Biomedical subjects
Publications and source records attributed to S Gambardella.
Plasma concentrations of insulin, growth hormone and glucagon were measured during an arginine test in obese women with normal (ON) or abnormal (OD) OGTT and in normal control subjects (N). Plasma insulin levels were higher than normal in both obese groups, while plasma growth hormone and glucagon levels were markedly reduced.
Plasma immunoreactive glucagon (IRG), insulin (IRI) and blood glucose (BG) were evaluated in the fasting state and during an arginine test (ATT) in 6 subjects with untreated hypopituitarism (H), in 2 hypopituitary subjects with normal cortisol production (H + C), in 3 subjects with Addison's disease (A) and in 14 normal volunteers (N). No increase in BG was observed in H and A after arginine, mean values being significantly lower than in N. Mean fasting and arginine-stimulated IRI levels were lower in H and A than in N; postabsorptive arginine-induced IRG levels were significantly reduced when compared to N. In contrast IRG levels in the two H + C patients were within the normal range. The impaired IRG production in A and in H (but not in H + C) suggests a close relationship between alpha pancreatic function and cortisol levels.
Effects of somatostatin on fasting and arginine-or tolbutamide-stimulated insulin release were studied in four patients with insulinoma. Somatostatin (bolus or bolus + infusion) reduced fasting insulin values in all patients; insulin response to tolbutamide was partially reduced in two patients; somatostatin bolus impaired the insulin response to arginine. Fasting glucagon levels and glucagon response to arginine were also reduced by somatostatin. These results indicate the potential usefulness of somatostatin in the diagnosis of insulinoma even if its effect on insulin is only partial.
IgG1 and IgG4 have similar molecular weights but differ in pH (about 9 and 4.6, respectively). Their different rates of excretion in the urine of diabetic patients may indicate an impairment of charge selectivity in the kidney filter. Working on this hypothesis, a sensitive new ELISA for the detection of urinary IgG4 has been developed. This method can detect less than 1 ng/ml of this immunoglobulin; total IgG was detected by a RIA method developed by our laboratory. Twenty-eight Type I diabetic patients with or without clinical nephropathy were included in a cross-sectional study. An additional seven diabetic patients were followed over time, and eight diabetic pregnant women were studied during the different trimesters of pregnancy. Whereas both IgG4 and total IgG values were increased in clinically nephropathic patients, levels of IgG4, but not IgG1-3, were enhanced in patients without clinical nephropathy. In the latter group as well, IgG4-positive patients were microalbuminuric; all but one of the remaining patients were IgG4 and albumin negative. There was no significant variation in IgG4 values with time on repeated samples. The increased glomerular filtration rate in diabetic pregnancy did not significantly modify the levels of IgG4 in the urine. These results are in accordance with a selective excretion of this medium to large sized anionic protein (IgG4) in incipient (or stage III) diabetic nephropathy. Urinary IgG4 could be an additional useful marker when studying diabetic patients with early and pre-clinical stages of diabetic nephropathy.
Previous studies have shown an increased incidence of sudden deaths and lower survival in diabetics with autonomic neuropathy. In hypertensive non diabetic patients a direct correlation has been found between nocturnal blood pressure levels and left ventricular hypertrophy. We have shown in diabetics with autonomic neuropathy a flattening in nocturnal blood pressure reduction and increased 24 hours blood pressure values compared to diabetics without autonomic neuropathy and controls. Our results suggest that abnormalities in 24 hours blood pressure profile might play a role in the increased incidence of cardiovascular morbidity and mortality in diabetics with autonomic neuropathy.
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This article describes how mobile radiography was used to examine a mummified cadaver exhumed in 1875 and stored in the Smithsonian Museum. Radiographs revealed artifacts imbedded in the cadaver, indicating 1824 as the earliest possible interment. Through radiographic assessment of the skeleton, researchers were able to approximate the individual's age at death. In addition, evidence of pathology, possibly ideopathic skeletal hyperostosis, suggested the individual may have been employed in manual labor. The radiographs, when compared to x-rays of another cadaver exhumed at the same time and place, refuted information in museum records.