Fast excitatory synaptic transmission in the central nervous system is primarily mediated by two major classes of ionotropic glutamate receptors, AMPA receptors (AMPARs) and NMDA receptors (NMDARs) (Bekkers & Stevens, 1989;Jonas & Spruston, 1994). It has been shown that both receptor subtypes can be co-localized at synapses, but at some synapses NMDARs dominate over AMPARs, and other synapses exist that lack AMPARs altogether (Bekkers &
BackgroundDetecting and treating dementia at an early stage are important. Although the Revised Hasegawa Dementia Scale (HDS-R) is commonly used to detect dementia, it takes about 10 min to complete. In contrast, the 1-min animal test (OMAT) takes only 1 min to complete and may be a helpful screening test for general practitioners in deciding whether to proceed with administering further diagnostic tests such as the HDS-R. We sought to examine the relationship between the OMAT and HDS-R scores, and determine the cut-off OMAT score that balanced the sensitivity and specificity in identifying HDS-R-positive patients.MethodsA total of 122 consecutive patients with diabetes who visited the outpatient clinic at the Fujiidera Municipal Hospital were enrolled. The patients underwent the OMAT and HDS-R on the same day. Tests were conducted in a single-blinded manner. The relationship between the OMAT and HDS-R scores was examined using Spearman’s rank correlation. Receiver operating characteristic curve analysis was performed to identify the optimal cut-off score of OMAT that will determine whether to proceed with further diagnostic tests.ResultsA strong positive correlation between the OMAT and HDS-R scores was observed (r = 0.70). The sensitivity and specificity of OMAT using cut-off scores of 12/13, 13/14, and 14/15 for HDS-R-positive patients were 0.87 and 0.66, 1.00 and 0.51, and 1.00 and 0.40, respectively among all the subjects. Similar results were obtained in a subgroup of subjects aged ≥ 65 years.ConclusionsA cut-off score of 13/14 on the OMAT balanced the sensitivity closest to 1.00 and allowed for the highest specificity for the HDS-R not only among all the patients, but also among just the patients aged ≥ 65 years. The OMAT may be an optimal screening test to determine whether to proceed with further diagnosis using HDS-R.Trial registration UMIN UMIN000025260. This study is retrospectively registered on December 13th, 2016
i-gel (Intersurgical Ltd., Wokingham, UK) is a new supraglottic airway device with a cuff made of thermoplastic elastomer gel. We retrospectively studied easiness of insertion and troubles in ventilation when this device was used by less experienced anesthesiologists. Consecutive eleven cases undergoing surgery under general anesthesia were studied. i-gel was successfully inserted in 7 cases (63%) at the first attempt, 2 cases at the second attempt without changing the size. In one case, the size was changed at the second attempt, which resulted in the successful insertion. There was one case of failed insertion even at the second attempt. Fiberoptic observation of the glottis showed direct contact of the cuff to the arytenoids cartilage in cases with successful insertion, however, spastic glottis, defined as contact of vocal cords was observed in 4 cases, and down-folding of the epiglottis was observed in 2 cases. During maintenance of anesthesia, ventilation trouble was observed in 3 cases. We conclude that i-gel should only be used with sufficient knowledge, preparations, skills or support from experienced physician to solve problems related to the safe use of supraglottic airway devices.
Omentin is an adipokine predominantly expressed in visceral adipose tissue and has insulin-sensitizing and vasculoprotective effects, like adiponectin, in rodents. Previous studies indicated associations of plasma omentin levels with atherosclerosis, vascular endothelial function, and coronary artery disease in nondiabetic individuals. In this study, we investigated the association between plasma omentin levels and vascular endothelial function in patients with type 2 diabetes. We included 428 patients with type 2 diabetes in this study. Fasting plasma omentin levels and total adiponectin levels were measured by ELISA, and the endothelium-dependent, flow-mediated dilatation (FMD) of the brachial artery was measured by ultrasonography. The medians of plasma omentin level, adiponectin level, and FMD were 572 ng/mL, 6.1 µg/mL, and 5.7%, respectively. Ninety one (21%) subjects had cardiovascular diseases (CVDs) which were confirmed by medical records. Plasma omentin levels were positively correlated with adiponectin and HDL-cholesterol, and negatively correlated with BMI, IRI, HOMA-R, triglycerides, and eGFR. Multivariate analysis showed that plasma omentin levels were not significantly associated with FMD after adjustment for adiponectin levels and traditional CVD risk factors. However, subgroup analysis revealed that plasma omentin level was an independent determinant of FMD (β = 0.403, p = 0.002) in subjects with CVDs, but not in those without CVDs. Interaction analysis indicated a potential effect modification by the presence of CVDs on the association of plasma omentin levels with FMD. In conclusion, plasma omentin levels are associated with vascular endothelial function, independently of adiponectin and traditional CVD risk factors, in patients with type 2 diabetes and CVDs. This study indicates a protective role of omentin in vascular endothelial function among patients with type 2 diabetes and CVDs. Disclosure M. Senda: None. T. Morioka: Consultant; Self; Ono Pharmaceutical Co., Ltd.. Research Support; Self; Novartis Pharma K.K., MSD K.K., Eli Lilly and Company, Sanofi K.K., Mitsubishi Tanabe Pharma Corporation. Speaker's Bureau; Self; Takeda Pharmaceuticals U.S.A., Inc., Novo Nordisk Inc., Kowa Pharmaceuticals America, Inc., Astellas Pharma US, Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Sumitomo Dainippon Pharma Co., Ltd.. M. Asada: None. Y. Kakutani: Speaker's Bureau; Self; Astellas Pharma US, Inc., Novo Nordisk Inc., Novartis Pharma K.K., Takeda Pharmaceuticals U.S.A., Inc.. Y. Yamazaki: None. K. Motoyama: None. K. Mori: Speaker's Bureau; Self; Boehringer Ingelheim GmbH, Eli Lilly and Company, Mitsubishi Tanabe Pharma Corporation, MSD K.K., Sanofi, AstraZeneca, Daiichi Sankyo Company, Limited. S. Fukumoto: Speaker's Bureau; Self; Astellas Pharma US, Inc.. Research Support; Self; Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation. Speaker's Bureau; Self; Novo Nordisk Inc., Sanofi K.K.. Research Support; Self; Takeda Pharmaceuticals U.S.A., Inc., Taisho Toyama Pharmaceutical Co., Ltd.. A. Shioi: None. T. Shoji: Speaker's Bureau; Self; Astellas Pharma Inc, Bayer Yakuhin Ltd. Research Support; Self; Bayer Yakuhin Ltd. Speaker's Bureau; Self; Kowa Pharamaceutical Co Ltd, Daiichi Sankyo Company, Limited, MSD K.K., Chugai Pharmaceutical Co., Ltd.. Research Support; Self; Chugai Pharmaceutical Co., Ltd.. Speaker's Bureau; Self; Kyowa Hakko Kirin Co., Ltd., Kissei Pharmaceutical Co., Ltd. M. Emoto: Speaker's Bureau; Self; Eli Lilly and Company, Boehringer Ingelheim Pharmaceuticals, Inc., Sumitomo Dainippon Pharma Co., Ltd.. Research Support; Self; Astellas Pharma Inc, Ono Pharmaceutical Co., Ltd., Kissei Pharmaceutical Co., Ltd., Kowa Pharmaceutical Company Ltd., Taisho Toyama Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation. M. Inaba: None.
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