Biomedical subjects
Publications and source records attributed to R Kikkawa.
We report a case of pancreatic pseudocyst which occurred in a 32-year-old woman with variant von Willebrand's disease. A curvilinearly calcified shadow incidentally seen in the upper abdomen on radiographic examination was the first sign of the cyst. The abnormality of hemostatic mechanism found in this patient is speculated to be related to the cyst formation.
Glucose, insulin and somatostatin infusion over 2 hours effectively suppressed endogenous secretion of insulin, glucagon and growth hormones. Steady state plasma glucose level (SSPG) which should be inversely proportional to insulin sensitivity was obtained. In 6 adult-onset non-obese untreated diabetics, mean value of insulin sensitivity indices was significantly reduced compared with normal. In 5 insulin-treated diabetics and in 5 subjects with borderline glucose tolerance including 2 obese subjects, insulin sensitivity for glucose utilization was also significantly diminished.
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A sieving technique was used to isolate human glomeruli and to fractionate them by size in order to determine whether nondiabetic and diabetic glomeruli can be separated from one another on the basis of size and mass and to observe the effects of diabetes on the physical properties of glomeruli. The kidneys studied were from five diabetic patients and five nondiabetic controls that were age- and sex-matched. About 40 percent of the glomeruli in the samples of renal tissues were isolated for study. The preparations consisted of more than 90 percent glomeruli, and over 90 percent of the glomeruli were isolated whole. The mean diameter of the diabetic glomeruli was 45 percent greater than that of nondiabetic glomeruli. The mean mass of the diabetic glomeruli was 2.5 times greater than the mean nondiabetic glomerular mass.
Previous studies of diabetic renovascular complications have measured morphologic changes in relatively few glomerular vessels by electron microscopy. The present study samples 20,000 to 80,000 glomeruli from each of ten nondiabetic and ten diabetic age- and sex-matched subjects. Glomeruli were isolated and fractionated by size with a sieving method. Three samples of glomeruli from each subject were analyzed for size, mass, and hydroxyproline content as an index of basement membrane collagen. Approximately 40 per cent of the glomeruli in each sample were isolated. Glomeruli comprised 94 per cent of the tissue elements present, and 92 per cent of the isolated glomeruli were intact. Diabetic glomeruli are larger than nondiabetic glomeruli (mean diameter +/- S.E.M. = 258 +/- 10 mu versus 196 +/- 6 mu) and heavier (499 +/- 63 ng. versus 232 +/- 16 ng.). Diabetic glomeruli have greater hydroxyproline content than nondiabetic glomeruli when content is expressed per glomerulus (21.9 +/- 3.3 ng. versus 7.1 +/- 0.5 ng.) and when expressed per milligram dry weight of glomeruli (44.0 +/- 2.4 mug. versus 31.6 +/- 1.9 mug.). Glomeruli from diabetics of longest duration show the greatest increases in mass and hydroxyproline values. A pathologist's semiquantitative estimation of diffuse glomerulosclerosis revealed a high correlation between hydroxyproline values and histologic determination of the extent of the renal lesion. These measurements allow quantification of basement membrane collagen and may be used to follow development of diabetic vascular complications.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The effects of cyprohepatadine (CPH) on plasma levels, of glucose, insulin and glucagon were studied in rats in order to clarify the diabetogenicity of this compound. CPH was given to the rats at a daily dose of 45 mg per kg body weight via gastric intubation for up to 20 days. Glucose intolerance appeared after 5 days of CPH treatment without significant increase in fasting glucose level. Plasma insulin response to glucose loading was depressed in the early phase of the glucose tolerance test in groups treated for 10 and 20 days. In these groups the insulinogenic index was significantly lowered. Pancreatic insulin content decreased rapidly after single dose of CPH. Plasma level and pancreatic content of glucagon were not changed by this compound. These results suggested that chronic treatment with CPH caused glucose intolerance in rats through its direct influence on pancreatic B-cell function.
In an attempt to characterize dermal diabetic microangiopathy, dermal microvessels were qualitatively and quantitatively assessed in 26 healthy control subjects and 47 non-insulin-dependent diabetic patients. Basement membrane thickness (BMT) was significantly greater and the homogeneous BM more frequent in diabetic than in control microvessels. BMT did not change with duration of diabetes but significantly decreased with age and onset age of diabetes, suggesting either a different process of BM thickening with respect to age in diabetic dermal microvessels or the implication of genetic influence on the pathogenesis of dermal diabetic microangiopathy. Endothelial cell hyperplasia was not noted in dermal diabetic microvessels. In view of the fact that the hyperplasia has been reported in other tissues and is closely associated with diabetic microangiopathy, the nature of dermal microvessels or endothelial cells or the milieu around dermal microvessels might be different from other organs.
The association between microalbuminuria and systemic blood pressure was investigated in 80 nonproteinuric subjects with non-insulin-dependent diabetes. Seventeen of 80 diabetics had urinary albumin excretion rates (AER) over 20 micrograms/min and were defined as microalbuminuric. The microalbuminuric diabetics showed a higher incidence of proliferative retinopathy and neuropathy than the normoalbuminurics. Moreover, the former group had significantly higher values of systolic blood pressure compared to the latter, although the creatinine clearance was not significantly different between the two groups. These results suggest that microalbuminuria is strongly associated with a rise of systemic blood pressure in non-insulin-dependent diabetics.
In order to elucidate the clinical significance of microalbuminuria in non-insulin-dependent diabetes mellitus (NIDDM), 62 Japanese subjects with NIDDM and without proteinuria were followed for three years. After the three-year follow up, four (19%) of 21 microalbuminuric patients--albumin excretion rates (AER) greater than 15 micrograms/min--developed overt proteinuria, while none of the 42 normoalbuminuric patients did. Among these normoalbuminuric patients, eight patients (19.5%) developed microalbuminuria. The microalbuminuric patients who developed overt proteinuria had higher AER at the beginning of the study than the patients who stayed microalbuminuric. The patients who developed microalbuminuria showed a significantly higher systolic blood pressure in the final year than the patients who stayed normoalbuminuric. These results indicate that microalbuminuria precedes overt proteinuria in Japanese NIDDM, and progression of diabetic nephropathy is rapid and associated with a rise in blood pressure.
Cultured mesangial cells possess a large number of receptors specific to IGF-I with a small number of insulin receptors. Physiological concentrations of IGF-I increased the uptakes of aminoisobutyric acid and 2-deoxyglucose in mesangial cells, while insulin exhibited similar effects only with unphysiologically high concentration. These findings suggest that, in cultured mesangial cells, IGF-I may regulate cellular metabolic functions such as glucose and amino acid uptakes through its own receptors rather than insulin receptors.