摘要:

Abstract.The adipose tissue volume, skeletal muscle and skin volume and visceral organ volume were determined using the multiscan CT (computed tomography) technique in 15 patients with acromegaly. The examinations were performed before treatment and 1 year after transsphenoidal adenectomy.The mean body weight did not change significantly after treatment; 91–3 kg and 92–3 kg pre and postoperatively in men and 66.7 kg and 65.9 kg in women respectively. The total adipose tissue volume increased by 7.1 1 (59.2%,P<0.01) in the male group and 3.9 1 (20.39%,P<0.05) in the female group. Muscle and skin mass and visceral organ mass decreased significantly after treatment. The muscle and skin mass decreased by 3.6 1 (‐7.4%,P<0.01) in males and by 3.2 1 in females (‐11.5%,P<0.02). The corresponding decrease in visceral organ mass was 1.5 1 (‐17.0%,P<0.01) in males and 1.0 1 (15.4%, P<0.05) in females respectively.On average, the fractions of adipose tissue in the subcutaneous trunk and the intra‐abdominal depots increased after treatment, while the fractions of adipose tissue in the limbs and the head and neck region decreased. The change in adipose tissue distribution pattern reached significance (P<0.005)

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1993.tb00762.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Animal experiments have shown that acute respiratory acidosis stimulates water, Na and C1 absorption and HCO3secretion in the ileum. The aim of this study was to investigate whether the human ileum also responds to changes in systemic acid‐base balance. Seven healthy volunteers (mean age 24, range 21–29 years) underwent segmental ilea perfusion using a multi‐lumen tube assembly with a proximal occluding balloon. A 30 cm test segment was perfused under steady state conditions with a plasma‐like electrolyte solution containing PEG as a non‐absorb‐able volume marker. After a control period, respiratory acidosis (blood pCO256.2 mmHg, pH 7.29 and [HCO3] 26.4 mmol 1‐1) was induced by CO2‐breathing over a period of 50 min. Acute respiratory acidosis stimulated net HCO3secretion in patients secreting HCO3and reduced absorption in patients exhibiting net HCO3absorption. These changes were immediate and appeared to be at least partly reversible. Net water, Na, K and CI movement were not affected. The data suggest that HCO3transport in the human ileum responds to acute respi

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1993.tb00763.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Primary culture of hepatocytes from puromycin aminonucleoside‐induced nephrotic rats were used to discriminate between the hepatic and extra‐hepatic contribution to the hyperlipidemia occurring in the nephrotic syndrome.De novolipogenesis and utilization of exogenous fatty acids were not modified in nephrotic hepatocytes as compared to controls. In contrast 2.2 and 5.3‐fold more triacylglycerol and phospholipids were secreted respectively by nephrotic hepatocytes than by controls. Triacylglycerol overproduction was not associated with an increase either in apo B mRNA level or in ape B synthesis or secretion measured by [35S]‐methionine incorporation and immunoprecipitation. We also observed a significant increase in apo A1 and apo E synthesis and secretion by nephrotic hepatocytes. This increase was correlated with a greater amount of apo A1 and apo E mRNA than in controls. The overproduction of apo A1 and apo E by nephrotic hepatocytes might intervene in the clearance of plasma lipoproteins and the redistribution of plasma chol

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1993.tb00764.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.To assess the degree of immune system activation associated with addiction or hepatotropic viruses infection, we examined 60 HIV‐negative heroin addicts for the presence of hepatitis B virus (HBV) infection markers, hepatitis C virus antibodies (anti‐HCV), various auto‐antibodies, and serum levels of soluble interleukin‐2 receptors (sIL‐2R). In addition, 28 anti‐HCV positive patients comprising the disease control group, were also examined. Our results demonstrated a high prevalence of anti‐HCV antibodies (61.7% and 90% with 1st and 2nd generation ELISA, respectively). Eighty‐seven percent (87Yi) of the addicts positive for anti‐HCV by the latter and 92.8% of the disease control patients, were also positive with 2nd generation recombinant immuno‐blot assay (RIBA‐II). In 88.9% of anti‐HCV positive addicts, antibody to C22–3 was the predominant (anti‐C33c in 81.5%). Antibodies to C33c and C22–3 polypeptides were also more frequent in disease control group (92.8% and 85.7%, respectively). Anti‐HCV antibodies were associated with increased transaminases (ALT or AST, P<0.05), as well as with longer duration of addiction (P<0.005). HBV infection markers (HBsAg, anti‐HBc only and anti‐HBs) were also present in the addicts (5%, 28.3% and 26.7%, respectively). Rheumatoid factors (RF) were detected in 36.7%, antinuclear antibodies (ANA) in 11.7%, antibodies (IgG and/or IgM) against cardiolipin (anti‐CL) and double stranded DNA (anti‐ds DNA) in 20% and 50%, respectively. RF, ANA, anti‐CL and anti‐dsDNA antibodies were also detected in the disease control group (32.10/, 89.3%, 28.5% and 28.5% respectively). Auto‐antibodies of at least one specificity, were found in 83.3% of addicts independently of anti‐HCV antibodies, HBV infection markers, increased ALT or AST levels, and the duration of addiction. They were, on the other hand, associated in addicts with antibodies to the C22–3 polypeptide of HCV (P =0.0001) and with both of the predominant antibodies (anti‐C33c and anti‐C22–3) of the HCV (P<0.01 andP<0.05 respectively) in the disease control group. Thirty‐nine addicts (65%) and 50% of the disease control patients were found to have increased levels of sIL‐2R. In contrast to the disease control group, serum sIL‐2R levels of addicts were associated with RF (P<0.05), anti‐dsDNA (P<0.0005) and total auto‐antibodies (P=0.0005), while there was a slight negative correlation with the duration of addiction (r= ‐0.26, P<0.05). However, sIL‐2R levels, were not associated with HBV and HCV infection markers in both groups. We conclude that intravenous heroin addiction appears to be associated with an increased prevalence of HCV and non‐organ specific auto‐antibodies. The latter may be driven by C22–3 and C33c polypeptides of HCV. Increased sIL‐2R levels attest to a cellular immune activation in addicts, which is slightly correlated with shorter duration of addiction, in

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1993.tb00765.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Obesity is associated with dyslipidaemia and increased morbidity and mortality from premature atherosclerosis and diabetes mellitus. Particularly, hypertriglyceridaemia is a characteristic finding in patients with obesity. In addition, the elevated levels of triglycerides may be an important risk factor for development of the obesity‐related complications. Lipoprotein lipase activity in skeletal muscle tissue (mLPL) has previously been found to be an important factor regulating the concentration of serum triglycerides. To describe the relationship between mLPL, triglycerides and fatness/fat distribution in more detail we have investigated these parameters under basal conditions and during insulin stimulation in 20 obese females. During hyperinsulinaemia (204 μU ml‐1) for 4 h the mLPL activity decreased from 528 ± 52 nmol FFA g‐1to 412 ± 44 (P<0.001). Basal mLPL was negatively correlated with serum triglycerides (r= ‐0.48,P<0.05) and positively correlated with HDL‐cholesterol (r = 0–58,P<0.01). Employing multiple variance analysis it was found that both BMI and WHR were negatively correlated to mLPL, however, the impaired lipid profile (high triglyceride, low HDL‐cholesterol, high FFA) could only be related to BMI and not to WHR in these obese females. However, reduced insulin‐action (insulin resistance) was closely related to abdominal fatness determined by WHR both in relation to the insulin‐effect on mLPL as well as for the insulin‐effect on whole‐body glucose metabolism (clamp‐study). A tendency to a positive correlation was observed between the impaired insulin‐stimulated glucose disposal and the reduced insulin‐effect on mLPL (r = 0.41, P = 0.08) indicating that mLPL might be an indicator of muscle insulin sensitivity. In conclusion, reduced mLPL activity seems to play a role for the increased triglyceride levels associated with obesity and the mLPL activity seems to be negatively influenced by both total fatness and abdominal fatness. Finally, mLPL is an insulin sensitive enzyme where short‐term insulin infus

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1993.tb00766.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Eight patients with mild heart failure were treated in random order for 1 week with 2 mg bumethanide at 0800 and 1200 (treatment I) h, 1 mg bumethanide at 0800, 1200, 1800, 2200 (treatment 2) and 5 mg bendroflumethiazide at 0800 and 1800 (treatment 3) h. The ‘quality of life’ did not differ significantly between the three treatment periods. At the presumed trough of the diuretic effect the circulating blood volume was largest during treatment 1; it was 6.3% smaller during treatment 2 (P<0.02) and 6.7%) lower during treatment 3 (P<0.05). In comparison with treatment 1, the maximal increase in rate‐pressure product during physical exercise was 24.6% higher in treatment 3. Compared with treatment 1 the area under the curve (AUC) for plasma lactate during physical exercise was 14% lower during treatment 2 (P<0.05) and 18% lower during treatment 3 (P<0.01). These findings suggest that the type of program for diuretic therapy influences the magnitude of inevitable diurnal fluctuations in body fluids, the ability of the heart to work and the ability of the body to adjust to the oxygen d

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1993.tb00767.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.HMG‐CoA reductase inhibitors effectively reduce the concentration of low density lipoproteins (LDL) in plasma. Lipoprotein(a) [Lp(a)] may be as atherogenic as LDL. A few studies, only one of which was placebo controlled, suggest that the HMG CoA reductase inhibitors either do not affect Lp(a) or they increase Lp(a). The response of Lp(a) to HMG‐CoA reductase inhibition has not been related to apolipo‐protein(a) phenotypes in previous studies. We conducted a double‐blind, placebo controlled study of pravastatin in 51 patients with familial hypercholester‐olemia (FH) (n= 43) or probable FH (n= 8). All patients had LDL‐cholesterol concentrations above 4.1 mmol 1‐1despite treatment with diet and bile acid sequestration. In patients assigned to pravastatin (n= 34), the mean concentrations of total cholesterol and LDL cholesterol fell significantly (P<0.01) when compared to placebo. Lp(a) increased (P<0.01) from a mean (±SD) of 33.6 ± 40.8 mgdl‐1to 411 ± 46.1 mg dl‐1on pravastatin but was unchanged during placebo treatment. The percentage increase in Lp(a) was the same in patients with different apo(a) phenotypes, and hence the absolute increase in Lp(a) was greatest in patients with the low molecular weig

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1993.tb00768.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Epidemiological studies have suggested that patients with rheumatoid arthritis (RA) have increased mortality due to cardiovascular disease. We studied cardiac performance in 12 asymptomatic male patients with RA and 14 control subjects to elucidate early disturbances in cardiac function. In echocardiography, isovolumic relaxation time was longer (64 ± 6 vs. 49 ± 3 ms, mean ± SEM, P = 0.010) and peak filling rate (134 ± 10 vs. 159 ± 6 mm s‐1,P =0.015) lower in patients with RA than in control subjects, reflecting an impairment in left ventricular diastolic function. Left ventricular systolic function assessed by radionuclide angiocardiography at rest and during exercise was similar in both groups. There were no differences between the patients with RA and control subjects in the heart rate, systolic blood pressure and oxygen uptake during peak exercise. Left ventricular diastolic function is impaired in spite of normal left ventricular systolic function in patients with R A without clinically evident cardiovascular disease and this may contribute to the excess of cardiovascular mortality in patients w

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1993.tb00769.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Peripheral lymph lipoproteins were studied in four hyperlipidaemic men before and after 6 weeks of treatment with gemfibrozil, a drug which is known to increase the fractional catabolic rate of very low density lipoproteins (VLDL) by raising lipoprotein lipase activity in peripheral tissues. Decreases in plasma triglycerides of 18–60% (mean, 45%) were accompanied by increases in lymph apolipoprotein (apo) A‐I concentration of 30–108% (mean, 66%; P<0.01), and in lymph cholesterol concentration of 35–100% (mean, 59%;P<0.05). The additional lymph cholesterol was distributed over a broad range of lipoprotein particle sizes. Effects on plasma apo A‐I concentration (mean, +7%) and plasma total cholesterol concentration (‐ 7%)) were not statistically significant. No changes were observed in four untreated control subjects. These findings are compatible with the hypothesis that lipolysis of VLDL at the blood‐endothelium interface increases the transfer of apo A‐I from plasma to interstitial fluids, and thereby promotes cholesterol ef

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1993.tb00770.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY