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C Kilo

Publications and source records attributed to C Kilo.

At least 73 records · Page 4Linked to original sources

The Achilles heel of the University Group Diabetes Program.

The controversial conclusions of University Group Diabetes Program (UGDP) investigators are refuted by new findings uncovered by analyses of patient data obtained from the UGDP Coordinating Center and by critical review of data previously published by UGDP investigators and the Biometric Committee. These new findings (1) document a notable discrepancy in the sex ratio of cardiovascular (CV) death rates in placebo-treated subjects, (2) show that all excess CV mortality in tolbutamide-treated subjects was restricted to a relatively small group of poorly controlled diabetics, and (3) provide evidence that insulin was efficacious in reducing CV deaths. The anomalous sex ratio of CV deaths in UGDP placebo-treated subjects dictates the conclusion that the CV death rate in placebo-treated subjects was spuriously low, giving the false impression of increased death rates in the other treatment groups, thereby accounting for all of the controversial observations reported by UGDP investigators. For this reason UGDP conclusions based on comparison with placebo-treated subjects should not be extrapolated to the general diabetic population.

Blood Glucose↗

Increased collagen cross-linkages in experimental diabetes: reversal by beta-aminopropionitrile and D-penicillamine.

The effects of diabetes on collagen cross-link formation and solubility were investigated in granulation tissue collagen induced by polyester fabric implanted subcutaneously in rats at the same time diabetes was produced by injection of streptozotocin. Thus, all the collagen analyzed was formed in a diabetic milieu. Ten days later the implants were removed and the total collagen content as well as the fraction soluble in 0.5 M acetic acid was determined. Predominantly type I collagen accumulated in the implants. Total collagen content was the same in diabetics and controls; however, the acid-soluble fraction in diabetic animals was only half that of controls (8.5% and 17.7%, respectively), and the ratio of beta chains to alpha chains in the acid-soluble fraction was higher in diabetics (0.89) than in controls (0.69). In animals treated with beta-aminopropionitrile or D-penicillamine the acid-soluble fraction of collagen from diabetics equaled that from controls. These observations indicate that both intramolecular and intermolecular cross-links are increased in type I collagen from diabetic animals. Since these cross-links interfere with degradation of collagen by collagenase, they may contribute to accelerated intimal sclerosis of arteries and to capillary basement membrane thickening in diabetes.

Amino Acids↗

Vitreous fluorophotometry in adult-onset diabetes mellitus.

We studied the breakdown of the blood-retinal barrier in 83 patients with adult-onset diabetes mellitus, by using vitreous fluorophotometry. The patients were in good stable metabolic control and were receiving injectible insulin or oral hypoglycemic agents. Vitreous fluorophotometry readings were abnormally high but similar in both groups of patients, and no significant differences were found between those with and those without early background diabetic retinopathy. Significantly more patients taking oral agents were hypertensive, and significantly fewer of these patients had background retinopathy.

Adult↗

Thin muscle capillary basement membranes in myotonic dystrophy.

Muscle capillary basement membrane width (MCBMW) was measured in 18 myotonic dystrophy patients and compared with that in age- and sex-matched normal and diabetic subjects. The MCBMW in myotonic dystrophy patients (773 +/- 258 A) was significantly thinner than in normal subjects (925 +/- 181 A, P less than 0.05) or in diabetics (1224 +/- 614 A, P less than 0.01). An increase in MCBMW with advancing age was present in all groups but was greatest in the myotonic dystrophy groups (r = +0.59, P less than 0.01). There was no relation between MCBMW and either the degree of glucose intolerance or insulin hypersecretion in the myotonic dystrophy group, though none had fasting hyperglycemia. This is the first report of a condition associated with thinner-than-normal capillary basement membrane.

Adolescent↗

Vitreous fluorophotometry in juvenile-onset diabetes mellitus.

Vitreous fluorophotometry was carried out in 99 juvenile-onset, insulin-dependent diabetics and 31 control subjects. The mean vitreous fluorescein concentration one hour after intravenous administration of fluorescein, 7 mg/kg, was 5.4 +/- 0.3 ng/ml (mean +/- SEM) for controls and 9.5 +/- 0.4 ng/ml for diabetics (P less than .005). Diabetic patients with or without background retinopathy, when randomly matched for age or duration of their disease, had similar vitreous fluorophotometry measurements. The break-down of the blood-retinal barrier to fluorescein appears to be the earliest detectable ocular abnormality of diabetes.

Adolescent↗

Quantitative vitreous fluorophotometry. A sensitive technique for measuring early breakdown of the blood-retinal barrier in young diabetic patients.

Vitreous and aqueous humor fluorescein concentrations were measured one hour after graded intravenous fluorescein was given to 20 juvenile diabetics, ages 20 to 40, with and without retinopathy, and to 12 controls of similar age. Vitreous fluorescein concentrations were significantly higher in diabetics, indicating breakdown of the blood-retinal barrier. Mean vitreous fluorescein values were 10.66 +/- 0.65 for the diabetics and 4.28 +/- 0.37 ng./ml. for the controls. Breakdown of the blood-retinal barrier was also confirmed in diabetics under the age of 20 without retinopathy. The blood-aqueous barrier was similarly altered in diabetics. Vitreous fluorophotometry quantitatively measures breakdown of the blood-retinal barrier, possibly the earliest detectable ocular vascular abnormality in juvenile diabetic patients.

Adult↗