Experience in glucose metabolism monitoring.
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Biomedical subjects
Publications and source records attributed to G Berg.
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While age is increasing involutiones specific to age can be proofed at the gastrointestinal tract, which lead to a deceleration but quantitative unchanged adsorption. Wrong nutrition concerning to the take up of fat, carbohydrates, proteins and trace elements can be found in greater age very often. By watching a collective of healthy persons beyond the age of 90 years however it turns out that this group keeps a nearly faultless nutrition. The requirements of lysin, methionin and calcium is a little higher in old age than in younger. By intermitting starvation or addition of antioxidants life can be prolonged in experiments on animals, when this therapy starts already in younger age. Starvation in higher age, however, leads to a shortening of life in experiments on animals.
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10 healthy men received an i.v. infusion of maltose at a dosage of 1.5 g/kg/h over a period of 1 h. No clinical side effects were observed. Total protein and albumin showed a significant drop. The glucose level remained constant. The concentration of maltose rose up to 495 +/- 77 mg/100 ml. The osmo-diuretic action of the solution was proven by a renal excretion of 289 +/- 57 ml water/h, 14.6 g maltose/h and 3.9 g glucose/h. The total carbohydrate elimination was 61.8 +/- 9.1 g/8 h, (44.5 +/- 13.5 maltose and 15.7 [+8.1--21,2] glucose). The specific action of maltose is an induction of glucosuria without hyperglycemia.
A flow-through glucose-analyser is described based on an oxygen-sensitive enzymatic system. Leak-current-proof welded PTFE-membranes contribute considerably to an easy maintenance of the O2-sensors. Soluble or immobilized glucose oxidase may be used in automatic analysers. As a primary instrument of analysis, the oxygen pO2-electrode lends itself to the measurement of other enzymatic reactions that involve oxygen.
Increased diagnostic information may be derived with Tc-99m diphosphonate from a detailed kinetic analysis of blood disappearance, urinary excretion, and quantitative assessment of skeletal uptake. Blood and urine determinations were studied in three populations: normal volunteers, patients with negative bone scans, and patients with positive bone scans. Quantitative imaging studies were performed in normal volunteers and patients with a scintillation camera interfaced to a computer. All subjects were scanned in the lower lumbar region up to 1 hr after Tc-99m diphosphonate administration. Blood levels exhibited a triexponential clearance pattern. Significant (p less than 0.05) differences were observed for the 5-min blood and 0-1 hr urine values among the various groups. The computer-generated images showed an initial early uptake in bone, kidneys and soft tissue. Thereafter, a parallel fall-off in activity was observed in kidney and soft tissue, with a concomitant increase in bone. Skeletal uptake was different for normal and diseased bone.
In 2466 in-patients the blood cholesterol concentration was measured. Also age, height, weight, excretory liver function, glucose tolerance, the concentration of total lipids, uric acid and the clinical diagnosis were correlated with the cholesterol levels. Higher cholesterol levels were found in elderly patients and in patients with impairment of liver function, glucose tolerance and with overweight. With increasing hight cholesterol decreases. Patients with disorders of gallbladder and liver had significantly higher cholesterol levels compared with patients with hematological disorders, malignancies and pulmonary affections.
Three patients with gout and seven with hyperuricaemia, previously untreated, took a single dose of 100 mg allopurinol and 20 mg benzbromaron (as a combined preparation) each morning. There occurred a highly significant decrease in serum uric acid concentration from 430.7 mumol/l (72.4 mg/l) to 268.6 mumol/l (45.2 mg/l), without any significant increase in urinary excretion of uric acid.
In 106 healthy adults and 34 in-patients with diabetes mellitus the venous blood concentration of lactate, pyruvate, hydroxybutyrate and acetacetate was measured. In healthy men we found a lactate concentration of 7.7 mg/100 ml (7.11-8.15), a pyruvate level of 0.37 (0.34-0.44) mg/100 ml, a level of acetoacetate of 0.41 mg/100 ml(0.38-0.47) and a level of hydroxybutyrate of 0.47 mg/100 ml(0.29-0.70).
During treatment with benzbromaron in a dose of 100 mg/day a significant fall of uric acid was shown beginning on the second day. On the forth day in the evening or the fifth day in the morning a steady state for the uric acid level is reached. The morning value was 2,9 mg/100 ml, the evening value 2,6 mg/100 ml. During treatment, even when serum uric acid levels are decreased, an augmented renal uric acid elimination excists but a hyperuraturia was not found.
The immunoglobulins G, A and M were determined quantitatively by radial immunodiffusion in 50 patients with ulcerative colitis and 41 with Crohn's disease. 50 clinically healthy probands formed the control group. There was no correlation with duration, severity, and localisation of the disease, or with the treatment used. IgA was significantly lower in ulcerative colitis as compared with the control group. The most marked changes of immunoglobulin levels observed were in Crohn's disease: whereas IgA was increased by 37%, IgM was decreased by the same percentage. A typical immunogram in Crohn's disease is a valuable differential diagnostic feature as compared with ulcerative colitis.
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A combined carbohydrate in fusate (glucose, fructose, and xylitol in the ratio of 2:2:1) was administered to eight healthy adults at the rate of 0.5 g.kg-1.h-1 for 12 hours. The solution also contained 80 mmol sodium, 30 mmol potassium, 2.5 mmol magnesium, 2.8 mmol phosphate and 110 mmol chloride per litre. Glucose and fructose were almost completely metabolised. The percentage loss of xylitol was very low (8.9% of the administered dose). There was a slight insulin incretion and moderate rise in lactate concentration. No disorder of fat and uric acid metabolism and acid-base equilibrium was observed. Nor was there intravascular volume dilution, as measured by protein, albumin and haemoglobin concentration and haematocrit. There was a significant fall in phosphate concentration due to increased phosphate utilisation. Calcium concentration was also significantly decreased. Excretion of sodium was 10 mmol/h of potassium 4 mmol/h, phosphate 0.02 mmol/h and of magnesium 0.27 mmol/h. Sodium balance was positive in six patients, potassium and phosphate balance in five, magnesium and waterbalance in eight. There was no change in transaminases and lactate dehydrogenase. A typical sign of carbohydrate infusion was the slight rise in bilirubin concentration by 6.84 mumol/l. The tested carbohydrate combination can, at the stated rate of administration, cover the entire daily energy needs of an adult.
The generation of density gradients for ultracentrifuging by freezing and thawing was applied to formation of linear density gradients with sodium metrizoate and metrizamide. Using these gradient materials simple and rapid methods for purification of virions and nucleocapsids of herpes virus were elaborated. Using metrizamide the recovery of infectivity was 10-30 per cent, and the purification of virions measured as reduction of host protein was 1700 times. Using metrizoate, the recovery of nucleocapsids was 30-60 per cent and the purification from host DNA and protein was 900 and 1700 times, respectively.
In 30 obese subjects three different methods for weight, reduction were applicated over a period of 14 days. One group (n=10) was treated with total starvation, the other group (n=10) with total starvation and 80 mval potassium in addition and the third group (n=10) with a 700 cal. diet. In total starvation the balance of sodium, potassium and phosphate amounted to -9 mval/d, -34,9/d and -8,8 mval/d respectively. Whereas calcium showed a positive balance of 4,4 mval/d. During addition of 80 mval potassium sodium excretion increased whereas potassium excretion was diminished resulting in a potassium balance less negative. During treatment with the 700 calorie diet the highest negative sodium and a high positive potassium balance were observed,
6 healthy subjects received a 20% electrolyte containing maltose solution over a period of 6 hours. The concentration of maltose rose up to 109 (76-215 mg/100 ml). During the infusion period 3,7 (1,9-7,7) g maltose were excreted. The concentration of glucose and insulin was not altered, although the renal glucose loss was 20,2 (7,5-38,7) g. In the same period 49,8 +/- 13,2 mval potassium and 135,4 +/- 35 mval sodium were eliminated. Maltose induced an osmotic diuresis which was not caused by hyperglycemia. Such a type of osmotic substance has not been described before.
Within 3 hours, 10 healthy male volunteers were infused 500 ml of a 5 percent emulsion in which 25 percent of the fat proportion had been replaced by MCT-fats. As expected, the ketone body concentration in the blood rose, while pyruvate remained constant and lactate dropped. The results show that, basically, a MCT-containing fat infusion is suited for parenteral nutrition and, because of their specific properties, medium chain triglycerides may be used as rapid energy donators.