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Volume 27, Issue 11
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[in Japanese]1984 Volume 27 Issue 11 Pages 1145-1146
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (393K) -
On the Assumption of the Dominance of IDDMToshiyuki Furusho, Hiroshi Yoshimaru, Kinori Kosaka1984 Volume 27 Issue 11 Pages 1147-1156
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn order to elucidate the genetic mechanism of the association between IDDM and HLA, the ratio of epistatic variance to genotypic variance (VI/VG) was estimated on the assumption of linkage equilibrium between IDDM and HLA. Here, the allele responsible for IDDM was assumed to be dominant, and the penetrance of genotype for IDDM was considered. Using the same data as the present study, Furusho et al. (1982) undertook a similar analysis on the assumption that the allele responsible for IDDM was recessive, but some errors were made in the calculations. Thus, they were corrected in the present study.
It was found that the ratio (VI/VG) was 1/2.3 between IDDM and HLA-Bw54, 1/2.7 between IDDM and HLA-DYT, and 1/3.5 between IDDM and HLA-DRw 4, irrespective of the penetrance of the genotype for IDDM, whether the allele for IDDM was dominant or recessive. These estimates suggest the existence of epistatic interaction between loci but the difference of these estimates from zero could not be tested statistically.
It is very difficult to determine whether the association at the phenotype level is due to the linkage disequilibrium at the gamete level or to the epistatic interaction between loci.View full abstractDownload PDF (1147K) -
Norikazu Kitano, Tomohiko Taminato, Michiyo Seno, Hitoshi Ishida, Shig ...1984 Volume 27 Issue 11 Pages 1157-1162
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThere are several methods for the detection of islet cell surface antibodies (ICSAb) including indirect immunofluorescence and radioligand assay using 125I-protein A, but they are not quantitative, cannot deal with many samples at once and have a problem in reproducibility. In order to improve these shortcomings, attempts have been made to detect ICSAb by using 125I-labeled wheat germ agglutinin (125I-WGA) bound islet cell glycoprotein as an antigen instead of living islet cells.
Isolated rat islets were allowed to bind with 125I-WGA, then solubilized with Nonidet P-40 and sonication. This solubilized islet cell protein was incubated with heat-inactivated test sera, then bound, and free antibodies were separated by heat-inactivated, formalin-treated Staphylococcus aureus Cowan I stain (SAC) or by rabbit anti-human IgG or IgM immunobeads.
Since 125I-WGA binding to the islet was inhibited by N-acetylglucosamine (GlcNAc), it is possible that the solubilized islet cell antigen is a glycoprotein with sugar chains including GlcNAc. As a separation method, immunobeads were found to be more suitable than SAC because they showed lower non-specific binding and could detect IgG-and IgM-ICSAb separately. Serum with a higher bound percent than the mean plus 2SD of control sera was decided to be antibody-positive. By this criterion, 54 percent of IDDM patients within one year of diagnosis are IgG-ICSA positive, and 31 percent are IgM-ICSA positive. On the other hand, 22 percent of IDDM patients be yond one year after diagnosis are IgG-ICSA positive, and 17 percent are IgM-ICSA positive.View full abstractDownload PDF (2218K) -
Kunihiro Doi, Masaaki Matsuura, Akira Kawara, Tsutomu Tanaka, Shigeaki ...1984 Volume 27 Issue 11 Pages 1163-1168
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSSix normal and five maturity-onset diabetic subjects were studied. On the first day, they received a control test meal after a 12-hour overnight fast. On the second day, the normal subjects and on the seventh day, the diabetics received the test meals with 3.9 g konjac mannan (glucomannan) respectively. The test meals with vitamins were prepared by adding 3000 r of vitamin B12 (mecobalamin, E1) and 500 mg of vitamin E (tocopherol acetate). Vitamin A (10000 units) was also given to the diabetic subjects with the test meals.
Venous blood samples were taken immediately before the test meal and again at 1, 3, 5, 8, 12 and 24 hours for analysis of vitamins.
The results showed that the absorption rates, of vitamins A and E in the intestine weae reduced when konjac mannan was added to the test meals, but that of vitamin B12 was not.
It is suggested that konjac mannan reduced fat-soluble vitamin absorption removing bile acids, but not fat insoluble vitamin absorption intheintes.View full abstractDownload PDF (687K) -
Akie Kamata, Yukihiro Sato, Mizuo Matsui1984 Volume 27 Issue 11 Pages 1169-1176
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSNinety-one childhood diabetics were studied using ophthalmoscopy and fluorescein angiography. Their ages at onset were confirmed to be less than 15° Based on the results of detailed examinations at our pediatric department, the 91 cases were classified into 33 of insulin-dependent diabetes (IDDM), 37 of non-insulin dependent diabetes (NIDDM), and 21 of chemical diabetes. The cases ranged in age at their initial ophthalmoscopic examination from 2 to 16 years.
Ophthatinoscopic abnormalities, small retinal hemorrhage of short duration and microaneurysm were observed only in the IDDM cases. The incidence of fluorescein angiographic abnormalities showed no difference between the two groups. The incidence of the angiogaphic abnormalities in NIDDM cases over 16 ye ars old was significantly higher than in those under 15 years old. The incidence of abnormal ophthalmoscopic findings was significantly higher in IDDM cases and abnormal angiographic findings were significantly higher in NIDDM cases having a longer duraton.
The multiplied effect of the patient's age and the duration of disease on the incidence of the abnormal findings was analyzed. With regard to the ophthalmoscopic findings of IDDM cases and angiographic findings of NIDDM cases, significantly higher incidences were recognized in the cases over 16 years old and those with more than 5 years, duration of the disease.
This was compared with the cases under 15 years old and with those having less than 5 years, duration of the disease.View full abstractDownload PDF (6923K) -
Toshiyuki Furusho, Hiroshi Maruyama, Kunikazu Kishi, Akira Tonomura, H ...1984 Volume 27 Issue 11 Pages 1177-1185
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSChromosome analysis was carried out in 12 IDDM patients with juvenile-onset diabetes and 12 healthy controls with special reference to the C-band and G-band to study the cytogenetics of the disease.
An analysis using the high-resolution chromosome banding technique and analysis of the G-band were also carried out in four selected cases of the ditease.
1) Out of the 12 patients, two were found to have an unusual chromosome 9, which did not have heterochromatic region on its long arm (9 qh-)(2/12=0.1667±0.1076), while no such case was found in the 12 control subjects. But this difference did not reach the statistically significant level.
Both the above-mentioned two cases with a 9 qh-had allergic manifestations. In particular, one of them was positive for ICA, despite a long duration, eight years, of the disease.
These results suggest a possible relation between 9 qh-and immunological abnormalities.
Generally speaking, variation in the C-band pattern is regarded as genetically inactive hetero-, morphism, having no effects on phenotypes. But recent studies have demonstrated that this region contains DNA with repeated sequences. Furthermore, molecular genetical studies have clarified that repeated sequences may have some relationship with the recombination of the chromosome. Some authors have postulated that there is a repeated sequence, which may play important roles at the end of the chromosome of the yeast.
These results of recent studies may shed light on the relationship between immunological abnormalities and 9 qh-.
2) No abnormalities were found in four IDDM cases in the analysis of the G-band and that with the high resolution banding techniques.
This negative result appears be reasonable, because it is considered that the mean number of genes per band or sub-band ranges from 25 to 165.View full abstractDownload PDF (5614K) -
Akira Kawa, Toshiyuki Furusho, Hiroshi Yoshimaru, Takuro Katsume1984 Volume 27 Issue 11 Pages 1187-1193
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSCytogenetic studies were carried out in 14 non-insulin-dpenedent diabetics (NIDDM) and 12 healdthy controls to clarify the genetic back-ground of the disease.
The number of variations in the C-band were 1.5±1. 2 and 2.3±0.9, respectively, in the patient group and the controls. No statistically significant differences were found in the incidence of C-band variants between NIDDM and the controls. A possible variant, 9 qh-, which was found in some cases of insulin-dependent diabetes mellitus associated with immunological abnormalities, was not found in NIDDM patients.
These results strongly suggest that all of the variants found in NIDDM patients result from heteromorphism, and have no effect on phentype.
No abnormalities were found in either G-band analysis or karyotype analysis using a highresolution chromosome banding technique, which were carried out in these patients with NIDDM.View full abstractDownload PDF (3653K) -
A Prospective Five-year Follow-up StudyToshihiko Mihara, Hiroshi Ohashi, Yukimasa Hirata1984 Volume 27 Issue 11 Pages 1195-1206
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo elucidate the prognosis of diabetic patients in Japan, we undertook a prospective follow-up study of 1, 629 diabetic patients (898 males, 731 females) who visited our Diabetes Center in 1976. In this paper, we describe the results of a five-year follow-up study, especially regarding the relationship between factors present at entry and the prognosis of diabetics.
During this follow-up study, only three cases dropped out within five years from the start. The deaths of 184 (127 males, 57 females) were confirmed at the end of the five-year follow-up. We obtained copies of death certificates for all the deceased patients.
Unfavorable prognostic factors at entry were as follows: an age at onset of younger than 30 years, a relative body weight of less than 90%, insulin treatment, a systolic blood pressure in excess of 200 mm Hg, a diastolic blood pressure in excess of 110mm Hg, a fasting plasma glucose level of more than 200 mg/dl, a plasma total cholesterol level of less than 150mg/dl or more than 300 mg/dl, a plasma triglyceride level of more than 300 mg/dl, a plasma urea nitrogen level of more than 30 mg/dl, a plasma uric acid level of more than 10 mg/dl, and the presence of diabetic neuropathy, retinopathy or proteinuria.
Malignant neoplasms were the leading cause of deatd among all the deceased diabetics and cerebrovascular disease, ischemic heart disease diabetic nephropathy and infections followed, in that order. However, diabetic nephropathy, ischemic heart disease and cerebrovascular disease were the main causes of death among the cases with following factors at entry; an age at onset of younger than 30 years, a relative body weight of more than 130%, a systolic blood pressure of more than 180mm Hg, a diastolic blood pressure of more than 100 mm Hg, a plasma total cholestcrol level of more than 300mg/dl, a plasma triglyceride level of more than 300mg/dl, a plasma urea nitrogen level of more than 30 mg/dl, a plasma uric acid level of more than 10mg/dl, and the presence of diabetic neuropathy, proliferative retinopathy or proteinuria.View full abstractDownload PDF (1930K) -
Eisuke Takazakura, Hiroshi Makino, Yasuto Terada, Hiroshi Tsuji1984 Volume 27 Issue 11 Pages 1207-1213
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe Report a case of severe brittle diabetes with undetectable C-peptide, in whom near-normal glucoregulation was successfully achieved by coritinuous intraperitoneal insulin infusion (CIPII) with a portable pump, although our first attempt to achieve a fair metabolic equilibrium by either intensified conventional insulin therapy (ICIT) with self-monitoring blood glucose or continuous insulin infusion (CSII) resulted in failure.
The patient, a 57-year-old man with a 26-year history of diabetes was admitted to our hospital on September 16, 1983 for poor control of blood glucose. He had been receiving injections of a mixture of short-acting and intermediate insulin three times a day.
Six-day glycemic profiles obtained with each treatmet, by ICIT, CSII and CIPII were compared. The M value of each treatment was 117.8±36.2 (mean±SD), 43.7±20.4 and 5.4±1.2 respectively.
The blood glucose level during CIPII was between 75-180 mg/dl, and the plasma-free IRI concentration wat periodically measured 23 times between 6: 30 and 21: 00. A sharp peak of free IRI, coincident with the rise in glucose after each meal, was obtained. This was similar in the plasma insulin profile pattern to normal subjects.
This report suggests that CIPII can maintain near-normal glucoregultion even in C-peptide negative brittle diabetics, who are unable to achieve good glycemic control by conventional ICIT or CSII methods.View full abstractDownload PDF (3403K) -
Taro Wasada, Hiroshi Ono, Yasuhiro Sako, Fumio Umeda, Jun Watanabe, To ...1984 Volume 27 Issue 11 Pages 1215-1222
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe previously reported a 19-year-old girl who showed marked insulin resistance (maximum insulin dose 360 U/day) and polycystic ovary syndrome. This is a report on an eight-year follow-up of this unique patient. Anti-insulin receptor antibodies (AIRA) initially detected in this patient disappeared over six months of clinical course, accompanied by spontaneous remission. Her polycystic ovary was successfully treated by wedge resection. Subsequently diabetic control was stabilized with oral hypoglycemic agents for four years, followed by diet alone for six months. Then she developed diabetic ketoacidosis upon supervention of acute pyelonephritis and an insulin regimen was reinstituted, thereafter. Although her insulin requirement (average 50 U/day) was not so large ad neither AIRA nor hyperandrogenism was present at this time (eight years after first admission), a considerable degree of insulin resistance was still demonstrated by the insulin tolerance test and the insulin suppression test (IST). A prominent feature of this case was chronic elevation of plasma FIRI (62-130 μU / ml) in blood drawn before injection of daily morning insulin and an exceptionally high steady state plasma FIRI level (370 μU / ml) shown by the IST. The patient's low CPR values in both plasma and urine suggest that the hyperinsulinemia found in this case was derived largely from exogenous insulin. Erythrocyte insulin binding was low due to a decrease in insulin receptor numbers. These findings suggest that an impaired receptor-mediated clearance of free insulin, the biologically active fraction, is responsible for the persistent high plasma FIRI found in this patient.View full abstractDownload PDF (1168K) -
S. Okada, Y. Miyai, K. Sato, Y. Masaki, Z. Ota, A. Takeda, T. Yoda1984 Volume 27 Issue 11 Pages 1223-1225
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe purpose of the present study was to examine the relation between ICSA, which is detected early in the course of IDDM in childhood, and the complement system. From among 90 children with IDDM occurring before 15 years of age who participated in summer diabetes camps in two populous districts of western Japan, 21 patients whose onsets of the disease were less than one year prior to the camps were chosen for study. ICSA was detected by the original method of Lernmark. C3 and C4 blood levels were determined by the immunodiffusion technique. Student's t-test was used for statistical analysis of the data.
Of the 21 patients 11 were ICSA-positive and the remaining 10 were negative for ICSA. The ICSA-positive patients had a mean blood C3 level of 63.6±8.9mg/dl (SD) which was lower than that of the ICSA-negative patients (76.6±13.3mg/dl)(p<0.02). The mean C4 blood level of the ICSA-positive patients (20.5±5.3 mg/dl) was lower than that of the ICSA-negative patients (31.8±9.0mg/dl)(p<0.01). These findings suggest the possibility that complement-dependent antibodymediated cytotoxicity may play a role in the pathogenesis of IDDM in childhood.View full abstractDownload PDF (413K) -
1984 Volume 27 Issue 11 Pages 1227-1240
Published: November 30, 1984
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (2725K)
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