Vasoactive intestinal peptide in human nasal mucosa

Vasoactive intestinal peptide (VIP), which is present with acetylcholine in parasympathetic nerve fibers, may have important regulatory functions in mucous membranes. The potential roles for VIP in human nasal mucosa were studied using an integrated approach. The VIP content of human nasal mucosa was determined to be 2.84 +/- 0.47 pmol/g wet weight (n = 8) by RIA. VIP-immunoreactive nerve fibers were found to be most concentrated in submucosal glands adjacent to serous and mucous cells. 125I-VIP binding sites were located on submucosal glands, epithelial cells, and arterioles. In short-term explant culture, VIP stimulated lactoferrin release from serous cells but did not stimulate [3H]glucosamine-labeled respiratory glycoconjugate secretion. Methacholine was more potent than VIP, and methacholine stimulated both lactoferrin and respiratory glycoconjugate release. The addition of VIP plus methacholine to explants resulted in additive increases in lactoferrin release. Based upon the autoradiographic distribution of 125I-VIP binding sites and the effects on explants, VIP derived from parasympathetic nerve fibers may function in the regulation of serous cell secretion in human nasal mucosa. VIP may also participate in the regulation of vasomotor tone

血液透析治療を受ける 2 型糖尿病患者の「社会力」を測定するための新しい尺度

Purpose:When beginning dialysis treatment, patients with type ２ diabetes face a need to build new relationships, as support receivers, with the people close to them, who become support givers. Taking as our base “social competence”, i.e. the ability to connect with people and build society, we created a social competence scale for Japanese patients with type ２ diabetes receiving dialysis. This study tested the reliability and validity of the scale. Method:This is a cross-sectional study that focuses on Japanese　patients with type ２ diabetes receiving dialysis (n=１６３, males=１２１, females=４２). The mean age of the patients was ６５.１±１０.３ (range ４４-９１). The mean duration of dialysis was ６.０±４.７ years (range ０.５-２５). Our data were analyzed using exploratory factor analysis, criterion related validity, and reliability testing.Results:The final version of the social competence scale for patients with type ２ diabetes receiving dialysis was composed of ５ factors, with ３２ items. All ３２ items had a Cronbach’s α of ０.８９, with a total distribution of ４９.０５%. The scale showed a significant correlation with KiSS-１８.Conclusion:This study suggests that a social competence scale for Japanese patients with type ２ diabetes receiving dialysis may be used as an essential tool for nurses in assessing the relationships between patients and those close to them. Also, by clarifying the constituent factors of social competence in patients with type ２ diabetes receiving dialysis, the study enables nurses to develop education programs for patients to cultivate their social competence. The study therefore facilitates the provision of better care in practical clinical care settings

Doppler Detection in Ama Divers of Japan

International audienc

Long-term safety and efficacy of alogliptin, a DPP-4 inhibitor, in patients with type 2 diabetes: a 3-year prospective, controlled, observational study (J-BRAND Registry)

Introduction Given an increasing use of dipeptidyl peptidase-4 (DPP-4) inhibitors to treat patients with type 2 diabetes mellitus in the real-world setting, we conducted a prospective observational study (Japan-based Clinical Research Network for Diabetes Registry: J-BRAND Registry) to elucidate the safety and efficacy profile of long-term usage of alogliptin.Research design and methods We registered 5969 patients from April 2012 through September 2014, who started receiving alogliptin (group A) or other classes of oral hypoglycemic agents (OHAs; group B), and were followed for 3 years at 239 sites nationwide. Safety was the primary outcome. Symptomatic hypoglycemia, pancreatitis, skin disorders of non-extrinsic origin, severe infections, and cancer were collected as major adverse events (AEs). Efficacy assessment was the secondary outcome and included changes in hemoglobin A1c (HbA1c), fasting blood glucose, fasting insulin and urinary albumin.Results Of the registered, 5150 (group A: 3395 and group B: 1755) and 5096 (3358 and 1738) were included for safety and efficacy analysis, respectively. Group A patients mostly (>90%) continued to use alogliptin. In group B, biguanides were the primary agents, while DPP-4 inhibitors were added in up to ~36% of patients. The overall incidence of AEs was similar between the two groups (42.7% vs 42.2%). Kaplan-Meier analysis revealed the incidence of cancer was significantly higher in group A than in group B (7.4% vs 4.8%, p=0.040), while no significant incidence difference was observed in the individual cancer. Multivariate Cox regression analysis revealed that the imbalanced patient distribution (more elderly patients in group A than in group B), but not alogliptin usage per se, contributed to cancer development. The incidence of other major AE categories was with no between-group difference. Between-group difference was not detected, either, in the incidence of microvascular and macrovascular complications. HbA1c and fasting glucose decreased significantly at the 0.5-year visit and nearly plateaued thereafter in both groups.Conclusions Alogliptin as a representative of DPP-4 inhibitors was safe and durably efficacious when used alone or with other OHAs for patients with type 2 diabetes in the real world setting