of the anteroposterior length of the crystalline lens. Her BCVA recovered to 20/20 with spherical equivalence of 0 D. [Conclusions and Importance] We reported on an extremely rare case of unilateral transient high myopization following strabismus surgery, which was resolved without additional surgery. This myopization was probably caused due to ciliary body inflammation

Darier\u27s Disease with Esophageal Involvement

Letter to the editorNo abstract available</p

Electrochemical response of biased nanoelectrodes in solution

Novel approaches to DNA sequencing and detection require the measurement of electrical currents between metal probes immersed in ionic solution. Here, we experimentally demonstrate that these systems maintain large background currents with a transient response that decays very slowly in time and noise that increases with ionic concentration. Using a non-equilibrium stochastic model, we obtain an analytical expression for the ionic current that shows these results are due to a fast electrochemical reaction at the electrode surface followed by the slow formation of a diffusion layer. During the latter, ions translocate in the weak electric field generated after the initial rapid screening of the strong fields near the electrode surfaces. Our theoretical results are in very good agreement with experimental findings

Clinical Relevance of Parafoveal Intercapillary Spaces and Foveal Avascular Zone in Diabetic Retinopathy Without Macular Edema

Purpose: To investigate the clinical significance of intercapillary spaces on swept source optical coherence tomography angiography images in diabetic retinopathy. Methods: We retrospectively reviewed 110 eyes of 110 patients suffering from diabetic retinopathy without macular edema for whom 3 × 3 mm swept source optical coherence tomography angiography images centered on the fovea were obtained. Automatic image processing of the superficial slab images allowed us to define the areas encircled by retinal vessels as intercapillary spaces within the central 2-mm circle. We evaluated how the quantitative parameters of intercapillary spaces are associated with logMAR and feasible to diagnose diabetic macular ischemia. Results: Total counts (ρ = −0.419; P < 0.001) rather than morphologic parameters of the intercapillary spaces showed a significant correlation with logMAR. There were individual levels of correlations between logMAR and counts of intercapillary spaces in individual sectors. In particular, the summed numbers of the spaces in three highly significant sectors were more significantly associated with logMAR (ρ = −0.515; P < 0.001). Multivariate analyses confirmed that the number of the intercapillary spaces (β = −0.266; P = 0.016) and foveal avascular zone area (β = 0.227; P = 0.042) were related to logMAR. The clustering using the foveal avascular zone area and the number of intercapillary spaces revealed two major clusters; one had fewer intercapillary spaces (P < 0.001) and poorer logMAR (P < 0.001) than the other, with a wide range of the foveal avascular zone area. Conclusions: Decreased intercapillary spaces contribute to visual impairment in diabetic retinopathy and suggest one possible criterion of objective diagnosis of diabetic macular ischemia

Peripheral Chorioretinal Imaging Through a Front Prism on Optical Coherence Tomography Angiography

Purpose: To evaluate the clinical feasibility of peripheral chorioretinal imaging through a front prism on swept-source optical coherence tomography angiography (SS-OCTA). Methods: We prospectively obtained en face OCTA images using SS-OCTA in 10 eyes of 10 healthy volunteers. For the peripheral chorioretinal imaging, the scanning laser passed and refracted through a 45 −90 −45 right-angle prism. We evaluated the qualitative and quantitative characteristics of chorioretinal vessels in the periphery. Results: Using peripheral chorioretinal imaging through a prism, the retinal vasculature was delineated to the equator on the OCTA images, and varices of the vortex vein ampullae were observed on choroidal OCT images. The 3×3-mm images revealed three-dimensional morphologies unique to the peripheral vasculature, such as the gap between retinal arterioles and venules in the superficial capillary plexus (SCP) and elliptical and greater lobules in the choriocapillaris layer. Compared with OCTA images obtained without the prism, those obtained through the prism demonstrated an approximately 1.24-fold increase in the lengths in the base apex direction, whereas the lengths in the perpendicular direction showed concordance. The peripheral vessel density (VD) in the inferior quadrant was lower than those in the other quadrants on the SCP and deep capillary plexus, whereas on the SCP images of the macula the lowest VD was observed in the temporal subfield. Conclusions: Peripheral chorioretinal imaging allowed us to generate ultra-widefield panoramic OCTA images and demonstrated morphologic characteristics unique to peripheral chorioretinal vessels. Translational Relevance: OCTA imaging through a front prism can be a technique for acquiring chorioretinal vasculature images in the periphery

Clinical and Pathological Improvement in Stroke-Prone Spontaneous Hypertensive Rats Related to the Pleiotropic Effect of Cilostazol

Background and Purpose-Cerebral infarction is a major cause of death or decreasing activities of daily living. This study aimed to investigate the efficacy of commonly used antiplatelet drugs on stroke and motor and cognitive functions in relation to oxidative stress markers and insulin-like growth factor 1 receptor (IGF-1R). Methods-Stroke-prone spontaneously hypertensive rats were treated with vehicle, aspirin, clopidogrel, and cilostazol from 8 to 10 weeks of age. Physiological parameters, regional cerebral blood flow, and serum lipids were examined. Motor and cognitive functions were evaluated weekly by the Rotorod and water maze task. Spontaneous infarct volume, oxidative stress markers for lipid, protein, and DNA at the ischemic boundary zone of spontaneous infarction, and the IGF-1R-positive cell ratio in the hippocampus were immunohistochemically examined in brain sections. IGF-1R beta expression in the hippocampus was assessed by Western blotting. Results-The antiplatelet drugs, cilostazol and clopidogrel, reduced the spontaneous infarct volume more than aspirin. Only cilostazol improved motor and cognitive functions with a significant increase (P<0.05) in the memory-related IGF-1R-positive ratio and IGF-1R beta expression in the hippocampus. Cilostazol reduced the 4 oxidative stress markers in affected neurons in stroke-prone spontaneously hypertensive rats regardless of blood pressure, regional cerebral blood flow, or serum lipid levels. Conclusions-The present results suggest that a possible pleiotropic effect of cilostazol resulted in the reduction of spontaneous infarct volume and preservation of motor and spatial cognitive functions. The increase of IGF-1R-positive cells in the hippocampal CA1 region could partly explain the preservation of spatial cognitive function in stroke-prone spontaneously hypertensive rats