Factitious diabetes mellitus as part of Munchausen's syndrome.

The patient presented here was known to have been suffering from diabetes mellitus for 3 yr, when the suspicion arose that we were dealing with a factitious disease. The coincidence of several other factitious illnesses led us to the diagnosis of Munchausen's syndrome, self-inflicted diabetes mellitus being part of this syndrome.

Glutathione metabolism of human vascular endothelial cells under peroxidative stress.

Glutathione (GSH) plays an important role in the cellular defense against (per-)oxidative stress. The capacity of this cellular defense system may be related to the oxygen tension, cells are normally subjected to in vivo; therefore, we studied the de novo synthesis of glutathione, and the redox turnover under peroxidative stress, in human umbilical vein and artery endothelial cells (HUVEC, HUAEC) and human skin fibroblasts. De novo synthesis in these cell types was studied in vitro by measuring the time course of intracellular GSH recovery after depletion with diamide. For fibroblasts, the initial rate of de novo synthesis after GSH depletion was twice that of the endothelial cell strains. In the endothelial cells (HUVEC, HUAEC) the original intracellular GSH level is reached within 40 min. while in the same time span, the GSH level in fibroblasts returned to 75% of control level. The activity of the hexose monophosphate shunt (HMS) was determined under oxidative stress as a measure for the coupled redox turnover of intracellular GSH. Under control conditions the HMS in endothelial cells was twice as high as in fibroblasts. Cumene hydroperoxide (40 microM) induced a three-fold increase in HMS in both HUVEC and HUAEC, while fibroblasts exhibited an increase of 83%. During the same peroxidative stress, the intracellular GSH concentration of HUVEC, HUAEC and fibroblasts stayed at control level. So with respect to GSH metabolism there were no differences between the two endothelial cell strains. In comparison with the endothelial cells, the fibroblasts were less susceptible toward oxidative stress.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of doxazosin and propranolol administration on lipoprotein lipases in cholesterol-fed rats.

The effects of alpha 1-adrenergic receptor inhibition with doxazosin, and beta-blockade with propranolol on tissue lipoprotein lipases and plasma lipids were studied in rats. In rats fed a normal lab chow, doxazosin increased heart lipoprotein lipase activity (+14%), while propranolol had the opposite effect (-20%). These effects were not statistically significant when compared with nontreated controls, although the difference between the doxazosin and propranolol groups was significant (p less than 0.05). There were no significant effects on adipose tissue lipoprotein lipase activity or hepatic lipase activity. In rats fed a cholesterol-enriched diet there were similar but smaller effects on heart lipoprotein lipase activity (+5% and -12%, respectively). In these rats alpha 1-inhibition also tended to increase adipose tissue lipoprotein lipase (+14%) and hepatic lipase (+13%), while beta-blockade had the opposite effect (-20% and -9%, respectively). The lipase activities were significantly different between the treatment groups in liver and heart but not in adipose tissue. Doxazosin and propranolol did not affect plasma triglyceride or total cholesterol, but high-density lipoprotein cholesterol was increased during alpha 1-blockade (+24%).

Different causes for hypertriglyceridemia in male and female patients with chronic renal failure?

The changes in plasma postheparin lipolytic activities that occur in patients with chronic renal insufficiency were found to be sex dependent. Male patients showed decreased hepatic lipase activity, while female patients exhibited decreased lipoprotein lipase activity. These findings offer 1) an explanation for the hitherto confusing data on postheparin lipolytic activities in chronic renal failure reported in the literature, and 2) a further argument for a role of hepatic lipase activity in the regulation of the breakdown of plasma triglycerides.