All issues
Volume 32, Issue 10
Displaying 1-12 of 12 articles from this issue
- |<
- <
- 1
- >
- >|
-
[in Japanese]1989 Volume 32 Issue 10 Pages 705-710
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (1138K) -
Hans-Henrik Parving1989 Volume 32 Issue 10 Pages 711-715
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSAbout 40% of all insulin-dependent diabetic (IDDM) patients develop persistent albuminuria, a decline in their glomerular filtration rate and increased arterial blood pressure, collectively constituting the clinical syndrome of diabetic nephropathy. Diabetic nephropathy in the main cause of the increased morbidity and mortality in IDDM patients. The excess mortality of IDDM patients with nephropathy is 80 to 100 times that of the age-and sex-matched background population and is due to an enormous excess of cardiovascular mortality and end-stage renal disease (thousands of times the age-matched population). On average, death occurs eight years after start of persistent albuminuria. The cost for end-stage renal care in USA currently exceeds 0.8 billion dollars per year for diabetic nephropathy alone and is rapidly rising.
Increased arterial pressure is an early and common occurrence in diabetic nephropathy. Fluid and sodium retention with normal concentrations of active renin, angiotensin I and II and aldosterone has been demonstrated in diabetic nephropathy. Systemic hypertension when transmitted to the glomerular capillary network results in glomerular capillary hypertension, which has also been shown in normotensive rats with streptozotocin diabetes. A link between glomerular hypertension and albuminuria and the development and progression of diabetic glomerulopathy has been suggested. Elevated blood pressure accelerates and effective blood pressure reduction with beta-blockers and/or ACE inhibitors delays the progression of nephropathy and reduces albuminuria. Apart from antihypertensive treatment, no other treatment modality has yet been proven to be effective in protection of kidney function in diabetic nephropathy. The introduction of effective antihypertensive treatment has increarsed the survival probability of the patients from 50 to 90% at eight years after the onset of albuminuria.View full abstractDownload PDF (712K) -
Toshika Otani, Hiroki Yokoyama, Yasuko Uchigata, Yuko Higami, Tadasu K ...1989 Volume 32 Issue 10 Pages 717-720
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe development of retinopathy was examined over an 8-year period in 98 patients with insulin-dependent diabetes mellitus (IDDM) whose diabetes was diagnosed under the age of 25 without retinopathy in 1980 (age at onset of diabetes: 9.0±5.9 years [mean±SD], duration of diabetes in 1988: 14.2±4.6 years, mean levels of HbA1: 11.9±1.6%). The duration of diabetes among the 38 patients who had developed retinopathy was 15.8 years, compared with 13.2 years in the 60 patients without retinopathy. Life-table analysis of these 98 IDDM patients suggested that the interval between diagnosis of IDDM and 50%-risk of developing retinopathy was 13.3 years. A rapid increase in the incidence of retinopathy was noted in those whose duration of IDDM was between 8 and 11 years (17-20 years of age), suggesting that puberty influences the development of retinopathy.View full abstractDownload PDF (568K) -
Kunihiko Suwa, Noriyuki Sato, Younosuke Shimomura, Yutaka Uehara, Isao ...1989 Volume 32 Issue 10 Pages 721-727
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe effect of ketone bodies (actoacetic acid [AcAc] and 3-hydroxybutyriacid [3-0H BA]) on production of active oxygen species by polymorphonuclear leukocytes (PMNs) from diabetic ketosis patients and normal volunteers were examiped using luminol-dependent chemiluminescence (LDCL) stimulated by opsonized zymosan. Clinically we observed the relationships between LDCL activity and serum ketone levels, arterial pH and fasting blood glucose levels. A negative correlation was found between LDCL activity and the level of serum ketone bodies (p<0.01). Effects of ketone bodies on LDCL were tested in vitro using normal PMNs. Both ketone bodies inhibited the LDCL of normal PMNs, and the inhibition rates were about 42% in the case of AcAc and 44% in the case of 3-OHBA, when PMNs were preincubated with ketone bodies (10 mM) for 60 min. LDCL activity was also inhibited 16% and 42% by the amount of AcAc 1mM and 10mM, respectively. The same inhibitory effect was observed by 3-OHBA. LDCL activity decreased as preincubation time increased. Ketone bodies also inhibited production of superoxide anion from PMNs stimulated by opsonized zymosan. However, they did not inhibi myeloperoxidase activity. Our data suggest that the improvement of both ketosis and hyperglycemia is important in preventing serious infections.View full abstractDownload PDF (1460K) -
Kyoichi Hasegawa, Fujiko Sasakuma, Kazuto Matsumiya, Naruto Horiuchi, ...1989 Volume 32 Issue 10 Pages 729-735
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSAnti-insulin antibodies were studied in 13 insulin-treated patients in reference to effectiveness of human insulin.
In seven patients, in whom antibody-bound insulin declined markedly after treatment with human insulin, anti-insulin antibodies showed a higher proportion of high-affinity binding capacities than did those in another six patients before treatment with human insulin. The ratio of high-affinity binding capacity to low-affinity binding capacity (H/L) was related to percent decrease of antibody-bound insulin.
When the H/L ratios were determined in 31 insulin-treated patients, high H/L levels were obtained in patients with bovine insulin therapy, patients treated with porcine insulin showed low H/L levels, and those treated with human insulin showed the lowest levels of all. In patients treated with mixed bovine-porcine insulin, H/L ratios were distributed over a wide range.
It is concluded that the H/L ratio is dependent upon the animal species of insulin preparations, and that it is the predictor of immunologic effect in human insulin therapy.View full abstractDownload PDF (1186K) -
Ikuo Segawa, Ko Shimizu, Hirofumi Ohashi, Yasumichi Kinoshita, Kazutos ...1989 Volume 32 Issue 10 Pages 737-742
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTwenty-four patients (15 males, 9 females) with diabetic gangrene are reported.The total number of inpatients with diabetes mellitus in our clinic from 1969 to 1985 was 1421 cases, of which twenty-four cases (1.7%) had diabetic gangrene. These patients had been in a state of poor control and required insulin therapy.
Many of the patients had diabetic neuropathy (100%), retinopathy (91%), and nephropathy (67%). In four cases, gangrene with infection or combined with arteriosclerosis worsened to the state which required amputation. In twenty cases (83%) the gangrene was eradicated without surgical treatment but nine cases (38%) died within five years; four cases due to cerebral and cardiac vascular disease, two cases due to renal failure, two cases due to liver cirrhosis and one case due to acute leukemia. The prognosis of the patients with diabetic gangrene was poor.View full abstractDownload PDF (5650K) -
Toshio Okutani, Tsutomu Kazumi, Jun-ichi Kato, Shigeichi Ohno, Toshio ...1989 Volume 32 Issue 10 Pages 743-748
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe report characteristics of familial hypercholesterolemia associated with a high prevalence of obesity, glucose intolerance, and atherosclerotic vascular disease. Of the family members examined, obesity was found in 88%, hypercholesterolemia in 82%, glucose intolerance in 60%, and macrovascular involvements in 45%. Mean (±SE) body mass index and plasma cholesterol concentrations were 28.0±1.1 kg/m2 and 389±17 mg/dl in affected members, respectively. Four members developed coronary artery disease and one developed cerebral infarction. They were all hypercholesterolemic females and had atherosclerotic vascular disease before 65 years of age. Two of these women died of vascular events in their early sixties. Large vessel disease developed in 5 out of 7 females (71%) who survived more than 50 years. Four out of these 5 members had obesity and/or diabetes mellitus in addition to hypercholesterolemia. One hypercholesterolemic female with diabetes mellitus and obesity as well as angina pectoris had three children who were all obese and hypercholesterolemic, even though her husband had a normal plasma cholesterol level of 169 mg/dl. The body mass index and plasma cholesterol concentration averaged 28.0±0.7 kg/m2 and 395±42 mg/dl, respectively in the children. In addition, the two sons had glucose intolerance.View full abstractDownload PDF (1009K) -
Toshiji Iwasaka, Nobuyuki Tsuda, Nobuyuki Takahashi, Tetsuro Sugiura, ...1989 Volume 32 Issue 10 Pages 749-753
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo evaluate the influence of serum insulin as a coronary risk factor, serum immunoreactive insulin, blood glucose and atherogenic index were reviewed in 96 patients with a past myocardial infarction. There was no significant differences in the total sum of blood glucose levels (ΣBG) during a 75 g. oral glucose tolerance test in patients with or without angina pectoris. On the other hand, thetotal sum of immunoreactive insulin (ΣIRI) was larger in the patients with angina pectoris than in those without angina pectoris. Atherogenic index correlated well with ΣIRI in the patients with past myocardial infarction (r=0.63, p<0.001).
These results indicated that hyperinsulinism might be one of the risk factors of coronary sclerosis.View full abstractDownload PDF (1012K) -
Yuri Ono, Masahiko Katoh, Satoshi Tsushima, Mamoru Kudoh, Shoich Nakag ...1989 Volume 32 Issue 10 Pages 755-760
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDiabetic retinopathy often progresses after rapid blood sugar control in patients with long-standing diabetes. We investigated the changes that occurred in diabetic patients who achieved blood sugar control from the standpoint of platelet aggregation and arachidonate cascade. Platelet aggregation induced by ADP, collagen, PAF or epinephrine, plasma TXB2 (TXB2) and 6-keto-PGF1 α(PG), the ability of platelets to produce TXB2 during spontaneous clotting, and blood viscosity, were measured pre-treatment and about 3 weeks and 6 weeks after blood sugar control in 19 diabetic patients.
Platelet aggregation induced by each agonist and plasma TXB2 increased at 3 weeks but returned to the previous level at 6 weeks after blood sugar control. Plasma PG gradually increased and the plasma TXB2/PG ratio decreased gradually after blood sugar control. Blood viscosity also decreased gradually after blood sugar control. There was a correlationship between the increase in plasma TXB2 and the decrease in HbA1 level at 3 weeks after blood sugar control. It is suspected that the increase in platelet aggregation and plasma TX may have an influence on the deterioration of retinopathy after blood sugar control.View full abstractDownload PDF (1035K) -
Takayoshi Nishino, Tetsuya Babazono, Hiroki Yokoyama, Yasuko Uchigata, ...1989 Volume 32 Issue 10 Pages 761-765
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 42-year-old female with rheumatoid arthritis (RA) and Basedow's disease was admitted to our institutsion for the treatment of acute hyperglycemia with ketoacidosis in December, 1987. She was diagnosed as suffering from RA in 1983, and Basedow's disease in 1986.
During her hospital stay insulin therapy was instituted and she was diagnosed as having insulin-dependent diabetes mellitus (IDDM). The laboratory determination of human leukocyte antigen (HLA) type revealed A24-Bw54-Cw1-DR4.
Several reports are available concerning IDDM complicated by other auto immune diseases, however, to our knowlege only one case of IDDM complicated by RA and Basedow's disease has been reported previously, by Torfs in 1986. Our case is the first case of IDDM complicated simultaneously by both RA and Basedow's disease ever reported in Japan.View full abstractDownload PDF (2742K) -
Noriyuki Takeda, Keigo Yasuda, Makoto Hayashi, Shinobu Goto, Kaori Aoy ...1989 Volume 32 Issue 10 Pages 767-771
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 23-year-old woman experienced two episodes of thyrotoxicosis, the first 1.5 years before pregnancy and a second in the postpartum period. She was diagnosed as having diabetes at the time of recovery from the first thyrotoxic episode. She did not take any medication for her diabetes until insulin therapy was started during the third month of pregracy. Insulin was replaced with sulfonylurea compound shortly after delivery. The titer of antithyroid microsomal antibodies decreased during pregnancy with a rebound increase after delivery. Three months postpartum she developed diabetic ketoacidosis simultaneously with thyrotoxicosis. Thereafter, she constantly needed more than 30 U/day of insulin, and demonstrated low plasma C-peptide levels. Presence of islet-cell antibodies in her sera and HLA DR4 indicated the autoimmune nature of her diabetes. Alteration of maternal immune response caused by pregnancy might be a precipitating factor in the development of overt insulin dependence in the postpartum period.View full abstractDownload PDF (834K) -
1989 Volume 32 Issue 10 Pages 773-780
Published: October 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (1984K)
- |<
- <
- 1
- >
- >|