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Volume 38, Issue 12
Displaying 1-10 of 10 articles from this issue
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Takako Nemoto1995 Volume 38 Issue 12 Pages 921-929
Published: December 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe diagnostic significance of plasma 1, 5-anhydroglucitol (AG) in screening for diabetes mellitus was studied in 2150 subjects undergoing complete medical check-ups [1626 subjects with normal glucose tolerance (NS), 393 patients with impaired glucose tolerance (IGT) and 131 diabetic patients (DM)]. The assays of fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), plasma fructosamine (FRA) and AG were performed on samples taken from the subjects. The ratios of FPG to AG (FPG/AG), of HbA1c to AG (HbA1c/AG) and of FRA to AG (FRA/AG) were then calculated.
Receiver operating characteristic curves showed that AG and FPG/AG were superior to FPG, HbA1c, FRA, HbA1c/AG and FRA/AG as diagnostic tests for diabetes mellitus. An AG level lower than the cut-off value (15.5μg/ml) was noted in 5.4% of NS, 15.5% of IGT, and 90.1% of DM. Furthermore, an FPG/AG level higher than the cut-off value (6.0mg/dl/[μg/ml]) was found in 5.7% of NS, 19.8% of IGT, and 93.9% of DM. According to the diagnostic sensitivity and specificity of the tests, both AG and FPG/AG measurements were superior to FPG, HbA1c, FRA, HbA1c/AG and FRA/AG determinations for diabetes screening.
From the above results, it can be concluded that AG or FPG/AG measurements in screening for diabetes mellitus are useful in diagnosing diabetic patients.View full abstractDownload PDF (1554K) -
The Quantitative Assessment of Autonomic Nerve Dysfunction by Whole Body Scintigraphy after Intraarterial Infusion of 99mTc-Microsphere Albumin through the Femoral ArteryEisuke Takazakura, Kensou Ohsawa, Yasuhiko Ieki, Hiroshi Makino, Hikar ...1995 Volume 38 Issue 12 Pages 931-937
Published: December 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThis study evaluated whether the arterio-venous shunt rate (AVSR), calculated by the intraarterial infusion of 99mTc-microsphere albumin (MISA), can serve as a reliable index for the quantitative assessment of autonomic nerve disturbance in diabetics with various degrees of neuropathy. Ten diabetic patients with gangrene (group G) and 14 with (group N) and 14 without (group C) peripheral neuropathy were examined. 99mTc-MISA was injected percutaneously into both femoral arteries. The RI perfusion scans were performed, and radioactivity counts in the lungs and whole body were examined by scanning anteriorly and posteriorly, and AVSR were calculated.
Results: 1) AVSR in group G (7.1±1.3%) and group N (3.9±0.3%) were significantly higher than that in group C (1.9±0.5%)(p<0.001). 2) There wasan inverse correlation between AVSR and the coefficient of variation of 100 R-R intervals on ECG (r=0.48 p<0.01).
These results suggest that AVSR is a reliable index for quantitative assessment of autonomic nerve dysfunction in diabetics and that increased arterio-venous shunting blood flow is an important cause of diabetic gangrene.View full abstractDownload PDF (2492K) -
Hiroshi Nakamura, Takashi Katagiri, Osamu Nakagawa, Nagayuki Tani, Sei ...1995 Volume 38 Issue 12 Pages 939-943
Published: December 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe effects of dietary salt on glycemic response and gastric emptying time to a test meal were investigated. Twelve healthy volunteers ate three meals on consecutive mornings and in random order; the meals were 28.6g carbohydrate (1) without salt, (2) with 5g salt or (3) with 5g salt wrapped in a wafer. Gastric emptying time was assessed using an ultrasonic method. The blood glucose level (BS), serum concentrations of immunoreactive insulin (IRI), gastrin, and motilin were compared before and after each meal. The net increase in BS at 30 and 60 minutes after meal (2) or (3) was significantly larger than after meal (1). The net increase in IRI at 30 and 60 minutes after meal (2) or (3) was significantly larger than after meal (1). Gastric emptying half time after meal (2) or (3) was shorter than after meal (1). The serum level of motilin at 30 minutes after meal (2) or (3) was significantly higher than after meal (1). These results suggest that gastric emptying time after carbohydrate intake is shortened by administration of added salt. This effect is combined with an increased serum motilin level.View full abstractDownload PDF (707K) -
Chieko Bannai, Seiji Suzuki, Masato Odawara, Yasushi Kawakami, Teruhik ...1995 Volume 38 Issue 12 Pages 945-950
Published: December 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo examine the participation of oxygen radicals in the development of diabetic nephropathy, effects of an antioxidant (α-tocopherol acetate, 300IU/day) were evaluated in NIDDM patients. After 3 months, erythrocyte superoxide dismutase (SOD) activity was elevated in 8 of 11 patients. Five patients with decreased urinary albumin excretion (UAE) all had increased SOD activity, 2 of 4 patients with unchanged UAE also had increased SOD activity, suggesting a relationship between oxygen radicals and diabetic UAE.
After 12 months, UAE in 11 patients with α-tocopherol was not significantly changed, whereas UAE in 30 control NIDDM patients was augmented to 203±40%(P<0.005). Comparison between patients with UAE less than 300mg/gCr also revealed that α-tocopherol suppressed the development of albuminuria, i. e., UAE in 8 α-tocopherol patients increased from 65.3±25.8mg/gCr to 73.6±28.9mg/gCr and UAE in 24 control patients from 51.4±10.2mg/gCr to 160.8±73.6mg/gCr (p<0.005). UAE in 3 of 24 controls had exceeded 300mg/gCr. The results of this study sugget that since the antioxidant had beneficial effects on albuminuria in NIDDM, oxygen radicals contribute to the progression of diabetic nephropathy.View full abstractDownload PDF (776K) -
Masao Kanauchi, Hisayuki Nishioka, Tadatoshi Kikawa, Mayumi Akai, Taka ...1995 Volume 38 Issue 12 Pages 951-957
Published: December 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe relationship between clinical stage of diabetic nephropathy and renal structural changes in 156 patients with non-insulin-dependent diabetes mellitus was investigated. The clinical stages were classified into 5 stages according to the criteria of the Ministry of Health and Welfare: stage 1 (59 cases), normoal buminuria; stage 2 (50 cases), microalbuminuria; stage 3A (8 cases), persistent proteinuria with normal renal function; stage 3B (11 cases), persistent proteinuria with decreased GFR; stage 4 (21 cases), persistent proteinuria with decreased GFR and elevated serum creatinine levels. The remaining seven cases were unclassified. The renal biopsy specimens were semiquantitatively evaluated in regard to glomerular diffuse lesions, nodular lesions, vascular lesions and tubulo-interstitial lesions. In the stage 1 cases a minimal to moderate degree of diffuse lesions was observed, but none had nodular lesions. Vascular and tubulo-interstitial lesions were already observed at this stage. In the stage 2 cases more advanced alterations in diffuse lesions were observed associated with various changes in the vascular and tubulo-interstitial lesions, but nodular lesions were found in only five cases. More advanced alterations in diffuse lesions accompanied by nodular lesions were noted in the stages of 3A, 3B and 4. The grades of vascular and tubulo-interstitial lesions were also more severe in these stages. Seven elderly patients with microalbuminuria, decreased GFR and elevated surum creatinine levels, had a high prevalence of hypertension and ischemic heart disease. We concluded that diabetic patients with various clinical stages of nephropathy have different underlying diabetic renal lesions.View full abstractDownload PDF (1180K) -
Takashi Nagai, Tetuo Negishi, Takashi Tomizawa, Toshio Mitimata, Masat ...1995 Volume 38 Issue 12 Pages 959-964
Published: December 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 76-year-old man had been treated for diabetes mellitus at our hospital over a 30 year period. At the age of 71 years he developed diabetic retinopathy. Since the age of 73 years. his feet had felt numb, and a diagnosis of diabetic neuropathy was made. At 75 years of age, he complained of upper abdominal fullness, and endoscopic examination revealed superficial gastritis. An Abdominal echogram showed normal images of the liver, gallbladder and pancreas. The patient's HbA1c levels had ranged from 7.0 to 7.5% since age 72. developeda gait disturbance two days prior to examination. He was admitted because of left partial hemiparalysis, diagnosed as due to cerebral infarction. On admission his abdomen was full. On the 4th day, he developed hypovolemic shock after sudden voming. An Abdominal X-ray showed gastric dilatation. A chest X-ray showed pneumonia and pulmonary edema. A diagnois of hypovolemic shock and aspiration pneumonia as a result of acute gastric dilatation was made. The patient died as a result of multiple organ failure on his 7th hospital day. The acute gastric dilatation may have occurred because of gastric paralysis resulting from diabetic neuropathy.View full abstractDownload PDF (2792K) -
Hiroyuki Suzuki, Takafumi Miyake1995 Volume 38 Issue 12 Pages 965-969
Published: December 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 79-year-old man was admitted to our hospital because of left spermatic varicocele and chronic epididymitis. Although he had diabetes mellitus, he had gone without treatment for a long time before admission. His fasting plasma glucose levels exceeded 200mg/dl, so insulin therapy was started. Left orchiectomy was complicated by urinary tract infection immediately postoperatively. About three weeks after the operation the patient complained of fever, lower back pain, and right flank pain. His leukocyte count was 22, 200/mm3. A CT scan of the abdomen showed low density in the right iliopsoas muscle, and iliopsoas abscess was diagnosed. Various antibiotics had little effect, so the abscess was surgically drained. Pus culture yielded methicillin-resistant Staphylococcus aureus (MRSA). The abscess was drained and resolve. This far, many bacteria, including Staphylococcus aureus and β-streptococcus, have been reported as pathogens of iliopsoas abscess. To our knowledge this is the first case in Japan of iliopsoas abscess caused by MRSA.View full abstractDownload PDF (2403K) -
Zenzo Saito, Toshinori Imamura, Takehide Shinohara, Kouzi Kazinami, Ry ...1995 Volume 38 Issue 12 Pages 971-977
Published: December 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 33-year-old man was referred to us with complaints of anorexia, fever and left back pain.He had a past history of recurrent episodes of abdominal pain with diabetes mellitus and hyperlipidemia. His mother was obese and his father was treated for hypertriglyceridemia complicating diabetes mellitus.
Physical examinations revealed gynecomastia, obesity and small firm testes. Laboratory findings were microscopic hematuria with leucocytosis, and marked hyperglycemia with FBS over 300mg/dl associated with high levels of Hb-A1C, cholesterol, triglyceride, LDL, VLDL, chylomicrons and low HDL-cholesterol. Serum and urinary amylase pancreatic type levels were also more than double the upper normal limit during the clinical course.Radiological findings were compatible with acute pancreatitis and there was associated hyperchylomicronemia probably induced by urinary tract infection secondary to poor control of his diabetes mellitus.Endocrinological examination revealed low peripheral levels of testosterone and its metabolites, high basal levels of LH and FSH and hyper-response to LH-RH stimulation.Chromosome analysis showed mosaicism with a 46, XX/47, XXY karyotype.Testicular biopsy revealed nodularly proliferated Leydig cells and marked atrophy of the seminal tubulus.Blood sugar and lipid were controlled and the urinary tract infection improved with insulin and antibiotics.
This is the first case of Klinefelter's syndrome associated with diabetes mellitus and hyperlipidemic crisis. The relationship between the syndrome and the association with marked hyperlipidemia, diabetes mellitus and recurrent acute pancreatitis in this patient is discussed.View full abstractDownload PDF (2929K) -
2. Red Blood Cell Myo-InositolNoriyuki Kuroda, Satoshi Tada, Tatsushi Kajikawa, Michio Niimi, Toshih ...1995 Volume 38 Issue 12 Pages 979-983
Published: December 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIt is thought that diabetes mellitus causes increased polyol pathway activity and decreased tissue myo-inositol levels. We analyzed myo-inositol contents in red blood cells from normal and diabetic subjects by high-performance liquid chromatography with pulsed amperometric detection (HPLC-PAD) which is a sensitive and simple method. The RBC myo-inositol levels were 91.58±27.45 (mean±SD) nmol/gHb in the normal subjects (n=24), 151.71±53.16nmol/gHb in diabetic subjects without microangiopathy (n=41), and 253.64±79.10nmol/gHb in diabetic sublects with microangiopathy (n=14). Concentrations of RBC myo-inositol in diabetic subjects without microangiopathy were significantly higher than those in normal individuals (P<0.01). Moreover, a significant increase in myo-inositol levels was observed in diabetic patients who had microangiopathy, as compared to those without microangiopathy, in all examined samples (P<0.01) incl ding glucose-or HbA1c-matched samples (P=0.0018). Although it is well known that RBC myo-inositol is increased in patients with renal failure, we found that concentrations of RBC myo-inositol in diabetic subjects (170.32±63.42nmol/gHb, n=39) were still significantly higher than those in normal individuals (P<0.01) even with a normal serum creatinine level. On the basis of these results, we suggest that determination of RBC myo-inositol by the HPLC-PAD method is useful for evaluating diabetic microangiopathy.View full abstractDownload PDF (674K) -
1995 Volume 38 Issue 12 Pages 985-992
Published: December 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (2107K)
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