Klinefelter's Syndrome: Hypogonadism,abnormal carbohydrate metabolism. Is it a result of biotin deficiency?

The aetiology of Klinefelter's Syndrome is not known. The causative factor(s) must explain the hypogonadism, low androgen levels, the disordered carbohydrate metabolism and the commonly associated psychiatric conditions. A biotin deficient/dependent state can account for the above. A biotin deficient Klinefelter's Syndrome patients with the above is described. The possible role of biotin in the primary, secondary and tertiary prevention of Klinefelter's Syndrome needs further research.     

肠外营养与生长激素联合应用对外科大手术术后患者蛋白代谢的影响

目的观察肠外营养与生长激素联合应用对大手术术后患者蛋白代谢的影响。方法将拟实施外科大手术(四类以上手术)熏APACHE-Ⅱ评分>7分的患者30例,入院后随机分为3组熏A组穴n=10雪押肠外营养治疗与生长激素穴金磊赛增雪联合治疗组(PN+GH)鸦B组穴n=10雪押肠外营养治疗组(PN)鸦C组穴n=10雪押正常补液组。其中A组在术后第2天开始给予生长激素皮下肌注,连续7d。结果术后8d内,B、C组患者均处于负氮平衡状态,血清白蛋白与胰岛素样生长因子-Ⅰ(IGF-Ⅰ)维持较低水平,A组在术后5d机体开始恢复氮平衡,血清白蛋白与IGF-Ⅰ水平逐渐上升,A组与B、C组比较差异有显著性(P<0.05)。结论较大的外科手术打击后,单纯给予常规的肠外营养要素不能被机体有效的利用,GH能够提高机体对肠外营养要素的利用率,促进机体蛋白合成。     

Effect of the antioxidant emoxypine on lipid metabolism in the lungs during development of pulmonary edema

Department of Pathophysiology, Yaroslavl' State Medical Institute. All-Union Research Center for Safety of Biologically Active Substances, Kupavna, Moscow Region. (Presented by Academician of the Academy of Medical Sciences of the USSR A. G. Chuchalin.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 113, No. 2, pp. 139–141, February, 1992.     

Spermidine/Spermine N-Acetyltransferase, a New Biochemical Marker for Epithelial Proliferation in Rat Bladder

We examined the activity of spermidine/spermine N ¹-acetyltransferase (SAT), a rate-limiting enzyme of the biodegradation of polyamines, in N -butyl- N -(4–hydroxybutyI)nitrosamine-induced transitional cell carcinoma (TCC) and melamine-induced papillomatosis of rat bladder, and compared the activity to that of ornithine decarboxylase (ODC). Both activities were higher in both lesions than in control rats. The difference between SAT and ODC activities in cancerous tissue and papillomatosis was not significant. Cells stained for proliferating cell nuclear antigen (PCNA) were abundant in papillomatosis. TCC had areas with much PCNA. The results indicated that an elevation of SAT activity occurs in both reversible and irreversible proliferation of bladder epithelium and could be important in bladder carcinogenesis.     

Surgical metabolism

Summary. Trauma, operative interventions, infection and other disturbances of homeostasis lead to a uniform reaction of the body, namely release and activation of hormones and cytokines. Profound alterations of substrate flow result, with mobilization of energy stores and degradation of structural and functional proteins of vital organs like the gut mucosa. Due to these reactions the energy demands of the organs are met and energy-consuming synthesis of substrates is indicated. Clinically, hypermetabolism, hyperglycemia, lipolysis and increased urea production with negative nitrogen balance can be observed. The metabolic reactivity is reached by an increased substrate cycling. To avoid negative consequences such as organ dysfunction, a rational situation-adapted substrate supply is warranted as well as reduction of catabolic stimuli and stimulation of anabolic factors. The metabolic care of the surgical patient is still a basic and important task.      

Acute actions of insulin-like growth factor II on glucose metabolism in adult rats

Summary The metabolic potency of recombinant human insulin-like growth factor II was studied in anaesthetized adult rats by obtaining dose-response curves for the hypoglycaemic action and for the stimulation of glucose metabolism during euglycaemic clamping. Compared to insulin, about 50 times higher doses of insulin-like growth factor II were required to result in identical in vivo responses, with half-maximally effective serum concentrations for the stimulation of glucose disposal during clamp studies of about 0.8 and 50 pmol/ml, respectively. A similar difference in potency was observed for the dose-dependent stimulatory actions on glucose metabolism in individual target tissues. Half-maximally effective serum concentrations in the range of 0.8 to 3.0 pmol/ml for insulin and of 40 to 70 pmol/ml for insulin-like growth factor II were seen to be required for 2-deoxyglucose uptake, glycogen formation in skeletal muscle and lipogenesis in epididymal fat. Maximal responses were identical with both peptides. These data suggest that in vivo acute metabolic actions of insulin-like growth factor II on carbohydrate metabolism occurred through insulin receptors.     

胃肠道肿瘤病人围手术期细胞因子及蛋白质代谢的变化

目的 :探讨胃肠道肿瘤病人手术后肿瘤坏死因子 α (TNF α)、白介素 6 (IL 6 )、白介素 10 (IL 10 )的变化以及与蛋白质代谢的关系。　方法 :用酶联免疫法 (ELISA)检测 19例胃肠道肿瘤根治术病人术前和术后 1、3、5天血清TNF α、IL 6和IL 10水平 ,同时检测蛋白质分解代谢相关指标、2 4h尿中尿素和肌酐排泄量。　结果 :胃肠道肿瘤根治术后病人TNF α呈下降趋势 ,术后第 1天较术前明显下降 (P <0 .0 5 )。IL 6和IL 10术后升高 (P <0 .0 1) ,尤以术后第 1天升高明显。术后 2 4h尿中尿素和肌酐排泄量明显升高。　结论 :胃肠道肿瘤根治术后病人IL 6和IL 10的升高支持手术应激导致的细胞因子释放变化 ,但TNF α呈下降趋势 ,可能与胃肠道肿瘤病人术前TNF α的高表达有关。术后蛋白质分解代谢增加 ,可能与细胞因子IL 6和IL 10的升高有关。     

The problem of rickets in UK Asians

A large body of work relating to the occurrence of rickets in UK Asians is reviewed. Several theories of the aetiology of this condition are shown to be untenable: it is not exclusively a function of sunlight deprivation or of darker pigmentation; nor is it simply due to phytate-induced losses of calcium from the gut. Asian rickets, however, is associated with a high consumption of cereals, and experiments with rats have suggested a mechanism. In the absence of adequate vitamin D from sunlight, the low-calcium, high cereal intake of the UK Asian population may induce a state of mild secondary hyperparathyroidism which enhances the destruction of vitamin D and leads to a progressive reduction in vitamin D status and, ultimately, to the development of clinical rickets.     

Natural history of parathyroid function and calcium metabolism after kidney transplantation: a single-centre study.

BACKGROUND: The natural history of parathyroid function after successful renal transplantation (RT) and the factors predisposing to persistent hyperparathyroidism (HPT) are not well established. A better knowledge of these data may be helpful in the development of algorithms for optimal surveillance and treatment of HPT after successful RT. Our aim was to evaluate the post-transplant natural history of parathyroid function and calcium metabolism in patients with a functional renal graft and to identify risk factors for persistent HPT. METHODS: Charts of 1165 allograft kidney recipients transplanted between 1989 and 2000 were reviewed. Patients with an intact parathyroid hormone (iPTH) level available at the time of transplantation were identified. The charts of the latter patients were checked for a variety of demographic and clinical data, and all determinations of the iPTH concentration available since transplantation were recorded. Serum levels of calcium, phosphorus, alkaline phosphatases and creatinine, concurrently determined, were also registered. RESULTS: After an initial fall, iPTH levels showed a slow but steady decline towards the upper normal limit. The prevalence of persistent HPT, defined as an iPTH level > or =2.5 times the upper normal limit or the need for parathyroidectomy following transplantation, remained stable at approximately 17% up to 4 years after transplantation. Patients with persistent HPT had significantly elevated serum levels of iPTH, calcium and phosphorus at the time of RT, and had spent a longer time on dialysis. Post-transplant iPTH levels correlated significantly with transplant kidney function. CONCLUSION: Kidney transplant recipients with a high iPTH and calcium x phosphate product at the time of transplantation are at risk for persistent HPT especially when renal function is suboptimal. Therapy for persistent HPT, if considered, should be initiated 3 months post-transplantation since further spontaneous improvement of parathyroid function thereafter is limited.