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Biomedical subjects

C B Kahn

Publications and source records attributed to C B Kahn.

At least 19 recordsLinked to original sources
PubMed1990

Differentiation of Charcot joint from osteomyelitis through dynamic bone imaging.

The bone scans of 25 patients with a clinical diagnosis of diabetic osteoarthropathy (Charcot joint) of the ankle and foot were analysed using the technique of dynamic bone imaging. The analysis of time-activity curves generated over the Charcot joint, the contralateral joint and the bone above the Charcot joint, produces characteristic patterns that are distinguishable from the ones observed for osteomyelitis. Recently it has been shown that the significance of dynamic bone imaging resides in its correlation to physiological and morphological components of bone. The difference in the blood supply to the long bones has been suggested as an explanation for the difference in time-activity curve patterns.

Arthropathy, Neurogenic↗
PubMed1983

Glucose kinetics in nondiabetic and diabetic women during the third trimester of pregnancy.

Glucose kinetics were measured with 78% enriched D-[U-13C] glucose by the prime constant infusion technique during the third trimester of pregnancy in nine nondiabetic women, nine insulin-dependent diabetic women, six gestational diabetic women, and five control women (nonpregnant, nondiabetic) after an overnight fast. The patients not dependent on insulin were diagnosed as diabetic by oral glucose tolerance tests with the use of O'Sullivan and Mahan's criteria as modified by Carpenter and Coustan during the third trimester. The turnover studies were repeated post partum (6 weeks to 5 months after delivery) in 14 of the 24 pregnant subjects. All pregnant groups had a progressive fall in plasma glucose concentration during the study, but there was a steady state of plasma glucose concentration during the turnover period. In comparison to the control subjects, both the pregnant nondiabetic and pregnant insulin-dependent diabetic women had significantly higher plasma insulin concentrations throughout the study (p less than 0.05). There were no differences in the glucose turnover rate between any of the pregnant groups (1.7 +/- 0.2 mg . kg-1 min-1 in pregnant nondiabetic women; 1.5 +/- 0.2 mg . kg-1 min-1 in pregnant insulin-dependent diabetic women; and 2.1 +/- 0.4 mg . kg-1 min-1 in gestational diabetic women) and the control group of women (1.8 +/- 0.2 mg . kg-1 min-1) (mean +/- SEM). When the pregnant patients were studied post partum, the glucose turnover rate was similar when referenced to body weight; however, because of a 9.6% to 14.5% fall in weight post partum, the absolute values were higher in the pregnant women. We conclude that, in the basal state after an overnight fast, (1) both nondiabetic and diabetic patients accelerated their glucose turnover rate during pregnancy to provide for increased maternal and fetoplacental metabolic requirements, and (2) in the diabetic subjects the nearly normal plasma glucose and insulin concentrations and other metabolic parameters, as well as the glucose turnover rate, suggested good metabolic control during pregnancy in most of the insulin-dependent and in all of the gestational diabetic patients.

Adult↗
PubMed1982

Seasonal incidence of insulin-dependent diabetes (IDDM) in Massachusetts, 1964-1973.

A total of 1142 Massachusetts resident, insulin-dependent diabetics were identified from medical records of the Joslin Clinic. All patients were less than 21 years of age at onset and developed diabetes between 1 January, 1964 and 31 December, 1973. This group consisted of 598 males (52.4%) and 544 females (47.6%) with mean ages at onset (+/- SD) of 11.1 +/- 4.9 and 10.9 +/- 4.6 years respectively. The period between onset and diagnosis was less than two months in 634 cases (81.8%). A first degree family history was noted in 209 cases (18.3%), while an additional 689 cases (60.3%) had more distant relatives with diabetes. The seasonal distribution of onsets was examined in the total group, and in subgroups categorized by sex, type of onset, age of onset, and family history. Significant peaks were noted during the first six months (January-June) in the total group and in all subgroups except those less than five or greater than 14 years of age at onset. Maximum incidence occurred in either January or February. During the second six month period (July-December) strong peaks were noted only in females and in those with no family history. Maximum incidence occurred in late July and in August, respectively. Exceptionally pronounced seasonal variation was demonstrated in a subgroup of 129 diabetics less than 15 years of age with onsets less than two months prior to diagnosis, and with no family history. The distribution of year of onset, in this group, showed considerable variation which did not correlate with year to year fluctuations in the reported incidence of aseptic meningitis, rubeola or mumps.

Adolescent↗
PubMed1980

Glycohemoglobin in diabetic pregnancy: a sequential study.

Glycohemoglobin (Hb Alc) was assayed sequentially during pregnancy and post partum in 53 women. In a group of nondiabetic women (N = 13) Hb Alc fell significantly (p less than 0.001) from the first to the third trimester and then rose to first-trimester levels by 12 weeks' post partum. Glycohemoglobin levels of insulin-dependent diabetic patients (N = 28) followed a similar pattern but at significantly elevated levels compared to nondiabetic patients (p less than 0.001). In contrast, patients with chemical diabetes (N = 12) did not manifest any change of Hb Alc with time, although they did have glycohemoglobin levels above those of the normal subjects during the third trimester (p less than 0.001) and before 12 weeks' post partum (p less than 0.02). It is speculated that these fluctuations in Hb Alc are most likely due to changes in long-term blood glucose control. Additionally, because Hb Alc increased in vitro oxygen affinity, some of these women were followed for parameters of oxygen transport as well. No significant changes of parameters of oxygen transport were found, with the exceptions of P50 in vivo and P50pH7.40 during the third trimester and of P50 in vivo before 12 weeks' post partum

Blood Glucose↗
PubMed1978

Glycohemoglobin (HbAIc): a predictor of birth weight in infants of diabetic mothers.

Hemoglobins AIa-c (fast Hb), minor variants of HbA, are elevated in patients with diabetes mellitus. Recent studies indicate a relationship of fast hemoglobins, especially HbAIc (glycosylated form), to chronic hyperglycemia. Since infant oversize has been attributed to maternal hyperglycemia and fetal hyperinsulinemia, the hemoglobin HbAIc fraction was compared to birth weight (actual and relative to gestational age) and to maternal glucose tolerance. Normal (13), probably normal (8), gestational diabetic (10), and insulin-dependent women (14) were studied in the third trimester; women with advanced diabetic vascular disease were excluded. When corrected for gestational age, relative birth weights correlated in a significant linear regression with HbAIc (n = 45, r = 0.57, P less than 0.001). Third trimester maternal glucose tolerance (Kt) of women, not insulin dependent, correlated in a signigicant manner with both HbAIc (P less than 0.05) and birth weight for gestational age (P less than 0.01).

Birth Weight↗