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Glucose Ratio (glucose + ratio)
Selected AbstractsSimple Measures to Monitor ,-Cell Mass and Assess Islet Graft DysfunctionAMERICAN JOURNAL OF TRANSPLANTATION, Issue 2 2007R. N. Faradji The aim of this study was to develop a simple test for the assessment of islet graft dysfunction based on measures involving fasting C-peptide. Calculations were made to account for the dependence of C-peptide secretion on glucose concentration (C-peptide/glucose ratio [CP/G]) and adjusted for renal function by calculating the C-peptide/glucose-creatinine ratio (CP/GCr). Values from 22 recipients were analyzed at different times post-last islet infusion. Receiver operating characteristic curves were used to determine which of these measures best predicts high 90-minute glucose (90 min-Glc; >10 mmol/L) after a Mixed Meal Tolerance Test (MMTT). In this initial analysis, CP/G was found to be superior predicting high 90 min-Glc with a larger area under the ROC curve than C-peptide (p = 0.01) and CP/GCr (p = 0.06). We then correlated C-peptide and CP/G with islet equivalents-IEQ/kg infused, 90 min-Glc after MMTT and clinical outcome (,-score). C-peptide and CP/G in the first 3 months post-last islet infusion correlated with IEQ/kg infused. CP/G correlated with 90 min-Glc and ,-score. C-peptide and CP/G are good indicators of islet mass transplanted. CP/G is more indicative of graft dysfunction and clinical outcome than C-peptide alone. The ease of calculation and the good correlation with other tests makes this ratio a practical tool when monitoring and managing islet transplant recipients. [source] Guidelines on routine cerebrospinal fluid analysis.EUROPEAN JOURNAL OF NEUROLOGY, Issue 9 2006Report from an EFNS task force A great variety of neurological diseases require investigation of cerebrospinal fluid (CSF) to prove the diagnosis or to rule out relevant differential diagnoses. The objectives were to evaluate the theoretical background and provide guidelines for clinical use in routine CSF analysis including total protein, albumin, immunoglobulins, glucose, lactate, cell count, cytological staining, and investigation of infectious CSF. The methods included a Systematic Medline search for the above-mentioned variables and review of appropriate publications by one or more of the task force members. Grading of evidence and recommendations was based on consensus by all task force members. It is recommended that CSF should be analysed immediately after collection. If storage is needed 12 ml of CSF should be partitioned into three to four sterile tubes. Albumin CSF/serum ratio (Qalb) should be preferred to total protein measurement and normal upper limits should be related to patients' age. Elevated Qalb is a non-specific finding but occurs mainly in bacterial, cryptococcal, and tuberculous meningitis, leptomingeal metastases as well as acute and chronic demyelinating polyneuropathies. Pathological decrease of the CSF/serum glucose ratio or increased lactate concentration indicates bacterial or fungal meningitis or leptomeningeal metastases. Intrathecal immunoglobulin G synthesis is best demonstrated by isoelectric focusing followed by specific staining. Cellular morphology (cytological staining) should be evaluated whenever pleocytosis is found or leptomeningeal metastases or pathological bleeding is suspected. Computed tomography-negative intrathecal bleeding should be investigated by bilirubin detection. [source] Development of a mathematical model for Bacillus circulans growth and alkaline protease production kineticsJOURNAL OF CHEMICAL TECHNOLOGY & BIOTECHNOLOGY, Issue 2 2009Chaganti Subba Rao Abstract BACKGROUND: An unstructured mathematical model was developed to understand information on the relationship between Bacillus circulans growth and metabolism-related protease production (using logistic and Luedeking,Piret equations respectively) in a batch reactor with respect to glucose consumption and fermentation time. The objective was to develop an indispensable tool for the optimisation, control, design and analysis of alkaline protease production. RESULTS: Biomass growth and enzyme production titres changed with a change in substrate concentration. Modelling analysis of biomass and enzyme production titres at different substrate concentrations revealed significant accuracy in terms of statistical consistency and robustness with respect to fermentation kinetic profiles. CONCLUSION: With the B. circulans strain used, an economic protease yield (2837 × 103 U g,1) with respect to biomass and glucose ratio was achieved at low substrate concentration (10 g L,1). The developed model could be effectively utilised for designing, controlling and up-scaling the protease production process in high-density fermentation in selected bioreactors with statistical consistency. Copyright © 2008 Society of Chemical Industry [source] A 5-year follow-up study of disease incidence in men with an abnormal hormone patternJOURNAL OF INTERNAL MEDICINE, Issue 4 2003R. Rosmond Abstract Rosmond R, Wallerius S, Wanger P, Martin L, Holm G, Björntorp P (The Cardiovascular Institute, Sahlgrenska University Hospital, Göteborg; and Huddinge University Hospital, Huddinge; Sweden). A 5-year follow-up study of disease incidence in men with an abnormal hormone pattern. J Intern Med 2003; 254: 386,390. Objectives. Previous studies have suggested that abnormal levels of cortisol and testosterone might increase the risk of serious somatic diseases. To test this hypothesis, we conducted a 5-year follow-up study in middle-aged men. Methods. A population-based cohort study conducted in 1995 amongst 141 Swedish men born in 1944, in whom a clinical examination supplemented by medical history aimed to disclose the presence of cardiovascular disease (CVD) (myocardial infarction, angina pectoris, stroke), type 2 diabetes and hypertension were performed at baseline and at follow-up in the year 2000. In addition, salivary cortisol levels were measured repeatedly over the day. Serum testosterone concentrations were also determined. Using the baseline data, an algorithm was constructed, which classified the secretion pattern of cortisol and testosterone from each individual as being normal or abnormal. Results. By the end of follow-up, men with an abnormal hormone secretion pattern (n = 73) had elevated mean arterial pressure (P = 0.003), fasting insulin (P = 0.009) and insulin : glucose ratio (P = 0.005) compared with men with a normal secretion pattern (n = 68). Body mass index, waist circumference, and waist : hip ratio were significantly elevated in both groups. However, the 5-year incidence of CVD, type 2 diabetes, and hypertension were significantly higher (P < 0.001) in men with an abnormal neuroendocrine secretory pattern compared to men with a normal pattern. Conclusions. These data suggest that an abnormal neuroendocrine secretory pattern is prospectively associated with an increased incidence of cardiovascular-related events and type 2 diabetes. [source] Seizures, ataxia, developmental delay and the general paediatrician: Glucose transporter 1 deficiency syndromeJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2006David J Coman Aim Glucose transporter 1 deficiency syndrome (GLUT1-DS) is an important condition for the general paediatrician's differential armamentarium. We describe a case series of eight patients in order to raise awareness of this treatable neurometabolic condition. The diagnosis of GLUT1-DS is suggested by a decreased absolute cerebrospinal fluid (CSF) glucose value (<2.2 mmol/L) or lowered CSF: plasma glucose ratio (<0.4). Methods This is a review of eight Queensland patients with GLUT1-DS. The clinical presentation, clinical course, laboratory investigations and treatment outcomes are discussed. Results The clinical features noted in our patient cohort include combinations of ataxia, developmental delay and a severe seizure disorder that is refractory to anticonvulsant medications. Seizures are the most common clinical manifestation and may be exacerbated by phenobarbitone. The paired CSF: plasma glucose results ranged from 0.2 to 0.39 (normal <0.6) with an average of 0.33. 3-O-Methyl-D-Glucose uptake and GLUT1 Genotyping analysis have been performed on five patients thus far. Rapid and impressive seizure control was observed in 100% of our patients once the ketogenic diet was instituted, with half of the cohort being able to wean completely from anticonvulsants. Conclusion Children presenting with a clinical phenotype consisting of a refractory seizure disorder, ataxia and developmental delay should prompt the consideration of Glucose transporter 1 deficiency syndrome. While the diagnostic test of lumbar puncture is an invasive manoeuvre, the diagnosis provides a viable treatment option, the ketogenic diet. GLUT1-DS displays clinical heterogeneity, but the value of early diagnosis and treatment is demonstrated by our patient cohort. [source] Natural Changes in Peritoneal Equilibration Test Results in Continuous Ambulatory Peritoneal Dialysis Patients: A Retrospective, Seven Year Cohort SurveyARTIFICIAL ORGANS, Issue 4 2000Kuan-Yu Hung Abstract: We conducted a retrospective, 7 year cohort survey to examine the natural changes in peritoneal equilibration test (PET) results in patients with long-term uneventful continuous ambulatory peritoneal dialysis (CAPD). Thirty-two (17 males, 15 females) patients on CAPD with two or more standard PETs performed more than 6 months apart, in the absence of peritoneal insult, were included. Changes and pattern of PET results were evaluated by the dialysate to plasma ratio of creatinine (D:P-cre), the fourth h dialysate to instilled glucose ratio (D4:Do) and ultrafiltration volume (UF, ml). The subgroups included high (H), high-average (HA), low-average (LA), or low (L) transporters with the dividing ratios (D:P-cre) of >0.81, >0.65 to 0.81, >0.5 to 0.65, and <0.5, respectively. The median D:P-cre significantly decreased (p = 0.04), but neither the D4:Do nor the final median UF significantly decreased. The change in D:P-cre was strongly and inversely correlated with the initial D:P-cre value (r = ,0.68; p < 0.05). A similar relationship was found between the change in the final D4:Do and the initial D4:Do (r = ,0.752; p < 0.01) and between the change in the final UF and the initial UF (r = ,0.875; p < 0.01). No correlation was found between the change in D:P-cre and the age of the patient, the time interval between PETs, monthly dialysate glucose exposure, or underlying diabetes/non-diabetes. The final peritoneal transport pattern was altered with 5 (15.6%) patients remaining in the extreme subgroups (H or L) and, by contrast, 84.4% (27/32) of the patients now in the averaged (HA or LA) groups (p < 0.01, ,2 test). We demonstrated a natural "centralization" migration of PET results after long-term uneventful CAPD, which may help to explain why patients with extreme PET characteristics, that is, H or L, continued to do well on CAPD. [source] Assimilate transport in grapevines -effect of phloem disruptionAUSTRALIAN JOURNAL OF GRAPE AND WINE RESEARCH, Issue 3 2001J.J.(KOBUS) HUNTER Abstract Assimilate translocation in mature grapevines (cv. Gewürztraminer and cv. Harslevelü) under field conditions was investigated during the growth season by quantifying individual sugars and organic acids in mature leaves, shoot bark and berries, as affected by girdling the shoot just above the bunches. Tissue was sampled at berry set, pea size, veraison and ripeness stages of the vine. Invertase activity was determined in the shoot bark at ripeness. In the leaves, malic acid concentrations reached lowest levels at pea size, but increased thereafter. Tartaric acid decreased after peaking at pea size stage. Tartaric acid concentrations increased with girdling. Despite the increase in leaf age, sucrose concentrations remained virtually stable during the season, emphasising the importance of mature leaves for nourishing bunches. Girdling resulted in a build-up of sucrose in the leaves. In the bark, malic and tartaric acid stayed more or less the same during the growth period, but increased above the girdle. As a result of phloem disruption, sucrose also increased. The increase in glucose and tartaric acid is believed to result from catabolic cleavage of sucrose by invertase. Invertase activity was evident in the bark (of mature Harslevelü vines) at ripeness, which may indicate involvement in osmotic adjustments and gradients in the bark/phloem structure. In the berries, malic and tartaric acids reached peak concentrations at pea size. The volume increase during the ripening period, and in the case of malic acid also respiratory loss, resulted in a decrease in organic acid concentration. Malic acid continued to decrease after the initial decline, whereas tartaric acid stayed virtually stable. Girdling had no marked effect on organic acid accumulation in the berries. Sucrose concentrations were low during the first part of the season, but increased thereafter. Sucrose concentrations during ripening increased with girdling, which may represent a concentration effect and/or import from the rest of the vine. Sucrose concentrations (in mature Harslevelü vines) were indeed lower below than above the girdle. Comparison of sucrose concentrations in the leaves, bark and berries showed the existence of a decreasing concentration gradient, in line with the source:sink transport concept. An equally prominent decrease in sucrose:glucose ratio in the berries from the start of the ripening period indicates that vacuolar integrity (compartmentation) was affected in the ripening berry, most probably allowing hydrolysis of sucrose by invertase and decreasing osmotic potential within the berry. The results provide further evidence for the hypothesis of an osmotic gradient driven transport to the berry. [source] Beta-cell function evaluated by HOMA as a predictor of secondary sulphonylurea failure in Type 2 diabetesDIABETIC MEDICINE, Issue 7 2001M. J Taverna Abstract Background and aims Secondary failure to oral hypoglycaemic agents, a common evolution of long-standing Type 2 diabetes, is usually assessed by non-standardized indices requiring fine clinical assessment, including hyperglycaemia resistant to maximum doses of sulphonylureas despite appropriate diet and follow-up. The goal of this study was to evaluate if HOMA, a modelized plasma insulin/glucose ratio allowing simple evaluation of residual insulin secretion and sensitivity, is a better predictor of the insulin requiring stage than clinical indices. Materials and methods HOMA was measured in 84 Type 2 diabetic patients aged 58 ± sd 6 years, with diabetes duration 11 ± 4 years, hospitalized because of hyperglycaemia resistant to maximal doses of sulphonylureas (e.g. glibenclamide ,,15 mg/day), with no apparent external reason for hyperglycaemia. Despite reinforced appropriate diet recommendations, 62 of these patients remained hyperglycaemic (insulin-requiring group). Results Age, duration of diabetes, body mass index (BMI) and HOMA value for insulin sensitivity (71 ± 6% vs. 76 ± 7%, normal values 59,161%) were comparable in the two groups. HbA1c was higher (10.0 ± 0.2% vs. 8.3 ± 0.3%, P < 0.001) and HOMA insulin secretion values lower (25 ± 2% vs. 43 ± 6%, normal values 70,150%, P < 0.01) in the insulin-requiring group. Of the following potential predictors: HbA1c >,8%, duration of diabetes ,,10 years, HbA1c combined with diabetes duration, insulin sensitivity ,,40%, insulin secretion ,,20%, the latter showed the best positive predictivity (86% patients with low insulin secretion were insulin-requiring). Conclusions (i) HOMA is a simple and good predictor of the insulin-requiring stage in Type 2 diabetes mellitus; (ii) this stage of diabetes is characterized by a further decline of insulin secretion rather than of insulin sensitivity. Diabet. Med. 18, 584,588 (2001) [source] | |||||||||||||