Nephrorlogy and Rheumatology
Kidney is the indispensable organ that plays an important role in multiple functions maintaining metabolism, electrolyte balance, body fluid adjustment, etc. Kidney diseases include not only primary diseases, e.g. IgA nephropathy, minimal change disease, but also secondary to other systemic diseases, e.g. infection, collagen diseases, metabolic diseases, and drug-induced. Worldwide, patients with end-stage renal diseases (ESRD) and subsequent renal replacement therapy (RRT) is increasing steadily. To date, the number of patients with RRT in Japan surpassed 300,000 and this causes an increase of national medical expenses, so prevention of renal dysfunction progress should be accomplished immediately. In the purpose as mentioned above, KDIGO had proposed the disease concepts chronic kidney disease (CKD) and acute kidney injury (AKI) for early diagnosis and clarifying their epidemiology. In our department, many specialists in the areas of nephrology, rheumatology and metabolism perform management of various diseases, and research kidney diseases by both experimental and clinical approach.
Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complication and to reduce the risk of long-term complications. Management and education of diabetes for each patient is performed both by diabetologist and by co-medical stuff including nutritionist, nurse, physical therapist, pharmacist, and medical technologist. In our department, clinical problems of patients with diabetes are solved by many Board Certified Diabetologists, Certified Diabetes Educator of Japan, and other co-medical stuffs belonging to Diabetes Care Support Team.
Endocrinology is an essential field of clinical internal medicine, because hormonal system is required to maintain homeostasis in human physiology. Endocrinology has the old history, and 98th American Endocrine Society meeting and 89th Japan Endocrine Society meeting will be held in 2016. Our department is working as a center of clinical endocrinology in Kochi prefecture, and endocrine patients (e.g. pituitary, thyroid, adrenal diseases) and also obesity patients are properly diagnosed and treated. Because several cases are difficult to treat, we have clinical conference weekly. In the cases of patients need for surgery, we have careful discussion with endocrine surgeon or neurosurgeon. It’s important to study the way of diagnosis and treatment in each case for educating resident, and it’s encouraged to make case reports for understanding endocrine disease.
Nephrorlogy and Rheumatology
【Molecular mechanism of autophagy in AKI】
Autophagy is one of important factors which play a pivotal role in AKI. We proposed that Sestrin-2 and BNIP3 regulate autophagy and mitophagy in renal tubular cells in AKI and that oxidative stress-induced apoptosis is ameliorated by HSPB1, reportedly regulate autophagy. Furthermore, we reported that 5-Aminolevulinic acid (ALA) has protective effect in cisplatin-induced AKI is via protection of mitochondrial viability and prevents tubular apoptosis.
【Analysis of clinical data to elucidate pathophysiology of AKI and CKD】
We investigate the biomarkers and epidemiology of CKD and AKI. We had already reported that soluble secreted α-Klotho could be a probable novel biomarker for CKD and that serum uric acid level is a risk factor for AKI in hospitalized patients.
【Molecular mechanism of impaired insulin secretion in diabetes】
One of the characteristics of type 2 diabetes is that the insulin secretory response of β-cells is selectively impaired to glucose due to impaired glucose metabolism in these cells. We propose that endogenous generation of reactive oxygen species (ROS) and lactate overproduction play important roles in impaired glucose-induced insulin secretion in β-cells.
【Analysis of clinical data to elucidate pathophysiology of diabetes】
We investigate the association between the histological severity of non-alcoholic fatty liver disease (NAFLD) and glucose tolerance. We also explore the possibility of the plasma mannose level as an indicator of glycogenolysis in human using clinical data of oral glucose tolerance tests in subjects with various degrees of glucose intolerance.
【Complication of Cushing syndrome】
Persistent glucocorticoid excess (Cushing syndrome) causes several complications such as obesity, diabetes mellitus and osteoporosis. To clarify molecular mechanism in these complications, we investigate the phenotype of Cushing model mice (CRH transgenic mouse and corticosterone administered mice) in detail. We also examine circulating hormone levels (ACTH, cortisol, AgRP, etc) before and after surgery in patients with Cushing syndrome.
【Central pathophysiology of hyperphagia and obesity】
Obesity is associated with adverse health outcomes (hypertension, diabetes mellitus, dyslipidemia, fatty liver, sleep apnea syndrome, etc) and is a growing problem worldwide. We investigate the pathophysiology of hyperphagia and obesity in the hypothalamus using diet-induced obese mice, gene-targeting mice (ob/ob mouse and AgRP knockout mouse) and hypothalamic cell line.
|Professor: Yoshio Terada
|Professor: Shimpei Fujimoto
|Associate Professor: Mitsuru Nishiyama
|Assistant Professor: Taro Horino
|Assistant Professor: Takafumi Taguchi
|Assistant Lecturer: Shogo Funakoshi
|Assistant Lecturer: Yoshinori Taniguchi
|Assistant Lecturer: Kosuke Inoue
|Assistant Lecturer: Shuichi Nakayama
|Assistant Lecturer: Seiki Hirano
|Assistant Lecturer: Yoshiko Shimamura
|Specially Appointed Assistant Lecturer：Tatsuki Matsumoto
|Specially Appointed Assistant Lecturer：Satoko Ohmi