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Biomedical subjects

J Mirouze

Publications and source records attributed to J Mirouze.

At least 127 records · Page 7Linked to original sources
PubMed1978

[Glucose tolerance test in children of diabetic mothers. Evaluation from birth to twelve years of age (author's transl)].

Twenty-five children born of 23 diabetic mothers, 17 of whom were treated with insulin, underwent glucose tolerance tests with estimation of blood insulin levels. These tests were performed on a regular basis before the age of five years, then every two years. Blood glucose and insulin disturbances were slight but appeared frequently since they were present in 56% of our cases. Our data show that blood glucose disturbances in children of diabetic mothers are more common if the diabetes of the mother suggests a maturity onset type on the basis of accompanying symptoms and treatment, and hence not insulin dependent. In this case, the chances that the child will become diabetic are much greater and this may be detected very early by a minor disturbance in the oral glucose tolerance test.

Blood Glucose↗
PubMed1978

Sustained insulin-induced remissions of juvenile diabetes by means of an external artificial pancreas.

Remission of diabetes was attempted in 12 recent acute onset ketosis-prone juvenile diabetes after short term (5 +/- 1 days) but excellent blood glucose control by the external artificial beta-cell. The comparison group comrised patients undergoing traditional treatment (n = 28). Nine (75%) persistent (over 3-14 months of duration) although partial (oral drugs required) remissions were obtained in the former group as compared to 3 (11%) in the latter group (p less than 0.05). Cases which showed remissions after insulin infusion had a plasma insulin response to IV glucagon still present before insulin infusion, and a daily urinary C-peptide excretion significantly enhanced after (p less than 0.01). Urinary C-peptide/blood glucose remained improved during the remission period. Thus, early effective treatment by means of the artificial pancreas may break the vicious circle hyperglycaemia-insulin depletion-hyperglycaemia and lead to frequent and sustained remissions of juvenile diabetes.

Acute Disease↗
PubMed1978

Antithrombin III deficiency in diabetes mellitus: influence on vascular degenerative complications.

Plasma Antithrombin III (At III), a natural inhibitor of coagulation, was determined using a single radial immunodiffusion technique. In 116 diabetics, plasma At III levels were significantly decreased (26.6 +/- 0.4 mg/100 ml) compared with those in 64 controls (31.0 +/- 0.3 mg/100 ml, P less than 0.001). An elevation of plasma fibrinogen degradation products in 42 per cent of our patients, and a positive linear relationship between platelet counts and At III levels ( r = 0.29, P less than 0.01), provided additional evidence for chronic disseminated intravascular clotting in diabetes mellitus. Diabetic retinal complications were more frequent in patient with low plasma At III levels (50.6 per cent of cases) than in those exhibiting At III concentrations within a normal range: 32.4 per cent of cases (X2 = 6.09, P less than 0.02). It is postulated that the low levels of At III encountered in diabetes result from excessive consumption, and that the deficiency may be responsible for the onset and/or aggravation of intravascular clotting. At III deficiency may therefore contribute to vascular degenerative complications, particularly those leading to diabetic retinopathy.

Adolescent↗
PubMed1978

[Chronologic study of free T3 and T4, of responses to TRH and of the suppression test during treatment of Basedow's disease].

32 patients with Graves' Disease were investigated before treatment, during ATD therapy and after recovery with a normal T3 suppression test. Before treatment, TRH response was negative with elevated values of plasma TT4, AFT4, TT3 and AFT3. The 3d, 6 - 9 and 12-18 months and after recovery, several patients remained unresponders to TRH despite normal AFT4 and AFT3 in serum. In an opposite way some patients were responders, 1 month after ATD withdrawal, at the 6-9 month, with elevated values of AFT4 or AFT3. The discrepancy between TRH response and T3 suppression test is pointed out after recovery. The unresponsiveness of TSH to TRH unexplained by serum AFT4 or AFT3 may be due to : 1) a decrease in pituitary TSH stores. 2) an unknown factor inhibiting TSH release during Graves' disease 3) an hypersensitivity of thyreotrop cells to T3.

Graves Disease↗
PubMed1977

[The oral antidiabetics (author's transl)].

Oral antidiabetics are given for preference to adult diabetics who do not need insulin. Biguanides are particularly indicated for adipose diabetics, sulphonamides for those of normal weight. Phenformin must not be used in the presence of renal insufficiency and severe liver diseases because of the high risk of lactacidosis. Oral antidiabetics should not to be given during pregnancy. With oral treatment of diabetics under the age of 30, proteinuria, peripheral vascular diseases and disturbances of fat metabolism occure more frequently while retinopathies, coronary diseases, peripheral neuropathies or infections of the urinary tract cannot be influenced orally, nor by insulin nor by a combination of the two. The i. v. lipid tolerance test is always pathological even in apparently well-adjusted orally treated diabetics. On the other hand it is normal even in less well adjusted insulin therapy. More epidemiological investigations should be carried out in order to be able to assess clearly the longterm effects of oral antidiabetics.

Administration, Oral↗
PubMed1977

[Clinical and diabetic research of the artificial extracorporeal pancreas].

With the external artificial pancreas used by the authors, blood glucose is continuously controlled by insulin delivered through an IV infusion and adjusted to two parameters: instantaneous blood glucose levels and increasing or decreasing patterns of blood glucose. The artificial pancreas can be used to treat acute diabetic disorders an to evaluate insulin needs. Furthermore, exogenous insulin homeostasis can be studied: the delay to reach an insulin effect is 18 mm +/- 2 and it remains within 28 mm +/- 2 after the infusion has been stopped; fractional insulin needs are evaluated. From these data, it appears that the efficiency of exogenous insulin exhibits a circadian rhythm.

Artificial Organs↗
PubMed1977

Evaluation of exogenous insulin homoeostasis by the artificial pancreas in insulin-dependent diabetes.

With the artificial pancreas used by the authors, insulin was delivered through a venous infusion and the rate of delivery was adjusted according to data provided by a continuous blood glucose monitor. After different trials we selected control algorithms integrating two parameters: instantaneous blood glucose concentration and increasing or decreasing patterns of blood glucose. A constant basal insulin infusion rate was added and improved the control of glycaemic excursions. Different parameters concerning exogenous insulin homoeostasis were determined. The delay to reach an insulin effect was 18+/-2 min and was shortened by a priming-dose at the beginning of the infusion. The insulin effect remained for 28+/-2 min after the infusion had been stopped, but differences were noted in the morning (21+/-2 min), in the afternoon (32+/-2 min) and during the night (25+/-3 min). Insulin needs were evaluated during meals. Related to the amount of carbohydrates, the doses fell from 0.53 units/hr/g of carbohydrate for breakfast to 0.15 for dinner. From these data, it appears that the efficiency of exogenous insulin exhibits a circadian rhythm.

Adolescent↗
PubMed1977

Short and long term effects of radioiodine and antithyroid drugs on T4 binding proteins, free T4 and T3, during Graves' disease therapy.

Ninety five patients with Graves' disease were studied before and at three months intervals after antithyroid drugs (ATD) (31 cases) or radioiodine (64 cases) therapy until recovery. Before treatment, the T4 maxima binding capacity of TBPA was significantly decreased 253.5 +/- 11.4 mug/100 ml)(mean + se) (control values: 287 +/- 10.4 mug/100 ml) (alpha = 0.04), especially in 53.7% of patients (m = 177 +/- 8 mug/100 ml). The mean of TBG (m = 20.7 +/- 0.9 mug/100 ml) was not different from euthyroid subjects (m = 19.7 +/- 1.7 mug/100 ml) except in 51.2% of patients who had a low TBG (m = 14.3 +/- 1.1 mug/100 ml). An inverse linear correlation was found between TBG-DFT4 (alpha = 0.05) and DF T 3 (alpha = 0.002), TBPA-log DF T4 (alpha = 0.05) but not between TBG and TBPA. The physiological relationship between DFT3, DFT4, TT3, TBG and TBPA was studied in vitro; after adding increased quantities of T4 to a pool of sera collected from eu, hypo or hyperthyroid patients, DFT4, DFT3, FT3 index increased in linear positive relationship with TT4 concentrations, the kinetic of this phenomena was inversely correlated with T4 maximal binding capacity of TBG or TBPA for T4. Addition of T3 to the same sera did not show any effect on the previous parameters. DFT3 depended on the level of T4 in serum more than T3 concentration and was in inverse relationship with the maximal binding capacity of TBG. This data might explain the paradoxal normal or slightly increased values of DFT3 found in T3 thyrotoxicosis. In patients treated with ATD or radioiodine, TBPA but not TBG increased significantly on year after. However, in subjects with an initial very low TGB or TBPA, this phenomenon occurred on the third month after radioiodine or ATD. During the same period, DF T4 and DF T3 were inversely correlated to TBG and TBPA. In conclusion, important changes in T4 binding proteins and free fractions of thyroid hormones were observed in Graves' disease but were corrected by antithyroid therapy. All these data were in good agreement with the normalisation of thyroid function.

Adolescent↗