Glucagon,insulin, and glucose responses to physiologic testing in normal and massively obese adults

Ten normal adults and ten nondiabetic massively obese subjects were studied following 4–7 days on identical diets. Intravenous arginine challenge resulted in similar glucose and glucagon responses and threefold greater integrated insulin responses in the obese when compared to the normal subjects. Following oral glucose, glucagon responses were similar, whereas both basal and integrated insulin values were higher in the obese subjects. Basal and integrated insulin concentrations were greater during intravenous glucose testing in the obese subjects, whereas similar glucagon suppression was observed in both groups. Hourly blood samples obtained during a 24-hr period revealed that the obese glucose profile differed significantly from the normals. Insulin values were two- to four-fold higher in the obese subjects, whereas no significant difference was observed in the glucagon concentrations. The nadir and peak glucagon concentrations for both groups occurred at 8:00 a.m. and 8:00 p.m., respectively, and were positively correlated with plasma amino acid values, and were similar in both groups.     

Oesophageal manometric studies in patients with chronic Chagas disease and megacolon

Intraluminal manometric studies performed on 12 patients with chronic Chagas disease and megacolon without clinical or radiological abnormalities of the oesophagus showed no alteration in oesophageal physiology under basal conditions when compared with a control group of 30 healthy subjects. Oesophageal peristalsis was unimpaired.Patients with chronic Chagas disease and megacolon differed from normals in their reaction to a small dose of a cholinergic drug. This agent induced an isolated but significant increase in resting pressure at the level of the oesophagogastric sphincter, accompanied in most cases by an increase in spontaneous activity but not by a change in resting pressure in the body of the oesophagus. This is interpreted as a subclinical expression of oesophageal pathology related to Chagas disease.     

Endoscopic harvesting of the radial artery as a coronary artery bypass graft

With an endoscopic approach we harvested the radial artery as a coronary artery bypass graft, using two transverse 2-cm incisions in the forearm. There were no complications in the forearm and hand. The short-term results of the radial artery graft were good.     

Reproducibility over Time of Mephenytoin and Debrisoquine Hydroxylation Phenotypes

Mephenytoin and debrisoquine hydroxylation phenotypes were determined twice in 15 Spanish healthy volunteers with an interval of about one year. The phenotype assignment did not change in any subject for either debrisoquine or mephenytoin. Among extensive metabolisers of mephenytoin, there was a slight increase (P = 0.04) of the mephenytoin-S/R enantiomeric ratio over the study period. The family members of a poor metaboliser of mephenytoin were phenotyped, and the heterozygous extensive metabolisers were found to have higher mephenytoin-S/R ratios than other extensive metabolisers suggesting a correlation between the genotype and the S/R ratio.     

Evaluation of the different methods used in the treatment of rhinoplastic sequelae

Reports on rhinoplastic sequelae are infrequent. Reported incidence rates vary from 5% to 12%. The authors have an overall rate of 8%, with 6.5% of cases involving slight sequelae and 1.5% moderate ones. Various techniques for correction are used, depending on the sequel. Silastic implants have been unsatisfactory over the long term, so generally autogenous implants are used.