PubMed Health⌕ Search

Biomedical subjects

T Nakagami

Publications and source records attributed to T Nakagami.

At least 19 recordsLinked to original sources

Prevalence of non-alcoholic fatty liver disease and its association with impaired glucose metabolism in Japanese adults.

AIMS: To assess the prevalence of non-alcoholic fatty liver disease (NAFLD) and its association with impaired glucose metabolism in Japanese subjects. METHODS: One thousand, nine hundred and fifty subjects enrolled in a general health examination programme from September 2002 to February 2003 were recruited. NAFLD was diagnosed if a person showed 'fatty liver' on ultrasonography, and his/her alcohol consumption, estimated by questionnaire, was < 40 gram/week. A general linear model was used for the comparison of estimated means of metabolic variables adjusted for age and body mass index (BMI) between subjects with NAFLD and those without fatty liver. Multivariate regression with fasting plasma glucose (FPG) as the dependent variable was performed in 1547 non-diabetic individuals after adjusting for age, gender, BMI and NAFLD. RESULTS: NAFLD was found in 566 of the 1950 health-check examinees (29%). Its prevalence increased with increasing FPG levels: 27% in the subgroup with normal fasting glucose, 43% in impaired fasting glucose and 62% in newly diagnosed diabetes. Adjusted means of FPG, HbA1c, triglyceride, total protein, albumin, AST and ALT were all significantly higher, while adjusted means of HDL cholesterol and AST/ALT ratio were significantly lower in subjects with NAFLD than those without fatty liver. Multivariate regression analysis showed that NAFLD was independently associated with increasing FPG in non-diabetic individuals. CONCLUSIONS: The prevalence of NAFLD was 29% in apparently healthy middle-aged Japanese adults and NAFLD was independently associated with impaired glucose metabolism.

Blood Glucose↗

Hyperglycaemia and mortality from all causes and from cardiovascular disease in five populations of Asian origin.

AIMS/HYPOTHESIS: The study was done to assess how well fasting and 2-h plasma glucose (FPG, 2-h PG) after a 75-g OGTT predict cardiovascular disease (CVD) and all-cause mortality in Asian subjects. METHODS: People ( n=6817) of Japanese and Asian Indian origin from five prospective studies in five countries were monitored for 5 to 10 years. Hazard ratios for death from all causes and CVD were estimated using Cox proportional hazard models, adjusting for FPG, 2-h PG and established risk factors. RESULTS: Multivariate Cox regression analysis showed that an increase in FPG from 7.0 to 8.0 mmol/l (increase of 0.76 SD) increased relative risk (95% CI) by 1.14 (1.05-1.25) for all-cause and 1.24 (1.10-1.39) for CVD mortality. An increase in 2-h PG from 9.0 to 11.9 mmol/l (0.76 SD) increased relative risks by 1.29 (1.18-1.41) and 1.35 (1.19-1.54). Inclusion of 2-h PG in the FPG model improved the predictive value ( p<0.001), whereas FPG did not influence the predictive value of 2-h PG ( p>10). In a model containing FPG and 2-h PG, hazards ratios for 2-h PG in subjects with IGT or diabetes were 1.35 (1.03-1.77) or 3.03 (2.18-4.21) for all-cause and 1.27 (0.86-1.88) or 3.39 (2.14-5.37) for CVD mortality, compared with normal subjects. The respective hazards ratio for FPG in subjects with IFG or diabetes were 0.94 (0.68-1.31) or 0.88 (0.59-1.32) for all-cause and 1.05 (0.67-1.65) or 0.88 (0.51-1.51) for CVD mortality, compared with normal subjects. CONCLUSIONS/INTERPRETATION: For prediction of premature death, 2-h PG was superior to FPG in several Asian populations.

Adult↗

Age, body mass index and Type 2 diabetes-associations modified by ethnicity.

AIMS/HYPOTHESIS: The aim of this study was to assess the effect of ethnicity on the association between age and body mass index as well as the prevalence of diabetes. METHODS: We selected population-based studies carried out after 1980 in the DECODE/A studies representing different ethnic groups: 11 European, 1 Maltese, 3 Indian, 2 Chinese and 3 Japanese surveys. The total numbers of subjects were 14,240 men and 15,129 women who were 30 to 89 years of age. Diabetes was diagnosed according to the 1999 World Health Organization criteria based on a standard 75 g OGTT. Sex-specific prevalence of diabetes by age and BMI was stratified by ethnic group, in particular the interaction of ethnicity on the associations between age/BMI and the prevalence of diabetes. RESULTS: The prevalence of diabetes was higher in studies from India and Malta compared to Japan, China, and the rest of Europe. The association between BMI and diabetes, adjusted for age, showed noticeable differences between the ethnic groups with an increase in prevalence starting at a BMI between 15 and 20 kg/m(2) in the Maltese and Indian populations compared to 25 kg/m(2 )in Europeans. CONCLUSION/INTERPRETATION: The effect of BMI on the age-adjusted prevalence of Type 2 diabetes was modified by ethnicity with considerably lower thresholds in Indian and Maltese subjects compared to those from the rest of Europe. This difference should be reflected in national and international recommendations regarding "optimal" BMI.

Adult↗

The Contribution of Inflammatory Cell Infiltration to Conjunctival Inclusion Cyst Formation.

Purpose: The incidence of inclusion cysts was examined histopathologically in conjunctival disorders where inflammatory cell infiltration was seen in the subepithelial connective tissue.Method: The incidence of inclusion cysts was examined histopathologically in pterygium, vernal conjunctivitis, pyogenic granuloma and pingueculitis. The specimens of pinguecula were used as control.Results: Inclusion cysts were recognized in 5/(55) cases of pterygium, 2/(12) cases of vernal conjunctivitis, 1/(4) cases of pyogenic granuloma, and 1/(2) cases of pingueculitis. On the other hand no inclusion cyst was recognized in 20 cases of pinguecula in which no inflammatory cell infiltration was seen.Conclusions: Inflammatory cell infiltration may contribute to the formation of conjunctival inclusion cysts in pterygium, pingueculitis, vernal conjunctivitis and pyogenic granuloma.

Journal Article↗

Comparison of the fasting and the 2-h glucose criteria for diabetes in different Asian cohorts.

AIMS/HYPOTHESIS: The American Diabetes Association recommended that only a single fasting plasma glucose of greater than or equal to 7.0 mmol/l should be used for diagnosing diabetes in epidemiological studies and did not recommend using a 2-h oral glucose tolerance test. We evaluated the effect of diagnostic changes on the prevalence of diabetes and on the choice of subjects diagnosed with diabetes. METHODS: Existing epidemiological data collected from Asian people between 30 and 89 years of age, was re-analysed separately in 11 population-based studies (n = 17,666), 6 pre-selected hyperglycaemic cohorts (n = 12,221) and one suspected diabetic cohort (n = 8382). RESULTS: Among the 11 population-based studies, the new fasting glucose criteria resulted in an overall reduction of 1.8% in the prevalence of diabetes, which ranged from a reduction of 4.8% to an increase of 1.7% in the different studies. Of 1215 subjects diagnosed with diabetes by either criteria, only 449 met both criteria, a concordance of 37%. More than half of the diabetic subjects had isolated post-challenge hyperglycaemia and three quarters of the subjects with impaired glucose tolerance, according to the 2-h glucose criteria, were normal according to the fasting glucose criteria. Subjects diagnosed as diabetic based only on the 2-h glucose criteria were, on average, older than those with diabetes according to the fasting criteria. CONCLUSION/INTERPRETATION: The fasting and the 2-h glucose criteria diagnose different groups of subjects. It would therefore be inappropriate to use the fasting glucose criteria alone for screening diabetes in Asian populations.

Adult↗

[The contribution of inflammatory cell infiltration to conjunctival inclusion cyst formation].

PURPOSE: The incidence of inclusion cysts was examined histopathologically in conjunctival disorders where inflammatory cell infiltration was seen in the subepithelial connective tissue. METHOD: The incidence of inclusion cysts was examined histopathologically in pterygium, vernal conjunctivitis, pyogenic granuloma and pingueculitis. The specimens of pinguecula were used as control. RESULTS: Inclusion cysts were recognized in 5/55 cases of pterygium, 2/12 cases of vernal conjunctivitis, 1/4 cases of pyogenic granuloma, and 1/2 cases of pingueculitis. On the other hand no inclusion cyst was recognized in 20 cases of pinguecula in which no inflammatory cell infiltration was seen. CONCLUSIONS: Inflammatory cell infiltration may contribute to the formation of conjunctival inclusion cysts in pterygium, pingueculitis, vernal conjunctivitis and pyogenic granuloma.

Aged↗

Adenosine triphosphate-sensitive potassium channels are involved in insulin-mediated glucose transport in humans.

We investigated the influence of treatment with nicorandil, a K-channel opener currently used for angina, on glucose homeostasis in patients with non-insulin-dependent diabetes mellitus (NIDDM) and coronary artery disease (CAD). Adenosine triphosphate (ATP)-sensitive K (K-ATP) channels are present in various tissues, including pancreatic B cells and skeletal muscle, and are the putative targets of this agent. Nine NIDDM patients with CAD and five healthy subjects participated in the study. Fasting plasma levels (mean+/-SEM) of glucose (144+/-11 to 180+/-22 mg/dL, P<.05) and insulin (5.8+/-1.6 to 7.0+/-1.8 microU/mL, P<.05) and hemoglobin A1c (7.54+/-0.47 to 8.11+/-0.55%, P<.01) increased significantly in nine NIDDM patients after treatment with nicorandil at a dose of 5 mg three times daily for 2 to 8 months. Glucose tolerance as examined by an identical meal test deteriorated (P<.001), but the insulin response did not change significantly. A washout of nicorandil for 1 to 4 months restored glucose tolerance almost to pretreatment levels in four patients. A 5- to 7-day trial of nicorandil (5 mg three times daily) in five healthy subjects resulted in a marginal to twofold increase in fasting plasma insulin, reflecting the progression of insulin resistance. In addition, three healthy subjects showed a substantial reduction in the glucose infusion rate (GIR) required in the euglycemic-hyperinsulinemic clamp study. Since the therapeutic dose of nicorandil did not affect pancreatic B-cell function but caused insulin resistance in both healthy and NIDDM subjects, we conclude that K-ATP channels play a regulatory role in insulin-mediated glucose transport in humans.

ATP-Binding Cassette Transporters↗

[Effect of ultraviolet-filtering contact lens on rabbit eyes after exposure to ultraviolet light].

We evaluated the protective effect of a newly designed soft contact lens (SCL) on rabbit eyes. This SCL absorbs the ultraviolet B light of wavelengths between 280 nm and 320 nm. Three weeks after resecting the nictitating membrane, the rabbit corneas were covered either by the new SCL or a conventional SCL. The eyes were exposed to ultraviolet light from two 15 W lamps placed 20 cm anteriorly for 3 hours. Another three hours after the exposure, the cornea was examined first with a slitlamp biomicroscope after staining with fluorescein and then by histopathological means after enucleation. Six eyes wearing the new SCL showed moderate superficial punctate keratopathy. Six eyes wearing conventional SCL showed severe superficial keratopathy or corneal erosion. These findings were in good agreement with the histopathological findings. The new ultraviolet-filtering SCL was thus effective in protecting the rabbit cornea under our experimental conditions.

Animals↗

[Pterygium and mast cells--expression of basic fibroblast growth factor increase in mast cells of the pterygium].

We examined the expression of basic fibroblast growth factor (bFGF) protein immunohistochemically, and bFGF specific messenger RNA (bFGF-mRNA) by in situ hybridization in the excised tissue of 5 cases of pterygium and 4 cases of normal conjunctiva. Immunohistochemical staining for bFGF showed strong positive staining in metachromatic mast cells stained with toluidine blue in the pterygium and in normal conjunctival specimens. The mean metachromatic mast cell count in pterygium specimens was increased significantly when compared with normal conjunctiva. In mast cells, bFGF positive rate was 84% in pterygium specimens, and 69% in normal conjunctival specimens. In situ hybridization indicated that the bFGFmRNA is located in most mast cells in pterygium specimens, but in only a few mast cells in normal conjunctival specimens. These results suggest that increased bFGF protein produced and stored by mast cells in the pterygium may contribute to its progression.

Female↗

Glycemic control and prevention of retinopathy in Japanese NIDDM patients. A 10-year follow-up study.

OBJECTIVE: To examine glycemic control for the prevention of retinopathy in early diagnosed Japanese NIDDM patients. RESEARCH DESIGN AND METHODS: There were 137 patients with NIDDM but without retinopathy who first visited our facility from 1983-1985. Their age at diagnosis ranged from 30-65 years, with a disease duration of < 3 years. The optic fundi were examined at least annually. The prevalence of retinopathy in the 10th year after registration in the study was compared in four groups stratified by mean HbA1c values for 10 years. Multiple logistic regression analysis was used to assess the relationship between retinopathy and covariates. RESULTS: None of the patients with a mean HbA1c < 6% had retinopathy. The prevalence of retinopathy was 17.2% in the group with a mean HbA1c of 6-6.9%, 14.3% in the group with a mean HbA1c of 7-7.9%, 41.9% at a mean HbA1c of 8-8.9%, and 54.8% when the mean HbA1c exceeded 9%. The prevalence of retinopathy increased with the increase in the mean HbA1c values over 10 years (trend, P < 0.005). Multiple logistic regression analysis revealed that mean HbA1c was the only significant risk factor for the development of retinopathy. CONCLUSIONS: Our results support the concept that an early diagnosis and better control lessen the risk for the development of retinopathy in Japanese NIDDM patients.

Adult↗

[A case of dermatomyositis with severe retinopathy in a patient who died of acute interstitial pneumonia].

Sight threatening ocular complications are rare in adult patients with dermatomyositis. We encountered a 52-year-old female with dermatomyositis who had severe visual disturbance and rapidly progressive intersitial pneumonia. She was admitted to our hospital because of skin erythema, general fatigue, mild fever, and severe bilateral visual disturbance. Rentinal hemorrhages, cotton wool spots, and macular edema were observed in her fundus at the first ophthalmic examination. A diagnosis of dermatomyositis was made because of the myogenic pattern of her electromyogram, elevation of serum creatine kinase, and skin lesions. Oral prednisolone treatment was started and the retinopathy was improved, but was complicated by acute interstitial pneumonia. The interstitial pneumonia was not respond to steroid pulse therapy with methylprednisolone, and the patient died of respiratory failure on the 47th day after the onset of visual symptoms. In adult dermatomyositis patients, the complication of severe retinopathy should be considered as a risk factor for rapid progress of interstitial pneumonia.

Acute Disease↗

In vitro and in vivo anti-platelet effects of enzymatic hydrolysates of collagen and collagen-related peptides.

Collagen-related peptides, Gly-Pro-Arg and its analogues, were examined for their inhibitory effects on platelet aggregation induced by the addition of ADP. Human platelet aggregation was suppressed by more than 50% with each of Gly-Pro-Arg and such Gly-Pro-Arg-containing peptides as Gly-Pro-Arg-Gly, Gly-Pro-Arg-Gly-Pro, Gly-Pro-Arg-Pro-Pro, and Gly-Pro-Arg-Pro-Pro-Pro at a concentration of 0.3 mM. The inhibitory effects of these peptides were about 10 times higher in human PRP than in rat PRP. Other Gly-Pro-Arg analogues such as Sar-Pro-Arg, Gly-Pro-Lys, Gly-Ala-Arg, and Ala-Gly-Pro-Arg had no inhibitory effect at a concentration from 0.1 to 0.8 mM even in human PRP. Intravenous and oral administrations of Gly-Pro-Arg and enzymatic hydrolysates of collagen suppressed the decrease in platelet count for endotoxin-induced DIC in rats. Collagen itself has been regarded as a potent inducer of platelet aggregation, but these findings suggest that collagen-related peptides and enzymatic hydrolysates of collagen prevent platelet aggregation.

Animals↗

[Pterygium and mast cells--mast cell number, phenotype, and localization of stem cell factor].

We examined the number and phenotype of mast cells, and the localization of stem cell factor (SCF) as a growth factor of mast cells in the excised tissue of 38 cases of pterygium. In histopathology with toluidine blue stain and immunohistochemistry with a monoclonal antibody to tryptase, the mean mast cell count in pterygium specimens was twice as high as in normal conjunctiva. In pterygium specimens more than 94% of tryptase-positive mast cells were found to express chymase and c-kit. There was no phenotypic difference between mast cells in pterygium and normal conjunctiva. In all immunohistochemical specimens in which we could examine the head of the pterygium, SCF was expressed in subepithelial fibroblasts at the central edge of pterygium. The results suggest that overexpression of SCF was accompanied with the augmentation of mast cells in the pterygium.

Cell Count↗

Prolylendopeptidase inhibitory activity of a glial fibrillary acidic protein fragment and other proline-rich peptides.

The brain prolylendopeptidase (PEP) inhibitory activity of synthetic peptides related to the bovine brain-derived PEP inhibitor, GFAP-(38-55) (MPPPLPARVDFSLAGALN), was investigated. Homologous peptides such as MPPPLPTRVDFSLAGALN (human type) and MTPPLPARVDFSLAGALN (mouse type) also inhibited PEP. Among various synthetic fragments of GFAP-(38-55), only MPPPLP had a Ki essentially the same as that of GFAP-(38-55). Similar synthetic proline-rich peptides such as synapsin fragments and SH3 domain-binding peptides had more or less inhibitory activity.

Amino Acid Sequence↗

[Comparative study on diode laser (680 nm) and krypton laser mild photocoagulation--histological findings and therapeutic outcome for diabetic maculopathy].

A histopathological study of macaca monkey retina-choroid was carried out for one month after mild photocoagulation with a diode laser (680 nm) and a krypton laser (647 nm). Both lasers produced the same damage to the outer layer of retina and to the melanocytes of 1/3 of the inner choroid. Mild focal photocoagulation was done for 6 patients (12 eyes) with diabetic maculopathy. The patients were 41 to 67 years old, suffering from diabetes mellitus for 5 to 25 years. The grade of their retinopathy was Fukuda's classification AI, AII, and BI. AII eyes were tested before and 3-6 months after photocoagulation for corrected visual acuity, fluorescein angiography, and visual field sensitivity by Octopus automated static perimetry. Visual acuity was stable in all cases. Central sensitivity was better in 2 eyes and unchanged in 4 eyes in both types of laser photocoagulation. In cases of total loss, one eye was improved, 4 eyes were unchanged and one eye was worsened by diode laser photocoagulation and one eye was improved, 2 eyes were unchanged and 3 eyes were worsened by krypton laser photocoagulation. The diode laser (680 nm) might be as useful for ophthalmic laser treatment as the krypton laser.

Adult↗

[The relationship between visual field defects and clinical factors in normal-tension glaucoma].

We investigated the relationship between visual field defects and some clinical factors in 30 eyes of 30 normal-tension glaucoma (NTG) patients. The static central visual field by the Humphrey field analyzer, diurnal variation of intraocular pressure (diurnal IOP), blood flow velocity of the ophthalmic artery by color Doppler imaging, blood flow volume of digital tissue by laser flowmetry, and systemic blood pressure (BP) were measured after rinsing out the anti-glaucoma drug for one month. Mean deviation (MD) calculated by the Humphrey STATPAC program as an index of visual field defect, was correlated to the Pourcelot index (RI) of ophthalmic arterial blood flow and magnitude of diurnal IOP. In multiple regression analysis, the multiple correlation coefficient was 0.79 and the coefficient of determination was 0.62. RI, systolic BP, magnitude of diurnal IOP, and the refraction and mean of diurnal IOP were used in the multiple correlation model as factors significantly related to MD. These results suggest that both IOP and some clinical factors may contribute to the visual field defects of NTG.

Aged↗