The role of oxygen supply in islet transplantation.
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Biomedical subjects
Publications and source records attributed to L Gerö.
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Authors analyzed the case history of 25 young diabetic patients, whose disease has been diagnosed before the age of thirty. The question that has been raised: is it allowed to treat young diabetics with oral drugs? By classifying the patients, they stated followings: In the 1. group they classified 16 verified MODY/NIDDY patients. In the second group they classified 3 young diabetics, whose disease had been evaluated as slowly progressing IDDM (autoimmune form). 3 patients belonged to the 3 group. They had been classified as MODY/NIDDY patients, however an extremely long lasting remission period--due to the short observation time--can not be excluded. The remaining 3 diabetic patients belonged to the IDDM group, with a long remission period. They were treated incorrectly with oral hypoglycemic drugs. Young diabetics can be treated with oral drugs only in case, when they are proven MODY/NIDDY patients. The precise differential diagnosis between this form and autoimmune IDDM, as well as long lasting remission periode, is extremely important.
The authors deal with the clinical picture of total remission in diabetes, among young patients (below 30 years). In their interpretation "complete remission" means total withdrawal of insulin treatment for at least 2 months. Out of 14 patients with complete remission, the classified 7 patients--by clinical and immunogenetical parameters--as noninsulin-dependent diabetes in the young (MODY-NIDDY). 1 diabetic patient belongs to the autoimmune-subgroup of IDDM. The remaining 6 patients could be classified as IDDM-s. However their clinical and immunogenetical parameters were rather atypical. In conclusion they raised the possibility that this subgroup is heterogenous with in IDDM.
Diabetes diagnosed in the so-called middle age of life is debated from the typological point of view. The authors investigated 45 diabetics, whose disease had been diagnosed between the age of 30-45 years. As a result of their observations they state that diabetes in this age range is heterogenous. Patients can be classified into insulin-dependent and non-insulin-dependent types of diabetes. Two of their patients could be classified into a newly described subtype (early onset diabetes, EOD). For the time being it seems that the exact delineation of this new diabetic subtype needs more detailed observations.
The authors treated 14 insulin-allergic diabetic patients in 1985-87. Previous short-term therapy with conventional insulins could be verified in 12 cases. The "presensitizing" effect of this transient treatment seems highly probable. Five of the 14 patients were allergic to all animal insulins incl. monospecies porcine monocomponent (MC) preparations. Surprisingly, all these patients proved to be allergic to biosynthetic human insulin (Huminsulin Normal and Huminsulin Basal) preparations too, but two of them could be treated with semisynthetic human insulins (Actrapid HM and Monotard HM). Another patient was able to receive Monotard HM exclusively. The remaining two patients proved to be allergic to all human insulins used. One of them was desensitized but the insulin therapy had to be supplemented with steroid drugs for two years. The fifth patient continued the oral treatment but her metabolism is poorly controlled. These results show that some diabetics with allergy to animal insulins are allergic to human insulins as well. As a prevention, transient therapy with conventional preparations should be avoided. If, however, there is an absolute indication for it (e.g. gestational diabetes or surgical intervention), it should be carried out with human insulin, or, if that is not available, with monospecies porcine MC insulin.
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Highly purified nuclear and cytoplasmic RNAs were obtained from Tetrahymena thermophila BVII containing only a minimal amount of cross-contamination. In the nuclear RNA fraction we have detected at least 6 distinct snRNAs. Some of the RNA species showed microheterogeneity. SnRNAs of Tetrahymena thermophila are very similar to rat snRNAs, as far as length is concerned. Our cytoplasmic small RNA fraction contained two RNAs, 7S and T7, reported recently as nuclear, particularly nucleolar RNAs. Moreover, we could detect only one cytoplasmic small RNA species Tc1, Tc2 was not observed. Neither the nuclear nor the cytoplasmic small RNA species are degradation products of ribosomal RNA as was shown by Northern blotting and following hybridization with pGY17 containing the entire transcribed region of the ribosomal DNA of Tetrahymena thermophila.
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The effect of glucose and Domperidon (R 33812, pharmaceutical factory Gedeon Richter, Budapest) on the insulin secretion were investigated in the isolated islets of Langerhans of rats. The insulin secretion was increased by glucose and also by Domperidon, however, in a smaller size. The insulin secretion of cryopreserved islets--stored in liquid nitrogen of -196 degrees C during 2-6 months--was equal with the secretion of fresh isolated islets. Thus the cryopreservation had not impaired the insulin secretion ability of the islets.
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Growth hormone (hGH) reserve following arginine administration and the paradoxical hGH response to thyrotropin-releasing hormone (TRH) were studied in 30 diabetics without evidence of vascular complications. The diabetics were divided into 4 groups according to the type of their disease and to the metabolic condition within the IDDM group (insulin-dependent: IDDM, in acceptable response and in poor metabolic control; non-insulin-dependent: NIDDM, and juvenile diabetics not requiring insulin at least for two years after diagnosing their disease: NIDDY). The results were compared with controls of identical age and normal weight. A paradoxical hGH response to TRH stimulation was found only in IDDM patients in poor metabolic control. In this group the hGH reserve revealed by arginine was significantly larger than in the others. It was shown that the induced hGH release was independent of the sex distribution of the groups and of the basal hGH values. Magnitude of the hGH reserve and appearance of the paradoxical hGH response were not necessarily correlated but the substantial reserve was frequently associated with a paradoxical response. It can be assumed that the unfavorable metabolic condition is of decisive importance in giving rise to these anomalies. Our observations seem to confirm the need for good metabolic control if the pathological hGH secretion in diabetics is to be prevented.