Defective glucagon secretion during hypoglycemia after intrahepatic but not nonhepatic islet autotransplantation.

Defective glucagon secretion during hypoglycemia after islet transplantation has been reported in animals and humans with type 1 diabetes. To ascertain whether this is true of islets from nondiabetic humans, subjects with autoislet transplantation in the intrahepatic site only (TP/IAT-H) or in intrahepatic plus nonhepatic (TP/IAT-H+NH) sites were studied. Glucagon responses were examined during stepped hypoglycemic clamps. Glucagon and symptom responses during hypoglycemia were virtually absent in subjects who received islets in the hepatic site only (glucagon increment over baseline = 1 ± 6, pg/mL, mean ± SE, n = 9, p = ns; symptom score = 1 ± 1, p = ns). When islets were transplanted in both intrahepatic + nonhepatic sites, glucagon and symptom responses were not significantly different than Control Subjects (TP/IAT-H + NH: glucagon increment = 54 ± 14, n = 5; symptom score = 7 ± 3; control glucagon increment = 67 ± 15, n = 5; symptom score = 8 ± 1). In contrast, glucagon responses to intravenous arginine were present in TP/IAT-H recipients (TP/IAT: glucagon response = 37 ± 8, n = 7). Transplantation of a portion of the islets into a nonhepatic site should be seriously considered in TP/IAT to avoid posttransplant abnormalities in glucagon and symptom responses to hypoglycemia.

[Non-visual effects of light mediated via the optical route: review of the literature and implications for occupational medicine]. / Effetti extravisivi della luce mediati dalle vie ottiche: rassegna della letteratura e implicazioni per la medicina del lavoro.

Artificial light which now plays an essential role in industrialized society differs from natural light both in intensity which is usually lower, and in spectrum, which is usually smaller. It is now a well-known fact that the human body is able to use luminous stimulation for aims other than sight; the pineal gland, though no longer directly sensitive to light as in lower animals, is nevertheless the fulcrum of a complex neuro-endocrine system which makes an interaction between light and the human body possible by means of the production of a number of substances of which melatonin is the most widely investigated. Melatonin is secreted at a circadian rhythm characterized by high nocturnal seric levels and low diurnal levels. This secretion appears to be correlated not only with the intensity of the light but also with its spectrum and time exposure. Even though the function of melatonin is still not fully understood, it seems possible to assign a mainly modulatory role to the pineal gland and melatonin. On the basis of studies performed on the pituitary-gonadal and/or hypothalamic axis and the reproductive system in animals, melatonin would appear to affect some endocrine functions (i.e., puberty) in man, too. Changes in melatonin secretion have been found in psychiatric illness, especially in cyclical affective disorders. Melatonin seems to be involved in stress-associated mechanisms, probably with an agonistic role, and also in carcinogenesis, where it seems to play a role in the growth of several tumors. Melatonin also affects both tumoral and cellular immune responses. Lastly, melatonin may be able to reduce the symptoms of the Jet Lag Syndrome. The consequences that prolonged and marked reduction in daylight exposure for occupational reasons could have on operators, especially young people, therefore constitute an interesting subject for occupational health; environmental photometry at the work-place, if adequately performed, could make a useful contribution to the development of this field of research.