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Biomedical subjects

G Somers

Publications and source records attributed to G Somers.

At least 19 recordsLinked to original sources
PubMed1992

Complementation of HLA-DQA and -DQB genes confers susceptibility and protection to insulin-dependent diabetes mellitus.

Lack of an aspartic acid 57 in the HLA-DQ beta chain was introduced as a genetic marker of insulin-dependent diabetes mellitus (IDDM). Because 25% of the control population carries the same marker, we analyzed the DQ locus for the presence of more specific disease susceptibility markers, taking into account a possible role for the polymorphic DQA gene. We thereby identified the DQA3-DQB3.2/DQA4.1-DQB2 (DQA1*0301-DQB1*0302/DQA1*0501-DQB1*0201) genotype which was detected in 30% of the 268 typed IDDM patients and only in 1% of the 331 typed healthy controls, resulting in a relative risk of 35. This genetic marker was more frequent in patients with clinical onset before age 18 years (36%) than in patients diagnosed between age 18 and 40 years (22%) and was not observed in patients with non-IDDM. The new susceptibility genotype DQA3-DQB3.2/DQA4.1-DQB2 (DQA1*0301-DQB1*0302/DQA1*0501-DQB1*0201) may explain the well-known excess of DR3/DR4 heterozygous IDDM patients and is expected to help identify individuals at risk for developing the disease.

Adolescent↗
PubMed1990

Gastrinomas in the duodenums of patients with multiple endocrine neoplasia type 1 and the Zollinger-Ellison syndrome.

In patients with multiple endocrine neoplasia type 1 (MEN-1), gastrinomas are common and thought to occur predominantly in the pancreas. We describe eight patients with MEN-1 and hypergastrinemia (seven with the Zollinger-Ellison syndrome) in whom we searched for neuroendocrine tumors in the pancreas and duodenum. Tumors were found in the proximal duodenum in all eight patients: solitary tumors (diameter, 6 to 20 mm) in three patients and multiple microtumors (diameter, 2 to 6 mm) in the other five. Paraduodenal lymph-node metastases were detected in four patients. Immunocytochemical analysis revealed the presence of gastrin in all the duodenal tumors and in their lymph-node metastases. In contrast, no immunoreactivity for gastrin was present in the endocrine tumors found in the seven pancreatic specimens available for study, except for one tumor with scattered gastrin-positive cells. In four of the six patients whose duodenal gastrinomas were removed, serum gastrin levels returned to normal; in the other two patients gastrin concentrations decreased toward normal. We conclude that in patients with MEN-1 and the Zollinger-Ellison syndrome, gastrinomas occur in the duodenum, but the tumors may be so small that they escape detection.

Adult↗
PubMed1990

Effect of rioprostil, a methylprostaglandin E1 analog, on basal and stimulated plasma pancreatic hormone levels in man.

The effect of rioprostil, a methylprostaglandin E1 analog on circulating pancreatic hormones was evaluated in 13 healthy male subjects. Rioprostil administration, 300 micrograms twice daily resulted in a significant decrease of fasting insulin, C-peptide, glucagon, and pancreatic polypeptide. No change in fasting plasma glucose or somatostatin levels was observed. An oral glucose tolerance test induced similar increments in plasma glucose concentration before and during treatment, but a delayed rise of insulin and C-peptide levels occurred during the administration of the drug. On rioprostil, the glucose load no longer inhibited peripheral glucagon or somatostatin. Treatment with rioprostil remained without effect on mixed meal-induced changes in plasma glucose levels and concomitant increases in insulin, pancreatic polypeptide, and somatostatin levels. It is concluded that in healthy individuals rioprostil influences the basal and glucose-induced levels of glucagon, insulin, and somatostatin. In healthy men this effect did not, however, result in glucose intolerance.

Adult↗
PubMed1990

Metastasizing neuroendocrine carcinoma of the larynx with calcitonin and somatostatin secretion and CEA production, resembling medullary thyroid carcinoma.

A 55-year-old man presented with a metastasizing moderately differentiated neuroendocrine carcinoma of the larynx (atypical carcinoid). Immunocytochemical demonstration of neuroendocrine markers (neuron-specific enolase and chromogranin-A) and presence of membrane-bound neurosecretory granules in the cells established the neuroendocrine nature of the tumour. In addition, the tumour was found to produce calcitonin, somatostatin and carcino-embryonic antigen (CEA). Calcitonin and somatostatin were also secreted. On the basis of this particular marker constellation the tumour closely resembles medullary thyroid carcinoma. Review of the recent literature on carcinoids of the larynx reveals immunoreactivity for calcitonin and CEA in a high percentage of cases.

Brain Neoplasms↗
PubMed1990

An unusual case of cystic lymphangiomatosis of the spleen.

Isolated lymphangiomatosis of the spleen is rare. When present, it is usually considered to be accompanied by splenomegaly. We describe a case of cystic lymphangiomatosis in a patient with a normal-sized spleen. While ultrasound, angiography and computed tomography are considered to complement each other in reaching a preoperative diagnosis of splenic lymphangiomatosis, in the present case, magnetic resonance imaging proved to be an additional helpful non-invasive diagnostic method.

Female↗
PubMed1990

The straight back syndrome.

Chest wall deformities may produce signs that closely mimic organic heart disease. In this category, the straight back syndrome is well recognized. Although clinical identification of this syndrome is thought sufficient to withdraw from any further investigation, its association with idiopathic mitral valve prolapse--a cardiac lesion with considerable morbidity and mortality--may be underestimated. The literature on straight back syndrome is reviewed and its association with mitral valve prolapse discussed.

Adult↗
PubMed1989

Cell surface antibodies in type 1 (insulin-dependent) diabetic patients. I. Presence of immunoglobulins M which bind to rat pituitary cells.

A standardized method has been developed for the assay of cell surface antibodies in IgM- and IgG-fractions from human serum. Suspensions of adult rat islet B cells, islet non-B cells, and anterior pituitary cells were used as antigen source and a cell sorter as analyser of the immunoglobulin binding to individual cells. Assay conditions were selected wherein no surface antibodies were detected in 33 control subjects younger than 20 years. In 30% of Type 1 (insulin-dependent) diabetic patients, surface antibodies were measured with rat anterior pituitary cells as well as with rat islet B cells. Binding to pituitary cells occurred with IgM- and IgG-fractions and correlated positively with IgG binding to islet B cells. At onset of the disease, the prevalence of IgM-rat anterior pituitary cell surface antibodies was higher than that of IgG-rat anterior pituitary cell surface antibodies. Cell surface antibodies were also detected in first-degree relatives of Type 1 diabetic patients, but corresponded primarily to IgM-rat anterior pituitary cell surface antibodies. It is concluded that the development of Type 1 diabetes in subjects younger than 20 years is associated with the generation of both IgM and IgG cell surface antibodies. The IgM surface antibodies may result from stimulated production of polyreactive natural autoantibodies and could precede the switch to the formation of monoreactive IgG autoantibodies. The assay of IgM cell surface antibodies can be useful in studies on the sequence of immune events in diabetes and other autoimmune disease.

Adolescent↗
PubMed1989

Cell surface antibodies in type 1 (insulin-dependent) diabetic patients. II. Presence of immunoglobulins M which bind to lymphocytes.

A standardized cell surface antibody assay was used to measure binding of circulating human immunoglobulins to rat or piglet splenocytes. In 100-fold diluted serum fractions, lymphocyte surface antibodies were detected in 30% of Type 1 (insulin-dependent) diabetic patients under 20 years of age but in none of 33 control subjects. Binding occurred with T and B lymphocytes, appeared unrelated to Fc receptors or protein glycosylation and was not attributable to insulin or albumin antibodies. At clinical onset of the disease, the lymphocyte surface antibodies belonged primarily to the IgM-class. Their presence was positively correlated to that of IgM-pituitary cell surface antibodies and their absorption by anterior pituitary cells occurred as well as by splenocytes. Lymphocyte surface antibodies remained present during the first years of insulin treatment. They were also detected in first degree relatives of lymphocyte surface antibody-positive patients. It is unlikely that IgM-lymphocyte surface antibodies mark the destructive process in the pancreatic B cell population. They may, instead, express a state of immune reactivity which precedes the formation of IgG-autoantibodies and therefore be associated with an event in the development of diseases such as Type 1 (insulin-dependent) diabetes.

Adolescent↗
PubMed1989

Pre- and peroperative diagnosis of metastatic pheochromocytoma in multiple endocrine neoplasia type 2a.

A 37-year-old woman with a multiple endocrine neoplasia type 2a underwent bilateral adrenalectomy and total thyroidectomy with parathyroidectomy in 1977. The left-sided pheochromocytoma was considered to be malignant. Seven yr after the initial operation, an enhanced urinary excretion-ratio of N-methyladrenaline/adrenalin suggested the possible presence of either persistent or metastatic pheochromocytoma Iodine-123-labeled metaiodobenzylguanidine scintigraphy (I-123 MIBG) showed a hot spot in the right lung. However, repeated chest-X-rays and computed tomographic scanning of the thorax remained negative. Anatomical localization of the lesion was finally obtained with magnetic resonance imaging. The surgical removal of the small pheochromocytoma was guided by the gamma-ray emission of I-123 MIBG administered iv before the operation. This case report illustrates the usefulness of new analytical methods and of new imaging techniques in the diagnosis and management of metastatic pheochromocytoma.

Adult↗
PubMed1989

Basal and tolbutamide-induced plasma somatostatin in healthy subjects and in patients with diabetes and impaired glucose tolerance.

Peripheral levels of basal and tolbutamide-induced somatostatin have been measured in patients with diabetes or impaired glucose tolerance (IGT) and compared with those in normal individuals. Basal somatostatin was significantly higher in patients with Type 1 diabetes than in age-matched control subjects. This increase was most pronounced at diagnosis, and appeared to be related to metabolic control in insulin-treated patients. No increase was noted in patients with Type 2 diabetes or with IGT. Intravenous bolus injection of tolbutamide enhanced peripheral somatostatin levels in healthy volunteers in a biphasic manner. Patients with IGT also exhibited a biphasic response but the amplitude of the first phase was higher. No secretory response was detected in 27/29 Type 1 diabetic patients at diagnosis; a somatostatin response to tolbutamide became detectable again in Type 1 patients with normalization of their basal somatostatin levels but was then paradoxically related to poor blood glucose control. In Type 2 diabetes, basal somatostatin levels were similar to age-matched control subjects, but decreased upon intravenous tolbutamide administration.

Adult↗
PubMed1988

Iodine-123 MIBG imaging in a generalized pancreatic polypeptide-gastrin-serotonin secreting tumor.

The usefulness of radio-metaiodobenzylguanidine (MIBG), a specific radiopharmaceutical agent for scintigraphic imaging and treatment of phaeochromocytoma and neuroblastoma, has been extended to the location of carcinoid tumors. Scintigraphic evaluation with I-123 MIBG in a patient with a histologically proven endocrine tumor (apudoma) of unknown origin with liver and bone metastases is reported. Elevated plasma hormone levels of gastrin, pancreatic polypeptide, and serotonin were found. Tumoral content of these hormones was immunocytochemically confirmed on liver biopsy. I-123 MIBG uptake could be seen in those areas of the liver with deficient lesions in the Tc-99m colloid image with a maximal uptake in a large mass at the level of the left liver lobe. No abnormal uptake could be observed at any other level, which was in contrast with autopsy findings of generalized metastatic disease.

3-Iodobenzylguanidine↗
PubMed1987

Granulomatous vasculitis as a complication of potassium iodide treatment for Sweet's syndrome.

A case of Sweet's syndrome treated with potassium iodide is hereby described. The patient responded well a few days after the initiation of therapy, but the evolution was complicated with a severe clinical deterioration two weeks later. Systemic vasculitis was diagnosed on the basis of significant impairment of renal function, involvement of the eyes (papillitis) and the skin biopsy which showed a leukocytoclastic vasculitis. This systemic vasculitis was attributed to the potassium iodide therapy.

Adult↗