Biomedical subjects
Publications and source records attributed to W Berger.
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The occurence of nexuses (gap junctions) in mouse uterine smooth muscle was found to depend on the hormonal state. As revealed by freeze-fracture electron microscopy, nexuses are virtually absent in virginal and pregnant mice. Abundant, large-sized nexuses were observed in the myometrium during parturition. Estrogen application to virginal mice also induced an increase in number and size of nexuses. Our observations indicate that a new formation of nexuses occurs in differentiated cells. New nexuses may be formed by the confluence of nexus subunits preexisting in the cell membrane or by newly biosynthesized components.
The effect of phenformin on fuel homeostasis and on gluconeogenesis from protein was studied in 8 normal subjects who underwent two 4-day fasts 8-12 weeks apart. Each person received placebo or phenformin 50 mg every 12 hours for 3 days before and during the fasts. Circulating glucose, lactate, pyruvate, free fatty acid and ketone levels as well as urinary nitrogen excretion observed during placebo and phenformin treatment were not significantly different from each other. The lack of an effect of phenformin on urinary nitrogen excretion and plasma glucose level strongly suggests that gluconeogenesis from amino acids was unaltered by phenformin in these fasting subjects. The present findings are at variance with those by other authors which may be related to differences in methodology.
The effects of beclomethasone, dipropionate aerosol (DBA) (400 microgram/day) on clinical course, pulmonary function, and pituitary-adrenal function was studied in 34 steroid-dependent asthmatic children. Asthma severity was assessed by daily symptom and medication scores, peak flow measured three times a day, and weekly spirometry. Pituitary-adrenal function was evaluated by diurnal cortisol levels, cortisol responses to intravenous (IV) corticotropin (ACTH), and steroid responses to IV metyrapone. After 12 weeks of BDA therapy, 30 of 34 patients no longer required prednisone. Mean weekly symptom and medication scores and the number of attacks decreased significantly (P less than .01)). A significant improvement was demonstrated in the patients' peak flow (P less than .01), forced expiratory volume in one second, and maximum midexpiratory flow rates (P less than .01). Thirty of the 34 patients initially had abnormal metyrapone responses, 28 had abnormal diurnal cortisol levels, whereas only 14 had abnormal IV ACTH response tests. Although significant improvement was noted in the mean metyrapone and diurnal cortisol tests, only partial recovery of pituitary-adrenal function was observed in 20 patients, complete recovery in 5, and no change in 9. BDA was found to be therapeutically superior to oral steroids in the group of steroid-dependent asthmatic children and produced no serious adverse effects.
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When a medical library serves both research scientists and practicing physicians, it may be predicted from the results of previous studies that computerized bibliographic search services will show more research and less clinical activity. The present paper reports the results of a statistical analysis of professional use of the National Library of Medicine's bibliographic retrieval system. MEDLINE (Medical Literature Analysis and Retrieval System on-Line), at a large medical school library. Results indicate that (1) demand for MEDLINE service is primarily research oriented; (2) frequency of use bears a relationship to rank and departmental affiliation; (3) broad and comprehensive searches are requested more frequently than searches for specific information; (4) usage shows an interesting curvilinear relationship with age and status of the user; and (5) grant funds and support correlate with the number of searches requested. Implication of these findings are that since clinicians' use of MEDLINE was found to be minimal, information services should be reevaluated in order to assist in meeting their information needs more effectively.
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Successful treatment of the diabetic patient is possible only if the patient himself takes an interest in his disease and also an active part in treating it, i.e. by adherence to diet, testing of urinary sugar and insulin administration. The precondition for cooperation is intensive medical advice covering the following three aspects: 1. education, 2. motivation to put the acquired knowledge into practice, 3. practicability of the advice given. Our program covers 5 points: 1. basic education on the nature of diabetes, 2. diet instructions, 3. testing of urinary sugar, 4. instruction on insulin administration, 5. oral hypoglycemic agents. Special instructions must be given to motorists and all other types of driver, and also for emergency situations (vomiting, fever etc.). An instruction sheet carrying the key points in helpful. The results of this educational scheme are regularly checked by questionnaire. Refresher courses have been found to be necessary at regular intervals. The permanent educational efforts of regional Diabetic Associations and appropriate literature (D-Journal) are also recommended. The time-consuming effort of achieving the goals associated with education of the diabetic calls for teamwork between general practitioner and teaching center, e.g. the hospital with its facilities (audiovisual program, dieteticians etc.). However, the crucial factor remains the physician's commitment to his patient and his disease, since education and treatment must be geared to the needs of the individual patient.
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In Basle in 1972 a diabetes survey was performed in subjects with increased risk of diabetes mellitus (overweight, age above 50, relatives of diabetics). For screening, the blood sugar was determined one hour after ingestion of 50 g of glucose. 404 males and 768 females (known diabetics excluded) were examined. One third of males and one quarter of females had a blood sugar value above 150 mg%. Blood sugar values of more than 200 mg% were found in 9% of the male and 7% of the female participants. A positive correlation existed between age and blood sugar values in males and females. Body weight and blood sugar value correlated only in females. However, in male subjects with pronounced obesity (Broca index greater than 1.23) there was a significantly higher incidence of blood sugar screening value above 150 mg% than in the rest of the males. It would appear that even slight overweight enhances glucose intolerance in females, whereas in males only marked overweight favours the manifestation of glucose intolerance. The cost of the detection of a new case of diabetes mellitus (blood sugar greater than 200 mg%) amounted to Sfr. 70.-. The Basle diabetes survey provides a model for successful conduct of a preventive program through cooperation of private organizations such as the local Medical Association and the local Diabetes Association.
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In the process of insulin release by exocytosis, a fusion between the membranes of secretory vesicles and the plasma membrane occurs which is followed by the rupture of these membranes and the formation of an exocytotic stoma. As revealed by freeze-fracturing, the membrane structure is altered in the region of membrane interaction. An accumulation of membrane-associated particles can be observed in membranes of secretory vesicles contacting the plasma membrane. At the exocytotic stoma the boundary between granule limiting membrane and plasma membrane is occasionally outlined by a ring-like aggregation of membrane-associated particles. The effects of hypertonic solutions on tissue structure indicate that the membrane junctions during exocytosis are permeable to ions and small molecules, forming a communication between the interior of the secretory vesicle and the extracellular space.
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