Pleiotropic effects of mitiglinide in type 2 diabetes mellitus.

This study investigated the effects of mitiglinide in 16 patients with type 2 diabetes mellitus treated with 30 mg/day mitiglinide, divided into three doses given just before each meal, for approximately 12 months. A 450 kcal meal tolerance test was performed at baseline and after 3, 6 and 12 months, and levels of plasma glucose and immunoreactive insulin were measured. Various parameters of glucose metabolism and lipid metabolism, urinary albumin and markers of atherosclerosis, coagulation and fibrinolysis were also determined. Mitiglinide showed a rapid stimulatory effect on insulin secretion and reduced the levels of plasma glucose. The free fatty acid level significantly decreased at 60 min after the meal tolerance test. Mitiglinide also significantly lowered glycosylated haemoglobin and raised 1,5-anhydroglucitol after 6 months, and significantly decreased urinary albumin after 12 months. These data indicate that mitiglinide may have beneficial effects not only on glycaemic control but also on lipid metabolism and urinary albumin excretion, and may have a role in the prevention of the vascular complications of diabetes.

Gastric carcinoma with lymphoid stroma: pathological and immunohistochemical analysis.

Nineteen gastric carcinomas with lymphoid stroma were selected from 554 surgical cases and examined pathologically and immunohistochemically using formaldehyde-fixed, paraffin embedded materials. Most showed ulcerative lesion and 15 cases located in fundic and cardiac gland regions. They were subdivided histologically into three groups, early (group I), localized (group II) and infiltrative tumors (group III), the number of cases being 2, 10 and 7, respectively. Lymph node metastases occurred in 3 cases in group II and 6 in group III, the latter showing a significantly higher incidence. The number of carcinoembryonic antigen and CA19-9 immunoreactive tumor cells was apparently smaller in gastric carcinomas with lymphoid stroma than in ordinary gastric carcinomas. Frequent presence of alpha 1-antichymotrypsin immunoreactivity characterized the tumor cells of gastric carcinoma with lymphoid cells. Stroma cells consisted of lymphocytes, plasma cells, granulocytes and histiocytes. Of these, the greatest number examined immunohistochemically was B cells and IgG cells, followed in descending order by T cells, IgA cells and IgM cells in the order given. A variable number of lysozyme immunoreactive histiocytes were also detected in all the cases. Gastric carcinoma with lymphoid stroma might be subclassified as a separate entity, although short term follow-up study did not demonstrate a favorable prognosis for this type of gastric cancer.

[An undifferentiated carcinoma of the esophagus--a case of an elderly patient].

Reported is the case of an undifferentiated carcinoma of the esophagus that had developed in an 80-year-old man. This polypoid a tumor was an elevated nodular mass, 9 x 5 cm in diameter, that had invaded the muscle layer. Microscopically, the tumor was composed of small polygonal cells with hyperchromatic nuclei that were unaffected by either Grimelius or PAS staining. An epidermal growth factor immunoreactivity was found in a few of the tumor cells. Ultrastructurally, the tumor cells had abundant ribosomes, a rough endoplasmic reticulum, and mitochondria. Coamplification of HST-1 or INT-2 genes was not observed by slot blot analysis. The patient is now well with no evidence of a tumor recurrence or a distant metastasis 11 months after surgery.