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Toshiyuki Moritan

Publications and source records attributed to Toshiyuki Moritan.

5 recordsLinked to original sources

Myocardial glucose utilisation in type II diabetes mellitus patients treated with sulphonylurea drugs.

PURPOSE: Chronic sulphonylurea treatment maintains improved glycaemic control through mechanisms other than enhancement of insulin secretion and may act on various organs. The aim of this study was to investigate whether the chronic use of sulphonylurea drugs influences PET measurement of myocardial glucose utilisation (MGU) in type II diabetes mellitus. METHODS: Forty-two patients with type II diabetes mellitus and 17 control subjects underwent dynamic (18)F-FDG PET to measure MGU during hyperinsulinaemic euglycaemic clamping. Twenty-one patients had been taking sulphonylurea drugs for more than 1 year (SU group), and the other 21 patients were drug naive (non-SU group). The haemoglobin A1c levels in the two patient groups were similar. Glucose disposal rate (GDR) was also determined as a marker of whole-body insulin resistance. RESULTS: GDR in the SU group (9.01+/-2.53 mg min(-1) kg(-1)) was significantly higher than that in the non-SU group (4.10+/-2.47, p<0.01) and was similar to that in the controls (9.76+/-2.97). MGU in the SU group (7.66+/-3.02 mg min(-1) 100 g(-1)) was significantly higher than that in the non-SU group (5.53+/-2.05, p<0.01) and was similar to that in the controls (7.49+/-2.74). CONCLUSION: Chronic sulphonylurea treatment influences MGU independent of the degree of glycaemic control. The effect of medication should be kept in mind when measuring and interpreting MGU in patients with type II diabetes mellitus.

Diabetes Mellitus, Type 2↗

Measurement of skeletal muscle glucose utilization by dynamic 18F-FDG PET without arterial blood sampling.

OBJECTIVE: Skeletal muscle glucose utilization (SMGU) can be measured by 18F-FDG PET to characterize insulin resistance. The aim of this study was to determine whether femoral muscle SMGU can be measured without arterial blood sampling by sequential PET imaging of the thoracic and femoral regions. METHODS: Ten patients with possible insulin resistance underwent dynamic 18F-FDG PET of the femoral region during hyperinsulinaemic euglycaemic clamping (group A), and femoral muscle SMGU was calculated using PET data of various time periods and measured arterial input. SMGU was also calculated using venous plasma activity, instead of arterial activity, as input during the late phase. Another five patients underwent sequential PET of the thoracic and femoral regions after single tracer injection (group B). The input function was estimated from aorta activity on thoracic images during the early phase and from venous activity during the late phase, and SMGU with this estimated input was compared with that with measured arterial input. RESULTS: In group A, exclusion of early dynamic PET data from analysis had essentially no effect on the calculated SMGU, and partial substitution of venous activity for arterial activity only marginally changed the estimates. The difference between SMGUs with measured and estimated inputs was minimal in group B. CONCLUSION: Femoral muscle SMGU can be calculated without femoral imaging early after tracer injection, and the input function can be assessed using data of thoracic imaging and venous blood samples. These results support the validity of measuring femoral muscle SMGU without arterial sampling, simultaneously with measurement of myocardial glucose utilization.

Adult↗

Delta-short consensus repeat 4-decay accelerating factor (DAF: CD55) inhibits complement-mediated cytolysis but not NK cell-mediated cytolysis.

NK cells play a critical role in the rejection of xenografts. In this study, we report on an investigation of the effect of complement regulatory protein, a decay accelerating factor (DAF: CD55), in particular, on NK cell-mediated cytolysis. Amelioration of human NK cell-mediated pig endothelial cell (PEC) and pig fibroblast cell lyses by various deletion mutants and point substitutions of DAF was tested, and compared with their complement regulatory function. Although wild-type DAF and the delta-short consensus repeat (SCR) 1-DAF showed clear inhibition of both complement-mediated and NK-mediated PEC lyses, delta-SCR2-DAF and delta-SCR3-DAF failed to suppress either process. However, delta-SCR4-DAF showed a clear complement regulatory effect, but had no effect on NK cells. Conversely, the point substitution of DAF (L147 x F148 to SS and KKK(125-127) to TTT) was half down-regulated in complement inhibitory function, but the inhibition of NK-mediated PEC lysis remained unchanged. Other complement regulatory proteins, such as the cell membrane-bound form factor H, fH-PI, and C1-inactivator, C1-INH-PI, and CD59 were also assessed, but no suppressive effect on NK cell-mediated PEC lysis was found. These data suggest, for DAF to function on NK cells, SCR2-4 is required but no relation to its complement regulatory function exists.

Amino Acid Substitution↗

Impaired myocardial vasodilatation during hyperaemic stress is improved by simvastatin but not by pravastatin in patients with hypercholesterolaemia.

AIMS: Impaired myocardial vasodilatation during hyperaemic stress with dipyridamole has been documented in hypercholesterolaemics without evidence of ischaemia. This study investigated whether two commonly used hydroxymethylglutaryl coenzyme A reductase inhibitors, simvastatin and pravastatin, are equally effective in restoring myocardial vasodilatation. METHODS AND RESULTS: Forty-four hypercholesterolaemics with a low probability of coronary artery disease and 22 controls were studied. Before and after lipid-lowering therapy with simvastatin (n = 22) or pravastatin (n = 22), myocardial blood flow at rest and during dipyridamole loading was measured using positron emission tomography with [(13)N]ammonia, and myocardial vasodilatation was assessed. Treatments with simvastatin and pravastatin similarly reduced plasma total cholesterol and plasma low-density lipoprotein cholesterol. Resting myocardial blood flow was comparable in the controls, simvastatin group, and pravastatin group and unchanged after therapy. Myocardial blood flow during dipyridamole loading and myocardial vasodilatation was lower in the two therapy groups before treatment than in the controls. These parameters improved significantly after therapy with simvastatin, whereas no improvement was observed after pravastatin therapy. The per cent change in myocardial vasodilatation after simvastatin therapy was significantly and inversely correlated with per cent changes in plasma lipid fractions. CONCLUSION: Diminished myocardial vasodilatation in hypercholesterolaemics is improved by simvastatin but not by pravastatin, suggesting differences in vascular effects among statins.

Anticholesteremic Agents↗

Simple quantification of skeletal muscle glucose utilization by static 18F-FDG PET.

UNLABELLED: Skeletal muscle glucose utilization (SMGU) can be measured by dynamic PET imaging with (18)F-FDG to characterize insulin resistance. The aim of this study was to determine the validity of simple methods to quantify SMGU by static PET imaging. METHODS: Ten patients underwent dynamic (18)F-FDG PET of the femoral region during hyperinsulinemic euglycemic clamping. SMGU was determined by Patlak graphical analysis using data from dynamic imaging with frequent arterial blood sampling. Standardized uptake values (SUVs) were calculated at 45 and 55 min after tracer injection. Skeletal muscle-to-background ratio (SM/B ratio), tissue count divided by venous plasma activity, was also computed at 45 and 55 min. These simple indices were compared by linear regression with the SMGU measured as above, and an estimated SMGU was obtained using the regression equation thus generated, together with a simple index. RESULTS: SMGU was highly correlated with SUVs (r = 0.941 at 45 min, r = 0.951 at 55 min) and SM/B ratios (r = 0.968 at 45 min, r = 0.984 at 55 min). Although SMGU was almost proportional to SM/B ratios, the y-intercepts of the regression lines for SUVs significantly differed from zero. The residual in estimating SMGU using the regression equation was marginally smaller for SM/B ratios than for SUVs and for indices at 55 min than at 45 min, but these differences did not reach statistical significance. Correction for plasma glucose level slightly elevated the correlation coefficients between SMGU and these simple indices. CONCLUSION: It is proposed that the simple quantitative indices, SUV and the SM/B ratio, are reliable indicators of SMGU during hyperinsulinemic euglycemic clamping. Static imaging with or without a single venous blood sampling may therefore be able to replace dynamic imaging with frequent arterial blood sampling, offering substantially greater convenience in evaluating insulin resistance.

Adult↗