Initial Experience of Percutaneous Extraction of Infected Cardiac Implantable Electric Devices Using Excimer Laser

Article信州医学雑誌 63(2):103-108 (2015)journal articl

Prospective randomized study for optimal insulin therapy in type 2 diabetic patients with secondary failure

<p>Abstract</p> <p>Background</p> <p>The large clinical trials proved that Basal-Bolus (BB) insulin therapy was effective in the prevention of diabetic complications and their progression. However, BB therapy needs multiple insulin injections per a day. In this regard, a biphasic insulin analogue needs only twice-daily injections, and is able to correct postprandial hyperglycemia. Therefore it may achieve the blood glucose control as same as that of BB therapy and prevent the diabetic complications including macroangiopathy.</p> <p>Methods</p> <p>In PROBE (Prospective, Randomized, Open, Blinded-Endpoint) design, forty-two type 2 diabetic patients (male: 73.8%, median(inter quartile range) age: 64.5(56.8~71.0)years) with secondary failure of sulfonylurea (SU) were randomly assigned to BB therapy with a thrice-daily insulin aspart and once-daily basal insulin (BB group) or to conventional therapy with a twice-daily biphasic insulin analogue (30 Mix group), and were followed up for 6 months to compare changes in HbA1c, daily glycemic profile, intima-media thickness (IMT) of carotid artery, adiponectin levels, amounts of insulin used, and QOL between the two groups.</p> <p>Results</p> <p>After 6 months, HbA1c was significantly reduced in both groups compared to baseline (30 Mix; 9.3(8.1~11.3) → 7.4(6.9~8.7)%, p < 0.01, vs BB;8.9(7.7~10.0) → 6.9(6.2~7.3)%, p < 0.01), with no significant difference between the groups in percentage change in HbA1c (30 Mix; -14.7(-32.5~-7.5)% vs BB -17.8(-30.1~-11.1)%, p = 0.32). There was a significant decrease in daily glycemic profile at all points except dinner time in both groups compared to baseline. There was a significant increase in the amount of insulin used in the 30 Mix group after treatment compared to baseline (30 Mix;0.30(0.17~0.44) → 0.39(0.31~0.42) IU/kg, p = 0.01). There was no significant difference in IMT, BMI, QOL or adiponectin levels in either group compared to baseline.</p> <p>Conclusion</p> <p>Both BB and 30 mix group produced comparable reductions in HbA1c in type 2 diabetic patients with secondary failure. There was no significant change in IMT as an indicator of early atherosclerotic changes between the two groups. The basal-bolus insulin therapy may not be necessarily needed if the type 2 diabetic patients have become secondary failure.</p> <p>Trial registration</p> <p>Current Controlled Trials number, NCT00348231</p

Catheter ablation of non-inducible atrial tachycardia after surgical repair of heart disease

We present a patient with non-inducible atrial tachycardia (AT) after atriotomy for surgical repair of heart disease who underwent ablation successfully. Using a 3-D mapping system, we presumed the atriotomy site on the lateral right atrial wall by searching for linear double potentials (DP) during sinus/paced rhythm from the coronary sinus, but it was evaluated incompletely. We could verify the edges of the atriotomy scar precisely by pacing from close to the linear DP lesion and the opposite site. After ablation between the presumed atriotomy scar and the inferior vena cava and cavotricuspid isthmus, no AT recurred without anti-arrhythmic drugs.ArticleHEART AND VESSELS. 27(1):114-118 (2012)journal articl

Onset and development of cannibalistic and schooling behavior in the early life stages of Pacific bluefin tuna Thunnus orientalis

Behavioral development was observed in the early life stages of Pacific bluefin tuna in order to provide fundamental information for improving seedling production techniques. Behavioral observations to quantify swimming, schooling and cannibalistic behavior were made at different developmental stages: pre-flexion (5 days after hatching, DAH), flexion (12 DAH), post-flexion (14 DAH) and juvenile (20 DAH). Video recordings of either observation containers or the rearing tank were made to observe swimming and schooling behavior, respectively. Cannibalistic behavior was estimated by frequency of chase behavior. Swimming speed maintained constant values from 6 DAH (9.2 ± 6.0 mm/s, pre-flexion stage) to 20 DAH (22.4 ± 9.0 mm/s, beginning of juvenile stage) and increased rapidly thereafter to 29 DAH (85.2 ± 32.5 mm/s). Schooling behavior was first observed on 25 DAH juveniles (SL 23.5 ± 5.0 mm). Chase behavior was first observed at 14 DAH (standard length, SL 6.1 ± 0.6 mm, transition at flexion to post-flexion stage) and increased thereafter. We propose that a practical developmental stage for size grading to reduce the mortality by cannibalism should be between post-flexion and early juvenile (SL 6-23 mm), when the cannibalistic behavior onsets and swimming speed are relatively low