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Volume 37, Issue 10
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[in Japanese]1994 Volume 37 Issue 10 Pages 715-716
Published: October 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (306K) -
Frequency and Salivary ConditionsMakiko Ogawa1994 Volume 37 Issue 10 Pages 717-723
Published: October 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThis study was performed to clarify the frequency of dental caries and periodontal diseases and salivary conditions in diabetic patients.
Dental examinations were performed as to the number of decayed, filled or missing teeth, status of calculus deposition and periodontal diseases in 30 male subjects with non-insulin dependent diabetes mellitus (NIDDM) under treatment at a diabetic clinic and 30 healthy male subjects matched for age and Body Mass Index.
Although there was no significant difference in the frequency of dental caries between NIDDM and healthy subjects, calculus deposition and periodontal diseases in NIDDM showed significantly higher frequencies than in healthy subjects.
There were no significant relationships among the frequency of dental caries, calculus deposition, periodontal diseases and fasting blood sugar (FBS) or glycohemoglobin A1c (HbA1c) levels in NIDDM.
The number of decayed teeth (C4) was smaller and that of filled teeth was significantly larger in the group with a long duration (over 10 years) of DM. Furthermore, the frequencies of calculus deposition and periodontal diseases were significantly higher in this group.
In 47 subjects (32 male and 15 female subjects) with NIDDM and 45 healthy subjects (33 male and 12 female subjects), whole unstimulated saliva in the fasting state was collected from 9 to 11 a.m. After measuring the amounts of saliva, concentrations of salivary components such as glucose, lactate, potassium, calcium, inorganic phosphorus and immunoglobulin A (IgA) were measured by Video Chemistry 600.
The salivary flow-rate was significantly decreased, but glucose, potassium, calcium, inorganic phosphorus and IgA concentrations in saliva were significantly increased in NIDDM.View full abstractDownload PDF (1225K) -
Thrombomodulin and Diabetes Mellitus Using a Unique Correction MethodKatsumasa Yui, Akira Tanaka, Masaharu Morohoshi, Isao Uchimura, Fujio ...1994 Volume 37 Issue 10 Pages 725-730
Published: October 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSFormerly, we reported the elevation of plasma thrombomodulin (TM) in diabetic patients. Because plasma TM is elevated in non-diabetic patients with renal failure, we speculated that plasma TM correction by the value of serum creatinine (Cr) would document the relationship between plasma TM and diabetes mellitus (DM) more precisely.
The relationship between plasma TM and serum creatinine in 43 healthy subjects and 17 nondiabetic patients with renal failure was expressed by the equation “TM=9.44Cr+11.0.” The value of TM calculated by this equation was regarded as 100% TM of every creatinine level. We adopted percentages beyond the level of this equation as corrections for each plasma TM value by serum Cr in diabetics.
The plasma TM of 51 diabetic patients was 146.7±63.8%(M±SD), significantly (p<0.005) higher than that of healthy subjects (98.9±17.2%). Significantly (p<0.005) higher percentages of plasma TM were detected in the patients having more severe nephropathy, 124.3±31.1% in patients with no preteinuria and 208.2±73.9% in patients with severe preteinuria. A positive relationship was found between plasma TM level and DM duration (r=0.290, p<0.05).
Therefore, we clarified the specific relationship between plasma TM and DM by using the correction method adopted in this study.View full abstractDownload PDF (632K) -
Yukie Yanagisawa, Takao Wakabayasi, Miyoko Sato, Fumio Yamagata, Shoic ...1994 Volume 37 Issue 10 Pages 731-738
Published: October 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe aim of the present study was to investigate the effects of the physical properties af various types of cooked rice on the glycemic index in non-insulin-dependent diabetes mellitus (NIDDM). We examined the plasma glucose, insulin and C-peptide responses of 27 NIDDM patients and 7 healthy subjects after loading each type of eooked rice energetically equivalent to 75g of oral glucose. All meals contained 75g of carbohydrate served as follows: rice gruel 409g, regular-cooked rice 196g, and hard-cooked rice 162g. In addition, in vitro α-amylase hydrolysis and in vivo hydralysis by mastication were tested using each type of cooked rice.
In diabetics, rice gruel elicited approximately a 2 times higher peak of plasma glucose and insulin than regular-cooked rice. The insulin response to rice gruel in normal subjects was also significantly greater than to regular-caaked rice, despite the absence af any difference in plasma glucose.
Unexpectedly, the postprandial response of plasma glucose to hard-cooked rice in diabetic subjects was significantly greater than to regular-cooked rice, although there were no significant differences between the insulin responses to regular-and hard-cooked rice in either diabetic or normal subjects, In the in vitro experiment, hard-cooked rice vvas hydrolyzed most slowiy, and it necessitated the largest number of chewing strokes when eating was observed in vivo. Adequate mastication may account for more rapid digestion and absorption of hard-cooked rice.
In diabetes, the average ratio of incremental areas under the curves of plasma glucose for 120min was 146±48% after rice gruel and 122±31% after hard-rice, taking 100% as the area after regular-cooked rice.View full abstractDownload PDF (1152K) -
Shoichi Tomono, Shoji Kawazu, Mitsuo Shimizu, Tomio Ohno, Norihiro Kat ...1994 Volume 37 Issue 10 Pages 739-746
Published: October 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSRemnant Like Particles (RLP) constitute a lipoprotein unbound to immunoaffinity gel mixture of and apo A-I and apo B-100 monoclonal antibodies coupled with Sepharose 4B. As already reported, RLP could thus be separated simply by a rapid method. It has also been reported that this RLP contains a chylomicron remnant and a very low density lipoprotein remnant. The concentrations of serum RLP-cholesterol (RLP-C) and RLP-triglyceride (RLP-TG) were determined in 217 non-insulin dependent diabetes mellitus (NIDDM: 62.3±9.8 years old) and 317 non-diabetic subjects (non-DM: 60.5±8.8 years old). The level of RLP-C was significantly higher in NIDDM (4.8+5.9mg/dl: mean±SD) than in non-DM (3.1±4.5mg/dl)(p<0.001). The percentage of subjects whose RLP-C concentration exceeded 5mg/dl was significantly higher in NIDDM (31%) than in non-DM (10%)(p<0.001). Even in the two groups of normolipidemic NIDDM and non-DM, the difference was signficant (p<0.001; 11%[15/136] in NIDDM and 3%[6/191] in non-DM, respectively). On the ather hand, the level of RLP-TG not differ significantly between NIDDM (34.5±31.2mg/dl) and non-DM (317±33.1mg/dl).
In NIDDM, RLP-C was lower in the good (fasting plasma glucose<140mg/dl and HbA1c<7.5%) than in the poor glycemic control group. RLP-C was further significantly augmented in macroalbuminuric patients (more than 200mg/g·creatinine, RLP-C: 7.8±11.4mg/dl) as compared tonormoalbuminuric (less than 10mg/g·creatinine, 4.2±4.2mg/dl) and microalbuminuric patients (10-200mg/g·creatinine, 4.4±4.7mg/dl). Thus, RLP-C was often elevated in NIDDM, even in patients with normolipidemia, and this elevation was dependent on glycemic control and an increased urinary albumin excreation rate.
In conclusion, RLP-C, which is a major component of cholesterol in apo-E rich remnant substance (lipoprotein remnant), was found to often be abnormally high in NIDDM, Thus atherosclerosis might be accelerated.View full abstractDownload PDF (1195K) -
Yutaka Hasegawa, Hiroaki Araki, Susumu Otomo, Shun-ichi Abe, Masahiro ...1994 Volume 37 Issue 10 Pages 747-752
Published: October 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIn the present study, we investigated the effect of Lipo-PGE1 on peripheral diabetic neuropathy in genetically diabetic mice (C57BL/Ksj-db/db). To estimate the nerve function in diabetic and non-diabetic mice (C57BL/Ksj), the F-wave latency in the tibial nerve was measured as an index. The F-wave latencies in C57BL/Ksj and C57BL/Ksj-db/db were 4.73±0.20 msec and 5.81±0.17 msec, respectively, and a significant difference was observed (P<0.01). With daily intravenous administrations of Lipo-PGE1 (1 and 3μg) for 4 weeks, the prolonged F-wave latency in C57BL/Ksj-db/db was conspicuously improved, in a dose-dependent manner. The difference in F-wave latency between C57BL/Ksj and C57BL/Ksj-db/db increased from 0.4 msec to 1msec. These results suggest that Lipo-PGE1 is effective for diabetic peripheral neuropathy, and that F-wave measurement is useful as an index of peripheral neuropathy.View full abstractDownload PDF (817K) -
Hideo Takahashi, Takamichi Kabata, Shinya Hayano, Toshio Hashimoto, Ta ...1994 Volume 37 Issue 10 Pages 753-757
Published: October 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report a 29-year-old man, a case of post-treatment diabetic neuropathy with tonic pupils. His diabetic control had been poor for 8 years and subsequent intensive therapy was introduced. Severe pain of the lower extremities, excessive sweating over the upper body, orthostatic hypotension and bilateral photophobia were observed. We identified tonic miotic responses after convergence, but no response to light in either pupil. Furthermore, we found segmental palsy, leading to a diagnosis of post-treatment neuropathy with tonic pupils. The instillation of 5% phenylephrine caused fine mydriasis in both eyes. It was suggested that his sympathetic nerves to the iris were in a hypersensitive state due to renervation. It was thought that denervation and renervation of autonomic nerves had caused post-treatment diabetic neuropathy. Therefore, we must at times be careful about pupillary alterations when acutely improving the hyperglycemia of poorly controlled diabetics.View full abstractDownload PDF (2944K) -
Noriyasu Shinohara, Kiyohide Nunoi, Yuichi Sato, Mototaka Yoshinari, M ...1994 Volume 37 Issue 10 Pages 759-765
Published: October 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 29-year-old woman was admitted in January, 1991, because of emaciation. She had had 6 episodes of fasting hypoglycemia, and the final event was severe coma. She was diagnosed as having anorexia nervosa, because there was no evidence of organic disease causing emaciation. After intravenous hyperalimentation was performed, she was discharged at a body weight of 35kg. One year later, she was readmitted because of weight loss to 25kg and gait disturbance. She had hypoglycemic shock on the third morning of admission. She was treated by intratracheal canalization and intravenous administration of glucose. Although sufficient weight gain was not obtained by intravenous hyperalimentation, she was treated successfully by operant conditioning using self-recording of daily body weight change on a graph. She gained weight up to 43kg and was discharged.
Although fasting hypoglycemic coma is a rare event in anorexia nervosa, prolonged fasting in patients who reject food intake and drip infusion of glucose should be avoided, since hypoglycemia may lead to sudden death.View full abstractDownload PDF (1017K) -
Compared to the Cases Reported as Pseudomyocardial Infarction over the Past 20 YearsMari Watanabe, Yuko Akehi, Sukenobu Ito, Hiroshi Kuwahara, Jun Hashigu ...1994 Volume 37 Issue 10 Pages 767-772
Published: October 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 49-year-old man was admitted because of thirst, general fatigue and abdominal pain. He had been suffering with a common cold for 6 days before admission and had drunk about 3.0 liters of sake over the previous 2 days. Laboratory findings on admission were plasma glucose 798mg/dl, urinary glucose 3+, urinary ketone bodies 3+, serum potassium 7.1mEq/l, and arterial blood pH 7.08. An electrocardiogram showed ST-segment elevation in leads V1-4. Initially acute myocardial infarction complicated by diabetic ketoacidosis (DKA) was suspected, but the ST segment elevation disappeared 3 hours after normalization of his serum potassium. ST-segment elevation is very rare during the course of DKA. Eleven cases had been reported as pseudomyocaridal infarction over the preceding 20 years. The factors which caused ST-segment elevation in those cases and the present case are compared.View full abstractDownload PDF (780K) -
The Causes of Death in Japanese Diabetics Based on Survey Results Among 11, 648 Diabetics during 1981-1990Nobuo Sakamoto, Nigishi Hotta, Takayoshi Toyota, Yoshio Ikeda, Kenpei ...1994 Volume 37 Issue 10 Pages 773-788
Published: October 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSUsing the survey of hospital records, the principal causes of death among 11, 648 diabetics (7, 106 men and 4, 542 women) who died in 225 hospital throughout Japan during the period of 1981-1990 were determined. There were 2, 289 autopsies among 11, 648 diabetics.
1. The most frequent causes of death were vascular diseases (39.3%) including renal failure (11.2%), ischemic heart disease (14.6%), and cerebrovascular disease (13.5%). The second most frequent cause was malignant neoplasm (29.2%) and the third was infections (10.2%). Diabetic coma due to hyperglycemia accounted for only 1.7% of deaths.
2. Concerning the relationship between age and cause of death in diabetics, diabetic nephropathy and infection were relatively common in patients over the age of 20 years. Cerebrovascular disease was the cause of death in about 10% of patients over 20 years of age. However, the high incidence of death due to ischemic heart disease was observed over the age of 60 years. Malignant neoplasm was the cause of death in about 30-40% in men over 30 years of age and in women over 40 years of age.
3. As a matter of convenience, Japan was divided into three areas: a rural district (Hokkaido and Tohoku), an urban district (six major cities, Tokyo, Osaka, Nagoya, Yokohama, Kyoto and Fukuoka), and all other districts. There were no differences between the areas in the frequency of vascular disease as the cause of death in diabetics.
4. The “poor” control of blood glucose reduced the life spans of those diabetics without malignant neoplasms or liver cirrhosis, especially those with diabetic nephropathy. In the 11, 648 patients, the average age at death was 67.3 years. The life span was two years shorter in patients with “poor” blood glucose control than in those with “good” or “fair” blood glucose control.View full abstractDownload PDF (2802K)
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