[Metabolic disorders in the development of macroangiopathy].
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Biomedical subjects
Publications and source records attributed to M Tsushima.
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To clarify the relationship between the 3,5,3'-triiodothyronine (T3) response and the insulin response after glucose ingestion in humans, serum T3, immunoreactive insulin (IRI), C-peptide immunoreactivity (CPR), nonesterified fatty acid (NEFA) and plasma glucose levels were measured in 11 nonobese inpatients with normal glucose tolerance after oral 75 g glucose tolerance test. Ingestion of the glucose solution significantly increased serum T3 levels from 120.1 +/- 4.1 ng/dl to 132.5 +/- 4.4 ng/dl (P less than 0.01) at 60 min after glucose ingestion and it continued to increase after 3 h. Serum IRI and CPR levels peaked at 60 min (P less than 0.01, respectively) after glucose ingestion and they also continued to increase after 3 h. Plasma glucose levels peaked at 30 min (P less than 0.01) after glucose ingestion and then decreased to basal level after 3 h. Negative correlation was found between sigma T3 level and sigma IRI level (r = -0.75), and between sigma T3 level and sigma IRI/sigma glucose ratio (r = -0.88). Negative correlation was also found between basal T3 level and sigma IRI level (r = -0.82). No correlation was found between sigma T3 level and sigma CPR level. Positive correlation was found between sigma glucose level and sigma dT3 level (r = 0.74), and between sigma dglucose level and sigma dT3 level (r = 0.81). The findings suggest that T3 regulates insulin level in the circulation after glucose ingestion and the increase in serum T3 levels after glucose ingestion is necessary for the glucose removal from the circulation in humans.
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In order to clarify the effects of insulin on the cardiovascular system in patients with and without coronary heart disease (CHD), we studied the changes of electrocardiogram (ECG), blood pressure, pulse rate, along with those of blood glucose, free fatty acid, immunoreactive insulin, cortisol and potassium during insulin tolerance test (ITT). The presence or absence of CHD was verified by the coronary angiography and various stress testings beforehand. In patients with CHD, ischemic ST-T wave changes were recorded following the increment of double product after insulin injection and these changes were quite similar to those recorded during exercise test. In patients without CHD, although hypoglycemia and suppression of lipolysis were achieved, ischemic ST-T wave changes were not recorded after insulin injection. Furthermore, in a patient with Triple Vessel Disease, ischemic changes of ECG provoked by ITT were abolished completely by the administration of nifedipine and propranolol. ITT may induce ischemic changes of ECG in patients with CHD by different mechanisms from those of exercise tests and it may provide a useful tool for the diagnosis of CHD in clinical applications.
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A 62-year-old man with 11 years' duration of type II diabetes was hospitalized because of non-ketotic diabetic coma. He had never noted any symptoms of swallowing difficulty until 3 days before admission when they developed gradually and he became comatous. He had never received special medication such as diuretics except anticonvulsants. Even after the recovery from diabetic coma he could hardly swallow solid foods or saliva for about 15 days, but these symptoms subsided gradually. Motility dysfunction of esophagus and pharynx in diabetes mellitus, in most cases they are mild, has been described, although diabetic coma preceded by dysphagia has not been documented except in one report. We studied, therefore, the autonomic nerve function of the present patient and discussed the relationship between dysphagia and diabetic coma together with the description of the clinical course of this patient. The relationship between this case and the previously reported cases were compared in terms of the sex, age, type of diabetes, clinical course, medication and the autonomic nerve function.
We studied the changes of glandular kallikrein activity in plasma of nine normal female volunteers, aged 22.2 +/- 1.20 years (mean +/- SEM), following 75 g glucose ingestion along with those of immunoreactive insulin, C-peptide immunoreactivity, free fatty acid and blood glucose using our recently developed assay system for plasma glandular kallikrein activity. Glandular kallikrein activities decreased initially from mean baseline level and then returned to baseline level with the lapse of time after glucose load. Furthermore, in hyperinsulinemic group, mean glandular kallikrein activities at 120 min after glucose load revealed to be significantly higher than those of normoinsulinemic group. The findings suggest that active glandular kallikrein is consumed and utilized during glucose uptake at the peripheral tissues, and hyperinsulinemia brings about prolonged activation of kallikrein-kinin system.
We assessed the effects of a pared diet (20, 60 or 150 g/day for days 6-20 after coitus) on the course of pregnancy in rabbits. Dams receiving 20 g/day manifested a marked weight loss, 5 of 6 animals aborted and in the remaining dam, the litter size, fetal and placental weight were significantly lower than in the controls. In the 60 g/day group, the maternal body weight remained stable throughout the observation period; the number of dead embryos on fetuses was significantly higher, that of liver fetuses lower, than in he controls. Feedings on the 150 g/day group did not markedly differ from the controls, indicating that pregnant rabbits require at least 150 g of food/day.
In an attempt to correlate xanthomas with atherosclerosis, the characteristics of serum lipid and lipoprotein profiles are explored in xanthoma patients. Xanthomas are classified into 5 subtypes: xanthelasma, planar xanthoma, papulo-eruptive xanthoma, tuberous xanthoma and tendon xanthoma. The clinical characteristics of xanthoma patients are summarized in the following. 1) Xanthelasma in 2 different types: one normolipemic and the other hyperlipidemic; of 30 xanthelasma patients, 5 were normolipemic, one of them had low HDL-cholesterol. 2) Tuberous and tendon xanthomas were all hypercholesterolemic, with serum cholesterol above 300 mg/dl and LDL-cholesterol above 255 mg/dl, while HDL-cholesterol was within normal range. 3) The xanthoma patients were generally not obese. 4) Their laboratory findings often showed such abnormalities as elevated levels in serum fibrinogen, LDH, CPK and uric acid. The resemblance of the clinical characteristics between xanthomas and atherosclerotic vascular disease, e.g., myocardial infarction, was striking. If the causation of their common tissue alterations by lipid accumulation is pathologically and biochemically defined, the correlation between those 2 kinds of disease can be established.
Food and water intake and the excretion of urine and faecal pellets during the day (0500-2100) and at night (2100-0500) were observed in Afghan pikas, rats and guineapigs fed appropriate diets. Urine composition was observed in these species after they had been fed the pika diet for 4 weeks. Rats ate more at night than did pikas or guineapigs. The pikas excreted numerous small, hard faeces and soft faeces, the latter being reingested. On the pika diet all species gained about 10% in bodyweight. Food consumption was similar to that shown by each species on its own diet. All animals fed the pika diet excreted alkaline urine. Chloride concentration in pika urine was similar to that of the rat and was significantly higher than that of the guineapig. The ratio of sodium to potassium in pika urine was 2.8 and 1.7 fold that of the rat and guineapig respectively. Osmolality of pika urine was slightly higher than that of the rat, and was 3.8 fold that of the guineapig.
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The audiotoxic effect of sisomicin was investigated in guinea pig injected intramuscularly with 6.25, 12.5, 25 and 50 mg/kg of sisomicin sulfate (potential) during weeks 1--5 or 5--9 of pregnancy, and the transplacental effect on their offspring was studied. While, in some dams the higher doses of sisomicin produced a limited effect on the pinna reflex and the outer hair cells of the organ of Corti, no such effects were noted in any of the offspring during the 3-week postnatal observation period.
Since there are some patient groups whos symptoms do not improve despite the fact that the use of the antidepressants will alleviate the symptoms to some extent, we have conducted a TRH test for depression and found that there are not a few cases who show a low TSH response. We therefore used a small amount of T3 together with the antidepressants in these cases and have found that the therapy is useful for improvement of tye symptoms. When the TRH test is made at the time of improvement of the symptoms due to the combined use of these two drugs and compared with the state at pre-treatment, it has been confirmed that the TSH response will go back to normal. Hence, we would like to present here two markedly improved cases due to the combined use of imipramine and clomipramine plus T, and to refer to the result of the TRH test.
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A new method has been developed for the quantitative assessment of atherosclerotic lesions, in which a conventional xerox machine is the sole equipment used. As an example, the aorta from a cholesterol-fed rabbit was removed in toto, opened longitudinally along its anterior margin, flattened in a transparent polypropylene bag and then xeroxed. The outlines of the atherosclerotic lesions were traced on translucent graph paper ruled into 1 mm squares. The squares within those outlines were counted and expressed as a percentage of the whole surface. This xerographic method is rapid and reproducible and is achieved without changing the magnification; it gives comparable or better results than other staining methods. As the aortic specimen is undamaged by fixation or staining, the specimen can be used for subsequent morphological or biochemical studies. Thus, the degree of surface involvement can be correlated with other morphological or biochemical changes in the same arterial samples.
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