Case report: Strong GAD antibody positivity and type 1 diabetes-HLA-susceptible haplotype-DRB1*04:05-DQB1*04:01 in a Japanese patient with immune checkpoint inhibitor-induced type 1 diabetes

Immune checkpoint inhibitors (ICIs) are widely used in cancer treatment; however, they can lead to immune-related adverse events, including immune checkpoint inhibitor-induced type 1 diabetes mellitus (ICI-T1DM). While fulminant T1DM is common in East Asia, ICI-T1DM has predominantly been reported in Western countries. In this report, we present the case of a 66-year-old Japanese man with type 2 diabetes mellitus undergoing dialysis for diabetic nephropathy. The patient was diagnosed with left upper lobe lung cancer, and treatment with nivolumab and ipilimumab was initiated. After 48 days, the patient experienced impaired consciousness and difficulty moving. His blood glucose levels were 815 mg/dL, and metabolic acidosis was detected, leading to a diagnosis of diabetic ketoacidosis. The patient was subsequently treated with continuous intravenous insulin. However, his C-peptide levels rapidly depleted, and new-onset ICI-T1DM was diagnosed. Although most Japanese patients with ICI-T1DM test negative for glutamic acid decarboxylase (GAD) antibodies, this case exhibited a strong positivity. Thus, we reviewed the literature on 15 similar Japanese cases, revealing a mean HbA1c level at onset of 8.7% and a mean time from ICI administration to onset of 9.7 weeks, which was shorter than that in GAD-negative cases. Moreover, human leukocyte antigen typing revealed five cases of DRB1*04:05-DQB1*04:01, including the present case, and one case of DRB1*09:01-DQB1*03:03, both of which were susceptible to T1DM haplotypes. These findings suggest that GAD antibody positivity may be associated with acute onset and disease progression in some cases of Japanese patients with ICI-T1DM. Given that the prediction of new-onset ICI-T1DM is challenging, monitoring GAD antibody levels might be useful. However, further studies with large sample sizes and validation across different racial and ethnic populations are warranted

Sr2V3O9 and Ba2V3O9: quasi one-dimensional spin-systems with an anomalous low temperature susceptibility

The magnetic behaviour of the low-dimensional Vanadium-oxides Sr2V3O9 and Ba2V3O9 was investigated by means of magnetic susceptibility and specific heat measurements. In both compounds, the results can be very well described by an S=1/2 Heisenberg antiferromagnetic chain with an intrachain exchange of J = 82 K and J = 94 K in Sr2V3O9 and Ba2V3O9, respectively. In Sr2V3O9, antiferromagnetic ordering at T_N = 5.3 K indicate a weak interchain exchange of the order of J_perp ~ 2 K. In contrast, no evidence for magnetic order was found in Ba2V3O9 down to 0.5 K, pointing to an even smaller interchain coupling. In both compounds, we observe a pronounced Curie-like increase of the susceptibility below 30 K, which we tentatively attribute to a staggered field effect induced by the applied magnetic field. Results of LDA calculations support the quasi one-dimensional character and indicate that in Sr2V3O9, the magnetic chain is perpendicular to the structural one with the magnetic exchange being transferred through VO4 tetrahedra.Comment: Submitted to Phy. Rev.

Rupture and Rhythm: A Phenomenology of National Experiences

This article investigates how people make sense of ruptures in the flow of everyday life as they enter new experiential domains. Shifts in being-in-time create breaks in the natural attitude that offer the opportunity to register national—or, for example, religious, gender, or class—experiences. People interpret ruptures in perception and proprioception by drawing connections with domains in which similar or contrasting kinds of disruption are evident. Normalizing the transition, rhythm—as both cadence and overall flow—helps people adjust to new circumstances, align action, and smooth subsequent ruptures. Based on extensive qualitative fieldwork, I examine the specific case of how novice and experienced tea ceremony practitioners in Japan move into, interpret, and normalize action within tea spaces

Studies of the Respiratory Dead Space Ⅱ: Variations of the respiratory dead space

The influences of additional dead space, tidal volume or muscular work upon the respiratory dead space were studied and the respiratory dead space in various pulmonary diseases was examined by the same Haldane method as in Part 1. The respiratory dead space increases in hyperpnae at will or at work, but the ratio of dead space to tidal volume i. e. VD/VT remains relatively constant. The respiratory dead space and VD/VT in pulmonal diseases are greater than in healthy state