Hulda J. Wohltmann

Flush method for blood pressure determinations in newborn infants

Summary A visual method of determination of blood pressures in newborn infants is presented. The cuff is placed around the ankle or wrist in the usual manner and a piece of rubber sheeting or old rubber glove is wrapped snugly around the foot or hand, so that the blood is pressed from the extremity. The cuff is then inflated to a pressure slightly above the suspected systolic pressure, the rubber bandage is then removed and the pressure is slowly released from the cuff. The approximate systolic pressure is the reading at which blood suddenly re-enters the foot or hand, causing a flush.

Lactate metabolism: Studies of a child with a serious congenital deviation

After a short summary of experiences with sodium lactate in the treatment of metabolic acidosis over a 30 year period, we present clinical and metabolic findings in a child born with a serious defect in the metabolism of lactate. The consequences were a constant threat of severe and perhaps fatal acidosis and tetany-like episodes leading to severe respiratory obstruction on the basis of bronchiolar muscle spasm and sometimes laryngeal spasm which would superimpose severe respiratory acidosis on an already severe metabolic acidosis. It is our opinion that no such case has previously been described.

Recognition and investigation of hypoglycemia.

F R o 1~ our experience with children with hypoglycemia during the past 35 years, we have come to feel that the disease is often not recognized before considerable brain damage has occurred. Early positive diagnosis and understanding of the etiology of hypoglycemia demand a high index of suspicion, proper laboratory evaluation, and a methodical plan of study. Suspicion of its possibility should be aroused both by the clinical picture and by circumstances judged favorable to its development, even in the absence of clearcut signs or symptoms. The latter is especially true of newborn or very young infants and of children who have had many episodes of hypoglycemia and who seem to have acquired some tolerance for it. The clinical picture seems dependent on quite a number of factors, such as age, duration of the hypoglycemia, its etiology,

Studies related to the concept that a thiol disulfide interchange is involved in the action of insulin on muscle cells

Abstract The accumulation and retention of [ 131 I]insulin were studied in isolated frog sartorius muscles that were first incubated with [ 131 I]insuline and then washed with Ringers solution. Most of the radioactive material that was retained in the tissue after thorough washing with ice-cold Ringers solution could be extracted later with 8 M urea. A portion of the labeled material that remained in the tissue after extraction with 8 M urea could be removed by additional washing with solutions that contained cysteine. These findings agree with the earlier results of other investigators who concluded that the action of insulin may involve formation of a disulfide bond linking the hormone to the tissue. However, the present extension of these studies has revealed that the amount of radioactive material (derived from labeled insulin) that could be extracted from frog sartorius muscles with cysteine solutions was not directly related to the magnitude of the effect of insulin on permeability to sugar. Therefore, demonstration of a release of radioactive material in the presence of cystein does not necessarily indicate that the biological action of insulin in skeletal muscle involves the formation of a disulfide bond between insulin and a specific receptor site in the tissue.