An investigation was made on the effect of prostaglandin (PG), a newly discovered acidic, fat soluble hormone-like substance on adipose tissue metabolism. For this purpose, the action of prostaglandin E1, A1, and F1α, was studied in an in vitro experiment with epididymal fat pad of rat, using the following parameters: 1) release of non-esterified fatty acid (NEFA) and glycerol from the adipose tissue, and 2) glucose uptake by the adipose tissue. Results obtained were as follows: PG inhibits the basal release of NEFA and glycerol from adipose tissue, and antagonizes the lipolytic action of norepinephrine and glucagon. The intensity of the effect is as follows: PGE1>PGA1> PGE1α. No synergistic action was found between the lipolytic action of PG and insulin. With regard to glucose uptake by the adipose tissue, but PG does not effect basal uptake, PGE1 and PGA1 promote the glucose uptake due to norepinephrine and glucagon. At present, it is known that PG is derived, in the body, from essential fatty acids. Results of our investigation investigation indicate that PG antagonizes the activity of lipolytic hormones and that it also influences the carbohydrate metabolism in adipose tissue. From the foregoing results it is inferred that PG has a subtle controlling effect on cellular metabolism by its close relation to adipose tissue metabolism.
An investigation was made on the therapeutic effect of Glybenclamide (HB 419), a new oral anti-diabetic drug, and also on the changes in the blood IRI reac tion after glucose administration during the course of treatment with the drug. Results were as follows: 1) HB 419, 5-10mg. was administered once daily after breakfast to 53cases of diabetes. Good control was obtained in 32cases (62%), fair control in 7cases (14%), primary failure in 12cases (24%), and of the remaining 2cases one case was a secondary failure and evaluation was not clear in the other case. 2) The therapeutic effect of HB 419is influenced by the type of diabetes mellitus, i. e., the drug is usually ineffective in juvenile and generally lean patients. The effect of the drug is unrelated to the severity of the disease as seen from the viewpoint of the fasting blood sugar level. The drug is more effective in non-treated cases than in cases which have received previous treatment. The drug lowers fasting blood sugar level, however, it does not completely normalize the glucose tolerance curve. 3) No serious side effect due to the drug has been observed, however, routine clinical examinations should not be neglected during use of the drug in order to detect any early sign of side effects. 4) The relation between glucose tolerance and IRI reaction was studied over a period of 12months, result of which was as follows: In 13non-obese cases IRI reaction tended to become normal with improvement of glucose tolerance. From the aforementioned results it is thought that the drug not only stimulates the β cells of the islands of Langerhans, but also has extra-pancreatic action such as that on the liver, or on adipose and muscle tissues, or that on insulin antagonism or on the modality of the presence of insulin in the blood.
Glucose tolerance test in mass-examination for a community or multiphasic screening in hospitals have offered much knowledge about the blood glucose level of aged people, but enough data do not seem to have been made on children or young adults. In this paper, screening tests for diabetes mellitus for primary school children and junior and senior high school students were described, and also a follow-up study was presented on those students revealing their abnormal blood glucose level, “borderline case” by definition. Two methods for screening test were employed; One, a total of 2, 039 subjects aged 6 through 17 years old, were tested for urine glucose. Eighty subjects who indicated positive urine sugar were further invited to glucose tolerance test, and 11 cases were found “abnormal” in their blood glucose level, exceeding either 160 mg/100 ml for one-hour level or 120mg/100ml for two-hour level, or both. The other, a total of 453 high school students, aged 15 years old, were examined for blood glucose onehour after glucose admioistration, in addition to routine urine test for glucose. Glucose tolerance test was performed on 14 subjects who had blood glucose level exceeding 160 mg/100 ml and/or positive urine sugar and 5 cases moved to be “abnormal” according to the above criteria. On the other hand, out of the remaining 439 subjects excluding 14 positive screenees, a random sample of 97 cases was taken, and subjected to glucose tolerance test as well, resulting in finding 13 “abnormal” cases by the same criteria. It is concluded (1) that those with elevated blood glucose level are not necessarily few in young subjects, not only in urineglucose-positives but also in negatives, and (2) that these rates are not so lower than those in an aged population. Furthermore, a follow-up was conducted on seven cases showed abnormal blood glucose level for a 1-through 4-year period. It was observed that 5 cases took a favourable course with a decrease of blood glucose level to a normal range, 2 cases remained unchanged and no case got worse, Thus it is indicated that, in young subjects as well as in the aged, blood glucose level would considerably fluctuate. Therefore, the upper limits of “normal” blood glucose level are actually higher than those generally accepted, advocating the authors' hypothesis that those indicated slightly elevated blood glucose level belong to “normal” population and would not develop diabetes mellitus in good agreement with the authors' opinion discussed elsewhere.
This study was undertaken to see the relationships between the maximum motor nerve conduction velocity of the ulnar nerve (MNCV) and the neurological manifestations or the clinical features of diabetic patient, and to find the factors influencing the MNCV. The diagnostic criteria of diabetic neuropathy was made by objective and/or subjective neurological signs in addition to the abnormal MNCV. The determination of the MNCV was made in 300 diabetic patients and 178 control subjects. As the changes of the MNCV was observed during the glucose or fructose tolerance test, the determination of MNCV was mady at the fasting state in addition to the fixed room temperature. On 86 inpatients, the renal biopsy, the fundscopic examination and the neurological studies were performed within a few days and the study of this group revealed that the neuropathy was the first to be recognized among the chronic complications (triopathy). The decrease in MNCV was related to age, to the duration of the diabetic state, to the presence of the diabetic vascular complications and to the severity of the disease. The definite correlations were seen between the MNCV and body weight, arteriosclerosis (glomerulosclerosis), serum mucoprotein and serum total cholesterol. The MNCV decreased remarkably in ketotic state and this change was usually reversible. The amelioration of the neurological disturbances in the hospitalized patients, was influenced by the severity of diabetic state at the discovery, by the control of fasting blood sugar and of blood pressure. The juvenile diabetics had usually a poor prognosis of neuropathy particularly in the cases having recurrent attacks of hypoglycemia or ketosis. A decrease of the MNCV was also observed in cases with liver disease or with liver dysfunction. The evaluation of the vitamine B therapy was made by the MNCV determinations.