Search PubMed⌕ Search

Biomedical subjects

J J Altman

Publications and source records attributed to J J Altman.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Sex hormones in chronic renal failure of the diabetic].

Renal failure per se complicates the study of the hypothalamo-hypophyso-gonadal axis. Impotence in the male and amenorrhoea in the female are virtually constant in advanced renal failure. In men, there is probably a double hypophysogonadal involvement and, hypothetically, in women, a hypothalamic involvement. Although the functional disorders were major in our group of haemodialysed diabetic patients, the laboratory abnormalities were only moderate. These abnormalities were absent in men and women with moderate renal failure. As the pathogenesis of the abnormalities is unknown, preventative treatment cannot be proposed. The clinical and biochemical status of the patients remains unchanged regardless of the dialysis procedure, but transplantation corrects the majority of the abnormalities, including the functional disorders.

Diabetes Mellitus↗
PubMed1987

Evidence of functional gastric inhibitory polypeptide (GIP) receptors in human insulinoma. Binding of synthetic human GIP 1-31 and activation of adenylate cyclase.

Specific gastric inhibitory polypeptide (GIP) receptors were characterized in human benign insulinoma plasma membranes employing [mono-[125I]iodo-Tyr10]-GIP (125I-GIP) as the radioligand. GIP 1-42 inhibited 125I-GIP binding with an IC50 value of 10(-9) M. Scatchard analysis showed two classes of binding sites: a high-affinity site (Kd = 2.23 x 10(-10) M; Bmax = 24 fmol/mg protein) and a low-affinity site (Kd = 8.39 x 10(-9) M; Bmax = 118 fmol/mg protein). A synthetic replicate of human GIP 1-31 inhibited 125I-GIP binding with an IC50 value of 10(-8) M. The GIP binding sites of human insulinoma were coupled to adenylate cyclase stimulation. GIP 1-31 regulated the adenylate cyclase activity to the same extent as GIP 1-42. The concentrations of GIP required for maximal activity ranged from 10(-9) to 10(-8) M for either GIP 1-42 or GIP 1-31. The existence of functional GIP receptors in human insulinoma substantiates our recent reports demonstrating the presence of GIP binding sites in transplantable hamster insulinoma and indicates that GIP could exert a direct control of the beta-cell function in humans through a purely endocrine pathway.

Adenoma, Islet Cell↗
PubMed1986

Long-term plasma glucose normalization in experimental diabetic rats with macroencapsulated implants of benign human insulinomas.

Permselective tubular membranes (1 mm i.d.) were filled with fragments of nine freshly resected human insulinomas, closed at both ends, and implanted in the peritoneal cavity of 30 streptozocin-induced diabetic rats. In 14 animals, nonfasting plasma glucose (PG) and insulin levels were normalized by these immunoprotected transplants for up to 1 yr (PG from 520 +/- 12 to 142 +/- 3 mg/100 ml; insulin from 6 +/- 0.5 to 44 +/- 3 microU/ml). These animals showed the same weight gain after 12 mo of observation as 20 controls. The remaining 16 animals showed an incomplete or transient correction of their diabetes and survived 4-6 mo, versus less than 8 wk in untreated animals. Removal of the membrane-encapsulated insulin-secreting tissue from 8 successfully treated rats led to hyperglycemia and death within 10 days. Histology and electron microscopy of insulinoma tissue retrieved after long-term implantation showed functionally active endocrine cells and no evidence of graft rejection. In vitro perifusion gave similar results for encapsulated and nonencapsulated insulinoma tissue. The amount of insulin secreted was quite variable, and responsiveness of the insulinoma to changes in glucose concentration of the surrounding medium was observed in three out of the five tumors studied. These observations establish the effectiveness of immunoseparation by a synthetic membrane in a pancreatic xenograft model.

Adenoma, Islet Cell↗
PubMed1985

[Effect of clinical hyperthyroidism and hypothyroidism on patent diabetes. 59 cases].

Fifty-nine patients with both clinical evidence of thyroid dysfunction and patent diabetes mellitus were investigated in our diabetology department. Patients with euthyroid goitre and iatrogenic or pituitary hypothyroidism were excluded from the study. Among the 45 diabetics with hyperthyroidism, 32 had Graves' disease and 13 had toxic adenoma; 71% were insulin-treated. Hyperthyroidism had passed unnoticed in 7 of these 32 patients because fatigue and loss of weight, which initially were the predominant or sole symptoms, are extremely frequent in uncontrolled diabetes. These symptoms, as well as polyuria, polyphagia and even sweating are common to both diseases. Considerable deterioration in the control of glycaemia was observed in 63% of the insulin-treated patients when hyperthyroidism developed, with a 17 to 212% (mean 82%) increase in insulin dosage in 53%. There was no correlation between the degree of hyperthyroidism and the loss of control. Following treatment of the hyperthyroidism, control was improved in 63%, with an 11-83% (mean 44%) decrease in insulin dosage in 59% of them. Insulin therapy could be withdrawn in only one of the 32 insulin-treated patients. Non-iatrogenic primary hypothyroidism was found in 0.2% of the diabetics investigated. This incidence was significantly higher than the calculated probability of the two diseases occurring by chance in the same patient. Eleven out of 14 patients were insulin-treated. When hypothyroidism developed, 73% of them had their insulin dosage reduced, with a high frequency of hypoglycaemic disorders: repeated "malaise" in 55% and coma in 27%. A higher proportion of vitiligo was also noted: 14% in the total patient population reported, and 18% in insulin-treated patients.

Adult↗
PubMed1985

Continuous subcutaneous infusion of glucagon by portable pump in non beta cell tumor hypoglycemia.

Subcutaneous infusion of glucagon by portable pump appears to give very effective symptomatic relief from non beta cell tumor hypoglycemia when surgery, radiotherapy and chemotherapy are impossible or ineffective. This mode of glucagon administration was proposed in a patient who had severe nocturnal hypoglycemic attacks. The aim of the study was to specify the modes of utilization and to test the efficiency and the tolerance of this treatment. Glucagon was infused at 400 micrograms/h during every 12 hour night. Because of the hepatic action of glucagon it is very important to use this treatment with an adequate diet and to stop the infusion during the day to reconstitute the glycogen overload. This mode of glucagon administration was very effective in over 6 months of use and well tolerated.

Blood Glucose↗
PubMed1978

[Familial idiopathic haemochromatosis with diabetes. Study of glucagon and growth hormone secretions (author's transl)].

In the course of familial idiopathic haemochromatosis with diabetes, after stimulation with arginine, the alpha cell responds perfectly to stimulation, in contrast to the case of chronic pancreatic diseases. After an oral glucose load, there is no reduction in plasma glucagon concentrations, and a paradoxal increase is sometimes seen. These results are quite similar to those reported in common diabetes. Secretion of growth hormone after an infusion of arginine and insulin hypoglycaemia seem to be significantly reduced in comparison with normal subjects and those suffering from common diabetes, paired and explored using the same protocol. This may perhaps explain the low degree of severity and slow course of associated vascular disease.

Adult↗
PubMedDate not supplied

The GnRH test in idiopathic hemochromatosis.

In 10 patients, 8 males and 2 females, suffering from idiopathic hemochromatosis (IH), the gonadotropic function has been studied using the GnRH test (iv administration of 100 micrograms) to make precise the pathogenesis of their hypogonadism. The FSH and LH mean basal levels were low and almost unaffected by GnRH (p < 0.001 at each time value when compared to controls). The hypogonadism often observed during the course of IH seems to be hypogonadotropic. Various factors could be responsible for this disturbance. The exact site of the lesion, whether hypothalamic or hypophyseal, remains unknown.

17-Ketosteroids↗
PubMedDate not supplied

Type 1 diabetes with no diabetic complications, 62 years later.

We report a type 1 diabetes in an 88-year-old female patient discovered in 1938 at the age of 26. She was promptly put on insulin, which lasted 62 years so far. This patient was highly remarkable because she portrayed a historical case of insulin-treated diabetes diagnosed in 1938. The absence of microangiopathy and specially retinopathy was quite singular, all the more reason that her diabetes was ill-controlled. Environmental or genetic factors may, one day, explain this unusual favourable outcome.

Aged↗
PubMedDate not supplied

[Pancreas and pancreatic islets grafts in humans].

The limitations of insulin therapy explain the growing interest expressed by diabetologists in pancreas and islet cell transplantations. Pancreatic graft is the most used method, and its technique is now well established; the exocrine secretion can be either dried up by pancreatic duct obstruction or drained, often into the bladder. However, this method demands permanent immunosuppression and for this reason it is used in 85 percent of the cases in diabetics requiring kidney transplantation. The mortality and morbidity due to transplantation have decreased considerably. The survival rate at 1 year is 81 percent for patients and 46 percent for grafts, with return to normal glycaemia levels in most cases. The effects of pancreas transplantation on diabetic microangiopathy are difficult to evaluate in these patients who often have very advanced complications, but the first data are encouraging. The indications for this transplantation are limited, and they should not be extented to early stage diabetes unless they are part of controlled studies. Islet cell transplantation has many potential advantages, including safety and the hope of grafts without permanent immunosuppression, but the results available in man are still very preliminary.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

Risk/benefit ratio of changing late obstetrical strategies in the management of insulin-dependent diabetic pregnancies. A comparison between 1971-1977 and 1978-1985 periods in 389 pregnancies.

We compared the results of 166 pregestational insulin dependent diabetic pregnancies in the period 1971-1977 to those of 223 in the period of 1978-1985, after the introduction of self monitoring of blood glucose. During this second study period late obstetrical strategies changed to prolongation of pregnancy up to term, avoidance of final hospitalization and decrease of the rate of cesarean section. Maternal blood glucose control was less optimal in the second period resulting in a higher incidence of fetal macrosomia. Despite this, unexplained stillbirth disappeared, neonatal morbidity did not change significantly and the overall benefit was a reduction of preterm birth and a better quality of life for our patients. We conclude that the final hospitalization from week 32 onward in insulin dependent diabetic pregnancies is no more mandatory.

Birth Weight↗