Tohru Murakami

Left ventricular filling determined by Doppler echocardiography in diabetes mellitus

Abstract Diabetes mellitus is associated with a high mortality from cardiac disease attributed to coronary artery atherosclerosis or systemic hypertension. Increasing evidence indicates that cardiac dysfunction occurs even in diabetics with normal coronary arteries. 1–3 In 1972, Rubier et al 1 reported 4 adult-onset diabetic patients who had cardiomegaly and congestive heart failure in the absence of major coronary artery disease or hypertension. Hamby et al 2 observed a high incidence of diabetes mellitus in their series of patients with idiopathic cardiomyopathy. Furthermore, several investigators have shown that abnormalities of left ventricular (LV) diastolic function are common even in diabetics without clinical manifestations of congestive heart failure. 3–6 Whether these abnormalities result from a microangiopathic process in the heart or from metabolic abnormalities inherent to diabetes mellitus is still unclear. 7 Measurement of transmitral flow velocity by Doppler echocardiography has recently been shown to be useful in identifying abnormal LV diastolic filling properties in a variety of disease states. 8–11 This study evaluates the diastolic LV filling characteristics in patients with adult-onset diabetes mellitus using pulsed Doppler echocardiography.

RHABDOMYOSARCOMA WITH BONE MARROW METASTASIS SIMULATING ACUTE LEUKEMIA

Rhabdomyosarcoma manifested as a systemic disease is very rare and cases showing diffuse metastasis in the bone marrow are most unusual. Recently we encountered two cases of rhabdomyosarcoma with diffuse bone marrow metastasis which were clinically manifested as acute leukemia. The first patient was a 15‐year‐old female, who was admitted in 1982 with pancytopenia and many large primitive cells in bone marrow aspirates, hematological malignancy being diagnosed. Thereafter the bilateral breasts showed rapid swelling and a biopsy specimen revealed the histological features of typical alveolar rhabdomyosarcoma. The primary site of the neoplasm remained undetermined during the course. At autopsy, it was disclosed that the neoplasm originated from the left thigh and showed generalized metastasis. The second patient was a 38‐year‐old man, who was admitted in 1986 because of a nasal polyp obstructing the nasal cavity, and persistent nasal bleeding. Peripheral blood samples showed leucoerythroblastosis and thrombocytopenia, and large primitive cells were found In bone marrow aspirates, so that hematological malignancy was initially diagnosed. A biopsy specimen of the nasal polyp showed proliferation of large round cells and electron microscopy demonstrated the ultrastructural features of rhabdomyosarcoma.

Glucocorticoid receptor in chick erythrocytes

Glucocorticoid receptor in chick erythrocytes has been characterized. The Scatchard plot analysis of (3H)-dexamethasone binding to red cells showed a single class of binding sites. The apparent Kd of (3H)-dexamethasone binding by whole cell assay was 0.33 nM and the maximum binding capacity was 5.1 fmole/10(7) cells. The apparent Kd of (3H)-dexamethasone binding to cytosol receptor was 0.48 nM. Steroid binding specificity was similar to that reported for leukocytes.

Effect of glycyrrhizine on hyperkalemia due to hyporeninemic hypoaldosteronism in diabetes mellitus

Liquorice extract has been claimed to induce inhibition of the activity of 11 beta-hydroxysteroid dehydrogenase which converts cortisol to cortisone. This enzyme is thought to protect the mineralocorticoid receptor from being occupied by endogeneous glucocorticoids in the kidney. Based on these hypotheses, we investigated the effect of low-dose glycyrrhizine on hyperkalemia due to hyporeninemic hypoaldosteronism in eight subjects with NIDDM. The mean serum potassium concentration decreased from 5.3 +/- 0.3 (SD) mEq/1 to 4.9 +/- 0.2 mEq/1 when 15 g of calcium polystyrene sulfonate, a potassium-binding resin, was given per day, and it decreased significantly to 4.4 +/- 0.4 mEq/1 with 150 mg/day of glycyrrhizine therapy. Changes in fasting plasma glucose and hemoglobin A1c were not significant. These data support the assumption that liquorice extract can be used safely in the therapy for treating hyperkalemia due to selective hypoaldosteronism in diabetes mellitus subjects.

Corticosteroid receptor in type II pneumocytes of the rat

Glucocorticoid receptor in rat type II pneumocytes has been characterized. The Scatchard plot analysis of 3H-dexamethasone binding to type II cells showed a single class of binding sites. The apparent Kd of 3H-dexamethasone binding by a whole cell assay was 9.1 nM and the maximal binding capacity was 78.0 f mol/10(6) cells (0.31 pmol/mg cytosol protein).