Diet control to achieve euglycemia induces significant loss of heart and liver weight via increased autophagy compared with ad libitum diet in diabetic rats

Intensive glucose control increases the all-cause mortality in type 2 diabetes mellitus (T2DM); however, the underlying mechanisms remain unclear. We hypothesized that strict diet control to achieve euglycemia in diabetes damages major organs, increasing the mortality risk. To evaluate effects on major organs when euglycemia is obtained by diet control, we generated a model of end-stage T2DM in 13-week-old Sprague-Dawley rats by subtotal pancreatectomy, followed by ad libitum feeding for 5 weeks. We divided these rats into two groups and for the subsequent 6 weeks provided ad libitum feeding to half (AL, n=12) and a calorie-controlled diet to the other half (R, n=12). To avoid hypoglycemia, the degree of calorie restriction in the R group was isocaloric (g per kg body weight per day) compared with a sham-operated control group (C, n=12). During the 6-week diet control period, AL rats ate three times more than rats in the C or R groups, developing hyperglycemia with renal hyperplasia. R group achieved euglycemia but lost overall body weight significantly compared with the C or AL group (49 or 22%, respectively), heart weight (39 or 23%, respectively) and liver weight (50 or 46%, respectively). Autophagy levels in the heart and liver were the highest in the R group (P<0.01), which also had the lowest pAkt/Akt levels among the groups (P<0.05 in the heart; P<0.01 in the liver). In conclusion, glycemic control achieved by diet control can prevent hyperglycemia-induced renal hyperplasia in diabetes but may be deleterious even at isocaloric rate when insulin is deficient because of significant loss of heart and liver mass via increased autophagy.

A High Carbohydrate Diet Induces Insulin Resistance Through Decreased Glucose Utilization in Ovariectomized Rats

BACKGROUND: Recent research has reported that high sugar diets increase insulin resistance, without abdominal obesity, in male, but not female Wister rats. Whether a high sucrose (SU) diet increased insulin resistance in ovariectomized (OVX) rats was determined. METHODS: Female Sprague Dawley rats, weighing 273 +/- 20 g, had either an ovariectomy or a sham operation (sham). OVX and sham rats were divided into two groups: one group had a 68 En% SU diet and the other a 68 En% starch (ST) diet for 8 weeks. RESULTS: The body weight was higher in the OVX than the sham rats, regardless of dietary carbohydrate subtype. The fasting serum glucose levels did not differ according to diet and ovariectomy. However, the fasting serum insulin levels were higher in the OVX than the sham rats, and in the OVX rats, a high SU diet increased the serum insulin levels more than a high ST diet. The whole body glucose disposal rates, which referred to the state of insulin sensitivity, were lower in the OVX rats fed both the high SU and ST diets, compared to sham rats. Glycogen deposits in the soleus and quadriceps muscles were lower in the OVX rats fed high SU and ST diets than in sham rats. The glucose transporter 4 content and fraction velocity of glycogen synthase in muscles showed similar glucose disposal rates. However, the triacylglycerol content in the muscles were higher in the OVX rats with a high SU diet than those with a high ST diet. CONCLUSION: These results suggested that an OVX increased the weight gain due to higher food intakes, regardless of dietary carbohydrate subtypes. OVX-induced obesity may be involved in the induction of insulin resistance from an increased triacylglycerol content, decreased glucose uptake and glycogen synthesis in skeletal muscles, regardless of dietary carbohydrate subtypes.

An Automatic System for the Delivery of Eye-Drops Using a Microinfusion Pump

PURPOSE: To evaluate the efficacy of continuous drug delivery system using microinfusion pump by animal study METHODS: Schirmer test was performed after connecting the microinfusion pump at the superior fornix of rabbit eye. The pump was settled to instill artificial tears. We also evaluated the efficacy of continuous 0.1% fluorometholone infusion after alkali burn induced by 1N NaOH. RESULTS: Average change in Schirmer tear test value was 12.0mm/5min. The recovery after alkali burn was improved in the eye of continuous infusion of steroid eye drops. CONCLUSIONS: Microinfusion pump was thought to be useful as a continuous eye drops delivery system. It would be applicable to infuse artificial tears continuously in severe dry eye patients and to infuse antibiotic eye drops in infectous eye disease patients.

The effects of dietary caloric distribution and exchange on insulin secretion and insulin resistance in rats / 대한내과학회지

BACKGROUND: In Korea, the prevalence of type 2 diabetes has been rapidly increased in parallel with the westernization of eating behavior, which can be potential contributors for insulin resistance. We determined whether Western diet (WD), Korean diet (KD), Western-Korean exchange diet (WDK), Korean-Western exchange diet (KDW) and control diet (CD) altered insulin secretion and insulin resistance in weaning male Sprague Dawley rats. METHODS: Weaning rats were provided by KD (77 En% of starch, 5 En% of corn oil and 13 En% of gluten plus 5 En% of casein), WD (42 En% of starch, 40 En% of butter and 18% of casein) or CD (62 En% of starch, 20 En% of corn oil and 18% of casein) for 21 weeks. At the 13th week, rats in the WDK and KDW groups exchanged the diets from WD to KD and KD to WD, respectively, and they continued on the exchanged diets for 9 weeks. RESULTS: Fasting serum glucose levels were lower in KD and WDK than any other groups. Insulin secretion was higher by 2.2+/-0.4 folds in WD and 1.9+/-0.3 folds in KDW than KD at baseline. In hyperglycemic clamp, insulin secretion to maintain 11.1 mmol/L of serum glucose levels showed the same results as the baseline. Whole body glucose disposal rates were highest in KD among all groups. Glycogen deposits in soleus and quadriceps muscles were highest in KD among all groups, and their triglyceride contents were lowest. GLUT4 contents and fraction velocity of glycogen synthase were highest in KD in soleus muscles. CONCLUSION: Westernized high fat diets increased insulin resistance, and insulin secretion increased to overcome insulin resistance. Increased insulin resistance was due to increased triglyceride and decreased glycogen, GLUT4 and glycogen synthase contents in muscles.

Blood glucose/insulin index and carbohydrate-to-insulin ratio in Korean type 2 diabetic patients treated by continuous subcutaneous insulin infusion / 대한내과학회지

BACKGROUND: According to the results of Diabetes Control and Complication Trial, the best strategy to prevent and/or delay diabetic complications is to maintain the normal blood glucose levels. This led to emphasize the necessity of intensive management of diabetes. The purpose of the study was to determine blood glucose/insulin index and carbohydrate (CHO)-to-insulin ratios after normalization of blood glucose levels, and to select the factors to influence the blood glucose/insulin index and CHO-to-insulin ratios in Korean type 2 diabetic patients with continuous subcutaneous insulin infusion (CSII) treatment using insulin pump and CHO counting as a meal management. METHODS: Fifty-five type 2 diabetic patients who started CSII therapy checked their blood glucose levels before and after three meals, and recorded the amounts of insulin injected in fasting and each meal and the amounts of carbohydrates consumed in each meal. Actual blood glucose/insulin index and CHO-to-insulin ratio were determined using the records, and also they were calculated using Functional Insulin Treatment Training Methods (FITTM) proposed by Howorka. Calculated values were compared to actual values. The meaningful factors to influence the actual values were selected by backward stepwise regression analysis. RESULTS: The average age of the subjects was 49.9+/-12.5 years, and the duration of diabetes was 8.7+/-4.5 years. Their body mass index was 22.5+/-3.6 kg/m2. Daily insulin requirements to normalize the blood glucose levels reached to maximum levels at l0 day CSII treatment, and they were reduced and stabilized after 20 days of the treatment. The quotient K, representing insulin sensitivity, was also decreased after CSII treatment. The basal insulin index was 0.21 IU/kg at 10 days and 0.16 IU/kg at 20 days in our study, and these values were lower than the value from FITTM, 0.35 IU/kg The blood/glucose index was -2.5 mmol/L at 10 day CSII treatment, and it was decreased to -4.4 mmol/L at 20 day treatment to the stable levels. CHO-to-insulin ratio provided by FITTM was 2.59 IU/CHO exchange unit and the ratio was 3.12 IU/CHO exchange unit at 10 days, which was decreased to 1.84 IU/CHO exchange unit at 20 days in our study. CHO-to-insulin ratios at breakfast from carbohydrate counting were higher than those of lunch and dinner, and the ratios were 1.5 to 2.5 IU/CHO exchange unit. According to the stepwise regression analysis, the blood glucose/insulin index was affected by gender, age, body mass index (BMI), fasting blood glucose levels and fasting c-peptide levels, and CHO-to-insulin ratios were influenced by gender, age, BMI, post-prandial blood glucose levels and post-prandial c-peptide levels. CONCLUSIONS: CSII treatment can make blood glucose levels maintain in normal ranges in Korean type 2 diabetic patients, and can improve insulin sensitivity. Basal insulin requirements were lower and prandial insulin requirements were higher than those calculated from FITTM. This difference between Korean and the Western can be related to difference of insulin secretion from pancreas and nutrient intake.

The effect of continuous subcutaneous insulin infusion therapy on oxidative stress in Korean type 2 diabetic patients / 대한내과학회지

BACKGROUND: It is known that hyperglycemia increase oxidative stress. Korean type 2 diabetic patients usually appear to be insulin deficient and insulin resistant. The blood glucose control can be normalized by the intensive insulin therapy. It has been reported that hyperinsulinemia have harmful effects on oxidative stress. The purpose of this study was to determine whether continuous subcutaneous insulin infusion (CSII) therapy by insulin pump affects the defense mechanism of oxidative stress in Korean type 2 diabetic patients. METHODS: Fasting blood from eighty three subjects was collected prior to starting CSII therapy using portable insulin pump and after hospitalization for 2 weeks. Serum and red blood cell lipid peroxide concentrations were analyzed by Yagi's methods. Serum tocopherol and vitamin C concentrations were measured by HPLC. Red blood cell glutathione peroxidase, superoxide dismutase and catalase activities were also measured. RESULTS: The mean age of subjects were 50.0+/-10.9 years, and they had diabetes for 8.4+/-5.8 years. Their average body mass index was 23.4+2.7 kg/m2. Their blood glucose levels were not controlled by oral hypoglycemic agents, diet and exercise treatment. Patients were divided into two categories according to blood glucose levels prior to CSII treatment. One category consists of patients with less than 11.1 mmol/L of average daily blood glucose levels prior to CSII treatment (the controlled group). The other category consists of patients with more than 11.1 mmol/L of average daily blood glucose levels (the uncontrolled group). Patients in the uncontrolled group had higher serum lipid peroxide levels than those in the controlled group before CSII therapy. After 2 weeks of CSII therapy, oxidative stress was not changed in controlled and uncontrolled groups. Serum insulin levels of all patients were increased after CSII treatment, but the levels before and after treatments were in the normal range, not hyperinsulinemic. Also, serum insulin levels did not correlate with serum lipid peroxide levels regardless of CSII treatment. Average serum vitamin C levels were remarkably increased after the therapy in all patients, but average serum total tocopherol levels was not altered. Also, activities of antioxidant enzymes such as glutathione peroxidase, superoxide dismutase, and catalase were not significantly changed. CONCLUSION: The blood glucose levels were normalized with the normal ranges of serum insulin levels after two weeks of CSII treatment. However, serum lipid peroxide levels were not changed even though serum vitamin C levels were increased. It is concluded that the oxidative stress of Korean type 2 diabetic patients are not changed after two weeks of CSII treatment, but there may be possibility the longer duation of CSII therapy may gradually improve oxidative stress.

The Effect of Surgical Stress on Insulin Resistance in Rats / 대한내분비학회지

BACKGROUND: It has been reported that surgical stress increased insulin resistance in human. However, there was no research about insulin resistance induced by surgical sttess in Korea. Catheters needed to be inserted in carotid artery and jugular vein of male Sprague Dawley rats to perform euglycemic hyperinsulinemic clamp procedures. The insertion of catheters in rats is a major surgery, which may increase insulin resistance. The purpose of the study is to determine whether surgical stress influence the insulin resistance. METHODS: The euglycemic hyperinsulinemie clamp procedures were performed 5 hours and 7 days after insertion of catheter in carotid artery and jugular vein. A continuous intravenous infusion of insulin was started at a rate of 12 mU/kg/minute and continued for 2 hours. Twenty-five percent glucose solution was infused through the venous line at a various rate to maintain blood glucose at 5.0-5.6 mmol/L and calculated the glucose disposal rate. Blood was collected from arterious line every 5 minutes and measured serum glucose and insulin levels. RESULTS: Prior to the clamp procedures, serum glucose levels of 5 hours and 7 days after catheter insertion were 29.8 +/- 9.8 and 7.8 +/- 0.9mmol/L, respectively. However, basal serum insulin levels were not different between 5 hours and 7 days after surgery. The glucose disposal rates were remarkably higher in rats who recovered from the surgery (22.0 +/- 7.8 mg/kg/minute) than those who did not (2.2 +/- 2.7 mg/kg/minute). Thus, surgical stress increased insulin resistance in male Sprague Dawley rats. CONCLUSION: Since surgery of catheter insertion increased insulin resistance about 10 times, euglycemic hyperinsulinemic clamp study should be performed in rats who completely recovered from the surgical stress.

The effect of w-6 polyunsaturated fat and vitamin E intakes on insulin resistance in 90% pancreatectomized rats / 대한내과학회지

High intake of omega-6 polyunsaturated fat (PUFA) can increase oxidative stress, which may in turn increase insulin resistance and be the cause of metabolic syndrome X (diabetes mellitus). One of the ways to reduce oxidative stress is through the consumption of antioxidants, such as vitamin E. However, it is controversial whether the consumption of vitamin E alleviates insulin resistance. The purpose of this study was to determine whether the excessive intake of omega-6 polyunsaturated fat and vitamin E influences the whole body glucose disposal rate (GDR), glycogen deposits in the liver and muscles, and the triglyceride content of muscles in 90% pancreatectomized rats. METHODS: Mildly diabetic rats were produced by removing 90% of the pancreas from Sprague Dawley rats aged 8 weeks. One week after surgery, the blood glucose levels of rats were more than 9.4 mmol/L, according to which the rats are considered to be diabetic. Two factors were examined in the 90% pancreatectomized rats: polyunsaturated fat levels with 40% and 10% of total energy intakes, and vitamin E contents with 300 IU and 30 IU per kg of diet mixture. Four different diets were given for 8 weeks. After 7 weeks of diet consumption indwelling catheters were inserted in the carotid artery and jugular vein of all rats so that the GDR could be measured while the rats were awake and in a relaxed state. RESULTS: Daily calorie and PUFA fat intake levels were higher in the high PUFA groups of diabetic rats. Daily vitamin E intake of the high vitamin E groups was ten times higher than that of the low vitamin E groups (p<0.0001). The GDR was lower in high PUFA groups, and the high intake of vitamin E tended to decrease the GDR in diabetic rats. The GDR of DHPHE was significantly lower than that of DLPLE (p<0.05). Sham operated rats (the control group) had a higher GDR by 44% than diabetic rats. Vitamin E deposits in the liver in DHPHE were higher in DLPLE (p<0.05). Glycogen deposits in the liver of diabetic rats were significantly higher in DLPLE than DHPLE. Muscle glycogen content showed a similar tendency to liver glycogen content in different diet groups of diabetic rats. Triglyceride deposits in muscles did not differ according to dietary fat and vitamin E contents in diabetic rats. CONCLUSIONS: High intake of omega-6 PUFA increased insulin resistance, and high vitamin E intake did not alleviate insulin resistance. Thus, increased oxidative stress may be an independent factor for increased insulin resistance in high intake of omega-6 PUFA. It is necessary to consume a minimum amount of omega-6 PUFA as well as the Recommended Daily Allowance of vitamin E.

The Meal Management of Korean Type 2 Diabetes Patients Using Carbohydrate Counting

Carbohydrate(CHO) counting is a meal planning approach used with diabetic patients that focuses on carbohydrate as the primary nutrient affecting post-prandial glycemic response. However, it has not been used in meal management of diabetic patients in Korea. CHO counting can be used by clients with type 1 and 2 diabetes. The purpose of the study was to determine the barriers to utilize the CHO counting when three levels of CHO counting were educated to type 2 diabetic patients who started continuous subcutaneous insulin infusion (CSII) therapy by nutrition lectures and counseling. And the CHO-to-insulin ratios were determined for the individual patients who followed the carbohydrate counting as a meal management, and the factors to influence the CHO-to-insulin ratios were selected through the stepwise regression analysis. Twenty- four subjects were received three lectures, and one or two nutritional counseling for a month. The average age of the subjects was 50.7 years, and the duration of diabetes was 9.4 years. Their body mass index (BMI) was 21.5 kg/m2. The difficulties of using CHO counting were 1) confusing the CHO exchange system to diabetic food exchange system, 2) lack of basic nutrition and not distinguishing nutrients such as CHO, fat and calorie, and 3) lack of motivation to make effort to count and record the amount of carbohydrates eaten. Nutritional counseling replenished the nutrition education and made patients practice CHO counting. Average CHO-to-insulin ratios at breakfast, lunch and dinner were 4.1+/-3.3, 2.9+/-2.6 and 2.9+/-3.0units/23g of CHO, respectively. CHO-to-insulin ratios were influenced by gender, age, BMI, post-prandial blood glucose levels and post-prandial c-peptide levels. The effective education and nutritional counseling of CHO counting can make CHO counting applicable to type 2 diabetic patients as meal management for improving glycemic control with less hypoglycemic episode.

Effect of smoking on oxidative status in healthy and young men / 대한내과학회지

OBJECTIVES: It has been reported that cigarette smoking increases free radical generation, which can also increase lipid peroxides and deplete antioxidants. The purpose of this study was to determine whether cigarette smoking and other lifestyle choices may affect serum lipid peroxide concentrations, serum antioxidant concentrations such as tocopherol and vitamin C, and serum antioxidant enzyme activity such as glutathione peroxidase and superoxide dismutase. METHODS: Dietary intakes were assessed by 24-hour recall and survey questionnaires from 48 male non-smokers and 52 male smokers. Overnight fasting blood was collected and measured for individual antioxidant status. RESULTS: The daily vitamin C intakes of smokers tended to be lower than those of non-smokers, and the intakes of both groups were under the Recommended Daily Allowance (RDA). Vitamin E intake was sufficient for smokers and non-smokers. Serum lipid peroxide concentrations were no difference among all subjects. The serum -tocopherol concentrations of all subjects were in a normal range, and they were highest in mild smokers (p<0.05). Mean serum vitamin C levels were lowest in heavy smokers (p<0.05). The activities of serum glutathione peroxidase and superoxide dismutase were not significantly different in smokers and non- smokers. CONCLUSIONS: Smoking did not increase oxidative stress in heathy young men. However, it is desirable for heavy smokers to consume more vitamin C than the RDA since their serum vitamin C concentrations are relatively low.

Correlation between Microalbuminuria Checked by RIA & Micral-Test® / 영남의대학술지

It is evident that an elevation of airway albumin excreation rate without clinical proteinuria strongly predicts a later progression on diabetic renal disease. So we studied the correlation between Microalbumin checkly RIA & Micral-Test®. We collected urine between 08:00 h and 08:00 h next day and then checked microalbuminuria by radioimmunoassay method and Micral-Test® The results are as follows: 1. There was significant correlation between microalbuminuria checked by RIA & Micral-Test® 2. There was poor correlation between diabetes duration or HV-A1c and maximal change in albumin excreation rate. 3. So we concluded that Micral-Test® can be used in laboratory instead of RIA.

One Case of Insulinoma / 영남의대학술지

Insulinoma is a rare tumor, occurring more often in women and in the older age range. Eighty percent of patients have a single benign tumor, usually 2 cm in diameter, located with about equal frequency in body, head or tail of pancreas and amenable to surgical cure. About 10% have multiple tumors. The remaining 10% of patients have metastatic malignant insulinoma. The symptom of insulinoma is characterized by the periodic attack of hypoglycemia of blood sugar level below 50mg%, by fasting or exertion, and rapid relief of symptom by oral or intravenous administration of glucose. Symptom often lead to misdiagnosis as a neurologic or psychiatric disorder. A case described by authors was 44-year old female with the chief complaints of the loss of consciousness, epileptic seizure although she has been treated by anticonvulsants. Serum blood sugar and insulin level during fasting suggested insulinoma but abdominal computed tomography shows no definitive mass in pancreas. Celiac angiography revealed insulinoma. She transferred to the department of General Surgery and was performed enucleation. Microscopic findings shows the islet cell tumor of pancreas. A brief review of the literature was made.

Graves' disease Associated with Idiopathic Thrombocytopenic Purpura and Iron Deficiency Anemia / 영남의대학술지

Since 1931, sporadic reports have appeared noting an apparent association between hyperthyroidism and idiopathic thrombocytopenic purpura. Recent various studies suggested that these two diseases may share a similar immunologic background, but the exact mechanism is still a matter of speculation. This 22-year-old female patient visited this hospital because of general weakness and purpura of legs for 2 months. The laboratory findings were compatible with Graves' disease associated with idiopathic thrombocytopenic purpura. The platelet count was 16000/mm³, hemoglobin was 10.9 g/dl and MCV was 60.1fL. T3 was 490.53 ng/dL, T4 was 24 ug/dL and free T4 was 5.66 ng/dL. Antiplatelet antibody and antimicrosomal antibody were positive. The bone marrow findings were compatible with iron deficiency anemia and idiopathic thrombocytopenic purpura. The thyroid biopsy showed adenomatous goiter. She was administered with propylthiouracil, Beta-blocker, iron and prednisolon. On the 10th hospital day, platelet count was 184000/mm³, hemoglobin was 12.0 gm/dL and MCV was 67.5 fL. On the 20th hospital day, T4 was 10.35 ug/dL and free T4 was 2.30 ng/dL. Therefore she was discharged and followed up.

A Clinical Study on the Patients with Pyuria / 영남의대학술지

To evaluate the features of pyuria related to the bacteriuria, 140subjects were studied from Jan. 1987 to Dec. 1987. They pyuria was frequently developed from the age 30 to 60 years old, and male to female ratio was 1:1.41. The most common disease was urethrocystitis that was shown 42.8%. Common precipitating factors were urethral catheterization (25%) and urinary tract obstruction (11.4%). Through the observation, symptomatic pyuric patients were 66 subjects (47.1%), and the subjects with significant urine culture were 121 subjects (86.4%). In the urine culture, the most common bacteria was E. coli (41.4%), and the next was Pseudomonas (19.3%). A large percentage of E. coli and Pseudomonas was susceptible of amikin. The pyuria due to S. epidermidis and Accinatobacter was well treated. High therapeutic rate was observed in the acute pyelonephritis (71%) and urethrocystitis (67%). In the persistent urinary tract infection, there were relapsing (22 cases) and recurrent urinary tract infection (16 cases).

Uptake of 99mTc - DISDA in Primary Hepatocellular Carcinoma and Metastatic Nodule in the Lung / 영남의대학술지

Recently, several reports of extrahepatic hepatocellular carcinoma metastasis demonstrated by technetium-99mTc-IDAs scan have shown that 99mTc-IDAs can be used to detect extrahepatic metastasis in hepatocellular carcinoma. We report here a case of hepatocellular carcinoma with pulmonary nodules that were demonstrated as metastasis in nature by the use of the 99mTc-DISIDA. The findings in this case and several reports reviewed here suggest that the 99mTc-DISIDA scan may be a useful diagnostic agent that can detect the extrahepatic metastasis of hepatocellular carcinoma and stage the disease. But more clinical study in needed to establish the position of 99mTc-DISIDA in the field of diagnosis of extrahepatic hepatocellular carcinoma.

The Observation of Clebopride Malate Effect on Funchional Gastrointestinal Disease by Use of Gastric Emptying Time / 영남의대학술지

The measurement of gastric emptying time is useful in differentiation of the hypochondriacal neurosis from the functional gastrointestinal disturbance, and also useful in searching the hidden gastro-intestinal disease in patients who are believed as the functional gastrointestinal disturbance. We confirmed in this study that the more delayed gastric emptying time was measured in functional gastrointestinal disturbance compared to normal group, and more shortened gastric emptying time was found after treatment with dopamine antagonist (cleboril) in this group.

Prevalence of Diabetes Mellitus and Associated Diseases in Yeungnam Province Area / 영남의대학술지

To know the prevalence of the diabetes mellitus and associated diseases, we analyzed the date of the 3,088 subjects who were examined with the Computed Automated Medi-Screening Test System which consisted of 65 parameters including blood glucose determination fasting and one hour after 100 g of oral glucose load. We grouped the subjects by the modified criteria of National Diabetic Data Group. Followings are the results of the various analysis: 1. The prevalence of diabetes mellitus and impaired glucose tolerance in 2.27% and 18.26% respectively. 2. The prevalence of diabetes mellitus is 2.63% in male and 1.66% in female. There is no statistically significant difference between male and female. 3. There in tendency of increasing prevalence of diabetes mellitus as the age increases. From second to eighth decade, the prevalence of diabetes mellitus increases as 0.0, 0.45, 0.67, 2.28, 3.47, 5.36, 10.00% respectively. 4. There is no statistically significant difference of prevalence of obesity between normal and diabetes: that is, 18.03%, 22.86% respectively (P≥0.1). 5. There is no statistically significant difference of prevalence of impaired glucose tolerance and diabetes between non-obese and obses group (P≥0.1). 6. There is statistically significant increases of frequency of proteinuria, azotemia, hypertension as the glucose tolerance decreases (P≤0.05).

A Study on the Intrapulmonary Shunt Measured by (99m) Tc-MAA Perfusion Lung Scan / 영남의대학술지

Intrapulmonary shunt measured by (99m)Tc-MAA perfusion lung scan. The study was included 76 patients. Significant amount of intrapulmonary shunt was observed in the pulmonary disease patients and liver disease patients. The shunt amount was correlated well with PaO2 and AaDO2 level. Further study is needed to search the various factors affecting the amount of intrapulmonary shunt.

1 Case of Primary Aldosteronism Caused by Adrenal Hyperplasia / 영남의대학술지

Primary aldosteronism is a disease that the stimulus for the excessive aldosterone production residues within the adrenal gland. It was first described by conn in 1955. And many cases were reported by physicians at present in the world. But it is relatively rare in Korea, probably due to lack of attention and medical facilities. Only about 13 cases have been reported at present. The clinical, biochemical feature in l case of primary aldosteronism caused by adrenal hyperplasia that was diagnosed at Yeungnam University Hospital was observed and the following result were obtained. 1. Clinical feature: The present case was 27-year-old woman who was admitted due to general weakness and easy fatigability. The above mentioned chief complaints occurred 8 months prior to admission when she delivered of second baby by cesarean section. Symptoms such as above chief complaints, intermittent muscle paralysis and cramping were noticed. Trousseau's sign was also present. The average blood pressure ranged from 170/90 to 200/120 2. Biochemical abnormalities: Severe hypokalemia lower than 2.5 mEq/L was presented and 24 hours urine potassium showed markedly increased urinary loss (228 mEq/day). Plasma rennin activity was decreased under normal range with furosemide administration. (Basal renin; 0.01 ng/ml/hr, stimulated rennin 0.12 ng/ml/hr). Saline suppression test revealed markedly elevated levels of aldosterone higher than normal range (Basal aldosterone; 320.68 pg/ml stimulated aldosterone; 451.86 pg/ml). And posture test showed decreased plasma rennin activity and increased plasma aldosterone level. 3. Adrenal CT scan revealed no abnormal findings. 4. Treatment and course: Spironolactione was given at OPD with regular follow-up. Her blood pressure ranged from 150/90 to 160/100 and symptoms were improved. The effect of treatment was satisfactory and further follow up would be performed.

A Study on the Development of R-R Interval Analyzer using Microcomputer (1) / 영남의대학술지

The R-R interval analyzer was developed to measure the autonomic nervous system function using microcomputer. The system based on 8 bit microcomputer including bandpass filter, R-wave detector and clock generator in order to obtain the mean value, standard deviation, total time, CV value, maximum value and minimum value in the specific view point of R-R interval variation. The pattern of R-R interval change after resting, voluntary standing and deep breathing can be analyzed in normal subjects and diabetics with autonomic nervous dysfunction. The amplitude of the R-R interval variation showed sensitive pattern for normal subjects at resting, standing and deep breathing. On the contrary, the periodicities of amplitude for abnormal subjects with autonomic nervous dysfunction showed dull pattern. It was suggested that R-R interval analyzer is a good detection method for dysfunction of autonomic nervous system.