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Volume 40, Issue 6
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[in Japanese]1997 Volume 40 Issue 6 Pages 329-333
Published: June 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (1092K) -
Masaki Yamaguchi, Hajime Kimura, Yoshio Kano, Junko Kita, Genshi Egusa1997 Volume 40 Issue 6 Pages 335-340
Published: June 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWith the aim of elucidating whether or not the blood glucose level can be estimated from the saliva glucose level, this study was conducted to establish a sampling method utilizing available saliva for the determination of saliva glucose level (Study 1). Next, 75 g OGTT was carried out in six healthy adults and the time-course changes in blood and saliva glucose levels were simultaneously determined (Study 2). Then, OGTT was conducted in eleven patients with diabetes to examine the relation between these two levels (Study 3). The results from Study 1 showed that an ultrafiltration method using a filter which allows fractionation of substances with molecular weights of less than 5000 is most suitable. Study 2 revealed that the saliva glucose levels in normal subjects varied within a range of 1/50-1/100 of their blood glucose levels and the former level correlated positively with the latter showing a correlation factor of 0.76±0.10. In Study 3, the glucose levels in blood and saliva also correlated, showing a correlation factor of 0.78 or more, in the diabetic subjects. The present study demonstrated that a positive correlation does exist between the blood and saliva glucose levels in individual subjects.View full abstractDownload PDF (1017K) -
Takayuki Kobayashi, Tamio Ieiri, Michiharu Asada, Yasushi Kataoka, Tak ...1997 Volume 40 Issue 6 Pages 341-346
Published: June 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSPasteurella multocida has been implicated in a variety of infections, including pulmonary, skin, bone, joint, cardiovascular, and central nervous system infections. Urinary tract infections caused by P. multocida, however, are rare. We studied a case of urinary tract infection caused by P. multocida in a 70-year-old woman with a 22-year history of non-insulin-dependent diabetes mellitus. Her urine was positive for gram-negative bacilli, which were identified as P. multocida. The same bacilli were isolated from the oral cavity of her daughter's pet dog. Both bacilli were found to be identical in terms of biological properties, drug susceptibility profile, serotype, and plasmid type. The clinical impact of the infection of this patient was minimal. Her hemoglobin A1c level had clearly improved one year after disappearance of the bacilli. The main reason for the improvement in the urinary findings was cessation of animal contact due to the death of the dog, with the antibiotic treatment only being temporarily effective. These findings suggest that P. multocida urinary tract infection is almost asymptomatic, even if such infection results in an increased hemoglobin A1c level.View full abstractDownload PDF (966K) -
Shigeru Nakano, Fumitake Hotta, Tomohiko Ito, Takashi Ishii, Mitsutaka ...1997 Volume 40 Issue 6 Pages 347-353
Published: June 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report herein an elderly-woman with a pancreatic tumor, who showed transient glucose intolerance requiring insulin therapy. She was diagnosed as having NIDDM with moderately decreased urinary C-peptide excretion, but had no family history of diabetes. Although serum levels of amylase and pancreatic secretory trypsin inhibitor were slightly increased on admission, she had no complaints of abdominal pain or jaundice-associated symptoms except for weight loss and symptoms related to hyperglycemia. The main pancreatic duct was cystically dilated on CT scan. Furthermore, mucus excretion was endoscopically observed through the markedly dilated orifice of the enlarged ampulla of Vater, suggesting the presence of a mucin-producing pancreatic tumor. After pancreaticoduodenectomy for the pancreatic tumor, the specimen was confirmed to be an intraductal papillary adenoma. After removal of the tumor, glucose intolerance improved markedly, and insulin therapy was not required because of an increase in insulin secretion. Thus, decreased insulin secretion, probably due to partial obstruction by gradual growth of the pancreatic tumor, may have been involved in the preoperative deterioration of glucose tolerance in this patient.View full abstractDownload PDF (5443K) -
Ryuichi Kawamoto, Akihiro Yamada, Masanori Abe, Kensho Okamoto1997 Volume 40 Issue 6 Pages 355-362
Published: June 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 56-year-old man who had thirst and general malaise from July 13, 1996 was referred to this hospital at 4: 35 am on the 16th as he did not improve after treatment given by a neighborhood doctor. At the time of admission, he was delirious and suffering from Kussmaul respiration and excessive dehydration. Tests revealed that his blood sugar level was 968 mg/dl, blood gas pH 7.135, HCO3- 3.4 mEq/l, serum CPK 8, 250 U/l, myoglobin 21, 000 ng/ml, and urinary ketone bodies, and he was diagnosed as having diabetes mellitus with ketoacidosis (DKA) accompanied by rhabdomyolysis. Transfusion and continuous administration of a small amount of insulin was started immediately, and his consciousness and electrolysis substantially returned to normal after 12 hours. CPK and myoglobin levels gradually decreased. On the evening of the 17th, however, he developed abdominal pain and mucous hematochezia, and was found by endoscopy of the colon to have ischemic enteritis with a partially necrosed sigmoid colon on the 18th. The necrosed ileocecum was removed by emergency surgery and colonostomy of the sigmoid colon. These abnormalities were attributed to abnormal metabolism and circulatory insufficiency with DKA.View full abstractDownload PDF (5061K) -
Bunzo Matsuura, Emiko Matsuura, Takenori Sakai, Morikazu Onji1997 Volume 40 Issue 6 Pages 363-368
Published: June 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report a rare case of an emphysematous cholecystitis with an abdominal wall abscess in a diabetic patient. A 70-year-old woman was admitted to our hospital with complaints of fever, right hypochondralgia, and aright hypochondrial tumor. On admission, her diabetic condition was rather poor: blood glucose concentration before lunch was 214 mg/dl, stable HbA1c was 6.3%. Diabetic nephropathy, retinopathy, and neuropathy were not revealed. Abdominal ultrasonography and computed tomography showed air in the intrahepatic bile duct and the choledochus, air and stones in the cholecyst, and an abscess in the abdominal wall continuing from the cholecyst. She was immediately treated by percutaneous transabscess cholecyst drainage. Purulent bile containing Escherichia coli was detected. She had the complications of a diverticulum of the duodenum near the papilla of Vater, and a fistula between the cholecyst and the duodenum. Diabetic patients often have gallstones and occasionally develop emphysematous cholecystitis. We think a strict follow-up of diabetic patients with gallstones is necessary.View full abstractDownload PDF (5046K) -
1997 Volume 40 Issue 6 Pages 369-385
Published: June 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (4008K)
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