The serum levels of the two enzymes of lysosomal origin, beta-N-acetyl-D-glucosaminidase and beta-D-glucuronidase, and the isozyme pattern of the former, were determined in control infants and in infants of diabetic mothers (IDM) on the 1st and 5th day after birth. IDM were divided into three groups. Group 1: class A diabetic mothers treated dietetically; Groups 2 and 3: class A and classes B, C, D diabetic mothers, respectively, treated with insulin. All, but one, diabetic mothers were in excellent metabolic control. In the controls the serum levels of both enzymes were quite elevated on the 1st day after birth, reflecting the condition of the mothers at the end of pregnancy, and increased further on the 5th day, presumably as a result of the concurrent burst of antiinsulin hormones. In Group 1 IDM the serum levels of the two enzymes were higher than in controls, on the 1st day, probably reflecting the higher concentrations present in the mothers at the end of pregnancy than in controls, but equalling the condition of normal neonates on the 5th day. This indicates that IDM of this group had a normal post-natal response of the lysosomal apparatus to hormone stress. In Groups 2-3 IDM the enzyme levels on the 1st day could not be distinguished from those of controls, while on the 5th day a decrease was seen, suggesting reduced effect of the antiinsulin hormone burst on the lysosomal apparatus. The isozyme pattern of beta-N-acetyl-D-glucosaminidase in all IDM was similar to that of controls. The behavior of serum lysosomal enzymes of Groups 2-3 IDM is a further indication that the lysosomal apparatus is extremely sensitive to even small metabolic perturbations occurring in diabetic mothers during pregnancy.

Acetylglucosaminidase↗

PubMedDate not supplied

Diabetes in the elderly: remarks from an epidemiological study carried out in a town in south-eastern Sicily (Militello V.C.).

Longer mean life span and life expectancy of diabetics and increased factors that favor onset of type II diabetes have determined greater prevalence of diabetes in the elderly population. According to HANES II, it is 17% in the elderly in U.S.A. We carried out an epidemiological study on the over 65 year olds in Militello V.C. and examined 910 elderly subjects (72.05% of the total elderly population). All were tested for peripheral fasting blood glucose, body weight and height and filled out a questionnaire with general and diabetological questions. The values recommended by the NDDG were used to diagnose diabetes. One hundred and sixty-one diabetics (25 newly diagnosed) were observed (17.69%). Onset had occurred before age 65 (aged diabetics) in 72 cases and after 65 in 89 (senile diabetics). Mean blood glucose was 152.91 +/- 55.56 mg/dl. Our results indicated that sulfonylureas and/or biguanides are first choice treatment. By grouping the diabetics on the basis of age at onset and duration of disease, a fall in the number of cases treated with diet alone and hypoglycemic drugs and an increase in patients on insulin were seen in aged diabetics as the disease evolves. On the contrary, there was a rise in the number of senile diabetics on hypoglycemic drugs.

Age Factors↗

PubMedDate not supplied

Continuous subcutaneous insulin infusion: a long-term study.

The authors report data obtained from a 3-year study of CSII and humanized insulin (semi-synthetic human insulin) administered to 18 insulin-dependent subjects in the outpatient clinic. The aim of this study was to evaluate the validity of insulin pumps in long-term treatment. Metabolic parameters were significantly improved (p less than 0.001) in the first month and remained so with only slight alterations throughout treatment. The authors underline some metabolic problems (ketosis) caused by malfunctioning of the insulin pumps, by the difficulties with the infusion system or by nodular skin lesions at the infusion site. Only these lesions called for treatment to be discontinued in 4 patients. The highest incidence of nodular skin lesions was seen after one year's uninterrupted treatment and they seem connected to the duration of treatment rather than to the patients' negligence (inadequate hygiene, delayed needle substitution). The authors conclude that CSII treatment is valid over short-term periods, whereas it presents drawbacks over long-term administration.

Adolescent↗

PubMedDate not supplied

Serum enzymes of lysosomal origin as indicators of the metabolic control in diabetes: comparison with glycated hemoglobin and albumin.

Several lysosomal enzymes (beta-N-D-acetylglucosaminidase, beta-D-glucuronidase, alpha-D-galactosidase, beta-D-galactosidase, alpha-L-fucosidase, alpha-D-glucosidase, alpha-D-mannosidase, beta-D-glucosidase), glycated albumin and glycated hemoglobin (HbA1c) were determined in the serum of 81 insulin-dependent diabetics with different degrees of metabolic control (optimal, 21 patients; good, 39 patients; poor, 21 patients) and without signs of complications, and in 42 control subjects. All parameters examined increased in serum in inverse proportion to the degree of metabolic control. A highly significant correlation (p less than 0.01) was found between lysosomal enzymes and both glycated albumin and HbA1c. All parameters correlated with hyperglycemia, glycated albumin having the highest r-value (0.586) and lysosomal enzymes the lowest one. Unlike glycated albumin and HbA1c, serum levels of lysosomal enzymes in patients with optimal metabolic control were undistinguishable or even lower than those of controls. A 2-month longitudinal monitoring of a patient who was hospitalized in conditions of poor metabolic control and adequately treated, proved that lysosomal enzymes diminished in serum parallel to glycated albumin and HbA1c in relation to improvement of the metabolic situation. The conclusion is drawn that serum lysosomal enzymes are good indicators of the metabolic control of diabetic patients probably reflecting the overall metabolic state connected with insulin action rather than hyperglycemia.

Adolescent↗

PubMedDate not supplied

Serum enzymes of lysosomal origin as indicators of the metabolic control in non-insulin-dependent diabetics.

Several lysosomal enzymes (beta-N-acetyl-D-glucosaminidase, beta-D-glucuronidase, alpha-D-galactosidase, beta-D-galactosidase, alpha-D-glucosidase, beta-D-glucosidase, alpha-L-fucosidase and alpha-D-mannosidase) were determined in the serum of 54 non-insulin-dependent diabetics with different degrees of metabolic control and without complications and in 18 non-insulin-dependent diabetics with complications. The serum levels of beta-N-acetyl-D-glucosaminidase, beta-D-glucuronidase, alpha-D-galactosidase, and alpha-D-mannosidase were significantly (p less than 0.01) higher in the diabetics without complications. The levels of beta-N-acetyl-D-glucosaminidase and beta-D-glucuronidase were inversely proportional to the degree of metabolic control, in a statistically significant manner. Moreover the levels of these enzymes decreased to normal values during a 2-month period of controlled oral hypoglycemic drug-diet therapy resulting in metabolic compensation. The presence of complications was indicated by a further increase of serum beta-N-acetyl-D-glucosaminidase and beta-D-glucuronidase; however the portion of lysosomal enzyme activities due to complications remained unchanged after controlled therapy aimed at compensating the metabolism. The conclusion is drawn that in non-insulin-dependent diabetics, as already shown for insulin dependent-diabetics, serum lysosomal enzymes, especially beta-N-acetyl-D-glucosaminidase and beta-D-glucuronidase, are good intraindividual indicators of the metabolic control of the disease.

Adult↗

PubMedDate not supplied

Isolation and characterization of a new thermophilic Methanosarcina strain (strain MP).

A thermophilic Methanosarcina strain was isolated from a digester fed with water hyacinths and inoculated with ground termites from the Congo. Optimal growth temperature was 55 degrees C. Methane production was at its optimum between pH 6.5 and 7.0. The bacterium grew on acetate, methanol and methylamines in the absence of growth factors, but could not use H2-CO2 or formate. H2-CO2 inhibited acetate utilisation. Yeast extract and vitamins stimulated growth.

Euryarchaeota↗

PubMedDate not supplied

The impact of coexistent diabetes on the prevalence of coronary heart disease.

The increased risk of developing cardiovascular disease in diabetic population has been well documented, but the prevalent mechanism of this susceptibility is still only partly explained. We compared the impact of diabetes on ischemic heart disease in patients hospitalized in a public general hospital over a 10-year period. The prevalence of coronary heart disease (CHD) was consistently higher among diabetic population [namely, among non-insulin-dependent diabetes mellitus (NIDDM) patients] when compared with the nondiabetic population. The prevalence was similar in both genders, increasing with age, and was independent from body-mass index, history of smoking, metabolic control, or lipid pattern. Heart rate and blood pressure levels were significantly higher in NIDDM patients with CHD; similarly, there was a significant association between ischemic heart disease and atherosclerotic peripheral artery disease prevalence, and this trend was observed even in subjects with impaired glucose tolerance. These observations support the evidence that diabetes exerts a deleterious effect on general risk factors of atherosclerosis and increases susceptibility to cardiovascular disease by itself as an "independent" risk factor; on the other hand, the epidemiological evidence of an excessive occurrence of type II diabetes in individuals with pre-existing vascular disease suggests a genetically determined link between metabolic disturbances and cardiovascular disease.

Adult↗

PubMedDate not supplied

Echocardiographic imaging in coronary artery disease: new techniques.

When analyzing left ventricular wall motion and thickening, two-dimensional echocardiography (2DE) represents a useful non-invasive tool for diagnosing and stratifying ischemic heart disease. New important technical advancements, such as harmonic imaging, allow to overcome limitations due to poor echocardiographic image quality in a large proportion of patients. Combination of exercise or pharmacological stress test with on-line echo images monitoring expands 2DE diagnostic and prognostic value in both ischemia or viability assessment. Study of contrast agents distribution is very promising for clarifying the complex interaction between myocardial perfusion and functional correlates, including myocardial stunning, hibernation and no-reflow phenomena. Direct visualization of epicardial coronary arteries and assessment of coronary artery blood flow has recently been demonstrated to be possible by either transthoracic (TTE) or transesophageal echocardiography (TEE). Acoustic quantification (AQ), automatic border detection (ABD), tissue Doppler imaging (TDI), and color kinesis are other technical modalities which may result to be useful for clinical evaluation of patients with either acute or chronic coronary syndromes.

Contrast Media↗

PubMedDate not supplied

Myocardial contrast echocardiography: a new tool in the noninvasive assessment of perfusion.

Although the ability to visualize the microvascular circulation by injection of microbubbles has been recognized for over 30 years, only recently the considerable progress in both ultrasound techniques and new contrast media has made myocardial contrast echocardiography a reliable, noninvasive method for the assessment of regional myocardial perfusion. Several clinical studies have validated this technique for the identification of resting myocardial perfusion defects after myocardial infarction and the detection of no-reflow in ischemia-reperfusion model. In addition, preliminary studies have shown the ability of this method to recognize regional myocardial ischemia during pharmacological stress tests in known or suspected coronary artery disease. Finally, in the experimental setting, the estimation of different degrees of severity of coronary artery stenosis has been proposed using the quantitative assessment of myocardial perfusion by time-intensity curves. Although to date some unresolved questions hinder the routine clinical application of this novel noninvasive technique, myocardial contrast echocardiography is close to providing significant advances in the ultimate goal of any cardiac imaging technique, i.e. the simultaneous assessment of both perfusion and function.

Contrast Media↗