[in Japanese]

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Adipocytokines, including adiponectin and leptin, are closely associated with insulin resistance, diabetes and obesity. The relationship between serum level of adipocytokines and clinical parameters were examined both in 79 patients with acute onset type 1 diabetes (AOT1D) and in 72 with slowly progressive type 1 diabetes (SPT1D). The patients with AOT1D were young and lean compared with those with SPT1D, and hadβ-cell dysfunction. Serum level of adiponectin correlated positively with age and HDL-C, and negatively with subcutaneous fat area (SFA) and C-peptide in AOT1D. On the other hand, SFA, visceral fat area (VFA), γGTP and C-peptide negatively correlated with serum adiponectin level in SPT1D. Serum level of C-peptide was a significant factor relative to serum adiponectin level only with AOT1D in multiple linear regression analysis. Our examination of AOT1D in Japan revealed a strong effect of serum C-peptide on serum adiponectin level.  

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Nonalcoholic fatty liver disease (NAFLD) is evaluated by liver biopsy. Degree of steatosis is assessed along with inflammation and fibrosis, although steatosis is usually assessed by a morphological semiquantitative method. For accurate evaluation and assessment in multi-institutional studies, an objective method is preferable. We attempted accurate evaluation of steatosis using virtual microscopy. Using variable parameters such as area, shape and separation indices, successful measurement was achieved. The results indicate that the morphological method overestimates the degree of fatty degeneration when compared with virtual microscopy.

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A 62-year-old male with living kidney trans-plantation had been treated with methylprednisolone, tacrolimus, and mycophenolate mofetil. He had a chest pain on October 2nd. On October 12th, he was transported by ambulance to our hospital because of the exacerbation of chest pain. Chest CT revealed a lung abscess in contact with the migrating pleura, and Kinyoun stain-positive Gram-positive rods were found in sputum and blood cultures. A few days after treatment, respiratory failure worsened, requiring temporary ventilator management. Later, the culture showed Nocardia farcinica, so treatment was continued and improvement was observed. On day 44, head MRI revealed multiple brain abscesses, and treatment was added for brain abscesses due to disseminated nocardiosis. Nocardiosis is a disease that should be identified as a respiratory infection in immunodeficient patients.

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