We evaluated the combination therapy of angiotensin-converting-enzyme inhibitor (ACE-I) and angiotensin II type 1 receptor blocker (ARB) offered an additional effect in reduction of albuminuria in type 2 diabetic patients with angiotensinogen (AGT) M235T polymorphism. The study subjects were type 2 diabetic patients with nephropathy who were attending Hirosaki University Hospital. Fifteen patients with 235T allele (TT genotype 9, MT genotype 6) were evaluated who had diabetic nephropathy in stage 2 or 3 and already treated with ACE-I. Each patient administrated ARB (20-40 mg of termisartan) in addition to ACE-I for 16 weeks as the combination therapy. The addition of termisartan induced a significant reduction in systolic blood pressure (BP) of 14.0 mmHg and diastolic BP of 5.4mmHg. The urinary albumin-creatinine ratio (ACR) was also reduced to 48.9%. There was no significant correlation between the reduction rate of ACR and the antihypertensive response of systolic blood pressure (BP) (rs = 0.1277) and of diastolic BP (rs =0.1420) by the addition of termisartan. These results indicated that the combination of ACE-I and ARB had an additional effect on urinary albumin excretion in type 2 diabetic patients with AGT 235T allele. Hirosaki Med. J. 59: 59-64, 2008 ~~****~~*~~~I*J~ ~ft~I*J~*~~ 53UijjIJ~~*)'c:t~# i$ '¥ptI9~8Ji 23 B~ft
In this paper, we propose two kinds of magnetic microactuators for a cytology brush built into a capsule endoscope. One is a moving-magnet linear actuator, in which the rotational oscillation of a permanent magnet is converted into linear movement through friction. The other is a rotating-magnet actuator with a flexible push-pull wire. Both actuators can be driven by an external magnetic field and can rub the brush back and forth. As in operational testing, we successfully pushed and pulled the brush back and forth along the surface of raw meat. We have also added a new angular positioning function to the capsule by using a DC magnetic field perpendicular to the magnetic field for rubbing the brush.
1) Abstract The study was to define plasma insulin level with the association of renin‑angiotensin‑aldosterone system activity in patients with type 2 diabetes. One hundred fi fty type 2 diabetic patients and 24 non‑diabetic subjects were studied. There was no statistical diff erence between the two groups in age gender the prevalence of hypertension and serum potassium concentration. Plasma aldosterone concentration (PAC) was signifi cantly higher in type 2 diabetics than that in non‑diabetic subjects (10.4±4.9 vs. 7.4±3.7 ng/dl;p=0.004) ; however plasma renin activity (PRA) did not diff er signifi cantly between the two groups. In diabetic patients PAC correlated signifi cantly with body mass index (BMI) fasting plasma insulin (F‑IRI) homeostasis model assessment insulin resistance (HOMA‑R) urinary C‑peptide excretion (U‑CPR) triglyceride (TG) and high‑density lipoprotein cholesterol (HDL‑C) . PRA correlated signifi cantly with F‑IRI and HOMA‑R but did not correlate with BMI U‑CPR TG and HDL‑C. The additional contribution of U‑CPR in predicting PAC was signifi cant after adjustment for age BMI F‑IRI TG HDL‑C and PRA (β=0.204 p=0.016) . These fi ndings indicate that hyperinsulinemia may aff ect the increase in PAC unrelated with obesity dyslipidemia insulin resistance that are components of metabolic syndrome in patients with type 2 diabetes.
In this paper, we have proposed two kinds of magnetic microactuators for a cytology brush built into a capsule endoscope. One is a moving-magnet linear actuator, in which rotational oscillation of a permanent magnet is converted into linear movement through friction. The other is a rotating-magnet actuator with a flexible push-pull wire. Both actuators can be driven by external magnetic field and rub the brush back and forth. As a result of the operation test, they successfully pushed and pulled the brush back and forth along the surface of raw meat. Furthermore, we have added a new function of angular positioning to the capsule by DC magnetic field perpendicular to the magnetic field for rubbing brush.
We made a basic approach about changes in the lifestyle to study the association between lifestyle-changes and health. 1, 404 male employees who took a medical examination every year for nine years from 1997 to 2005 are the study subjects. We reviewed changes in tobacco use, drinking, physical activity and an intake of various foods, using an analysis of variance, and a figure of bubble. We summarized degree of changes in the lifestyle by using cluster analysis. Changes in tobacco use during 9 year period were small. As for the drinking habit, intea-individual variation was not so large, but an inter-individual variation was large. As for the changes in dietary habits and other habits, there may be 3 or 4 groups according to their variation. Because we examined about answers of questionnaire among limited subjects, we should be careful for interpretation of the results. However, we newly showed that there were various patterns among changes in the lifestyle. And for example, tobacco use is a relatively stable lifestyle and that enables typical epidemiologic studies meaningful. Coaching on health which considers an individual pattern of lifestyle-changes becomes important. It seems that we can make use of this result as a suggestive reference. And we found that a figure of bubble is useful to evaluate the lifestyle changes without any application for statistical analysis.
Summary This research was designed to investigate the acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia. Forty‐nine patients with complaints of swallow difficulty received a videofluorographic ( VF ) examination. They were divided into three groups: nine who did not have any apparent disease ( G roup N ), 22 patients with head and neck cancer ( G roup H&N ) and 18 patients with other diseases including cerebrovascular disease ( G roup OD ). After liquid barium swallows, they exhaled voluntarily without voicing. Videofluorographic findings were classified into four groups: normal ( N ormal), acceptable swallow (Acceptable), swallow with residue (Resid) and swallows with penetration or aspiration (Pen/Asp). The duration of expiratory sounds was measured on the time waveform. Frequency characteristics of expiratory sounds were obtained using one‐third octave band analysis ranging from 62·5 to 2000·0 Hz of central frequency. The averaged level of the 1000·0‐Hz band was chosen as the reference band level ( RB level). The revised averaged level of each band was obtained by subtracting the RB level from the averaged level of each band. Zero decibel of the revised magnitude of the 125·0‐Hz band was set as the critical value to differentiate dysphagia ( R esid or Pen/Asp) from no dysphagia ( N ormal or A cceptable). Comparison of this assessment with VF findings showed a significant percentage agreement (85·4%). These results suggest that frequency characteristics of post‐swallow expiratory sounds can differentiate dysphagia from no dysphagia among multiple dysphagic patient groups.
Over the last decade, a capsule endoscope (CE) has become widespread as an effective device inspecting a small intestine. Its function of inspection using a built-in camera and wireless communication allows a physician to examine in a minimally invasive manner. The current research on the CE is focused on a next-generation CE equipped with additional functions such as biopsy and drug delivery [1,2]. But there have been very few clinically successful studies so far because conventional techniques can hardly build both a power supply and a micro-actuator into the limited space. In order to provide a feasible solution for these problems, this study has proposed a function of diagnosis using external magnetic operation. We fabricated a magnetically driven cytology brush that can scrape cells of gastrointestinal tract. This paper describes its basic concept, structure and testing results.
This study evaluated usefulness of serum tumor necrosis factor-alpha (TNF-alpha) levels in the diagnosis and prognosis of oral squamous cell carcinoma (O-SCC). We performed a clinico-pathological estimation of 38 patients with O-SCC and determined the more valuable factors in making a prognosis. The mean serum concentration of TNF-alpha for the patients with O-SCC (14.13 +/- 13.17 pg/ml) was significantly higher (p < 0.05) than that of the healthy controls (3.49 +/- 2.97 pg/ml). The mean serum concentrations of TNF-alpha were significantly higher (p < 0.05) in the good-prognosis group (16.73 +/- 18.64 pg/ml) than in the poor-prognosis group (9.62 +/- 5.92 pg/ml). The survival curve revealed a better prognosis for patients with serum TNF-alpha-positive than for patients with serum TNF-alpha negative. There was a significant correlation (p < 0.05) with serum TNF-alpha levels and two tumor markers (SCCA, IAP). These results of the present study suggest that a evaluation of serum TNF-alpha levels in O-SCC is a valuable tool as a tumor marker for the diagnosis, prognosis and treatment monitoring of O-SCC.
