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Volume 36, Issue 9
Displaying 1-12 of 12 articles from this issue
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[in Japanese]1993 Volume 36 Issue 9 Pages 683-684
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (237K) -
Takashi Naito, Hiroshi Yamaguchi, Shigeo Aizawa1993 Volume 36 Issue 9 Pages 685-691
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe studied 70 autopsied kidneys with diabetic nephropathy (DN) and 50 age-matched kidneys without DN by means of morphometrical analysis. The ratio of intimal to medial thickness in the arcuate and interlobular arteries, the severity of sclerosis in afferent arterioles, the prevalence of global sclerosis, and the rates of exudative and nodular lesions were measured. In the diabetic group, arterial intimal thickening, arteriolar sclerosis and glomerular global sclerosis were much more severe than in the non-diabetic group. The severity of sclerosis of the arcuate arteries and afferent arterioles, except for interlobular arteries, correlated significantly with the prevalences of global sclerosis and exudative lesions in glomeruli. All these lesions were significantly more common in hypertensive than in non-hypertensive cases. The prevalance of global sclerosis correlated significantly with the rates of exudative and nodular lesions. There was no correlation between the rate of nodular lesions and arterial intimal thickening. In both groups, a significant correlation was noted between age and intimal thickening of the arcuate and interlobular arteries.
These findings suggest that there may be heterogeneity in the development of renal arteriolosclerosis in DN and non-DN groups, and that exudative lesions are highly correlated with this development, while nodular lesions may be due to diabetic glomerular injury.View full abstractDownload PDF (1069K) -
Hiroyuki Yamada, Nigishi Hotta, Jiro Nakamura, Naoki Koh, Fumihiko Sak ...1993 Volume 36 Issue 9 Pages 693-700
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe preventive effect of an aldose reductase inhibitor (ARI), SNK-860, on diabetic neuropathy was investigated electrophysiologically and biochemically in streptozotocin induced diabetic rats (STZ-DM). 1) The delayed caudal motor nerve conduction velocity in STZ-DM was significantly improved by SNK and insulin treatment. 2) The R-R interval variation on ECG was decreased in STZ-DM and this decrease was prevented by SNK and insulin treatment. 3) The characteristic accumulation of sorbitol and fructose and depletion of myo-inositol content in the sciatic nerves of STZ-DM were normalized by SNK. 4) SNK treatment normalized the decreased Na+/K+-ATPase activity in the sciatic nerves of STZ-DM, as did insulin treatment. 5) Plasma catecholamine concentrations were decreased in STZ-DM and either SNK or insulin treatment prevented this defect.
These findings suggest that activation of the polyol pathway is associated with the pathogenesis of diabetic autonomic neuropathy, as well as somatic neuropathy, and that SNK has a preventive effect in both types of neuropathy.View full abstractDownload PDF (1415K) -
Clinical Differences between Cranial and Trunk-Extremitas MononeuropathyYoshiastu Takahashi, Takeshi Itoh, Kazuhiro Owada, Yukiko Inoue, Yasue ...1993 Volume 36 Issue 9 Pages 701-705
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSForty nine patients with diabetic mononeuropathy, referred to our diabetes center, were evaluated in terms of clinical differences between cranial nerves (n=32) and trunk-extremitas nerves (n=17). The patients with cranial mononeuropathy were older and had a tendency for obesity as compared to those with trunk-extremitas mononeuropathy. Abrupt onset of mononeuropathy had occurred in 91% of cranial mononeuropathy and 47% of trunk-extremitas mononeuropathy cases. A recovery period within 3 months was recognized in 78% of cranial mononeuropathy and 41% of trunk-extremitas mononeuropathy cases. There was a significant correlation between the recovery period and the difference in HbA1c from onset to recovery in trunk-extremitas mononeuropathy cases whose HbA1c levels at onset were over 8.0%. On the other hand, there was no difference in the duration of diabetes and HbA1c level at onset between the two groups.
In conclusion, diabetic trunk-extremitas mononeuropathy had a clinical picture which differed, in terms of onset and course, from that of cranial mononeuropathy and showed a significant correlation between prognosis and blood glucose control.View full abstractDownload PDF (835K) -
Naoki Nakashima, Tomoya Miyamura, Tsukasa Yamashita, Toshihiko Hashimo ...1993 Volume 36 Issue 9 Pages 707-714
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSFamilies with hyperproinsulinemia may be considered a model of excess secretion of insulin by pancreatic beta cells, and those with mutant insulin receptors as a model of insulin resistance. We evaluated members of two families, one with hyperproinsulinemia (IIis65-proinsulin) and the other with mutant insulin receptors (His252-insulin receptor), employing the oral glucose tolerance test (OGTT) and other parameters of glucose metabolism. Alterations in glucose tolerance were observed over a five-year period. Genotypes of relevant mutations were reflected by the fasting serum CPR/IRI molar ratio in the family with hyperproinsulinemia, and by the degree of abnormality in serum IRI on OGTT in the family with mutant insulin receptors. In both families, a low insulin secretory response, indicating pancreatic beta cell dysfunction, might exacerbate glucose intolerance. We conclude that not only the mutations, but also other genetic or environmental factors, may contribute to glucose intolerance in both families.View full abstractDownload PDF (1354K) -
Yuka Ueda, Shigeru Wakabayashi, Akira Matsuoka1993 Volume 36 Issue 9 Pages 715-723
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe effectiveness of an indigestible dextrin (Pine fibre-C®: PF-C) on blood glucose (BG) levels and 2-hour urine C-peptide immunoreactivity (U-CPR) levels following a sucrose load were investigated in healthy human subjects.
1) In order to estimate an effective dose of PF-C for a reduction in BG and U-CPR levels following a 30 g sucrose load, an oral sucrose tolerance test was conducted in 6 male subjects. The percent increase in BG levels following a sucrose load (av. 154%) was reduced by PF-C, 3 and 6g (av. 141% each). Furthermore U-CPR levels were reduced to 86% by addition of PF-C 6g as compared to the sucrose load (4.62±0.72 μg/2hr). The intensity of reduction in U-CPR levels by PF-C, 3 and 30 g were less than that by PF-C 6g. Our results show that the most effective dose of PF-C for a reduction in BG and U-CPR levels is 6 g to sucrose 30 g.
2) To evaluate the effectiveness of a PF-C-supplemented meal on a reduction in U-CPR levels, another sucrose tolerance test was conducted in 35 subjects (male 31, female 4) with a soft adzuki-bean jelly (Mizuyoukan) as a high sucrose (30 g) meal. The percentage of reduction of U-CPR levels in each sex were found to be significant in both the PF-C 3 g-(av. male 85%, female 88%) and 6 g-supplemented meals (av. male 80%, female 64%) as compared to the PF-C-free meal. In addition, in the male subjects, significant relation were found among the percentage of reduction in U-CPR by PF-C, the waist to hip ratio, and the levels of serum total cholesterol, triglyceride and γ-GTP. These results suggest that PF-C is effective for the improvement of hyperinsulinemia in obesity.View full abstractDownload PDF (1414K) -
Hiroyuki Nishio, Yasunori Kutsumi, Hiroshi Kato, Yusuke Koshino, Yoshi ...1993 Volume 36 Issue 9 Pages 725-732
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe role of diabetes mellitus (DM) in the progression of coronary atherosclerosis was studied in 72 patients who underwent coronary angiographies twice, performed 1-year apart. Patients were divided into two groups, progression (37 patients) and non-progression (35 patients), and evaluated by the findings of the two coronary arteriograms. In all patients, DM, smoking, apoprotein B levels and apoprotein B/A-I ratio were related to the progression of coronary atherosclerosis. Next we evaluated 25 patients with DM (17 in the progression and 8 in the non-progression group), and 47 patients without DM (20 in the progression and 27 in the non-progression group). In diabetic patients, total cholesterol, LDL-cholesterol, apoprotein B levels and apoprotein B/A-I ratio were related to progression of coronary atherosclerosis, while fasting glucose, HbA1 and HbA1c were not. In the non-diabetic patients, smoking, obesity, apoprotein B levels and apoprotein B/A-I ratio were related to progression. Our data indicate that DM is a risk factor for progression of coronary atherosclerosis, and that cholesterol-and apo B-rich lipoproteins play an important role in progression of coronary atherosclerosis in diabetic patients and that total cholesterol levels of diabetic patients should be lowered to prevent progression of coronary atherosclerosis.View full abstractDownload PDF (1232K) -
Takashi Nagai, Makoto Imamura, Syuntaro Konaka, Takashi Tomizawa, Hiro ...1993 Volume 36 Issue 9 Pages 733-739
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe experienced a diabetic patient with severe neuropathy accompanied by relapsing paralytic ileus after the administration of omeprazole. A 52-year-old man had been suffering from numbness of the lower extremities, dizziness, impotence, sense of residual urine, pyrosis, epigastric pain and watery diarrhea due to diabetic neuropathy for two years. He experienced vomiting and abdominal pain the after omeprazole (20 mg/day) admnistration for the treatment of reflux esophagitis. Bowel sounds were absent. Plain abdominal X-ray film showed gas retention in the small bowel. Therefore, we diagnosed his condition as paralytic ileus. Eight months later, omeprazole was administrered by a general, practitioner for treatment of his epigastric pain. The next day, he again suffered from abdominal pain due to paralytic ileus. Examination of the upper gastrointestinal tract showed no significant abnormality except for gastric dilatation. Barium enema, abdominal echography and abdominal computed tomography showed no significant abnormality. Caution should be exercised in administering drugs, which may affect gastrointestinal motility, to diabetic patients with severe neuropathy.View full abstractDownload PDF (5197K) -
Tadasu Nagaoka, Yasutugu Mizuno, Shigeto Matsushita, Shin-ichi Mihira1993 Volume 36 Issue 9 Pages 741-746
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe patient was a 44-year-old man who had diabetes that had gone without treatment for one year. He was hospitalized with chief complaints of lumbago and pain in the right lower limb. Hyperglycemia leukocytosis a positive CRP test and erythrocyte hypersedimentation were seen and Staphylococcus aureus was detected by urine culture. Abscess of the right iliopsoas muscle was found by CT scan. Treatment with antibiotics resulted in symptomatic improvement and the patient was discharged one month later. Two months after discharge he was re-hospitalized with a recurrence of lumbago and pain in the left lower limb. Abscess of the left iliopsoas muscle was detected by CT scan and antibiotics were again administered. However the abscess did not disappear and incision and drainage were performed. One month later disappearance of the iliopsoas muscle abscess was confirmed by CT scan. We speculate that this patient with non-insulin-dependent diabetes mellitus developed a urinary tract infection becaused of inadequate blood glucose control and that this infection led to an iliopsoas abscess which later recurred on the contralateral side. The experience with this case indicates the necessity of adequate care in cases of diabetes complicated by iliopsoas abscess.View full abstractDownload PDF (2847K) -
1993 Volume 36 Issue 9 Pages 747-756
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (2330K) -
[in Japanese]1993 Volume 36 Issue 9 Pages 757
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (186K) -
[in Japanese]1993 Volume 36 Issue 9 Pages 758
Published: September 30, 1993
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (176K)
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