[Application of the electric instrument for the measurement of the dysfunction of the body and extremities in progressive muscular dystrophy].
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Biomedical subjects
Publications and source records attributed to Y Harano.
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Abnormal responses of plasma lipase, trypsin, and amylase to pancreozymin and secretin in poorly controlled diabetics were found in 42%, 41% and 30% while these responses in well controlled diabetics were 25%, 9% and 9% respectively. Positive provocation of at least one of these enzymes was observed in 67% of poorly controlled diabetics and was significantly more frequent than that (18%) in well controlled diabetics (p less than 0.01). An elevation of fasting lipase and amylase activities was also noted in 26% and 37% in the former in contrast to 0% and 18% in the latter. In the same 6 subjects the degree of abnormal plasma enzyme response was greater in the poorly controlled diabetic state than in the well controlled diabetic state. When insulin effect on plasma lipase response was tested in experimentally diabetic rats, insulin administration for 3 to 5 days normalized the abnormal provocation of lipase observed in chronically diabetic rats. These findings indicate that pancreatic enzymes tend to leak to the systemic circulation in insulin deficiency.
The purpose of the present study was to elucidate the characteristic lipoprotein disorder in essential hypertension. Twenty-six patients with essential hypertension (HT) but without diabetes mellitus or obesity and 24 healthy subjects (control) were recruited into this study. Lipoproteins of HT and controls were separated by ultracentrifugation to very-low-density lipoprotein (VLDL), intermediate density lipoprotein (IDL), low-density liproprotein (LDL), and (HDL) fractions. Cholesterol and triglycerides were determined with enzyme assay, and apoB were determined by highly sensitive latex agglutination (Kyowa-hakko Co. LD). There was no difference in age (mean +/- SE; HT, 63 +/- 2 versus control, 60 +/- 2 years) or body-mass index (22.7 +/- 0.4 versus 21.7 +/- 0.5 kg/m2) between HT and controls. Blood pressure in HT and controls was 158 +/- 2/87 +/- 12 mm Hg and 123 +/- 3/72 +/- 2 mm Hg, respectively. Cholesterol did not change significantly in plasma (192.1 +/- 7.0 versus 176.4 +/- 4.2 mg/dL), VLDL (15.2 +/- 2.4 versus 11.8 +/- 1.7 mg/dL), IDL (14.8 +/- 2.4 versus 10.7 +/- 1.6 mg/dL), LDL (93.7 +/- 4.6 versus 83.1 +/- 3.9 mg/dL), nor in HDL (51.9 +/- 2.7 versus 58.1 +/- 3.2 mg/dL). Triglycerides (TG) increased in plasma (120.0 +/- 10.0 versus 87.5 +/- 9.3 mg/dL, p < 0.05), although TG did not change in all subfractions. ApoB increased in plasma (105.5 +/- 5.1 versus 85.6 +/- 3.6 mg/dL, p < 0.01), IDL (9.0 +/- 1.3 versus 5.4 +/- 0.6 mg/dL, p < 0.05), and LDL (76.3 +/- 4.3 versus 59.4 +/- 3.7 mg/dL, p < 0.01) in HT compared with controls. The ratio of cholesterol to apoB in LDL decreased (1.27 +/- 0.06 versus 1.48 +/- 0.08, p < 0.05). In essential HT, number of apoB containing lipoproteins (IDL, LDL) increased. Low ratio of cholesterol to apoB was noted in LDL, indicating the presence of small, dense LDL. As cholesterol in LDL was normal, hyperbetalipoproteinemia is also a characteristic disorder of essential HT.
To investigate whether insulin resistance is associated with diabetic microangiopathies in type 2 diabetes mellitus, insulin sensitivity was measured in 133 type 2 diabetic subjects with or without diabetic retinopathy and/or nephropathy. Insulin sensitivity was measured by steady-state plasma glucose method or euglycemic glucose clamp method. Regarding retinopathy, in the insulin-resistant group, advanced retinopathy (preproliferative and proliferative retinopathy) was more frequently observed compared with the insulin-sensitive group (significance: p<0.02). Similarly, as for nephropathy, the occurrence of continuous proteinuria in the insulin-resistant group was significantly (p<0.01) more frequent compared with the insulin-sensitive group. Insulin sensitivity expressed as glucose utilization and glucose clearance was significantly (p<0.05) lower in diabetic subjects with retinopathy (without nephropathy) compared with subjects without the microangiopathies after adjustment for age, body mass index (BMI), fasting blood glucose (FBS), and diabetic duration. Similarly, insulin sensitivity in subjects with nephropathy (without retinopathy) was significantly (p<0.05) decreased compared with those without microangiopathies. Furthermore, insulin resistance was significantly (p<0.01) severe in the subjects with both retinopathy and nephropathy than in those without the two microangiopathies. Insulin resistance of type 2 diabetes is closely associated with the progression of microangiopathies, and causal relationship between insulin resistance and microangiopathies has remained to be solved.
Using cross-sectional and prospective analyses, the risk factors for macroangiopathy (MA) in nonobese Type 2 diabetic patients were evaluated. In the cross-sectional study, we determined a cutoff point for each variable at which changes in the prevalence of total MA reached statistically significant levels. In the prospective study, those who met more than four out of seven control criteria as set forth in the Multiclinical Study for Diabetic Macroangiopathy (MSDM) had less risk of MA in Type 2 diabetes initially diagnosed without MA compared with those who fulfilled less than three factors. These results suggest that multiple risk factor control is the most effective and reasonable way to lower the incidence of MA in Type 2 diabetes.
A rapid paper-strip test for the semiquantitating 3-hydroxybutyrate (3-OHBA) has been developed. The color develops within 5 min after applying the serum to the paper strip, and the purple color was read either visually or by reflectance meter. This can detect 3-OHBA levels as low as 0.1 mmol/L up to 2.0 mmol/L. The more concentrated sample can be measured on serial dilution. Clinical usefulness has been tested in a summer camp for insulin-dependent diabetic children as well as in a routine diabetes clinic. Serum 3-OHBA levels ranged from greater than 100 mumol/L to 4 mmol/L in all the subjects before breakfast in a summer camp. In four subjects, 3-OHBA was elevated to the level of 2-4 mmol/L, and only one of these four subjects exhibited ketonuria by nitroprusside test. In a diabetes clinic, a new paper-strip test for 3-OHBA has revealed ketonemia in 34 (74%) of 46 diabetic subjects, while nitro-prusside test revealed ketonemia in only 4 (13%). The present paper-strip test for 3-OHBA is sensitive enough to detect levels as low as 0.1 mmol/L and is clinically useful for rapid detection of ketosis proneness as well as for monitoring of diabetes control.
BACKGROUND: The effect of glycemic control on the incidence of restenosis after percutaneous transluminal coronary angioplasty (PTCA) in non-insulin-dependent diabetes mellitus (NIDDM) has not been well analysed. METHODS: Out of 1282 consecutive patients who had undergone elective and successful PTCA over 8 years, 86 known to have NIDDM and 117 non-diabetic cases were analysed for restenosis following PTCA. Definition of restenosis is an increase from 50% to 75% diameter stenosis at the same lesion within 1 year after angioplasty. Those with familial hypercholesterolemia, renal failure, unstable angina pectoris, bypass graft surgery within 1 month were excluded. Blood pressure, body mass index, history of smoking, fasting blood glucose, post-prandial glucose, HbA1c, cholesterol, triglycerides, number of stenotic vessels, restenosis rate were studied - 6 months before PTCA and 1, 3, 6 and 12 months after PTCA. RESULTS: The frequency of restenosis within 1 year of PTCA was significantly greater in poorly controlled NIDDM (75%) than in well or moderately controlled NIDDM (30-40%) or non-diabetic subjects (33%). Multivariate analysis showed that the degree of control of diabetes was significantly correlated with restenosis. CONCLUSION: Restenosis following elective and successive PTCA was significantly more frequent in poorly controlled NIDDM compared with moderately or well-controlled NIDDM or non-diabetic subjects. Multivariate analysis also showed the significant correlation between restenosis and glycemic control. These findings indicate that control of diabetes plays an important role in reducing restenosis after PTCA.