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Biomedical subjects

H Gin

Publications and source records attributed to H Gin.

At least 127 records · Page 7Linked to original sources
PubMed1987

Perisinusoidal fibrosis and basement membrane-like material in the livers of diabetic patients.

A direct correlation exists between collagenization of Disse's space and the presence of diabetic microangiopathy in type I diabetes. To confirm and extend this finding, we studied four liver biopsy samples from two patients with type I diabetes (one with retinopathy) and two patients with type II diabetes (no retinopathy). All had normal or subnormal results on liver function tests and normal liver architecture. Levels of collagen types I, III, and IV, laminin, and fibronectin, as determined by immunocytochemical techniques, appeared increased in all patients. Liver biopsy samples were perfusion fixed for electron microscopy of sinusoids and sinusoidal cells. Numerous and thick collagen bundles could be seen in Disse's space, as could the increase of basement membrane-like material underlying the endothelial cells, perisinusoidal cells, and sinusoidal membrane of hepatocytes. Perisinusoidal cells were active and had abundant rough endoplasmic reticula and thick processes. This preliminary study indicates that collagenization of Disse's space is not specific to a certain type of diabetes. The increase of basement membrane-like material raises the question of whether liver sinusoids are truly different from other capillaries as far as diabetic microangiopathy is concerned.

Adult↗
PubMed1987

Use of the glucose clamp technique for confirmation of insulinoma autonomous hyperinsulinism.

The diagnosis of insulinoma on the basis of persistent hypoglycemia requires further confirmation. The insulin suppression test has been used to support this diagnosis prior to surgical intervention. In this study the euglycemic clamp technique was used to compare five control volunteers with four hypoglycemic patients with suspected insulinoma. Insulin was infused over successive two-hour periods at 2, 4, and 8 mU/kg/min. Plasma glucose levels were clamped at 80 mg/dL (4.4 mmol/L) using an artificial pancreas. High insulin levels were measured in all subjects, ranging from 225 +/- 30 microU/mL (1614 +/- 215 pmol/L) to 1018 +/- 239 microU/mL (7304 +/- 1714 pmol/L). Levels of C peptide fell to 0.1 ng/mL (0.028 nmol/L) in control subjects but remained at high levels in the patients. Insulinoma was confirmed on laparotomy in all four patients. In two patients tested after removal of the tumor the results were found to have returned to normal.

Adenoma, Islet Cell↗
PubMed1985

Metformin improved insulin resistance in type I, insulin-dependent, diabetic patients.

The biguanides have been shown to reduce insulin requirements in type I (insulin-dependent) diabetic patients with an increase in insulin binding to insulin receptors. The aim of this was to measure the effect of metformin (850 mg/twice daily) on insulin sensitivity. Ten type I diabetic patients of normal weight received metformin or placebo in addition to their insulin therapy for seven days. On the last day of metformin or placebo treatment, tissue sensitivity was measured by the euglycemic hyperinsulinaemic clamp procedure using the artificial pancreas. An 18% improvement in glucose uptake was observed after metformin therapy (P less than 0.01). Metformin was therefore effective in improving the insulin action in type I diabetic patients, although its use in such circumstances requires consideration of several other factors.

Adolescent↗
PubMed1985

[Peripheral sensitivity to insulin in aged subjects].

Insulin sensitivity has been studied in ten young patients (22 years old means) and in eleven elderly patients (72 years old means). They were free of family diabetes history, glucose intolerance, hypertriglyceridemia, hepatic or renal failure or factor of insulin resistance such as infectious diseases. A two hours hyperinsulinic euglycemic clamp was done with an artificial pancreas (Biostator GCIIS Miles). The ten young patients and the eleven old patients had a stable hyperinsulinic level (93.3 +/- 5 uu/ml and 90 +/- 8 uu/ml) they respectively required 8.08 +/- 0.73 and 5.5 +/- 2.5 mg/kg/min of glucose. Metabolic clearance of insulin does not seem altered with aging. For a same hyperinsulinic level the glucose requirement is less in old patients. So there is an apparent insulin resistance in aging.

Adult↗
PubMed1984

Prosthetic valve endocarditis: diagnosis and prognosis.

From 1972 to 1982, 22 patients were admitted for prosthetic valve endocarditis on homografts (3), bioprostheses (2) or mechanical prostheses (17). Staphylococcus epidermidis was the most common aetiologic agent in early-onset endocarditis and streptococci in late-onset. Echo-cardiographic or cinefluoroscopic findings enhanced diagnosis mainly in advanced stages of the disease. Despite medical therapy and prompt reoperation in most cases, mortality remains high: 66%, 80% in the early group, 50% in the late group; the prognosis was definitely improved, however, by surgical treatment.

Bioprosthesis↗
PubMed1984

Influence of glycaemic normalisation by an artificial pancreas on phagocytic and bactericidal functions of granulocytes in insulin dependent diabetic patients.

Ten insulin dependent diabetic patients were maintained in normoglycaemia for 36 h with an artificial pancreas. Circulating polymorphonuclear leucocytes were extracted and incubated with staphylococcus before and after treatment; phagocytic and bactericidal activities were studied. Granulocytes from diabetic patients showed a decreased ability to absorb staphylococcus and a reduced capacity for intracellular destruction of bacteria. These two functions were improved after 36 h of normoglycaemia but were not corrected.

Adult↗
PubMed1984

[Feasibility and reproductibility of a euglycemic hyperinsulinic glucose clamp technic].

The euglycemic hyperinsulinaemic clamp is a means for the study of insulin sensitivity. Several techniques have been described: some are manual, others are automatic and use hypertonic glucose (50%). A semi-automatic technique is described using an artificial B cell (Biostator Miles) and a pump (Vial). The method and its reproductibility in ten healthy subjects were studied. The choice of appropriate algorithms ensure a constant and stable insulin level of 93,3 +/- 5 uU/ml and good glycemic feedback through graduated glucose perfusion. The use of a supplementary pump in series with an artificial pancreas insures basic glucose input without recourse to strong concentrations (20%); glycemic feedback of the artificial pancreas is thereby dynamically controlled. The glucose requirement is 8,08 +/- 0,73 mg/kg/min. The same values are found in the same patients three weeks later and resemble those obtained using other techniques. Automatic feedback makes the technique objective; low concentration glucose solution avoids damage to veins.

Adult↗
PubMed1984

Study of insulin metabolism in hyperthyroid patients.

Hyperthyroidism is associated with degradation of carbohydrate metabolism. The insulin metabolism in 12 hyperthyroid patients is compared with 10 control subjects. The patients were connected to an artificial beta cell (Biostator GCIIS Miles) for two hours of insulin infusion (40 mU/m2/mn) while glycemia was maintained at its basal level by a modulated glucose infusion. Blood samples were taken, every 15 minutes for insulin and C peptide dosage. In control subjects the insulin steady state level was 93.3 +/- 5 microU/ml whereas this ranged from 42 +/- 3.4 microU/ml to 68 +/- 3.9 microU/ml in hyperthyroid patients. After treatment the insulin level was not quite normal, and ranged from 52 +/- 4.8 microU/ml to 82.2 +/- 9 microU/ml. A glucose intake not corresponding to the same insulin steady state is not therefore to be interpreted. Here there is no evidence of a correlation between the percentage decrease in the insulin test level and the thyroid hormone levels. An impairment of insulin metabolism is suggested in hyperthyroid patients, which might contribute to the decrease in carbohydrate tolerance.

Adult↗
PubMed1984

[Symptoms and incidence of hypoglycemia in 100 insulin dependent diabetics].

The aim of this study was to discover the frequency and the symptoms of hypoglycaemic reaction and coma. One hundred type I diabetic patients answered an oral questionnaire and explained how they were awaken from their hypoglycaemicoma. The frequency of hypoglycaemic reaction was from one a day to one a year. 41 patients had nocturnal hypoglycaemic reactions. Our patients described 27 different symptoms of oncoming attack; however, not all of these symptoms was experienced by any one of the patients. Treatment of hypoglycaemic reaction was administered correctly but at the precise moment of the interview, 13% of patients had no carbohydrates with them. 42 patients had had hypoglycaemic reaction but no coma. Shared between 48 patients were 578 insulin years and 148 comas. Treatment of hypoglycaemic coma was variable: 20 patients remained at home receiving appropriate treatment; 33 were always hospitalised on attack and 20 were still comatous on each admission. The explanation of hypoglycaemic attack was variable; an emotional factor was given by 19% of patients. Both type I diabetic patients and their immediate entourage should be made aware of all the symptoms of oncoming attack and of the treatment of hypoglycaemic coma. Systematic glycemic auto control should testify to the existence of genuine hypoglycaemic reaction and perhaps diminish its supposed frequency.

Adolescent↗
PubMed1983

[Pheochromocytoma and its diagnostic pitfalls].

A sixty-year-old man experienced successively over two years several episodes of circulatory collapse and meningeal hemorrhage, a myocardial infarction, an episode of ketoacidosis and a seizure before acute abdominal pain with fever related to the sudden, partial, necrosis of his tumor, led to the discovery of a pheochromocytoma. This observation exemplifies the multiple clinical aspects and diagnostic pitfalls of this secreting tumor. It underscores the misleading nature of normotensive pheochromocytomas.

Adrenal Gland Neoplasms↗
PubMed1983

Attempted suicide by insulin injection treated with artificial pancreas.

An elderly woman with longstanding insulin dependent diabetes tried to commit suicide by injecting 400 units of insulin subcutaneously (usual total daily dose 56 units). She was admitted to hospital within the hour and treated with the aid of an artificial pancreas. This avoided the usual difficulty of the physician having to cope with rapid and substantial fluctuations in blood glucose concentrations and 67 hours after the overdose insulin was reinstituted. Using an artificial pancreas in insulin overdose is an important advance in management and may avoid the need for surgical intervention such as excising the site of injection.

Aged↗