Temporal evolution of ion fragment production from methylsilane by a hot tungsten wire

S. Yoshimura et al., Journal of Applied Physics 100, 096107 (2006) https://doi.org/10.1063/1.236405

Sodium glucose co-transporter-2 inhibitors in intensive care unit patients with type 2 diabetes: a pilot case control study

Abstract Background Sodium glucose co-transporter-2 (SGLT2) inhibitors improve long-term cardiovascular and renal outcomes in individuals with type 2 diabetes. However, the safety of SGLT2 inhibitors in ICU patients with type 2 diabetes is uncertain. We aimed to perform a pilot study to assess the relationship between empagliflozin therapy and biochemical, and clinical outcomes in such patients. Methods We included 18 ICU patients with type 2 diabetes receiving empagliflozin (10 mg daily) and insulin to target glucose range of 10–14 mmol/l according to our liberal glucose control protocol for patients with diabetes (treatment group). Treatment group patients were matched on age, glycated hemoglobin A1c, and ICU duration with 72 ICU patients with type 2 diabetes exposed to the same target glucose range but who did not receive empagliflozin (control group). We compared changes in electrolyte and acid–base parameters, hypoglycemia, ketoacidosis, worsening kidney function, urine culture findings, and hospital mortality between the groups. Results Median (IQR) maximum increase in sodium and chloride levels were 3 (1–10) mmol/l and 3 (2–8) mmol/l in the control group and 9 (3–12) mmol/l and 8 (3–10) mmol/l in the treatment group (P = 0.045 for sodium, P = 0.059 for chloride). We observed no differences in strong ion difference, pH or base excess. Overall, 6% developed hypoglycemia in each group. No patient in the treatment group and one patient in the control group developed ketoacidosis. Worsening kidney function occurred in 18% and 29% of treatment and control group patients, respectively (P = 0.54). Urine cultures were positive in 22% of treatment group patients and 13% of control group patients (P = 0.28). Overall, 17% of treatment group patients and 19% of control group patients died in hospital (P = 0.79). Conclusions In our pilot study of ICU patients with type 2 diabetes, empagliflozin therapy was associated with increases in sodium and chloride levels but was not significantly associated with acid–base changes, hypoglycemia, ketoacidosis, worsening kidney function, bacteriuria, or mortality

Neuroendocrine carcinoma of the esophagus: Clinicopathological and immunohistochemical features of 14 cases.

BACKGROUND:Neuroendocrine carcinoma (NEC) of the esophagus is a rare and highly aggressive disease but the biological features are poorly understood. The objective of this study was to analyze the clinicopathological and immunohistochemical features of NEC of the esophagus. METHODS:Fourteen patients diagnosed with NEC of the esophagus from 1998 to 2013 were included in this study. Clinicopathologic features, therapeutic outcomes and immunohistochemical results were analyzed. RESULTS:Eleven out of 14 cases showed protruding or localized type with or without ulceration. Only three patients were negative for both lymph node and organ metastasis and seven cases were positive for metastases to distant organs and/or distant lymph nodes. Of the six patients with limited disease (LD), three patients were treated by surgery. Three patients with LD and seven patients with extensive disease (ED) were initially treated with chemotherapy, except for one who underwent concurrent chemo-radiotherapy due to passage disturbance. The median survival of patients with LD was 8.5 months, whereas that of patients with LD was 17 months. Among the 14 cases, 12 cases (83.3%), 13 cases (91.7%) and 12 cases (83.3%) showed positive immunostaining for choromogranin A, synaptophysin and CD56, respectively. Nine of 14 cases (64.2%) presented positive staining for c-kit and most (8/9, 88%) simultaneously showed p53 protein abnormality. Two cases were negative for c-kit and p53, and positive for CK20. CONCLUSION:Consistent with previous reports, the prognosis of NEC of esophagus is dismal. From the results of immunohistochemical study, NEC of esophagus might be divided into two categories due to the staining positivity of c-kit and p53. This study provides new insight into the biology of NEC of the esophagus

Clinicopathologic features of neuroendocrine carcinoma of esophagus.

<p>Clinicopathologic features of neuroendocrine carcinoma of esophagus.</p

Overall survival in patients of neuroendocrine carcinoma of esophagus with LD or ED.

<p>The MST of patients with ED was 8.5 months, whereas the MST of patients with LD was 17 months.</p

Immunohistochemical pictures of neuroendocrine carcinoma of esophagus.

<p>A) Case 3 shows positive staining for c-kit and p53 protein. B) Case 13 shows positive staining for CK20, and negative staining for both c-kit and p53 immunostainings.</p

Imuunostaining of neuroendocrine markers (choromogranin A, synaptophysin and CD56) and other markers.

<p>Imuunostaining of neuroendocrine markers (choromogranin A, synaptophysin and CD56) and other markers.</p