The preoperative thyroid function and perioperative course in patients with Graves\u27 disease

Graves\u27 disease is an autoimmune disorder that induces increase in thyroid hormone production and release. Although euthyroidshould be desirable to ensure a safe operation, some patients still undergo thyroidectomy with hyperthyroidism. The aimof this study was to evaluate our preoperative strategies in patients with Graves\u27 disease. A total of 186 patients underwent thyroidectomy for Graves\u27 disease between 2003 and 2017. We gave all of these patients potassium iodide (KI) in order todecrease their thyroid hormone levels. We compared the clinical factors among three groups defined by the value of serumfree triiodothyronine (FT3) after the administration of KI: (1) the good control group (n=126) with ?6.0 pg/mL, (2) the fair control group (n=35) with >6.0 but ?10.0 pg/mL, and (3) the poor control group (n=25) with >10.0 pg/mL. KI decreased the serumlevels of thyroid hormone. However, some patients still had hyperthyroidism, and the subsequent administration of corticosteroidreduced FT3 but not thyroxine. Regarding the intraoperative course, the heart rate at 1 h after beginning general anesthesiawas higher in the poor control group than in the good control group (p<0.05), and the proportion of patients givenadrenergic beta-blocker was higher in the poor control group than in the other groups (p<0.01 each). One patient in the faircontrol group experienced suspected thyroid storm after total thyroidectomy. The occurrence rate of other deteriorations wasidentical among the three groups. With preparative KI and corticosteroid administration, almost all patients with Graves\u27 disease were able to undergo thyroidectomy safely

Guideline from Japanese Society of Echocardiography : 2018 focused update incorporated into Guidance for the Management and Maintenance of Echocardiography Equipment

Echocardiography plays a pivotal role as an imaging modality in the modern cardiology practice. Information derived from echocardiography is definitely helpful for a patient care. The Japanese Society of Echocardiography has promoted echocardiography for a routine clinical and research use. One of the missions of the Society is to provide information that is useful for high-quality examinations. To ensure it, we believe equipment in good conditions and a comfortable environment are important for both a patient and an examiner. Thus, the Committee for Guideline Writing, the Japanese Society of Echocardiography published brief guidance for the routine use of echocardiography equipment in 2015. Recently, the importance of international standardization has been emphasized in the medical laboratories. Accordingly, the committee has revised and updated our guidance for the routine use of echocardiography equipment

lmmunocytochemistry of perinatal rat livers with a special reference to the roles of mesenchymal cells in hepatic differentiation

To investigate the roles of extracellular matrix produced by hepatic mesenchymal cells in the organization of hepatic cell cords, perinatal rat livers were examined with immunocytochemistry of fibronectin (FN) and larninin (LM). Some hepatocytes in a free state at prenatal day 15 actively produced FN and LM in the rough endoplasmic reticulum but lost this synthetic activity when such cells were incorporated into hepatic cell cords. On the other hand, hepatic mesenchymal cells, especially those associated with the perisinusoidal space, retained this synthetic activity throughout the stages examined. In the differentiating hepatic cell cords, positive imrnunoreactions for FN and LM were preferentially seen on the cell surface facing both sinusoidal space and differentiating bile canaiiculus concomitant with the expression of the tight junction protein, ZO-1, from prenatal day 17. Since such hepatocytes have lost or reduced their synthetic activities of both glycoproteins in the rER, the immunoreactions appear to be mainly due to hepatic mesenchymal cells which seem to play a role in the formation of the hepatic cell cords and the bile canaliculi

Environmental enrichment ameliorated high-fat diet-induced Aβ deposition and memory deficit in APP transgenic mice.

The pathogenesis of Alzheimer's disease (AD) is tightly associated with metabolic dysfunctions. In particular, a potential link between type 2 diabetes (T2DM) and AD has been suggested epidemiologically, clinically, and experimentally, and some studies have suggested that exercise or dietary intervention reduces risk of cognitive decline. However, there is little solid molecular evidence for the effective intervention of metabolic dysfunctions for prevention of AD. In the present study, we established the AD model mice with diabetic conditions through high-fat diet (HFD) to examine the effect of environmental enrichment (EE) on HFD-induced AD pathophysiology. Here, we demonstrated that HFD markedly deteriorated memory impairment and increased β-amyloid (Aβ) oligomers as well as Aβ deposition in amyloid precursor protein (APP) transgenic mice, which was reversed by exposure to an enriched environment for 10 weeks, despite the continuation of HFD. These studies provide solid evidence that EE is a useful intervention to ameliorate behavioral changes and AD pathology in HFD-induced aggravation of AD symptoms in APP transgenic mice

Exercise is more effective than diet control in preventing high fat diet-induced β-amyloid deposition and memory deficit in amyloid precursor protein transgenic mice.

Accumulating evidence suggests that some dietary patterns, specifically high fat diet (HFD), increase the risk of developing sporadic Alzheimer disease (AD). Thus, interventions targeting HFD-induced metabolic dysfunctions may be effective in preventing the development of AD. We previously demonstrated that amyloid precursor protein (APP)-overexpressing transgenic mice fed HFD showed worsening of cognitive function when compared with control APP mice on normal diet. Moreover, we reported that voluntary exercise ameliorates HFD-induced memory impairment and β-amyloid (Aβ) deposition. In the present study, we conducted diet control to ameliorate the metabolic abnormality caused by HFD on APP transgenic mice and compared the effect of diet control on cognitive function with that of voluntary exercise as well as that of combined (diet control plus exercise) treatment. Surprisingly, we found that exercise was more effective than diet control, although both exercise and diet control ameliorated HFD-induced memory deficit and Aβ deposition. The production of Aβ was not different between the exercise- and the diet control-treated mice. On the other hand, exercise specifically strengthened the activity of neprilysin, the Aβ-degrading enzyme, the level of which was significantly correlated with that of deposited Aβ in our mice. Notably, the effect of the combination treatment (exercise and diet control) on memory and amyloid pathology was not significantly different from that of exercise alone. These studies provide solid evidence that exercise is a useful intervention to rescue HFD-induced aggravation of cognitive decline in transgenic model mice of AD

The preoperative thyroid function and perioperative course in patients with Graves' disease

Graves' disease is an autoimmune disorder that induces increase in thyroid hormone production and release. Although euthyroid should be desirable to ensure a safe operation, some patients still undergo thyroidectomy with hyperthyroidism. The aim of this study was to evaluate our preoperative strategies in patients with Graves' disease. A total of 186 patients underwent thyroidectomy for Graves' disease between 2003 and 2017. We gave all of these patients potassium iodide (KI) in order to decrease their thyroid hormone levels. We compared the clinical factors among three groups defined by the value of serum free triiodothyronine (FT3) after the administration of KI: (1) the good control group (n=126) with ≤6.0 pg/mL, (2) the fair control group (n=35) with >6.0 but ≤10.0 pg/mL, and (3) the poor control group (n=25) with >10.0 pg/mL. KI decreased the serum levels of thyroid hormone. However, some patients still had hyperthyroidism, and the subsequent administration of corticosteroid reduced FT3 but not thyroxine. Regarding the intraoperative course, the heart rate at 1 h after beginning general anesthesia was higher in the poor control group than in the good control group (p<0.05), and the proportion of patients given adrenergic beta-blocker was higher in the poor control group than in the other groups (p<0.01 each). One patient in the fair control group experienced suspected thyroid storm after total thyroidectomy. The occurrence rate of other deteriorations was identical among the three groups. With preparative KI and corticosteroid administration, almost all patients with Graves' disease were able to undergo thyroidectomy safely