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Volume 36, Issue 11
Displaying 1-10 of 10 articles from this issue
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Hisayoshi Oka, Soichiro Mochio, Kenishi Sato, Hironori Sato, Yukihide ...1993 Volume 36 Issue 11 Pages 829-838
Published: November 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe studied sympathetic nervous system dysfunction using the principle of maximum entropy (ME) to perform spectral analysis of systolic blood pressure in patients with diabetes mellitus.
The subjects consisted of 23 patients with diabetes mellitus and 23 healthy controls.Systolic blood pressure was measured using a continuous, noninvasive monitoring system devised by Nihon Colin Co., Ltd., the CBM-2000.Systolic blood pressure(SYS)power spectra were obtained using ME, and areas were measured in two frequency components:a low frequency component (ITC) from 0.02 to 0.15 Hz, and a high frequency component (HFC) from 0.15 to 0.5 Hz.We also compared these results with those of other autonomic nervous function tests and various clinical features of diabetes mellitus.
The low frequency component of systolic blood pressure (SYS-LFC) in patients with diabetes mellitus (2.08 mmHg2) was significantly smaller than that of healthy controls (4.16mmHg2). There was, however, no significant difference in SYS-HFC between patients with diabetes mellitus (0.97mmHg2) and healthy controls (1.21mmHg2). The SYS-LFCs in diabetic patients with disturbed Valsalva overshoot, a positive cold pressor test and/or orthostatic hypotension were significantly smaller than in those who did not have these features. In patients with delay of peripheral nerve conduction velocity, SYS-LFC was significantly smaller than that in patients without this delay.
In diabetics, measurements of the low frequency component of systolic blood pressure using spectral analysis correlated with sympathetic nervous system function and may therefore be useful for evaluating sympathetic nervous system dysfunction.View full abstractDownload PDF (1546K) -
Narihito Yoshioka, Toshiko Nakatsu, Naoko Fukuzawa, Yasuo Akanuma1993 Volume 36 Issue 11 Pages 839-845
Published: November 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSChanges in the plasma and urinary concentrations of 1, 5-anhydro-D-glucitol (1, 5-AG) werestudied during the 75g oral glucose tolerance test (OGTT). Whereas the urinary excretion of 1, 5 AG increased during OGTT, plasma 1, 5 AG increased significantly (P<0. 01) irrespective of the degree of glucose tolerance. To evaluate the renal tubuler reabsorpition of 1, 5-AG, fractional excretion of 1, 5 AG was determined. During OGTT, the increment of fractionl excretion of 1, 5-AG was significantly augmented in subjects with abnormal glucose tolerance, whose plasma 1, 5-AG concentration has already decreased. Changes in the fractional excretion of 1, 5-AG were correlated with those of urinary glucose excretion. These data suggest that increased fractional excretion of 1, 5 AG contributes to the decrease in plasma 1, 5-AG concentration in diabetic subjects.View full abstractDownload PDF (940K) -
Tsutomu Kanda, Mitsuko Nakamura, Makoto Iwasaki, Masahiko Wada, Mariko ...1993 Volume 36 Issue 11 Pages 847-854
Published: November 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIt is well known that red cell half-survival time (RCST) is shortened with reduced serum protein concentration in liver cirrhosis.In this study we investigated the best index of glycemic control among HbA1c, fructosamine (FRT), and 1, 5-anhydroglucitol (AG), in non insulin dependent diabetes mellitus complicated with liver cirrhosis (NIDDM-LC).
In 18 NIDDM-LC patients, the level of HbAic correlated with the fasting plasma glucose (FPG) level of one month earlier, while the level of FRT and AG did not correlate with those of two weeks earlier and the test day, respectively.
When NIDDM-LC patients were divided into two groups, group A, having 19 days or more RCST, and group B, having 18 days or less RCST, liver function was more damaged in group B than in group A. In group A, there was a positive correlation between HbA1c and the FPG level of one month earlier or FRT and that of two weeks earlier, while a correlation was noted only between HbAjc and the FPG level of one month earlier in group B. These results suggest that FRT is not appropriate as a glycemic control index in NIDDM-LC patients with increased hepatic dysfunction. The level of HbAic in NIDDM-LC patients was significantly lower(ranging from 0.5 to 2.2%, with a mean of 1.7%) than that in 30 FPG-matched, NIDDM-LC patients.
These findings indicate that, while HbAlc in NIDDM LC patients shows lower levels than in NIDDM patients, it is more useful than serum FRT and AG as an index of glycemic control.View full abstractDownload PDF (1082K) -
Yuri Ono, Masahiko Katoh, Katsuyuki Yanagisawa, Mamoru Kudoh, Takao Ko ...1993 Volume 36 Issue 11 Pages 855-860
Published: November 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo investigate changes in the ratio of locally-produced renal prostanoid versus whole body prostanoid in patients with diabetic nephropathy, we measured urinary 11 dehydrothromboxane B2 (11DTX) and 2, 3-dinor-6-keto-prostaglandin F1α(231)6), which are thought to reflect whole body thromboxane (TX) Az and prostaglandin (PG) I2, and urinary TXB2 and 6 keto PG Fia (6keto-PG), which are thought to reflect enhanced intrarenal production of TXA2 and PGI2.
The subjects were 32 outpatients with diabetes mellitus who we found to have proteinuria based on the spot urine test. There were significant correlations between urinary protein, albumin, N-acetylglucosaminidase (NAG), β2 microglobulin and sodium levels, and urinary TXB2 levels, the ratio of urinary TXB2/6keto-PG, the ratio of urinary TXB2/I1DTX and the ratio of TXB2/6keto-PG to 11DTX/23D6. The urine 11DTX level, however, was not correlated with any of these parameters. Based on these findings, we conclude that there may be increased local production of TXA2 in the kidneys of patients with diabetic nephropathy.View full abstractDownload PDF (871K) -
Akira Tanaka, Seiji Morohoshi, Katsumasa Yui, Yoshinori Fujinuma, Isao ...1993 Volume 36 Issue 11 Pages 861-867
Published: November 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe administered simvastatin (5mg/day for 6 months), an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase (the cholesterol synthesis rate-limiting enzyme), to 28 patients with non insulin dependent diabetes mellitus complicated by hypercholesterolemia (serum cholesterol≥220mg/dl) and assessed its effect on remnant-like particles (RLP). Both RLP cholesterol (RLP) C) and LDL cholesterol (LDL-C) levels were decreased significantly by simvastatin. Intype lIb hyperlipidemia, changes in both RLP C and RLP-triglycerides (RLP-TG) were strongly correlated with changes in the serum TG level, but not with changes in LDL-C. In patients with type IIa hyperlipidemia, changes in RLP TG were strongly correlated with changes in TG, but the changes in RLP C were better correlated with changes in LDL-C than TG. Based on these findings, simvastatin reduces RLP in diabetes and appears to be potentially useful in preventing the progression of arteriosclerosis. Our findings also suggest that an RLP metabolic pathway other than LDL receptors is involved in type Ilb hyperlipidemia.View full abstractDownload PDF (772K) -
Yoshihiko Suzuki, Kempei Matsuoka, Hiroko Kadowaki, Yasuo Akanuma, Tak ...1993 Volume 36 Issue 11 Pages 869-874
Published: November 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report a 33-year-old diabetic woman with hearing impairment and severe leg pain. Her mother, a sister and a brother also had hearing impairment.
At the age of 30 years old, she developed hyperglycemic coma and was first diagnosed with diabetes. At that time, she began to notice decreased hearing acuity.
After 3 months of glycemic control, she began to suffer from severe, sustained posttreatment painful neuropathy of the leg. Six months later, retinopathy appeared. Because of her short stature, abnormality on electro-cardiogram, high serum levels of lactate and pyruvate, and A to G transition at nucleotide 3243 in the mitochondrial tRNALeu gene, she was diagnosed as having a new type of diabetes and hearing impairment due to mitochondrial DNA mutation.
Unlike earlier reports, this case showed unique clinical features in that she had severe posttreatment painful neuropathy and early onset of retinopathy. It was speculated that the energy deficiency in nerve cells and retinal cells after a fall in blood glucose was accelerated or aggravated due to mitochondrial dysfunction.
Thus, this mitochondrial mutation could not only cause underlying diabetes but also influence its complications. Therefore, careful clinical observation is needed in treating patients with these symptoms.View full abstractDownload PDF (2241K) -
Akihisa Imagawa, Naoto Itoh, Toshiaki Hanafusa, Atsushi Miyazaki, Hiro ...1993 Volume 36 Issue 11 Pages 875-880
Published: November 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 22-year-old female developed diabetic ketoacidosis and was diagnosed as having IDDM with positive tests for islet cell antibodies (ICA) and HLA-DR4/9. The patient also had Graves'disease. Four months after the onset of IDDM, we performed laparoscopic biopsy of the pancreas to evaluate immunohistological abnormalities in the islets. Immunohistochemical analysis of the biopsy specimens revealed a decrease in the number of β-cells, preservation of α and δ cells, and mononuclear cell infiltration of the islets (insulitis). The infiltrating cells consisted of T lymphocytes, B-lymphocytes and macrophages, and the most predominant subpopulation was CD8+ T-lymphocytes. As regards T-cell receptors, both αβ-and γδT-lymphocytes were observed in the islets. The biopsy specimen also showed hyperexpression of MHC class I antigens in the islet cells and of MHC class I and II antigens in the endothelial cells.
These findings suggest that CD8+ T-lymphocytes, which predominantly infiltrated the islets, recognize β-cell-autoantigens in conjunction with the hyperexpressed self MFIC class I antigens, and may then have mediated β-cell destruction. The positive ICA test and association with Graves' disease support the involvement of immunological abnomalities in the destruction of β cells in this case.View full abstractDownload PDF (2537K) -
Effect of the PGI2 Analogue, Beraprost Sodium (BPS), on Diabetic Neuropathy in Diabetic WBN/Kob RatsSoichiro Mochio, Yutaka Mori, Hisayoshi Oka, Akira Kurita, Shyoichi Ha ...1993 Volume 36 Issue 11 Pages 881-884
Published: November 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe electrophysiologically examined the effect of the PGI2 analogue, Beraprost sodium (BPS), on neuropathy in spontaneously diabetic WBN/Kob rats, Diabetic male WIIN/Kob rats, aged 43 to 45 weeks, were randomly divided into BPS-treated (n=7) and untreated (n=6) groups. BPS was orally administered at a dose of 30μg/kg every day, while untreated rats were given distilled water, for 16 weeks. Motor nerve conduction velocity (MNCV) of the tail nerve and the coefficient of variation (CV) of pulse intervals of the tail artery, as indicators of parasympathetic nerve function, were determined before and after treatment. After the 16 week treatment period, the sciatic nerve blood flow (NBF) was measured by laser doppler flowmetry. At the end of treatment, the CV of pulse intervals of the tail artery in the BPS treated group was significantly increased in comparison with that in the untreated group, while there was no significant difference in MNCV between the two groups. In addition, NBF in the BPS-treated group was increased in comparison with that in the untreated group.
In conclusion, these results suggest that BPS treatment might be useful not only for peripheral neuropathy but also for autonomic neuropathy.View full abstractDownload PDF (448K) -
Kenichiro Tsukahara, Yukichi Okuda, Masakazu Mizutani, Motomi Ezure, C ...1993 Volume 36 Issue 11 Pages 885-888
Published: November 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe effects of elevated glucose and eicosapentaenoic acid ethyl ester on in vitro 2 [3H] myoinositol uptake were evaluated in cultured rat vascular smooth muscle cells (VSMC).Since Na+-deprivation and the addition of ouabain (1mM) are known to reduce myo inositol uptake, we speculated that myo-inositol incorporation into VSMC might be dependent on an active transport system mediated by Na+-K+ATPase activity. Glucose inhibited myo inositol uptake in a dose-dependent manner. However, the addition of eicosapentaenoic acid ethyl ester (3×104M) prevented this glucose mediated inhibition of myo inositol uptake. These results suggest that eicosapentaenoic acid supplementation may prevent or ameliorate myo inositol related disorders in diabetics.View full abstractDownload PDF (392K) -
Yoshihiko Suzuki, Kempei Matsuoka1993 Volume 36 Issue 11 Pages 889-892
Published: November 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAlthough the measurement of beatto-beat heart rate variation is generally accepted as a valid test, there is still considerable debate as to which currently available method is the most practical for general clinical use. This study was designed to assess which test is most suitable in terms of the relationship with diabetic neuropathy.
Three different methods of analysing RR interval (heart rate) variation were compared in 16 normal subjects and 48 diabetics with responses to diabetic neurological measurements such as achilles tendon reflex, blood pressure fall on standing, and motor conduction velocity of the tibial nerve. The subjects selected were all in their 40s so as to exclude the influence of age as much as possible.
Hinge spread of RR intervals on deep breathing differentiated most accurately not only between normal subjects and diabetics, but also between diabetics with and without neurological damage. The coefficient of variation of RR intervals at rest and the difference between the maximum and minimum heart rates on deep breathing did not differentiate groups more accurately than the hinge spread of RR intervals.
Therefore, for routine clinical usage, we conclude that recording the hinge spread of RR interval variation on deep breathing is the most practical method currently available.View full abstractDownload PDF (462K)
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