A村の特定健康診査受診者の非肥満者を対象とした健診結果の実態及び血糖と生活習慣の関連

目的：A村の特定健康診査受診者の非肥満者を対象とした健診結果の実態及び血糖と生活習慣の関連を明らかにする． 方法：A村の平成29年度特定健康診査受診者のうち，血圧や血糖等の服薬をしていない非肥満者533人を研究対象者とした．非肥満者533人を高血糖の有無による2群に分け，生活習慣との関連を分析した． 結果：健診結果では，非肥満者は，LDLコレステロールの平均値が特定健診受診者全体よりも高かった． 生活習慣では，非肥満者において高血糖群の方が定期的な運動をしている割合及び遅い時間の夕食をとっていない割合が有意に高く，生活習慣が良好な割合が高かった． 結論：非肥満者のうち高血糖の住民は，生活習慣には留意していると考えられた．今後は，詳細な生活習慣を確認し，その結果とともに健診結果に基づく指導が重要である．Objectives: The purpose of this study was to clarify the actual conditions of specific health checkups for non-obese individuals in A Village and the relationship between blood glucose and lifestyle habits. Method: The research participants were the 533 non-obese people who were not taking medication among of the all people who received a specific health checkup in A Village in 2017. We divided the 533 participants into two groups based on the presence or absence of hyperglycemia, and the relationship between blood glucose and lifestyle habits was analyzed. Results: Average LDL cholesterol was higher in the participants than in the recipients of specific health checkups overall. In terms of lifestyle habits, the proportion of participants in the hyperglycemic group who exercised regularly and those who did not eat dinner late at night was significantly higher than the non-hyperglycemic group, and the proportion of favorable lifestyle habits was higher. Conclusion: Non-obese people with hyperglycemia were considered to be aware of healthy lifestyle habits. It will be important for medical professional to ask more detailed questions about lifestyle during health checkups and to provide health guidance based on the results of blood test data.原

プールの健康教室に参加することによる心身への影響―低身体活動高齢女性の実態調査―

目的：群馬県内のAプールが実施している健康教室に参加することが心身に及ぼす影響を明らかにすることを目的とした． 方法：研究参加に同意した65歳以上の低身体活動の女性11名を対象者とした．教室参加前に年齢，健康状態，気分を，教室当日に運動前，中，後の血圧・脈拍，主観的運動強度を，教室終了後に気分を調査した．任意で体力測定を行った． 結果：体力測定の結果は，握力，上体起こし，長座体前屈，開眼片足立ち，10m障害物歩行の全てで全国平均よりも低かった．気分は，教室参加後に緊張・不安が有意に低下した．収縮期血圧は運動後では運動前よりも有意に上昇し，脈拍は運動前よりも有意に低下した．主観的運動強度は運動前よりも有意に上昇した． 結論：対象者は，肥満，筋力低下傾向にあるが，集団で実施する水中運動の強度は適度であった．健康教室により，緊張・不安が改善し，適度な運動強度においても血圧や脈拍の有意な変動が認められた．Objectives: The purpose of this study was to investigate the effects of a health class offered at a swimming pool. Methods: The subjects were 11 women aged 65 years or older who had low active mass. We investigated age, health condition, and mood before the health class. On the day of the health class, we measured blood pressure, pulse, and perceived exertion before, during, and after aquatic exercise. We then investigated mood after the health class. We also offered an optional physical fitness test to the subjects. Results: Scores for grip strength, sit-ups, toe touching, one-leg standing with eyes open, and 10-m obstacle walking test results were below healthy levels. The mood test showed that tension and anxiety were improved. Systolic blood pressure was significantly higher, pulse was significantly lower, and the rate of perceived exertion was significantly higher after exercise than before. Conclusions: The subjects were obese and had muscle weakness, but the exercise was of moderate intensity. Tension and anxiety improved after the health class. Significant changes in blood pressure and pulse were found after exercise.原

Diagnostic criteria for acute-onset type 1 diabetes mellitus (2012): Report of the Committee of Japan Diabetes Society on the Research of Fulminant and Acute-onset Type 1 Diabetes Mellitus

Type 1 diabetes is a disease characterized by destruction of pancreatic β-cells, which leads to absolute deficiency of insulin secretion. Depending on the manner of onset and progression, it is classified as fulminant, acute-onset or slowly progressive type 1 diabetes. Here, we propose the diagnostic criteria for acute-onset type 1 diabetes mellitus. Among the patients who develop ketosis or diabetic ketoacidosis within 3 months after the onset of hyperglycemic symptoms and require insulin treatment continuously after the diagnosis of diabetes, those with anti-islet autoantibodies are diagnosed with \u27acute-onset type 1 diabetes mellitus (autoimmune)\u27. In contrast, those whose endogenous insulin secretion is exhausted (fasting serum C-peptide immunoreactivity <0.6 ng/mL) without verifiable anti-islet autoantibodies are diagnosed simply with \u27acute-onset type 1 diabetes mellitus\u27. Patients should be reevaluated after certain periods in case their statuses of anti-islet autoantibodies and/or endogenous insulin secretory capacity are unknown

The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force

「コロナ制圧タスクフォース」COVID-19患者由来の血液細胞における遺伝子発現の網羅的解析 --重症度に応じた遺伝子発現の変化には、ヒトゲノム配列の個人差が影響する--. 京都大学プレスリリース. 2022-08-23.Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection

DOCK2 is involved in the host genetics and biology of severe COVID-19

「コロナ制圧タスクフォース」COVID-19疾患感受性遺伝子DOCK2の重症化機序を解明 --アジア最大のバイオレポジトリーでCOVID-19の治療標的を発見--. 京都大学プレスリリース. 2022-08-10.Identifying the host genetic factors underlying severe COVID-19 is an emerging challenge. Here we conducted a genome-wide association study (GWAS) involving 2, 393 cases of COVID-19 in a cohort of Japanese individuals collected during the initial waves of the pandemic, with 3, 289 unaffected controls. We identified a variant on chromosome 5 at 5q35 (rs60200309-A), close to the dedicator of cytokinesis 2 gene (DOCK2), which was associated with severe COVID-19 in patients less than 65 years of age. This risk allele was prevalent in East Asian individuals but rare in Europeans, highlighting the value of genome-wide association studies in non-European populations. RNA-sequencing analysis of 473 bulk peripheral blood samples identified decreased expression of DOCK2 associated with the risk allele in these younger patients. DOCK2 expression was suppressed in patients with severe cases of COVID-19. Single-cell RNA-sequencing analysis (n = 61 individuals) identified cell-type-specific downregulation of DOCK2 and a COVID-19-specific decreasing effect of the risk allele on DOCK2 expression in non-classical monocytes. Immunohistochemistry of lung specimens from patients with severe COVID-19 pneumonia showed suppressed DOCK2 expression. Moreover, inhibition of DOCK2 function with CPYPP increased the severity of pneumonia in a Syrian hamster model of SARS-CoV-2 infection, characterized by weight loss, lung oedema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 has an important role in the host immune response to SARS-CoV-2 infection and the development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target

Surgery for long tubular intestinal duplication with massive hemorrhage: a case report and literature review

Abstract Background Long tubular duplication is a rare congenital intestinal disease, that can lead to emergency situations marked by massive hemorrhage. However, preoperative diagnosis and surgical treatment are challenging. This report presents preoperative images and details a surgical procedure for long tubular intestinal duplications with massive hemorrhage. Case presentation A 3-year-old boy presented to the emergency department with melena. Despite undergoing a Tc-99m pertechnetate scintigraphy one year prior, which revealed nonspecific findings with enhancement of some parts of the intestine, enhanced abdominal CT revealed an edematous small intestine with luminal extravasation. The patient received a transfusion of red blood cells; however, his hemoglobin level did not improve. Arterial angiography and double-balloon endoscopy revealed no remarkable findings. Exploratory laparotomy revealed a long tubular duplication in half of the small intestine. Utilizing the Wrenn procedure, we successfully removed all duplicate mucosa. Pathological findings showed that almost all duplications contained gastric mucosa and revealed an ulcer with a ruptured arterial vessel. His symptoms were resolved, and the hemoglobin level stabilized. At 2 months postoperatively, no surgical complications were present. Conclusions Effective management of long tubular duplications with massive hemorrhage involves timely application of the Wrenn procedure. Recognition of specific imaging findings is crucial to prompt exploratory laparotomy, ensuring optimal outcomes and preventing delays in treatment