Acta endocrinologica. Supplementum最新文献

Somatostatin is present in the gastrointestinal tract in appreciable amounts. The highest concentrations of the polypeptide are found in the stomach, the upper small intestine, and the pancreas. Within the gastrointestinal tract, somatostatin inhibits various functions, including endocrine and exocrine secretion, motility, blood flow, absorption, and growth. The polypeptide regulates these functions by endocrine, paracrine, neurocrine or luminal mechanisms. Abnormalities of endogenous somatostatin have been implicated in several gastrointestinal disorders, including the somatostatinoma syndrome, antroduodenal D-cell hyperplasia, peptic ulcer, obesity, and liver cirrhosis. Because of its potent inhibitory effects, somatostatin or somatostatin-analogues have been used as therapeutic agents in various clinical conditions, such as upper gastrointestinal haemorrhage, endocrine pancreatic tumours, gastrointestinal and pancreatic fistulas, pancreatitis, secretory diarrhoea, and dumping syndrome. The recent availability of the synthetic long-acting somatostatin-analogue SMS 201-995 (Sandostatin) has greatly facilitated the therapeutical application of somatostatin-polypeptides.

Primary cell cultures of normal and adenomatous human thyroid tissues were incubated with TSH or ammonium sulphate precipited IGG fractions (1 mg/ml) of sera from patients with different thyroid diseases (Graves' disease: active n = 7 in remission n = 12; thyroid autonomy n = 39; simple euthyroid goitre n = 15) and were compared to controls (n = 26). [3H]thymidine incorporation in primary thyrocyte cultures demonstrated a typical bell shape curve after incubation with EGF and TSH with a maximal effect at 10-100 microIU/ml. This effect, however, was inconsistent and positive only in 2 of 7 primary cultures. Only TSH positive cultures were used for IgG studies. 16-28% of IGG fractions from sera of thyroid patients caused high (more than X + 5 SD of controls) stimulation of [3H]thymidine incorporation. Dose response curves of IgG fractions of 19 additional patients (Graves' disease in remission n = 15; thyroid autonomy n = 4) showed an increase in [3H]thymidine incorporation at 0.1 mg protein/ml for 10 patients and at low concentrations of 10-5 mg/ml for 5 patients. There was a good correlation (r = 0.72) (P less than 0.0001) between positive findings in TSH-binding inhibition (TBII) and AC-stimulation (TSI) IGG fractions but none between stimulation of [3H]thymidine incorporation and any other thyroid specific immunoglobulin nor thyroid function nor any other available data. Immunoglobulins stimulating [3H]thymidine incorporation differ therefore from TBII and TSI. The growth effect of these immunoglobulins, however, has yet to be determined.

A fast and precise method for routine, large scale measurements of HbA1, with elimination of pre-Alc, was established. Near normal blood glucose levels were obtained during treatment with CSII and MI; significantly better than during conventional treatment with two daily injections of mixed regular/intermediate insulin. On most parameters of glycemic control, CSII was slightly better than MI (n.s.). The frequency of hypoglycemic coma was significantly reduced, but blood glucose values below 2.5 mmol/l were more frequent on CSII, compared to conventional treatment. The frequency on MI was similar to that of conventional treatment. CSII patients have an increased risk of developing ketoacidosis by accidental cessation of insulin infusion, and of developing cutaneous infections at the infusion site. Insulin antibodies increased during one year of CSII and MI, when compared to conventional treatment. Rapid tightening of blood glucose control may lead to transient deterioration of retinopathy, mainly by the occurrence of cotton wool spots. Patients who already have background retinopathy are at higher risk for such changes. A significant increase in the number of microaneurysms and haemorrhages was observed on conventional treatment whilst no significant change was found on CSII and MI. Less progression of retinopathy (elevated by fluorescein angiograms) was observed on CSII and MI (n.s.) when compared to conventional treatment. Thus long term near-normoglycemia may retard the progression of early retinopathy. Urinary albumin excretion was reduced during CSII and MI (n.s.), but no change was observed during conventional treatment. Glomerular hyperfiltration improved during intensified treatment. Motor nerve conduction velocity deteriorated on conventional treatment, but improved during CSII. No change occurred on MI.