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There is little evidence concerning the need to treat gestational diabetes (GDM) in the same way as pregestational diabetes. We evaluated the efficacy of the simple insulin injection (SII) regimen for achieving the target glucose goal without increasing adverse perinatal outcomes in singleton pregnant women with GDM. All subjects underwent self-monitoring of blood glucose (SMBG), and insulin therapy was indicated according to the SMBG profile. Insulin was initially started with the SII regimen, in which one daily injection of NPH insulin before breakfast was used, and another NPH injection was added at bedtime, if necessary. We used the target glucose as the SII>the diet group. The rate of achieving target glucose levels before delivery in the SII group at fasting, postprandial < 120 mg/dL and

INTRODUCTION Cardiac metastasis is relatively common in malignant neoplasms, such as lung cancers, breast cancers, melanomas, lymphomas, and leukemias. In contrast, cardiac metastasis of uterine cervical cancer, solitary metastasis to the heart, and tumors inducing severe thrombocytopenia are rare. CASE REPORT The present patient was a 52-year-old female who was diagnosed with a solitary cardiac tumor prior to uterine cervical cancer and presented with severe thrombocytopenia. Our case had two remarkable aspects: 1) successful treatment under the condition of severe thrombocytopenia in association with the presence of a cardiac tumor, and survival without recurrence of the carcinoma one year after surgery; and 2) a solitary cardiac metastatic tumor larger than the primary uterine cervix carcinoma. COMMENT we report an extremely rare case of solitary cardiac metastasis of uterine cervical cancer, which wassuccessfully treated. One year after cardiac surgery, the patient is alive without recurrence of the carcinoma.

Objective. To demonstrate whether or not the routine use of prophylactic oxytocin (RUPO) reduces the blood loss and incidence of postpartum hemorrhaging (PPH). Methods. We used a prospective cohort and a historical control in a tertiary perinatal care center in Japan. In the prospective cohort, we introduced RUPO in April 2012 by infusing 10 units of oxytocin per 500 mL of normal saline into a venous line after anterior shoulder delivery (RUPO group). In the historical control, oxytocin was administered via a case-selective approach (historical control group). We included completed singleton vaginal deliveries and compared the volume of blood loss and the incidence of PPH between the groups. Results. We found a significantly lower volume of blood loss (520±327 versus 641±375 mL, p<0.001) and a lower incidence of PPH (6.1% versus 14.0%, p<0.001) in the RUPO group (n=392) than in the control group (n=407). Although the oxytocin dose was significantly higher in the RUPO group (12.8±6.7 versus 10.1±8.0 IU, p<0.001), no adverse outcomes were observed to be associated with RUPO. Conclusions. The introduction of RUPO significantly reduced blood loss and the incidence of PPH during completed singleton vaginal deliveries without an increase in adverse effects.

This study describes the start/unstart characteristics of a finite and rectangular supersonic biplane wing. Two wing models were tested in wind tunnels with aspect ratios of 0.75 (model A) and 2.5 (model B). The models were composed of a Busemann biplane section. The tests were carried out using supersonic and transonic wind tunnels over a Mach number range of0.3≤M∞≤2.3with angles of attack of 0°, 2°, and 4°. The Schlieren system was used to observe the flow characteristics around the models. The experimental results showed that these models had start/unstart characteristics that differed from those of the Busemann biplane (two dimensional) owing to three-dimensional effects. Models A and B started at lower Mach numbers than the Busemann biplane. The characteristics also varied with aspect ratio: model A (1.3