Search

We performed TOF-SIMS analyses of one UCAMM to investigate pristine organic matter and to determine if UCAMMs are representative of cometary CHON grains.

International audience; The interstellar medium (ISM) is a physico-chemical laboratory where extreme conditions are encountered and whereparticular environmental parameters (e.g., density, reactant nature, radiation, temperature, time scales) define the compositionof matter. With present observational possibilities, the fundamental question regarding the possible link betweenISM and solar system samples can be addressed by astrophysicists, planetologists, and cosmochemists. This article focuseson observations of diffuse ISM and dust components of molecular clouds, setting constraints on the composition oforganic solids and large molecules associated with matter cycling in the Galaxy. This study aims at drawing somecommonalities and differences between the materials found in the Solar System and those found in interstellar dust.

An organic residue is remaining at 300 K after the VUV photolysis of ices mixture and subsequent heating. This residue is thought to be representative of the organic matter contained in comets. Our experiments show that the thermal evolution is an important process. Indeed, the organic residue remaining at 300 K is not produced completely during the photolysis at low temperature but also during the heating. Furthermore, when heated at temperature higher than 300 K, the residue undergoes chemical evolution which has to be taken into account in astrophysical models. Furthermore, our work allows to propose observational strategy to maximize the chance to detect in-situ some compounds, such as POM and HMT, thanks to COSIMA which is one of the mass spectrometers on board of the Rosetta spacecraft.

One important component of refractory organic residues synthesized from interstellar/cometary ice analogues is hexamethylenetetramine (HMT, C6H12N4). However, HMT has never been observed in any astrophysical or planetary environment so far. We investigated thermal evolution of HMT above ambient temperature. The synthesis of the organic residue (ice deposition, photolysis and warming) as well as its heating to temperatures higher than 300 K are performed by means of the same experimental apparatus. The later also allows in situ continuous monitoring of both the solid organic residue (by FTIR spectrometry) and of the gas species (by mass spectrometry).

International audience; The current Solar System architecture is aheritage of the protoplanetary disk that surrounded the young Sun, 4.56 Gy ago. Primitive extraterrestr ial objects provide means to trace back the primordial composi- tion and radial distribution of matter in this disk. Here, we present acombined micro-IR, Raman, chem- ical and isotopic study of two ultracarbonaceous micrometeorites recovered from Antar ctica (UCAMMs). This study reveals particles containing an unusually high nitrogen- and deuterium-rich organic matter analogous to a polyaromatic hydrogenated carbon nitride, characterized by nitrogen concentration with bulk atomic N/C ratios of 0.05 and 0.12 (locallyexceeding 0.15).We propose that such nitrogen-rich car- bonaceous material can be formed by energetic irradiations of nitrogen-rich ices in very low temperature regions of the Solar System. Such conditions are encountered at the surface of small objects beyond the trans-neptunian region. UCAMMs provide unique insights on physico-chemical processes that occurred beyond the nitrogen snow-line, revealing orga nic material from the extreme outer regions of the Solar System that cannot be investigated by remote sensing methods

International audience; CR chondrites are considered as one of the most primitive classes of meteorites. Most of them experienced a mild aqueous alteration and show no evidence of significant effect of thermal metamorphism. We present here a search for low degree metamorphic effects in CR chondrites. We studied 15 CR chondrites using different metamorphic indicators: (1) structure and Ni content of metal grains; (2) hydration state of matrix; (3) structure and composition of organic matter. The different metamorphic indicators show that two of the analyzed CR chondrites, GRA 06100 and GRO 03116, experienced thermal metamorphism. Indeed, all of the metal grains in GRA 06100 and half of the metal grains in GRO 03116 show Ni-rich phases; the matrix of GRA 06100 is almost completely dehydrated, and the matrix of GRO 03116 is partially dehydrated; Raman spectra of organic matter in these two meteorites are clearly different from those obtained for organic matter in the other CR chondrites, which resemble Raman spectra of organic matter in unmetamorphosed, CM2 meteorites; IR spectra of insoluble organic matter extracted from GRA 06100 and GRO 03116 show lower carbonyl abundance and higher CH2/CH3 ratio with respect to organic matter of unmetamorphosed chondrites. The other CR chondrites analyzed here lack these characteristics and only show a few metal grains with Ni-rich inclusions. Our results also show that the metamorphic effects observed in GRA 06100 and GRO 03116 are different from those observed in type 3 chondrites, which experienced long-duration metamorphism of radiogenic origin. We infer that thermal processing in these two CRs extended over a short duration and was triggered by impacts.

The presence of polyoxymethylene (POM) in cometary grains has been debated years ago. Although never proven, its presence can not be excluded. Rosetta, the ESA mission to comet 67P/Churyumov-Gerasimenko, may answer this question. On board the spacecraft, COSIMA (COmetary Secondary Ion Mass Analyzer) will analyze the grains ejected from the nucleus using a Time Of Flight Secondary Ion Mass Spectrometer (TOF-SIMS). In this paper we report the extent to which COSIMA will be able to detect POM if this compound is present on cometary grains. We have analyzed two kinds of POM polymers with a laboratory model of COSIMA. Positive mass spectra display alternating sequence of peaks with a separation of 30.011 Da between 1 and 600 Da related to formaldehyde and its oligomers but also to the fragmentation of these oligomers. The separation of 30.011 Da of numbers peaks, corresponding to the fragmentation into H2CO is characteristic of POM and we show that it could be highlight by mathematical treatment. POM lifetime on COSIMA targets have also been studied as POM is thermally instable. It can be concluded that the cometary grains analysis have to be planned not too long after their collection in order to maximize the chances to detect POM. This work was supported by the Centre National d'Etudes Spatiales (CNES).

To evaluate beta-cell function in patients with pancreatic cancer, the glucagon stimulation test was performed in seven patients with pancreatic adenocarcinoma, seven patients with type I diabetes mellitus, seven patients with type II diabetes mellitus, and in seven healthy controls. C-peptide serum levels were determined before and after a 1-mg i.v. glucagon injection. Basal C-peptide values were normal or slightly increased in pancreatic cancer and type II diabetic patients and low in type I diabetic patients. Following glucagon stimulation, no significant increase was observed in C-peptide values of type I diabetics and pancreatic cancer patients, whereas significant increases occurred in controls and type II diabetics. It is concluded that the altered beta-cell function found in pancreatic cancer patients may lead to hyperglycemia, which is frequently associated with this tumor type.

This multicenter study evaluated the efficacy and safety of simvastatin in patients with primary hypercholesterolemia and in patients with hypercholesterolemia associated with type II diabetes who were being treated with diet or oral antidiabetic agents. The metabolic control of diabetes during drug treatment was also evaluated. Of 90 patients from seven centers, 88 (48 nondiabetic and 40 diabetic) patients completed the study; 2 patients dropped out for reasons other than drug-related adverse events. Patients were admitted to the study if their total cholesterol was ⩾250 mg/dl, low-density lipoprotein (LDL) cholesterol was between 160 to 350 mg/dl, and total triglycerides were 200 mg/dl and again from 20 to 40 mg after 12 or 18 weeks if the goal cholesterol value ( 1c , did not change during the trial. Simvastatin is an effective and safe drug not only for the treatment of primary hypercholesterolemia but also for the treatment of hypercholesterolemia associated with type II diabetes.

The metabolic effects of a three-month treatment with a high-fiber diet (15 grams of guar-gum added to a standard diet) were investigated in seven type 1 diabetic subjects, with a moderately poor metabolic control. HbA1c levels, daily insulin requirement, cholesterol, triglyceride, amino acid and intermediate metabolite concentrations were evaluated before and following the high fiber diet, both in the postabsorptive state at euglycemia and during a euglycemic, hyperinsulinemic, hyperaminoacidemic clamp. Insulin-mediated glucose utilization, an index of insulin-sensitivity, was also measured during the clamp. Following the diet, no differences in HbA1c levels (7.6 +/- 0.7%----7.3 +/- 0.6%), daily insulin requirement (50 +/- 5----51 +/- 3 U/d), triglyceride, amino acid and intermediary metabolite concentrations in the basal, euglycemic state, were observed. Only cholesterol concentrations decreased significantly (from 165 +/- 12 to 142 +/- 12 mg/dl, P less than 0.01) after the diet. During the clamp, the concentrations of all measured substrates were comparable before and after high fiber treatment. Insulin-mediated glucose disposal was also unchanged by guar-gum treatment. Patients' body weights were not modified by the diet. In conclusion, our study shows that a high fiber diet, obtained with the addition of 15 grams of guar-gum to a standard diet, is of no benefit to IDDM either as regards the metabolic control or insulin sensitivity. Only cholesterol levels were decreased. Therefore, the costs and benefits of these diets in the treatment of IDDM should be reconsidered.

Carbohydrates (CHO) are a major determinant of post-prandial blood glucose in the diet of people with Type 1 diabetes mellitus, but patients frequently fail to evaluate CHO food content. Poor education is thought to contribute heavily to this failure. Our aim was to plan and evaluate a simple educational program to improve dietary knowledge and teach how to count CHO in Type 1 diabetic subjects. Forty-eight patients (age 27+/-1 yr, diabetes duration 11+/-1 yr, HbA1c 9%) attended 4 interactive meetings held at monthly intervals. The targets of the course were: 1) to identify sources of CHO, fats and proteins; 2) to count CHO and to split them among meals; 3) to assume CHO-rich foods without changing daily calorie or carbohydrate intake; 4) to modify the diet so as to correct hypoglycaemic events. To evaluate the effect of the course, patients completed a 7-day food record and answered a questionnaire covering the targets of the course at baseline, at the end of the course and 7 months later. After the course dietary knowledge improved significantly. The number of patients who weighed foods, estimated CHO food content and correctly distributed CHO among meals also increased. After the course patients reacted better when faced with hypoglycaemia. The knowledge acquired persisted 7 months after the end of the course. Therefore, we conclude that a simple teaching program can improve diet knowledge in Type 1 diabetics and establish a sustained habit of counting CHO.

We report a rare case of primary carcinoma of the fallopian tube. A 72-year-old post-menopausal woman presenting with abnormal secretion of blood-stained liquid, underwent surgery because of findings of atypical squamous cells (ASCUS) on a routine Papanicolaou smear. The histological diagnosis on cervical biopsy was of CIN 3. Adenocarcinoma of the Fallopian tube was incidentally found.

The gastrointestinal mesenchymal tumors from a heterogenous group that include several entities: leiomyomas, schwanomas and less differentiated tumors often referred as GIST. These neoplasm are uncommon and their clinical behaviour is most difficult to predict. We describe a malignant gastrointestinal stromal tumor of the ileum coexisting with renal cell carcinoma. The neoplasms were fixed in formaldehyde, embedded in paraffin and stained with hematoxylin-eosin. For immunohistochemical studies deparaffinized tissue sections were incubated with antibodies against vimentin, desmin, muscle specific actin, S100, CD34, GFAP, NSE and keratin. The epithelioid and spindle cells of ileal neoplasm were arranged in interlacing fascicle with occasional palisading and were positive for vimentin and CD34. Positivity for muscle specific actin was focally found. The renal neoplasm required differential diagnosis from metastatic GIST. The morphological and immunohistochemical investigations in our case were consistent with GIST coexisting with primitive renal cell carcinoma. One of the problems connected to the anatomo-clinical evaluation of GIST consist in the difficulty of making a prognosis. An almost complete review of the literature and view point on the topic has been performed. As a conclusion judging from papers regarding this argument, no clear parameters of biological behaviour exist excluding mitotic index.

Hepatoid adenocarcinoma of the stomach is an uncommon gastric tumor. A throughout search of the literature revealed only 86 cases: the first case was reported by Bourreille et al in 1970. We describe a patient with primary gastric adenocarcinoma with high serum alpha-fetoprotein (AFP) levels (7000 ng/ml). Histologically foci strongly resembling hepatocellular carcinoma with hyaline globules were noted. Immunoreactivity for alpha-fetoprotein (AFP), a1 antitrypsin and CEA also indicate hepatocellular differentiation. This case provides informations on the DNA content and Ki67 expression of this unusual and aggressive variant of gastric adenocarcinoma.

Micrometeoroids (cosmic dust with size between a few $\mu$m and $\sim$1 mm) dominate the annual extraterrestrial mass flux to the Earth. We investigate the range of physical processes occurring when micrometeoroids traverse the atmosphere. We compute the time (and altitude) dependent mass loss, energy balance, and dynamics to identify which processes determine their survival for a range of entry conditions. We develop a general numerical model for the micrometeoroid-atmosphere interaction. The equations of motion, energy, and mass balance are simultaneously solved for different entry conditions (e.g. initial radii, incident speeds and angles). Several different physical processes are taken into account in the equation of energy and in the mass balance, in order to understand their relative roles and evolution during the micrometeoroid-atmosphere interaction. In particular, to analyze the micrometeoroid thermal history we include in the energy balance: collisions with atmospheric particles, micrometeoroid radiation emission, evaporation, melting, sputtering and kinetic energy of the ablated mass. Low entry velocities and grazing incidence angles favor micrometeoroid survival. Among those that survive, our model distinguishes (1) micrometeoroids who reach the melting temperature and for which melting is the most effective mass loss mechanism, and (2) micrometeoroids for which ablation due to evaporation causes most of the the mass loss. Melting is the most effective cooling mechanism. Sputtering-induced mass loss is negligible., Comment: accepted (2013 Feb. 4) for publication in Astronomy and Astrophysics; V.2 - corrected problems with bibliography/citations in the tex file, otherwise no changes

From 1982 to 1993, four hundred and sixty transthoracic biopsies were performed to diagnose lung lesions. 258/460 examinations (56%) were made under fluoroscopic and 202/460 exams (44%) under CT guidance. All the instrumental examinations were made with fine cyto/histologic needles (21-22G); the pathologist was always present. Lesion features and biopsy modalities were analyzed statistically to assess which factors correlate with biopsy yield and complications. Sampling efficacy averaged 85%, specific cell typing was 96% and diagnostic accuracy was 97%. The radiologic features of the lesions (masses or inhomogeneous opacities) and their size, needle type (cyto/histologic needles), the number of punctures per biopsy and examination time were statistically influential factors on biopsy accuracy. Complications were observed in 31% of cases, 5% of them consisting of pneumothorax cases requiring surgical drainage. The factors bearing a statistical influence on complications were lesion site and size, lung parenchymal alterations, needle course depth, scissure plane crossing, the patient's position during biopsy and examination time. Finally, CT allowed smaller and deeper lesions to be studied than fluoroscopy, with the same diagnostic yield.

Between 1976 and 1994, 318 patients underwent surgical closed retro-endoperitoneal drainage and post-operative lavage for acute necrotizing severe pancreatitis. The main indication was sepsis (66.4%). The ratio between operated on and the overall number of observed patients has been progressively shifting towards medical treatment. Furthermore in the operated group the timing of surgery has been delayed step by step. The Authors discuss improvements in the understanding of the etiological and therapeutical aspects of the disease which has had a better outcome in recent years, survival rate of 91.4%. The personal option for the closed surgical approach is based on the progressive improvement of the technique and on the good results obtained both in terms of mortality and associated morbidity; as regards the latter problem the open techniques seems to be related to a higher complication rate than the closed one.

An Italian prospective multicentre study evaluated the efficacy of octreotide, a synthetic somatostatin analogue, in preventing the complications of elective pancreatic surgery. 303 patients with tumours of the pancreas or the ampullary region, in whom ultrasonography and computed tomography scan had shown a resectable lesion, or with chronic pancreatitis, were randomized in a double-blind fashion to treatment with octreotide 100 micrograms t.i.d. s.c. starting at least 1 h before surgery and continued till the 7th postsurgical day, or with matching placebo. Unresectable lesions were found at laparatomy in 31 patients (15% of those with tumours). In 14 others, procedures not anticipated in the study protocol had to be performed, and in 6 additional cases there were other protocol violations so that these 20 patients were excluded from the study analysis. Considering the 252 evaluable patients, the complication rate was significantly higher in the 130 placebo-treated patients than in the 122 who received octreotide (29.2 vs. 15.6%; p = 0.01). We therefore suggest that octreotide may substantially reduce the risk of complications after elective pancreatic surgery.

OBJECTIVE To assess kidney function and AER in patients with PD. RESEARCH DESIGN AND METHODS Thirty-three patients with PD (age 52 ± 7 yr, duration of disease 11 ± 6 yr, BMI 24 ± 3 kg/m2) and 33 patients with IDDM were matched for sex, BMI, and duration of disease. GFR and RPF were determined by single injection of [51Cr]EDTA and [125I]hippurate. AER was measured by radioimmunoassay in a single timed overnight urine collection. RESULTS GFR and RPF were, respectively, 113 ± 35 and 441 ± 145 ml · min−1 · 1.73 m2 in patients with PD and 123 ± 30 and 549 ± 94 (P < 0.001) in IDDM. FF was significantly higher in patients with PD (0.26 ± 0.05 vs. 0.22 ± 0.03; P < 0.001). Prevalence of hyperfiltration (GFR > 135 ml · min−1 · 1.73 m2) was similar in both groups (30% in patients with PD vs. 28% in those with IDDM). Geometric mean of urinary AER was 10.4 μg/min (range 1–186) in patients with PD and 11.2 (1–198) in IDDM patients. Some 30.3% of patients with PD and 18% of those with IDDM were microalbuminuric (AER > 20 μg/min). By multiple regression analysis, AER was significantly related to systolic (P < 0.04) and diastolic blood pressure (P < 0.01) and to BMI (P < 0.03) in patients with PD. Retinopathy was more frequent in microalbuminuric patients with PD than in those without elevated AER. CONCLUSIONS We suggest that early renal abnormalities occur similarly in patients with PD and IDDM.

A retrospective analysis of blood glucose control was performed in 17 type 1 diabetic patients who regularly monitored their blood glucose concentration by visual strips over a period of 3-83 months. Analysis was performed by a patient management software loaded on a personal computer. In this cohort of patients the average daily blood glucose reading was 1.6 +/- 0.3. Blood glucose readings were collected more frequently following meal ingestion (40.3%) than in the post-absorptive state (24.6%; P less than 0.05). Blood glucose concentration fluctuated from a basal level of 146 +/- 5 mg/dl to 167 +/- 4 mg/dl in the post-prandial phases with an average daily value of 156 +/- 2 mg/dl. Blood glucose values below 80 mg/dl were evenly distributed throughout the day, while hyperglycemia (greater than 300 mg/dl) occurred more commonly after meals (42%). Daily blood glucose was higher during weekends (164 +/- 5 mg/dl) than during weekdays (155 +/- 2 mg/dl; P less than 0.05). A weak correlation was found between the number of blood glucose readings/day and daily blood glucose level. These results suggest that long-term maintenance of satisfactory metabolic control is attainable in type 1 diabetic patients and that this is mainly dependent upon subject self awareness.

Adenomatoid tumor of the epididymis diagnosed using fine needle aspiration (FNA). The adenomatoid tumor of the male genital system is a relatively uncommon, well recognized neoplasm with benign histologic appearance, and mostly asymptomatic clinical features. We describe a case of adenomatoid tumor of the epididymis diagnosed before surgery by fine needle aspiration cytology (FNA). This diagnostic procedure has allowed a rapid, reliable, and conclusive surgical approach.

The authors report a case of lymph node metastasis of a Merkel cell carcinoma with unknown primary localization. The definitive diagnosis was posed histologically since the FNA report was--in this case--only "coherent with a small malignant cells proliferation".

The presence or absence of histological signs of cholestasis (on the basis of liver specimens obtained by means of liver biopsy) was compared with total bilirubin, alkaline phosphatase, gamma-glutamyl transpeptidase, ornithine carbamoyltransferase, serum glutamic oxaloacetic transaminase levels and LP-X test in 157 patients suffering from different liver diseases. The LP-X test was positive in 93% of the 59 cases in whom histological evidence of cholestasis was observed and negative 95% of the 98 cases in whom histological examination was negative. LP-X concurs more frequently with the histological picture than do total bilirubin and alkaline phosphatase. These data confirm that LP-X test is more specific than the tests traditionally used to demonstrate or exclude cholestasis. An increment in gamma-GT levels was observed in 97% of the patients with a positive LP-X test. These clinical results have been discussed in the light of recent data regarding the mechanism of lipoprotein-X formation and the possible relationships between LP-X and gamma-glutamyl transpeptidase.

Gli AA. hanno eseguito uno studio sulle correlazioni tra colesterolo e trigliceridi, rispettivamente aree beta e pre-beta, in agarosio-gel (86 pazienti) e tra questi ultimi valori e quelli delle lipoproteine Sf 0-20 e Sf 20-400 determinate con il metodo nefelometrico (46 pazienti). Venticinque dei soggetti esaminati presentavano livelli lipidemici normali, i rimanenti erano affetti da forme diverse di iperlipoproteinemia (tipo Ha, IIb e IV di Fredrickson). E stata trovata una correlazione altamente significativa tra trigliceridi e area pre-beta e tra Sf 0-20 e Sf 20-400 e rispettivamente aree beta e pre-beta ottenute mediante elettroforesi su agarosio-gel, arbitrariamente espresse in unita planimetriche. Viene discusso infine, anche alla luce di recenti dati della letteratura, il possibile impiego dell’elettroforesi in agarosio-gel come metodo di determinazione quantitativa delle varie frazioni lipoproteiche del siero.

We evaluated the effect of a diet rich in natural (NF) or extractive fibres (guar gum) on 12 male IDD (insulin-dependent diabetes) out-patients. The treatment lasted for 2 months. During the first month the patients were on an isocaloric diet containing 30 g of fibres and then they were randomly subdivided into two groups. One group followed an isocaloric diet rich in fibres (70 g/day), the second group an isocaloric diet enriched by guar (9 g of guar added to 30 g of natural fibres/day). Reduced serum levels of HbA1c and several amino acids showed that metabolic control significantly improved under each dietary regimen.

L’elettroforesi delle lipoproteine su gel di agarosio e stata eseguita in 61 pazienti affetti da iperlipemia del tipo II, IV e « misto ». I tracciati elettroforetici sono stati sottoposti a lettura densitometrica, con successivo calcolo delle percentuali densitometriche delle aree beta e pre-beta, nonche del rapporto area beta/area pre-beta. Tutti i pazienti appartenenti al tipo II e IV erano separabili sulla base delle percentuali beta e pre-beta. Infatti nel tipo II la percentuale pre-beta era sempre inferiore al 21 %, mentre nel tipo IV era sempre superiore al 35 %. L’area beta nel tipo II e sempre risultata superiore al 55 %, nel tipo IV sempre inferiore al 44 %. Nel confronto tra tipo II e « misto » e tra tipo IV e « misto » non esisteva invece altrettanto netta separazione sulla base dei valori percentuali delle bande beta e pre-beta. Il numero di sovrapposizioni si riduceva di molto se venivano invece presi in considerazione i valori dei rapporti area beta/area pre-beta. I nostri risultati dimostrano l’utilita dell’analisi densitometrica dei tracciati elettroforetici quale mezzo diagnostico per discriminare i piu comuni tipi di iperlipidemia, nel superare alcune difficolta classificative e collegate all’interpretazione solo « visiva » di alcuni «patterns » elettroforetici di tipo « misto ».

Guar gum in two forms of preparation decreased post-prandial glycemic profiles in patients when compared to controls. No differences were observed between the two guar gum preparations and no significant changes were exhibited in the FFA, lactate or pyruvate areas. From IRI and C-peptide curves the preparations containing guar gum produced slower and later responses when compared to controls. 30% of patients reported diarrhea after consumption of one guar gum preparation and 60% of patients found that one preparation was not palatable whereas the other preparation was considered to be pleasant.

The authors describe one case of paraganglioma of the posterior mediastinum successfully removed after being discovered accidentally in a young male patient who showed no symptoms attributable to the tumor. The latter was a round mass, about 6 cm in diameter, richly vascular, located in the right costomediastinal gutter. Histologically it was a functionally silent paraganglioma originating from the intrathoracic aortosympathetic paraganglia, these being part of the very numerous groups of the paragangliar system distributed segmentally into metamers, particularly in the adrenal medulla. According to the more recent views, chemodectoma or paraganglioma (chromaffine or non-chromaffine, functionally active or silent) and pheochromocytoma (functionally active or silent, adrenal or extra-adrenal) constitute a group of tumors sharing the same tissue matrix, namely paragangliar cells.

The authors report three cases of endobronchial lipoma, and study the etiopathogenesis and the main clinical and therapeutical aspects of such neoplasiae. Both diagnosis and treatment should be timely, in order to prevent irreversible damages to lung parenchyma, compelling surgeons to mutilating operations making the function of the apparatus heavier.

The incidence of diabetic retinopathy was evaluated by means of fluorescein angiography in 54 patients with diabetes secondary to chronic pancreatitis or to pancreatectomy. Thirty-one percent of the patients had background retinopathy; none had proliferative retinopathy. The percentage of patients with retinopathy was the same in groups with or without a family history of diabetes. There was no correlation between the degree of metabolic control, the levels of C-peptide, glucagon, growth hormone, and the presence of retinopathy. Retinopathy was correlated with the duration of diabetes. In conclusion, diabetes caused by pancreatitis or pancreatectomy has a significant prevalence of retinopathy, which has more benign characteristics and slower evolution than the retinopathy in patients with primary diabetes.

Twenty subjects with familial hypercholesterolemia (12 Type IIa and 8 Type IIb), previously treated with Colestipol for 16 months, were subjected to therapy with Colestipol (15 g/day) + clofibrate (2 g/day) for 15 months. During the second treatment period these patients continued to follow the isocaloric hypocholesterolemic diet initiated during the original trial. In Type IIa patients, the association of these drugs enhanced the decrease in plasma cholesterol levels. The total mean decrease was -40 +/- 17 mg/dl (P less than 0.05). In Type IIb patients, on the other hand, the association of clofibrate with Colestipol induced an increase in plasma cholesterol levels. The total mean increase was +24 +/- 7 mg/dl (P less than 0.05). A markedly significant decrease in plasma triglyceride levels was observed in this group (- 107 +/- 30; P less than 0.01). These results seem to indicate that, in Type IIa, clofibrate increased the resin's hypocholesterolemic effect. In Type IIb, on the other hand, the association of these drugs did not seem to be indicated since a marked hypotriglyceridemic effect was accompanied by an increase in plasma cholesterol levels. These results are briefly discussed in the light of recent data obtained on the effects of Colestipol and clofibrate on lipoprotein metabolism.

The cytologic picture in fine needle aspirates from a unique type of breast tumor, with stromal proliferation of osteoclastlike giant cells, cartilaginous metaplasia and metaplastic spindle-shaped carcinomatous cells, is described. In this case, an erroneous cytologic diagnosis of fat necrosis associated with a rich component of reactive fibroblasts was made. This false-negative report, which was mainly due to lack of an obvious carcinomatous component in the aspirated material, is discussed with emphasis placed on the need to exclude spindle cell metaplasia in a breast carcinoma whose aspirates are characterized by a rich component of spindle-shaped cells.

Near-normal plasma daily glucose profile was induced by Continuous Subcutaneous Insulin Infusion (CSII) treatment in order to evaluate its influence on diabetic somatic and autonomic neuropathy. Twelve insulin-dependent diabetic subjects with somatic neuropathy were studied before and after a short term CSII treatment of 10 days. Four out of these subjects, all affected by autonomic neuropathy, were followed for 1 yr with controls dvery four months. Metabolic equilibrium was monitored by mean daily plasma glucose (MPDG) profile and by Glycosylated Hemoglobin (GHb) evaluation. Somatic neuropathy was studied assessing conduction velocity at peroneal motor (PMCV) nerve, ulnar motor (UMCV), ulnar sensory (USCV) and sural sensory (SSCV) nerves. Autonomic neuropathy was assessed by means of a battery of five cardiovascular autonomic tests: Valsalva Manoeuvre (VR), Deep Breathing (DB), Lying-to-Standing (LS), Sustained HandGrip (SHG) and Postural Hypotension (PH). Short-term CSII treatment induced a near normalization of metabolic parameters, a significant improvement in VR (p < 0.05) and DB (p

Results related to long term treatment with Colestipol (a new resin sequestering bile acids) in 23 subjects with familial hypercholesterolaemia, 12 with Type IIA, 8 with Type IIB and 3 homozygotes are reported. Patients were given 15 g/day active drug for a period of 12 months and a double dose (30 g/day) for a successive period of 4 months along with a low cholesterol, low saturated fat, polyunsaturated fat-rich diet. Mean cholesterol decrease was --42 +/- 18 mg/dl (P less than 0.05) after 12 months of 15 g/day Colestipol and --69 +/- 17 mg/dl (P less than 0.01) after the following 4 months of 30 g/day Colestipol. The difference between the two periods of treatment (15 g and 30 g/day was not statistically significant. A slight but not significant increase in triglyceride levels was observed. Serum uric acid showed a significant increase throughout the entire period of treatment. No malabsorption syndrome or signs of toxicity were seen. Most frequent side effects were constipation, nausea, and metheorism which, with the exception of 4 cases which were withdrawn from the study, were reported as being transitory and mild.

The effect of imidazole-2-hydroxibenzoate on urinary excretion rates of glycosaminoglycans and albumin in 22 insulin-dependent diabetics with albumin excretion rates under 300 mg/day was evaluated in a 165-day double blind crossover study. Unlike placebo, the drug reduced glycosaminoglycan and albumin excretion rates significantly after 40 and 60 days of treatment, and the effects were significantly intercorrelated. Moreover, a parallel reduction in urinary excretion of N-acetyl-beta-D-glucosaminidase was also observed. These pharmacological effects may have a positive impact on the subsequent natural history of diabetic nephropathy.

Metformin's hypolipidemic effects (2.55 g/day for 3 months) have been studied in 19 subjects with Fredrickson's Type IV hyperprebetalipoproteinemia. The majority of patients were above ideal body weight (relative body weight = 118 +/- 2.7 %). Eleven of the subjects presented chemical diabetes, 5 fasting hyperglycemia, and 3 normal glucose tolerance. After treatment with metformin, body weight showed a slight, but significant reduction (--2.4 +/- 0.3 kg). Glucose tolerence was not substantially altered while basal glucose was significantly reduced in the 5 subjects with fasting hyperglycemia. Basal plasma insulin was significantly reduced in all the patients following metformin treatment. Insulin response to OGTT was slightly reduced in the subjects with fasting hyperglycemia. Independent of the patients' glucose tolerance, metformin treatment induced a marked decrease in plasma triglycerides (-- 40 %) and a reduction in plasma cholesterol (-- 12 %). No correlation was found between triglyceride and cholesterol reduction and body weight, glucose, and plasma insulin variations. Like phenformin, metformin acts not only on glucose metabolism and insulin secretion but on lipid metabolism as well.