Hajime Ide

Characteristics of pulmonary function in patients with diabetes mellitus

The incidence of pulmonary diseases among diabetics in Japan has been found to be more than 50% at death. This suggests the existence of some pulmonary risk factors. We analyzed pulmonary functions in 50 diabetics (31 males and 19 females) without overt lung disease, compared to 21 healthy male subjects of the same age (around 50 years old). Forced vital capacity and timed vital capacity were lower in diabetics (P less than 0.005). Diffusing capacity was also decreased in male diabetics (P less than 0.05). Among diabetics, a decrease in the diffusing capacity was dominant in patients with diabetic retinopathy, which correlated with an increasing duration of their diabetes. Analysis by the partial correlation method which accounts for the smoking index showed that standardized indices for peripheral airflow in male diabetics decreased significantly as the patients age increased (P less than 0.005); the rate of decrement was greater than that of the control subjects. Diabetic patients showed abnormal lung function in the peripheral airways which increased with age and gas transfer was also affected by diabetic microangiopathy as well as the duration of diabetes. These changes seemed to deteriorate progressively, possibly combining and contributing to respiratory insufficiency in critical pathological conditions.

Clinical application of breath analysis for dimethyl sulfide following ingestion of dl-methionine

After overnight-fasting, the concentration of dimethyl sulfide in expired alveolar gas (alv-DMS) was determined serially following ingestion of 2 g of DL-methionine in normal subjects and patients with liver diseases. Alv-DMS rose to a peak in 30 to 90 min, declined markedly within 3 h, and then decreased gradually. Half-disappearance times (T 1/2) (mean +/- S.E. min) in each experimental group were: normal (N = 9) 61.7 +/- 4.7, acute hepatitis (N = 6) 62.5 +/- 6.8, chronic hepatitis (N = 10) 84.0 +/- 13.0, and liver cirrhosis (N = 13) 159.2 +/- 30.4, respectively. Cirrhotics had a T 1/2 significantly longer than that of the other three groups: vs. normal P less than 0.02, vs. acute hepatitis P less than 0.05, and vs. chronic hepatitis P less than 0.05. T 1/2 of alv-DMS following ingestion of DL-methionine seems to be of clinical interest.

Plasma cyclic nucleotide responses to insulin-induced hypoglycaemia and methacholine in patients with hyperthyroidism

Abstract. The effect of insulin‐induced hypoglycaemia and methacholine on plasma cAMP and cGMP levels was studied in normal volunteers, hyperthyroid and hypothyroid patients. A significant positive correlation existed between the maximal increase in plasma cAMP and the maximal decrease in plasma glucose in normals during insulin‐induced hypoglycaemia. Therefore, the plasma cAMP response is considered to be dependent on the degree of hypoglycaemia, rather than the dose of insulin. The cAMP response to hypoglycaemia was significantly higher in hyperthyroid patient, and was lower in patients with hypothyroidism than in normals. The cAMP response of the hyperthyroid patients was normalized when their hyperthyroidism was controlled after 3 months of treatment. The plasma level of cGMP was slightly elevated during hypoglycaemia, but there was no significant difference between controls and hyperthyroid patients. The cGMP response to methacholine, which is probably mediated by cholinergic receptors, was significantly potentiated in hyperthyroid patients. The cAMP response, which is presumably dependent on endogenous catecholamines secreted during metha‐choline‐induced hypotension, was also enhanced in hyperthyroid patients. It is likely that β‐adrenergic receptor responses and cholinergic receptor responses are both enhanced in hyperthyroidism.

Effect of thyroid hormone on the levels of erythrocyte carbonic anhydrase isozymes and 2,3-diphosphoglycerate in rabbits

Levels of rabbit erythrocyte carbonic anhydrase B and C isozymes were determined in experimental hyperthyroidism using a quantitative immunologic technique. Levels of erythrocyte 2,3-diphosphoglycerate and protein binding iodine were simultaneously determined. Thyroxine and 3,5,3-triiodothyronine were administered to rabbits orally for 30 days. A significant decrease in carbonic anhydrase B type was observed after 30 days, although no significant change was observed in carbonic anhydrase C type. These findings suggest that the steady state level of carbonic anhydrase B type in red cells is affected by thyroid hormone more readily than that of carbonic anhydrase C type. The level of red cell 2,3-diphosphoglycerate increased markedly after 10 days of treatment, corresponding to the increase of protein binding iodine. The clinical or pathologic significances were discussed in relation to the changes in the levels of these isozymes and 2,3-diphosphglycerate in red cells.

Improvement of respiratory resistance by hot water immersing exercise in adult asthmatic patients

Acute effect of hot water immersing exercise on respiratory resistance (RR) was investigated in 12 adult asthmatics and six healthy males. They underwent mild exercise with comparable heart rates (HR = 120) in a hot water pool (water temp. 38°C) for 10 minutes. RRs were measured before and until 40 minutes after the exercise. Mean RRs of the patients before exercise (0.36 Kpa/l/s) reduced to less than 0.32 during 15 to 30 minutes after exercise (p<0.05). RRs of healthy subjects (0.19 Kpa/l/s) did not decrease significantly. Analysis of humoral factors relating to exercise metabolism and autonomic nervous system function of the patients suggested that the influence of sympathetic nervous activation persisted until 20 minutes after exercise. This physiotherapy had a specific feasibility for adult asthmatics in preventing exercise-induced wheezing.