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Biomedical subjects

M Karp

Publications and source records attributed to M Karp.

At least 109 records · Page 6Linked to original sources
PubMed1985

Cytoplasmic islet cell antibodies in type I diabetics in Israel and their first-degree relatives.

The prevalence of islet cell antibodies (ICA) was studied in 172 newly diagnosed juveniles with Type I diabetes and in 300 unaffected first-degree relatives of 93 of these patients. Approximately 60% of the juvenile diabetics were ICA-positive at onset. Most of these patients gradually lost their antibodies, although two patients remained positive for ICA for periods up to 5 years. Complement-fixing ICA (CF-ICA) were found in 20% of the patients having ICA at onset. Disappearance of CF-ICA was rapid, with all patients showing negative values by the end of the second year. In 19 patients ICA intermittently disappeared and reappeared. ICA were found in 17 healthy family members (7 parents and 10 siblings). Although Type I diabetes is relatively rare in both the Jewish and Arab populations in Israel, these findings indicate that it has a similar autoimmune pathogenesis to that found in other populations around the world. The percentage of patients with ICA was as reported elsewhere, but that of CF-ICA was lower; its similarity with that reported for a Mediterranean population in France suggests a possible link with ethnic origin.

Adolescent↗
PubMed1985

Comparison of metabolic and psychological parameters during continuous subcutaneous insulin infusion and intensified conventional insulin treatment in type I diabetic patients.

Two methods of insulin treatment--intensified conventional therapy (ICT) of three to four daily injections and continuous s.c. insulin infusion (CSII)--were compared in nine patients with insulin-dependent diabetes mellitus (mean age +/- SD 29.4 +/- 5.6 years; duration of diabetes 14.6 +/- 2.9 years). Patients followed each regimen for 3 to 4 months. Under both regimens hemoglobin A1 (HbA1) levels were lower than those recorded previously, but under CSII the mean HbA1 and glucose levels were significantly lower than under ICT (7.8 +/- 0.1 vs. 8.9 +/- 0.2% for HbA1 and 136 +/- 40 vs. 155 +/- 60 mg/dl for blood glucose, P less than 0.001). There was no difference in the frequency of blood glucose levels less than 60 mg/dl, but under CSII hypoglycemic symptoms appeared at lower glucose levels. There was no marked difference between the two regimens regarding scores for depression and anxiety and other psychological parameters, but patients who chose to continue treatment with CSII following completion of the study had previously manifested a significantly higher degree of distress symptoms, which had been reduced during the study. CSII was preferred by some patients because of the superior metabolic control achieved and the greater flexibility in time and size of meals permitted, but was rejected by others because of technical failures and bulkiness of the device. It is concluded that metabolic control can be improved by either regimen, but external pumps must be further miniaturized and technical failures eliminated before CSIII is acceptable to larger numbers of patients.

Adult↗
PubMed1984

Unusual association of insulin-dependent diabetes mellitus with congenital myasthenia gravis and autoimmune thyroid disease.

A 26-year-old woman with congenital myasthenia gravis and antibodies to the acetylcholine receptor developed overt insulin-dependent diabetes with positive islet cell antibodies and thyroid microsomal and gastric parietal cell antibodies. Her younger sister has been an insulin-dependent diabetic since the age of 7 years, and the mother has nongoitrous hypothyroidism. In the same period the woman in question developed a transient chemical hyperthyroidism. HLA typing of the family members showed that the diabetes was probably associated with an HLA AW30, BW38, DR4 haplotype, found in both sisters and in their father, and that the thyroid disease was associated with the A29, B7, DR6 haplotype found in the patient and in her mother. This familial HLA pattern may indicate that each autoimmune manifestation in the patient is due to a different susceptible gene associated with the HLA system.

Adult↗
PubMed1984

Dietary adjustment during self-blood-glucose monitoring in pregnant women with insulin-dependent diabetes mellitus.

The interaction between the daily distribution of carbohydrates and frequent self-blood-glucose monitoring (SBGM) was studied in 13 pregnant women who had had diabetes for 4 to 19 years. Before and during SBGM, data were obtained on dietary history, daily blood glucose levels, and HbA1C. Optimal control was found with 3 main meals and 5 snacks. The total daily caloric intake decreased without change in the proportions of protein, fat, and carbohydrate. Consumption of starch increased, and that of simple sugars decreased. Although no changes were made in the daily amount of insulin, the women's diabetic control improved significantly.

Adult↗
PubMed1983

Residual B cell function in diabetic children as determined by urinary C-peptide.

C-peptide was determined in 24-h urine collections and in fasting plasma of 27 Type 1 (insulin-dependent) diabetic children (duration of disease 0-6 years) and in 11 matched normal children. Grouping the patients according to duration of disease from onset to 6 years, it was found that in the first year of disease the B cell reserve was a mean of 4.89 +/- 1.95 pmol X mg creatinine-1. 24 h-1 compared with a mean of 24.51 +/- 2.91 pmol X mg-1 X 24 h-1 in the control group. A further diminution was seen with increase in the duration of disease, until after 6 years when only traces of C-peptide could be detected. There was a good correlation between the levels of plasma C-peptide and urinary C-peptide values as related to creatinine (r = 0.89; p = less than 0.001). In view of this, and since it is simpler and less traumatic to obtain frequent urine samples from children than it is to obtain blood samples, it was felt that the determination of urinary C-peptide constitutes a valuable tool in the evaluation of the diabetic child.

Adolescent↗
PubMed1983

8-Bromo cyclic GMP inhibits NADH and lactate accumulation in hypoxic rat atria.

The effects of 8-bromo-cGMP on tissue lactate and NADH levels were studied under conditions of high oxygen saturation (95-100%) and hypoxia (50%) in spontaneously beating rat atria. The induction of hypoxia caused a rapid decline in contractility with a simultaneous increase in tissue lactate and NADH. 8-bromo-cGMP (10(-4) mol/l) prevented the accumulation of lactate occurring during hypoxia. It also lowered the level of lactate during high oxygen saturation. Furthermore, 8-bromo-cGMP inhibited the hypoxia-induced increase in NADH and lowered the level of NADH in high oxygen saturation. 8-bromo-cGMP did not affect contractility or heart rate during hypoxia. It is concluded that cGMP may influence the redox-state and metabolism in a direction which is beneficial for the hypoxic myocyte. It is also suggested that antianginal nitro compounds which enhance the level of cGMP might exert an effect similar to that of 8-bromo-cGMP.

Animals↗
PubMed1983

Diencephalic syndrome due to a suprasellar epidermoid cyst. Case report.

A 5-year-old child with the unusual association of late-onset diencephalic cachexia and pituitary insufficiency is described. At operation a suprasellar epidermoid cyst was found and excised. This curable tumor should be added in the differential diagnosis of diencephalic syndrome.

Brain Diseases↗
PubMed1981

Genetics of insulin dependent diabetes mellitus in Israel: population and family study.

The association between insulin dependent diabetes mellitus (IDDM) and the HLA system was studied in two groups of Jewish patients: 50 Ashkenazim and 42 non-Ashkenazim. The pattern of association of HLA-A and B locus antigens was somewhat different from that observed in European Caucasian patients. HLA-B8 had a higher frequency; B15 and Cw3 were rare in the population studied and were less frequent in IDDM patients than in controls. On the other hand, the frequency of A26, B18, and Bw38 was increased in Ashkenazi patients, but not in non-Ashkenazim, who in turn showed an increase for Bw51. Although the association between IDDM and HLA-A and B locus antigens shows a marked variability in different populations, the association with HLA-DR3 and DR4 is constant feature. There was a typical excess of DR3/DR4 heterozygotes in both patient groups. This heterozygote type carries the highest relative risk, followed by DR4/DR4 homozygotes. These data can well be interpreted by a model of two different HLA-linked susceptibility genes, one associated with DR3 and the other one with DR4, that interact so that different genotypes are associated with different levels of penetrance. This model received further support from studies in 15 multiple case families where there is an excess of affected sib pairs sharing two DR antigens.

Adolescent↗
PubMed1978

Wolfram syndrome.

Explore the source record for details and available documents.

Adolescent↗
PubMed1977

Relationship between food intake and insulin response to oral glucose tolerance test in short lean children.

Based on diet questionnaires and food intake analysis, a study was made of the eating habits of 35 lean children and adolescents with constitutional familial short stature. The children were divided into four groups according to their plasma insulin response to an oral glucose tolerance test (normal or low) and to the season during which the test was given. No statistically significant differences in caloric intake were found. The overall total caloric intake in all groups was 166 to 190% of the recommended dietary allowances set by the U.S. National Academy of Sciences. It is concluded that the insulin response to the oral glucose tolerance test is not related to caloric intake.

Adolescent↗
PubMed1976

Glucose and insulin responses to an oral glucose load in normal children and adolescents in Israel.

Sixty-three normal, healthy children and adolescents (39 males and 24 females) ranging in age from 2 to 20 years, were given a standard oral glucose tolerance test. A tendency to higher blood glucose levels and a statistically significant increase in insulin levels were found in the older age group in response to the glucose load. The older age group showed a significantly higher response of both glucose and insulin when separate percentile curves for prepubertal and pubertal boys and girls were constructed. No statistical differences were found between the sexes. Our findings demonstrate the necessity of applying norms for the oral glucose tolerance test according to age, particularly with respect to insulin values. The possibility of additional differences in response among various populations, as apparent from a comparison with the results of several other investigators, requires further study.

Adolescent↗
PubMed1975

Insulin response to intravenous glucagon in children with familial constitutional short stature.

An intravenous glucagon test was performed in 8 children with familial constitutional short stature who were also lean. These children were randomly selected from a larger group of children with the same clinical manifestation and who had been shown to have a low insulin response to an oral glucose tolerance test and to an intravenous arginine test, without glucose intolerance. 7 out of 8 children showed a normal insulin response to intravenous glucagon, with a peak level of 53--180 millimicron/ml 2 minutes after the injection. It is assumed that these insulin responses represent an intact 'rapid' pool of insulin within the beta-cell, and can explain the absence of glucose intolerance in all the children so far studied.

Blood Glucose↗