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Saitama, Japan

Hashiba Y.,Saitama Memorial Hospital | Ishikawa M.,Jichi Medical University | Otani T.,Saitama Memorial Hospital
Journal of the Japan Diabetes Society | Year: 2013

A 36-year-old woman had been aware of changes in her facial features since approximately 2006 (at 33 years of age). A sense of excessive thirst manifested in 2008 (at 35 years of age); however, it was left untreated. The patient developed a fever of 37.3 t, nausea and epigastric pain in January 2009 (at 36 years of age) and presented to our hospital the following day. Her blood glucose level was 645 mg/d/. Metabolic acidosis (pH: 7.144, HCCV: 3.8 mmol//, PC02:11.4 mmHg) with a high anion gap (31.2 mEq//) was detected and the urinary ketone body concentration was 3 +. Diabetic ketoacidosis was diagnosed. The patient had acromegalic facial features and high levels of growth hormone (260 ng/m/) and insulin-like growth factor-1 (1,047 ng/m/). A head computed tomography scan revealed a well-defined mass with a maximum diameter of 4 cm and a high density in the sella turcica. These findings led to a diagnosis of acromegaly. The patient experienced sudden onset of visual disturbance and headaches on hospital day 6 and underwent emergency surgery under a diagnosis of pituitary apoplexy. There are few reports of patients with diabetic ketoacidosis that are diagnosed with acromegaly. We herein describe this rare case of acromegaly complicated by pituitary apoplexy. Source


Kotani K.,Jichi Medical University | Yamada S.,Shino Test Corporation | Uurtuya S.,Jichi Medical University | Yamada T.,Jichi Medical University | And 2 more authors.
Lipids in Health and Disease | Year: 2010

Background. Oxidized lipoproteins play important roles in the atherosclerotic processes. Oxidized lipoprotein(a) (oxLp(a)) may be more potent in atherosclerotic pathophysiology than native Lp(a), a cardiovascular disease-relevant lipoprotein. Increased blood glucose concentrations can induce oxidative modification of lipoproteins. The aim of this study was to investigate the association between circulating oxLp(a) and cardiometabolic variables including blood glucose in healthy volunteers within the normal range of blood glucose. Methods. Several cardiometabolic variables and serum oxLp(a) (using an ELISA system) were measured among 70 healthy females (mean age, 22 years). Results. Lp(a) and glucose were significantly and positively correlated with oxLp(a) in simple correlation test. Furthermore, a multiple linear regression analysis showed oxLp(a) to have a weakly, but significantly positive and independent correlation with only blood glucose ( = 0.269, P < 0.05). Conclusions. These results suggest that increased glucose may enhance the oxidization of Lp(a) even at normal glucose levels. © 2010 Kotani et al; licensee BioMed Central Ltd. Source


Otani T.,Saitama Memorial Hospital | Otani T.,Tokyo Womens Medical University | Yokoyama H.,Jiyugaoka Medical Clinic | Uchigata Y.,Tokyo Womens Medical University
Diabetes Research and Clinical Practice | Year: 2015

Aims: We investigated changes in vital prognosis according to the year at diagnosis of type 1 diabetes mellitus (T1DM) in a hospital-based survey. Methods: Of 1054 Japanese subjects diagnosed as T1DM between 1952 and 1999 before the age of 30 and consulted the diabetes center between 1962 and 1999, the survival status up to 2010 or 20 years of follow-up was investigated. Subjects were divided by the year at diagnosis of T1DM: before 1979 (Group A: n=. 359), 1980 to 1989 (Group B: n=. 400), and 1990 to 1999 (Group C: n=. 295). The mortality (/100,000 person years) and standardized mortality ratio (SMR) were calculated, and the effect of year at diagnosis of T1DM was explored by the Cox proportional hazard model. Results: The survival status was confirmed in 90.0%. The mortality rate (95%CI) and age and sex adjusted SMR (95%CI) were 457 (288-627) and 3.0 (1.9-4.2) in Group A, 265 (143-387) and 2.2 (1.2-3.2) in Group B, and 144 (29-259) and 1.6 (0.3-2.9) in Group C, respectively. The cumulative survival rate was significantly different according to the year at diagnosis of T1DM (. p=. 0.0239). Cox's proportional hazard model revealed that Groups B and C had significantly lower risks of death than Group A after adjustment for gender and age at diagnosis of T1DM (HR 0.48 [95%CI 0.26-0.87] for Group B and HR 0.25 [95%CI 0.09-0.60] for Group C). Conclusion: This study indicated that vital prognosis is improving according to the year at diagnosis of T1DM and suggested the need of a nationwide survey. © 2015 Elsevier Ireland Ltd. Source


Kotani K.,Jichi Medical University | Yamada S.,Shino Test Corporation | Yamada T.,Jichi Medical University | Taniguchi N.,Jichi Medical University | Sakurabayashi I.,Saitama Memorial Hospital
Lipids in Health and Disease | Year: 2011

Background: Oxidized lipoprotein(a) (oxLp(a)) can be a more potent marker of atherogenesis than native Lp(a), although Lp(a) is considered to be a risk factor for atherosclerotic diseases. Limited clinical data are available regarding the significance of oxLp(a) in atherosclerotic manifestations. This study aimed to investigate the association between the serum oxLp(a) and carotid artery intima-media thickness (CIMT), in comparison to the serum Lp(a) levels, among asymptomatic subjects. Methods. The atheroscrerosis-related variables including Lp(a) and oxLp(a) were measured in 136 cardiovascular disease-free subjects (61 males and 75 females, mean age of 64 years). The serum oxLp(a) level was quantified using a sandwich ELISA system. The CIMT level was ultrasonographically measured on bilateral carotid arteries. Results: The median level of Lp(a) was 120 mol/L, oxLp(a) was 0.06 nmol/L, and CIMT was 0.7 mm, respectively. A simple correlation test showed that the CIMT was significantly and positively correlated with age, systolic blood pressure and oxLp(a) (r = 0.208, P < 0.05). A multiple linear regression analysis revealed that oxLp(a) continued to show a significant and positive correlation with the CIMT ( = 0.202, P = 0.01). Although the similar analyses were conducted for Lp(a), it showed only a weak correlation with the CIMT (r = 0.011, = 0.041, both P < 0.05). Conclusions: These results suggest that oxLp(a) may be more closely associated with accelerated carotid atherosclerosis, in comparison to Lp(a), in this population. This finding can be important for obtaining a better understanding of the different atherogenic roles played by oxLp(a) in comparison to Lp(a). © 2011 Kotani et al; licensee BioMed Central Ltd. Source


Otani T.,Saitama Memorial Hospital | Otani T.,Tokyo Womens Medical University | Sato A.,Tokyo Womens Medical University | Uchigata Y.,Tokyo Womens Medical University
Journal of the Japan Diabetes Society | Year: 2012

We studied the clinical characteristics of five Japanese patients (one male) younger than 30 years of age with onset of type 1 diabetes who died of acute myocardial infarction between 1962 and 31 December, 2010. We conducted the data analysis before the subjects' deaths. One patient had familial hypercholesterolemia (FH). All patients, except for the FH patient, had end-stage renal disease (stage 4: one patient, stage 5: three patients, BMI: 21.2 ± 1.7 kg/m2, TC: 174.8 ± 23.8 mg/d/, HDL: 68.3 ± 19.1 mg/d/, TG: 77.3 ± 37.5 mg/dl [mean ± SD]). The duration of dialysis in the three patients with stage 5 nephropathy was one, seven and 14 years. All of the Japanese type 1 diabetic patients who died of acute myocardial infarction, except the patient with FH, had end-stage renal disease. Source

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