Nonalcoholic fatty liver disease(NAFLD),a manifestation of metabolic syndrome,includes a wide range of clinical entities from simple fatty liver,a benign condition,to nonalcoholic steatohepatitis(NASH),a condition whi...Nonalcoholic fatty liver disease(NAFLD),a manifestation of metabolic syndrome,includes a wide range of clinical entities from simple fatty liver,a benign condition,to nonalcoholic steatohepatitis(NASH),a condition which can progress to cirrhosis,hepatocellular carcinoma and hepatic failure.The diagnosis of NASH requires no history of previous or current significant alcohol cons umption and no evidence of other chronic liver dis eases.Ethanol intake levels of 20 g daily(or 140 g weekly) are endorsed as the acceptable threshold to define no nalcoholic patients.Liver biopsy is the current gold stan d ard for the diagnosis of NASH and provides progn o stic information.Histopathological diagnosis of NASH is based on the following 3 features:(1) hepatic macrovesicular steatosis;(2) lobular inflammation;and(3) ballooning degeneration of hepatocytes.It is impractical to biopsy every patient with suspected NAFLD.Although highly accurate and affordable noninvasive screening tools can differentiate NASH from NAFLD,no imaging studies or laboratory tests are able to precisely diagnose NASH.There is no universal agreement regarding the indications for liver biopsy in NAFLD patients.In Japan,liver biopsies are considered in patients with sus pected NAFLD based on several criteria including low platel et counts,elevated fibrosis markers,increasing age and other deciding parameters.Further studies are needed to establish a suitable scoring system that can distinguish steatohepatitis from simple steatosis.展开更多
An 86-year-old man, diagnosed as having mycosis fungoides in May 2008 and treated with repeated radiation therapy, was admitted to our hospital for initiation of hemodialysis due to end-stage renal disease(ESRD) in Ap...An 86-year-old man, diagnosed as having mycosis fungoides in May 2008 and treated with repeated radiation therapy, was admitted to our hospital for initiation of hemodialysis due to end-stage renal disease(ESRD) in April 2012. On admission, his corrected serum calcium level was 9.3 mg/d L, and his intact parathyroid hormone level was 121.9 pg/mL(normal range 13.9-78.5pg/mL), indicating secondary hyperparathyroidism due to ESRD. After starting hemodialysis, urinary volume diminished rapidly. The serum calcium level increased(12.7 mg/dL), and the intact parathyroid hormone level was suppressed(< 5 pg/m L), while the 1,25-dihy-droxyvitamin D3(calcitriol) level increased(114 pg/mL, normal range: 20.0-60.0 pg/m L) in June 2012. The possibilities of sarcoidosis and tuberculosis were ruled out. Skin biopsies from tumorous lesions revealed a diagnosis of granulomatous mycosis fungoides. The serum soluble interleukin-2 receptor levels and the degrees of skin lesions went in parallel with the increased serum calcium and calcitriol levels. Therefore, the patient was diagnosed as having calcitriol-induced hypercalcemia possibly associated with granulomatous mycosis fungoides. Granulomatous mycosis fungoides is rare, and its association with calcitriol-induced hypercalcemia has not been reported. Careful attention to calcium metabolism is needed in patients with granulomatous mycosis fungoides, especially in patients with ESRD.展开更多
The Ontology registry system is developed to collect, manage, and compare ontological information for integrating global observation data. Data sharing and data service such as support of metadata deign, structuring o...The Ontology registry system is developed to collect, manage, and compare ontological information for integrating global observation data. Data sharing and data service such as support of metadata deign, structuring of data contents, support of text mining are applied for better use of data as data interoperability. Semantic network dictionary and gazetteers are constructed as a trans-disciplinary dictionary. Ontological information is added to the system by digitalizing text based dictionaries, developing 'knowledge writing tool' for experts, and extracting semantic relations from authoritative documents with natural language processing technique. The system is developed to collect lexicographic ontology and geographic ontology.展开更多
文摘Nonalcoholic fatty liver disease(NAFLD),a manifestation of metabolic syndrome,includes a wide range of clinical entities from simple fatty liver,a benign condition,to nonalcoholic steatohepatitis(NASH),a condition which can progress to cirrhosis,hepatocellular carcinoma and hepatic failure.The diagnosis of NASH requires no history of previous or current significant alcohol cons umption and no evidence of other chronic liver dis eases.Ethanol intake levels of 20 g daily(or 140 g weekly) are endorsed as the acceptable threshold to define no nalcoholic patients.Liver biopsy is the current gold stan d ard for the diagnosis of NASH and provides progn o stic information.Histopathological diagnosis of NASH is based on the following 3 features:(1) hepatic macrovesicular steatosis;(2) lobular inflammation;and(3) ballooning degeneration of hepatocytes.It is impractical to biopsy every patient with suspected NAFLD.Although highly accurate and affordable noninvasive screening tools can differentiate NASH from NAFLD,no imaging studies or laboratory tests are able to precisely diagnose NASH.There is no universal agreement regarding the indications for liver biopsy in NAFLD patients.In Japan,liver biopsies are considered in patients with sus pected NAFLD based on several criteria including low platel et counts,elevated fibrosis markers,increasing age and other deciding parameters.Further studies are needed to establish a suitable scoring system that can distinguish steatohepatitis from simple steatosis.
文摘An 86-year-old man, diagnosed as having mycosis fungoides in May 2008 and treated with repeated radiation therapy, was admitted to our hospital for initiation of hemodialysis due to end-stage renal disease(ESRD) in April 2012. On admission, his corrected serum calcium level was 9.3 mg/d L, and his intact parathyroid hormone level was 121.9 pg/mL(normal range 13.9-78.5pg/mL), indicating secondary hyperparathyroidism due to ESRD. After starting hemodialysis, urinary volume diminished rapidly. The serum calcium level increased(12.7 mg/dL), and the intact parathyroid hormone level was suppressed(< 5 pg/m L), while the 1,25-dihy-droxyvitamin D3(calcitriol) level increased(114 pg/mL, normal range: 20.0-60.0 pg/m L) in June 2012. The possibilities of sarcoidosis and tuberculosis were ruled out. Skin biopsies from tumorous lesions revealed a diagnosis of granulomatous mycosis fungoides. The serum soluble interleukin-2 receptor levels and the degrees of skin lesions went in parallel with the increased serum calcium and calcitriol levels. Therefore, the patient was diagnosed as having calcitriol-induced hypercalcemia possibly associated with granulomatous mycosis fungoides. Granulomatous mycosis fungoides is rare, and its association with calcitriol-induced hypercalcemia has not been reported. Careful attention to calcium metabolism is needed in patients with granulomatous mycosis fungoides, especially in patients with ESRD.
基金the Data Integration and Analysis System (DIAS) Project
文摘The Ontology registry system is developed to collect, manage, and compare ontological information for integrating global observation data. Data sharing and data service such as support of metadata deign, structuring of data contents, support of text mining are applied for better use of data as data interoperability. Semantic network dictionary and gazetteers are constructed as a trans-disciplinary dictionary. Ontological information is added to the system by digitalizing text based dictionaries, developing 'knowledge writing tool' for experts, and extracting semantic relations from authoritative documents with natural language processing technique. The system is developed to collect lexicographic ontology and geographic ontology.
