Biomedical subjects
Publications and source records attributed to J Malmquist.
Treatment of the chemically dependent adolescent has recently evolved from the realization that youth also suffer from the primary, progressive, and chronic disease of compulsive addiction. Although based on models known to be effective with adults, treatment of the adolescent recognizes developmental needs and differences. A brief overview of the inpatient, residential, and outpatient approaches to treatment is provided.
Among 1134 patients, cineradiologically examined because of dysphagia, 85 (7.5%) had webs in the pharyngo-oesophageal segment. Webs were more common in women (10%) compared to men (5%). Radiologic characteristics of the webs such as precise location, multiplicity, circumferential extension, thickness, accompanying streamline phenomenon and encroachment on the lumen, were compared to the presence of concomitant anaemia, thyroid disease, neoplasm, as well as the age and sex of the patients. Webs were regularly deeper in women compared to men. Patients with iron deficiency anaemia had thicker webs compared to patients without such anaemia. No other radiologic characteristics were found that could be used for distinguishing these potentially more significant webs from those in patients without such concomitant diseases.
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Pancreatic B-cell function was studied as part of a health control examination by measuring fasting plasma C-peptide concentration in 433 44-55 year-old males with normal glucose tolerance. Fasting C-peptide levels were correlated with relative body weight (r = 0.48) and fasting blood glucose concentrations (r = 0.43), yielding a multiple correlation coefficient of 0.56, and the multiple regression equation: FCP (nmol/l) = -0.89 + 0.61 X RBW + 0.16 X FBG (mmol/l). (FCP = fasting plasma C-peptide, RBW = relative body weight, FBG = fasting blood glucose). In 26 subjects with impaired glucose tolerance, fasting plasma C-peptide levels were even more strongly correlated with relative body weight (r = 0.63) and fasting blood glucose concentrations (r = 0.47). Subjects older than 52 years had a significantly higher fasting C-peptide level than younger subjects (p less than 0.01). In the 26 subjects with impaired glucose tolerance, fasting plasma C-peptide levels were not significantly different from those in the 433 men with normal glucose tolerance. However, when compared to a group with normal glucose tolerance matched for relative body weight, the subjects with impaired glucose tolerance had an elevated fasting blood glucose level (p less than 0.01) without difference in C-peptide level, suggesting a reduced insulin sensitivity. It is concluded that, in order to evaluate B-cell secretory function by determining fasting plasma C-peptide concentration, the relative body weight and simultaneous blood glucose concentration should be taken into consideration.
The influence of insulin on collagen and total protein production was studied in cultured human skin fibroblasts from patients with Type 1 (insulin-dependent) diabetes and Type 2 (non-insulin-dependent) diabetes, and from non-diabetic subjects. Fibroblast cultures were exposed to various concentrations of insulin (0-10(5) mU/l) for 48 hours in serum-free medium containing tritium labelled proline. With medium glucose at 5.6 mmol/l, cells from diabetic subjects displayed an increase in collagen and protein radio-activities in the extracellular medium in the presence of insulin at 10(2) or 10(3) mU/l. Concentrations above 10(3) mU/l did not stimulate further. In cells from non-diabetic subjects, stimulated incorporation was evident only at insulin 10(3) mU/l. In the presence of high glucose concentration (38.9 mmol/l) in the medium, the lowest insulin level (10(2) mU/l) did not influence collagen production in any cell type, and the effects of insulin on total protein radioactivity was reduced in all cells. The enhancement by insulin of collagen secretion, and the higher sensitivity of cells from diabetics to this insulin action, is of interest in relation to the possible role of insulin in the accelerated atherosclerosis observed in diabetics.
High and low insulin responders, a total of 133 non-diabetic men, matched for age and body weight, were reinvestigated after an average period of 3 1/2 years by means of oral glucose tolerance tests, simultaneous insulin and C-peptide measurements and submaximal work tests. The number of individuals with impaired glucose tolerance did not increase during the observation period, and none became diabetic. Intergroup differences in glucose and insulin values were largely the same as in the initial screening procedure, although some regression towards the mean was observed. The high insulin group, compared with the low insulin group, had overall higher glucose, insulin and C-peptide levels, significantly higher increment 0-40 min of insulin but not C-peptide, and significantly lower maximal oxygen uptake. The present data indicate no difference in insulin secretory capacity but a decreased hepatic insulin extraction and a peripheral insulin insensitivity among the high insulin responders, related to a lower degree of physical fitness.
Isoproterenol-stimulated accumulation of adenosine 3',5'-monophosphate (cyclic AMP) in skin fibroblast cultures from type 2 diabetics was twice as high as in fibroblasts from control subjects.
Addition of heparin and dextran sulphate to human skin fibroblasts in cell cultures caused an increase in [3H]-proline incorporation into collagen and total protein in the culture medium by cells derived from nondiabetics. Cells from type 2 diabetic subjects were significantly less affected by dextran sulphate addition, suggesting altered regulatory mechanisms for collagen production in these cells. Addition of chondroitin sulphate caused a dose-dependent increase in labelled collagen, indicating a possible role for this glycosaminoglycan as modulator of collagen deposition.
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The relation between glucose homeostasis and insulin secretion (immunoreactive insulin and C-peptide) was studied in middle-aged males matched for age and body weight. Subjects with mild type II diabetes mellitus were compared to normals and to individuals with impaired glucose tolerance (IGT). In addition, the diabetics were subdivided according to duration, some of the subjects having recently deteriorated from IGT status. In the IGT individuals, there were no indications of a reduction in basal or glucose-induced insulin output. On the contrary, data indicate somewhat higher than normal secretion. Within the type II diabetics, those of short duration were largely similar to normals, whereas diabetes of longer duration was associated with some diminution in indices of B cell secretion. The data support the notion that a deficient insulin output is not a primary pathophysiological event in the development of type II diabetes.
The effects of low density lipoproteins (LDL) from non-smokers and heavy smokers on rabbit aortic smooth muscle cells and human skin fibroblasts in culture were studied. The addition of LDL in increasing concentrations resulted in a decrease in cell mass. When data correction for cell loss was made, collagen secretion and cell proliferation were found to have been increased by LDL. The two different cell types used did not differ in their response to LDL. The effect of LDL from smokers and non-smokers was the same. Thus there was no indication of growth stimulation by factors carried by LDL from smokers, i.e. lipid-soluble hydro-carbons--mutagens.
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The influence of the synthetic weak estrogen cyclofenil was studied in vitro on skin fibroblasts from scleroderma patients, normals, and human embryos. The drug had no effect on the synthesis of sulfated glycosaminoglycans or collagen. Collagen synthesis was lower in scleroderma fibroblasts than in normal cells, whereas there was no difference in sulfated glycosaminoglycans synthesis.
The report concerns a man with onset of diabetes in 1921 and treated with insulin since 1922. In 1981, at the age of 75, he is in excellent health, with no signs of significant diabetic organ injuries. Among other factors, this benign course may be due to retention, until now, of some endogenous insulin production.
Plasma immunoreactive insulin and peptide were measured in the basal and glucose-stimulated state in middle-age males. Normals were compared with individuals with mild to moderate glucose intolerance. Ths results demonstrate the value of C-peptide measurements in the assessment of "true" insulin secretion and suggest that a reduced hepatic insulin extraction is a feature of the glucose intolerant state.
The effect of standing and physical exercise and catecholamines and cyclic nucleotides in plasma was measured in 8 patients with essential hypertension under standardized conditions before and after prolonged treatment with clonidine. Before clonidine medication noradrenaline, adrenaline and cyclic AMP (cAMP) increased in response to standing and bicycling for 20 min. No significant correlation was found between their absolute levels nor was the increase in cAMP following exercise correlated to the increase in noradrenaline. Standing and physical exercise were without effect on cyclic GMP (cGMP). Clonidine reduced the plasma noradrenaline concentration in supine position and the noradrenaline and the adrenaline response to standing and exercise. Plasma cAMP was uneffected by clonidine under basal conditions but the response to exercise was slightly reduced initially. During clonidine there was a positive correlation between the plasma levels of cAMP and noradrenaline following work. Clonidine produced an increase in plasma cGMP in supine position, immediately prior to bicycling and after 5 min of exercise.
A young woman with a previous history of anorexia nervosa presented with severe finger clubbing. Urine samples intermittently contained significant amounts of aspartylglucosamine. Liver biopsy showed abnormal cytoplasmic inclusions in phagocytic cells. The patient was found to be abusing senna laxative.
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