All issues
Volume 34, Issue 4
Displaying 1-10 of 10 articles from this issue
- |<
- <
- 1
- >
- >|
-
Tadashi Okabe, Hajime Tei, Hiroaki Hashizume, Yoshiharu Hirobe, Yoshih ...1991 Volume 34 Issue 4 Pages 293-300
Published: April 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESS31P nuclear magnetic resonance spectroscopy was used to assess the effects of diabetes control on skeletal muscle metabolism during ischemic contraction. The relative concentrations on inorganic phosphate (Pi), phosphocreatine (PCr) and ATP in hamstring muscles were measured, along with intracellular pH, at rest, during ischemic exercise and in the subsequent recovery period. Ischemic exercise resulted in a severe reduction of PCr and fall in pH in diabetic patient. The time required to resynthesize ATP during the recovery period, as measured by the time required to replete PCr after exercise, was significantly lower in diabetic patients. The Pi peak was split during ischemic exercise in patients whose diabetic control was poor. This could be accounted for on the basis of differential recruitment of glycolytic and oxidative fibers or muscle oxidative capacity. Correction of blood suger led to correction of these metabolic abnormalities. These results indicate that energy production via oxidative metablolism is impaired but glycolysis may be increased in diabetic patients with poor control. These changes can not be explained by impaired blood flow or oxygen delivery. These observations suggest that exertional fatigue in diabetic patients with poor control may, in part, be the result of severe PCr depletion and /or acidosis in working muscle.View full abstractDownload PDF (1036K) -
Characteristics of Coexisting Peripheral Arteriosclerosis in Patients with Coronary Artery Disease and Abnormalities in Skin MicrocirculationTatsuo Nakamura, Yoshihiko Seino, Teruo Takano, Minoru Ohtake1991 Volume 34 Issue 4 Pages 301-310
Published: April 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSStudy (I): To clarify the pathophysiological features of diabetic macroangiopathy, the incidence and clinical features of peripheral (PVD) and/or carotid artery disease (CTD) were examined non-invasively, and correlated with diabetes mellitus, the results of coronary angiography and cardiac parameters in 121 Japanese patients with coronary artery disease. PVD was found in 16.5 %, CTD in 33.1 % and both in 9.9 %. The prevalence of PVD was significantly higher in diabetic patients than in nondiabetic patients (21.7 vs 13.3%). PVD patients showed significantly higher peak CK and peak CK-MB values than those without PVD. The results suggested larger infarct size in the patients with PVD. One of the clinical characteristics of diabetic macroangiopathy (PVD and CTD), was a significantly higher prevalence of bilateral lesions in diabetic patients. These patients also tended to lack subjective symptoms.
Study (II): By analyzing the skin microcirculation using a laser Doppler flowmeter in 23 diabetic patients, significantly lower skin blood flow in all segments of the hands and feet, an increased reactive hyperemic response in the digits, and a decreased cold pressor vasoconstriction response in the toes were observed. Possible mechanisms underlying these abnormalities in skin microcirculation, include reduced blood flow velocity resulting from regulatory dysfunction of the AV shunt and “auto sympathectomy”. These observations may shed light on the pathophysiology of foot lesions in diabetes mellitus.View full abstractDownload PDF (4182K) -
Especially in Regard to RetinopathyYuri Ono, Masahiko Katoh, Mamoru Kudoh, Yasuko Miyabe, Shoichi Nakagaw ...1991 Volume 34 Issue 4 Pages 311-317
Published: April 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn order to evaluate blood coagulation and fibrinolysis in diabetics, especially in regard to diabetic retinopathy and blood glucose control, thrombin-antithrombin III-complex (TAT) and ce2-plasmin inhibitor-plasmin-complex (PIC) were measured. TAT and PIC in 264 diabetic patients and 66 healthy people used as normal controls showed the following changes.
(1) TAT and PIC were significantly higher in diabetic patients in general (TAT: 2.52μg/l, PIC: 1.28μg/ml) than in normal controls (TAT: 1.72μg/l, PIC: 1.09μg/ml). (2) TAT became significantly higher as retinopathy worsened. (3) Both TAT and PIC showed high values in patients with proliferative retinopathy (TAT: 3.53μg/l, PIC: 1.43μg/ml) and in patients whose retinopathy was progressive (TAT: 3.07μg/l, PIC: 1.56μ/ml)(4) Both TAT and PIC showed high values in patients with improving blood glucose control (TAT: 3.55μg/l, PIC: 1.47 μg/ml). Among patients with improving blood glucose control, TAT was slightly higher and PIC was significantly higher in patients whose retinopathy was progressive (TAT: 3.53μg/l, PIC: 1.93μg/ml) than in patients whose retinopathy was not progressive (TAT: 3.24μg/l, PIC: 1.36μg/ml) Considering the above results, diabetic complications, especially the progress of retinopathy, and increases in TAT and PIC seem to be closely related, and it is conceivable that changes in bloodcoagulation and fibrinolysis along with blood glucose control, affect the progress of retinopathy.View full abstractDownload PDF (1088K) -
Noriko Tamura1991 Volume 34 Issue 4 Pages 319-326
Published: April 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo investigate whether the negative surface charge of the erythrocyte membrane is reduced in parallel with the progression of diabetic nephropathy, we measured the negative surface charge of the erythrocyte membrane in diabetic patients with different urinary albumin excretion rates (AER) by the modified alcian blue method. According to a recent recommendation at a consensus conference, the diabetic patients were divided into three groups: those with normoalbuminuria (less than 20μg/min), those with microalbuminuria (20-200μg/min) and those with macroalbuminuria (more than 200 pg/min). The negative surface charges in each group were 0.235±0.023, 0.229±0.028 and 0.234±0.026, respectively. There were no correlations between the negative surface charge of the erythrocyte membrane and AER or between the negative surface charge of the erythrocyte membrane and the severity of retinopathy. But there was a negative correlation between the negative surface charge and the level of HbAic that was measured one month later. These results suggest that the negative surface charge of the erythrocyte membrane dose not reflect the severity of microangiopathy.View full abstractDownload PDF (1020K) -
Comparison in the Presence of L-Alanine and L-GlutamineTatsuya Haga, Nigishi Hotta, Naoki Koh, Humihiko Sakakibara, Ryuzo Kit ...1991 Volume 34 Issue 4 Pages 327-334
Published: April 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIt is well known that the utilization of alanine and glutamine is accelerated in diabetics with poor control, and that this is accompanied by significantly elevated serum levels of glucagon and vasopressin. Isolated livers from rats fasted for 20 hours were perfused in the presence of 10 mM L-alanine or L-glutamine with 100 nM glucagon and/or vasopressin for 60 min.
1) Either glucagon or vasopressin alone significantly increased gluconeogenesis and ketogenesis. 2) When these two hormones were added simultaneously to the perfusate, an additive effect on ketone body production was observed in the presence of L-alanine, but not in the presence of L-glutamine. 3) The additive effect on gluconeogenesis induced by combining glucagon and vasopressin was not seen in the presence of either L-alanine or L-glutamine. Rather, vasopressin showed a tendency to suppress glucagon-induced gluconeogenesis.
These results strongly suggest that vasopressin has an additive effect on glucagon action in some circumstances and that vasopressin may be one of the possible factors contributing to the aggravation of diabetic states.View full abstractDownload PDF (1300K) -
Masato Matsushima, Naoko Tajima, Junichi Yokoyama, Yoshio Ikeda, Yukih ...1991 Volume 34 Issue 4 Pages 335-341
Published: April 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo investigate factors affecting serum immunoreactive trypsin concentration (IRT), we examined the correlation IRT and various clinical indices in 42 IDDM patients with an age of onset of 16.5±0.8 (Mean±SE) years and duration of disease of 6.8±0.8 years. The indices used for analysis were sex, age at onset, duration, family history of diabetes, mode of onset, season of onset, history of obesity, percentage ideal body weight, pancreatic B-cell function, presence of ICA, HLA DR type, serum creatinine concentration, and glycemic control. The variables selected by the stepwise method were 1) HLA DR9, 2) serum creatinine concentration, 3) presence of ICA, 4) sex, and 5) age at onset. The regression model established, which was significant, was as follows: structure log (IRT) =4.00-0.39 (presence of HLA DR9) +1.51 (serum creatinine concentration)-0.33 (presence of ICA) +0.33 (female)-0.02 (age at onset). Serum IRT reflects pancreatic exocrine function, hence the data suggest that these clinical indices must be taken into consideration in determining the cause of the decline in pancreatic exocrine function.View full abstractDownload PDF (1224K) -
Tamio Wakugami1991 Volume 34 Issue 4 Pages 343-349
Published: April 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe effect of probucol on the development of diabetes mellitus and its immunological effects were studied in female NOD mice. Mice aged 30 days were given either a standard diet or diet containing 1 % probucol until 210 days of age. The mice were observed through out the period up to 210 days of age. Forty-three (82.7 %) of the 52 control mice became diabetic during the observation period, whereas only (61.8 %) 34 of the 52 treated mice did. The cumulative incidence of diabetes mellitus in the treated group was significantly lower than in the control group (p<0.05). The degree of insulitis in the treated group was also significantly milder (p<0.05). The percentages of Thy1.2-, L3T4-and Lyt2-positive spleen cells in the treated mice were significantly lower than in the control mice (p<0.001).
These results suggest that probucol might be a useful tool in preventing the development of diabetes mellitus. The mechanism by which probucol inhibits the onset of diabetes may be due, at least in part, to its effects on the immunological process.View full abstractDownload PDF (3909K) -
Yukihiro Nagai, Hisatsugu Miyakoshi, Ichirou Miyamoto, Nobuhiko Koike, ...1991 Volume 34 Issue 4 Pages 351-358
Published: April 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo investigate the role and mechanisms of insulin resistance in glucose intolerance in acromegaly, we performed the 75 g oral glucose tolerance test (OGTT) and euglycemic clamp studies in four acromegalic patients before and after transsphenoidal adenomectomy.
The preoperative glucose curves of three patients obtained as a result of the 75 g OGTT, defined as borderline-type on the basis of JDS criteria in 1982, improved after surgery and their insulin levels, which were normal or hyperresponse type before surgery, were lower after surgery in keeping with the reduction in serum growth hormone levels. In the one patient with low preoperative insulin responses defined as the diabetic-type glucose curves and insulin responses failed to change after surgery in spite of a decrease in serum growth hormone levels.
In the euglycemic clamp study, the insulin dose-response curves of the glucose metabolic clearance rate (MCR) were shifted both downward and to the right in all cases before surgery, meaning decreased sensitivity and responsiveness to insulin. After surgery, insulin sensitivity or responsiveness to insulin improved in the borderline cases, but remained unchanged in the diabetic case.
In conclusion, insulin resistance (decreased sensitivity and responsiveness to insulin) plays an important role in glucose intolerance in acromegaly. Although the main cause of insulin resistance in borderline cases can be ascribed to increased serum GH levels, its cause in diabetic cases remains to be elucidated.View full abstractDownload PDF (1212K) -
Naomi Shibata, Teiko Amemiya, Noriko Ujihara, Sumiko Hasumi, Yasuko Uc ...1991 Volume 34 Issue 4 Pages 359-364
Published: April 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe course of Necrobiosis lipoidica diabeticorum (NLD) is characterized by its chronicity and poor response to various treatment agents. This case, which was clinically and histologically typical of NLD, was successfully treated with an 8-month course of local corticosteroid creams in combination with aspirin and dipyridamole.
A 20-year-old woman diagnosed as having IDDM (insulin-dependent diabetes mellitus) at ten years of age, was admitted to our hospital because of severe skin lesions in the pretibial areas of both legs. The skin lesion on the right leg had developed at age 14 and those on the left leg, since age 18. The patient's control of her diabetes had been poor (HbA1c 11-12 %). However, the only diabetic complication which had occured was neuropathy. Increased sensitivity of the patient's platelets to ADP, epinephrine and collagen, as well as spontaneous platelet aggregation, were observed. Biopsy of one of the skin lesions in the right pretibial area showed findings typical of NLD. The patient was treated with aspirin, 1 g, and dipyridamole, 225 mg, daily in addition to local corticosteroid creams. After 8-months of therapy, the skin lesion was noticeably lighter.View full abstractDownload PDF (7951K) -
1991 Volume 34 Issue 4 Pages 365-382
Published: April 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (4147K)
- |<
- <
- 1
- >
- >|