In this study, 121 patients who showed diabetic or decreased glucose tolerance and were treated with diet alone for one to fifteen years were investigated as subclinical diabetes. Glucose tolerance in these patients was improved or remained unchanged during the clinical course. Aggravation in glucose tolerance was observed in only seven cases. However, abnormalities in glucose tolerance were still found in 107 cases (88%) of the subclinical diabetes. Insulin response to oral glucose was investigated in 74 patients with subclinical diabetes. Delayed response and/or decreased response in the initial phase were demonstrated in 58 out of 74 patients (79%). No significant difference was observed in the insulinogenic index (ratio of insulin increment/glucose increment) at 30 min between the normal controls and either group with abnormal glucose tolerance. Diabetic retinopathy, including microaneurysm, was detected in 25 out of 109 patients with diabetic glucose tolerance. Abnormal insulin response, delayed and/or decreased, was demonstrated in 13 of 16 patients with diabetic retinopathy (81%). These results indicate the possibility that subclinical diabetes in the present study is a mild type of primary diabetes. In addition, it is suggested that abnormal response of plasma insulin to glucose, delayed and/ or decreased, might be one of the prominent findings in diagnosis of diabetes mellitus.
Changes of serum gastrin and acid secretory responses to histamine, feeding and insulin stimulation before and after various types of vagotomy (TV, SV, SPY and SAY) were investigated in Heidenhain pouch dogs. The following results were obtained: (1) The acid secretory response to histamine slightly decreased after various types of vagotomy. (2) The responses of serum gastrin and acid secretion to feeding were elevated after various types of vagotomy. (3) The serum gastrin response to insulin was highly increased after SPV and TV, whereas the response was slightly increased and decreased after SV and SAV, respectively. The acid secretion in response to insulin was increased only after SPV, while it was decreased after the other types of vagotomy. These results led to the conclusion that there might be no correlation between serum gastrin and acid secretory responses to feeding and insulin after various types of vagotomy.
Serum β2-glycoprotein I of the patients with rheumatoid arthritis was studied by means of single radial immunodiffusion method. There was a significant lowering of β2-glycoprotein I concentration in patients with rheumatoid arthritis. An inverse proportional correlation was seen between the concentrations of β2-glycoprotein I and of α1-antitrypsin, and between the former and C-reactive protein (CRP) rates in individual specimens. Slightly positive relationship was observed between the concentrations of β2-glycoprotein I and of α2-HS glycoprotein. The β2-glycoprotein I concentrations in healthy adults were significantly higher than those of previous reports
Patients with breast cancer were studied with regard to changes in the levels of serum thyroxine (T4) and serum triidothyronine (T3) after intramuscular administration of TSH for three days to investigate the thyroid reserve in these patients. The changes were exmained also in normal subjects, in patients with Hashimoto's thyroiditis and primary hypothyroidism. In primary hypothyroidism no increase was seen in serum T4 and T3 levels after TSH administration, and the thyroid reserve was considered to be absent. In Hashimoto's thyroiditis the serum T3 levels after TSH administration were the same as in normal subjects, but the serum T4 levels were significantly lower than normal. This suggests that in patients with Hashimoto's thyrioditis the thyroid reserve is decreased and is in a state of so-called low thyroid reserve. In patients with breast cancer, however, the levels of serum T4 and T3 showed no difference as compared with those in normal subjects after TSH administration, and this implies that the thyroid reserve is well maintained.
Light and electron microscopic study was carried out on skin lesions of patients with the hand, foot and mouth disease (HFM. D) with special respect to virus localization in the affected skin. Light microscopic observations revealed a considerable number of eosinophilic inclusions in the nuclei of epidermal cells around the intraepidermal vesicles. Intracytoplasmic inclusions were not clearly observed. Crystalline arrays of virus particles were detected in the cytoplasmic portions of some epidermal cells by electron microscopy. These particles were approximately 20 nm in diameter. The skin lesions of the HFM. D are possibly a manifestation of virus proliferation in the epidermal cells.
Liver specimens from 68 cases of biliary atresia were histologically studied in reference to postoperative prognosis. The histological findings were classified into 4 to 5 groups by the degree of fibrosis, bile duct proliferation, bile plugs, giant cell transformation, and intralobular cholestasis. Furthermore, morphometrical studies of interstitial area, bile duct (ductules), intrahepatic portal vein, and intrahepatic artery were done and correlated with the age of patients and with operative results. From this study, it was shown that 1) marked fibrosis (cirrhosis) and interstitial areas occupying more than 35% of the sectional area of the liver specimen, 2) severe ductular proliferation, shown by proliferated bile ducts occupying more than 20% of interstitial areas, 3) no or slight intralobular cholestasis and 4) marked interlobular cholestasis are considered to predict poor postoperative bile excretion.
The cytotoxic reaction of effector cells on target cells was performed on cover slips which were set in a petri dish so as to be interposed from the dish surface through the bases of the slide glasses. After incubation, the target cells remaining on the cover slips were pulse-labeled with 3H-TdR for 45 min. Subsequently, the cover slips were removed from the bases, and dipped in cold 5% TCA to be freed from non-incorporated isotopes. The residual target cells adhering on the cover slips were counted without being removed. By this assay system, the specific or non-specific cytotoxicity of lymphocytes or macrophages was easily demonstrated with reliability.
Anti-M and -N antibodies are usually prepared from rabbit immunized with human O. M or O. N red cells. The crude antisera must be adsorbed with non-corresponding red cells to remove heteroagglutinin. To specify the crude antisera, we have employed dextran gel (DEAE-Sephadex A-50) as an immunoadsorbent, which was mixed with M or N group substance prepared by the phenol-saline method, and was fixed with formaldehyde. The substance-coupled gel was added to the corresponding crude antiserum and washed with cold saline. Then, the gel added with an equal volume of saline was heated at 55°C for 10 min and applied on a funnel with slight evacuating. By this method, specific anti-M and -N antibodies (titer 1:16 to 1:32) were prepared, but the antibody was not eluted from the gel reacted with IgM fraction. The recovery rate and specificity of the eluted antibodies are discussed.
The PAO2-PaO2 relationship was studied for the entire therapeutic range of oxygen in patients and animals in acute respiratory failure. The method is based on the assumption that the steady state values of PaO2 may be obtained as a mean of the two PaO2 values at an identical FIO2, one obtained 6 min after the FIO2 was raised from a lower level, the other obtained 6 min after the FIO2 was reduced from the higher level. We found that the shunts were large in the low FIO2 range (170 mmHg and below), took a minimum value in the moderate PAO2 range (170 to 300 mmHg), and increased again in the high PAO2 range (300 to 700 mmHg). A similar pattern was observed in the animal experiments, two or more hr following experimentally produced aspiration pneumonitis. In contrast, the dogs with bilateral pneumothorax showed a pattern which followed the isoshunt line closely. It was concluded that patients with acute respiratory failure requiring artificial ventilation have two components of the pulmonary shunt, one parallel with and the other inversely related with the PAO2. Possible mechanisms for the former were discussed.
Effects of gastrointestinal hormones on electrical and mechanical activity of smooth muscle of cat stomach were studied. Spontaneous electrical activity of the antrum preparation consisted of slow waves with superimposed spike-like potentials. Phasic contractions occurred synchro-nously with the electrical activity. Pentagastrin, tetragastrin, pancreozymin and secretin increased frequency of slow wave component and amplitude of phasic contraction. Atropine and tetrodotoxin did not block the spike-like potential and slow wave component. Noradrenaline and verapamil blocked the phasic contraction. The excitatory effects of these gastrointestinal hormones were observed in the presence of atropine, tetrodotoxin and dibenamine, but not in verapamil. When the mechanical activity of the antral strips was depressed by caffeine or theophylline, the excitatory effects of gastrointestinal hormones were also suppressed. The excitatory effects produced by these hormones were potentiated by imidazole. These results suggest that gastrointestinal hormones have a direct excitatory action on the longitudinal smooth muscle of the antrum region and that the excitatory action is associated with phosphodiesterase activity and intracellular cyclic AMP content.
Antibacterial activity could be detected in bacterium-negative duodenal juice from 3 patients, whereas it was not detected in bacterium-positive duodenal juice from other 3 patients. The follow-up study revealed that appearance of the activity in duodenal juice was just coincident with disappearance of bacteria in duodenal juice. The activity was not influenced by pH of the duodenal juice. These results seem to suggest that some antibacterial activity, different from that of pH, in duodenal juice regulates in some way proliferation of the upper gastrointestinal flora.
The effect of enriched human plasma-cholinesterase preparation on the phase II block of succinylcholine chloride was studied in man during anesthesia and surgery. Intravenous administration of 8 esterase units/kg of plasma-cholinesterase did not show any discernible effect on the phase II block of succinylcholine chloride, while edrophoniinn 10 mg clearly antagonized the block. The finding of the present study suggests that the preparation may be ineffective for patients with a prolonged apnea following the administration of succinylcholine chloride.