In healthy subjects (n = 10) and non-insulin-dependent (type II) diabetics (n = 10) matched for age 43.1 +/- 2.2 vs. 41 +/- 4.4 yr, P = not significant (NS), body mass index (25.1 +/- 1.1 vs. 26 +/- ...0.8 kg/m2, P = NS), gender ratio 5 males (M)/5 females (F) vs. 5M/5F, and mean arterial blood pressure (105 +/- 7 vs. 106 +/- 9 mmHg, P = NS), we determined the changes in insulin secretion and action after glutathione infusion (15 mg/min) and the relative increase in the plasma reduced (GSH)/oxidized (GSSG) glutathione ratio. The rise in the plasma GSH/GSSG ratio significantly improved total body glucose disposal in healthy subjects and in diabetic patients. In this latter group, GSH infusion potentiated the beta-cell response to glucose slightly. In controls and diabetics, insulin infusion with a simultaneous increase in the plasma GSH/GSSG ratio significantly enhanced nonoxidative glucose disposal without affecting oxidative glucose metabolism. After glutathione infusion, all metabolic and hormonal changes correlated with a significant decline in plasma membrane microviscosity. In conclusion, the plasma GSH/GSSG ratio seems to play a major role in the modulation of glucose homeostasis mainly in diabetics.
To explore the possible link between diabetic nephropathy and the enhanced activity of the polyol pathway, known to occur in IDDM subjects.
We studied the effects of the aldose reductase inhibitor ...tolrestat (200 mg/day) on urinary albumin excretion rate and glomerular filtration rate in 20 IDDM patients with diabetic nephropathy.
Six months of placebo treatment produced no significant changes in glomerular filtration rate, urinary albumin excretion rate, and renal plasma flow. Consequently, filtration fraction remained unchanged. During tolrestat treatment, glomerular filtration rate decreased from the basal value of 156 +/- 14 ml.min-1.1.73 m2 to 142 +/- 13.7 ml.min-1.1.73 m2 (P < 0.001) at 2 mo; 128 +/- 12.4 ml.min-1.1.73 m2 (P < 0.001) at 4 mo; and 123.7 +/- 13.0 ml.min-1.1.73 m2 at 6 mo. A significant decrease of urinary albumin excretion rate was observed during the trial (basal values 219 +/- 32.5 vs. 196.9 +/- 28.5 micrograms/min at 2 mo P < 0.05; 171.6 +/- 25.5 micrograms/min at 4 mo P < 0.001; and 58.6 +/- 19.3 micrograms/min at 6 mo P < 0.001). No significant change in renal plasma flow was seen during tolrestat treatment. Filtration fraction significantly decreased in the tolrestat group from the basal value of 0.23 +/- 0.02 to 0.21 +/- 0.01 at 2 mo (P < 0.005); 0.18 +/- 0.02 at 4 mo (P < 0.001); and 0.17 +/- 0.02 at 6 mo (P < 0.001).
The polyol pathway is implicated in hemodynamic changes associated with early diabetic nephropathy, and aldose reductase treatment can positively influence these parameters.
To evaluate the effect of glutathione infusion on beta-cell response to glucose in elderly people with impaired glucose tolerance (IGT).
Ten patients with normal glucose tolerance and 10 patients ...with IGT were matched for age (mean +/- SE, 72.1 +/- 2.8 vs. 71.0 +/- 3.4 yr), body mass index (23.1 +/- 1.1 vs. 22 +/- 2.1 kg/m2), and sex (6/4 vs. 5/5, men/women) underwent glutathione infusion (10 mg/min) under basal conditions and during 75-g oral glucose tolerance tests and intravenous glucose tolerance tests (0.33 g.kg body wt-1.3 min-1). Patients with IGT were also submitted to euglycemic-hyperinsulemic and hyperglycemic glucose clamps.
In subjects with normal glucose tolerance, glutathione infusion failed to affect beta-cell response to glucose. In contrast, glutathione significantly potentiated glucose-induced insulin secretion in patients with IGT. Furthermore, in the latter group studied by hyperglycemic clamps, glutathione infusion significantly potentiated the beta-cell response to glucose when plasma glucose levels varied between 10 and 15 mM. This effect disappeared at plasma glucose levels greater than 15 mM. No effect of glutathione on insulin clearance and action was observed.
Glutathione infusion enhances insulin secretion in elderly people with IGT.
A wavelength dispersive system based on a flat crystal coupled to a CCD position-sensitive detector is described. The system, to be used in conjunction with an external beam facility for PIXE ...measurements, is particularly compact, easy to use, and has a useful energy range extending from about 4 to 13 keV. The performance of the system with respect to efficiency and energy resolution is studied as a function of different experimental conditions. Possible simple applications are briefly discussed.
A group of 18 burned patients was excised between days 2 and 5 postburn days, while 20 patients were operated later, between days 25 and 35 postburn. After early excision the wounds covered with ...meshed grafts contracted to a mean wound size of 56 per cent while the wounds covered with non-meshed grafts contracted to a mean wound size of 64 per cent. After late excision wounds covered with meshed grafts contracted to a mean wound size of 40.5 per cent while wounds covered with non-meshed grafts contracted to a mean wound size of 51.5 per cent. With early excision, meshed grafts grew back to a size of 78.5 per cent while non-meshed grafts grew back to a size of 91 per cent. With late excision, meshed grafts grew back to a size of 69.5 per cent while non-meshed grafts grew back to a size of 75.5 per cent.
We demonstrated similar plasma concentrations and urinary losses but lower erythrocyte magnesium concentrations (2.18 +/- 0.04 vs 1.86 +/- 0.03 mmol/L, P 0.01) in twelve aged (77.8 +/- 2.1 y) vs 25 ...young (36.1 +/- 0.4 y), nonobese subjects. Subsequently, aged subjects were enrolled in a double-blind, randomized, crossover study in which placebo (for 4 wk) and chronic magnesium administration (CMA) (4.5 g/d for 4 wk) were provided. At the end of each treatment period an intravenous glucose tolerance test (0.33 g/kg body wt) and a euglycemic glucose clamp with simultaneous D-3Hglucose infusion and indirect calorimetry were performed. CMA vs placebo significantly increased erythrocyte magnesium concentration and improved insulin response and action. Net increase in erythrocyte magnesium significantly and positively correlated with the decrease in erythrocyte membrane microviscosity and with the net increase in both insulin secretion and action. In aged patients, correction of a low erythrocyte magnesium concentration may allow an improvement of glucose handling
This paper presents guidelines for the safe outpatient practice of aesthetic surgery. These guidelines have been prepared by the Lombard Association of Plastic Surgery for Outpatients (ALChiPlA), an ...association confined to board certified plastic surgeons and holders of official authorizations issued by the Lombard ASL to perform outpatient surgery. The cornerstone of these guidelines is the health and safety of patients, who are turning to this type of surgery in ever increasing numbers. This is the first and thus far the only attempt of its kind and its value is increased by the fact that it has been prepared by specialists who have been carrying out this type of surgery in outpatient situations for years.
A case of "hemicrania continua" after cluster headache in the same subject is described. Indomethacin exerted an absolute, persistent effect on the present headache. Even though our data are ...insufficient to demonstrate a causal relation between the two forms of headache, they do suggest this real possibility.
In insulin-dependent (type 1) diabetic subjects (n = 7) with intact hormone response to hypoglycaemia, oxytocin infusion (0.2 mU/min over 60 min) produced significant rises in basal plasma glucagon ...and adrenaline levels, while it reduced basal plasma cortisol levels. During insulin-induced hypoglycaemia, oxytocin potentiated the increases in plasma glucagon and adrenaline, while an inhibitory effect on plasma cortisol levels was still present. In insulin-dependent (type 1) diabetic subjects (n = 7) with blunted counter-regulatory hormone response to hypoglycaemia, the same dose of oxytocin (0.2 mU/min over 60 min) increased basal plasma glucose and glucagon concentrations and lowered basal plasma cortisol concentration. In the same group of patients, oxytocin delivery (0.2 mU/min), simultaneously to an insulin-induced hypoglycaemia, produced a significant elevation of plasma glucagon and adrenaline concentrations thus enhancing glucose recovery from hypoglycaemia. In conclusion, in insulin-dependent (type 1) diabetic patients, oxytocin delivery enhances plasma glucagon and adrenaline levels in basal conditions and during insulin-induced hypoglycaemia.
