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Xin Gao,Yuto Yamazaki,Yuta Tezuka,Kei Omata,Yoshikiyo Ono,Ryo Morimoto,Yasuhiro Nakamura,Fumitoshi Satoh,Hironobu Sasano 대한내분비학회 2021 Endocrinology and metabolism Vol.36 No.1
Primary aldosteronism (PA) is the most common cause of secondary hypertension, and is associated with an increased incidence of cardiovascular events. PA itself is clinically classified into the following two types: unilateral PA, mostly composed of aldosteroneproducing adenoma (APA); and bilateral hyperaldosteronism, consisting of multiple aldosterone-producing micronodules (APMs) and aldosterone-producing diffuse hyperplasia. Histopathologically, those disorders above are all composed of compact and clear cells. The cellular morphology in the above-mentioned aldosterone-producing disorders has been recently reported to be closely correlated with patterns of somatic mutations of ion channels including KCNJ5, CACNA1D, ATP1A1, ATP2B3, and others. In addition,in non-pathological adrenal glands, APMs are frequently detected regardless of the status of the renin-angiotensin-aldosterone system (RAAS). Aldosterone-producing nodules have been also proposed as non-neoplastic nodules that can be identified by hematoxylin and eosin staining. These non-neoplastic CYP11B2-positive nodules could represent possible precursors of APAs possibly due to the presence of somatic mutations. On the other hand, aging itself also plays a pivotal role in the development of aldosterone-producing lesions. For instance, the number of APMs was also reported to increase with aging. Therefore, recent studies indicated the novel classification of PA into normotensive PA (RAAS-independent APM) and clinically overt PA.
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( Kuni Shiina ),( Shinpei Yamashita ),( Yuta Tezuka ),( Hiroko Sakurai ),( Hisanori Gamada ),( Toru Yoshida ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Iwate Prefectural Senmaya Hospital (Senmaya Hospital) adjoins the coastal area where seriously damaged by the Tsunami on 2011.3.11. From the disaster, we are working as the second-line hospital. We perform this study to verify the role of the second-line hospital of tsumami disaster, for taking better steps to deal with the future disasters. Methods: The data was obtained from patient record of Senmaya Hospital and assessed. Results: The patient surge started on the day of the tsunami. Overall 136 patients from tsunami swept area (60% from Iwate Prefecture and 40% from Miyagi Prefecture, next to Iwate) was admitted to Senmaya Hospital within 1 month after the disaster. Temporally, the number of inpatients decreased on 16th, the next day of the restoration of electricity, but increased again. The average inpatient per month was 1.0-1.8 fold (average 1.3) compared with that of the previous year (before tsunami). The highest number of the inpatients was found in February 2012, the coldest month in the fi rst winter. Then cost-free pneumococcus vaccination was introduced to the population more than 65 years old. The rate of pneumonia on admission and discharge by death were signifi cantly decreased from 2012-2013 winter. Conclusions: The second-line hospital must receive many patients immediately after the disaster and continuously accept the excess of the inpatients at least 1 year. The pneumococcus vaccination was effective to decrease admission and hospital death by pneumonia. The second-line hospital should store additional space, equipments and goods for the immediate and continuous excess of the patients.
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