Objectives and Methods : The present study was performed to determine whether patients with HbA1c ≥ 7.0% can show improvement with additive treatments. A total of 252 patients ≤ 75 years old with type 2 diabetes mellitus (T2DM) and with HbA1c ≥ 7.0% were enrolled in this study. The primary endpoint was a rate of achievement of HbA1c < 7.0% in 1 year.
Results : HbA1c was ≥ 7.0% (7.0%-10.1%) in all patients in the study population. Initially, mean HbA1c was 7.66%±0.59%. Thus, treatments were changed for 50.4% of patients. However, treatment was not changed in nearly half of the patients. In 3 months, mean HbA1c remained at 7.63%±0.83%, and HbA1c was < 7.0% in only 18.3% of patients. At this time point, treatments were changed in 68.3% of patients. Over 1 year, treatments were changed in a total of 86.5% of the patients. However, only 27.8% of patients had HbA1c < 7.0% within 1 year.
Conclusion : The rate of reaching the target HbA1c in 1 year was only 27.8% in our study population. This was not sufficient for the control of blood glucose (BG). Thus, greater treatment intensity and further planning to improve patient condition are required to achieve the target.

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Patients who require intensive care have recently increased because of an increase in elderly patients and developments in the treatment of severe illnesses. It is important for saving more of those patients to effectively utilize the limited number of beds in an intensive care unit (ICU). The aim of this study is to clarify the current status and issues about intensive care for patients with severe illness in our ICU.
We investigated 819 patients who were admitted to the ICU between 1st April 2016 and 31st March 2017.
Median age was 68 years. Over 90% of the patients were treated surgically and 49.2% of them had cardiovascular disease.
The operation rate of beds was 80% and the share of beds per day was 100%. Patient outcomes revealed that 96.8% of patients recovered sufficiently to be moved to a general ward and the ICU mortality rate was 2.4%. Forty-four patients (5.4%) stayed in the ICU longer than 14 days. Those long-stay patients had more emergency admissions, higher APACHE II scores and a higher ICU mortality rate than the other 775 patients who were discharged within 14 days. Eighty-two patients who required intensive care could not be admitted to the ICU because beds were fully occupied.
Overall patient outcomes were relatively good but many patients could not be admitted to the ICU due to a shortage of beds. Establishing a step-down unit for long-stay patients with severe illness might solve this problem.

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To conduct intraoperative motor evoked potential (MEP) monitoring, it is necessary to apply on adequate amount of electrical intensity to the motor cortex. Direct cortical electrical stimulation by silicon electrode has two problems : 1) intraoperative displacement of the silicon electrode induces misjudgement of MEP monitoring, and 2) brain damage by electrical stimulation remains unclear. Fibrin glue, which is a biological tissue sealant, is investigated for the feasibility of utilizing it as a stimulation electrode.
The fibrin glue electrode consists of the fibrin glue and silicon strip electrode. The fibrin glue electrode is made as follows : 1. determining the placement of the electrode and putting the fibrin glue on the brain cortex. 2. placing the silicon electrode on the fibrin glue. 3. putting additional fibrin glue on the electrode for fixation. Two preclinical tests were conducted : a mechanical strength test and a stimulation test. The maximum strength force of the fibrin glue electrode was 43.3±7.6 gf (n＝4) in the strength test, which was sufficient to keep the position of the electrode stable intraoperatively. Rat brain tissue was stimulated by anodal high frequency stimulation for MEP monitoring in the stimulation test. The maximum depth of the lesion under the anodal electrode was measured and compared between the direct stimulation group and the fibrin glue electrode group. The maximum depth in the direct stimulation group was significantly deeper than that in the fibrin glue electrode.
The fibrin glue electrode decreases displacement of the stimulation electrode and electrical brain damage.

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