Factors Related to Diagnosis of Diabetes After Detecting High Blood Glucose Levels Through Screening: One-Year Follow-up Among Publicly Insured Adults in Gunma, Japan.

This study aimed to assess the diagnosis of diabetes after detecting high blood glucose levels through screening among insured individuals in Gunma, Japan. Data for men and women 35 to 74 years of age were provided by Japan Health Insurance Association, and 4133 individuals with high blood glucose levels while not currently being treated for diabetes were included in the study. About 13% received a diagnosis of diabetes at a subsequent physician visit, and individuals who were under treatment for hypertension were less likely to receive the added diagnosis of diabetes compared with those not being treated for hypertension (odds ratio = 0.42; 95% confidence interval = [0.33, 0.54] from a logistic regression model). Fasting blood glucose levels were significantly improved in the next year only among individuals with a confirmed diagnosis of diabetes.

Segmental HOG: new descriptor for glomerulus detection in kidney microscopy image.

BACKGROUND: The detection of the glomeruli is a key step in the histopathological evaluation of microscopic images of the kidneys. However, the task of automatic detection of the glomeruli poses challenges owing to the differences in their sizes and shapes in renal sections as well as the extensive variations in their intensities due to heterogeneity in immunohistochemistry staining. Although the rectangular histogram of oriented gradients (Rectangular HOG) is a widely recognized powerful descriptor for general object detection, it shows many false positives owing to the aforementioned difficulties in the context of glomeruli detection. RESULTS: A new descriptor referred to as Segmental HOG was developed to perform a comprehensive detection of hundreds of glomeruli in images of whole kidney sections. The new descriptor possesses flexible blocks that can be adaptively fitted to input images in order to acquire robustness for the detection of the glomeruli. Moreover, the novel segmentation technique employed herewith generates high-quality segmentation outputs, and the algorithm is assured to converge to an optimal solution. Consequently, experiments using real-world image data revealed that Segmental HOG achieved significant improvements in detection performance compared to Rectangular HOG. CONCLUSION: The proposed descriptor for glomeruli detection presents promising results, and it is expected to be useful in pathological evaluation.

Graphical representation of quality indicators based on medical service ontology.

For recent years, it has grown importance to evaluate medical service qualities of medical staffs and/or hospitals by using quality indicators. This paper introduces a representation system QI-RS of quality indicators. By using QI-RS, one can define quality indicators that satisfy understandability and formality, where "understandability" means that one can understand the calculation formula of a quality indicator easily and correctly, while "formality" means that the formula can be calculated to obtain the values of the indicator based on databases in a coherent manner.

[Anesthetic management of exploratory laparotomy for a patient with panperitonitis with hyperkalemia: a case report of spontaneous rupture of the urinary bladder].

A 71-year-old woman was admitted with panperitonitis, hyperkalemia and acute renal failure. Immediately after a large amount of ascites had been drained by laparotomy, hyperkalemia and acidosis were remarkably improved. During the operation, rupture of the urinary bladder was detected and repaired. The level of potassium and renal function became normal the next morning, and it seemed that peritoneal-self-dialysis had been related to hyperkalemia and acute renal failure. Rupture of the urinary bladder is very rare but should be considered in any cases of acute abdomen with hyperkalemia and acute renal failure.

[Anesthetic managements of premature triplets for PDA ligation through median sternatomy].

Extreme premature triplets were scheduled for PDA ligation through median sternatomy. Anesthesia was maintained with fentanyl, ketamine, pancuronium and sevoflurane or isoflurane with N2O, oxygen and air. During operation, steady ventilation with low oxygen concentration was maintained. Monitoring size and contraction of hearts in the face, 5% albumine solution could be administered safely for hypotension after PDA ligation. PDA ligation through median sternatomy might be a less invasive surgical procedure.

[Comparison of total intravenous anesthesia and inhalation anesthesia regarding hormonal responses during lung lobectomy].

BACKGROUND: Anesthetic techniques can modulate surgical stress responses. We studied the response of plasma epinephrine, norepinephrine, dopamine, adrenocorticotrophic hormone (ACTH), and serum cortisol during lung lobectomy under sevoflurane, propofol and fentanyl anesthesia. METHODS: Fifty patients with lung cancer were of ASA physical status 1 or 2 and aged 50-75 yr. Blood samples were drawn before anesthetic induction, 5 min after tracheal extubation, and 24 h as well as 72 h after operation. RESULTS: Five min after tracheal extubation, plasma levels of epinephrine, norepinephrine and dopamine were significantly lower in the group that had received propofol - fentanyl anesthesia (P-F group) compared with the group that had received sevoflurane-fentanyl anesthesia (S-F group). In the P-F group, plasma levels of norepinephrine and dopamine 5 min after tracheal extubation were the same as the pre-induction levels. The increase in ACTH levels was significantly less in the P-F group in comparison with the group S-F. CONCLUSIONS: Propofol-fentanyl anaesthesia prevents the increase in catecholamines and reduces the ACTH response during lung lobectomy.

[Importance of anesthetic management for the patients with systolic anterior motion after mitral valve plasty].

Systolic anterior motion (SAM) after mitral valve plasty (MVP) occurs at an incidence of 1 to 4%. The management is related to this condition. Three patients developed SAM just after MVP. In the first patient, a 51-year-old man, volume loading and methoxamine were employed, which elevated arterial pressure, but led to a severer catastrophe. This suggested the indication of mitral valve replacement to the surgeons. The second patient, a 75-year-old woman, underwent re-annuloplasty after the first MVP because of incomplete correction. Before the separation from the second CPB, continuous dopamine infusion was started because we feared that the long CPB time would have impaired LV function. The TEE showed the catastrophe, but it disappeared just after the discontinuation of the dopamine infusion and the administration of propranolol and norepinephrine. The last patient was a 72-year-old woman. For the catastrophe, propranolol was given and an immediate improvement followed with TEE showing no evidence of the catastrophe. The goal for anesthetic management of the catastrophe after MVP is to decrease the hyperdynamic ventricular contraction. We managed SAM by volume loading and discontinuation of beta-stimulants and/or administration of beta-blockers.