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Biomedical subjects

J Mirouze

Publications and source records attributed to J Mirouze.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Urinary excretion of 3-methylhistidine. Value and application to the study of protein catabolism].

The urinary excretion of 3-methylhistidine (3 MH) is considered an easy and reliable method to quantify muscle protein catabolism in man. The 3 MH/creatinine (Cr) ratio is thought to be a good index of fractional degradation of muscle fibre protein. In the present article, the stress is placed on the limitations of 3 MH assays an- on their clinical applications. In thyroid diseases and in malnutrition (anorexia nervosa), the 3 MH/Cr ratio differentiates clearly marasmic malnutrition without increase in protein catabolism from hypercatabolic states, such as hyperthyroidism, with excessive protein degradation. 3 MH measurements therefore appear to be useful to determine the contribution of protein catabolism to lean mass reduction.

Adolescent↗
PubMed1985

Influence of the frequency of gonadotropin-releasing hormone (GnRH) administration on ovulatory responses in women with anovulation.

In attempt to optimize gonadotropin-releasing hormone (GnRH) treatment of anovulation, we compared the effect of intravenous GnRH administration at three pulse intervals (PI) during 63 cycles in 30 anovulatory patients who had: (1) amenorrhea secondary to anorexia nervosa (group I: 10 patients, 21 cycles); (2) unexplained anovulation with normal to high luteinizing hormone plasma levels (group II: 12 patients, 24 cycles); and (3) polycystic ovarian disease (PCOD) (group III: 8 patients, 18 cycles). Ovulation was achieved more frequently in group I (85%) than in group II (41%) or in group III (50%). In both groups I and II, the frequency of ovulatory responses was not different with the PI used, and 6 of the 17 women treated for infertility conceived; 3 with 90-minute PIs, 2 with 64-minute PIs, and 1 with 128-minute PIs. In women with PCOD, seven of the nine ovulatory responses and three pregnancies were obtained with 128-minute PIs. The overweight women with PCOD did not respond reliably to GnRH at the doses used, i.e., 4 to 15 micrograms per pulse. In all groups, the urinary estrone and estradiol preovulatory peak, duration of luteal phase, progesterone levels, and preovulatory follicle diameter were unrelated to the frequency of GnRH administration.

Anovulation↗
PubMed1985

Experience with long-term peritoneal insulin infusion from external pumps.

The long-term acceptability and feasibility of continuous peritoneal insulin infusion (CPII) from external pumps was evaluated in 40 insulin-dependent diabetic patients continuously treated for 1-27 months (mean 12 months). Blood glucose control was satisfactory and did not deteriorate with time (glycosylated haemoglobin 8.1 +/- 1.1%, mean +/- S.D., normal range 5.5-7.5%). Major problems included 1 episode of local peritonitis, 12 hypoglycaemic comas, 7 severe hyperglycaemic episodes, all cured without sequelae. Minor problems were frequent, mostly pump and catheter-related. Pump and catheter survival rates were 46% and 70% at one year, respectively. No peritoneal reaction was noted apart from occasional tissue growth around the catheter. This method of insulin treatment was judged satisfactory and acceptable by most of the subjects. Only one patient dropped out, after 1.5 years. These results were achieved through stringent selection of patients, intensive education with strict instructions, careful medical care, and possibly through the inherent physiological advantages of intraperitoneal insulin infusion.

Adult↗
PubMed1985

Pharmacokinetics of insulin infused intra-peritoneally via portable pumps.

Plasma free insulin was measured repeatedly for 4 hours following a standardized breakfast in 20 C-peptide negative chronically pumped type I diabetic patients and 5 normal subjects. In the former group, insulin was given as a 1 u/h basal infusion and a 1h superimposed meal-dose of 6 u via a peritoneal (IP) catheter lying in the low (n = 10), or in the mid-abdomen (n = 10). The results of the IP patients were correlated with glycosylated haemoglobin and home capillary blood glucose. Fasting free insulin of IP patients was lower than those of normals (14.7 +/- 0.5 vs 21.0 +/- 1.3 mU/l, p less than 0.01). Dose-induced peak occurred similarly in IP patients and normals (70 +/- 6 vs 70 +/- 12 min.). Values tended to baseline after 165 +/- 15 and 185 +/- 22 min. in IP patients and normals (NS). Results of the mid--and low peritoneum subgroups differed only for peak values (31.5 +/- 2.9 vs 25.0 +/- 1.6 mU/l respectively) and did not correlate with diabetic control.

Adult↗
PubMed1984

Peripheral blood T-cell subsets studied by monoclonal antibodies in type 1 (insulin-dependent) diabetes: effect of blood glucose control.

Peripheral T lymphocyte subsets were investigated, using monoclonal antibodies, in 14 patients with acute diabetes of duration less than 1 month (before insulin treatment) and after prolonged strict blood glucose control, and also in 40 healthy volunteers. At the time of diagnosis, the percentage total T cells was decreased (67.6 +/- 8.4 versus 72.8 +/- 6.6%), but T4 'helper' cells and T8 'suppressor/cytotoxic' cells were in the normal range. The T4/T8 ratio was not significantly higher than in the control group and B-cell percentages were increased (IgS: 18.3 +/- 7.1 versus 12.4 +/- 4.9%). The second T cell enumeration, performed after sustained normoglycaemia, showed a normal total T cell percentage and a decrease in the T4/T8 ratio depending on a decrease of T4 cells (38.3 +/- 12.8 versus 49.3 +/- 13.4), without any change of T8 lymphocytes; B cells remained elevated. These results suggest that insulin deficiency/metabolic derangement was responsible for an imbalance of circulating lymphocytes and underlines the importance of metabolic control in the assessment of such immunological parameters.

Adolescent↗
PubMed1984

Thyroid status and muscle protein breakdown as assessed by urinary 3-methylhistidine excretion: study in thyrotoxic patients before and after treatment.

Urinary 3-methylhistidine (3MH) excretion was studied in nine thyrotoxic patients before and after treatment. Urinary creatinine (Cr) output was also measured and was low in the thyrotoxic subjects before treatment. Thus, although urinary output of 3MH was not greater than among the control population when expressed per subject, it was significantly elevated when expressed as the ratio of 3MH to Cr; this ratio fell significantly, reaching normal control values after a euthyroid state was obtained. In one patient who became hypothyroid, the 3MH/Cr ratio fell under the control value. There was a significant linear correlation between the 3MH/Cr ratio and the hormonal variables (T3, T4, FT4l); moreover, variations in the 3MH/Cr ratio and variations in the T3 level were closely correlated. 3-Methylhistidine appears to be a reliable index of muscular breakdown in thyrotoxicosis. From our results, it can be concluded, first of all, that hyperthyroidism is accompanied by an increased muscular catabolism, and, second, that the return to a euthyroid state results in an immediate normalization of muscular breakdown.

Adult↗
PubMed1984

Effects of dietary fiber on postprandial glycemic profiles in diabetic patients submitted to continuous programmed insulin infusion.

Conventional (C) or fiber supplemented (F) test breakfast and lunch were given on 3 successive randomized days to six insulin-dependent diabetic patients treated with continuous programmed insulin infusion. Meal distribution was as follows: day 1 (C breakfast and C lunch), day 2 (F breakfast and C lunch), day 3 (F breakfast and F lunch). No rise in blood glucose (BG) was observed after F breakfast (days 2 and 3) while a small rise in BG occurred after the C breakfast (day 1). Significant differences were observed between day 1 and days 2 and 3 for absolute BG values as well as for BG changes (delta BG) from base-line. At lunch slight differences in delta BG were only noted at 45 min (p less than 0.05) between days 2 and 3, while there was no difference between days 1 and 2. Our results indicate that fiber supplementation is useful even in pump-treated insulin-dependent diabetics but that F breakfasts have no influence on the carbohydrate tolerance to the subsequent lunch.

Adult↗
PubMed1984

Optimal routes for chronic insulin infusion with portable and implantable devices.

The optimal route for chronic insulin infusion via portable or implantable pumps is still a subject of controversy. Through the literature reports and personal experience (representing 70 patient-years of continuous treatment), the authors have found that the subcutaneous route is the ideal route in terms of comfort, safety, and cost. However, owing to sluggish and unpredictable insulin resorption, it appears that subcutaneous infusion is often not more effective than intensive conventional insulin therapy. The intravenous route gives the best diabetic control, but with a high risk of infection and obstruction. The intramuscular route, although more efficient than the subcutaneous, can be envisaged for only short periods because of its poor tolerance. The portal route is still at an experimental stage. The authors chose the intraperitoneal route because of the following advantages: near physiological insulin resorption kinetics; better diabetes control than subcutaneous infusion although comparable to intravenous; a 30% reduction of insulin requirements; and satisfactory local tolerance and acceptability with respect to severe asepsy precautions, patient selection, intensive education, and careful medical follow-up. The intraperitoneal route is feasible for portable insulin pumps, but basically more adaptable to implantable devices.

Humans↗
PubMed1984

Plasma beta-thromboglobulin response to insulin-induced hypoglycemia in type I diabetic patients.

The effect of an insulin-induced hypoglycemia was examined in 14 type I diabetic patients. After an overnight blood glucose normalization, each patient received an additional intravenous bolus of 3 U regular insulin at 0900 h (time 0). Blood glucose was continuously recorded up to 180 min. Plasma samples were assayed for beta-thromboglobulin (beta TG, ng/ml), pancreatic glucagon (pg/ml), cortisol (microgram/dl), and growth hormone (ng/ml) 30 min before the insulin stress, at time 0, at blood glucose nadir, and at 180 min. The blood glucose fell from a baseline level of 85.0 +/- 3.2 mg/dl to a nadir value of 39.2 +/- 1.9 mg/dl (P less than 0.001) reached at an average time of 41.4 +/- 4.9 min. Plasma beta TG increased significantly (P less than 0.05) during the insulin stress: 93.4 +/- 23.7 ng/ml at nadir versus 42.5 +/- 5.9 at time 0. Plasma cortisol and growth hormone were significantly increased (P less than 0.02 and P less than 0.01) at nadir compared with time 0 values. Plasma pancreatic glucagon was higher at nadir than at time 0, but the difference was not significant. The present results indicate that in vivo platelet activation can be triggered by hypoglycemic episodes in insulin-treated diabetic patients.

Adolescent↗