[A case of Paget's disease found by chance on the examination for blunt trauma].
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Biomedical subjects
Publications and source records attributed to N Tajima.
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In the objective judgment of the therapeutic effects and in the comparison of results in institutions and treatment methods, it is essential to introduce the technique of scientific and statistical analysis, in the clinical evaluation. We have tried to clinically evaluate lumbago and sciatica using the technique of multiple regression analysis. Selection of evaluation item and allocation of scores to the item were carried out in 104 patients. Multiple regression analysis was carried out in all patients and the standard regression coefficient showed a correlation with criterion variable (dependent Y) in the order of walking, pain, posture, paralytic symptom in lower limbs and SLR (straight leg raising test). The proportion was 0.69, which seems to be a nearly valid value when other factors are considered.
Diabetic autonomic neuropathy was expressed quantitatively using the coefficient of variation of R-R intervals (CVR-R) in ECG and its critical level where diabetics were plagued with various symptoms was investigated. The subjects were 58 diabetics under the age of 40 years. ECGs were recorded in the resting supine position and the degree of autonomic neuropathy was expressed as CVR-R by processing 100 consecutive R-R intervals. Symptoms caused by diabetic autonomic neuropathy were determined using a questionnaire. CVR-R were 1.10 +/- 0.34% (mean +/- SD) and 4.31 +/- 2.01% in patients with and without orthostatic hypotension respectively, the former being significantly lower. CVR-R were 1.30 +/- 0.88% and 3.81 +/- 1.31% in those with and without impotence respectively, the former being significantly lower. CVR-R were 0.80 +/- 0.14% and 3.85 +/- 2.17% in those with and without diabetic diarrhea respectively, the former being significantly lower. Concerning sweating abnormality CVR-R were significantly reduced in subjects exhibiting gustatory sweating (1.52 +/- 0.74%) and hypohidrosis (2.26 +/- 1.44%) when compared to those without these symptoms. From the results obtained, a CVR-R of 2% can be considered as the critical level which determines whether symptoms due to diabetic autonomic neuropathy will appear or not.
In order to estimate the strength of normal and spondylolytic vertebrae, vertebrae with laminectomy, anterior fusion, posterior fusion, and postero-lateral fusion, (vertebral) models were produced using acrylic resin (a composite of vinyl ester resin 70% and soft polyester resin 30%) for vertebrae and sponge rubber for intervertebral disc. Compression, flexion, and torsion tests were carried out on the various types of lumbar vertebral models with the following results. 1. Normal models are low in mechanical strength but highly flexible and resilient. 2. Anterior fusion models are mechanically stronger but inflexible. 3. Postero-lateral fusion models and posterior fusion models provide increased strength and retain some flexibility. 4. Laminectomy and spondylolysis models are the weaker than normal's in all mechanical strength tests.
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Self-measurement of blood glucose was performed by eight insulin-dependent juvenile-onset diabetics. The patients were well motivated and improved control of diabetes was obtained. The method would seem to be useful for juvenile-onset diabetics, especially of the unstable type and for pregnant diabetics.
This study was performed in order to evaluate the effects of somatostatin on insulin releasing mechanisms and on glucose uptake in peripheral tissues using isolated pancreatic islets, isolated rat diaphragms and epididymal fat pads. Insulin release by various concentrations of glucose were examined, and it was found that 100 ng/ml of somatostatin significantly inhibited insulin release at the glucose concentration of 200 mg/dl. Somatostatin also significantly inhibted insulin release by the administration of 5microgram/ml of glucagon with 200 mg/dl of glucose concentration and 20 mM of orginine with 200mg/dl of glucose concentrations. But at the glucose concentration of 50mg/dl, no significant inhibition of somatostatin on insulin release was observed even when various concentrations of glucagon or arginine were added. The influence of somatostatin on peripheral tissues was examined in vitro, and no significant change on glucose uptake compared with the control group was shown in either tissues. The results indicated that somatostatin directly inhibited insulin release from rat pancreatic islets but had no effect on glucose uptake in peripheral tissues. The inhibitory effect of somatostatin on insulin release may act through the common mechanism of both glucose and other substances in leading to insulin release.
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Epidemiologic studies are providing important new insights into the etiology and clinical course of IDDM as well as providing critically needed data on the magnitude of the problem in different parts of the world. The development of national IDDM registries have documented extraordinary differences in diabetes incidence and prevalence, with the highest incidence figures in Finland (greater than 30/100,000/yr) and the lowest in the Orient with Korea reporting incidence rates below 1 and Japan between 1.0-2.4/100,000/yr. The great geographic variation in expression of diabetes in childhood is strongly supportive of environmental factors playing a major role in the etiology of disease. Our studies document a linear correlation between IDDM incidence and distance from the equator and a similar but inverse correlation with mean annual environmental temperature. Other workers find a direct correlation with dairy product consumption. Factors that may play a role in beta cell damage include viral infections, environmental toxins, nutrients and stress factors. Because of the low incidence of IDDM among children living in Asia it is most important to expand the current national registries in the Asian countries and begin a careful study of the environmental differences within Asian countries as well as comparison of studies between countries with very high incidence rates and those with the lowest rates.
In order to elucidate the role of macrophage in lipid-induced nephrotoxicity in diabetic nephropathy, we examined the effect of macrophage colony-stimulating factor (M-CSF) on the progression of renal lesions in hypercholesterolemic steptozotocin (STZ)-diabetic rats fed with high cholesterol chow. Hypercholesterolemia aggravated albuminuria in diabetic rats accompanied by infiltration of macrophages in glomeruli. Treatment with M-CSF suppressed simultaneously infiltration of glomerular macrophages and urinary albumin excretion in hypercholesterolemic diabetic rats. These results suggest that infiltration of glomerular macrophage has a primary role in lipid-induced nephrotoxicity in diabetic nephropathy, and M-CSF is involved in this process as a preventive factor.
There are marked geographic differences in the incidence of insulin-dependent diabetes mellitus (IDDM); for example, children in countries such as Finland are over 35 times more likely to develop IDDM than children in Japan. An understanding of the reasons for the geographic differences is likely to be important for understanding and, hopefully, preventing IDDM. There are problems, however, because of the lack of registries with adequate standardization. The major needs for the future studies include (1) to clarify the definition of IDDM for epidemiologic study, (2) to establish a standardized approach for IDDM registries, (3) to use registries to evaluate viral, immunologic, and genetic differences in order to explain differential risks across populations, and (4) to encourage the development of new population-based registries worldwide.