Prediction of insulin requirements by explainable machine learning for individuals with type 1 diabetes.

Objective: Adverse events related to insulin therapy remain common in individuals with type 1 diabetes. Optimization of insulin dose can reduce the frequency of these events and help to prevent macrovascular and microvascular complications. The aim of the present study was to develop machine learning models to predict the total daily dose (TDD) of insulin on the basis of data available in routine clinical practice, to evaluate the performance of the models, and to interpret the relation between its predictions and features.

[Diagnosis and treatment of obesity disease in older adults].

In Japan, the proportion of older adults with obesity is rising, highlighting the need for specialized medical care for older adults with obesity. The Japan Society for the Study of Obesity (JASSO) defines 'obesity' as excessive fat storage in adipose tissue with body mass index (BMI) ≥ 25 kg/m, and "Obesity Disease" as a condition with health disorders associated with obesity and/or visceral fat accumulation.The term 'high-degree obesity' applies to those with BMI≥ 35 kg/m, and "Obesity Disease" with high-degree obesity is defined as "high-degree Obesity Disease".

Amyloid deposition through endocytosis in vascular endothelial cells.

No mechanistic lead is known for establishing AL amyloid deposits in organs. We here report an electron microscopic (EM) analysis in a case of intestinal AL amyloidosis before initiating treatment for amyloidosis. The dense deposits of amyloid fibrils are concentrated around the small blood vessels in the submucosal area of intestinal tissue.

Successful diagnosis and treatment of pheochromocytoma during severe coronavirus disease 2019 (COVID-19): a case report.

Pheochromocytoma is a rare but life-threatening condition due to catecholamine release induced by drug treatments such as β-blockers or glucocorticoids. We present a case of hypertensive crisis due to pheochromocytoma, induced after the initiation of dexamethasone and landiolol during intensive care for severe coronavirus disease 2019 (COVID-19). Based on a detailed medical history review, the patient was previously diagnosed with primary aldosteronism by confirmatory tests, moreover, an abdominal computed tomography scan identified an adrenal tumor 2 years before current admission.

Survey of glucocorticoid dose escalation in patients with adrenal insufficiency during the peri-COVID-19 vaccination period.

There is uncertainty regarding the need for COVID-19 peri-vaccination glucocorticoid coverage in patients with adrenal insufficiency. In this survey conducted in a single tertiary medical institution, 167 consecutive outpatients taking physiological glucocorticoids because of adrenal insufficiency were included. The patients declared if they developed an adrenal crisis after vaccination, and the amount and duration of an increase in their glucocorticoid dosage, if any.

Bilateral adrenal uptake of I MIBG scintigraphy with mild catecholamine elevation, the diagnostic dilemma, and its characteristics.

Cases in which bilateral adrenal I-Metaiodobenzylguanidine (I-MIBG) scintigraphy accumulation is sometimes shown, with mildly elevated catecholamine (CA) or metanephrine (MN) levels (within 3 times the upper reference limit) are diagnostic dilemmas. We experienced 3 cases of adrenal incidentalomas with this dilemma in the differential diagnosis. The clinical diagnosis was subclinical Cushing's syndrome in 2 cases, and primary aldosteronism in 1.

Do inferior vena cava filters reduce the risk of acute pulmonary embolism in preoperative patients with venous thromboembolism?

Purpose: Although prophylactic anticoagulants reduce the risk of acute pulmonary embolism (PE), inferior vena cava filters (IVCF) remain elusive in prophylactic use. This study investigated whether IVCF in addition to anticoagulants augment the prophylactic effect on acute PE in the highest-risk patients.

Methods: This study included patients with existing venous thromboembolism (VTE) or a history of previous PE, who underwent subsequent surgery for the underlying disease.

In vivo electroporation enhances plasmid-based gene transfer of basic fibroblast growth factor for the treatment of ischemic limb.

Background: Angiogenic therapy for ischemic tissues using angiogenic growth factors has been reported on an experimental and a clinical level. Electroporation enhances the efficiency of plasmid-based gene transfer in a variety of tissues. The purpose of this study was to evaluate the angiogenic effects of plasmid-based gene transfer using basic fibroblast growth factor (bFGF) in combination with electroporation.

Appropriate control of ex vivo gene therapy delivering basic fibroblast growth factor promotes successful and safe development of collateral vessels in rabbit model of hind limb ischemia.

Purpose: In our previous study, adenovirus-mediated ex vivo gene transfer of basic fibroblast growth factor promoted significant collateral vessel development in a rabbit model of hind limb ischemia. The present study examined how to control the efficacy and safety of this gene therapy, and also evaluated the feasibility of repeat application of this procedure.

Methods: Modified hFGF gene with the secretory signal sequence was adenovirally transferred to cultured autologous fibroblasts, and various numbers of the cells (2 x 10(5), 1 x 10(6), 5 x 10(6), or 2.