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Biomedical subjects

E F Pfeiffer

Publications and source records attributed to E F Pfeiffer.

At least 19 recordsLinked to original sources

On line continuous monitoring of subcutaneous tissue glucose in men by combining portable glucosensor with microdialysis.

For the normalisation of blood glucose levels in diabetic patients by feedback controlled insulin delivery, a self-manageable and reliable method for continuous glucose estimation is still not available. By combining a commercially available needle type dialysis probe (molecular cutoff 20,000 Da) with a sensitive glucose sensor, we obtained a device for continuous glucose measurement in dialysate. This device was tested in healthy volunteers during a 75-g oral glucose tolerance test and in Type 2 (non-insulin-dependent) diabetic patients. Venous glucose and subcutaneous sensor signal were followed for 300 min (ten healthy subjects), 21 h (three healthy subjects) or 9 h (seven Type 2 diabetic patients). The recovery of the microdialysis was interindividually different, but after calibration, glucose levels in the dialysate and subcutaneous glucose sensor signal correlated well (r = 0.84-0.95). Under the assumption of a physiologic and technical delay between intravenous and subcutaneous glucose, correlation coefficient between intravenous glucose and subcutaneous sensor signal ranged from 0.60 to 0.93. We conclude that changes in blood glucose could be monitored in the subcutaneous tissue by the microdialysis technique in a continuous on line manner.

Adult

Serum angiotensin-converting enzyme activity and active renin plasma concentrations in insulin-dependent diabetes mellitus.

We report here the alterations of serum angiotensin-converting enzyme activity (S-ACE) and of active renin plasma concentrations (ARPC) in 41 insulin-dependent diabetes mellitus (IDDM) patients compared with those of 26 control subjects. The IDDM patients had S-ACE activity (54 +/- 16 I.E.) in the upper normal range (controls, 39 +/- 7). When the patients were subclassified according to their diabetic complications, a significant increase of S-ACE within the IDDM group compared to the controls was observed in patients with nephropathy (68 +/- 13, P less than 0.001) with persistent proteinuria and with retinopathy (63 +/- 14, P less than 0.001). A significant correlation was found between proteinuria and S-ACE (r = 0.98, P less than 0.001) and between retinopathy and S-ACE levels (r = 64, P less than 0.001). No correlation between blood pressure and S-ACE or between blood glucose and S-ACE was observed. The ARPC were within the normal range in the IDDM (21 +/- 9 ng/l) and in control (19 +/- 3) groups. No correlations between ARPC and blood pressure or blood glucose or the degree of diabetic complications were registered. These data show that S-ACE activity is elevated in IDDM patients with nephropathy-proteinuria and/or with retinopathy and the circulating renin may not represent the renal renin-angiotensin vascular system.

Adult

Dilatory and inotropic effects of corticotropin-releasing factor (CRF) on the isolated heart. Effects on atrial natriuretic peptide (ANP) release.

The effects of CRF administration on cardiac performance, coronary flow and ANP release were investigated in the rat heart. Isolated hearts were perfused at a constant filling pressure according to working heart model with a Krebs-Henseleit solution containing glucose and insulin, saturated with a gas mixture containing 95% O2 and 5% CO2. Administration of CRF via a cannula into the left atrium elicited a prolonged increase in the coronary flow rate and a transient increase in the aortic pressure resulting in an overall increase in the pressure-volume work. The oxygen consumption, after the administration of CRF, increased in accordance with the cardiac effort. No changes were observed in the spontaneous heart rate. Furthermore, administration of CRF induced a short-term increase of ANP release into the coronary perfusate. Our experiments suggest that administration of CRF produces a prolonged dilatory effect on the coronary arteries while producing a transient positive inotropic effect and a transient increase of ANP release on the isolated rat heart.

Animals

Combination of microdialysis and glucosensor permits continuous (on line) SC glucose monitoring in a patient operated device. II. Evaluation in animals.

The microdialysis technique was used for following the glucose content of the extracellular subcutaneous (SC) fluid under varying blood glucose levels in rats. The glucose content in the microdialysis perfusion fluid was continuously analyzed by means of the measuring flow chamber of an ex vivo glucose monitor. In six ChBB rats blood glucose levels were varied between 40 mg/dl and 575 mg/dl by intravenous (IV) infusion of glucose and by SC injections of insulin, respectively. After a running-in period of about half an hour, the glucose content in the perfusion fluid was closely related to the blood glucose concentration (r > 0.92) up to a time period of 6 hrs. The "relative recovery" rate of glucose by the microdialysis probe in the SC tissue varied within the 6 experimental sessions. The relative recovery rate could be shown to be not dependent on the absolute blood glucose levels in the individual rat within the glucose concentration range tested.

Animals

Experiences with a computerized diabetes information system.

This study shows the results of working with a computerized system which stores values of blood glucose, insulin, diet and exercise and demonstrates which diabetic patients are suitable for continuous monitoring. The recording of blood glucose as well as the insulin doses, diet and exercise correlated to time is more accurate and easier than the usual protocolling of data. Deficiencies in diet, exercise or insulin regimens are detected more easily by evaluation of data with a computerized system, for example by making an average profile of a day. These results have a strengthening effect: Well controlled diabetic patients are ambitious to further improve their blood glucose control. Poorly controlled diabetics appear to be frustrated by this kind of unfailing control.

Adolescent

Insulin autoantibodies as determined by competitive radiobinding assay are positively correlated with impaired beta-cell function--the Ulm-Frankfurt Population Study.

Out of a random population of 4208 non-diabetic pupils without a family history of Type I diabetes 44 (1.05%) individuals had islet cell antibody (ICA) levels greater or equal to 5 Juvenile Diabetes Foundation (JDF) units. 39 of these ICA-positives could be repeatedly tested for circulating insulin autoantibodies (CIAA) using a competitive radiobinding assay. The results were compared with the insulin responses in the intravenous glucose tolerance tests (IVGTT) and with HLA types. Six pupils were positive for CIAA. All of them had complement-fixing ICA, and 5 of them were HLA-DR4 positive. Three of the 6 showed a first-phase insulin response below the first percentile of normal controls. Our data indicate that in population-based studies CIAA can be considered as a high risk marker for impaired beta-cell function in non-diabetic ICA-positive individuals.

Adolescent

Sex hormone concentrations in men with angiographically assessed coronary artery disease--relationship to obesity and body fat distribution.

The relationship between circulating sex hormone levels and the occurrence of coronary artery disease (CAD) was studied in a group of 274 men undergoing coronary angiography. Hormone levels in men with CAD (n = 200) were compared to those in men found to be free of coronary lesions (n = 74). No significant differences were found for serum concentrations of estradiol, total testosterone, sex-hormone-binding globulin, free androgen index, dehydroepiandrosterone sulfate, or cortisol between the two groups. Serum androgens were negatively correlated to age in both groups, whereas estradiol was weakly associated with total cholesterol in the group of men without CAD. No consistent associations were detected between sex hormone levels and the degree of obesity or the distribution of body fat, the latter being assessed by the ratio of waist-to-hip circumferences. The results of this study do not support a significant role of sex steroid hormones in coronary artery disease in men.

Adult

Thyrotropin-releasing hormone: further extraction studies and analysis by fast protein liquid chromatography and radioimmunoassay.

We describe the clinical application of a radioimmunoassay combined with fast protein liquid Chromatography (FPLC) for measuring TRH immunoreactivity (TRH-IR) in blood samples extracted previously with methanol or with Sep Pak C18 cartridges. Sensitivity of the RIA was 3 fmol/tube, displacement at 50% B/B0 was achieved by 55 fmol of unlabelled TRH. Our specific antibody K2B7 (km = 2.2 fM) showed no cross reaction with other peptides. No difference was observed between the mean values of TRH-IR in 19 euthyroid, 22 hyperthyroid, 18 hypothyroid and 10 hypophysectomised patients (45 +/- 17.8, 58 +/- 30, 40 +/- 22 and 36 +/- 12 fmol/ml, mean +/- SD, respectively), whereas TRH-IR was significantly lowered (p less than 0.05) in 6 euthyroid pancreatectomised patients (21 +/- 5 fmol/ml). The reversed phase FPLC analysis of the TRH-IR presented in the methanol extracts was shown to have the same retention time as synthetic TRH. TRH could not be measured in unextracted blood samples. TRH added in preincubated (60 min, at 37 C), before extraction, blood samples showed a loss of 83.4% of immunoreactivity. Our results demonstrate that this method is able to detect TRH-IR in human blood by whole methanol extraction and/or by Sep Pak C18 cartridges extraction. Furthermore the findings suggest that the main source of circulating TRH-IR may be of extrahypothalamic (pancreatic?) origin and that the basal peripheral TRH levels are not involved or they do not clearly represent a pathological condition.

Adult

Morphological and hormonal changes following vasectomy in rats, suggesting a functional role for Leydig-cell associated macrophages.

The effects of bilateral vasectomy on hormone serum levels as well as Leydig cell and associated macrophage structure were analysed in parallel in rats 36 weeks following the operation. Serum testosterone was decreased in vasectomized rats (1.96 +/- 0.11 ng/ml) compared with control animals (3.44 +/- 0.22 ng/ml, p less than 0.05). Vasectomy also resulted in an increase in serum luteinizing hormone (LH) to 0.299 +/- 0.02 ng/ml compared to the control group (0.175 +/- 0.01 ng/ml, p less than 0.05). Also serum follicle-stimulating hormone (FSH) was increased following vasectomy (350.88 +/- 15.5 ng/ml) compared to 132.0 +/- 4.8 ng/ml in control animals (p less than 0.01). Morphometric analysis of Leydig cells showed hypertrophy with a 19% increase of total cell area, p less than 0.01 (cytoplasm 28%, nucleus 8% increase). On the ultrastructural level, leydig cells demonstrated massively dilated smooth endoplasmic reticulum characteristic for stimulated cells. There was also a significant hypertrophy of the Leydig cell-associated macrophages. The macrophage cell area was enlarged by 22%, p less than 0.01 (cytoplasm 25%, nucleus 18%). Vasectomy also led to remarkable ultrastructural changes of macrophages with a marked dilated and extended rough endoplasmic reticulum. Macrophages were found in apposition to Leydig cells with close cellular contact zones, and they frequently formed cell extensions on Leydig cells. Our data obtained following vasectomy indicate that, by their close contacts to Leydig cells, as well as the known influence on Leydig-cell steroidogenesis, macrophages may form the basis of a local immunoendocrine regulation of the pituitary-gonadal axis.

Animals

Combination of microdialysis and Glucosensor permits continuous (on line) s.c. glucose monitoring in a patient operated device: I. In vitro evaluation.

A device for continuous glucose monitoring in fluids was obtained by combining the microdialysis technique with a measuring flow chamber of the "Glucosensor Unitec Ulm" using the GOD method for determining amperometrically blood glucose profiles. The in vitro experiments demonstrate that the relative recovery of glucose by this device is inversely related to the flow rate of the microdialysis perfusion fluid, which, in turn, is inversely related to the response time of the device. The glucose signal increases linearly with the area of the microdialysis working membrane (r = 0.98), and with the glucose concentrations of the standard solutions (r greater than 0.95). The variation coefficient for repeated measurements is below 8%. The accuracy of the device as demonstrated by mean measuring deviation ranges between 1 and 3.8%.

Biosensing Techniques

Diastolic ventricular function in type 1 diabetic patients: a study using Doppler echocardiography.

The transmitral flow velocity pattern of 28 Type 1 diabetic patients and 39 age-matched healthy control subjects was studied for determination of left ventricular diastolic function. No patient had systemic hypertension, congestive heart failure, or ischaemic heart disease by clinical or electrocardiographic criteria. Echocardiographic measures of systolic ventricular function were within normal range in all subjects. The ratio of early to late transmitral peak flow velocity (ve/va) was significantly decreased in the diabetic patients (1.3 +/- 0.1 (+/- SE) vs 1.6 +/- 0.1, p less than 0.05), while other Doppler derived variables did not show any significant difference. No correlation of ve/va with duration of diabetes was found (r = -0.27), but it correlated with age in both groups (both r = -0.40, p less than 0.05). Furthermore, a significant correlation was found between ve/va and heart rate (r = -0.55 for diabetic patients, p less than 0.01; r = -0.58 for control subjects, p less than 0.01). After matching for heart rate (24 diabetic patients and 24 control subjects) no significant decrease of ve/va was observed in the diabetic group.

Adult

Comparative effects of dopamine and dobutamine on glucoregulation in a rat model.

The influence of dopamine as compared with dobutamine on glucose homeostasis has been assessed in thyroidectomized euthyroid rats. Both sympathomimetic agents were given intravenously over 6 h at four dosages, varying from 2 to 30 micrograms.kg-1.min-1. Immediately before the end of the infusion period, serum concentrations of glucose and insulin as well as plasma glucagon concentrations were measured. Dobutamine infusions did not exert any influence on these parameters. At a dose of 7.5 micrograms.kg-1.min-1, dopamine infusion caused a decrease in glucose concentrations, accompanied by a rise of glucagon and insulin levels. Glucose levels were significantly increased in the presence of unaltered insulin and decreasing glucagon levels at higher dopamine doses. The rise in glucose levels was reversed by 8 micrograms.kg-1.min-1 and inverted to a decrease by 12 micrograms.kg-1.min-1 of the alpha-adrenergic blocking agent phentolamine, simultaneously infused with 15 micrograms.kg-1.min-1 dopamine, while the insulin levels were increased and glucagon levels remained elevated. These findings demonstrate that dopamine acts on glucoregulation divergently, according to the dosage applied. The data suggest that dopamine rather than dobutamine treatment may disturb glucose homeostasis.

Animals

Role of the vasoactive intestinal peptide in a neuroendocrine regulation of the adrenal cortex.

Using a method for isolation and perfusion of pig adrenal glands with preserved nerve supply, we measured the release of cortisol and aldosterone and of the vasoactive intestinal peptide (VIP) after electrical stimulation of the splanchnic nerves. Additionally, the effect of VIP (at final concentrations of 10(-10)-10(-7) M) in the perfusion medium on the release of cortisol and aldosterone was investigated. The amount of VIP contained within the adrenal was measured by chromatography, and the localization of VIP in the adrenal gland was investigated immunohistochemically. Stimulation of the splanchnic nerves provoked a significant release of VIP (2.7- to 17-fold) and of the corticosteroids cortisol (2.5- to 6.7-fold) and aldosterone (1.6- to 2.8-fold). VIP added to the perfusion medium stimulated secretion of both corticosteroids with a maximal effect at 10(-8) M. Cortisol release increased 20- to 58.5-fold over basal, aldosterone release increased 2.9- to 4.9-fold over basal. This VIP-stimulated release had the same range of magnitude as the release stimulated by adrenocorticotropic hormone in physiological concentrations (10(-10) M). The mean concentration of VIP-like immunoreactivity in the adrenal glands was 8.9 +/- 2.1 pmol/g wet weight. Immunohistochemical investigations showed immunoreactive cells within the adrenal medulla as well as VIP-ergic nerve fibers in the cortex of the adrenal gland. These data show that the adrenal cortex can be stimulated independent of the hypothalamus-pituitary-adrenal axis via a neuroadrenocortical axis. In this regulatory pathway, the VIP-ergic innervation of the adrenal cortex may be a potent stimulatory element.

Adrenal Cortex

Aspects of chronic oral treatment with thyrotropin-releasing hormone: the hypothalamic-pituitary-thyroid axis in rats. A study with a pharmacological dose of thyrotropin-releasing hormone.

The effects of 16 days of oral treatment with thyrotropin-releasing hormone (TRH, 1 mg/24 h) on serum levels of thyrotropin (TSH), thyroxine (T4) and triiodothyronine (T3) and the kinetics of TRH in the blood were studied in normal rats. A second group of animals served as controls. TRH was dissolved by sonification (10 mg/l) and was stable in tap water. TRH was measured by a radioimmunoassay procedure (normal range: 20-80 pmol/l, antiserum K2B9 1:120,000 final dilution). An increase in basal TSH (7,200 +/- 440 ng/l, mean +/- SD) was found after 2 days of treatment (11,420 +/- 810 ng/l), but a significant increase was observed after 5 days of treatment (12,530 +/- 640 ng/l, p less than 0.001). T4 serum concentrations remained in the normal range during the entire period of study, whereas T3 serum concentrations (0.76 +/- 0.1 micrograms/l) were increased to 1.22 +/- 0.2 micrograms/l on day 5 (p less than 0.001). A subsequent decline of TSH, T4 and T3 up to the end of the study was observed. TRHmax concentrations were registered on day 5 (790 +/- 24 pmol/l). The mean value of TRHmax was 723 +/- 34 pmol/l. To improve the stability of TRH in tap water, 1-ml samples of drinking water with dissolved TRH were measured. The mean TRH concentration in drinking water was 73 +/- 1.5% (SD). No significant correlations were found between the area under the curve of TSH (184,340 ng.l-1.24 h) and that of TRH (14,954 pmol.l-1.24 h).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Thyrotropin-releasing hormone degradation in patients with insulin dependent diabetes mellitus. Effects of metabolic control.

We investigated thyrotropin releasing hormone (TRH) degradation in terms of half-life (t1/2) and metabolic clearance rate (MCR) in eight subjects with insulin dependent diabetes mellitus (IDDM) before and after strict metabolic control. The results were compared with those of six healthy control subjects. The basal plasma TRH-IR levels (31 +/- 9 fmoles/ml) were on the lowest normal limit in the IDDM patients and were not considerably changed (24 +/- 10) after strict metabolic control. The basal and delta max rise of TSH to TRH (200 micrograms i.v.) were not significantly different before or after improved metabolic control in IDDM and as compared to controls. The TRH-degradation curves showed similar exponential decay before and after improvement of metabolic control (t1/2: 7.6 +/- 0.4 min and 7.3 +/- 0.3 respectively; 6.5 +/- 0.4 min for the controls). The MCR of exogenously administered TRH in IDDM before (65.5 +/- 8.6 l/m2/day) and after (65.0 +/- 8.9) control was not different compared to the normals (76.5 +/- 9.6). The area under the plasma concentration-time curve (AUC) in IDDM before (52.193 +/- 6.773 fmoles.ml-1.min) and after improvement of metabolic control (53.186 +/- 7.856) was slightly higher than in the healthy subjects (40.151 +/- 3.741, n.s.). These findings demonstrate that a) the degradation of exogenous TRH is not dependent on the glucose metabolic state, b) insulin deficient diabetes mellitus does not affect the enzymatic system responsible for TRH degradation and, c) the hypothalamic-pituitary axis appears to be intact in IDDM.

Adolescent