Long-term prognosis of diabetic patients with acute myocardial infarction in the era of acute revascularization

Abstract Background The long-term prognosis of diabetic patients with acute myocardial infarction (AMI) treated by acute revascularization is uncertain, and the optimal pharmacotherapy for such cases has not been fully evaluated. Methods To elucidate the long-term prognosis and prognostic factors in diabetic patients with AMI, a prospective, cohort study involving 3021 consecutive AMI patients was conducted. All patients discharged alive from hospital were followed to monitor their prognosis every year. The primary endpoint of the study was all-cause mortality, and the secondary endpoint was the occurrence of major cardiovascular events. To elucidate the effect of various factors on the long-term prognosis of AMI patients with diabetes, the patients were divided into two groups matched by propensity scores and analyzed retrospectively. Results Diabetes was diagnosed in 1102 patients (36.5%). During the index hospitalization, coronary angioplasty and coronary thrombolysis were performed in 58.1% and 16.3% of patients, respectively. In-hospital mortality of diabetic patients with AMI was comparable to that of non-diabetic AMI patients (9.2% and 9.3%, respectively). In total, 2736 patients (90.6%) were discharged alive and followed for a median of 4.2 years (follow-up rate, 96.0%). The long-term survival rate was worse in the diabetic group than in the non-diabetic group, but not significantly different (hazard ratio, 1.20 [0.97-1.49], p = 0.09). On the other hand, AMI patients with diabetes showed a significantly higher incidence of cardiovascular events than the non-diabetic group (1.40 [1.20-1.64], p Conclusions Although diabetic patients with AMI have more frequent adverse events than non-diabetic patients with AMI, the present results suggest that acute revascularization and standard therapy with aspirin and RAS inhibitors may improve their prognosis.</p

Complex orbital state in manganites

The $e_g$-orbital states with complex coefficients of the linear combination of $x^2-y^2$ and $3z^2-r^2$ are studied for the ferromagnetic state in doped manganites. Especially the focus is put on the competition among uniform complex, staggered complex, and real orbital states. As the hole-doping $x$ increases, the real, the canted complex, and the staggered complex orbital states appears successively. Uniform complex state analoguous to Nagaoka ferromagnet does not appear. These complex states can be expressed as a resonating state among the planer orbitals as the orbital liquid, accompanied by no Jahn-Teller distortion.Comment: 14 pages, 6 figure

Mice with defects in HB-EGF ectodomain shedding show severe developmental abnormalities

Heparin-binding EGF-like growth factor (HB-EGF) is first synthesized as a membrane-anchored form (proHB-EGF), and its soluble form (sHB-EGF) is released by ectodomain shedding from proHB-EGF. To examine the significance of proHB-EGF processing in vivo, we generated mutant mice by targeted gene replacement, expressing either an uncleavable form (HBuc) or a transmembrane domain–truncated form (HBΔtm) of the molecule. HBuc/uc mice developed severe heart failure and enlarged heart valves, phenotypes similar to those in proHB-EGF null mice. On the other hand, mice carrying HBΔtm exhibited severe hyperplasia in both skin and heart. These results indicate that ectodomain shedding of proHB-EGF is essential for HB-EGF function in vivo, and that this process requires strict control

Jahn-Teller effect and Electron correlation in manganites

Jahn-Teller (JT) effect both in the absence and presence of the strong Coulomb correlation is studied theoretically focusing on the reduction $\Delta K$ of the kinetic energy gain which is directly related to the spin wave stiffness. Without the Coulomb interaction, the perturbative analysis gives $\Delta K / (g^2/M\Omega^2) \cong 0.05-0.13$ depending on the electron number [$g$: electron-phonon(el-ph) coupling constant, $M$: mass of the oxygen atom, $\Omega$: frequency of the phonon]. Although there occurs many channels of the JT el-ph interaction in the multiband system, the final results of $\Delta K$ roughly scales with the density of states at the Fermi energy. In the limit of strong electron correlation, the magnitude of the orbital polarization saturate and the relevant degrees of freedom are the direction (phase) of it. An effective action is derived for the phase variable including the effect of the JT interaction. In this limit, JT interaction is {\it{enhanced}} compared with the non-interacting case, and $\Delta K$ is given by the lattice relaxation energy $E_{L}$ for the localized electrons, although the electrons remains itinerant. Discussion on experiments are given based on these theoretical results.Comment: 24 pages, 7 figure

A4 Flavor Models in Split Seesaw Mechanism

A seesaw mechanism in an extra-dimension, known as the split seesaw mechanism, provides a natural way to realize a splitting mass spectrum of right-handed neutrinos. It leads to one keV sterile neutrino as a dark matter candidate and two heavy right-handed neutrinos being responsible for leptogenesis to explain the observed baryon asymmetry of the Universe. We study models based on $A_4$ flavor symmetry in the context of the split seesaw mechanism. It is pointed out that most of known $A_4$ flavor models with three right-handed neutrinos being $A_4$ triplet suffer from a degeneracy problem for the bulk mass terms, which disturbs the split mechanism for right-handed neutrino mass spectrum. Then we construct a new $A_4$ flavor model to work in the split seesaw mechanism. In the model, the experimentally observed neutrino masses and mixing angles can be realized from both type I+II seesaw contributions. The model predicts the $\mu-\tau$ symmetry in the neutrino mass matrix at the leading order, resulting in the vanishing $\theta_{13}$ and maximal $\theta_{23}$. The flavor symmetry $A_4$ is broken via the flavon vacuum alignment which can be obtained from the orbifold compactification. The model can be consistent with all data of neutrino oscillation experiments, cosmological discussions of dark matter abundance, leptogenesis, and recent astrophysical data.Comment: 21 pages, 1 figure, version to appear in JHE