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Volume 37, Issue 9
Displaying 1-9 of 9 articles from this issue
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Chiaki Kitaoka, Yasuko Uchigata, Satomi Minei, Meimi Shimizu, Mayumi S ...1994 Volume 37 Issue 9 Pages 641-648
Published: September 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo investigate the pathogenesis of deterioration of diabetic retinopathy in pregnancy, insulin like growth factor-I(IGF-I) in serum was measured periodically during pregnancy. The subjects were 137 pregnant diabetics consisting of 42 insulin dependent and 95 non insulin dependent diabetics. Forty-seven normal age-matched pregnant women served as controls. Serum samples extracted with acid-ethanol were subjected to radioimmunoassav for IGF-I. Normal pregnant women showed a 1.5-fold physiological increase in IGF-I during pregnancy. Roth IDDM and NIDDM pregnant women showed the same longitudinal change in IGF-I as normal pregnant women. NIDDM subjects tended to show a higher IGF I level than IDDM, but the difference was not singnificant. Sixty percent of patients who experienced proliferative retinal deterioration, around 20 weeks of pregnancy had a preceding, transient rise in serum IGF-I, and these patients tended to show larger changes in serum IGF-I.
In conclusion, our observations suggest a correlation between serum IGF-I levels and proliferative deterioration of retinopathy in pregnant diabetics.View full abstractDownload PDF (1179K) -
Isao Okada1994 Volume 37 Issue 9 Pages 649-657
Published: September 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIn order to elucidate the cause of an increase in urinary protein excretion, upon standing, in diabetic patients with orthostatic hypotension (OH), responses of heart rate, blood pressure, renal hemodynamics and urinary albumin (ALB) excretion rate to the postural change from supine to standing were investigated in groups of diabetics without OH (n=17) and with OH (n=24). Furthermore, urinary protein fractions were determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis in 9 with OH and 8 without OH, and urinary proteins were divided into three classes high molecular weight proteins (HMWP), ALB and low molecular weight proteins (LNIWP). In the standing position, heart rate was elevated in the two groups, but no statistically significant differences were found. The group of diabetics with OH showed a significant decrease in systolic blood pressure, which exceeded 30mmHg. Renal plasma flow (RPF) was reduced in both groups, and marked reductions were observed in the group of diabetics with OH. Renal glomerular filtration rate (GFR) was unchanged in the group of diabetics without OH. In contrast, GFR was significantly (p<0.001) medunced in the gmoup of diabetics with OH. In the diabetics with OH, urinary HMWP, ALB and LMWP excretion rates were all increased significantly (p<0.05, respectively), whereas no changes were observed in the group without OH. These results indicate that OH affects the renal function of diabetics, as evidenced by the elevations in urinary HMWP, ALB and LMWP excretion rates with decreased RPF and GFZ. An increase in proteinuria upon standing, with OH, is apparently caused by renal glomerular and tubular dysfunction. OH may be considered to affect renal function in patients with diabetic nephropathy.View full abstractDownload PDF (1389K) -
Toshiaki Sato, Yohji Masaki, Nobuyuki Oka, Kazumi Notsu, Hiroshi Furuy ...1994 Volume 37 Issue 9 Pages 659-665
Published: September 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe measured blood pressure (BP) for 24hr in 61 patients with non-insulin dependent diabetes mellitus (NIDDM) and 10 healthy control subjects by the use of a non-invasive ambulatory BP monitoring system (TM-2420).
In the control subjects, mean (±SD) levels of systolic BP during the daytime (0900-2300) were higher than in the nocturnal period (2300-0700)(114±12 vs 100±9mm Hg, p<0.05). In 46 out of 61 diabetic patients (group A), the circadian rhythm of systolic BP was similar to that of controls (day 120±61 vs night 108±15mm Hg, p<0.05). On the other hand, in 15 patients, mean systolic+BP levels at night were much higher than those during the daytime (group B)(135±16 vs 27±12mm Hg, p<0.05). Group B had a higher incidence of hypertension and diabetic nephropathy that did group A. Serum creatinine levels and CCr were significantly greater in group B than in group A. In contrast, CV% of R R intervals on ECG at rest and after deep breathing were significantly lower in group B than in group A.
In the diabetic groups, the difference in mean systolic BP levels during the daytime, as compared to at night. was significantly related to both CV% and CCr.
These findings indicate that impaired circadian rhythm of BP is closely related to altered parasympathetic nervous system function and diabetic nephropathy in NIDDM.View full abstractDownload PDF (1120K) -
Yasushi Tanaka, Atsunori Kashiwagi, Hiroshi Maegawa, Takayuki Asahina, ...1994 Volume 37 Issue 9 Pages 667-674
Published: September 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe evaluated the effect of a 6-month-exercise training program on exercise capacity and glucose tolerance in 53 obese women (26-62y.o.47±9: mean±SD), showing an obesity level of over 20% on the obesity index (OI) with no medical problems except for an abnormality in glucose tolerance. We prescribed an exercise program based on an anaerobic threshold (AT) value obtained from ventilatory analysis during a bicycle ergometer test. The results of 75g-OGTT in all subjects significantly improved from the pre-training state (normal: 32% impaired glucose tolerance (IGT): 62%/diabetic (DM): 6%) to the post-training state (normal: 57%/IGT: 41%/DM: 2%)(P<0.01). The group which had acquired a habit of exercise training (ex-acquired group, n=30) showed both remarkable decreases in Σplasma glucose concentration (PG, -108mg/dl, P<0.01) and ΣIRI (-54μU/ml, P<0.01) during OGTT with a signficant improvement on OI, body mass index (BMI) and waist/hip ratio (W/H). However, the group which had not acquired the habit of exercise (n=23) did not show any significant change in glucose or IRI concentrations. The group which increased their V02, at the AT level, by 15% more as compared to that obtained prior to training (n=12) also showed remarkable decreases in both ΣPG (-153mg/dl, P<0.01) and ΣIRI (-54μU/ml, P<0.01), as compared with those in the group whose VO2, at the AT level, changed less than 14%(n=18).
Thus, we conclude that regular exercise training can lead to improvements in insulin sensitivity and glucose tolerance with an increase in exercise capacity in obese subjects. Therefore, education to reinforce the habit of exercise training, as a public health service, may contribute to the prevention of the onset of overt diabetes in obses subjects.View full abstractDownload PDF (1531K) -
Yutaka Kishi, Hideyuki Sasaki, Keigo Naka, Gensaku Matsumoto, Yoshio N ...1994 Volume 37 Issue 9 Pages 675-680
Published: September 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDiabetic macroangiopathy, especially cerebrovascular disease, is becoming a more serious problem in diabetes mellitus patients as life-spans increase. In this study, we attempted to clarify clinical features of cerebrovascular disease in diabetic patients.
Clinical features of cerebrovascular disease were studied in 69 diabetic patients admitted to our hospitals over a 5 year period (1987-1992). Furthermore, we examined changes in blood pressure and HbA1c before the onset of cerebral infarction in 24 patients.
Cerebral infarction (90%), transient ischemic attack (6%) and cerebral hemorrhage (4%) were diagnosed. Thirty patients (53%) had multiple lesions and 35 patients (61%) suffered from lacunar infarctions of penetrating arteries. The distribution of ages at onset of cerebral infarction showed two peaks. The patients could be divided into two groups; a middle aged group (65 years old and under) and an elderly group (66 years old and over). Significantly higher levels of hemoglobin A1 c, triglyceride and uric acid were observed in the middle aged group than in the elderly group. Significant declines in systolic blood pressure, before the onset of cerebral infarction, were observed in the group receiving hypotensive medications.
These findings suggest that small, multiple cerebral infarctions are characteristic of diabetic patients, and that metabolic disturbances accompanying diabetes mellitus may accelerate the onset of cerebral infarction. It is suggested that there is a relationship between a blood pressure fall and an episode of cerebral infarction.View full abstractDownload PDF (1003K) -
Toshiyuki Nakamura, Tomonori Tsuchiya, Nobuhito Onogi, Masahiro Tajika ...1994 Volume 37 Issue 9 Pages 681-685
Published: September 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 42 year old male who had been diagnosed with diabetes mellitus and Charcot-Marie-Tooth disease was admitted to our hospital because of general fatigue, nasal and gingival bleeding, and petechie on the extremities. Treatment with glibenclamide had been changed to chlorpropamide ten days before admission because the patient's diabetic state could not be adequately controlled. His platelet count was 0.3×104/mm3, but both the white cell count and red cell counts were normal. The megakaryocyte count in the bone marrow was also normal. The IgG level on the surface of the platelets had increased to 624ng/107 platelets. Chlorpropamide was discontinued, and platelet transfusions, prednisolone, and insulin were started. The platelet count was normal (17×104/mm3) one week later and his symptoms were relieved. Thrombocytopenia recurred after accidental re-administration of chlorpropamide, demonstrating that the thrombocytopenia observed in this patient was caused by chlorpropamide, probably via immunological mechanism (s).View full abstractDownload PDF (2727K) -
Tsutomu Araki, Yohei Tofuku1994 Volume 37 Issue 9 Pages 687-693
Published: September 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report a case of diabetes mellitus associated with emphysematous cystitis and prostatic abscess. A 56-year-old man was admitted to the hospital because of general weakness, fever, hematuria and pneumaturia. He had taken insulin from the age of 45 until two months before admission. Diabetic ketoacidosis and emphysematous cystitis were diagnosed based on laboratory data and the findings of gas in the bladder on abdominal X-P. He was immediately treated with insulin and antibiotics. Nonetheless, he developed disseminated intravascular coagulation with high fever and marked leukocytosis. Based on the findings of a low density area in the prostate on pelvic CT, prostatic abscess was diagnosed and treated conservatively with antibiotics. Five weeks after admission, the prostatic abscess disappeared on pelvic CT in association with a general improvement in his condition. Emphysematous cystitis and prostatic abscess are frequently associated with diabetes mellitus. If urinary tract infection occurs in patients with poorly controlled diabetes mellitus, early diagnosis based on abdominal X-P, ultrasonography and computed tomography, as well as early treatment including surgery, are necessary.View full abstractDownload PDF (3064K) -
1. Red Cell SorbitolNoriyuki Kuroda, Satoshi Tada, Tatsushi Kajikawa, Michio Niimi, Toshih ...1994 Volume 37 Issue 9 Pages 695-698
Published: September 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA sensitive and simple method of high-performance liquid chromatography with pulsed amperometric detection (HPLC-PAD) has been developed to determine red cell sorbitol, a potentially useful indicator of diabetic complications. Red cells were hemolyzed with deionized water and deproteinized with ultrafilter Centricon-10. Red cell sorbitol was separated with sugar pak Pb columns, eluted with deionized water at 80°C, and detected using PAD. The standard curve for sorbitol was linear up to 10.0μg/ml.The CVs for within-run precision (n=20) were 9.81% at 0.24 μg/ml and 2.65% at 4.18μg/ml. Analytical recovery was 99.3%. Red cell sorbitol values determilled by the enzymatic method (X) were higher than those obtained by the HPLC-PAD method (Y)(n=25, y=0.45x+7.80, r=0.804, X=45.04nmol/gHb, Y=28.38nmol/gHb). We analyzed red cell sorbitol from normal subjects and diabetic subjects. The sorbitol levels were 17.27±9.12 (mean±SD) nmol/gHb in the normal subjects (n=11), 31.00±12.29nmol/gHb in diabetics without complications (n=16), and 61.10±25.11nmol/gHb in diabetics with complications (n=6). The HPLC-PAD method for red cell sorbitol will be useful in assessing polyol abnormalities in diabetes mellitus.View full abstractDownload PDF (507K) -
1994 Volume 37 Issue 9 Pages 699-712
Published: September 30, 1994
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (3207K)
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