The aim of the present study was to investigate the prevalence of fear of hypoglycemia, in association with severe hypoglycemia and social factors, in insulin-treated patients with type 2 diabetes mellitus. A questionnaire survey on hypoglycemia and patient–physician communication was carried out in 355 patients with insulin-treated type 2 diabetes mellitus patients at 16 hospitals and clinics. A fear of hypoglycemia was reported by 27.7% of patients. A stepwise logistic regression analysis found that severe hypoglycemia during the past 1 year was a significant determinant of fear of hypoglycemia (odds ratio 2.16, 95% confidence interval 1.06–4.41; P = 0.034), and age (odds ratio 1.02, 95% confidence interval 1.00–1.05, P = 0.038) and living alone (odds ratio 1.93, 95% confidence interval 1.00–3.73, P < 0.05) were significantly higher in patients with fear of hypoglycemia than in those without it.
Glucagon as a measure to treat severe hypoglycemia was underutilized among T1DM patients in Japan.
It has been shown that an adenine (A) to guanine (G) transition at position 3243 of the mitochondrial transfer RNA(tRNA)leu(UUR) gene is associated with a subgroup of diabetes mellitus. Therefore, we screened for this transition in 86 patients with non-insulin-dependent diabetes mellitus (NIDDM)in which two or three generations were affected with diabetes, in 14 patients with insulin-dependent diabetes mellitus, and in 9 families with diabetes mellitus and/or associated disorders suggesting mitochondrial gene abnormalities. Wefailed to identify the mutation in 100 diabetic patients, 86 NIDDMand 14 insulin-dependent diabetes mellitus (IDDM). Out of the latter 9 families, we identified an A to G transition in 14 individuals in 5 families. Diabetes mellitus was shown to be maternally inherited in one family. In 9 of 14 patients with the mutation, insulin was required to treat diabetes mellitus, indicating impaired insulin secretion. A hyperglycemic clamp test performed in one subject revealed significant impairment of insulin secretion, whereas euglycemic clamp test showed normal insulin sensitivity in this patient. The heteroplasmy of the mutant mitochondrial DNA(mtDNA)in leukocytes does not appear to correlate with the severity of diabetes in terms of the insulin therapy required. Bodymass index of the affected individuals was less than 23.3. In one family, in addition to diabetes mellitus and hearing loss, hypoparathyroidism was associated with the mutation, suggesting that hypoparathyroidism is caused by the impaired processing and/or secretion of proparathyroid hormone due to the mutation. In addition, the affected subjects presented with proteinuria at the time of diagnosis of diabetes mellitus which appeared not to be related with diabetic nephropathy. (Internal Medicine 37: 265-272, 1998)
The present study investigated the development of literacy skills of deaf and hard-of-hearing (DHH) children in Japan. The three components of literacy, vocabulary, orthographic knowledge, and grammatical knowledge were assessed by using the subtests of the Adaptive Tests for Language Abilities (ATLAN), based on the item response theory developed by the authors). The participants consisted of 207 DHH children (first through twelfth grades) in Study 1, and 425 hearing children (first through sixth grades) in Study 2. The findings show that more than 80% of DHH children's vocabulary variance was explained by the other two componential skills, while the three tasks' difficulty was different. More specifically, their vocabulary and especially, their grammar lagged behind those of hearing children, whereas the difference between the two groups on kanji (one of the three orthographic systems in Japanese taught during the school years) was less. Although considerably delayed, their pattern of responses in grammar was similar to that predicted from normative data. Effective instruction for DHH children's literacy skills was generally discussed.
The correlation between the dynamic behaviour of a focused plasma and the bursts of neutrons, X-rays and charged particle beams have been investigated experimentally using a 65 kV plasma focus device. The dynamic bahaviour has been observed with a Mach-Zehnder interferometric system operating in the framing mode. The ion- and the electron beams are detected by a Thomson parabola analyzer and a Čerenkov detector, respectively. Neutrons, X-rays and charged particle beams are produced when a voltage spike appears. The generation of the electron- and the ion beam occur in an interval of 20 ns around the peak of the voltage spike. The m=0 type instabilities are observed even if the voltage spike does not appear. The plasma inductance increases monotonically but rather slowly during the process of the m=0 type instability growth. The neutron yield is ascribed to a generation of the anomalous resistivity in the plasma.
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