Antidiabetic action of somatostatin--assessed by the artificial pancreas.

By means of a glucose-controlled insulin- and glucose-infusion system (GCIGIS) we examined the effect of somatostatin on insulin and glucose requirements following meals or oral glucose loads in juvenile diabetics. In six of seven patients the insulin requirement with somatostatin was remarkably reduced to between 38 per cent and 79 per cent of that of otherwise identical control experiments. No reduction could be found in the seventh case, fed only 575 kcal. In all cases we observed an increase in dextrose demanded from the GCIGIS ranging between 28 per cent and 192 per cent of the control amounts. In addition, a lowering and smoothing of postprandial blood glucose curves caused by somatostatin application was a general finding. It seems to us most likely that the well-known suppression of the secretion of growth hormone and glucagon, both insulin antagonists, is responsible for the antidiabetic action of somatostatin.

Radioimmunoassay of somatostatin in human plasma.

A radioimmunoassay procedure for determination of somatostatin immunoactivity in human plasma is described. Labelling of tyrosine-1-somatostatin is performed by chloramine T. Specific activity of the tracer is 1.34 mol iodine for 1 mol of somatostatin. The immunoreactivity is 85%. Antisera are produced in rabbits at a titre of 179 X 10(-12) mol somatostatin per ml antiserum. Human plasma is extracted by n-butanol/2 mol/l acetic acid. Recovery rate is 85-105%. The intra-assay CV varies from 12% to 1.7%, the inter-assay CV from 16% to 7.5%, depending on the concentration of somatostatin.

Influence of adenoid hypertrophy on secretory otitis media.

The prognostic influence of adenoidectomy on the clinical course of chronic secretory otitis media (SOM) is reported after an observation period of five years in 166 children. Adenoidectomy was performed in connection with the first tubulation on the basis of concurrent symptoms of nasal obstruction, and resulted in a significant reduction in the need for repeated insertion of tympanostomy tubes in patients younger than eight years of age. The tubulation rate was also significantly reduced when adenoidectomy was performed in association with the first recurrence of SOM. This effect was, however, absent when the operation was performed at later stages, and both the otoscopic and audiological findings after five years revealed no significant differences between the adenoidectomy and nonadenoidectomy groups. Possible pathogenetic mechanisms leading to the development of SOM in the presence of large adenoids are discussed.

Chronic secretory otitis media.

Of 242 children and teenagers treated surgically for chronic secretory otitis media in 1972, 212 presented for evaluation 5 years later. Although the pure-tone audiometric threshold was 20 dB HL or better in 87.7% of the ears, only 40.6% were judged to be otoscopically normal. The findings at the first myringotomy for insertion of tympanostomy tubes were of no prognostic value for the course of the disease, and the presence of characteristics of middle ear fluid at subsequent myringotomies varied unpredictably. Adenoidectomy performed at an early stage, and in the presence of nasal obstruction, resulted in a significant reduction in the need for re-insertion of tympanostomy tubes.

Predicting cardiac patients' quality of life from the characteristics of their spouses.

Recovery from surgery can be facilitated by personal and social resources such as perceived self-efficacy and social support. Moreover, the existence of a social network and the behavior of its members can also have a positive effect. Patients (N = 381; 302 men, 79 women) undergoing heart surgery were surveyed once before and twice after surgery. In addition, 114 social-network members (18 men, 96 women), most of them spouses, reported about their own perceived resources at Time 1. The patient-spouse dyad was chosen as the unit of analysis. It turned out that characteristics of spouses were related to those of patients. Recovery from surgery at Time 2 and readjustment to normal life after half a year (Time 3) could be partly predicted by spouses' perceived self-efficacy and social support as measured at Time 1.

Proximal and Distal Predictors of AIDS Risk Behaviors among Inner-city African American and European American Women.

AIDS risk behavior and attitudes towards safer sex were studied in a sample of 666 African American and 626 European American women. Condom use, AIDS-related knowledge, risk perception, self-efficacy beliefs, attitudes and perceived partner attitudes, and an assertive coping style were analyzed with regard to mean differences and predictive power in both ethnic groups. Compared to European American women, African American women had less knowledge and lower self-efficacy beliefs towards safer sex behavior, but they perceived themselves to be at more risk and reported greater condom use. Further, ethnicity was found to moderate the effects of the psychological predictors on safer sex behavior. This moderator effect was tested using a structural equation modeling design. In both groups, risk perception was the strongest predictor of condom use. Among African American women, social-cognitive barriers (e.g. low self-efficacy beliefs, negative attitude towards condom use) worked as a second predictor and mediator of the effects of risk perception on condom use. In contrast, among European American women, social-cognitive factors had no effect on condom use. In general, prediction of safer sex behavior was stronger among African American women.

Spontaneous haematoma in the head and neck.

Three cases of spontaneous haematoma in the head and neck are presented. Whereas one case was associated with lingual haemangiomatosis, no source of bleeding could be demonstrated in either a chronic, spontaneous orbital blood-cyst or an acute retropharyngeal haematoma.

Differential diagnosis of a mass in the upper lateral neck.

The differential diagnosis and the duration of symptoms are presented for a group of 288 patients encountered over a ten-year period with a mass in the region of the neck behind and below the angle of the mandible. While infections constituted the largest aetiological group (48.3 per cent), 109 cases (37.9 per cent) had some form of neoplasia, with malignancy being found in 48 (16.6 per cent). The duration of symptoms varied widely, only the acute infections having an acceptably short delay prior to hospital admission. The mean symptom duration for all the neoplastic cases was in excess of five months.

Chronic serous otitis media in the adult.

Twelve adult patients with serous otitis media have been seen in a five-year-period. Five of seven patients with nasopharyngeal neoplasm have died, and one case of polyarteritis nodosa has also terminated fatally. The remaining four patients had benign pathology in the nasopharynx, including one case of branchial cyst. A group of patients with chronic nasopharyngitis but without otological involvement is also reviewed.

A World Wide Web-service to aid the development of AMBER parameters using analogy to standard parameters.

A World-Wide Web service has been constructed to assist the development of force field parameters extending the AMBER force fields. This service extracts parameters from the standard AMBER force field parameter databases. From a Web-based interface the user can choose between bond, angle and torsional parameters with certain constraints on element and/or atom hybridization. The software constructed for the purpose of finding appropriate parameters will locate standard AMBER force field parameters matching the user specification. For bond and angle parameters a scatter plot of the reference values against force constants is provided. This service has been produced to assist in extraction and evaluation of parameters that may be useful for molecules other than proteins and nucleic acids.

Money doesn't talk, it swears: how economic stress and resistance resources impact inner-city women's depressive mood.

We examined the differential impact of chronic versus acute economic stress on depressive mood among a sample of 1241 low-income, single, European and African American women. Based on Hobfoll's (1988, 1989) conservation of resources (COR) theory, we predicted that acute resource loss would be more distressing than chronic economic lack. That is, although chronically impoverished conditions are stressful, the attendant resource losses created will be more distressing. We further predicted that mastery and social support would be more beneficial in offsetting the negative consequences of acute resource loss than the negative consequences of chronic economic lack, because acute loss creates identifiable demands that resources may address. Hence, we hypothesized that mastery and social support would show stress buffering effects only for material loss, not chronic lack. The findings generally supported the hypotheses, but mastery buffered only European American women's resource loss and social support buffered only African American women's resource loss. The findings are discussed in light of implications for prevention within theoretical and cultural contexts.

Clinical investigations into the modification of the effect of endogenous and exogenous insulin by human proinsulin in type II and type I diabetics.

The investigation on hand leads to the conclusion that HPRO can additively increase the blood glucose lowering effect of endogenous and exogenously administered insulin. Etiologically the prolonged retention time of HPRO in the circulation - compared to HI - must be primarily discussed. In the further course the question arises to what extent traditional retard insulins would have to be replaced or supplemented by HPRO.

Chronic secretory otitis media.

212 of 242 patients (88%) treated for chronic secretory otitis media in 1972 were re-examined 5 years later. A total of 668 otological procedures has been performed, 99 patients being treated only once, while one patient received 12 procedures. The pure tone threshold was 20 dB or less in 88% of the ears in 1977, whilst only 57% had a type A tympanogram. Normal otoscopy was found in 40.5% of the ears, persisting secretory otitis in 11%, atelectasis in 2.8% and chronic suppurative otitis in 2.6%; the remaining 42.9% showed varying degrees of scarring and myringosclerosis.

Cysts and sinuses of the lateral head and neck.

A series of 82 cysts and sinuses in the lateral head and neck has been reviewed with a view to features which may help to determine origin from the fetal branchial apparatus. Whilst both pre-auricular and lateral cervical sinuses are often hereditary and associated with other developmental anomalies, these features are lacking in the case of infra-auricular first cleft anomalies and lateral cervical cysts. Although salivary tissue occurred in 50 per cent of lateral cervical sinuses, only one of the cysts presented this feature. Lymphoid tissue was present in all lateral cervical cysts, but no sinusoids were found within the cyst wall. Lymph nodes were present in the majority of these specimens, but separated from the cyst wall by a fibrous layer. It is therefore unlikely that the cysts arise from salivary inclusions in cervical lymph nodes. The different clinical features would not support the view that lateral cervical cysts and sinuses have identical embryological origins.

Granulomatos cervical lymphadenitis.

One hundred and thirty-nine cases of pathologically involved cervical lymph nodes have been reviewed, and granulomatous lymphadenitis found in 29 patients (20.9 per cent). There were two cases of sarcoidosis, 10 of tularemia, five patients (3.6 per cent) had tuberculous lymphadenitis and 12 (8.7 per cent) fulfilled commonly accepted criteria for infection with atypical mycobacteria. The clinical features of the latter condition, which is probably insufficiently recognized, are reviewed, and surgery is recommended as the primary treatment modality.

[Aortobronchopulmonary fistula following a pulmonary contained aortic rupture in patients with a thoracic aortic aneurysm and severe aortic sclerosis]. / Aortobronchopulmonale Fisteln nach pulmonal gedeckter Aortenruptur bei thorakalen Aortenaneurysmen und schwerer Aortensklerose.

Rupture of the thoracic aorta is usually widespread and fatal. Rupture limited by the lung and aorto-bronchopulmonary fistula are rare. We report two patients with a contained perforation of the thoracic aorta, who presented with haemoptysis. Chest radiographs demonstrated an aortic aneurysm and pulmonary haemorrhage in the first, while in the other perforation of an atherosclerotic aorta with a pulmonary haematoma was misinterpreted as bronchial carcinoma. In both cases contrast enhanced CT clearly demonstrated the abnormality in the aorta and the pulmonary haemorrhage. Since aortography often fails to demonstrate a perforation, CT or MRI should be performed early in patients with suspected rupture of the thoracic aorta.