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Volume 45, Issue 7
Displaying 1-10 of 10 articles from this issue
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Yasuo Kida2002 Volume 45 Issue 7 Pages 457-464
Published: July 30, 2002
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSProlongation of the QT interval due to autonomic neuropathy has been considered a possible mechanism of sudden cardiac death in diabetic subjects, but the acuracy of QTc determined by Bazett's equation (BQTc) has come into question.Because significant inverse correlation between the BQTc and RR interval after conversion of QT by Bazett's equation (QT/RR1/2), alinear regression equation has been recomended in the Framingham heart study to determine QTc. Vagalneuropathy in diabetes tends to be associated withrelative tachycardia (RR interval shortening) and results in QTc overestimation when use BQTc in subjects with autonomic neuropathy. We determined QTc using a regression-based method (NQTc: QT+[1-RR]×143) as mentioned in the Framingham heart study. We compared the relationship of RR and QT and BQTc and NQTc between type-2 diabetes (group D) and age-matched controls (group N) with normal resting ECG. We also studied BQTc as a marker of diabetic cardiac autonomic neuropathy.(1) Theregression curve was linear and significantly positively correlated between QT and RR in both groups. On the contrary, the BQTc showed an inverse correlation with the RR in both groups. NQTc was independent of RR in both groups suggesting NQTc was appropriately adjusted for the heart rate (QT interval at 60 bpm).(2) NQTc is significantly longer in group D than in group N, and in women than in men.(3) Because of the significant correlation between.heart rate and RR-interval variation (CV) and orthostatic change in systolic blood pressure (ΔSBP), influence of these autonomic nerve functions on BQTc becomes less significant when adjusted to the heart rate. The relationship between NQTc and CV or ΔSBP is still consistent even after being adjusted for age, gender, and heart rate. This data indicates that previously reported QTc prolongation in subjects with autonomic neuropathy using Bazett's equation may be due, at least in part, to decreased RR interval induced overestimaiton of QTc. The simple measurement of NQTc based on the linear regresson curve could thus be a useful marker for evaluating QTc prolongation due to diabetic cardiac autonomic neuropathy.View full abstractDownload PDF (1470K) -
Yoshiji Ogawa, Jun Matsui, Takashi Goto, Naoki Tamasawa, Yusuke Tando, ...2002 Volume 45 Issue 7 Pages 465-469
Published: July 30, 2002
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe studied the effects of glimepiride on lipid metabolism compared to glibenclamide, focusing on small dense LDL related to both insulin resistance and atherosclerosis.Glimepiride therapy was started to 21 diabetic patients who had treated with glibenclamide. Two months after the regimen change, serum IRI significantly decreased (9.1±5.7 to 6.3±3.2, p<0.05), and LDL density decreased significantly (0.40±0.02 to 0.32±0.05, p<0.01) in 7 patients who had small dense LDL. These results suggested that glimepiride may increase LDL size, which would improve lipid metabolisrn and prevent the development of atherosclerosis.View full abstractDownload PDF (679K) -
Evaluation by Scatchard AnalysisNoriko Sakamoto, Yoichi Sakamoto, Michihiko Maruyama, Akira Tsuruoka, ...2002 Volume 45 Issue 7 Pages 471-476
Published: July 30, 2002
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 38-year-woman admitted in March 1999 for prolonged fasting hypoglycemiaand postprandial hyperglycemia since February 1998 was diagnosed with type 1 diaebetes mellitus with ketosis in 1997. She was treated with human insulin and initially well-controlled. 125I-insulin binding was 83% and fasting plasma total IRI 1700μU/ml. Scatchard analysis of the insulin antibody demonstrated a low affinity constant (0.18×108M-1) and high binding capacity (10×108M) of high-affinity binding sites. Insulin antibody binding was similar to that in insulin autoimmune syndrome. Binding capacity decreasedin hypoglycemia more than in hyperglycemia, suggesting that the large amount of insulin bound to the insulin antibody in hyperglycemia was gradually released from the antibody and caused prolonged fasting hypoglycemia due to the large amount of free insulin. We concluded that the patient's fasting hypoglycemia and postprandial hyperglycemia were mainly due to an alteration in insulin pharmacokinetics induced by the insulin-binding antibody.View full abstractDownload PDF (1088K) -
Hisao Wakasaki, Masayuki Nishino, Toru Hamanishi, Masato Kobayashi, Hi ...2002 Volume 45 Issue 7 Pages 477-482
Published: July 30, 2002
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSCentral pontine myelinolysis (CPM) complicating severe hyponatremia or serum hyperosmolarity has been widely reported, but few reports cover central pontine myelinolysis in diabetes. We describe an untreated diabetic case presenting typical magnetic resonance imaging (MRI) findings following left-sided muscle weakness and involuntary movement in the absence of documented electrolyte changes. Sustained hyperosmotic status following hyperglycemia may contribute to causing CPM.View full abstractDownload PDF (2220K) -
Kazuomi Watanabe, Naoto Ishizaki, Mamoru Inoue, Tadashi Yano, Yoshihar ...2002 Volume 45 Issue 7 Pages 483-488
Published: July 30, 2002
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSPosttreatment painful neuropathy (PPN) is acute painful neuropathy which occurs in a poorlycontrolled diabetic subject after glycemicontrol. We report a case in which PPN was successfully cured with transcutaneous electrical nerve stimulation (TENS). A52-year-old man with type 2 diabetes gradually developed painful neuropathy in the back and leg shortly after glycemic control by subcutaneous insulin injection in September 1998. Despite strict treatment with Mexiletine and PGE1 from February 1999, his subjective symptoms worsened. TENS therapy was applied at the painful area (40-100Hz) and acu points (1.3Hz). After 9 sessions of TENS therapy for 15 days, the area and intensity of pain both in the back and leg were obviously reduced. We concluded that TENS therapy had a considerable analgesic effect, and consequently patient symptoms reduced.View full abstractDownload PDF (983K) -
Ikuo Yamamori, Akiko Muramoto, Seiko Takefuji, Haruhiko Hasegawa2002 Volume 45 Issue 7 Pages 489-493
Published: July 30, 2002
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 75-year-old woman with dimentia hospitalized for sustained myoclonic seizure with disturbed consciousness and hyperglycemia had been demented 4 years and diabetic 2years. Physical examination showed a deeply comatose, markedly dehydrated woman with pendular nystagmus. Several diabetic bullae were noted on her skin. Serum chemistry was sodium 173 mEq/l, plasma glucose 545 mg/dl, and HbA1c 10.6%. Urine was negative for ketone bodies. Arterial blood pH was 7.463. The clinical diagnosis was nonketotic hyperosmolar diabetic coma. She did not recover consciousness even after serum sodium was decreased with fluid and insulin infusion. Brain computed tomography (CT) showed marked cerebral edema on hospital day 4, followed by a large infarct with hemorrhage in the left hemisphere on hospital day 11. Sagittal sinus thrombosis was diagnosed on hospital day16. Due to the large cerebral infarct, she remained unconscious even after brain edema gradually subsided. To the best of our knowledge, this is the first case report of deep cerebral venous thrombosis complicated by a nonketotic hyperosmolar state. Chronic hemoconcentration secondary to poorly controlled diabetes appeared to be a predisposing factor in the unusual comorbidity in this case.View full abstractDownload PDF (1264K) -
[in Japanese], [in Japanese]2002 Volume 45 Issue 7 Pages 495-499
Published: July 30, 2002
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESS -
[in Japanese]2002 Volume 45 Issue 7 Pages 501
Published: July 30, 2002
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (94K) -
[in Japanese], [in Japanese]2002 Volume 45 Issue 7 Pages 502
Published: July 30, 2002
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (74K) -
2002 Volume 45 Issue 7 Pages 503-511
Published: July 30, 2002
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (2577K)
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