Prevention of hypoglycemia by intermittent-scanning continuous glucose monitoring device combined with structured education in patients with type 1 diabetes mellitus : A randomized, crossover trial

Aims: We conducted a randomized, crossover trial to compare intermittent-scanning continuous glucose monitoring (isCGM) device with structured education (Intervention) to self-monitoring of blood glucose (SMBG) (Control) in the reduction of time below range. Methods: This crossover trial involved 104 adults with type 1 diabetes mellitus (T1DM) using multiple daily injections. Participants were randomly allocated to either sequence Intervention/Control or sequence Control/Intervention. During the Intervention period which lasted 84 days, participants used the first-generation FreeStyle Libre (Abbott Diabetes Care, Alameda, CA, USA) and received structured education on how to prevent hypoglycemia based on the trend arrow and by frequent sensor scanning (≥10 times a day). Confirmatory SMBG was conducted before dosing insulin. The Control period lasted 84 days. The primary endpoint was the decrease in the time below range (TBR; <70 mg/dL). Results: The time below range was significantly reduced in the Intervention arm compared to the Control arm (2.42 ± 1.68 h/day [10.1 %±7.0 %] vs 3.10 ± 2.28 h/day [12.9 %±9.5 %], P = 0.012). The ratio of high-risk participants with low blood glucose index >5 was significantly reduced (8.6 % vs 23.7 %, P < 0.001). Conclusions: The use of isCGM combined with structured education significantly reduced the time below range in patients with T1DM

CO2 absorption effect on electric conductivities for butylethanolamine and methyldiethanolamine aqueous solutions at 313 K

The CO2 absorption, density, viscosity, pH, and electric conductivity were measured for aqueous solutions of butylethanolamine (BEA) and methyldiethanolamine (MDEA) at 313.2 K under atmospheric pressure. The CO2 loading [mol-CO2/mol-amine] of aqueous BEA and MDEA solutions studied decreased with increasing BEA and MDEA concentration. The CO2 loading of an aqueous BEA solution was larger than that of an aqueous MDEA solution in the range of 10 - 40 wt% amine concentration. The electric conductivity of the aqueous BEA solution is larger than that of aqueous MDEA solutions, and the amine concentration dependence of the electric conductivities for both solutions studied showed maxima at 10 wt%. The electric conductivities of BEA and MDEA solutions after CO2 absorption increased with increasing CO2 loading. The CO2 loading dependence of the electric conductivity was correlated with a linear function. It may be suggested that the correlation coefficients predict the CO2 loading and amine concentration in solution at 313.2 K

Popliteal artery aneurysm in a 14-year-old boy with tuberous sclerosis complex

Tuberous sclerosis complex (TSC) is rarely associated with aneurysms. We have described a patient with a popliteal artery aneurysm that was associated with TSC and occlusion of the right posterior tibial artery. The patient underwent aneurysm resection and vein graft replacement, with an uneventful postoperative course and no recurrence at 11 months of follow-up. Patients with TSC could have aneurysms in areas that will not be recognized on abdominal imaging. Physical examination of the lower extremities should be performed owing to the possibility of a popliteal artery aneurysm, and imaging studies should be performed if an aneurysm is suspected

A Radiation-Crosslinked Gelatin Hydrogel That Promotes Tissue Incorporation of an Expanded Polytetrafluoroethylene Vascular Graft in Rats

人工血管移植後に生じる重篤な漿液腫を予防するためには、組織との迅速な一体化（器質化）を促進することが望ましい。そこで生体内環境に類似した化学的・物理的特性を持ち、創傷治癒や器質化を促進すると考えられる量子ビーム架橋ゼラチンゲル(RXgel)を一般的なPTFE製人工血管表面に被覆する手法を開発した。vitroで繊維芽細胞の浸潤を評価するとともに、ラットへ移植して生分解速度を評価して、適切なRxgelの硬さを絞り込んだ。さらに硬さと厚みを調整したRxgel被覆人工血管をラットに移植し、14日後・28日後に組織切片を免疫染色したところ、被覆無しの従来の人工血管に比べ、αSMAやIII型コラーゲンの陽性率が高いことが分かった。Rxgel被覆人工血管の器質化促進効果により漿液腫が予防できれば、患者のQOL向上に貢献できる可能性がある