Course title

Clinical pathophysiology 1Term

後期 2nd HalfCredit(s)1The main day

The main period

Program/Department

48 Physiological Sciences

Lecturers

Motohiro Nishida, Junichi Nabekura, et al.

成績評価区分 Grading Scale A,B,C,Dの4段階評価 Four-grade evaluation
レベル Level

Level 3

力量 Competence

専門力 Academic expertise

Instructor

Full name* FURUSEMIKIONABEKURA

JUNICHINISHIDA

MOTOHIRO

OutlineAbout each of four topics, cardiovascular system, nociception and pain, epithelial
homeostasis, and metabolic regulation, lecturers in the basic fields will give anoverview of the mechanisms of the normal functioning. After that, clinical researchers
invited from outside will give a lecture on the clinical pathology and treatment for
diseases caused by abnormalities in these mechanisms. By relating the basic
understanding of physiology to pathologies, students will learn how abnormalities inbasic physiology contribute to the development of diseases and pathologies. Students
will also understand how the normalization of basic physiological mechanisms can leadto the treatment of pathologies and diseases.

Learning objectives(1) To explain the signaling mechanisms of cardiovascular dynamism and theirpathophysiology in terms of biological functions of molecules and cells constituting
the cardiovascular system.
(2) To explain the mechanism by which nociceptive stimuli are received at peripheral
nerve endings and transmitted through the spinal cord to the cerebrum where they aremodified and become pain sensations.
(3) To explain the cellular basis of epithelial homeostasis and pathologies caused by
its failure, with a particular focus on the epithelial barrier function.
(4) To explain the mechanism of whole-body homeostasis by organ-organ interaction,including the brain, that regulates feeding and metabolism.

Grading policy

Assignments will be given for each of the four topics of the course: CardiovascularSystem, Nociception and Pain, Epithelial Homeostasis, and Metabolic Regulation.
Students are required to prepare and submit a report on one of them. The faculty
member in charge of each topic will evaluate the content of the report. Attendance ofat least half of the class is required for credit.

Lecture Plan

1st lecture, October 23 (Wed) 10:00-11:30 AM"Cardiovascular system (clinical)"Motohiko Sato (Aichi Medical University, Graduate School of Medicine)
Cardiovascular system consisting of the heart and vessels plays important roles tomaintain the biological function of human and animals. In this lecture, the mechanismof the heart as blood pump and regulation of the cardiac output within the systemic
circulation will be described. Consequently, students will increase understanding of 1)
cardiac excitation-contraction coupling, 2)the harmonized coordination of each cardiac
cambers and valves to facilitate blood flow, and 3) the compensatory mechanism embeddedin the cardiovascular system which is essential for upholding systemic circulation
under human disease.

2nd lecture, October 30 (Wed) 10:00-11:30 AM"Cardiovascular system (basic)"
Motohiro Nishida (Physiological Sciences Program)In this lecture, I will introduce the pathophysiological mechanisms of diseases
resulting from the formation, maintenance, and dysfunction of cardiovascular tissues
responsible for blood circulation in human body. First, I will discuss ion channels andsignal transduction molecules that serve as the basis for the control of electricalexcitation conduction and muscle contraction in mature cardiomyocytes and vascularsmooth muscle cells. Additionally, I will introduce therapeutic targets for heart
failure and discuss the pathophysiological mechanisms of cardiovascular dysfunction.
Furthermore, I will introduce the roles of central metabolic pathways and organ-organinteractions in the pathogenesis of drug-resistant heart failure.
3rd lecture, November 6 (Wed) 10:00-11:30 AM"Nociception and pain (basic 1)"
Makoto Tominaga (Nagoya City University, Center for Advanced Research and Development)
Nociception is caused by activation of nociceptive receptors in the peripheral sensory
neurons. Most of the receptors are ion channels, activation of which leads to theaction potential generation through activation of voltage-gated Na+ channels.
4th lecture, November 13 (Wed) 10:00-11:30 AM"Nociception and pain (basic 2)"
Junichi Nabekura (Physiological Sciences Program)
Nociceptive information is conveyed to the brain through spinal code, and the ‘pain’sensation occurs. The nociceptive signals go to limbic system involved in memory andemotion in addition to the sensory area of cerebral cortex in the brain while thesignals are well modified in the brain.
5th lecture, November 27 (Wed) 10:00-11:30 AM"Nociception and pain (clinical)"Takahiro Ushida (Aichi Medical University, Graduate School of Medicine)In the lecture "Treatment Strategies for Pain Patients in Clinical Practice," we
explore the essentials of understanding pain's physiological and psychological aspects.
We differentiate between chronic and acute pain and discuss assessment methods likeobservation, interviewing, and examination. The lecture highlights a comprehensive
approach to treatment, incorporating pharmacotherapy, physical therapy, psychotherapy,and complementary medicine. The objective is to enhance participants' skills inapplying these strategies effectively in clinical settings.
6th lecture, December 11 (Wed) 10:00-11:30 AM"Epithelial homeostasis (basic)"
Mikio Furuse (Physiological Sciences Program)In this lecture, I will introduce the epithelial barrier function and the pathologies
caused by its dysfunction. First, I will present the mechanisms that support theepithelial barrier function, which separates the inside and outside of the body, of theintestinal tract and skin as examples. Next, I will explain the mechanisms that limit
the permeation of substances through the intercellular space, and the pathologies
caused by abnormalities in these mechanisms.
7th lecture, December 18 (Wed) 10:00-11:30 AM"Epithelial homeostasis (clinical)"
Akiharu Kubo (Kobe University, Graduate School of Medicine)In this lecture I will present the mechanisms that maintain the homeostasis of theskin, which is the barrier that covers our body and is the interface with the outside
world. I will also introduce the pathological mechanisms of diseases, including atopic
dermatitis, caused by the breakdown of the skin barrier. In particular, (1) themechanism of cell replacement with maintaining the tight junction barrier in theepidermis, where cells are continuously replaced by cell turnover, and (2) thesymptoms caused by clonal proliferation of mutant cells in the epidermis and themechanism to inhibit their overgrowth will be presented.
8th lecture, January 15 (Wed) 10:00-11:30 AM"Metabolic regulation (basic)"
Yasuhiko Minokoshi (Sugiyama Jogakuen University, School of Life Studies)
In this lecture, I will introduce the mechanisms of whole-body homeostasis by feeding
and peripheral metabolism. First, I will introduce how organ-organ interaction,
including the brain, maintains homeostasis by controlling feeding-induced metabolic
disturbance. Next, I will overview the molecular mechanisms of feeding. In this theme,
I will introduce the idea that feeding involves feeling "positive valence," and themechanism, such as the reward system, contributes to metabolic homeostasis andabnormality.

9th lecture, January 29 (Wed) 10:00-11:30 AM"Metabolic regulation (clincal)"Hiroshi Arima (Nagoya University, Graduate School of Medicine)
Water balance is regulated by water intake and an antidiuretic hormone, vasopressin,
which is released from the posterior pituitary, while energy balance is regulated byfood intake and energy expenditure. In this lecture, I will explain the regulation ofwater and energy balance by hypothalamus, as well as the pathophysiology and treatmentof the disorders such as central diabetes insipidus, hyponatremia and obesity.

Location

onlineLanguage

English (Some lectures may be given in Japanese)

Textbooks and references

Arnold M. Katz, "Physiology of the Heart", Lippincott Williams & Wilkins (1stlecture)
Guyton and Hall Textbook of Medical Physiology (13th edition) (2nd lecture)

Notes for students of other programs Please contact the faculty member in charge in advance.
Contact for Course Inquiries

Mikio Furuse
furuse@nips.ac.jp