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Volume 36, Issue 4
Displaying 1-7 of 7 articles from this issue
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Toeko Matsumoto, Yoshikazu Oka, Yasuo Ohashi, Masatoshi Kikuchi1993 Volume 36 Issue 4 Pages 261-268
Published: April 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThis study proposes a method of categorizing clinical findings which can be used for selecting variables in a multivariate analysis of risk factors for diabetic retinopathy. Eye ground findings and 19 other clinical parameters at the initial visit were analyzed in 1, 200 non-insulin-dependent diabetics seen at the Third Department of Internal Medicine, Tokyo University.
Based on correlations between these findings and associations with retinopathy, the 19 clinical findings were classified into the following 7 categories: “gender”, “age” and “duration”, epidemiological components: “obesity” represented by body mass index; “hyperglycemia”, represented by plasma glucose level; “hypertension” represented by blood pressure;and “atherosclerosis”, represented by cholesterol. Duration of diabetes, systolic blood pressure, initial body mass index (inverse) and plasma glucose level at 120 min. on GTT were identified as independent risk factors for diabetic retinopathy by multivariate analysis using the 7 major variables representing each category.
Our method, which selects variables from categorized clinical findings, is valid since it takes into account the complexity of interrelated factors among the miscellaneous clinical findings noted at the initial visit.View full abstractDownload PDF (1117K) -
Takashi Asano, Tetsuhiro Futata, Kohtaro Kan, Hiroshi Ninomiya, Takash ...1993 Volume 36 Issue 4 Pages 269-275
Published: April 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe relationship between changes in peripheral plasma insulin, C-peptide levels, and the pancreatic insulin secretory rate (ISR) during isoglycemic oral and iv glucose loading and IVGTT were studied in 17 normal subjects. Pancreatic ISR was calculated according to a two-compartment model of distribution for C-peptide. Whereas the plasma insulin levels in OGTT increased 5.2±0.7-fold over the basal level at 15 min, and the plasma C-peptide concentrations increased to only 3.1±0.3-fold above the basal value at 15 min after the stimulus, the corresponding pancreatic ISR increased reaching a peak value at 8.0±1.0-fold over the basal level at 15min.Peripheral insulin concentrations paralleled changes in ISR more closely than C-peptide.In IVGTT, the ISR was more closely reflected by changes in peripheral insulin than in C-peptide levels. In conclusion, changes in pancreatic ISR after oral and iv glucose administration are more accurately reflected by parallel changes in peripheral plasma insulin than in plasma C-peptide levels.View full abstractDownload PDF (964K) -
Yasuo Kida, Atsunori Kashiwagi, Yasushi Tanaka, Tsutomu Ogawa, Nanami ...1993 Volume 36 Issue 4 Pages 277-283
Published: April 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAlthugh unexpected sudden death in diabetics with autonomic neuropathy has previously been reported, the prevalence and clinical characteristics of sudden death have not been extensively evaluated. For this study we have investigated the prevalence and clinical characteristics of sudden death in 606 diabetics.The mean follow up period was 7 years.
Furthermore, the corrected QT interval (QTc) as a marker of sympathetic nerve function in these diabetics was compared with 45 age and sex matched healthy controls to evaluate the association of QTc prolongation with sudden death.
1) Among the 606 diabetics, 127 were already deceased and 39 of these (c. a. 31%) had been judged to be sudden deaths.
2) These sudden death cases tended to be eldery, and were frequently associated with hypertension, ischemic heart disease, autonomic or peripheral neuropathy, gangrene and nephropathy, as compared with survivors.
3) Although cardiac or cerebrovascular accidents were the major causes of death, the causes of sudden death in more than half of the cases could not be determined.
4) QTc intervals, in both diabetic survivors (418±26msec, p<0.05) and sudden death cases (445±33msec, p<0.01), were longer than that in controls (401±17msec).
5) The QTc prolongation in sudden death subjects might be attributable to autonomic neuropathy.View full abstractDownload PDF (1335K) -
Takehiro Nozaki, Yasuko Uchigata, Youichi Takei, Tetsuya Babazono, Yos ...1993 Volume 36 Issue 4 Pages 285-291
Published: April 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe characteristics of the onset of insulin-dependent diabetes mellitus (IDDM) in 287 patients who had had IDDM for more than one year were studied. The patients were divided into two groups: those with or without autoimmune thyroid disease (ATD). The onset of IDDM was classified as acute, subacute or slowly progressive, according to the period before a daily insulin dose of ≥0.5 U/kg became necessary. The onset of IDDM differed significantly between IDDM patients with and without ATD. All four male IDDM patients with ATD had the slowly progressive type. The onset of IDDM was significantly different between male and female IDDM patients with ATD, but was not different in IDDM patients without ATD. The age at onset of IDDM was significantly higher for the slowly progressive than the acute type of IDDM in patients with ATD.
It is concluded that there are significant differences in clinical features between IDDM patients with ATD, based on whether the disease is acute and slowly progressive, whereas no significant difference was observed among the three types of IDDM patients who did not have ATD. No distinctive clinical characteristics were observed in patients with the subacute type of IDDM.View full abstractDownload PDF (1189K) -
Masaki Amenomori, Hitoshi Yasuda, Ryuichi Kikkawa, Yukio Shigeta1993 Volume 36 Issue 4 Pages 293-298
Published: April 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSRetrospective analysis of clinical features and pathogenetic factors of diabetic mononeuropathy was performed using data from 24 inpatients with this disesae. Mononeuropathy was seen in 3.1% of 768 diabetic patients admitted to our hospital from 1978 to 1990.
The oculomotor, abducens and peroneal nerves were frequently involved.The average age of diabetic patients with mononeuropathy was older than that of all diabetic patiens. Most of the patients with mononeuropathy showed increased platelet aggregation and almost all male patients were smokers. The ophthalmoplegic patients tended to be older, to be hypercholesterolemic and to have long durations of diabetes associated with other diabetic complications.
A negative correlation between age and HbA1 was found at the onset of diabetic mononeuropathy, suggesting that aged diabetic patients are prone to develop mononeuropathy even with good glycemic control. Five patients (20.8%), all of whom were female and had distal symmetrical polyneuropathy, developed mononeuropathy after rapid normalization of glycemic control.View full abstractDownload PDF (1092K) -
Shigeki Moritani1993 Volume 36 Issue 4 Pages 299-306
Published: April 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo study the effect of high glucose concentration on the production of type IV collagen and laminin P1 from cultured human umbilical vein endothelial cells (HUVEC), we measured type IV collagen and laminin P1 from HUVEC that were cultured under different conditions of glucose. The amount of type IV collagen in the cultured medium with 30mM D-glucose was significantly higher than in those with 5.6mM D-glucose, 30mM L-glucose or 30 mM mannitol. The increase of type IV collagen in the medium was dependent on the glucose concentration and the incubation time. The amount content of intracellular type IV collagen in the cultured HUVEC was also significantly higher with high glucose concertrations than with low glucose or L-glucose concentrations. No morphological changes were found by phase-contrast microscopy in HUVEC cultued with 5.6mM or 30mM D-glucone for 96 hours. The concentrations of protein in the HUVEC showed no significant differences between the media with 5.6mM D-glucose, 15mM D-glucose, 30 mM D-glucose, 30mM L-glucose or 30mM mannitol.Pulse thymidine incorporation was similar for the cells exposed to 5.6mM, 30m D-glucose or 30mM mannitol. Pulse proline incorporation was significantly higher at high than low glucose concertrations.In contrast, the levels of laminin P1 in the media cultured with high glucose concentrations were similar to those cultured with 5.6mM or 15mM D-glucose. These results suggest that high glucose concentration may directly affect the production of type IV collagen, and that hypertonicity or non-metabolizable glucose does not contribute to the production of type IV collagen. Increase of type IV collagen may be involved in the development of diabetic microangiopathy.View full abstractDownload PDF (3307K) -
1993 Volume 36 Issue 4 Pages 307-339
Published: April 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (8153K)
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