giovedì 7 maggio 2009

Quantum Biophysical Semeiotics Evaluation of pancreatic beta-Cell Function by means of acute pick stimulation of GH-RH secretion.




Introduction.

Among other well-known biological activities, Growth Hormone (GH) plays an important role in metabolism, as well as in regulating insulin secretion from the b-pancreatic cells, additionally controlling GH-RH secretion (analogously, e.g., thyroid hormone) (1-8).

Interestingly, the emerging age of Quantum Biophysical Semeiotics allows doctors, especially General Practitioners, to assess pancreas chaotic-determinist oscillations (fluctuations – 6 x sec. – of pancreatic body vertical diameter) (1-8), correlated with functional endocrine activity of the gland, according to Angiobiopathy theory (6-12).

(For technical information,See http://www.semeioticabiofisica.it, Technical Page 4).

The acute stimulation of GH-RH secretion, is brought about by “mean-intense” digital pressure applied on the related trigger-points (Fig.1 and 2).

Consequently, with the aid of Quantum Biophysical Semeiotics, physicians can evaluate bedside endocrine pancreas efficiency during the acute stimulation of the GH-RH and, thereby, obtaining useful and reliable GH information regarding current insulin secretion activity and efficiency (1, 2, 4, 7, 8).

Moreover, quantum-biophysical-semeiotic preconditioning (9), (also http://www.semeioticabiofisica.it ), enables the the practitioner can assimilate information (using the variables of Auscultatory Percussion and so-called Auscultatory Percussion-Reflex-Diagnostic, which studies non-linear dynamics of all biological systems) regarding the patient’s condition, as well as the possible insulin secretion evolution: physiological insulin secretion, hypersecretion of insulin (IIR) with or without initial failure of the pancreatic b-cells (prediabetes), overt type 1 and type 2 diabetes mellitus, even in early phase.

Finally, bedside evaluation can also reveal pancreatic endocrine activity, employing analogously other “endogenous” hormones of insulin counter-regulation (i.e., thyroid hormone, glucagone, adrenalin) (6, 7).

Method.

With the subject in supine position, psycho-physically relaxed (eyes open to avoid the melatonin secretion), the practitioner performs repetitive auscultatory percussion of a short tract of the lower pancreatic margin, assessing accurately its fluctuations, chaotic-determinist under physiological condition (Fig. 1).

For comprehensible reasons, the gathered data are meal-dependent, showing different parametric values in relation to the meals, i.e., in the absorptive or in the post-absorptive state.

However, in the practice, such as fact results neither important nor significant.

Notoriously, in overt type 2 diabetes, that is to say in manifest disorder, the dimensionality (i.e., value of deterministic chaos in a determined biological system, in our case the pancreas) fluctuations appear significantly and gradually reduced, all equal, and minimal, showing the fractal dimension of 1, i.e., topological dimension (6).

At this point, General Practitioner applies “mean-intense” digital pressure on the trigger-points of GH-RH neuronal centre, that is located 2 cm. over external auditory meatus (Fig. 2), evaluating accurately the pancreatic size behaviour.

In health, after approximately 6 seconds, the pancreas decongests suspending temporarily its secretive activity: the lower margin of the pancreatic body rises and remains in this higher position for 10 sec. exactly. In the absorptive state, the duration is approximately 11-12 seconds (in a non significant manner).

Under this experimental condition, pancreatic microcirculation shows the phenomenon of “microcirculatory disactivation”, characterized from minimal microvessel activity, resulting from the lesser flow-motion: in both vasomotility and vasomotion, according to Hammersen (7) fluctuation intensity is hardly 0,5 cm., and the durartion of AL + PL phase appears to be 5 sec., (6, 8, 10,11, 12) (See the above cited web site http://www.semeioticabiofisica.it/microangiologia).

On the contrary, in the subject with insulin hypersecretion (IIR), the pancreas decongestion (i.e., pancreatic functional rest) appears prolonged (12-14 sec. significantly) in direct relationship with the intensity of insulin secretion (i.e., hyperinsulinaemia).

The behavior of the pancreas during the biophysical-semeiotic preconditioning is briefly illustrated, allowing the practioner to immediately recognize insulin hypersecretion (IIR), with or without slow tendency to the b-pancreatic cell failure, and, lastly, overt type 2 diabetes.

In diabetes mellitus, even in its initial phases, the duration of pancreatic decongestion appears significantly reduced (£ 9 sec.), in obvious relation the severity of the underlying disorder.

Beside evaluation can result in important data regarding insulin secretion using quantum-biophysical-semeiotic preconditioning. (After accurately assessing the duration of pancreatic decongestion brought about by the acute peak of the GHRH secretion, withdraw the digital pressure, consequently removing the hormonal hypersecretion of GH, for 5 seconds exactly. Immediately repeat the evaluation a second time, as described above.)

In a healthy patient, the duration of the pancreatic decongestion rises from exactly 10 sec. (i.e., normal basal value) to 14 sec., in a statistically significant way, a result of the physiological activation of local Microcirculatory Functional Reserve (9, 10).

Interestingly, in hyperinsulinsecretion (IIR), one observes a large number of parameter (i.e., duration) behaviours, which parallel the present functional efficacy of the endocrine pancreas activity, in individuals with or without diabetic constitution (11):

a) in preconditioning, the duration of pancreatic decongestion can arise either to more than 14 sec. or hardly to 11-12 sec. in not meaningful way, in relation to the efficiency condition of insulin secretion;

b) the duration does not show modification, so that it persists unchanged in the comparison of the initial, basal value;

c) this parametric value (= duration length) results reduced, e.g., 9 sec., indicating the “quantitative” alteration of b-cell secretion.

Identical are the data collected also, for example, using the stimulation of the TSH-RH (Fig.2), that provokes the acute peak of thyroid hormone secretion, as demonstrates the contemporaneous associated microcirculatory activation, type 1, in the thyroid (8, 9): “variant” biophysical semeiotics test.

Discussion and conclusions.

Today, literature worldwide reflects an increased urgency for early recognition of the Metabolic Syndrome, and its risk factors (CAD, CVD, type 2 DM, etc.) as well as its pathophysiological and clinical definition (13-15).

From quantum-biophysical-semeiotic view-point (6, 12, 14, 15), Pre-Metabolic Syndrome, always precedes Metabolic Syndrome for years and even decades, (V. also http://www.semeioticabiofisica.it/microangiologia), and involves both sexes, with or without diabetes, but “all” experiencing dyslipidaemic complication..

For this reason, we can finally understand why glucose metabolism alterations and type 2 diabetes are present only in well-defined patient population with metabolic syndrome, as well as why doctors can now fortunately recognize numerous early clinical stages of the metabolic syndrome resulting in positive and favorable benefits in primary prevention..

Because of the numerous and dangerous complications of Metabolic Syndrome in individuals with both dyslipidaemia and diabetes, large scale optimal primary prevention of metabolic syndrome, is needed to allow doctors the diagnostic “clinical” tool, to determine pancreatic endocrine complications and enabling future monitoring.

As recent as four years ago, Biophysical Semeiotic testing became a reliable and useful means for clinicians, to assess insulin-secretion conditions, physiological and pathological, including functional failure of pancreatic b-cells, even in the initial stage.

In conclusion, Quantum-Biophysical Semeiotic testing, above briefly described, is a useful tool for diagnosis, therapeutic monitoring, and clinical research.

References.

1) Stagnaro S., Stagnaro-Neri M. Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131, 1986.

2) Stagnaro-Neri M., Stagnaro S., Il Segno di Bilancini-Lucchi nella diagnosi clinica del diabete mellito. The Pract. Ed. It. 176, 30,1993.

3) Stagnaro-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617, 1993 [Medline]

4) Stagnaro S., Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. letter [Medline]

5) Stagnaro S. Pre-metabolic syndrome: the real initial stage of metabolic-syndrome, type 2 diabetes and arteroscleropathy. Cardiovascular Diabetology 2004, 3:1

http://www.cardiab.com/content/3/1/1/comments.

6) Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Travel Factory SRL., Roma, 2004.

http://www.travelfactory.it/semeiotica_biofisica.htm.

7) Cited in: S.B. Curri. Le Microangiopatie. Inverni della Beffa, Verona, 1986.

8) Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: valutazione clinica del picco precoce della secrezione insulinica di base e dopo stimolazione tiroidea, surrenalica, con glucagone endogeno e dopo attivazione del sistema renina-angiotesina circolante e tessutale. Acta Med. Medit. 13, 99, 1997.

9) Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: la manovra di Ferrero-Marigo nella diagnosi clinica della iperinsulinemia-insulino resistenza. Acta Med. Medit. 13, 125,1997.

10) Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. 13, 109,1997.

11) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche. Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Ediz. Travel Factory, Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm

12) Stagnaro S., Stagnaro-Neri M., Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Travel Factory SRL., Roma, 2005. http://www.travelfactory.it/semeiotica_biofisica.htm

13) Kahn R., Buse J., Ferrannini E. and Stern M. The Metabolic Syndrome: Time for a Critical Appraisal.Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes . Diabetes Care 28:2289-2304, 2005.

14) Stagnaro Sergio. Pre-Metabolic Syndrome and Metabolic Syndrome: Biophysical-Semeiotic Viewpoint. www.athero.org, 29 April, 2009. http://www.athero.org/commentaries/comm904.asp
15) Stagnaro Sergio. CAD Inherited Real Risk, Based on Newborn-Pathological, Type I, Subtype B, Aspecific, Coronary Endoarteriolar Blocking Devices. Diagnostic Role of Myocardial Oxigenation and Biophysical-Semeiotic Preconditioning. www.athero.org, 29 April, 2009 http://www.athero.org/commentaries/comm907.asp

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