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Gas-forming liver abscess associated with rapid hemolysis in a diabetic patient

World Journal of Diabetes 2014年第2期5卷 224-229页

作者： Miwa Kurasawa takashi nishikido Junko Koike Shin-ichi Tominaga Hiroyuki Tamemoto Department of Interna Medicine Nishi-agatsuma Welfare Hospital Naganohara machi Agatsuma-gun Gunma Prefecture 377-1308 Japan Clinical Laboratory Nishi-agatsuma Welfare Hospital Naganohara-machi Agatsuma-gun Gunma Prefecture 377-1308 Japan Department of Biochemistry Jichi Medical University

We experienced a case of liver abscess due to Clostridium perfringens(CP) complicated with massive hemolysis and rapid death in an adequately controlled type2 diabetic patient. The patient died 6 h after his first visit to the hospital. CP was later detected in a blood culture. We searched for case reports of CP septicemia and found 124 cases. Fifty patients survived, and 74died. Of the 30 patients with liver abscess, only 3 cases survived following treatment with emergency surgica drainage. For the early detection of CP infection, detection of Gram-positive rods in the blood or drainage fluid is important. Spherocytes and ghost cells indicate intravascular hemolysis. The prognosis is very poor once massive hemolysis occurs. The major causative organisms of gas-forming liver abscess in diabetic patients are Klebsiella pneumoniae(K. pneumoniae) and Escherichia coli(E. coli). Although CP is relatively rare,the survival rate is very poor compared with those of K. pneumoniae and E. coli. Therefore, for every case that presents with a gas-forming liver abscess, the possibility of CP should be considered, and immediate aspiration of the abscess and Gram staining are important.

关键词： Liver abscess Gas-forming Clostridium perfringens Hemolysis Diabetes

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Ipragliflozin-induced improvement of liver steatosis in obese mice may involve sirtuin signaling

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World Journal of Hepatology 2020年第7期12卷 350-362页

作者： Takayoshi Suga Ken Sato Tatsuya Ohyama Sho Matsui Takeshi Kobayashi Hiroki Tojima Norio Horiguchi Yuichi Yamazaki Satoru Kakizaki Ayaka nishikido takashi Okamura Masanobu Yamada TadahiroKitamura Toshio Uraoka Department of Gastroenterology and Hepatology Gunma University Graduate School of MedicineMaebashi 371-8511GunmaJapan Metabolic Signal Research Center Institute for Molecular and Cellular RegulationGunma UniversityMaebashi 371-8512GunmaJapan Department of Medicine and Molecular Science Gunma Graduate School of MedicineMaebashi 371-8511GunmaJapan

BACKGROUND Sodium glucose cotransporter 2(SGLT2)inhibitors are newly developed oral antidiabetic ***2 is primarily expressed in the kidneys and reabsorbs approximately 90%of the glucose filtered by the renal ***2 inhibitors lower glucose levels independently of insulin action by facilitating urinary glucose *** SGLT2 inhibitor ipragliflozin has reportedly improved liver steatosis in animal models and clinical ***,the mechanisms by which SGLT2 inhibitors improve liver steatosis are not fully *** To investigate the ameliorative effects of ipragliflozin on liver steatosis and the mechanisms of these effects in obese *** We analyzed 8-wk-old male obese(ob/ob)mice that were randomly divided into a group receiving a normal chow diet and a group receiving a normal chow diet supplemented with ipragliflozin(3 mg/kg or 10 mg/kg)for 4 *** also analyzed their lean sex-matched littermates receiving a normal chow diet as another control group. Body weight and liver weight were evaluated, and liverhistology, immunoblotting, and reverse transcription-polymerase chain reactionanalyses were *** lipid accumulation was significantly ameliorated in ob/ob mice treatedwith 10 mg/kg ipragliflozin compared to untreated ob/ob mice irrespective ofbody weight changes. Ipragliflozin had no appreciable effects on hepatic oxidativestress-related gene expression levels or macrophage infiltration, but significantlyreduced hepatic interleukin-1β (IL-1β) mRNA expression levels. Ipragliflozinincreased both the mRNA and protein expression levels of sirtuin 1 (SIRT1) in theliver. The hepatic mRNA levels of peroxisome proliferator-activated receptor γcoactivator 1α (PGC-1α), peroxisome proliferator-activated receptor α (PPARα),and fibroblast growth factor-21 (FGF21) were also significantly higher inipragliflozin-treated ob/ob mice than in untreated ob/ob *** study suggests that the liver steatosis-ameliorati

关键词： Selective sodium glucose cotransporter 2 Nonalcoholic fatty liver disease Sirtuin 1 Peroxisome proliferator-activated receptorγcoactivator 1α Peroxisome proliferator-activated receptorα Fibroblast growth factor-21

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