Six-month multicentric, open-label, randomized trial of twice-daily injections of biphasic insulin aspart 30 versus multiple daily injections of insulin aspart in Japanese type 2 diabetic patients (JDDM 11)

To evaluate glycemic control using convenience-oriented biphasic insulin analog compared with intensified insulin therapy, we conducted a 6-month multicentric, open-label, randomized trial in Japanese insulin-naive patients with type 2 diabetes mellitus. A total of 160 adult patients at 19 centers were randomized into two groups: those who received twice-daily injections of biphasic insulin aspart 30 and those on three-times-daily injections of insulin aspart with or without NPH insulin (multiple daily injections). At 6 months, mean HbA(1c) decreased by approximately 2.5% in both groups. Reduction of HbA(1c) on both regimens was better in patients whose prior therapy before starting the study was only diet and exercise (-5.0%) than in patients who were previously taking oral antidiabetic agents (-1.0%). No incidence of major hypoglycemia was observed in either regimen. These results suggest that convenience-oriented insulin therapy using biphasic insulin analog is as useful as intensified insulin therapy with insulin analog for the treatment of type 2 diabetes mellitus over 6 months. Furthermore, early induction of insulin therapy in individuals hitherto using only diet and exercise may provide good glycemic control. This study suggests that convenience-oriented biphasic insulin aspart 30 might be a useful option for the treatment of type 2 diabetes mellitus, especially for insulin-naive patients over 6 months, although it should be changed to another regimen when expected efficacy is not obtained.     

A common tattoo chemical for energy storage: henna plant-derived naphthoquinone dimer as a green and sustainable cathode material for Li-ion batteries

The burgeoning energy demands of an increasingly eco-conscious population have spurred the need for sustainable energy storage devices, and have called into question the viability of the popular lithium ion battery. A series of natural polyaromatic compounds have previously displayed the capability to bind lithium via polar oxygen-containing functional groups that act as redox centers in potential electrodes. Lawsone, a widely renowned dye molecule extracted from the henna leaf, can be dimerized to bislawsone to yield up to six carbonyl/hydroxyl groups for potential lithium coordination. The facile one-step dimerization and subsequent chemical lithiation of bislawsone minimizes synthetic steps and toxic reagents compared to existing systems. We therefore report lithiated bislawsone as a candidate to advance non-toxic and recyclable green battery materials. Bislawsone based electrodes displayed a specific capacity of up to 130 mA h g⁻¹ at 20 mA g⁻¹ currents, and voltage plateaus at 2.1–2.5 V, which are comparable to modern Li-ion battery cathodes.

The burgeoning energy demands of an increasingly eco-conscious population have spurred the need for sustainable energy storage devices, and have called into question the viability of the popular lithium ion battery.     

Valsalva-Like Retinopathy Spontaneously Occurred after Ocular Massage

Purpose

The aim of this study is to describe a case of Valsalva-like retinopathy that occurred after ocular massage.

Case Presentation

A healthy 44-year-old Japanese female had massaged her eye with strong pressure several times. Subsequently, she noticed a loss in the left central vision. A left-eye fundus examination showed a dense preretinal hemorrhage located under the internal limiting membrane at the posterior pole and a mild vitreous hemorrhage. We performed a neodymium-doped yttrium-aluminium-garnet laser membranotomy to perforate the internal limiting membrane. Her best-corrected visual acuity improved from 0.01 to 1.0. No retinal vascular abnormalities in the macular area were found.

Conclusion

Ocular massage can cause Valsalva-like retinopathy.Key Words: Neodymium-doped yttrium-aluminium-garnet laser membranotomy, Ocular massage, Valsalva-like retinopathy     

Association between the sense of coherence 13-item version scale score of pregnant women in the second trimester of pregnancy and threatened premature birth

Objectives

The purpose of this study is to determine whether the score of the sense of coherence 13-item version (SOC-13) scale in the second trimester of pregnancy is associated with threatened premature birth.

Methods

All the subjects gave their informed written consent before their participation in the study. A self-reported questionnaire survey was conducted on the pregnant women at approximately 18 weeks of pregnancy. The questionnaire consisted of items on demographic characteristics, perinatal abnormalities, stress perception scale (SPS), and SOC-13 scale. Approximately 30 weeks of pregnancy after the first survey, we surveyed whether any treatment had been provided for threatened premature birth during the course of the current pregnancy. The study period was from December 2007 to February 2010. One hundred and seventy-seven pregnant women participated in the study, but only the data from 151 pregnant women were analyzed.

Results

Forty-three (28.5 %) pregnant women had threatened premature birth and received some treatment. Logistic regression analysis was carried out with threatened premature birth as the dependent variable and age, childbirth history, smoking habit, history of miscarriage or premature birth in previous pregnancies, SPS score, and SOC-13 scale score as the independent variables. It was shown that SOC-13 scale score affected threatened premature birth (p < 0.001) and that a low SOC-13 scale score was associated with threatened premature birth.

Conclusions

This study suggests that the SOC-13 scale score in the second trimester of pregnancy could be of great value in clinical health care of pregnant women with a risk of threatened premature birth in the subsequent course of pregnancy.     

A novel procedure of puncture to access the pulmonary venous atrium in complex congenital heart disease with surgical correction

BackgroundIn complex congenital heart disease, supraventricular arrhythmia develops long term after surgical repair. The arrhythmia could have pharmacological tolerance and sometimes be fatal. We report our experiences with puncturing tough or calcified surgical repair material to access the pulmonary venous atrium for the purpose of the management of arrhythmia in complex congenital heart disease with surgical correction.MethodsFrom June 2016, subsequent 9 patients underwent the procedure. Their age at the procedure ranged from 11 to 43 years old (median 26.4 years old). Surgical procedures were Mustard procedure (Xenomedica^?) in 6, lateral tunnel total cavo-pulmonary connection with autologous pericardium in 2, and extra-cardiac total cavo-pulmonary connection with expanded polytetrafluoroethylene (ePTFE) tube in 1.ResultsMulti-planar reconstruction imaging by cardiac computed tomography was done for making plans before the procedures. Under intracardiac echocardiography guidance, an 8 French steerable sheath was perpendicularly adjusted to target objects. The sharpened edge of 0.014 inch guide wire penetrated with gentle forward force. Subsequently, the puncture site was dilated from a small balloon to a large one step by step. In all patients, penetration was successfully completed. Catheter ablation was achieved in 8 patients and a pacemaker was implanted through the re-canalized superior caval vein in 1 patient. No complications were recorded.ConclusionThe trans-catheter puncture of the synthetic or calcified material is safe and feasible, although careful planning is required with imaging. A steerable sheath could easily be controlled to the make appropriate angle to the target object for preventing slippage and conveying effective force.     

Exacerbation of Ulcerative Colitis with Tocilizumab: A Report of Two Cases,One with Takayasu Arteritis and the Other with Relapsing Polychondritis

Tocilizumab (TCZ), a biologic that blocks the signal transduction of interleukin-6, has been used for the treatment of various autoimmune diseases. Many of these cases are sometimes complicated by ulcerative colitis (UC). However, the effect of TCZ on UC is unclear. We experienced two cases with concomitant UC that were treated with TCZ, one for Takayasu arteritis (TAK) and the other for relapsing polychondritis (RP). TCZ did not improve UC in either of these cases. TCZ might have adverse effects on the intestinal tract, since interleukin-6 signaling plays an important role in intestinal epithelium maintenance. Treatment with TCZ should therefore be carefully provided in patients complicated with UC.