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Aims/Introduction Although nerve conduction study (NCS) using a standard electromyography system (EMGS) is considered to be the gold standard in evaluating diabetic polyneuropathy, this examination requires expensive equipment and well‐trained technicians. We aimed to validate a point‐of‐care device, NC‐stat/DPNCheck™, that has been developed for widespread use of NCS in diabetic polyneuropathy. Materials and Methods Diabetes patients underwent two kinds of NCS: DPNCheck™ and electromyography system. Inter‐/intrarater reliability of DPNCheck™ were also determined by the intraclass correlation coefficient. Results A total of 57 patients were evaluated. The parameters of NCS between the two methods correlated well (r = 0.7734 for the sural nerve conduction velocity, r = 0.6155 for the amplitude of sural nerve action potential). The intraclass correlation coefficients were excellent (intrarater: the velocity 0.767, the amplitude 0.811; interrater: the velocity 0.974, the amplitude 0.834). Conclusions The point‐of‐care device has excellent reproducibility and good agreement with standard electromyography system. The device might be useful to evaluate diabetic polyneuropathy.

PURPOSE This study aimed to clarify the positional relationship between the crown contour and pulp chamber of protostylids using three-dimensional reconstructed images. METHODS Fourteen molars with protostylids from Japanese subjects were subjected to micro-computed tomography. The external surface configurations of the teeth and pulp chambers were reconstructed. Hard tissue thicknesses in appointed buccal areas were measured on the reconstructed images. RESULTS Well-developed protostylids exhibited pulp-prominences above or at the cervical line level. Those that were moderately developed exhibited bulges of the pulp chamber subjacent to the protostylids. Ten of the 14 teeth had prominences in the crown pulp above or at the cervical line level. In addition, 13 teeth exhibited pulp chamber bulges surrounding the lower tooth trunk. No significant differences were apparent in the buccal horizontal thickness of the hard tissue between the protostylids with pulp chamber prominences and the protostylids without pulp chamber prominences at the cervical line level. CONCLUSION Pulp chamber configurations subjacent to protostylids vary based on the development of the traits of the protostylids. Minimum possible taper should be applied during standard vital tooth preparations, as reduced residual dentin thickness is predicted in well- and moderately developed protostylids.

Background: Diabetic complications (DCs) are conventionally classified as micro- or macro-angiopathies. However, in the case of diabetic neuropathy (DPN), it is thought that impairments of neurons and glial cells of the peripheral nervous system, which do not consist of the vascular system, occupy a pivotal role in the pathology. Furthermore, recent accumulated evidences indicate that diabetic retinopathy (DR) which has been mentioned as a microangiopathy, should be also considered as adisease with complex pathogenesis consist of neurodegeneration and angiopathy. Based on this fact, we hypothesized that retinal function can predict the presence or absence of early stage DCs. The current study aimed to elucidate the relationship between DCs and retinal function in diabetic patients (DM) using a handheld device of electroretinogram (ERG) RETevalTM. Methods: Subjects: 175 hospitalized DM. Microvascular complications were assessed using urine albumin creatinine ratio (ACR) measurements, digital retinal images, and nerve conduction studies. Atherosclerosis was assessed utilizing baPWV, ABI, TBI, and carotid IMT. The Pearson’s or Spearman’s coefficient was used for data analysis. Results: Patient background: 112 males, average 60.4±14.0 years old, mean duration of disease 10.7±11.3 years, and mean HbA1c 10.1±2.3%. Prevalence of DCs were 29.4% of DR, 32.9% of nephropathy (DN), and 43.8% of DPN. Relationships with significant correlation between indices of ERG and DCs: ERG latency (LAT) and DR (p = 0.003); ERG amplitude (AMP) and DR (p < 0.001), DN (p = 0.024), or DPN (p = 0.019). Relationships with significant correlation between indices of ERG and indices of DCs: LAT and minimal F-wave latency of the tibial nerves or sural nerve NCVs; AMP and T-Chol, LDL-C, eGFR, urinary C-peptide, ACR, IMT, baPWV, TBI, or SNAP of the sural nerves. Conclusion: AMP and LAT were correlated with prevalence of DCs and their indices. The handheld ERG might predict DCs. Disclosure M. Kawai: None. T. Himeno: None. Y. Yamada: None. E. Asano: None. Y. Sugiura: None. H. Shimoda: None. Y. Shibata: None. M. Kondo: None. S. Tsunekawa: None. H. Kamiya: Speaker's Bureau; Self; Astellas Pharma Inc., Eli Lilly Japan K.K., MSD K.K., Novartis Pharma K.K., Novo Nordisk Oharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi K.K. J. Nakamura: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Japan Tobacco Inc., Kissei Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Kowa Pharmaceu. Co. Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation.

We present a case of a 32-year-old diabetic woman with Prader-Willi syndrome who developed severe ketoacidosis caused by a sodium-glucose cotransporter 2 (SGLT2) inhibitor, a novel class of antihyperglycemic agents, during a strict low-carbohydrate diet. At admission, a serum glucose level of 191 mg/dL was relatively low, though laboratory evaluations showed severe ketoacidosis. This is the first report of ketoacidosis caused by a SGLT2 inhibitor. It is necessary to not only pay attention when using a SGLT2 inhibitor in patients following a low-carbohydrate diet, but also to start a low-carbohydrate diet in patients treated with a SGLT2 inhibitor because of a high risk for developing ketoacidosis.

The effect of the carbon chain-length for Ph 2 P–R–PPh 2 (R = –CH CH–, –CH 2 –CH 2 –, –CH 2 –CH 2 –CH 2 –, and –CH 2 –CH 2 –CH 2 – CH 2 –) and S -(CH 2 ) n -pyridine ligand ( n = 0 to 2) on the aurophilic interaction has been explored systematically. The effect of the N position in x -mercaptopyridine ( x = 2 or 4) toward Au(I) center and/or the SR group was also investigated. X-ray structural study was made for 12 new derivatives. The Au–Au distances are below 3.0 A for 2- S -pyridine derivatives with Ph 2 P–CH CH–PPh 2 ( t -dpen) and Ph 2 P–CH 2 –CH 2 –PPh 2 (dppe) ligand and the pyridine N atoms come in close contact with the H atoms of these diphosphine carbon chains. A local coplanar conformation is formed between 2- S -pyridine and Au–P–CH groups for these derivatives. The carbon chain lengths are not too consequential on the induction of aurophilicity. Various infinite and/or dimer structures have been revealed from single crystal X-ray analysis for the present series of compounds.