[A new therapeutic principle in diabetes: continuing insulin infusion using portable pumps].
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Biomedical subjects
Publications and source records attributed to M Berger.
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LH was measured by radioimmunology from the 18th day of gestation to birth in 318 male and female pituitary glands. LH was first detectable in the pituitary of 19 day old fetuses of both sexes. In both sexes pituitary LH levels increased from the 18th to the 31st day of gestation with a marked acceleration from the 24th day. LH pituitary levels were not sex-dependent.
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The effects of Ca2+ and calcitonin infusions on circulating glucagon, glucose, C-peptide, Ca2+, and calcitonin were investigated in hyper-glucagonaemic insulin-dependent diabetics. In 14 insulin-deprived diabetics and 12 healthy volunteers 2h infusions of saline (0.154 mol/1), Ca2+ (0.375 mmol/kg body weight), and calcitonin (4.5 IU/kg body weight) were performed. There were no significant changes during saline infusion. In the diabetics, Ca2+ infusions induced a rise of plasma Ca2+ up to 3.2 +/- 0.1 mmol/1 and a fall of circulating glucagon (-26.4 +/- 5.7%; p less than 0.001) and glucose (-23.3 +/- 3.6%; p less than 0.05). Plasma calcitonin rose to twice basal values (p less than 0.025). During calcitonin infusions plasma Ca2+ decreased slightly to 2.1 +/- 0.2 mmol/1; a fall was found in both glucose (-24.4 +/- 4.0%; p less than 0.05) and circulating glucagon (-22.5 +/- 4.3%; p less than 0.001). Two groups of 6 healthy volunteers were subjected to saline and Ca2+, or to Ca2+ and calcitonin infusions. Both Ca2+ and calcitonin infusions induced a fall of serum insulin (-30.1 +/- 6.6%; p less than 0.05). Calcitonin depressed circulating glucagon by -18.6 +/- 4.4% (p less than 0.025), whereas during Ca2+ infusions glucagon decreased only by -6.5 +/- 1.9% (p greater than 0.1). We conclude from our results that an increase of circulating calcitonin induced by Ca2+ infusions or by exogenous calcitonin administration appears to depress elevated circulating glucagon and glucose in insulin-dependent diabetics.
Muscle biopsies from the lower extremities of four patients with severe tetraplegic form of diphtheritic polyneuropathy were examined by modern techniques including histochemistry, electron microscopy and morphometric procedures. Until now comparable studies have not been published. The biopsies were removed during the acute stage of the polyneuropathy. We found scattered small angulated muscle fibers beside a more generalized slight atrophy predominantly of type 2 B fibers and targetoid-phenomenons or cores in type 1 fibers. Beside this neurogenic pattern there also were, corresponding with the results of electromyography, primary myogenic alterations with different degenerative phenomenons, suspicious of toxic origin as in cardiac muscle. The intramuscular vessels showed no abnormalities except some perivascular predominantly mononuclear cellular reactions with a remarkable number of cerebriform lymphoid cells, probably T-lymphocytes. No specific pathological alterations could be detected in 11 intramuscular nerves and two motor endplates. This may reflect the more proximal demyelination of human peripheral neurons by the diphtheria toxin as found in experimental diphtheria of the rabbit in contrast to the more distal type of the guinea pig.
To determine the optimal noninvasive method for the demonstration of endocarditic vegetations, 35 consecutive episodes of clinically diagnosed endocarditis in 33 patients were studied with M mode and two dimensional echocardiography, and with gallium-67 citrate and technetium-99m stannous pyrophosphate cardiac scanning. Clinical criteria for the diagnosis of endocarditis were: temperature higher than 38 degrees C; sustained bacteremia with at least three positive blood cultures; no extracardiac focus of bacteremia; and known underlying heart disease, a new or changing murmur or a history of intravenous drug abuse with radiologic evidence of septic pulmonary emboli. M mode echocardiography detected 18 vegetations in 17 of the 35 episodes of endocarditis studied (49 percent positive); two dimensional echocardiography detected 30 vegetations in 28 of the 35 episodes studied (80 percent positive). In contrast, no vegetations were detected with technetium-99m stannous pyrophosphate scanning,, and only two gallium-67 citrate scans were positive. The advantage of the two dimensional echocardiographic technique over all others tested was particularly notable for the identification of aortic and tricuspid valve vegetations.
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The steady-state gamma radiolysis of deaerated aqueous solutions of thymidine generated a complex mixture of pyrimidine and nucleoside derivatives. Twenty-two of these compounds have been isolated and unambiguously characterized by spectroscopic methods including proton nuclear magnetic resonance and mass spectrometry. The major 5,6-saturated products has been identified as the 5R and 5S diastereoisomers of 5,6-dihydrothymidine and their mono and dihydroxylated derivatives on the 5 and/or 6-carbons. The G values of these various compounds has been determined. The roles of the primary reactive species derived from the radiolysis of water have been studied by using specific radical scavengers i.e., ethanol, t-butanol and potassium nitrate.
Pituitary content and concentration of LH and FSH were measured by radioimmunoassay from birth to adulthood. The pituitary contents and concentrations of both gonadotropins increased from birth to 70-90 days, then reaching adult levels. 1 microgram/100 g body weight of synthetic LHRH was administered to immature (25 and 55 days of age) and adult male rabbits. LH and FSH were measured in plasma samples taken just before and 30 min after LHRH injection. At all stages studied, LHRH significantly increased circulating LH and FSH. The FSH response at 55 days and at adult age was lower than that of LH. There was a peripubertal increase of the mobilizable pituitary reserve of LH while the FSH reserve slightly but not significantly increased. This change in the pituitary responsiveness to LHRH could play a role in pubertal processes.
Male mice were raised in populations of two different sizes from birth to adulthood: six animals (three of each sex) or 30 animals (15 of each sex) being maintained in cages of the same dimensions. Animals were killed every 10 days from weaning to 60 days and at 90 days. Increased population size induced decreased body and seminal vesicle weights; testicular, pituitary and adrenal weights were little affected. Plasma testosterone levels were lowered by increasing population size over the period from weaning to 50 days but they were increased at 60 and 90 days. The age at which first fertile matings occurred was not affected. These results indicate that the endocrine function of the testis, as determined by the measures used here, was specifically affected by this differential housing.
Experiments were designed to examine the influence of either one or both parents on the sexual maturation of male mice. A pregnant female and an adult vasectomized male were housed together and, at delivery, the litter was reduced to 6 pups, 3 of each sex. After weaning, mother, foster-father or both, stayed in cohabitation with their pups until sacrifice. The results showed that: (1) the permanent presence of one or both parents did not affect either testicular growth or the age at first fertile matings. (2) in maturing males (30-40 days), seminal vesicle growth was accelerated by the presence of the mother, inhibited by the presence of the foster-father. (3) in maturing males, the presence of one or both parents lowered plasma testosterone levels. On the opposite, in 90-day-old males, the same conditions increased testosterone levels. These results indicate that only the endocrine function of the testis is affected by the parental environment. The effects are age-dependent.
In 1332 patients with different degrees of obesity (344 men, mean age 36 +/- 13 years, Broca Index 1.46 +/- 0.23; 988 women, mean age 37 +/- 13 years, Broca Index 1.67 +/- 0.30), cardiovascular risk factors (RF), serum HDL-cholesterol, and insulin levels were investigated. The most frequent RF was diastolic hypertension (68 per cent), followed by systolic hypertension (56 per cent), glucose intolerance (55 per cent), hypertriglyceridemia (31 per cent), hyperuricemia (19 per cent) and hypercholesterolemia (18 per cent). Only 9.4 per cent of the patients were without RF, and these patients were younger and less obese than patients with RF. Compared with controls, HDL-cholesterol levels were decreased in obese patients, however, the negative linear correlation between relative body weight and HDL-cholesterol levels was only significant in women, not in men. HDL-cholesterol levels were higher in women than in men. Serum insulin levels were correlated positively with relative body weight and negatively with age. Partial correlation analysis revealed a stronger influence of age than body weight on blood pressure, serum levels of total cholesterol, LDL-cholesterol, triglycerides and blood glucose levels. Uric acid levels correlated positively, and HDL-cholesterol levels negatively with relative body weight alone and not with age. On the basis of prevalence of RF, low serum HDL-cholesterol and high insulin levels, obese patients must be considered at high risk with respect to the development of cardiovascular disease.
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The acute transplanted rat leukemia L 5222 was used to investigate the two-drug combinations 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) and cyclophosphamide (CPA) as well as methyl-CCNU and CPA. A therapeutic synergism could not be demonstrated in either combination. In both combinations the monotherapy with the nitrosourea was superior to the combination as well as to the monotherapy with CPA.
Based on the reviewed literature and the data from the düsseldorf Obesity Study there is a close association between obesity and hypertension. This association is found in adults, adolescents and children. Hypertension is the most frequent cardiovascular risk factor in obesity. The black population shows higher blood pressure levels than the white population within the same relative weight. Prospectively investigated normotensive obese subjects are more likely to develop hypertension than normal weight subjects. In Western population there is also an association between hypertension and age. This is not seen in tribal populations, where after the age of 20 years body weight does not increase, suggesting body weight to be an important factor for the regulation of blood pressure. Present epidemiological evidence strongly calls for detailed prospective studies of obesity and hypertension, in order to define particularly hypertension-prone obesity subtypes.
Fourteen patients with aortic valve endocarditis were evaluated. Twelve patients had vegetations detected by two-dimensional echocardiography and two were diagnosed anatomically. M-mode echocardiography was positive in eight patients. Two-dimensional echocardiography was superior to M-mode in determining size, shape, and mobility of vegetations. The following three morphologic types of vegetative lesions were seen on two-dimensional echocardiogram: globular polypoid masses (seven); irregular, elongated lesions with chaotic movement (four); and a cord-like structure (one). Serial two-dimensional echocardiograms performed after completion of antibiotic therapy in seven patients revealed no change in appearance in five and complete disappearance in two patients. Among the 12 patients with vegetations visualized on the two-dimensional echocardiogram, seven responded to medical therapy, four required aortic valve replacement, and one patient died. One of the patients who initially responded to medical therapy eventually required aortic valve replacement following a second episode of aortic endocarditis. In those patients with negative two-dimensional echocardiograms, the vegetations were 3 mm in diameter or less at surgery or autopsy. Vegetations that were visualized on two-dimensional echocardiography were found to be at least 5 mm in diameter at the time of operation. Two-dimensional echocardiography is a valuable noninvasive tool in the evaluation of patients with aortic valve endocarditis.
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