Anti-Müllerian hormone beyond an ovarian reserve marker: the relationship with the physiology and pathology in the life-long follicle development

Anti-Müllerian hormone (AMH), an indirect indicator of the number of remaining follicles, is clinically used as a test for ovarian reserve. Typically, a decline suggests a decrease in the number of remaining follicles in relation to ovarian toxicity caused by interventions, which may implicate fertility. In contrast, serum AMH levels are elevated in patients with polycystic ovary syndrome. AMH is produced primarily in the granulosa cells of the preantral and small antral follicles. Thus it varies in association with folliculogenesis and the establishment and shrinking of the follicle cohort. Ovarian activity during the female half-life, from the embryonic period to menopause, is based on folliculogenesis and maintenance of the follicle cohort, which is influenced by developmental processes, life events, and interventions. AMH trends over a woman’s lifetime are associated with in vivo follicular cohort transitions that cannot be observed directly

The effect of concentric constriction of the visual field to 10 and 15 degrees on simulated motor vehicle accidents

金沢大学附属病院眼科Purpose: Traffic accidents are associated with the visual function of drivers, as well as many other factors. Driving simulator systems have the advantage of controlling for traffic- and automobile-related conditions, and using pinhole glasses can control the degree of concentric concentration of the visual field. We evaluated the effect of concentric constriction of the visual field on automobile driving, using driving simulator tests. Methods: Subjects meeting criteria for normal eyesight were included in the study. Pinhole glasses with variable aperture sizes were adjusted to mimic the conditions of concentric visual field constrictions of 10° and 15°, using a CLOCK CHART®. The test contained 8 scenarios (2 oncoming right-turning cars and 6 jump-out events from the side). Results: Eighty-eight subjects were included in the study; 37(mean age = 52.9±15.8 years) subjects were assigned to the 15° group, and 51 (mean = 48.6±15.5 years) were assigned to the 10° group. For all 8 scenarios, the number of accidents was significantly higher among pinhole wearing subjects. The average number of all types of accidents per person was significantly higher in the pinhole 10° group (4.59±1.81) than the pinhole 15° group (3.68±1.49) (P = 0.032). The number of accidents associated with jump-out scenarios, in which a vehicle approaches from the side on a straight road with a good view, was significantly higher in the pinhole 10° group than in the pinhole 15° group. Conclusions: Concentric constriction of the visual field was associated with increased number of traffic accidents. The simulation findings indicated that a visual field of 10° to 15° may be important for avoiding collisions in places where there is a straight road with a good view. © 2018 Udagawa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

大学教育の総合評価 : その4 在学生・卒業生・教職員による学生生活の評価の比較研究

Purpose In concluding a series of evaluative study of the student life at ICU, the present study compared responses to a questionnaire obtained from 3 groups: undergraduate students, almnus members, and faculty members and staffs. Specific aims of the study were as follows: (1) to find both common and different value orientations among the groups, (2) to analyze their conflicts produced from the gaps between their goals and their assessments of student life, (3) to diagnose psychological tensions among the groups and within the individuals, and (4) to explore the possibility of improving our educational activities. Method A questionnaire consisted of 121 items in 8 areas of student life (general impression, academic programs, extracurricular activities, university events, unique characteristics of ICU, facilities and equipments, cultural environment, and daily living) was distributed, and 197 undergraduate students, 133 alumni and 27 faculty members and staffs voluntarily responded. Responses for those items were obtained on 5 point scales, separately indicating how much they were important and how much they were fulfilled. Results and discussion General trends observed hereby were as follows: 1. Three groups showed very similar response patterns in all areas. 2. The sense of satisfaction fell short of the sense of importance in all areas by all groups; thus great degrees of dissatisfaction were manifested. 3. While the evaluation of importance were in the order of the faculty members and staffs, the alumni and the students, much higher satisfaction than others was shown by the alumni. Therefore, the faculty members and staffs manifested the most and the alumni the least dissatisfaction. 4. Assessments of the alumni were significantly lower than the other groups on those items representing the utility of higher education in general, but the faculty members and staffs evaluated the unique characteristics of ICU significantly higher than the others. Therefore, though the students appreciated secular values of higher education, they tended to ignore the goals and the uniqueness of ICU. The facts hitherto described imply enormous psychological dissents both between those who are in the campus at present and who have left, and between those who are teaching now and who are studing or have studied in the same campus. From the present study, we are able not only to reveal various problems involved in our student life, but also to gain some insights for the directions which we should pursuit our educational goals. Some of those inevitable questions we are confronted are mentioned as follows: 1. Methods to clarify our common value orientations. 2. Methods to practice the actualization of own values on campus. 3. Methods to perticipate in decision making. 4. Methods to enhance our communication. 5. Methods to deepen our understanding of group dynamism. 6. Methods to promote our community mental health. 7. Methods to establish longterm comprehensive evaluation programs

シロリムス ヨウシュツ ステント リュウチ 7ネンゴ ニ ハジメテ ゾウエイザイ ステント シュウイ シミダシゾウ オ ミトメタ イチレイ

A 74-year-old man who had a history of percutaneous coronary intervention ［left anterior descending coronary artery ＃6‐7, sirolimus eluting stent （SES） （Cypher stent,3.0×18mm）, left circumflex coronary artery ＃13, SES （Cypher stent, 2.5×23mm）］ for angina pectoris experienced chest pain on effort after seven years from the coronary intervention. He was introduced to our hospital and coronary angiography revealed late acquired peri-stent contrast staining （PSS）, which is defined as an angiographical finding of contrast medium stain outside the stent being ＞20％ of the stent diameter, in the SES of the left anterior descending artery. Drug-eluting stent （DES） significantly inhibits neointimal proliferation, thereby significantly reducing in-stent restenosis. However, the risk of very late stent thrombosis has become a major problem after the DES implantation against the bare-metal stent implantation. PSS has been reported that PSS after SES implantation could predict late stent thrombosis and incomplete stent apposition of the lesion with PSS. In this case, PSS was pointed out for the first time in seven years after SES implantation nevertheless it did not be pointed out in three years. The mechanism and prognosis of PSS is unclear. But, we found the increase in local coagulation at the coronary artery in this case and the degree of prothrombin fragment F1＋2, one of the coagulation marker, was greater in seven years after SES implantation than in three years. We thought these findings might reflect that PSS after SES implantation was associated with very late stent thrombosis. So we started the dual antiplatelet therapy for the prevention of stent thrombosis. Careful long-term observation might be recommended in patients with late acquired PSS and elevated local coagulation response following SES implantation