Long range medical follow-up and updating of computerized records.
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Biomedical subjects
Publications and source records attributed to G Debry.
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Male Wistar rats were fed either a balanced diet whose protein source was a mixture of amino acids (diet 1), or a similar diet which differed only in having 48% less the quantity of the sulfur-containing amino acids methionine and cystine (diet 2). The diets were given either continuously for 1 month or for 15 days after a protein-free diet. Both diets 1 and 2 permitted good growth of rats and relatively stable microsomal protein content. Protein depletion decreased the total proteins, total phospholipids, and cytochrome P-450 content, and it strongly increased UDP-glucuronosyltransferase activity in rat-liver microsomes. Repletion with diet 1 restored those values, to the level found in control rats. However, diet 2, given continuously induced an increase in UDP-glucuronosyltransferase activity and in the cytochrome P-450 concentration. Since high UDP-glucuronosyltransferase activity was related to lessened amounts of sulfur-containing amino acids in the diet, we discuss the possible effect of methionine and cystine on the regulation of glucuronoconjugation in relation to sulfoconjugation.
An intravenous fat tolerance test (IV FTT) was performed in a group of patients with type IV hyperlipoproteinemia before and after reduction of triglyceride level, the latter is obtained through a diet adapted to the nutritional sensitivity, body weight remaining constant. Before the diet the increase in cholesterol (CT) and triglycerides (TG) was related in both obese and non-obese patients to an increase in very-low-density lipoproteins (VLDL), while other lipoprotein fractions were not affected. In these patients, K2 is significantly lower than in controls whatever the nutritional sensitivity. However, K2 is lower in obese patients than in patients with normal weight, VLDL-CT and VLDL-TG are tremendously reduced by the relevant diet and K2 is constantly and significantly increased, although it does not reach a normal value in obese subjects. There is a highly significant correlation between VLDL-TG levels and K2 in obese and non-obese subjects. Several physiopathological explanations are discussed to account for the variation of K2 according to TG levels. The results obtained support the view that the K2 defect is secondary to the hyperlipoproteinemia.
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The blood viscosity of 15 insulin-dependent, poorly controlled, diabetic subjects was determined by using a microviscosimeter at low shear rates, with cylindrical cuvettes of the Couette type. It was found that the blood viscosity of these diabetics was more elevated than that of control patients (p less than 0.001). In ten diabetics, the return to a strict metabolic control over a period of more than 24 h by means of an artificial pancreas resulted in a significant systematic lowering of blood viscosity. These results suggest that the metabolic control of diabetes influences blood viscosity, and they underline the importance of an artificial pancreas for the dynamic study of the factors affecting blood viscosity during the course of diabetes.
Substances which react with anti-insulin antibodies, but have a higher molecular weight than insulin are described. They have been studied by various authors in pancreatic adenomas, pancreas extracts, serum and cell-free systems. Proinsulin was the first of these products to be discovered, followed by its precursor, pre-proinsulin, and subsequently by a whole series of substances of ill-defined composition and more or less similar properties, grouped under the heading of "high molecular weight immunoreactive insulin" (HWIRI).
After summing up existing theories about the origins and development of functional hepatic encephalopathy, the authors report on the effects of six-hour intravenous infusions of ornithine alphaketoglutarate (60 g dissolved in 500 ml distilled water), administered to 10 patients with ethylic hepatic cirrhosis in conjunction with a normal protein intake (70 g/day). Arterial blood ammonemia, venous blood aminoacidemia and the insulin/glucagon ratio did not vary during or after infusion. This method of treatment therefore seems to meet the protein requirements of these undernourished patients.
The manifestations of diabetic osteoarthropathy are described. Computerized analysis of the films of the feet of 1501 diabetic patients showed one or more lesions in 55% of patients. Exostosis (36%), vascular calcifications (25%) and osteoporosis (12.2%) are by far the most frequent symptoms. Geodes (3.7%), destructive lesions (3.9%), sclerosis (4%) and articular lesions (5.1%) are second in frequency. Osteolytic lesions and reconstruction showed a high female predominance, whereas sclerosis is predominant in males (61.6--38.4%).
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The lipid and protein composition of lipoprotein is now regarded with great interest for the identification of hyperlipoproteinemias. Because this relatively time-consuming study cannot be envisaged currently in clinical services, it seems useful to analyse a storage procedure which does not affect the composition of very-low density lipoproteins, whose proportion is very important among subjects with type IV hyperlipoproteinemia. Two studies were considered, one using whole sera stored at -20 degrees C and one using very low-density lipoproteins held in the same conditions. The lipid composition was determined for triglycerides and cholesterol concentrations of total proteins, proteins soluble in tetramethylurea (apoprotein C, "arginine-rich fraction", and apoprotein D), and peptides CII, CIII1 and CIII2 of apoprotein C. For both procedures considered, no significant changes were seen in lipid and protein composition for periods as long as 8 weeks.
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