Subacute Development of Polymyalgia Rheumatica (PMR) In Diabetic Patient with Clinical Efficacy of Tocilizumab and Xultophy

The patient is 76-year-old men with previous history of type 2 diabetes mellitus (T2DM) in 2012, acute myocardial infarct (AMI) in 2015 and dyslipidemia in 2017. He had no health or medical problems of rheumatism and joints. As his social and sports history, he was an excellent long-distance runner with the similar level to Olympian Kenji Kimihara during 14-30 years old. He worked hard from 38 years as city assembly member. In 2019, he continued low carbohydrate diet (LCD) with decreased HbA1c from 9.0% to 6.3% for half year. In autumn 2021, he developed subacute generalized arthralgia and muscle weakness with elevated HbA1c 10.6%. He was diagnosed as polymyalgia rheumatica (PMR). For treatment, prednisolone was not effective, and then he was provided Tocilizumab (Actemra). It showed remarkable efficacy for symptom improvement and normalized C-reactive protein (CRP) 8.3 to <0.1 mg/dL, matrix metalloproteinase-3 (MMP-3) 610 to 79 ng/mL. For glucose control, he was initiated insulin human 4-4-4 to 14-14-14 units, followed by Xultophy 18 to 5 doses with satisfactory glucose variability. HbA1c was remarkably decreased from 10.6% to 6.4 % about 2 months. Various discussion perspective was described, and this article will be hopefully useful for future practice and research

Simulation of Transitions between "Pasta" Phases in Dense Matter

Calculations of equilibrium properties of dense matter predict that at subnuclear densities nuclei can be rodlike or slablike. To investigate whether transitions between phases with non-spherical nuclei can occur during the collapse of a star, we perform quantum molecular dynamic simulations of the compression of dense matter. We have succeeded in simulating the transitions between rodlike and slablike nuclei and between slablike nuclei and cylindrical bubbles. Our results strongly suggest that non-spherical nuclei can be formed in the inner cores of collapsing stars.Comment: 4 pages, 4 figures, final version published in Phys. Rev. Lett., high-res figures can be seen at http://www.nordita.dk/~gentaro/research/fig

Effects of carbon incorporation on doping state of YBa2Cu3Oy

Effects of carbon incorporation on the doping state of YBa2Cu3Oy (Y-123) were investigated. Quantitative carbon analysis revealed that carbon could be introduced into Y-123 from both the precursor and the sintering gas. Nearly carbon-free (< 200 ppm) samples were prepared from a vacuum-treated precursor by sintered at 900 &#730;C and cooling with 20 &#730;C /min in flowing oxygen gas. The lower Tc (= 88 K) and higher oxygen content (y = 6.98) strongly suggested the overdoping state, which was supported by the temperature dependence of resisitivity and thermoelectric power. The nuclear quadrapole resonance spectra and the Raman scattering spectra indicated that there was almost no oxygen defect in the Cu-O chain in these samples. On the other hand, in the same cooling condition, the samples sintered in air stayed at optimal doping level with Tc = 93 K, and the intentionally carbon-doped sample was in the underdoping state. It is revealed that about 60% of incorporated carbon was substituted for Cu at the chain site in the form of CO32+, and the rest remains at the grain boundary as carbonate impurities. Such incorporation affected the oxygen absorption process in Y-123. It turned out that the oxygen content in Y-123 cannot be controlled only by the annealing temperature and the oxygen partial pressure but also by the incorporated carbon concentration.Comment: 16pages, 9figure

Magnetization under High Pressure in MnSi

The magnetization M(H) has been measured in the weakly helimagnetic itinerant compound MnSi under high pressure up to 10.2 kbar and high magnetic field up to 9 Tesla. We interpret the simultaneous decrease under pressure of the saturated magnetization, $p_s$, and the Curie temperature, $$ in the frame of the self-consistent renormalization theory (SCR) of spin fluctuations. From the analysis of the so-called Arrot-plot ($H/p [ H,T ]$ versus $p^2[ H,T ]$) and the respective volume dependence of $p_s$ and $T_c$, we estimate the evolution of the characteristic spin fluctuation temperatures, $T_0$ and $T_A$ when the system approaches its critical pressure, $P_c$=15 kbar, corresponding to the disappearance of the long range magnetic order at T=0.Comment: 12 pages, 5 figures. Submitted to Phys. Rev.

Opening of a pseudogap in a quasi-two dimensional superconductor due to critical thermal fluctuations

We examine the role of the anisotropy of superconducting critical thermal fluctuations in the opening of a pseudogap in a quasi-two dimensional superconductor such as a cuprate-oxide high-temperature superconductor. When the anisotropy between planes and their perpendicular axis is large enough and its superconducting critical temperature T_c is high enough, the fluctuations are much developed in its critical region so that lifetime widths of quasiparticles are large and the energy dependence of the selfenergy deviates from that of Landau's normal Fermi liquids. A pseudogap opens in such a critical region because quasiparticle spectra around the chemical potential are swept away due to the large lifetime widths. The pseudogap never smoothly evolves into a superconducting gap; it starts to open at a temperature higher than T_c while the superconducting gap starts to open just at T_c. When T_c is rather low but the ratio of varepsilon_G(0)/k_BT_c, with varepsilon_G(0) the superconducting gap at T=0K and k_B the Boltzmann constant, is much larger than a value about 4 according to the mean-field theory, the pseudogap must be closing as temperature T approaches to the low T_c because thermal fluctuations become less developed as T decreases. Critical thermal fluctuations cannot cause the opening of a prominent pseudogap in an almost isotropic three dimensional superconductor, even if its T_c is high.Comment: 25 pages, 5 figures (14 subfigures

Microscopic Study of Slablike and Rodlike Nuclei: Quantum Molecular Dynamics Approach

Structure of cold dense matter at subnuclear densities is investigated by quantum molecular dynamics (QMD) simulations. We succeeded in showing that the phases with slab-like and rod-like nuclei etc. can be formed dynamically from hot uniform nuclear matter without any assumptions on nuclear shape. We also observe intermediate phases, which has complicated nuclear shapes. Geometrical structures of matter are analyzed with Minkowski functionals, and it is found out that intermediate phases can be characterized as ones with negative Euler characteristic. Our result suggests the existence of these kinds of phases in addition to the simple ``pasta'' phases in neutron star crusts.Comment: 6 pages, 4 figures, RevTex4; to be published in Phys. Rev. C Rapid Communication (accepted version

Useful Xultophy for Older Diabetic with Various Problems

The case was 79-year-old female with type 2 diabetes mellitus (T2DM) and other medical problems who has been treated on insulin for Multiple Daily Injections (MDI). She has recently developed cough and was diagnosed as slight bronchopneumonia, followed by the admission to the hospital with intensive treatment. Simultaneously, she could not control her usual daily life, and then her diabetic therapy was changed to Xultophy. It is the combined agent of liraglutide and insulin degludec that can be injected once a day. In this article, the clinical progress and some discussion from various points of view would be described