Toshihiro Akai

Thyroid hormone abnormalities in patients with diabetes mellitus

Thyroid hormone abnormalities in serum were investigated in 47 patients with diabetes mellitus. Although no significant differences in T4 were found between normal subjects and diabetics, a group of diabetics whose fasting blood sugar levels were over 250 mg/dl showed significantly higher reverse T3(rT3) (p < 0.01) and lower T3 levels (p < 0.05) than healthy controls. A significant correlation was observed between rT3and FFA levels in diabetics. Moreover, patients in diabetic ketoacidosis showed markedly high rT3 with low T3 levels. With insulin treatment, these levels returned to normal in several days. These findings suggest that the reduction of T3and the increase of rT3 may indicate an adaptation to limit catabolism in diabetics.

Changes in serum enzyme activity after transcatheter arterial embolization for hepatic neoplasm

We assayed serum levels of certain enzymes and tumor markers in patients after transcatheter arterial embolization (TAE) to evaluate the effectiveness of this treatment. Twenty patients had hepatocellular carcinoma and two patients had metastases to the liver from colon cancer. Assays were first done immediately after TAE and were continued for the next 12 days. Glutamic oxaloacetic transaminase (GOT; EC 2.6.1.1, L-aspartate:2-oxoglutarate aminotransferase), glutamic pyruvic transaminase (GPT; EC 2.6.1.2, L-alanine:2-oxoglutarate aminotransferase), and lactate dehydrogenase (EC 1.1.1.27; (S)-lactate:NAD+ oxidoreductase) peaked 24 to 48 h after TAE and returned to the base lines in 7 to 10 days. Mitochondrial GOT (mGOT) and glutamate dehydrogenase (GLDH; EC 1.4.1.2, L-glutamate:NAD+ oxidoreductase) also peaked at the same time after TAE. alpha-Fetoprotein peaked 2 h after TAE and decreased to half of the baseline on day 7. Carcinoembryonic antigen peaked at 24 h and fell at 48 h only in the patients with colon cancer. The total amount of cytosolic GOT, GPT, mGOT, and GLDH released was correlated to the volume of the necrotic mass estimated by computed tomography scans. The correlation coefficients for mGOT and GLDH were r = 0.919 and r = 0.939 (both p less than 0.001), respectively. Assays of mGOT and GLDH may be useful to estimate the volume of the necrotic mass of a hepatoma or metastatic carcinoma in the liver.