All issues
Volume 37, Issue 7
Displaying 1-5 of 5 articles from this issue
- |<
- <
- 1
- >
- >|
-
Hiroaki Mizumoto, Munehisa Tamiya, Akira Matsuda, Kumiko Matsuya, Akem ...1994 Volume 37 Issue 7 Pages 471-477
Published: June 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe studied the adverse effect of rapid blood glucose control on the retina in non-insulin-dependent diabtics. Eighty nine patients with no diabetic retinopathy (NDR)[Group A] and 39 patients with simple diabetic retinopathy (SDR)[Group B] participated in this study. All subjects were hospitalized for a check-up and were then followed up for one year after discharge. The definition of rapid blood glucose control was an HbA1c level which decreased by more than 30% in three months. We also evaluated other clinical factors: age, sex, duration of diabetes, body mass index, blood pressure, Achilles' tendon reflex (ATR), microalbuminuria, proteinuria, methods of therapy, alcohol intake, and smoking habits. The HbAi c was measured every 3 months, while a retinal examination was done on admission and again one year after discharge. Of the 89 patients in Group A, 5 patients progressed to SDR and 2 patients to preproliferative retinopathy (PPDR). Of the 39 patients in Group B, 5 patients progressed to PPDR, while 9 patients improved to NDR. The deterioration in retinopathy occurred significantly more often in the patients in Group A (75%, p<0.01) than in Group B (36%) when rapid glucose control was achieved in patients without ATR. There was little effect of the rapid glucose control on retinopathy in patients with ATR. In the cases who remained as they were or who improved to NDR, the mean HbAic levels were less than 7% and were statistically lower (p <0.05) than those of the patients with retinopathy after one year.View full abstractDownload PDF (898K) -
Yumiko Ohkubo, Hiroki Yokoyama, Asako Sato, Tetsuya Babazono, Hiroko Y ...1994 Volume 37 Issue 7 Pages 479-484
Published: June 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 38-year-old male was admitted to the Diabetes Center because of renal failure and congestive heart failure. He had undergone Glenn's operation (connection of the superior vena cava to the right pulmonary artery) for tetralogy of Fallot to increase pulmonary arterial flow at the age of 8. He was diagnosed as having non-insulin-dependent diabetes mellitus (NIDDM) at the age of 20 in 1973. Diabetic background retinopathy, persistent proteinuria, and proliferative retinopathy developed at 6 years, 7 years, and 12 years duration of diabetes respectively.
Hemodialysis was started on admission at 18 years duration of diabetes. At the first hemodialysis, blood was returned to the superficial vein of the upper limb and resulted in right chylothorax due to the anomalous blood system created by Glenn's operation. Thereafter, blood was returned to the lower limb and hemodialysis has since been continued without complications. In Japanese patients with NIDDM, background retinopathy and proliferative retinopathy have been reported to develop at 16.6 years and 18.9 years duration of diabetes, respectively. Diabetic microangiopathy developed rapidly in this case. This rapid development was considered to be influenced by poor blood glucose control and chronic hypoxia due to tetralogy of Fallot.View full abstractDownload PDF (687K) -
Noriyuki Sato, Masashi Tanaka, Takayuki Ogiwara, Hiroyuki Shimizu, Yoh ...1994 Volume 37 Issue 7 Pages 485-491
Published: June 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIt is well known that poorly controlled diabetic patients have a susceptibilty to infection, though the precise mechanism remains unknown. A 56-year-old non-insulin-dependent diabetic man was admitted to our hospital complaining of cerivical pain and high fever. A large tumor was noted in his cervical soft tissue and cervical vertebras. Fasting plasma glucose and HbA1c were 198 mg/dl and 11.6%, respectively. The generation of oxygen-derived free radicals [luciferin-dependent chemiluminescence (CLA-DCL, which is dependent on the generation of superoxide anion) and luminol-dependent chemiluminescence (L-DCL, which is dependent on the myeloperoxidase-H2O2-Cl-system)] and myeloperoxidase (MPO) activity in neutrophils were apparently decreased. The tumor was diagnosed as actinomycosis by pathological examination. Insulin and antibiotics (PIPC and ABPC) therapies were very effective in alleviating fever and diminishing the size of the tumor. Furthermore, these treatments improved the impaired neutrophil bactericidal functions (CLA-DCL, L-DCL, and MPO activity).
Actinomycosis is a very rare infection and 30-60% of actinomycosis patients are reported to have diabetes mellitus. This case suggests that impaired neutrophil function, especially of the oxygen dependent MPO-H2O2-Cl- system, may be one factor leading to susceptibility to infectious disease in poorly controlled diabetic patients.View full abstractDownload PDF (3399K) -
Tomohumi Fujisaki, Hisae Kashida, Hiroshi Sameshima, Masayuki Hatae, M ...1994 Volume 37 Issue 7 Pages 493-498
Published: June 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report the case of a 31-year-old, primigravida, who underwent vitrectomy for diabetic proliferative retinopathy and delivered a healthy baby without progression of her retinopathy.
She first manifested glucosuria in 1986, but no further examinations were performed. In 1988, she complained of left eye pain. Ophthalmologic examinations revealed diabetic retinopathy and her fasting plasma glucose value was 337 mg/dl and HbA1c was 12.5%. Her retinopathy progressed gradually under meticulous glucose control with insulin. Photocoagulation was performed on botheyes in 1989, and vitrectomy was required on her right eye 8 months later. Thereafter, her retinopathy subsided.
She became pregnant in 1991 and her HbA1c was 7.2% at that time. Under multidisciplinary discussion and management, her pregnancy course was uncomplicated, and she delivered a 3, 062g healthy baby by cesarean section at 39 weeks gestation. up to 6 months postpartum, her retinopathy showed no particular changes.
In the patient with proliferative retinopathy after vitrectomy, our experience suggests that intensive and careful management by a multidisciplinary medical team enables diabetic women to complete pregnancy without progression of major complications.View full abstractDownload PDF (3054K) -
Masayuki Inouye, Akimitsu Tsutou, Kyoya Narutaki1994 Volume 37 Issue 7 Pages 499-502
Published: June 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSUsing gas chromatographic mass spectrometry, we identified cholesteryl-6 (2, 6-di-tertialy butylphenol-4)-thioether (CT) in the urine of diabetics with hypercholesterolemia who were being treated with oral glibenclamide, 2.5 mg, and probucol, 500 mg/day.
Presumably probucol was hydrolyzed to form 4-mercapto-2, 6-di-tertialy-butylphenol (MBP), the MBP reacted with cholesterol-5 α, 6 α-epoxide, oxidized cholesterol, and CT was then formed as a result of dehydration and condensation reactions.
Probucol is expected to be useful in preventing diabetic macroangiopathy and removing oxidized cholesterol from the plasma into the urine.View full abstractDownload PDF (460K)
- |<
- <
- 1
- >
- >|