Gerald J.M. Tevaarwerk

Placental weight in diabetic pregnancies

The placenta from 30 women with diabetes mellitus were examined and weighed at delivery. Nineteen of these were from women with overt and eleven from women with gestational diabetes. Eleven placentae from normal pregnancies served as controls. There was no difference between the mean +/- s.d. placental weight for the diabetic group and the control group (609 +/- 148 versus 591 +/- 93 g, NS). The mean placental weight ratios for the diabetic group and the control group were also similar (0.98 +/- 0.23 versus 0.89 +/- 0.15, NS). Moreover, there was no difference between the weights and weight ratios of placentae from women with overt (622 +/- 173 g, 1.02 +/- 0.27) and those with gestational diabetes (586 +/- 90 g, versus 0.90 +/- 0.13). Placental weights correlated with birthweights (r = 0.70, P less than 0.01) and with skinfold thickness measurements fo the infants (r = 0.40, P less than 0.05), but neither with gestational ages (r = 0.15, NS) nor with maternal glycosylated haemoglobin levels in the third trimester (r = 0.24, NS). Among the women with overt diabetes, placental weights were greater in those in Whites class B and C than those in class D and R (689 +/- 143 versus 530 +/- 177 g; P less than 0.05). In general, placentae from well controlled diabetic patients were not heavier than those from normal pregnant women, although there was an increase in placental weight in Whites class B and C, as compared with those in class D and R.

Insulin binding to myotonic dystrophy fibroblasts.

Insulin receptor binding was examined in cultured skin fibroblasts from 10 myotonic dystrophy patients and 10 age- and sex-matched control subjects. The conditions for insulin binding to fibroblasts were optimal and employed HEPES binding buffer, pH 8.0 at 15 degrees C for 5 h. These conditions correspond to those previously employed with monocytes from MyD subjects. The normalized initial insulin binding capacity showed a decrease of 62% from 5.04 +/- 0.28% of the total labeled insulin added/mg protein in the control to 1.93 +/- 0.13% in the myotonic dystrophy group (P less than 0.01) due mainly to a marked reduction in high affinity receptors or in receptor affinity. The addition of 1.0 ng/ml of unlabeled insulin produced significant decreases to 3.80 +/- 0.25% in the control group and 1.24 +/- 0.09% in the MyD group. The results are similar to previously reported findings with monocytes from myotonic dystrophy patients and suggest that a surface membrane defect exists in this disease. However, the conditions that have been employed in the binding procedures in all of the studies, while optimal, are performed at a high pH and low temperature and could have an important bearing on the interpretation of a membrane disorder.

Evaluation of an affinity chromatographic procedure for the determination of glycosylated hemoglobin (HbA1)

An affinity chromatographic method for the determination of glycosylated hemoglobin (HbA1) was evaluated. The procedure was shown to be precise, the within- and between-assay coefficients of variation being less than 5%. It was also shown to correlate well with electrophoresis (r = 0.968) and ion-exchange chromatography (r = 0.916). An inverse relationship was shown to exist between increasing temperature and HbA1 levels measured by affinity chromatography. A statistically significant difference was found for samples run at 20 degrees C and 25 degrees C respectively, suggesting that the method should be run in a temperature-controlled environment. The affinity procedure was also shown not to be affected by the type of anticoagulant, the concentration of hemoglobin in the hemolysate, and acetylation.

Glucose transport and oxidation in adipose tissue of patients with myotonic dystrophy

The effect of insulin on the transport of 2-deoxyglucose and the oxidation of glucose in chopped adipose tissue was investigated in 14 myotonic dystrophy (MyD) patients and 28 age and size-matched control subjects. The transport of 0.55 mM 2-deoxyglucose was measured over 3 min at 37 degrees C both with and without 32 ng/ml of insulin. Oxidation was determined at 37 degrees C for 90 min by the measurement of 14CO2 released from a system containing 0.55 mM glucose with and without 50 ng/ml of insulin. Basal 2-deoxyglucose transport was not reduced in MyD subjects but insulin-stimulated 2-deoxyglucose transport in MyD was significantly less at 0.512 +/- 0.220 nmole compared to control subjects with 0.906 +/- 0.160 nmole/100 mg tissue/3 min (P less than 0.02). Both the basal and insulin-stimulated glucose oxidation were significantly less in the MyD group. Insulin-stimulated oxidation was 2.92 +/- 0.21 nmole in the control subjects compared to 2.20 +/- 0.27 nmole/100 mg tissue/90 min in the MyD cases (P less than 0.02). Similar findings were obtained when calculations were based on nmoles of 2-deoxyglucose transport and glucose oxidation/100 mg lipid. The findings indicate that both glucose transport and oxidation are impaired in MyD.

Canada’s e-health software mess: simple solution

The manner in which electronic medical record (EMR) applications are being introduced in Canada is totally reminiscent of the drug industry: push for sales at all costs and without regard for unintended consequences and cost.[1][1] Unfortunately, we are hoodwinked into believing that the

Electronic medical records

A recent editorial by Ken Flegel repeats the purported advantages of keeping electronic medical records.[1][1] The results of the electronic conversion of paper records in other industries suggest that such a conversion in medicine will be a boon to patients, payers and providers. Surprisingly,

Recruiting foreign-trained professionals

Truly democratic countries recognize the right of their citizens to seek their fortune wherever they wish. However, in most instances, health care professionals are educated at great expense to their country of origin. One way of minimizing the negative effect of brain drain would be to require

Longitudinal Doppler Ultrasound Assessment of Fetal Circulation in Diabetic Pregnancies in Relation to Maternal Glycemic Control

In order to determine the influence of maternal glycemic control on the fetal circulation, Doppler flow velocity waveforms (DFVWs) were obtained at 30, 33, and 36–40 weeks in 17 women with overt diabetes, 20 with gestational diabetes (GDM), and 14 low-risk pregnant women. DFVWs were obtained from the umbilical artery (UA), internal carotid artery (ICA), ascending aorta, and main pulmonary artery. The ICA resistance index was lower in GDM than controls (P = 0.014). As a result, the cerebral-umbilical Doppler ratio (ICA resistance index/UA resistance index) was lower in GDM than controls (P = 0.031). There was a significant correlation between either the mean daily glycemia (r = 0.54, P < 0.01) or the mean daily M-value, an index of glucose excursion and mean glycemia (r = 0.61, P< 0.001), and the cerebral-umbilical Doppler ratio. As the maternal glycemic control became tighter, the fetal cerebral-umbilical Doppler ratio decreased to values similar to the “brain-sparing” effect described in growth-retarded ...

Radioactive Selenium Labeling of Rat Insulin in Vivo

The clinical symptomatology of j8-cell adenomas of the pancreas is due to uncontrolled production of insulin and the resultant hypoglycemia.Removal of these otherwise usually benign adenomas results in complete cure. But there is difficulty in proving the diagnosis and localization of these tumors which are often less than one centimeter in diameter. This report deals with some preliminary studies which, it is hoped, will eventually lead to an accurate method of localizing, and thereby facilitate surgical removal, of insulinomas. It was proposed to employ a radioactive substance that would be concentrated in an insulinoma to a greater degree than elsewhere in the body. Floyd and his associates extracted the insulin from insulinomas and found that the concentration in the neoplastic tissue was several times that found in normal islet cell tissue. Recently, Taylor et al. showed that the insulin extracted from a /3-cell adenoma was identical to that of normal islet cell tissue. Because of the high concentration of insulin in the adenomas a substance was searched for which would be incorporated into the insulin molecule. A survey of the literature revealed the sulfur content of insulin to be 3.4 per cent while it is only 0.5 to 2 per cent for other animal proteins. The sulfur is part of the amino acid cystine of the insulin molecule. Hansson used cystine labeled with radioactive sulfur (cystine-S 35) to study the formation of pancreatic juice proteins. Using the radioautography technic of Leblond he noted that in the first few hours after intravenous injection into rats the radioactivity was highest in the exocrine tissue, but twenty-four hours after injection it was higher in the islands of Langerhans. However, as S 35 is a beta-emitter it cannot be used for external body scanning and, for that reason, in this study selenocystine labeled with radioactive selenium (selenocystine-Se 75) was used, it being a gamma-emitter. The selenocystine-Se 75 was injected into the tail veins of rats which were slaughtered twenty-four hours later. The pancreata were excised, the insulin was extracted, purified and identified, and its radioactivity determined. The results of the present study are qualitative only.