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Biomedical subjects

Y Goriya

Publications and source records attributed to Y Goriya.

At least 19 recordsLinked to original sources
PubMed2000

Follow-up of elderly diabetics with or without hypertension and hyperlipidemia.

Elderly diabetic patients were followed up prospectively for 4 years to see the effects of blood pressure and dyslipidemia on the development of diabetic micro- and macroangiopathies. We studied 84 elderly diabetic patients whom we divided into four groups according to the association of above complications: (1) diabetes alone group (DM), (2) hypertensive diabetic group (DM + HT), (3) hyperlipidemic diabetic group (DM + HL), and (4) hypertensive and hyperlipidemic diabetic group (DM + HTL). The treatment of diabetes was different among the groups. Glycemic control such as fasting blood glucose and HbA1c did not change between groups or through the follow-up years. As a matter of course, blood pressure of DM was lower and triglyceride of HTL was higher than in other groups. Microangiopathies such as retinopathy, nephropathy, and neuropathy and macroangiopathies such as ischemic heart disease (IHD), cerebral vascular disease (CVD), and arteriosclerosis obliterans were evaluated by using a grading scale according to the severity. The grade of microangiopathies in DM + HT increased gradually during the follow-up years and the grade of IHD and CVD in DM + HTL was relatively higher than in the other groups. Our findings support the general principle of control of hypertension and hyperlipidemia for the prevention of diabetic microangiopathy and macroangiopathy in the elderly diabetic patients.

Aged↗
PubMed1993

Improvement in blunted glucagon response to insulin-induced hypoglycemia by strict glycemic control in diabetics.

To elucidate the mechanism of impaired pancreatic A cell function in hypoglycemia in diabetics, the effect of long-term strict glycemic regulations on hypoglycemia-induced glucagon secretion was studied. Firstly, the effect of plasma insulin concentrations on suppressing A cell was studied in healthy volunteers by injecting insulin at doses of 0.1 U/kg and 0.3 U/kg. With 0.3 U/kg of insulin, the rate of fall in glycemia and the nadir of blood glucose were made similar to those with 0.1 U/kg of insulin by glucose infusion with artificial endocrine pancreas. Plasma glucagon response after 0.3 U/kg of insulin was significantly suppressed as compared to that after 0.1 U/kg of insulin, demonstrating that not only hypoglycemic stimulus but also plasma insulin concentration were important determinants responsible for glucagon secretion in insulin-induced hypoglycemia. Secondly, effect of strict glycemic control was studied. Short-acting insulin at a dose of 0.1 U/kg was injected in an intravenous bolus form into 12 insulin-dependent (IDDM) and 9 non-insulin-dependent (NIDDM) diabetics before and 1-3 months after strict glycemic control with multiple insulin injections therapy. Before strict glycemic regulations in IDDM, no significant rise in plasma glucagon concentrations was observed during the insulin-induced hypoglycemia. In NIDDM, a rise in plasma glucagon concentrations was observed, though the response was delayed. After strict glycemic regulations, in patients with residual endogenous insulin secretion, the glucagon response to hypoglycemia improved considerably in IDDM and normalized in NIDDM. In IDDM and NIDDM, improvement in glucagon response to hypoglycemia related positively to daily urinary secretion rate of C-peptide.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

[Hormonal and metabolic aspects of diabetes mellitus in the elderly].

Hormonal and metabolic characteristics of diabetes mellitus in the elderly were investigated in the following groups; elderly DM subdivided into obese DM and non-obese DM, elderly non-DM subdivided into obese and non-DM and non-obese non-DM, adult DM and adult non-DM. Responses of plasma glucose, insulin and glucagon during oral glucose tolerance test (OGTT), arginine tolerance test (ATT) and intravenous glucose tolerance test (IVGTT) were measured individually and the daily urinary C-peptide excretion (U-CRP), fasting plasma levels of free fatty acid (FFA), triglyceride (TD), total cholesterol (TC) and HDL-cholesterol (HDL-C) were also measured. In comparison with adults, insulin responses in IVGTT and ATT in elderly non-DM were low but not in OGTT. It was noteworthy that glucagon response during OGTT in elderly DM was considerably lower than adult DM, probably due to factors other than insulin deficiency. Comparing elderly DM and elderly non-DM, the initial response of insulin in OGTT was found to be low in elderly DM but not in total response. In the comparison between the obese and the non-obese, higher insulin levels in elderly obese DM than in elderly non-obese DM during OGTT, IVGTT and ATT were observed, implying decreased insulin sensitivity. This difference, however, was not apparent between elderly obese non-DM and non-obese non-DM. A good correlation between U-CPR and the response of plasma insulin in OGTT was shown even in the elderly but not between U-CPR and that of plasma insulin in IVGTT.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Simultaneous cardio-cerebral ultrasonic measurement technique for assessing the interrelationship between cardiac and cerebral circulations in elderly subjects: a preliminary study.

To assess the interrelationship between the cardiac and cerebral circulations, simultaneous measurements of cardiac output (CO) and common carotid blood flow volume (CCBFV) was performed by M-mode echocardiography of the left ventricle, and quantitative ultrasonic Doppler blood flowmetry of the common carotid artery. The subjects studied were 12 healthy persons living in a home for the elderly ranging in age from 62 to 99 years. These subjects were divided into two groups: those who were in their 90s (Group I, 5 females) with a mean age of 93.6 +/- 3.5 years (mean +/- SD), and those who were in their 60s to 80s (Group II, 1 male and 6 females) with a mean age of 77.1 +/- 8.1 years. The average CO in Group I was 2.85 +/- 0.37 L/min, and 4.18 +/- 0.52 L/min in Group II. The average CCBFV was 4.74 +/- 0.64 dl/min in Group I, and 4.44 +/- 1.01 dl/min in Group II. The ratio of CCBFV to CO was 16.6 +/- 1.32% in Group I, and 10.6 +/- 1.45% in group II. Good linear correlations of y = 1.44x +0.65 (r = 0.82) in Group I and y = 1.58x - 2.15 (r = 0.81, p less than 0.05) in Group II were observed between CO (x) and CCBFV (y). No such close correlations were observed between CCBFV and other indices of left ventricular function such as circumferential fiber shortening or fractional shortening of the diameter of the left ventricle (r less than or equal to 0.56, p greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Echocardiographic assessment of the effect of aging on the diastolic and systolic functions of the left ventricle].

The effects of aging on the diastolic and systolic functions of the left ventricle were studied by echocardiography as follows. (1). Maximum velocity of circumferential fiber lengthening (negative peak Vcf) and shortening (peak Vcf) was assessed by digital M-mode echocardiography in 20 healthy young subjects and 26 healthy elderly subjects. The mean value of negative peak Vcf (-cir/sec) was -3.87 +/- 0.85 in the 20's. -4.48 +/- 1.14 in the 30's, -3.71 +/- 1.21 in the 40's, -2.70 +/- 0.90 in the 60's, -2.57 +/- 0.64 in the 70's, -2.33 +/- 0.77 in the 80's and -2.57 +/- 0.65 in the 90's showing significant difference among young and elderly groups (p less than 0.05- p less than 0.005). The mean value of peak Vcf showed no significant difference among young and elderly groups except for the group in the 30's which showed significant (p less than 0.05) difference between other groups. (2). Indices of the left ventricular systolic and diastolic functions were calculated by standard M-mode echocardiographic technique in 227 healthy subjects from 5 to 94 years in age by dividing them into 3 young groups and 4 elderly groups. As for the left ventricular internal diameters a tendency of increase was observed in the end diastolic diameter of the left ventricle in accordance with ageing. Fractional shortening of the left ventricular diameter which ranged from 36.2% to 36.7% in the 3 young groups and 36.9 to 40.3% in the 4 elderly groups and cardiac output showed no age dependent decrease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Osteopenic changes in high sugar diet-induced diabetic rabbits (HSDD-R).

Rabbits maintained on a persistent high sugar diet eventually develop diabetes mellitus with a marked decline in glucose tolerance, but no studies have been conducted on the associated bone changes in these high sugar diet-induced diabetic rabbits (HSDD-R). Radiographs have revealed a significant thinning of the femoral cortex of these rabbits with markedly decreased bone mass. Scanning electron microscopy of the femoral cortex using the freeze-fractured technique have revealed the loss of a typical structure of Haversian canals and the surrounding concentric and radiating lamellar bones and also the loss of fibrous components in the section. The border created by the cement line was indistinct and resulted in amorphous changes. Formation of heterogenous bundles of fibrous components different from the usual reticular structure was seen within the subendothelial space of the Haversian canals. These results indicate that qualitative changes can apparently occur in the bone along with the development of osteopenia in the diabetic state.

Animals↗
PubMed1990

[The application of the glycemic index to the treatment of diabetes mellitus in the elderly].

For the application of the glycemic index (GI) to the therapy of diabetes mellitus (DM) in the elderly, effects of aging and foods were studied in 3 groups of subjects, conducting 3 oral tests of equal calories, namely, glucose, white bread (high-GI meal) and kidney beans (low-GI meal). Group I: healthy adults (N = 7), Group II: elderly non-DM (N = 7), Group III: elderly DM (N = 7). No significant changes with age could be found in blood glucose or GI. However, ingestion of a low-GI meal revealed excellent inhibitory effects upon postprandial glycemic elevation in the elderly diabetics. This implies the clinical usefulness of a low-GI meal (beans) for postprandial glycemic regulation in elderly diabetes mellitus.

Adult↗
PubMed1990

[Echocardiographic assessment of mitral annular calcification in hypertrophic cardiomyopathy with asymmetric septal hypertrophy and healthy elderly cases].

The prevalence and degree of mitral annular calcification (MAC) in elderly cases of hypertrophic cardiomyopathy with asymmetric septal hypertrophy (ASHCM) were studied in comparison with healthy elderly and chronic hypertensive elderly with concentric left ventricular hypertrophy (HT + LVH) by echocardiography. In seven elderly patients with ASHCM (mean age 77.3 +/- 8.1 years) severe MAC was observed in all cases (1 male and 6 females) and systolic anterior motion of the mitral valve (SAM) was present in 3 cases, incomplete in 2 and absent in 2 cases. Of 57 healthy elderly with a mean age of 78.8 +/- 8.8 years, 8 subjects (1 male and 7 females, 14%) showed MAC. The prevalence of MAC was 0% in the sixties, 14% in the seventies, 16% in the eighties and 29% in the nineties. MAC was severe in four subjects above eighty years old. In 3 cases with HT + LVH with a mean age of 72.3 +/- 4.7 years no MAC was observed and SAM was present in one, partially observed in one and absent in one case, respectively. Serum calcium (Ca) and phosphorus (P), reported to be related with the formation of MAC, and fasting blood sugar level (FBS) were evaluated. In healthy elderly with MAC, serum Ca was 8.78 +/- 0.46 mg/dl, P 3.55 +/- 0.37 mg/dl and FBS 97.75 +/- 29.01 mg/dl, P 3.55 +/- 0.37 mg/dl and FBS 97.75 +/- 29.01 mg/dl.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Fail-safe systems for the wearable artificial endocrine pancreas.

For the long-term clinical use of the wearable artificial endocrine pancreas, a fail-safe system is an essential mechanism. Several hardware alarm systems have been incorporated for battery-down, and short-run of the pumps. Software alarm systems for overflow or underflow of the AD converter, empty bags, hypoglycemia, hyperglycemia, abnormal values of parameters, and excessive insulin infusion have also been built into the system. The software noise filter was effective in eliminating superimposed artificial noises and the noises induced by muscle exercise. Sudden changes in sensor output during glycemic control of diabetics due to short circuit, or disconnection of the sensor lead, were detected as overflow or underflow of the AD converter. A gradual change in the sensor output was heralded by the hyper- or hypoglycemia alarm sound. These data indicated that the fail-safe system built into the wearable artificial endocrine pancreas is useful for the long-term glycemic control of diabetics.

Blood Glucose↗
PubMed1985

Long-term application of wearable artificial endocrine pancreas--closed-loop intravenous vs subcutaneous insulin infusion.

For closed-loop glycemic control on IDDM, closed-loop sc insulin infusion algorithm has developed by analysing the pharmacokinetics of sc insulin absorption. With the algorithm, daily glycemic excursion in IDDMs was controlled to near-normal levels. These data suggested that the closed-loop sc insulin infusion algorithm might be feasible to regulate glycemia in diabetic patients for a long-term period by wearable artificial endocrine pancreas.

Algorithms↗
PubMed1983

Glycaemic control in pancreatectomized dogs with a wearable artificial endocrine pancreas.

A needle-type glucose sensor has been developed using a platinum electrode covered with immobilized glucose oxidase. Experiments with albumin-saline solution in vitro showed that at 5.5 mmol/l glucose concentration the output current generated was 1.2 +/- 0.4 nA (mean +/- SD). The current increased as a linear function of glucose concentration over the range (0-27.7 mmol/l). The response time to reach 90% of the final plateau value was 16.2 +/- 6.2s. The signal-to-noise ratio of the sensor was 15.8 +/- 2.6 decibels. The temperature coefficient in output was 2.3 +/- 1.0%/degrees C. The current output was not affected significantly by changes in oxygen tension of the solution in the range 25-150 mmHg. In vivo, the output current of sensors inserted into the subcutaneous tissues of dogs was directly related to blood glucose concentrations after oral glucose or meals. Daily checking of the sensors maintained in subcutaneous tissues in five dogs showed that the sensitivity decreased gradually to 87.2 +/- 7.6% at 72 h, and dropped significantly to 57.4 +/- 7.0% of the initial output by 96 h. A wearable artificial endocrine pancreas (18.0 x 17.7 x 7.9 cm, 700 g) was developed, consisting of a needle-type glucose sensor, a microcomputer system and a pump driving mechanism. Three pancreatectomized dogs were fitted with the system by inserting the sensor into subcutaneous tissue. By renewing the sensor every fourth day, the device could maintain the daily glucose variations in diabetic dogs within the range 5-9.5 mmol/l for 7 days.

Animals↗
PubMed1983

Evidence of beneficial effects of strict glycemic control on diabetic vascular complications--a prospective study with artificial devices.

This prospective study was undertaken to examine whether glycemic normalization could have beneficial on the course of diabetic vascular complications in 6 insulin-dependent diabetics. A significant amelioration of glycemic regulation was achieved by intensive glycemic control with artificial devices and multiple injections for 3 months, which also resulted in an improvement in conduction velocity, a regression in retinovascular permeability and a decrease in urinary total protein excretion. These results indicate that even after short-term treatment, glycemic near-normalization can have a beneficial effect on the early stage of diabetic vascular complications.

Blood Glucose↗
PubMed1982

Responses to mixed meals in pancreatectomized dogs deprived of postprandial insulin.

Insulin plays a central role in metabolic control after a mixed meal. In the absence of adequate meal insulin release, abnormal circulating concentrations of most meal-derived metabolic substrates can be expected. To quantify these abnormalities in depth, responses of six pancreatectomized dogs on long-term intravenous insulin replacement were compared to those of five normal control dogs. Blood samples were drawn hourly for 24 h via a chronic indwelling catheter, and all animals ate a single mixed meal. To establish whether there were route-related differences, insulin was delivered into either the portal or the peripheral circulation of the diabetic animals at constant rates. These insulin infusion rates resulted in premeal fasting normoglycemia and in normal levels of insulin, glucagon, lactate, pyruvate, 3-hydroxybutyrate, nonesterified fatty acids, and 9 of 13 amino acids. In the absence of enhanced meal insulin infusion, the subsequent responses of glucose, lactate, pyruvate, alanine, and 10 of 13 other blood amino acids were exaggerated in terms of both amplitude and duration. Only minor or transient differences were attributable to the routes of insulin infusion. Remarkably, in spite of these abnormal postmeal responses, basal insulin alone (with constant circulating levels) succeeded in restoring all metabolite and hormonal levels during the postabsorptive period 16-23 h after the meal. Thus, with intravenous insulin infusions, the requirements for fasting metabolic normalization may be considered independently of those for metabolic control following caloric intake. It remains to be shown how prolonged deprivation of the postprandial insulin supplement results in metabolic decompensation under these conditions.

Animals↗
PubMed1981

The metabolic and hormonal responses to a mixed meal in unrestrained pancreatectomised dogs chronically treated by portal or peripheral insulin infusion.

The metabolic and hormonal consequences of long term intravenous insulin replacement were studied in 11 pancreatectomised dogs. Insulin was delivered into the portal circulation of six animals for 164-224 days and into the peripheral circulation of the remainder for 123-365 days. Infusion rates were initially adjusted to achieve normoglycaemia in the fasting (0.37 +/- 0.01 mU Kg-1 min-1 portal; 0.45 +/- 0.03 mU kg-1 min-1 peripheral) and post-prandial states (2.57 +/- 0.07 mU kg-1 min-1 for 7 1/2 h portal; 3.16 +/- 0.18 mU kg-1 min-1 for 7 h peripheral). Animals were fed their usual mixed diet and blood samples were drawn from indwelling catheters at regular intervals for 24 h. A matched group of six normal dogs was similarly studied. Significantly less insulin was needed for glycaemic normalisation with portal (1.05 +/- 0.03 U kg-1 day-1) compared with peripheral (1.27 +/- 0.08 U kg-1 day-1) infusions, but post-prandial insulin levels were not normalised. Glucagon levels were normal and unaffected by the route of insulin infusion. Lactate and pyruvate responses were exaggerated post-prandially in the diabetic compared with the normal dogs. Fasting non-esterified fatty acid levels were suppressed with peripheral but normal with portal insulin infusion. There were only minor differences in the branched chain, essential and other non-essential amino acids except for alanine which was significantly above normal in the diabetic animals. Fasting levels of insulin, lactate, pyruvate and non-esterified fatty acids were normalised only with portal infusion while glucose, glucagon, 3-hydroxybutyrate and most amino acids were normalised regardless of the route of infusion. We conclude that the metabolic regulation achieved with portal insulin replacement is closer to normal than that achieved with peripheral infusion.

3-Hydroxybutyric Acid↗