摘要:

A single-blind, randomized, comparative evaluation of glyburide (GL) and chlorpropamide (CP) therapy was performed in twenty previously untreated patients with non-insulin dependent diabetes mellitus (NIDDM) of about two years duration. Only newly diagnosed patients who were never treated and whose fasting blood glucose (FBS) levels were >140 mg/dl after a six to eight week trial of dietary restriction were evaluated. Metabolic studies were performed before and after four months of therapy.GL and CP produced essentially the same effects on serum levels of glucose, insulin, glucagon (IRG), growth hormone (GH), cholesterol, and triglyceride, The mean 24-hour glucose levels for both the GL and CP groups were significantly lower than the pretherapy values (p <0,001). The mean 24-hour insulin levels did not change significantly during therapy (p >0.05). Excellent control of plasma glucose was possible during the entire day without producing nocturnal hypoglycemia. Neither GL nor CP therapy influenced the mean 24-hour levels of IRG, GH, or cholesterol. However, mean 24-hour levels of triglyceride were lower in both groups.IRG levels were elevated and the pattern of change in the insulin and IRG levels paralleled each other, which suggested that glucagon may play a role in the resistance of insulin action in NIDDM. GH levels were normal and remained unchanged during therapy.It was concluded that detailed 24-hour studies are important for better understanding the spectrum of abnormalities in newly diagnosed patients with NIDDM who were never treated. Results of the glucose-insulin interrelationships throughout the day and night indicate that these NIDDM patients appear to have an islet cell impaired glucose/insulin release abnormality as well as a resistance to the action of insulin. Chronic therapy with GL or CP appeared to lower glucose levels by improving insulin action.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The blood pressure, heart rate, and plasma cate-cholamine (CA) response to standing and mental stresses were studied in 14 normotensive subjects with normotensive parents (PNT group), 14 normotensive subjects with hypertensive parent(s) (PHT group), and eight borderline hypertensive patients (BHT group).Mean basal plasma norepinephrine (NE) concentration in BHT group (302 ± 94 pg/ml) and PHT group (289 ± 167 pg/ml) were significantly higher than in PNT group (205 ± 76 pg/ml). Significant differences in the mean basal plasma epinephrine (E) were found only between the PNT and BHT groups (22 ± 12 vs 43 ± 18 pg/ml, p < 0.01). Both plasma NE and E increased significantly on standing in all groups. With mental stress, plasma E increased significantly, though plasma NE did not change significantly in all three groups, The mean changes in blood pressure, heart rate, and plasma CA in response to standing and mental stresses were not different in the three groups. However, a higher incidence (50%) of high blood pressure responders (5≥20 mmHg in systolic blood pressure) to mental stress was found in the PHT group compared with PNT (14%) and BHT (12%).The high responders in the PHT group had significantly higher mean plasma E concentrations throughout the experiment. Also, their increases in plasma NE and E in response to mental stress were higher than those of the low responders.The results indicate that genetic predisposition to hypertension plays a significant role in determining plasma catecholamine levels and the responsiveness to stress, especially to mental stress.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Resistance and flow across compliant coronary stenoses may be altered by changes in intraluminal pressure. The effects of a distal circumflex coronary stenosis on a proximal compliant circumflex stenosis were evaluated in 17 open-chest dogs.In ten dogs, both stenoses were produced with external snares. As the distal stenosis was tightened, a point was reached at which flow through the circumflex coronary artery paradoxically increased (8 ± 1 to 11 ± 1 ml/min; p<0.001]. At the point of flow increase, there was an increase in intraluminal pressure between the stenoses (35 ± 4 to 61 ± 5 mmHg; p<0,001), and a decrease in pressure gradient (69 ± 5 to 43 ± 4 mmHg; p<0.001) and resistance (10.5 ± 2.7 to 4.7 ± 0,8 units; p<0.025) across the proximal stenosis. A similar increase in circumflex blood flow was found in dogs in which the proximal compliant stenosis was produced with an intraluminal balloon.In six additional dogs in which the proximal stenosis was produced with fixed noncompliant plastic tubing, tightening the distal snare did not result in an increase in circumflex blood flow. Thus, the increase in flow occurred only when the proximal stenosis was compliant. Increasing the severity of the distal stenosis caused an increase in intraluminal pressure in the area of the proximal stenosis and may have passively distended the compliant proximal stenosis decreasing its severity.Therefore, in the presence of compliant coronary stenoses in series, increasing severity of the distal stenosis may cause a paradoxical increase in flow through the stenotic artery.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Oxygen transport, the major function of hemoglobin, is dependent upon reduced heme iron. In the red cell, the heme iron is maintained in the reduced form by the methemoglobin reduction system. When the balance between oxidation and reduction of heme iron is perturbed due to the presence of excessive oxidants, decreased reducing capacity or the presence of abnormal hemoglobin, methemoglobinemia ensues. In most cases methemoglobinemia is transitory and of no major clinical consequence. Occasionally, however, it can be life threatening and must be rapidly diagnosed and treated. When methemoglobinemia is of hereditary nature, either due to deficiency of red cell NADH-methemoglobin reductase or due to the presence of M hemoglobin, it is a lifelong problem. Since most of these patients do not have major disabling symptoms, the treatment is aimed at correction of cyanosis.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A patient with arsenic intoxication is reported, who presented with a variety of gastrointestinal and neurologic disturbances including unilateral facial nerve palsy and acute symptomatic pancreatitis, neither of which have been previously described as sequelae of arsenic poisoning. The patient also suffered hematologic, dermatologic, and cardiopulmonary complications. A review of the literature about this interesting problem is also presented.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID