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Biomedical subjects

Y Sumida

Publications and source records attributed to Y Sumida.

At least 73 records · Page 4Linked to original sources

Protein C activation in NIDDM patients.

Enhanced activation of the clotting system has been recently implicated in the pathogenesis of vascular complications in patients with diabetes mellitus. Abnormalities of the anticoagulant system may constitute a potential trigger factor for the haemostatic activation observed in diabetic subjects. The current study aimed to evaluate anticoagulant activity in diabetic patients by assessing the plasma levels of activated protein C-protein C inhibitor complex; and by measuring the anticoagulant response to exogenous thrombomodulin. This study comprised 61 patients (34 men, 27 women) with non-insulin-dependent diabetes mellitus (NIDDM) of whom 22 showed microalbuminuria and 39 normoalbuminuria. Data obtained in 31 non-obese and non-diabetic subjects were available for comparison. The plasma levels of fibrinogen (p < 0.02), prothrombin fragment 1 + 2 (p < 0.05), fibrin monomer (p < 0.0001), protein C antigen (p < 0.005), total protein S antigen (p < 0.02), soluble thrombomodulin (p < 0.005) and soluble E-selectin (p < 0.005) were significantly higher in diabetic patients than in healthy subjects. The plasma level of activated protein C-protein C inhibitor complex (7.4 +/- 3.8 vs 3.0 +/- 0.4 pmol/l) was significantly higher (p < 0.0001) and the anticoagulant response to exogenous thrombomodulin (23.4 +/- 2.6 vs 35.3 +/- 3.0 ng/ml) was markedly lower (p = 0.005) in all diabetic patients than in healthy subjects. Cases with microalbuminuria presented low plasma levels of activated protein C-protein C inhibitor complex (5.5 +/- 0.6 vs 8.6 +/- 0.7 pmol/l, p < 0.05) and significantly decreased values of the anticoagulant response to exogenous thrombomodulin (16.5 +/- 2.9 vs 23.4 +/- 2.6%, p = 0.03) as compared to those with normoalbuminuria. The present study suggests that the hyper-coagulable state in NIDDM is associated with an increased activation of protein C but with a poor plasma reactivity to the anticoagulant effect of thrombomodulin.

Adult↗

Acute and chronic regulation of serum sex hormone-binding globulin levels by plasma insulin concentrations in male noninsulin-dependent diabetes mellitus patients.

This study was undertaken to investigate the relationship of the serum sex hormone-binding globulin (SHBG) levels with the plasma insulin concentration and with the insulin resistance in male subjects with noninsulin-dependent diabetes mellitus (NIDDM). This investigation comprised 12 patients with NIDDM and 16 normal subjects matched for age, sex, and body mass index (BMI). There was a significant increase in insulin levels (P < 0.03) and a decrease in SHBG levels (P < 0.01) in the diabetic group as compared with those of the normal group. The sex hormone and plasma insulin levels were measured in NIDDM patients undergoing exercise and dietary therapy. Insulin sensitivity was evaluated by the hyperinsulinemic euglycemic clamp technique expressed as the glucose infusion rate (GIR) before and after the treatment. The SHBG levels correlated significantly with the insulin concentrations (r = -0.643, P < 0.05) and with the GIR (r = 0.615, P < 0.05) before the treatment. The SHBG levels (P < 0.02) and GIR (P < 0.01) increased, and the insulin concentrations (P < 0.01) decreased significantly during the treatment. The SHBG levels showed a negative and significant correlation with the plasma insulin concentrations at the end of the clamp study before (r = -0.615, P < 0.05) and after (r = -0.626, P < 0.05) the treatment. These findings suggest that, in the hyperinsulinemic state, plasma insulin has a direct effect on the SHBG levels. SHBG levels decreased significantly during the clamp study before (P < 0.02) and after (P < 0.01) the treatment. This may represent the acute effect of insulin on the SHBG levels. Briefly, these results suggest that insulin may directly affect the SHBG levels and that SHBG may constitute an index of the insulin resistance only in the hyperinsulinemic state.

Blood Glucose↗

Zinc-ion-dependent acid phosphatase exhibits magnesium-ion-dependent myo-inositol-1-phosphatase activity.

We have purified bovine brain Zn(2+)-dependent acid phosphatase (Zn(2+)-APase), which requires Zn2+ ions to hydrolyze the substrate p-nitrophenyl phosphate (pNPP) in an acidic environment. The substrate specificity and metal requirement of Zn(2+)-APase at a physiological pH was also studied. The enzyme exhibited hydrolytic activity on myo-inositol-1- and -2-monophosphates, 2'-adenosine monophosphate, 2'-guanosine monophosphate, and the alpha- and beta-glycerophosphates, glucose-1-phosphate, and fructose-6-phosphate in 50 mM Tris-HCl buffer (pH 7.4) in the presence of Mg2+ ions, but not on pNPP and phosphotyrosine. Zn2+, Mn2+ and Co2+ ions were less effective for activation. Among the above substrates, myo-inositol-1-phosphate was the most susceptible to hydrolysis by the enzyme in the presence of 3 mM Mg2+ ions. The enzyme exhibited an optimum pH at around 8 for myo-inositol-1-phosphate in the presence of 3 mM Mg2+ ions. The Mg(2+)-dependent myo-inositol-1-phosphatase activity of the enzyme was significantly inhibited by Li+ ions. The Zn(2+)-dependent p-nitrophenyl phosphatase activity and Mg(2+)-dependent myo-inositol-1-phosphatase activity of the purified enzyme fraction exhibited similar behavior on Sephadex G-100 and Mono Q colomns. These findings suggest that Zn(2+)-APase also exhibits Mg(2+)-dependent myo-inositol-1-phosphatase activity under physiological conditions.

Acid Phosphatase↗

[A case of idiopathic hypoparathyroidism associated with primary hypothyroidism and diabetes mellitus].

A 50-year-old man was admitted to our hospital for the evaluation of hypocalcemia and the treatment of diabetes mellitus. Seven months before admission, he sometimes felt thirst and polyuria, and 4 months before admission, he went to a doctor to check his blood glucose and was diagnosed as having diabetes mellitus which had suddenly developed. At that time he was treated with sulfonylurea, but his diabetic control was very poor. At the time of admission to our hospital, the patient's serum calcium (Ca) level was 5.7 mg/dl, phosphorus (P) 5.0 mg/dl, and fasting blood glucose 308 mg/dl, but urinary ketone bodies were not detected. High sensitive assay of parathyroid hormone (HS-PTH), intact PTH and C-terminus PTH concentrations were under the level of detection. TSH level was slightly high (6.1 mu U/ml) with positive antimicrosomal and antithyroglobulin antibodies but thyroid hormone levels were within normal limits. TRH test showed over-response of TSH. Based on Ellsworth-Howard test, we made the diagnosis of idiopathic hypoparathyroidism associated with primary hypothyroidism and diabetes mellitus. He was treated with insulin twice a day and reached good control, and he was also administered 1 alpha-OH-D3 and calcium lactate resulting in an increase of serum Ca level after 2 weeks. These findings suggest that this case may be a polyglandular autoimmune (PGA) syndrome type 1 reported by Neufeld, which is very rare in Japan. The type of diabetes mellitus of this case is controversial. It is, however, necessary to pay attention to the decrease of the patient's insulin-secreting activity because autoimmune disorders are accompanied by this case.

Diabetes Mellitus, Type 1↗

Effects of hexoses and their derivatives on glucagon secretion from isolated perfused rat pancreas.

Although it has been firmly established that D-glucose inhibits glucagon secretion from pancreatic A cells, the regulatory mechanism of glucagon secretion by D-glucose has not been elucidated. To study this regulatory mechanism by D-glucose, the effects of hexoses and their derivatives on glucagon secretion from the A cells of isolated perfused rat pancreas were investigated. When these cells were perfused with D-glucose, D-fructose, D-sorbitol, D-galactose, 2-deoxy-D-glucose, D-gluconic acid sodium salt and D-glucosamine HCl salt, glucagon secretion was significantly inhibited. None of the hexoses or their derivatives tested were found to stimulate glucagon secretion. The effects of these sugars on glucagon secretion were independent of their metabolism in the cells. From the findings that the sugars both metabolized and unmetabolized in the cells demonstrated comparable inhibition of glucagon secretion from the isolated perfused rat pancreas, it is speculated that the recognition system for these sugars may be probably present on the A cell membrane and responsible for mediating these inhibitory effects of glucagon secretion.

Animals↗

Primary sites of actions of staurosporine and H-7 in the cascade of insulin action to glucose transport in rat adipocytes.

The insulin-stimulated glucose transporter in rat adipocytes was inhibited by two protein kinase inhibitors, staurosporine (SSP) and H-7 (1-(5-isoquinolinylsulfonyl)-2-methylpiperazine). However, whereas SSP (10 microM) blocked the insulin-dependent translocation of glucose transporter, H-7 (3 mM) did not. The latter inhibited glucose transporter activity not only in cells, but also in reconstituted liposomes. On the other hand, SSP blocked both the action of insulin and the insulinomimetic action of GTP gamma S (Guanosine 5'-O-(3-thiotriphosphate)). GTP gamma S had distinct effects on the glucose transport and cAMP phosphodiesterase (PDE) activities. It is suggest that H-7 may inhibit glucose transport activity per se; a SSP sensitive protein kinases (protein kinase C isoforms?) may be involved in cascade of the insulin action on glucose transporter as modulated by GTP gamma S; and glucose transport and PDE activities may be regulated by distinct GTP gamma S-sensitive factors.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗

Effects of fluorescein isothiocyanate on insulin actions in rat adipocytes.

The effects of fluorescein isothiocyanate II (FITC) on the actions of insulin in rat adipocytes were studied. When adipocytes were incubated with FITC at pH 7.4 (2 mM agent, 8 min), the cells were completely deprived of their specific insulin-binding activity and rendered unresponsive to the hormone. The effect of FITC on the insulin-binding activity was milder at pH 9.0, and cAMP phosphodiesterase in cells exposed to FITC at pH 9.0 was maximally stimulated if the insulin concentration was increased to 100 nM. Under identical conditions, however, glucose transport activity was rendered not only less sensitive but also less responsive to the hormone. When FITC was added to cells after insulin at pH 9.0, the glucose transport activity that had been stimulated by the hormone was considerably reduced. This reduction was largely, but not entirely, prevented if the cells were deprived of ATP, suggesting that FITC (a) elicited the ATP-dependent reversal of the hormonal effect and, simultaneously, (b) mildly inhibited the transport activity per se. Western blot assay of GLUT-4 (a major isoform of glucose transporter in adipocytes) indicated that FITC (a) partially blocked insulin-dependent translocation of GLUT-4 from the intracellular site to the plasma membrane while it (b) induced a mild "insulin-like" effect. It is concluded that FITC at pH 9.0 (a) renders both glucose transport and phosphodiesterase activities less insulin sensitive presumably by modifying the cellular hormone receptor and (b) makes glucose transport activity less responsive to insulin presumably by (i) blocking hormone-dependent translocation of glucose transporter and (ii) mildly inhibiting intrinsic glucose transport activity.

Adipose Tissue↗

Plasma renin activity and norepinephrine as predictors for antihypertensive effects of nifedipine and captopril.

To examine predictors for the efficacy of antihypertensive agents, we investigated the effects of nifedipine and captopril on blood pressure (BP) and humoral factors in patients with essential hypertension. Eleven essential hypertensive patients (mean age: 54) were treated with long acting nifedipine at 20 to 40 mg/day for 8 weeks and 25 essential hypertensives (mean age: 51) were treated with captopril at 37.5 to 75 mg/day. Blood pressure was measured every 2 weeks. Plasma renin activity (PRA), and plasma concentrations of aldosterone, epinephrine and norepinephrine were determined before and at the end of treatment. Both nifedipine and captopril decreased BP (nifedipine: mean BP 119 +/- 3 to 101 +/- 2 mm Hg, captopril: 124 +/- 2 to 100 +/- 2, P less than .01 for each), whereas neither of them affected heart rate. The 8-week treatment of nifedipine showed no significant effect on humoral factors. Captopril increased PRA by 63% (P less than .05) and decreased plasma epinephrine by 42% (P less than .01) and norepinephrine by 35% (P less than .01). The change in mean BP was positively correlated with pretreatment PRA (r = 0.68, P less than .01) in nifedipine-treated patients and inversely with pretreatment norepinephrine (r = -0.53, P less than .01) in captopril treatment. The results suggest that both nifedipine and captopril were effective antihypertensive agents and that the long term treatment of nifedipine is more effective in essential hypertensives with lower PRA, while captopril is more effective in those with higher plasma norepinephrine concentration.

Aged↗

[Alpha-atrial natriuretic peptide, antidiuretic hormone and aldosterone levels in patients undergoing aortocoronary grafting under high dose fentanyl anesthesia].

Plasma concentrations of alpha-atrial natriuretic peptide (alpha-ANP), antidiuretic hormone (ADH) and aldosterone (ALDS) were determined by radioimmunoassay in 9 patients undergoing aortocoronary bypass grafting under high dose fentanyl (94.4 micrograms.kg-1) anesthesia. These three levels in pre-anesthetic period (control values) were within normal ranges suggesting the absence of congestion and dehydration. Although these values changed significantly after sternotomy, they all increased at the termination of cardiopulmonary bypass (CPB) reaching 2.5 fold in alpha-ANP, 27.7 fold in ADH and 2.4 fold in ALDS as compared with control (P less than 0.05). Present results indicate that high dose fentanyl anesthesia cannot suppress ADH and ALDS level during CPB as was previously demonstrated and the observed rise in alpha-ANP level is considered to be inadequate not only for diuresis but also for vascular dilatation. Administration of alpha-ANP to ameliorate circulatory insufficiency after CPB should probably be considered.

Aged↗

Effects of treatment with captopril on exercise tolerance and plasma catecholamines in elderly hypertensives.

We examined the effects of antihypertensive therapy with captopril, an angiotensin converting enzyme inhibitor, on exercise tolerance and humoral factors in 19 elderly patients (greater than 60 years old) with essential hypertension. Captopril (37.5-75 mg/day) was administered for 8 weeks. Fourteen of the 19 patients in whom captopril was effective took a treadmill exercise test according to Kattus' protocol. Exercise tolerance was increased in all patients (from 13.1 +/- 1.3 to 16.5 +/- 1.0 min, P less than 0.01). Captopril attenuated the rise in blood pressure during the exercise test but did not affect the heart rate. Resting values of plasma adrenaline decreased by 47% and noradrenaline by 17%, with no significant changes in plasma renin activity (PRA) or aldosterone. The change in mean blood pressure showed an inverse relationship to pretreatment plasma noradrenaline (r = -0.73, P less than 0.01). The results show that captopril is effective in the treatment of hypertensive elderly patients, and suggest that the sympathetic nervous system is involved in the mechanism of the antihypertensive response to captopril therapy.

Aged↗

[Anesthetic management of a patient with Conradi's syndrome (chondrodysplasia punctata)--a case report].

Conradi's syndrome is a rare hereditary disease characterized by punctate epiphyseal calcifications. The symptoms include short stature, typical facies with hypertelorism, saddle nose, short neck, tracheal stenosis and scoliosis. The deformities of airway and thoracic cage are expected to bring about ventilatory failure during anesthesia and operation. Although there has been a brief report of a death of a child with this syndrome during induction of anesthesia, we cannot find any other report concerning the perioperative respiratory management. This is a report on a girl with Conradi's disease who developed respiratory problems due possibly to gastric aspiration during ophthalmic surgery under general anesthesia. Several anesthetic problems raised by this case are discussed.

Anesthesia, General↗

Enhancement of the mutagenicity of 2-acetylaminofluorene by flavonoids and the structural requirements.

The enhancing effects of 12 kinds of flavonoids on the mutagenicity of 2-acetylaminofluorene (AAF) in Salmonella typhimurium TA98 were investigated. In the mixed applications of AAF (22.4 nmoles/plate) with flavonoids (31.4-45.0 nmoles/plate) in the presence of a mammalian metabolic activation system (S9 mix), morin, galangin, flavonol, kaempferol, quercetin and myricetin enhanced the mutagenicity of AAF by 3.3-10.2-fold. The potency of the mutagenicity enhancing effects increased in the described order. For the mutagenicity-enhancing effects of the flavonoids on AAF, the flavonol structure, including the free 3-hydroxyl group and the 2,3-double bond, were essential. In the quercetin analogues, the 5-hydroxyl group was also essential. Further, the numbers of the hydroxyl groups substituted at the 3', 4' and 5'-positions in the B-ring contributed to an increase of the enhancing effect, whereas the substitution of a hydroxyl group at the 2'-position depressed the potency of the effect.

2-Acetylaminofluorene↗