Journal of International Medical Research

A multicentre study was conducted to evaluate the effect of the α-glucosidase inhibitor, voglibose, on glycaemic control in 113 patients with type 2 diabetes whose blood glucose control was poor on treatment with a sulphonylurea drug. The patients were treated for 24 weeks with 0.6 mg voglibose, given orally three times daily, before a meal, together with their usual sulphonylurea drug treatment. In the 86 patients who completed the study, fasting plasma glucose, 2-h post-prandial plasma glucose and haemoglobin showed statistically significant decreases in FPG, 2h-PPG and HbA_1c compared with the baseline (P < 0.05) at almost all time-points during treatment. No serious adverse reactions were reported and there were no significant changes in mean body weights. Plasma glucose control was considered to be improved in 65% of patients; there were no adverse events in 92.9% of patients. The results suggest that the combined use of this α-glucosidase inhibitor and sulphonylurea drugs may be effective in controlling plasma glucose in patients with type 2 diabetes and that this combination might delay the onset of vascular complications in these patients.

We evaluated the usefulness of the newly defined Doppler index combining systolic and diastolic myocardial performance, in assessing right-heart dysfunction in 29 patients with chronic respiratory failure caused by old tuberculosis who were on 24-h home oxygen therapy. We measured tricuspid inflow velocity, right-ventricular outflow velocity, late/early diastolic peak velocities (A/E), the ratio between pre-ejection period and ejection time (PEP/ET), and the new index of systolic and diastolic myocardial performance (SDMP) calculated as (isovolumetric contraction time + isovolumetric relaxation time)/ejection time. The calculated A/E, PEP/ET and SDMP in our patients were significantly higher than those in age-matched healthy subjects (n = 37, mean age 67 ± 8 years). There was no overlap in the SDMP index between healthy subjects and patients and the index was not influenced by heart rate. Our results suggest that SDMP index is a better marker than A/E and PEP/ET for the assessment of right-ventricular impairment.

Macrophage activity as indicated by phagocytosis in the corpus luteum at the luteolysis stage was examined in rabbits during pseudopregnancy. The day of induction of pseudopregnancy was regarded as day 0, and the phagocytotic activity of macrophages obtained from luteal tissues was examined on days 7 and 16. When sheep red blood cells (SRBCs) were used to assess phagocytotic activity there was no difference in phagocytosis between days 7 and 16 but, when sensitized SRBCs were used to assess phagocytotic activity, the activity of macrophages on day 16 was more than double that on day 7 (P < 0.05). These results indicate that immunomediated phagocytosis of luteal macrophages is enhanced at the luteolysis stage (day 16). This phenomenon may contribute to the process of luteolysis.

Increased release of polymorphonuclear leucocyte (PMNL) elastase, when the PMNLs are activated, can damage tissues in vivo. It was postulated that PMNL elastase might have a tissue-remodelling effect in the body and that obese individuals might have less PMNL elastase activity than lean individuals. To test this hypothesis, plasma PMNL elastase levels were determined in 70 obese individuals and 30 lean normal controls. The PMNL elastase levels (determined by enzyme-linked immunosorbent assay) in the obese group (median 36.2 ng/ml) did not differ significantly from those in the lean healthy controls (32.6 ng/ml; P = 0.5).

The activity, safety and tolerability of the azalide azithromycin were compared with those of co-amoxiclav in the treatment of acute periapical abscesses in adults in an open, randomized, multicentre comparative study. Patients of either sex, recruited from 106 dental practices in Belgium, were aged between 18 and 75 years and had acute periapical abscesses not requiring drainage, confirmed by radiology. Azithromycin was administered as a 500-mg tablet orally once daily for 3 days (n = 150) and co-amoxiclav as a 625-mg capsule three times daily, for 5–10 days (n = 153). Both before and after treatment, masticatory pain, percussion pain, headache, and oedema and redness of soft tissue were graded on a four-point scale. Overall clinical success (cure plus improvement) was seen in 131/144 (91%) evaluable patients receiving azithromycin and in 142/148 (96%) receiving co-amoxiclav (difference not significant). There was no significant difference between the two groups in the incidence or severity of adverse events or in the number of discontinuations because of adverse events.

For patients with severe disabling emphysema, lung-volume reduction surgery has recently been introduced as an alternative to transplantation. Performing parenchyma resection from appropriate areas can improve pulmonary functions in selected patients having severe emphysema with a flattened diaphragm. We report the case of a patient, who urgently needed coronary revascularization and was otherwise inoperable because of severe chronic obstructive pulmonary disease (COPD). We carried out lung-volume reduction surgery at the same time as the coronary bypass.