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Biomedical subjects

I M Burr

Publications and source records attributed to I M Burr.

At least 37 records · Page 2Linked to original sources
PubMed1984

Chemiluminescence as an index of drug-induced free radical production in pancreatic islets.

Chemiluminescence induced in isolated islets from rat pancreas by the diabetogenic drugs, alloxan and streptozotocin, has been measured. The assay system consisted of 3 microM of luminol, 10 islets, and 100 microM of alloxan or 500 microM of streptozotocin in 5 ml Krebs-Ringer bicarbonate buffer containing 16 mM of Hepes (pH 7.4). Alloxan-induced chemiluminescence appeared very rapidly and lasted more than 5 min. On the other hand, streptozotocin failed to produce chemiluminescence over a period of 60 min after addition. The presence of superoxide dismutase (1000 U/ml) and/or catalase (100 U/ml) markedly suppressed alloxan-induced chemiluminescence. These results suggest that alloxan acts as an exogenous free radical generator in pancreatic islets, but that streptozotocin does not. The involvement of superoxide anion and hydrogen peroxide in production of chemiluminescence by alloxan suggests that the hydroxyl radical may mediate this chemiluminescence.

Alloxan↗
PubMed1983

Modification of chemically induced diabetes in rats by vitamin E. Supplementation minimizes and depletion enhances development of diabetes.

Administration of the antioxidant vitamin E to rats, prior to administration of either streptozotocin or alloxan, provided protection against the diabetogenic effect of both these agents. This was demonstrated by their response to a glucose load, their pancreatic insulin content and light microscopy findings. In addition, rats whose antioxidant state was depleted, by being maintained on a vitamin E and selenium-deficient diet, demonstrated increased diabetogenic susceptibility to normally nondiabetogenic doses of streptozotocin. These findings provide indirect support for the suggestion that the chemical agents streptozotocin and alloxan may exert their diabetogenic effect by acting as oxidants or free radical producers.

Alloxan↗
PubMed1982

Reversal of debrancher deficiency myopathy by the use of high-protein nutrition.

A child with debrancher deficiency presented with myopathy, recurrent hypoglycemia, and growth failure. Evidence for enhanced gluconeogenesis was demonstrated by low postabsorptive gluconeogenic plasma amino acids, a marked fall in alanine during fasting, and a substantial rise in plasma glucose following protein ingestion. The patient was treated with high-protein nocturnal intragastric therapy, which resulted in marked improvement in exercise tolerance, muscle strength and mass, electromyographic findings, and growth.

Amino Acids↗
PubMed1982

Ovarian development in 46,XY gonadal dysgenesis.

In humans the XY ovary is degenerative, there being scant evidence of persistence of that organ beyond the perinatal period. Here we describe indications of functional ovarian tissue in a 17-year-old female with male karyotype, H-Y+ cellular phenotype, and some signs of the Turner syndrome. Her gonads were removed after the onset of secondary amenorrhea. Histological examination revealed a degenerative right ovary devoid of germ cells and follicles, and a left streak gonad. There was no trace of testicular development in either side.

Adolescent↗
PubMed1982

Cholesterol reduction by a high-glucose diet in a patient with homozygous familial hypercholesterolemia. A preliminary report.

Homozygous familial hypercholesterolemia is refractory to standard dietary or drug therapy. Recent studies, however, suggest that a high-carbohydrate/low-fat diet may reduce circulation cholesterol levels in normal or hyperlipidemic subjects. In this regard, we treated a nine year old boy with homozygous familial hypercholesterolemia with a liquid formula diet containing 82 to 90 percent of total calories as glucose. The diet was given as a constant nasogastric infusion or as intermittent daytime drinks followed by a nighttime infusion. Plasma total and low-density lipoprotein cholesterol fell from basal levels of 719 mg/dl and 676 mg/dl to 456 mg/dl and 434 mg/dl, respectively, after one week of therapy. After approximately 14 weeks of treatment, plasma total and low-density lipoprotein cholesterol levels were 311 mg/dl and 277 mg/dl, each representing approximately a 58 percent decrease from basal levels. The fall in circulating cholesterol levels was accompanied by a regression of xanthomatous skin lesions, a rise in plasma insulin levels and no change in plasma glucose or glucagon concentrations. No adverse effects of therapy occurred. We conclude that high-carbohydrate diets may be a safe and effective adjunct in the treatment of homozygous familial hypercholesterolemia.

Anticholesteremic Agents↗
PubMed1981

Dietary-dependent carnitine deficiency as a cause of nonketotic hypoglycemia in an infant.

Recurrent episodes of hypoglycemia, prostration, vomiting, and hepatomegaly were observed in an infant fed a carnitine-free soy formula. The extremely low plasma and urinary carnitine concentrations, elevated plasma free fatty acids, disproportionately low plasma beta hydroxybutyrate, and elevated urinary dicarboxylic acids, in the presence of a fatty liver, suggested that carnitine deficiency was the basis for this child's metabolic disturbance. When the infant was fed an enriched carnitine diet, remarkable clinical, biochemical, and histologic improvement was observed. The possibility that carnitine may be an essential nutrient for some infants is raised by the findings in this patient.

Carnitine↗
PubMed1981

Elevated cholesterol and bile acid synthesis in an adult patient with homozygous familial hypercholesterolemia. Reduction by a high glucose diet.

Elevated levels of cholesterol synthesis are reported for several young children with homozygous familial hypercholesterolemia (HFH) and are considered to contribute directly to their hypercholesterolemia. In contrast, increased cholesterol production has not previously been found in adult patients with HFH. Using the fecal steroid balance technique, we studied rates of cholesterol and bile acid synthesis in a 24-yr-old man who had severe hypercholesterolemia typical of HFH and who lacked skin fibroblast low density lipoprotein (LDL) receptor activity. On an average diet (45% carbohydrate, 40% fat, 15% protein) mean +/- SEM cholesterol (24.8 +/- 1.4 mg/kg per d) and bile acid (11.1 +/- 1.6 mg/kg per d) excretion were approximately threefold higher than normal. When an isocaloric high carbohydrate, low fat diet (90.5% glucose oligosaccharides, 1.3% safflower oil, 8.2% crystalline amino acids was substituted, mean cholesterol (13.0 +/- 0.5 mg/kg per d) and bile acid (8.6 +/- 0.4 mg/kg per d) fell markedly. The decline in fecal steroid excretion was accompanied by modest reductions in plasma total and LDL cholesterol concentrations and by a softening of cutaneous xanthomata. Although the patient phenotypically and biochemically resembled the HFH state, his family pedigree was not noteable for hypercholesterolemia. While the patient's father had premature cardiovascular disease, his mother had no evidence of heart disease, had normal plasma total and LDL cholesterol levels, and had normal fibroblast LDL receptor activity. Likewise, the plasma cholesterol levels of three other members of the patient's family were normal. Despite the unusual genotypic background of this individual, however, the fecal balance data shows that elevated cholesterol and bile acid synthesis may occur in adult, as well as juvenile, patients with HFH and may be responsive to dietary control.

Adult↗
PubMed1981

Chorea associated with the use of oral contraceptives: report of a case and review of the literature.

A 17-year-old black female developed Sydenham's chorea 8 weeks after inaugurating the daily use of an oral contraceptive. Two weeks after she stopped the oral contraceptive, her signs and symptoms of chorea disappeared. Other causes of chorea were eliminated by various lab tests and a 4-year follow-up on the patient. Phenytoin sodium and methadone are cited as two other medications that have been associated with drug-induced chorea. Some theories are presented about altered dopaminergic sensitivity by various drugs that could produce choreic movements. The literature of chorea associated with oral contraceptives is reviewed. The pediatrician is reminded to consider side effects of oral contraceptives when dealing with a sick teenager.

Adolescent↗
PubMed1981

Subcutaneous, isogeneic transplantation of duct-ligated pancreas in streptozotocin-diabetic mice. Relationships between carbohydrate tolerance and hormone content in transplant or host pancreas.

Mice with subcutaneous, isogeneic transplants of duct-ligated pancreas from either two or five donors displayed impaired glucose tolerance to gastric or intravenous glucose, or to an overnight fast followed by a 15-min meal of mouse food. Compared with peripheral insulin responses in normal controls, those of transplant recipients were less after gastric or intravenous glucose, but no different after the meal. Despite normalization of peak insulin levels in the peripheral circulation of isografted mice, glucose clearance was still impaired and this probably resulted, in part, from a relative insufficiency of insulin in the portal circulation. Results of glucose tolerance tests, after transplant recipients consumed a relatively small amount of food, suggested that near-normal glucose homeostasis may be present for these mice under normal feeding conditions. In mice that received incremental doses of streptozotocin, impaired glucose tolerance to a meal was observed if pancreatic insulin content fell below 26% of normal. We failed to show a similar relationship between glucose tolerance and pancreatic insulin content in transplant recipients since all showed impaired glucose tolerance. Despite the initial transplantation of different amounts of islet tissue, at termination insulin content (transplant plus endogenous pancreas) was essentially the same for all recipients, totaling 19-22% of that found in a normal mouse pancreas.

Animals↗
PubMed1980

Protection against streptozotocin-induced diabetes by superoxide dismutase.

Suerpoxide dismutase was administered intravenously to rats 50 min prior to intravenous administration of a diabetogenic dose of streptozotocin. A dose of 45 mg/kg streptozotocin alone produced marked glucose intolerance and a decrease in pancreatic insulin content to less than 10% of control; both of these effects were abolished by prior administration of 105 mu/g of superoxide dismutase. Superoxide dismutase (105 mu/g) administered 50 min before 65 mg/kg intravenous streptozotocin did not prevent the development of diabetes. The fall in pancreatic insulin content seen with streptozotocin alone was, however, partially reversed by superoxide dismutase.

Animals↗
PubMed1980

True hermaphroditism: a rational appraoch to diagnosis and treatment.

Eight previously unreported cases of true hermaphroditism are presented, and their basic characteristics are described and discussed with regard to diagnosis and management. Two basic groups are identified: those diagnosed prior to establishment of gender role and those diagnosed at a later date. The latter group should benefit from therapy designed to enhance and maintain their sex of rearing, while the former group should be reconstructed according to functional considerations first and fertility considerations second. Diagnostic criteria are evaluated, and the value of the exploratory laparotomy is stressed.

Adult↗
PubMed1980

Type I glycogen storage disease: five years of management with nocturnal intragastric feeding.

It has been five years since the original report indicating that intragastric feedings could reverse most of the clinical and metabolic abnormalities present in patients with type I glycogen storage disease. We have now treated seven patients with nocturnal intragastric feedings for five years. All patients have shown marked improvement in blood chemical values (urate, lactate, triglyceride, cholesterol) as well as linear growth. The only serious complication has been symptomatic hypoglycemia and acidosis resulting from acute gastroenteritis and vomiting. Results indicate that nocturnal intragastric feeding is a practical, safe, and effective form of long-term treatment for patients with type I glycogen storage disease.

Child, Preschool↗
PubMed1979

Nocturnal intragastric therapy in type I glycogen storage disease: effect on hormonal and amino acid metabolism.

The acute hormonal and amino acid responses to differing food substrates were examined in type 1 glycogen storage disease. Ingestion of a glucose load or a glucose-plus-beef meal caused an acute fall in the initially elevated plasma glucagon, alanine, proline, and lactate. Ingestion of beef alone caused a sharp rise in these parameters. Long term nocturnal intragastric therapy of a high carbohydrate and moderate amino acid content resulted in a similar fall in these parameters as well as a fall in the elevated plasma glutamate, uric acid, triglycerides, and RBC-reduced glutathione. A remarkable clinical improvement and growth spurt accompanied the improvement in these biochemical values. The possible relation between the disturbed plasma hormonal and amino acid findings and growth failure and hyperuricemia is discussed.

Adolescent↗
PubMed1979

Effects of calcium, lanthanum, and bicarbonate ion on epinephrine modification of insulin release in vitro.

The role of calcium flux in mediating epinephrine modification of insulin release was investigated by using lanthanum, an inhibitor of calcium flux, in the in vitro perifusion system. Lanthanum inhibits insulin secretion stimulated by glucose and by acetylcholine to basal levels. Epinephrine and lanthanum have additive effects in inhibiting insulin secretion to glucose stimulation. The effect of epinephrine prestimulation on insulin secretion to subsequent glucose challenge varies markedly, depending on the presence or absence of bicarbonate ion: epinephrine priming is reversed in the absence of bicarbonate, and effect possibly related to reduced calcium uptake. In the presence of bicarbonate, lanthanum blocks the priming effect of epinephrine on insulin secretion. The data further support the postulated role of calcium in adrenergic effects on beta cell function.

Animals↗
PubMed1978

ATP depletion, a possible role in the pathogenesis of hyperuricemia in glycogen storage disease type I.

Other investigators have shown that fructose infusion in normal man and rats acutely depletes hepatic ATP and P(i) and increases the rate of uric acid formation by the degradation of preformed nucleotides. We postulated that a similar mechanism of ATP depletion might be present in patients with glucose-6-phosphatase deficiency (GSD-I) as a result of ATP consumption during glycogenolysis and resulting excess glycolysis. The postulate was tested by measurement of: (a) hepatic content of ATP, glycogen, phosphorylated sugars, and phosphorylase activities before and after increasing glycolysis by glucagon infusion and (b) plasma urate levels and urate excretion before and after therapy designed to maintain blood glucose levels above 70 mg/dl and thus prevent excess glycogenolysis and glycolysis. Glucagon infusion in seven patients with GSD-I caused a decrease in hepatic ATP from 2.25 +/- 0.09 to 0.73 +/- 0.06 mumol/g liver (P <0.01), within 5 min, persisting in one patient to 20 min (1.3 mumol/g). Three patients with GSD other than GSD-I (controls), and 10 normal rats, showed no change in ATP levels after glucagon infusion. Glucagon caused an increase in hepatic phosphorylase activity from 163 +/- 21 to 311 +/- 17 mumol/min per g protein (P <0.01), and a decrease in glycogen content from 8.96 +/- 0.51 to 6.68 +/- 0.38% weight (P <0.01). Hepatic content of phosphorylated hexoses measured in two patients, showed the following mean increases in response to glucagon; glucose-6-phosphate (from 0.25 to 0.98 mumol/g liver), fructose-6-phosphate (from 0.17 to 0.45 mumol/g liver), and fructose-1,6-diphosphate (from 0.09 to 1.28 mumol/g) within 5 min. These changes, except for glucose-6-phosphate, returned toward preinfusion levels within 20 min. Treatment consisted of continuous intragastric feedings of a high glucose dietary mixture. Such treatment increased blood glucose from a mean level of 62 (range 28-96) to 86 (range 71-143) mg/dl (P <0.02), decreased plasma glucagon from a mean of 190 (range 171-208) to 56 (range 30-70) pg/ml (P <0.01), but caused no significant change in insulin levels. Urate output measured in three patients showed an initial increase, coinciding with a decrease in plasma lactate and triglyceride levels, then decreased to normal within 3 days after treatment. Normalization of urate excretion was associated with normalization of serum uric acid. We suggest that the maintenance of blood glucose levels above 70 mg/dl is effective in reducing serum urate levels and that transient and recurrent depletion of hepatic ATP due to glycogenolysis is contributory in the genesis of hyperuricemia in untreated patients with GSD-I.

Adenosine Triphosphate↗