The effect of physical training on serum lipid levels in relation to insulin sensitivity was studied in 18 patients with NIDDM. The 8-week physical training consisted of jogging and stretching ...exercises for one hour, in addition to diet therapy. Insulin sensitivity was determined using the insulin clamp technique. The following results were obtained: (1) After the 8-wk training period, the rate pressure product (heart rate systolic blood pressure) decreased by 13.0% at rest, 15.2% at stage 1, and 13.2% at stage 2 during treadmill testing (p<0.05). (2) Glucose metabolic clearance rate (MCR) under euglycemic insulin clamp increased significantly during the training program (p< 0.01). (3) Serum triglyceride (TG) decreased and HDL-cholesterol (HDL-C) increased significantly (TG: p<0.01, HDL-C: p<0.01). (4) The increase in MCR correlated significantly with the decrease in TG (r=0.46, p<0.05) and the increase in HDL-C (r=0.74, p<0.01) during the training programs. In conclusion, these data suggested that the decrease in serum triglyceride and the increase in HDL-cholesterol levels induced by physical training are related to improved insulin sensitivity in patients with NIDDM.
In reconstructive surgery for head and neck cancer, it is most important to perform the operation with cooperative teamwork between the resection side and reconstruction side. On the resection side, ...the operator should carefully preserve a good blood supply and healthy tissue of the surgical cut end and carefully manage the vessels for microanastomosis. On the reconstruction side, the operator should prepare the best flap with a good blood supply and suitable volume, and perform reconstruction to produce the best post-operative function with some devices to avoid complications. To achieve excellent head and neck reconstructive surgery seamlessly, it is essential that the operators know each other's intentions in detail and cooperate with each other.
To evaluate glomerular charge selectivity in patients with type 2 diabetes, we studied changes in fractional clearance of proteins with different sizes and charges when patients were placed on two ...diets with different salt contents.
Nineteen patients with type 2 diabetes and normoalbuminuria (< 20 micrograms/min, n = 8), microalbuminuria (20-100 micrograms/min, n = 7), or advanced albuminuria (> 100 micrograms/min, n = 4) were placed on a low-salt diet (85 mEq of sodium daily) or a high-salt diet (255 mEq of sodium daily) for 1 week, and then on the other diet, in random order. Fractional clearances of albumin and immunoglobulin G (IgG) were calculated on the last 3 days of each diet.
In patients with normoalbuminuria, the high-salt diet increased the fractional clearance of IgG, which is electrically neutral, but the fractional clearance of albumin, which is anionic, was unaltered, suggesting that the pore charge of the glomerular barrier was unaffected. However, in patients with microalbuminuria, the high-salt diet increased the fractional clearances of IgG and albumin equally, indicating some neutralization of the pore charge. Fractional clearance of IgG in these first two groups was similar when salt intake was low, so pore size was the same in these groups. In patients with advanced albuminuria, fractional clearance of IgG was higher than in the other groups, indicating that size selectivity had worsened.
In type 2 diabetic patients, charge selectivity is lost before size selectivity as diabetic nephropathy progresses.
The type B insulin-resistance syndrome is characterized by the presence of anti-insulin receptor antibodies that cause severe insulin resistance. Treatments including steroids, cyclophosphamide, ...plasmapheresis, or insulin-like growth factor-1 (IGF-1) are chosen according to severity of insulin resistance. We describe a patient with type B insulin resistance syndrome who was treated successfully with human recombinant (hr) IGF-1, although this treatment provoked a severe allergic reaction. An elderly man with impaired glucose tolerance and unpredictable hypoglycemic episodes which were gradually worsening increased in hemoglobin (Hb)A1c concentration from 6.5 to 13.4%. His fasting and postprandial hyperglycemia were associated with severe hyperinsulinemia. The patient was diagnosed with type B insulin-resistance syndrome by the presence of anti-insulin receptor antibodies. Double-filtration plasmapheresis, plasma exchange, and immunosuppressive therapy with cyclophosphamide and cyclosporin all failed to suppress anti-insulin receptor antibodies more than transiently. When we attempted the treatment by daily administration of hrIGF-1, fasting and postprandial plasma glucose concentrations became normal and HbA1c levels decreased to 7.1% over 2 months, until on one occasion administration resulted in anaphylaxis. After the patient became stable, desensitization therapy was performed successfully, and hrIGF-1 could be administered again with the plasma glucose returning. We concluded that IGF-1 therapy was an effective treatment choice for type B insulin-resistance syndrome in cases whose plasma exchange and immunosuppressive therapy have failed.
A conceptual diagram of upward gas migration in a shallow ground, hydrogeological structure model and two phase flow model of groundwater and methane were constructed in this study using results of ...the survey and the test which were performed for the shows of the natural gas in the surface adjacent to the fault and its fractured zone. Numerical simulation of the methane upward movement in the ground was conducted by using these models. The results showed that capillary pressure, methane saturation of around 0.02-0.03 at 100m deep, fault fracture zone, and trap structure caused by fault displacement could reproduce the behavior of the methane movement in the shallow ground.
The aim of this research is to clarify problems of communication among children, which is declining in most of rural areas because of decrease in population and urbanizing lifestyles.We evaluated ...their communications in a quantitative way to grasp the differences from distinctions in spatial and temporal conditions. We analyzed those data to clarify the effects of their residential character and their private lessons after school to communication in the suburban area. As a result, their main spaces for communication were only private ones, such as their houses and their friends houses, and they seldom use public spaces or distinctive rural spaces. From the evaluations it was also clarified that each space had particular time to be used and specific area of users. In the most developed (urbanized) area children communicated with each other frequently. The reason for this tendency of privatization and urbanization was considered that their residences were scattered around the school area and it was difficult to share communication spaces, and their private lessons were given in the time when public communication spaces were used mostly.
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