1.A 3-year-old girl with Wernicke’s encephalopathy due to a severely unbalanced diet
Sonoko Kubota ; Tatsuo Fuchigami ; Wakako Ishii ; Yuki Kawamura ; Yayumi Kamiyama ; Ayumi Fukuda ; Ryutaro Kohira ; Momoko Takahashi ; Yukihiko Fujita ; Shori Takahashi
Neurology Asia 2015;20(1):95-99
Wernicke’s encephalopathy, an acute neuropsychiatric syndrome caused by thiamine (vitamin B1
)
deficiency, is associated with serious clinical disease and can be fatal. It has rarely been reported in
infants and children. We report a case of a 3-year-old girl with Wernicke’s encephalopathy. The patient’s
diet had been severely unbalanced since the age of 2 years, and for about a month prior to admission
to our hospital had consisted almost exclusively of polished white rice and noodles. Her clinical
symptoms supported thiamine deficiency-related neuropathy. Brain MRI findings revealed abnormalities
consistent with pediatric Wernicke’s encephalopathy with involvement of the putamen. The diagnosis
prompted thiamine replacement therapy, to which the patient showed an excellent response.
Central Nervous System
2.The Dipeptidyl Peptidase-4 Inhibitor Sitagliptin Improves Vascular Endothelial Function in Type 2 Diabetes.
Yoshiaki KUBOTA ; Masaaki MIYAMOTO ; Gen TAKAGI ; Takeshi IKEDA ; Sonoko KIRINOKI-ICHIKAWA ; Kotoko TANAKA ; Kyoichi MIZUNO
Journal of Korean Medical Science 2012;27(11):1364-1370
The vascular endothelial function is impaired in the very early stage of atherosclerosis in diabetic patients. The goal of this study was to identify the mechanism underlying the improvement in vascular endothelial function by sitagliptin in type 2 diabetes mellitus patients. This study was an open-labeled prospective observational single arm trial. Forty patients were treated with 50 mg of sitagliptin once daily for 12-weeks. The flow-mediated dilation (FMD) and plasma adiponectin were measured at baseline and 12 weeks after initiating treatment. The %FMD was significantly increased after treatment (4.13 +/- 1.59 vs 5.12 +/- 1.55, P < 0.001), whereas the nitroglycerin-mediated dilation (NMD) did not change. The plasma adiponectin levels significantly increased (13.0 +/- 11.3 vs 14.3 +/- 12.8, P < 0.001). The changes in the FMD were significantly correlated with those of the plasma adiponectin (r = 0.322, P < 0.05). A multivariate linear regression analysis demonstrated that the improvement in the FMD is associated with the plasma adiponectin (P < 0.05). The treatment of type 2 diabetes mellitus patients with sitagliptin reverses vascular endothelial dysfunction, as evidenced by increase in the FMD, and improvement of the adiponectin levels (UMIN Clinical Trials Registry System as trial ID UMIN000004236).
Adiponectin/blood
;
Aged
;
Aged, 80 and over
;
Atherosclerosis/complications/drug therapy
;
Diabetes Mellitus, Type 2/complications/*drug therapy
;
Dipeptidyl-Peptidase IV Inhibitors/pharmacology/*therapeutic use
;
Drug Administration Schedule
;
Endothelium, Vascular/*drug effects/physiopathology
;
Female
;
Humans
;
Male
;
Middle Aged
;
Nitroglycerin/therapeutic use
;
Prospective Studies
;
Pyrazines/pharmacology/*therapeutic use
;
Regression Analysis
;
Triazoles/pharmacology/*therapeutic use
;
Vasodilation/drug effects
;
Vasodilator Agents/therapeutic use
3.The Dipeptidyl Peptidase-4 Inhibitor Sitagliptin Improves Vascular Endothelial Function in Type 2 Diabetes.
Yoshiaki KUBOTA ; Masaaki MIYAMOTO ; Gen TAKAGI ; Takeshi IKEDA ; Sonoko KIRINOKI-ICHIKAWA ; Kotoko TANAKA ; Kyoichi MIZUNO
Journal of Korean Medical Science 2012;27(11):1364-1370
The vascular endothelial function is impaired in the very early stage of atherosclerosis in diabetic patients. The goal of this study was to identify the mechanism underlying the improvement in vascular endothelial function by sitagliptin in type 2 diabetes mellitus patients. This study was an open-labeled prospective observational single arm trial. Forty patients were treated with 50 mg of sitagliptin once daily for 12-weeks. The flow-mediated dilation (FMD) and plasma adiponectin were measured at baseline and 12 weeks after initiating treatment. The %FMD was significantly increased after treatment (4.13 +/- 1.59 vs 5.12 +/- 1.55, P < 0.001), whereas the nitroglycerin-mediated dilation (NMD) did not change. The plasma adiponectin levels significantly increased (13.0 +/- 11.3 vs 14.3 +/- 12.8, P < 0.001). The changes in the FMD were significantly correlated with those of the plasma adiponectin (r = 0.322, P < 0.05). A multivariate linear regression analysis demonstrated that the improvement in the FMD is associated with the plasma adiponectin (P < 0.05). The treatment of type 2 diabetes mellitus patients with sitagliptin reverses vascular endothelial dysfunction, as evidenced by increase in the FMD, and improvement of the adiponectin levels (UMIN Clinical Trials Registry System as trial ID UMIN000004236).
Adiponectin/blood
;
Aged
;
Aged, 80 and over
;
Atherosclerosis/complications/drug therapy
;
Diabetes Mellitus, Type 2/complications/*drug therapy
;
Dipeptidyl-Peptidase IV Inhibitors/pharmacology/*therapeutic use
;
Drug Administration Schedule
;
Endothelium, Vascular/*drug effects/physiopathology
;
Female
;
Humans
;
Male
;
Middle Aged
;
Nitroglycerin/therapeutic use
;
Prospective Studies
;
Pyrazines/pharmacology/*therapeutic use
;
Regression Analysis
;
Triazoles/pharmacology/*therapeutic use
;
Vasodilation/drug effects
;
Vasodilator Agents/therapeutic use