Accuracy and Time Delay of Glucose Measurements of Continuous Glucose Monitoring and Bedside Artificial Pancreas During Hyperglycemic and Euglycemic Hyperinsulinemic Glucose Clamp Study

Background: Glucose values of continuous glucose monitoring (CGM) have time delays compared with plasma glucose (PG) values. Artificial pancreas (STG-55, Nikkiso, Japan) (AP), which measures venous blood glucose directly, also has a time delay because of the long tubing lines from sampling vessel to the glucose sensor. We investigate accuracy and time delay of CGM and AP in comparison with PG values during 2-step glucose clamp study. Methods: Seven patients with type 2 diabetes and 2 healthy volunteers were included in this study. CGM (Enlite sensor, Medtronic, CA) was attached on the day before the experiment. Hyperglycemic (200 mg/dL) clamp was performed for 90 minutes, followed by euglycemic (100 mg/dL) hyperinsulinemic (100 μU/mL) clamp for 90-120 minutes using AP. CGM sensor glucose was calibrated just before and after the clamp study. AP and CGM values were compared with PG values. Results: AP values were significantly lower than PG values at 5, 30 minute during hyperglycemic clamp. In comparison, CGM value at 0 minute was significantly higher, and its following values were almost significantly lower than PG values. The time delay of AP and CGM values to reach maximum glucose levels were 5.0 ± 22.3 (NS) and 28.6 ± 32.5 (p<0.05) min, respectively. Mean absolute rate difference of CGM was significantly higher than AP (24.0 ± 7.6 vs. 15.3 ± 4.6, p < 0.05) during glucose rising period (0-45 min), however, there are no significant difference during other periods. Conclusions: Both CGM and AP failed to follow plasma glucose values during non-physiologically rapid glucose rising, however, indicated accurate values during physiological glucose change

Are Two z~6 Quasars Gravitationally Lensed ?

Several high-z (z > 5.7) quasars have been found in the course of Sloan Digital Sky Survey. The presence of such very high-z quasars is expected to give constraints on early structure formation. On one hand, it is suggested that these most luminous objects at high redshift are biased toward the highly magnified objects by gravitational lensing. To clarify the effect of gravitational lensing on the high-z quasars, we began the imaging survey of intervening lensing galaxies. Indeed our previous optical image showed that SDSSp J104433.04+012502.2 at z=5.74 is gravitationally magnified by a factor 2. In this paper, we report our new optical imaging of other two high-z quasars, SDSSp J103027.10+052455.0 at z=6.28 and SDSSp J130608.26+035626.3 at z=5.99. Since we find neither intervening galaxy nor counter image with i^{\prime} < 25.4-25.8 around each quasar, we conclude that they are not strongly magnified regardless that a lens galaxy is dusty.Comment: 10 pages, 8 figures, Accepted for PAS

SDSSp J104433.04−-012502.2 at z=5.74z=5.74 is Gravitationally Magnified by an Intervening Galaxy

During the course of our optical deep survey program on L$\alpha$ emitters at $z \approx 5.7$ in the sky area surrounding the quasar SDSSp J104433.04$-$012502.2 at $z=5.74$, we found that a faint galaxy with $m_B$(AB) $\approx 25$ is located at \timeform{1".9} southwest of the quasar. Its broad-band color properties from $B$ to $z^\prime$ suggest that the galaxy is located at a redshift of $z \sim 1.5$ -- 2.5. This is consistent with no strong emission line in our optical spectroscopy. Since the counter image of the quasar cannot be seen in our deep optical images, the magnification factor seems not to be very high. Our modest estimate is that this quasar is gravitationally magnified by a factor of 2.Comment: 11 pages, 5 figures, PASJ, in pres

The Discovery of a Very Narrow-Line Star Forming Obat a Redshift of 5.66ject

We report on the discovery of a very narrow-line star forming object beyond redshift of 5. Using the prime-focus camera, Suprime-Cam, on the 8.2 m Subaru telescope together with a narrow-passband filter centered at $\lambda_{\rm c}$ = 8150 \AA with passband of $\Delta\lambda$ = 120 \AA, we have obtained a very deep image of the field surrounding the quasar SDSSp J104433.04$-$012502.2 at a redshift of 5.74. Comparing this image with optical broad-band images, we have found an object with a very strong emission line. Our follow-up optical spectroscopy has revealed that this source is at a redshift of $z=5.655\pm0.002$, forming stars at a rate $\sim 13 ~ h_{0.7}^{-2} ~ M_\odot$ yr$^{-1}$. Remarkably, the velocity dispersion of Ly$\alpha$-emitting gas is only 22 km s$^{-1}$. Since a blue half of the Ly$\alpha$ emission could be absorbed by neutral hydrogen gas, perhaps in the system, a modest estimate of the velocity dispersion may be $\gtrsim$ 44 km s$^{-1}$. Together with a linear size of 7.7 $h_{0.7}^{-1}$ kpc, we estimate a lower limit of the dynamical mass of this object to be $\sim 2 \times 10^9 M_\odot$. It is thus suggested that LAE J1044$-$0123 is a star-forming dwarf galaxy (i.e., a subgalactic object or a building block) beyond redshift 5 although we cannot exclude a possibility that most Ly$\alpha$ emission is absorbed by the red damping wing of neutral intergalactic matter.Comment: 6 pages, 2 figures. ApJ Letters, in pres

Unmanipulated HLA 2–3 Antigen-Mismatched (Haploidentical) Stem Cell Transplantation Using Nonmyeloablative Conditioning

AbstractThe major problems in human leukocyte antigen (HLA)-mismatched stem cell transplantation (SCT) are graft failure and graft-versus-host disease (GVHD). Less-intensive regimens should be associated with a lower release of inflammatory cytokines and possibly less GVHD. The objective of this study was to investigate whether HLA-haploidentical SCT can be performed using nonmyeloablative conditioning and pharmacologic GVHD prophylaxis, including glucocorticoids. Using conditioning consisting of fludarabine, busulfan, and anti–T-lymphocyte globulin and GVHD prophylaxis consisting of tacrolimus and methylprednisolone (1 mg/kg/day), 26 patients who had hematologic malignancies in an advanced stage or with a poor prognosis underwent transplantation using peripheral blood stem cells from an HLA-haploidentical donor (2–3 antigen mismatches in the graft-versus-host [GVH] direction) without T-cell depletion. All patients except for 1 achieved donor-type engraftment. Rapid hematologic engraftment was achieved (neutrophils > 0.5 × 109/L on day 12 and platelets > 20 × 109/L on day 12), with full donor chimerism achieved by day 14. Fifteen patients did not develop acute GVHD clinically, and only 5 patients developed grade II GVHD. The recovery of CD4+ T cells was delayed compared with that of CD8+ T cells. Sixteen of the 26 patients are alive in complete remission. Four died of transplantation-related causes, and 6 died of progressive disease. These data suggest that nonmyeloablative conditioning, GVHD prophylaxis consisting of tacrolimus and methylprednisolone, and early therapeutic intervention for the GVH reaction allow stable engraftment and effectively suppress GVHD in HLA 2–3 antigen-mismatched SCT

The Subaru Deep Field Project: Lymanα\alpha Emitters at Redshift of 6.6

We present new results of a deep optical imaging survey using a narrowband filter ($NB921$) centered at $\lambda =$ 9196 \AA ~ together with $B$, $V$, $R$, $i^\prime$, and $z^\prime$ broadband filters in the sky area of the Subaru Deep Field which has been promoted as one of legacy programs of the 8.2m Subaru Telescope. We obtained a photometric sample of 58 Ly$\alpha$ emitter candidates at $z \approx$ 6.5 -- 6.6 among $\sim 180$ strong $NB921$-excess ($z^\prime - NB921 > 1.0$) objects together with a color criterion of $i^\prime - z^\prime > 1.3$. We then obtained optical spectra of 20 objects in our $NB921$-excess sample and identified at least nine Ly$\alpha$ emitters at $z \sim 6.5$ -- 6.6 including the two emitters reported by Kodaira et al. (2003). Since our Ly$\alpha$ emitter candidates are free from strong amplification of gravitational lensing, we are able to discuss their observational properties from a statistical point of view. Based on these new results, we obtain a lower limit of the star formation rate density of $\rho_{\rm SFR} \simeq 5.5 \times 10^{-4}$ $h_{0.7}$ $M_\odot$ yr$^{-1}$ Mpc$^{-3}$ at $z \approx 6.6$, being consistent with our previous estimate. We discuss the nature of star-formation activity in galaxies beyond $z=6$.Comment: 49 pages, 16 figures, PASJ, Vol. 57, No. 1, in pres

Sarcopenia and AGEs in type 1 diabetes

Accumulation of advanced glycation end-products (AGEs) is thought to contribute to muscle weakness in a diabetic animal model. Skin autofluorescence is a proposed marker for accumulation of AGEs in the skin. We aimed to investigate the relationship between AGEs accumulation, sarcopenia and muscle function of Japanese patients with type 1 diabetes. A total of 36 patients with type 1 diabetes participated in the present cross-sectional study. Sarcopenia parameters (skeletal muscle mass index and knee extension strength) were compared with subcutaneous AGEs accumulation using skin autofluorescence. The prevalence of sarcopenia and impaired knee extension strength was 16.6% (men 0.0%, women 22.2%) and 47.2% (men 22.2%, women 55.6%), respectively. Knee extension strength was negatively correlated with skin autofluorescence (r² = 0.14, P < 0.05), but not with skeletal muscle mass index. In conclusion, the AGEs accumulation might be one of the reasons of impaired lower limb muscle function in Japanese patients with type 1 diabetes

Outcome of Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia Patients with Central Nervous System Involvement

AbstractCentral nervous system (CNS) involvement in adult acute myeloid leukemia (AML) is rare and associated with poor outcomes. Therefore, CNS involvement in AML is an indicator for allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the impact of CNS involvement in AML on the outcome of allo-HSCT remains unclear. We performed a large-scale nationwide retrospective analysis to elucidate the outcomes of allo-HSCT on AML with CNS involvement (CNS+AML). Clinical data were collected from a registry database of the Japan Society for Hematopoietic Cell Transplantation. CNS involvement was defined as the infiltration of leukemia cells into the CNS or myeloid sarcoma in the CNS identified at any time from diagnosis to transplantation. One hundred fifty-seven patients with CNS+AML underwent allo-HSCT between 2006 and 2011. The estimated overall survival, cumulative incidence of relapse and nonrelapse mortality at 2 years for CNS+AML (51.2%, 30.2%, and 14.5%, respectively) were comparable with those for AML without CNS involvement (48.6%, 27.4%, and 22.0%, respectively). Univariate and multivariate analyses indicated that the development of chronic graft-versus-host disease, disease status, and cytogenetic risk category were independent prognostic factors for overall survival for CNS+AML. These results suggest that allo-HSCT may improve outcomes in patients with CNS+AML

Dynapenia and AGEs in type 2 diabetes

Aims/Introduction: Advanced glycation end-products (AGEs), which are a major cause of diabetic vascular complications, accumulate in various tissues under chronic hyperglycemic conditions, as well as with aging in patients with diabetes. The loss of muscle mass and strength, so-called sarcopenia and dynapenia, has recently been recognized as a diabetic complication. However, the influence of accumulated AGEs on muscle mass and strength remains unclear. The present study aimed to evaluate the association of sarcopenia and dynapenia with accumulated AGEs in patients with type 2 diabetes. Materials and Methods: We recruited 166 patients with type 2 diabetes aged ≥30 years (mean age 63.2 ± 12.3 years; body mass index 26.3 ± 4.9 kg/m2; glycated hemoglobin 7.1 ± 1.1%). Skin autofluorescence as a marker of AGEs, limb skeletal muscle mass index, grip strength, knee extension strength and gait speed were assessed. Results: Sarcopenia and dynapenia were observed in 7.2 and 13.9% of participants, respectively. Skin autofluorescence was significantly higher in patients with sarcopenia and dynapenia. Skin autofluorescence was the independent determinant for skeletal muscle mass index, grip strength, knee extension strength, sarcopenia and dynapenia. Conclusions: Accumulated AGEs could contribute to reduced muscle mass and strength, leading to sarcopenia and dynapenia in patients with type 2 diabetes

Clustering of Lyman Break Galaxies at z=4 and 5 in The Subaru Deep Field: Luminosity Dependence of The Correlation Function Slope

We explored the clustering properties of Lyman Break Galaxies (LBGs) at z=4 and 5 with an angular two-point correlation function on the basis of the very deep and wide Subaru Deep Field data. We found an apparent dependence of the correlation function slope on UV luminosity for LBGs at both z=4 and 5. More luminous LBGs have a steeper correlation function. To compare these observational results, we constructed numerical mock LBG catalogs based on a semianalytic model of hierarchical clustering combined with high-resolution N-body simulation, carefully mimicking the observational selection effects. The luminosity functions for LBGs predicted by this mock catalog were found to be almost consistent with the observation. Moreover, the overall correlation functions of LBGs were reproduced reasonably well. The observed dependence of the clustering on UV luminosity was not reproduced by the model, unless subsamples of distinct halo mass were considered. That is, LBGs belonging to more massive dark haloes had steeper and larger-amplitude correlation functions. With this model, we found that LBG multiplicity in massive dark halos amplifies the clustering strength at small scales, which steepens the slope of the correlation function. The hierarchical clustering model could therefore be reconciled with the observed luminosity-dependence of the angular correlation function, if there is a tight correlation between UV luminosity and halo mass. Our finding that the slope of the correlation function depends on luminosity could be an indication that massive dark halos hosted multiple bright LBGs (abridged).Comment: 16 pages, 17 figures, Accepted for publication in ApJ, Full resolution version is available at http://zone.mtk.nao.ac.jp/~kashik/sdf/acf/sdf_lbgacf.pd