The prevalence and clinical features of diagnosed mellitus secondary to chronic pancreatitis (CP) were assessed from northern (Hokkaido) to southern (Okinawa) Japan by means of a questionnaire to elucidate whether WHO-classified malnutrition-related diabetes mellitus (MRDM) exists in Japan. Of a total 17,500 diabetic patients, only two (0.011%)-one fibrocalculous pancreatic diabetes (FCPD) and one protein-deficient pancreatic diabetes (PDPD) - exhibited MRDM characteristics. A total of 649 CP were collected and classified into 268 cases with chronic alcoholic pancreatitis (CAP), 150 cases with chronic calcified pancreatitis (CCP) and 231 cases with other CP. The prevalence of diabetes mellitus was found to be 50.7% in CAP, 72.7% in CCP and 22.8% in other CP. Among all diabetics, 56.6% was noninsulin-dependent (NIDDM) and 26.4% insulin-dependent (IDDM). IDDM was most frequent in CP. Satisfactory and less than satisfactory glycemic control was obtained in approximately three quarters of all subjects. Only one quarter showed poor glycemic control. Insulin treatment was frequent in CAP (52.2%) and CCP (61.7%), but less in other CP (27.5%). The prevalence of diabetic retinopathy was observed in 33.1% of all subjects, nephropathy 21.0% and neuropathy 36.3%, respectively. The prevalence of complications, including macroangiopathy tended to be higher in CAP and CCP (40.3 and 56.9%) than in other CP (31.4%).

Blood Glucose↗

PubMedDate not supplied

Cerebral amyloid angiopathy in an aged great spotted woodpecker (Picoides major).

A male great spotted woodpecker (Picoides major), which was at least 16 years old, died due to general weakening. Cerebral vascular walls, including capillaries, were positively stained with Congo red with green-gold birefringence, and some of which showed a severe deposition of the Congophilic materials resulting in a corona-like fibrillar radiating structure. The Congophilic materials were positive for beta amyloid protein, but negative for prion protein. Only a few senile plaque-like structures were observed in the cortex by PAM stain and beta amyloid immunostain. The present case is the first observation of cerebral amyloid angiopathy in avian species and will indicate the presence of such age-related cerebral lesions also in birds.

Animals↗

PubMedDate not supplied

Lumbar sympathetic block for pain relief in two patients with interstitial cystitis.

BACKGROUND AND OBJECTIVES: Interstitial cystitis (IC) is characterized clinically by lower abdominal pain, pain during urination, and increased frequency of urination. Treatment of the symptoms in IC remains challenging. We report effective treatment using lumbar sympathetic block for 2 patients with IC. CASE REPORT: A 63-year-old and 78-year-old woman were diagnosed with IC. Medical therapy with nonsteroidal anti-inflammatory drugs (NSAID), anticholinergics, and hydrodistention of the bladder failed to improve their symptoms. Subsequently, a continuous lumbar epidural block using 1% mepivacaine was used in these patients. A transient reduction of the symptoms in both patients was achieved. A lumbar sympathetic block with a neurolytic agent produced almost complete, and long-lasting relief of their symptoms. CONCLUSION: Lumbar sympathetic block using a neurolytic agent produced long-lasting pain relief in 2 patients with IC. Reg Anesth Pain Med 2001;26:271-273.

Aged↗

PubMedDate not supplied

Development of a vascular prosthesis for a growing child. A graft expandable in vivo.

Specially designed vascular prostheses that can be dilated after implantation using a percutaneous transluminal angioplasty (PTA) balloon catheter have been developed. The grafts are made of woven polyester fiber fabrics, the circumferential yarns of which consist of two different types of polyester fiber bundles: One is a straight weak bundle, the other is a strong bundle wound around the former. The graft with an initial diameter of 6 mm could be dilated to 9 mm by luminal inflation of the balloon four to five times at 10 atmospheres (atm) in vitro. After disrupting the weak bundle by the dilatation procedure, the strong bundles were straightened, which maintained the enlarged diameter of the new caliber. Grafts of 6 mm in initial diameter implanted into the thoracic aortas of mongrel dogs for 3 months also could be dilated in vivo by inflating the PTA four to five times at 15 atm, as found in the vitro study. Macroscopic observation revealed that, around the dilated grafts, only a tiny hematoma was formed and nominal subsequent bleeding was observed, which indicated that the dilatation procedure was performed safely. The graft, which enables adaptation of the hydrodynamic property of the graft to the increased blood flow by PTA after implantation, is applicable in a growing child.

Angioplasty, Balloon↗