Existing concepts and models for glucose-stimulated insulin secretion (GSIS) are overviewed and a newer perspective has been formulated toward the physiological understanding of GSIS. A conventional model has been created on the basis of in vitro data on application of a square wave high glucose in the absence of any other stimulatory inputs. Glucose elicits rapid insulin release through an adenosine triphosphate-sensitive K + channel (K ATP channel)-dependent mechanism, which is gradually augmented in a K ATP channel-independent manner. Biphasic GSIS thus occurs. In the body, the b-cells are constantly exposed to stimulatory signals, such as glucagon-like peptide 1 (GLP-1), parasympathetic inputs, free fatty acid (FFA), amino acids and slightly suprathreshold levels of glucose, even at fasting. GLP-1 increases cellular cyclic adenosine monophosphate, parasympathetic stimulation activates protein kinase C, and FFA, amino acids and glucose generate metabolic amplification factors. Plasma glucose concentration gradually rises postprandially under such tonic stimulation. We hypothesize that these stimulatory inputs together make the b-cells responsive to glucose independently from its action on K ATP channels. Robust GSIS in patients with a loss of function mutation of the sulfonylurea receptor, a subunit of K ATP channels, is compatible with this hypothesis. Furthermore, pre-exposure of the islets to an activator of protein kinase A and/or C makes b-cells responsive to glucose in a K ATP channel-and Ca 2+-independent manner. We hypothesize that GSIS occurs in islet b-cells without glucose regulation of K ATP channels in vivo, for which priming with cyclic adenosine monophosphate, protein kinase C and non-glucose nutrients are required. To understand the physiology of GSIS, comprehensive integration of accumulated knowledge is required. (J Diabetes Invest,

The results indicate that the Dental 3D-CT imaging system is suitable for clinical assessment of alveolar bone grafting before and after installation of dental implants or orthodontic treatment of the cleft-adjacent teeth.

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Shoots and foliage on branches of old Pseudotsuga menziesii (Mirb.) Franco var. menziesii (coastal Douglas-fir) trees are constantly renewed by epicormic shoot production. Epicormic shoots are produced in all parts of the crown, and epicormic buds remain dormant for 5 or 6 years on average. Epicormic shoot production results in reiteration of shoot cluster units (SCUs), an architectural unit of shoot organization within branches. Five phases of SCU development were identified based on relative age structures of regular and epicormic shoots. SCUs produce epicormic branchlets as early as 3 or 4 years of age, and peak production occurred around 6-13 years. Epicormic branchlets occur toward the proximal end of main axes of SCUs, where regular lateral branchlets are no longer producing new shoots. In some lower-crown branches, nearly 50% of shoots and foliage are epicormic shoots. Demographic analysis of SCUs showed that upper-crown branches are still growing in size, while mid- and lower-crown branches have reached maximum size, and are being maintained by reiteration of SCUs. Epicormic shoot production maintains shoots and foliage of old P. menziesii trees after height growth and crown expansion have stopped and may contribute to prolonging tree longevity.Key words: aging, branch growth, epicormic shoots, longevity, Pseudotsuga menziesii, reiteration.

A detailed analysis of diameter-height relationships was applied to an old-growth Pseudotsuga menziesii (Mirb.) Franco var. menziesii - Tsuga heterophylla (Raf.) Sarg. forest in southwestern Washington State, U.S.A., to predict future development of vertical stratification among tree species. Differences among species in relative abundance and size structure resulted in diameter-height regressions of varying certainty and stability. Damage and shading had negative impacts on predicted heights and estimates of maximum attainable height (Hmax) in all species. However, species varied as to the main causes and size dependency of damage in relation to tree height. Current height-growth rates of the upper canopy species declined with increasing tree height, reaching minimum values near the predicted Hmax. The future development of the forest canopy would involve a slow invasion of the upper canopy by Tsuga heterophylla and Thuja plicata Donn ex D. Don, as P. menziesii are near their maximum attainable height, and Abies amabilis Dougl. ex Forbes and Taxus brevifolia Nutt. are restricted to the middle to lower canopy. However, if current height-growth rates continue, P. menziesii should maintain its dominant status in the upper canopy for at least another century.

Aim Recently, the accessory middle colic artery (AMCA) has been recognized as the vessel that supplies blood to the splenic flexure. However, the positional relationship between the AMCA and inferior mesenteric vein (IMV) has not been evaluated. Herein, we aimed to evaluate the anatomy of the AMCA and the splenic flexure vein (SFV). Method Two hundred and five patients with colorectal cancer who underwent enhanced CT preoperatively were enrolled in the present study. The locations of the AMCA and IMV were evaluated, focusing on the positional relationship between the vessels and pancreas – below the pancreas or to the dorsal side of the pancreas. Results The AMCA was observed in 74 (36.1%) patients whereas the SFV was found in 177 (86.3%) patients. The left colic artery (LCA) was the major artery accompanying the SFV in 87 (42.4%) of patients. The AMCA accompanied the SFV in 65 (32.7%) patients. In 15 (7.8%) patients, no artery accompanied the SFV. The origin of the AMCA was located on the dorsal side of the pancreas in 15 (20.3%) of these 74 patients. Similarly, the destination of the IMV was located on the dorsal side of the pancreas in 65 (31.7%) of patients. Conclusion The SFV was observed in most patients, and the LCA or AMCA was the common accompanying artery. In some patients these vessels were located on the dorsal side of the pancreas and not below it. Preoperative evaluation of this anatomy may be beneficial for lymph node dissection during left‐sided hemicolectomy.

Although radiofrequency ablation for lung cancer is generally safe (with a mortality rate <1%), it may cause various complications. Common complications include pneumothorax, pleural effusion, and parenchymal hemorrhage. Although most complications can be treated conservatively or with minimal therapy, physicians should be aware of rare but serious complications. Potentially fatal complications include massive hemorrhage, intractable pneumothorax due to bronchopleural fistula, pulmonary artery pseudoaneurysm, systemic air embolism, and pneumonitis. Other serious complications include injury to the nearby tissues (e.g., brachial nerve plexus, phrenic nerve, diaphragm, and chest wall), needle tract seeding, lung abscess, empyema, and skin burn. Although cavitation of the ablation zone is usually insignificant clinically, such a cavity occasionally ruptures, leading to pneumothorax and bleeding. Cavities may also serve as a scaffold for fungal colonization. Precautions to minimize risk should be taken whenever possible. Nevertheless, serious complications may occur, and thus physicians should be aware of the appropriate treatments for these complications. This article reviews complications associated with lung cancer ablation.