Serum-to-saliva transfer of the immunoreactive insulin (IRI) in children with obesity associated with insulin-resistance.

Assuming that the serum-to-saliva transfer of insulin reflects internalization and re-cycling of the hormone in the membrane-located binding sites of salivary epithelial cells and that these cells have in obesity a'marked decrease in insulin receptor content, it has been postulated that insulin resistance in infantile obesity can be detected by the changes in the salivary immunoreactive insulin during the oral glucose tolerance test (OGTT). The study included 31 obese children and adolescents of both sexes, subjected to OGTT. Samples of blood and saliva were collected at 30, 60, 120, 180 and 240 minutes for determinations of glucose and IRI. The blood glucose values were generally normal whereas IRI was excessively high. The dynamics of salivary IRI was similar (easy peak followed by slow descent) with the mean serum values but lower by about two-thirds, and the peak was 30-60 minutes delayed. The serum IRI values correlated significantly with the saliva ones at all time-intervals except for the 30-minute ones. The serum IRI values were significantly lower at the 30-minute time interval, whereas the salivary IRI were the lowest (and of borderline significance) at the 60-min. time interval. The mean glucose/kg doses given orally were not significantly different in the two groups. It was concluded that a hormonal activity detectable by IRI assay through the PEG separation method does exist, with a concomitant variation of serum-to-saliva transfer as shown by the OGTT test. It was also concluded that since the salivary values are lower, the direction of the flow is from serum to saliva and not the reverse. Finally, on the basis of our data, an "in situ" synthesis of insulin (hormonogenic exocrinism) can not be ruled out.

Peptide hormones in saliva. I. Insulin in saliva during the oral glucose tolerance test in female patients.

The radioimmunoassay (RIA) of insulin was performed in the serum and saliva of 27 female patients during the oral glucose tolerance test (OGTT). The patients were divided into two groups: 19 non-diabetic patients and 8 patients diagnosed as impaired glucose tolerance (IGT) disease. In one patient in each group, the OGTT was performed twice at intervals of 3-5 days. The results show that immunoreactive insulin (IRI) is present in saliva and its concentration increases during the glucose stimulation test from 6.48 +/- 1.13 microU/ml (means +/- SEM) in basal conditions at peak values of 45.46 +/- 10.14 microU/ml at 2 hrs after glucose intake. In patients with IGT salivary IRI increases from 5.18 +/- 1.39 microU/ml in basal conditions to peak values of 83.34 +/- 25.85 microU/ml at 3 hrs after glucose administration. Great response variations were observed either inter-individual or intraindividual in both groups of patients. Some patients had unusual high salivary IRI concentration especially in those with gastrointestinal troubles. Further, some hypotheses and experimental models, are advanced, considered useful for the explanation of the physiologic significance of the salivary IRI or of the IRI-like material.

Plasma renin activity (PRA) and plasma aldosterone in the adrenal cortex hyperactivity. Studies on 50 hypertensive patients.

The authors have studied on 50 patients hospitalized in the Adrenal Pathology unit of the Institute of Endocrinology, the etiopathogeny of arterial hypertension (AH) in hypercorticism and the therapeutic implications, arriving at the conclusion that in 20% of the cases AH was probably due to an increased activity of renin-angiotensin and in 47% to elevated levels of aldosterone. The authors hypothesize that AH in the remaining 30% of the hypercorticism cases in this study is due to other mineralocorticoids in excess and suggest that the treatment should be pathogenic and strictly individualized.

Studies of the reproduction function in hyper- and hypoadrenocorticism.

The investigation was carried out on 66 patients with hypo- or hyperfunctional syndromes of adrenocorticism, hospitalized and treated by our team. The patients were grouped into 5 lots according to their diseases. Lot one consisted of 34 female patients with Cushing's syndrome, lot two of 10 males with Cushing's syndrome, lot three of 10 males with Addison's disease and lot four, of 6 females with androgenic hypercorticism. The morphofunctional disorders of reproduction were followed up clinically and by complex hormone assays, before and after treatment. The incidence of these disorders is very high, and the results of clinical observations and of laboratory data demonstrate that both the excess of adrenocortical hormones and the decrease in their circulating level have a negative influence on the reproduction function or represent a risk factor in cases of pregnancy. By the curative treatment of the adrenal cortex a preventive treatment of abortion and/or sterility is achieved.

The role of the renin-angiotensin system in arterial hypertension in hypercorticism.

The authors have studied on 25 cases of hypercorticism, one of the mechanisms of producing arterial hypertension, the renin-angiotensin system. The study showed that in only 20% of the cases plasma renin activity was high whereas in the remaining 80% other mechanisms were responsible for the hypertension. In the cases in which the plasma activity of renin was high, by studying the changes in the value of electrolytes we were able to derive some understanding of the mechanism of action of the RA2A system. Thus, the literature data show that sometimes the excess of glucocorticoids causes hypertension by activating directly the RA2A system and concomitently inhibiting the renin-kalikrein system (RKKS) and PgS; at other times, the excess of glucocorticoids is exerted on the same renin-angiotensin system, but via ACTH and ADH, the electrolytes values being those that demonstrate the borrowed mechanism.

Studies concerning the effects of a pineal peptide extract on collagen metabolism.

The effects of Crinofizin (Cfz), cortisone, triiodothyronine (T3) and methylthiouracil (MTU), alone or in association with one another, on collagen metabolism of impuberal and adult rabbits were tested. These effects were assessed by the hydroxyprolinuria (Hyp) assay corroborated with observations regarding mortality, body weight, diuresis and excretion of nitrogenous substances. Cfz given alone stimulated weight gain and did not alter characteristically the Hyp. Cortisone and T3 given in various doses and ways without Cfz induced general phenomena of the antianabolic or catabolic type, affecting characteristically the Hyp, which was low after administration of cortisone and increased after T3; association of Cfz to both cortisone and T3 had general protecting and corrective effects and brought Hyp towards or at normal values. Chronic administration of MTU with or without Cfz did not have significant effects. The corrective value of Cfz by anabolic and anti-catabolic actions on collagen metabolism disturbed by cortisone or T3 in excess is discussed.

The dyslipemic syndrome in acromegaly.

The clinico-hormonal course of acromegaly and the presence of the hyperlipemic syndrome were studied in relation to age, sex, associated hypothyroidism, diabetes, obesity and cardiovascular and atherosclerotic complications in 43 acromegalic patients (18 males and 25 females) of which 6 had received no treatment and 37 had been submitted 2 - 13 years to conventional roentgentherapy (31 cases), 90Y (5 cases) and hypophysectomy (1 case). Hyperlipemia (HLP), present in 24 acromegalic patients (55.8% of the cases) unrelated to age, was more frequent in women (64% as against 44% in males) and correlated with the clinico-hormonal evolution (GH greater than 20 mg) (60% of the cases), and associated hypothyroidism (79%), obesity (42%) and diabetes (25%). Of the hyperlipemic acromegalic patients, 62% had cardiovascular and atherosclerotic complications. The results of the study point to the need for a hypoglucidic, hypolipidic and associated treatment for hypothyroidism, diabetes and obesity in the prophylaxis of acromegalic atherosclerosis.

Hypercorticism--a risk factor in arterial hypertension and atherosclerosis.

The present work has attempted an analysis of the role hypercorticism as a risk factor in arterial hypertension and atherosclerosis. Our series consisted of 149 male and female patients of various ages. The incidence of cardiovascular disorders in relation to age and the glucidic lipidic metabolic disorders were also investigated. The results showed that hypercorticism may trigger in very young patients as well arterial hypertension (AH) and glucidic-lipid metabolic disorders both incriminated as risk factors in including atherosclerosis. Hypercorticism was proved to be an aggravating factor of pre-existing cardiopathy. Efficient management of adrenocortical hormones excess brings complete resolution of arterial hypertension and glucidic lipid metabolic disorders in young patients and most adult patients who had no cardiovascular complaints prior to the endocrine syndrome.

The antagonism between pineal peptides and catecholamines. I. The action of the pineal peptide extract on some effects of exogenous adrenaline in the rat.

The effects of adrenaline alone or associated with Crinofizin, a pineal polypeptide extract, were studied on rats. The drug given 15 minutes before a hyperglycemic adrenaline dose counteracted the pharmacologic effects with lethal consequences of catecholamine as well as certain metabolic effects such as elevation of blood levels of glycerol, phospholipids and cholesterol. Post-adrenaline hyperglycemia was not reduced by Crinofizin under the given experimental circumstances. The glycogenolytic effect of adrenaline was slightly inhibited.

The effect of combined administration of L-proline and glycine on GH and IRI release in healthy prepuberal children.

Proline (100 mg/kg b.w.) was given per os and after 30 minutes 10% glycine was i.v. injected to 25 healthy children of both sexes. A positive response (an increase of over 5 ng/ml of serum level of GH) was found in 21 of the 25 children. The insulin test showed a positive response in 24 of the 25 children. It was concluded that the decrease in glycine dosage from 250 mg/kg b.w. (earlier reports by the same authors) to 100 mg/kg b.w. (present data) is generally compensated by l-proline priming. The IRI serum levels were almost unchanged. By l-proline priming, the glycine test can also be applied to subjects with body weight over 40 kg, in doses of 100 mg/kg b.w. for exploring the secretory reserve of the somatotropic axis.

Changes in plasma lipids in hirsute women.

The changes in blood cholesterol, triglycerides, total lipids and lipoproteinograms were examined in 40 women with hirsutism compared to 40 normal women of similar ages as control. The results show a significant increase in cholesterol, triglycerides and total lipids in hirsutism. The lipoproteins, analysed according to Frederickson's classification show that while only 12% of the normal women came within type II A, in hirsutism the proportion was 50%. A proportion of 5% of normal women came within type II B whereas in hirsutism there were 28%. In conclusion, both types of blood lipoprotein alteration with atherogenic potential are significantly better represented in hirsutism cases.

L-proline loading for the assessment of pituitary GH reserve.

Intravenous insulin (0.1 U/kg body weight) and oral 1-proline (100 mg/kg body weight) tolerance tests were performed in 22 healthy and 30 short-statured children and adolescents and blood glucose, serum immunoreactive growth hormone (GH), immunoreactive insulin (IRI) and 1-proline were determined. The peak level of serum GH was significantly higher following insulin than after 1-proline. The proline loading correctly identified the normality of GH axis in 12 out of 22 controls and in 3 out of 7 normopituitary short-statured patients. The serum 1-proline levels consideration did not improve much the ability of 1-proline load to detect either the normal GH responsiveness or the pituitary insufficiency. The mechanism of GH stimulatory properties of 1-proline in some healthy subjects is not known.

[Value of methods used in the etiological diagnosis of pleural exudates]. / Valoarea metodelor folosite în diagnosticul etiologic al revarsatelor pleurale

A study was carried out on 64 cases of pleural exsudates, i.e. 23 of neoplastic origin, 13 tuberculous, 10 with various etiologies and 8 the cause of which could not be determined. In all cases pleural biopsy puncture was performed, once or several times, the histologic examination confirming 80% of the cases of tuberculosis and 40% of the cancer cases. Biochemical methods are orientative, their significance increasing when the other probability tests give convergent results.

Clinical use of glycine intravenous load for diagnosis of growth hormone deficiency.

Intravenous glycine injection (250 mg/kg of body weight) resulted in growth hormone release in normal children but not in those with growth hormone deficiency diagnosed by insulin-induced hypoglycaemia. In the latter significantly higher peak concentrations of serum alpha-amino nitrogen were also found. False negative responses to glycine (no GH release) were observed in two patients of short stature but normal pituitary function. In them the peak levels of serum alpha-amino nitrogen were lower than in those with hypopituitarism. We propose the clinical use of glycine as an inexpensive and innocuous procedure for the detection of GH deficiency in children. A post-glycine GH peak greater than 10-0 mu/l seems to be a good index of an intact GH reserve.