Relationship between postprandial glucose level and carotid artery stiffness in patients without diabetes or cardiovascular disease

BACKGROUND: The aim of this study was to evaluate the relationship between postprandial glucose level and atherosclerosis in patients without diabetes and cardiovascular disease by determining carotid ultrasonographic variables and serum levels of 1,5-anhydroglucitol (1,5-AG). METHODS: The subjects were 72 patients without diabetes and cardiovascular disease being treated for hypertension or dyslipidemia. The clinical characteristics of all subjects, including the serum level of 1,5-AG, which appears to be well suited for monitoring postprandial hyperglycemia, were evaluated after an overnight fast. The average intima-media thickness (IMT) and the average pulsatility index (PI) of the right and left common carotid arteries were determined with high-resolution ultrasonography and used as ultrasonographic variables. The subjects were divided into a Lower 1,5-AG group (n = 36) and a Higher 1,5-AG group (n = 36). We evaluated the relationship between clinical characteristics and ultrasonographic variables of the carotid artery in both groups. RESULTS: The average PI in the Lower 1,5-AG group was significantly higher than that in the Higher 1,5-AG group, but the average IMT did not differ between the groups. Linear regression analysis, with the ultrasonographic variables as the dependent variables, with 1,5-AG as the independent variable, and adjusted for other clinical characteristics, showed significant correlation between 1,5-AG and the PI but not between 1,5-AG and IMT. CONCLUSION: Our results suggest that postprandial hyperglycemia increases carotid artery stiffness, but not morphological change, in patients without diabetes or cardiovascular disease

Efficacy of SGLT2 inhibitors in IgA nephropathy associated with alcoholic liver cirrhosis accompanied by nephrotic syndrome: a case report

We present a 51-year-old male patient with a history of Child-Pugh Grade B alcoholic liver cirrhosis (ALC) who developed renal impairment (serum creatinine of 2.00 mg/dL) and nephrotic syndrome (a urinary protein level of 4.35 g/gCr). The patient was diagnosed with immunoglobulin A nephropathy (IgAN) associated with ALC based on findings from comprehensive evaluations, including markedly elevated serum IgA levels (883.7 mg/dL), a kidney biopsy revealing significant IgA deposition in the para-mesangial area, and a liver diagnosis showing long-standing advanced ALC. Our treatment approach involved initiating dapagliflozin therapy, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, alongside strict alcohol abstinence. Remarkably, the patient demonstrated a dramatic reduction in proteinuria within one week of dapagliflozin administration. No hypoglycemic events were observed. This case adds valuable clinical insights into the potential therapeutic role of SGLT2 inhibitors in IgAN associated with ALC. Specifically, in cases where conventional steroid therapies may be contraindicated due to coexisting comorbidities such as diabetes or obesity, dapagliflozin emerges as a potentially efficacious alternative. Further investigations are warranted to validate these preliminary observations

フランス高等教育における職業教育

In France, a so-called “dual system” is employed where two types of higher education institutions (HEIs)-universités and grandes écoles-coexist with different purposes. While in the latter, education has traditionally been vocationally oriented, universities have offered mainly academic courses. However, since the 1960s, vocationalisation (professionnalisation in French) of programmes has progressed in the university sector, such as the creation of IUTs (internal technical colleges) in 1966 and of the licence professionnelle (vocational bachelor) in 1999. Throughout Europe, the process of vocationalisation has been accelerated by European Commission’s policy, in particular “Education and Training (E&T)”, boosted by the Lisbon Strategy (2000) that focuses on economic growth and increased employment. In higher education, the Commission has promoted competency-based learning, by means of various instruments including the Bologna Process (particularly as regards development of qualifications frameworks and quality assurance systems) and E&T, influencing member countries’ higher education systems, including the French, despite national specificities related to the transition from university to the labour market, above all in the French context the “adéquation” (adequacy). In France, along with other countries, amelioration of employment and enhancement of students’ employability have become a major concern of society in the course of massification of higher education. Gradually, competency-based learning has prevailed in French universities. In 2018, the Loi ORE (Law for Student Orientation and Success) requires every university to define “expected competencies in bachelor’s” by programme. In addition, the labour market has also increasingly shed light on the competencies required of workers during the employment process. This book, concerning vocational education in French higher education, aims to structurally analyse the historical development, policies and reforms undertaken and issues at stake, and then to give some thoughts to Japanese higher education which shares similar problems in the matter.はじめに…1 フランスの高等教育課程体系図…3 略号一覧…4 第1章 フランスにおける高等教育改革と職業教育 大場淳…7 第2章 フランスの大学における職業準備機能拡充の政策と取組 夏目達也…31 第3章 フランスの大学における雇用可能性の追求―職能・能力指標の可視化と制度化の試み― 田川千尋…47 第4章 フランスにおける産学連携による大学教育の展開 ―見習訓練制度の現状と問題― 夏目達也…69 第5章 大学における生涯学習の支援と経営 ―フランスにおける具体的展開― 夏目達也…93 おわりに…11

Relaxation in Thin Polymer Films Mapped across the Film Thickness by Astigmatic Single-Molecule Imaging

We have studied relaxation processes in thin supported films of poly­(methyl acrylate) at the temperature corresponding to 13 K above the glass transition by monitoring the reorientation of single perylenediimide molecules doped into the films. The axial position of the dye molecules across the thickness of the film was determined with a resolution of 12 nm by analyzing astigmatic fluorescence images. The average relaxation times of the rotating molecules do not depend on the overall thickness of the film between 20 and 110 nm. The relaxation times also do not show any dependence on the axial position within the films for the film thickness between 70 and 110 nm. In addition to the rotating molecules we observed a fraction of spatially diffusing molecules and completely immobile molecules. These molecules indicate the presence of thin (<5 nm) high-mobility surface layer and low-mobility layer at the interface with the substrate

Dietary milk sphingomyelin prevents disruption of skin barrier function in hairless mice after UV-B irradiation

Exposure to ultraviolet-B (UV-B) irradiation causes skin barrier defects. Based on earlier findings that milk phospholipids containing high amounts of sphingomyelin (SM) improved the water content of the stratum corneum (SC) in normal mice, here we investigated the effects of dietary milk SM on skin barrier defects induced by a single dose of UV-B irradiation in hairless mice. Nine week old hairless mice were orally administrated SM (146 mg/kg BW/day) for a total of ten days. After seven days of SM administration, the dorsal skin was exposed to a single dose of UV-B (20 mJ/cm2). Administration of SM significantly suppressed an increase in transepidermal water loss and a decrease in SC water content induced by UV-B irradiation. SM supplementation significantly maintained covalently-bound ?-hydroxy ceramide levels and down-regulated mRNA levels of acute inflammation-associated genes, including thymic stromal lymphopoietin, interleukin-1 beta, and interleukin-6. Furthermore, significantly higher levels of loricrin and transglutaminase-3 mRNA were observed in the SM group. Our study shows for the first time that dietary SM modulates epidermal structures, and can help prevent disruption of skin barrier function after UV-B irradiation

A Randomized Controlled Trial Comparing the Effects of Sitagliptin and Glimepiride on Endothelial Function and Metabolic Parameters : Sapporo Athero-Incretin Study 1 (SAIS1)

Objectives; The DPP-4 inhibitors are incretin-related drugs that improve hyperglycemia in a glucose-dependent manner and have been reported to exert favorable effects on atherosclerosis. However, it has not been fully elucidated whether DPP-4 inhibitors are able to improve endothelial function in patients with type 2 diabetes. Therefore, we investigated the efficacy of sitagliptin, a DPP-4 inhibitor, on endothelial function and glycemic metabolism compared with that of the sulfonylurea glimepiride. Materials and Methods: In this multicenter, prospective, randomized parallel-group comparison study, 103 outpatients with type 2 diabetes (aged 59.9 +/- 9.9 years with HbA1c levels of 7.5 +/- 0.4%) with dietary cure only and/or current metformin treatment were enrolled and randomly assigned to receive sitagliptin or glimepiride therapy once daily for 26 weeks. Flow-mediated dilation (FMD), a comprehensive panel of hemodynamic parameters (Task Force(R) Monitor), and serum metabolic markers were assessed before and after the treatment. Results: During the study period, no statistically significant change in %FMD was seen in both groups (sitagliptin, 5.6 to 5.6%; glimepiride, 5.6 to 6.0%). Secretory units of islets in transplantation, TNF-α, adiponectin and biological antioxidant potential significantly improved in the sitagliptin group, and superoxide dismutase also tended to improve in the sitagliptin group, while improvements in HbA1c levels were similar between groups. Cardiac index, blood pressure and most other metabolic parameters were not different. Conclusions: Regardless of glycemic improvement, early sitagliptin therapy did not affect endothelial function but may provide favorable effects on beta-cell function and on inflammatory and oxidative stress in patients with type 2 diabetes without advanced atherosclerosis