Résumé
Control of the blood sugar level is the fundamental treatment for diabetes mellitus. However, it is extremely difficult to effectively control the blood sugar level over a long period, during which complications such as neuropathy, retinopathy and nephropathy may develop. Impaired polyol (sorbitol) metabolism is considered to be a cause of neuropathy among these complications of diabetes. Diabetic neuropathy occurs in a relatively early stage. Its incidence increases with the prolongation of the diabetic condition, and the plight of the patients suffering from extensive tissue damage is profound. In this study, assessment was made regarding the effects of the aldose reductase inhibitor epalrestat, which is expected to reverse the pathogenic mechanism of diabetic neuropathy, on symptoms of neuropathy, erythrocyte sorbitol level, and threshold of vibratory sensibility.<BR>[Subjects] The subjects were 7 male and 4 female outpatients who consistently exhibited spontaneous pain, dysesthesia, and autonomic disorders, or showed abnormalities in the erythrocyte sorbitol level and threshold of vibratory sensibility, and were taking 50 mg of epalrestat (1 tablet) before each meal for at least 6 months. The period of investigation was from October 1992 to March 1993.<BR>[Methods] The subjects were explained about the aim of the study and their informed consents were obtained. They were inquired about symptoms while they were waiting for medicine in the Drug Information Management Office. Data concerning the erythrocyte sorbitol level and threshold of vibratory sensibility were obtained from charts.<BR>[Results and Conclusions] 1) <I>Improvement rates by subjective symptom</I>: 75.0% for spontaneous pain; concerning dysesthesia, 57.1% for numbness of hands and feet, 40.0% for coldness of extremities, 33.3% for hot flushes, 75.0% for hypoesthesia, and 50.0% for itching; concerning autonomic disorders, 75.0% for dizziness on standing up, and 33.3% for abnormal perspiration. 2) <I>Effects by the duration of illness</I>: Improvements were greater as the duration of illness was shorter. 3) <I>Erythrocyte sorbitol level</I>: Improvements were generally unremarkable. 4) <I>Threshold of vibratory sensibility</I>: Fair improvements were observed in general. Neuropathy occurs from a relatively early stage of diabetes, and chronic hyperglycemia is considered to be the most important factor. Regulation of the blood sugar level is essential for the treatment, but if it is impossible, the pain and discomfort of patients may be alleviated by epalrestat, and the administration should be started as early as possible since, in this study, the drug was more effective as the duration of illness was shorter.
Résumé
This is a report on the precision controlled gastric mass screenings conducted under the sponsorship of the Welfare Federation of Agricultural Cooperatives in Nagano Prefecture and the assessment test using some samples of radiographic stomach images.<BR>Physicians and x-ray technicians participated in the test and interpreted in their own ways the radiographs of 30 healthy cases and 20 cases of cancer of the stomach. Experienced physicians and technicians made better scores on the test than those less experienced in reading radiographs. Physicians read a little better that technicians in checkups of different parts regardless of years of experience, but the difference was not significant. In terms of FP and FN percentages (?), physicians scored 40.5% and 20.8% on the first tryout, and 34.0% and 29.0% on the second tryout.<BR>The 1988 mass screening found 67.4% of cancer in antral and angular areas and 23.8% on the lesser curvature side of the angular area.<BR>Grade 5 means that “No doubt about the existence of cancerous lesions.” In the 1983 screening, 25% of the grade 5 cases turned out to be nothing wrong upon close examination. The figure went down to 5.9% in the 1988.
Résumé
This time, residents (male: 2449, female: 2165, age: 20-39) who lived in 3 areas were studied: the western area of Tono, Nakatsugawa and Ena in Gifu prefecture. A health examination and questionnaire survey was conducted for 3 years between 1983 and 1985 in order to do a comparison study with regard to their living conditions, eating habits, family and medical histories.<BR>Here we report the study.