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Volume 37, Issue 1
Displaying 1-7 of 7 articles from this issue
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Toru Inoue, Hisako Fushimi, Yuya Yamada, Fukashi Udaka, Masakuni Kamey ...1994 Volume 37 Issue 1 Pages 1-6
Published: January 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe relationship between asymptomatic lacunes detected on MRI to micro-and macroangiopathy in diabetics is poorly understood. Asymptomatic patients in a multiple lacune (ML) group (57 cases) were studied in comparison with a lacune-free group (53 cases). Explanatory variables are duration of diabetes mellitus, CHO, TG, HDL-C, LDL-C, atherogenic index (AI), LP (a), retinopathy, neuropathy, nephropathy, CHD, ASO, hypertension, blood sugar control and treatment. Both groups were then divided to younger (≤64) and older (≥65) patients, and reanalyzed in the same manner. Based on the results of univariate analysis, age, hypertension, and neuropathy were associated with ML. Multivariate analysis showed age to be an independent predictor of ML. In younger patients, a combination of 4 factors: retinopathy, hypertension, BMI and Al yielded the most significant association with ML. Among older patients, no combinations of variables led to any significant association with ML. In conclusion, ML was associated with aging, and in the middle-aged group it was associated with microangiopathy and hypertension.View full abstractDownload PDF (788K) -
A ngiographic Assessment and Clinical DiagnosisAkito Kawaguchi, Hiroshi Matsuo, Nobuko Tsushima, Akira Yamamoto1994 Volume 37 Issue 1 Pages 7-15
Published: January 30, 1994
Released on J-STAGE: August 04, 2011
JOURNAL FREE ACCESSTo examine insulin effects on peripheral vascular disease, 108 patients with arteriosclerosis obliterans (ASO) diagnosed by angiography were subjected to the 75g OGTT and analysis of their clinical profiles, including correlations among different metabolic parameters. Forty-four of these patients (41%) were classified as diabtes and 28 as having IGT by WHO diagnostic criteria, but there was no significant difference in the severity of angiogram scores (ASO score) or clinical profiles, except for the plasma urate concentration. On the other hand, the K classification, which consists of 4 categories according to presence of hyperinsulinemia (insulin area > 0.9 nMh) or hyperglycemia (glucose area > 20 mMh), clinically characterized 23 (21%) hyperinsulinemic patients, those who exhibit clustering of multiple risk factors, such as increased body weight, dyslipoproteinemia and hemoconcentration. However, their ASO scores were not significantly different from those with normal insulin response and diabetes. It is concluded that ASO patients with hyperinsulinemia defined by the K classification were well characterized by a metabolic environment as a “syndrome” the same as CAD patients, but not by WHO criteria. The peripheral arteriosclerosis in this group, however was not always severe.View full abstractDownload PDF (830K) -
Akira Ohsawa1994 Volume 37 Issue 1 Pages 17-22
Published: January 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSBezafibrate (Bf) is now clinically used as an effective antilipemic drug, especially against hypertriglyceridemia. Some of the literature states that Bf is also effective for lowering blood glucose concentrations, but few clinical data have yet been reported. We tried administeing Hf to 26 NIDDM patients moderately controlled with sulfonylurea or diet alone, and monitored serum lipid, glucose, glycohemoglobin (HbA1c) and insulin concentrations for six months. The results showed that serum triglyceride was significantly lower in 30% compared to before treatment, and that blood glucose had also been significantly reduced from 199±40 to 160±42 mg/dl in the fasting state. Glycohemoglobin levels were slightly elevated. This glucose-lowering effect of Hf is supposed to be due to inhibition of glucogenesis in the liver.View full abstractDownload PDF (646K) -
Hiroshi Obayashi, Mitsuhiro Ohta, Yoshihiro Kitagawa, Naoto Nakamura, ...1994 Volume 37 Issue 1 Pages 23-30
Published: January 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo investigate the clinical significance of autoantibodies to two forms of glutamic acid decarboxylase (GAD), we used Western blot analysis to isolate then from rat brain on an immunoaffinity colums with anti-synthetic C-terminal GAD peptide antibodies which recognize both GAD65 and GAD67. The frequency of antibodies to GAD65 and/or GAD67 in 45 cases of insulin dependent diabetes mellitus (IDDM) was 88%(14/16) in ICA-positive subjects and 10%(3/29) in ICA-negative subjects. Antibodies to GAD67 were detected in 1 ICA positive NIDDM patient and antibodies to GAD65 were detected in 1 of 2 Stiff-man syndrome patients without IDDM, whereas no antibodies to GADs were detected in 20 patients with autoimmune thyroid disease or in 30 normal subjects. In this study, we found that some sera from IDDM patients recognized only GAD65 or GAD67, however, we found no obvious correlation between duration of illness or ICA-titers and the specificity of antibodies to either form of GAD. Antibodies to GAD65 and GAD67 are considered useful markers for the diagnosis of IDDM and for understanding its pathogenesis.View full abstractDownload PDF (4408K) -
Yoshihiko Suzuki, Ikuo Takeuchi, Kazuhiro Hosokawa, Yoshito Atsumi, Ke ...1994 Volume 37 Issue 1 Pages 31-35
Published: January 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report a 23-year-old woman who was a probable case of multiple sclerosis (MS) associated with insulin dependent diabetes (IDDM). She was diagnosed as having IDDM at 14 years of age and subsequently experienced several episodes of ketoacidosis.
At the age of 22, she suffered from acute episode of neurological disturbances such as hemiparesis and dysarthria. Because of her youth and the identification of oligoclonal immunoglubulins in cerebral spinal fluid and multiple abnormal high signal intensity areas on MRI, she was diagnosed as a probable case of MS. One year later, her neurological disturbance had subsided. However, certain complications of MS, such as excessive food intake and ceasing to visit the hospital because of a euphoric character, have intervened with clinical treatment and diagnosis.
Because this is the first Japanese case report of IDDM and probable MS in the same patient, it prompts us to think about the pathogenic relationship between these two disorders.
Among the various hypotheses put forth, autoimmune pathogenesis may be the most plausible. As HLA-DR2 has a positive association with MS, as does HLA-DR4 with IDDM, it is interesting that this case had both HLA-DR2 and HLA-DR4.View full abstractDownload PDF (2245K) -
Katsumi Yamauchi, Keiichiro Tanigawa, Yuzuru Kato1994 Volume 37 Issue 1 Pages 37-42
Published: January 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report the clinical course of a patient with diabetic amyotrophy complicated by HTLV-I-associated myelopathy (HAM). A 63-year-old woman developed diabetes mellitus 9 years ago. Since then, she has been treated with oral glibenclamide (5 mg/day). Her diabetes has been poorly controlled, resulting in severe weight loss (55→34 kg). Muscle atrophy and motor weakness of the lower extremities and a gait disturbance were first noted 2 years age. When she consulted our clinic last year, augmented deep tendon reflexes in the lower extremity were observed. Serum HTLV-I antibody was 32768. A spinal tap showed the following: cells 41/3, protein 57 m/dl, HTLV-I antibody 8194. A diagnosis of HAM was made. Although predonisolone (40 mg/day, P.O.) lowered the HTLV-I titer in cerebro spinal fluid, no major improvement of the gait disturbance was observed. Therefore, the major cause of the walking difficulty may be diabetic amyotrophy. Since HAM has a poor prognosis, further careful observation are required.View full abstractDownload PDF (2362K) -
1994 Volume 37 Issue 1 Pages 43-65
Published: January 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (4876K)
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