K. R. Crispell

A STUDY OF THE RATE OF PROTEIN SYNTHESIS BEFORE AND DURING THE ADMINISTRATION OF L-TRIIODOTHYRONINE TO PATIENTS WITH MYXEDEMA AND HEALTHY VOLUNTEERS USING N-15 GLYCINE

The purpose of this paper is to report studies of the protein synthesis rate and the size of the metabolic pool using the amino acid, glycine labeled with isotopic nitrogen N-15. Employing the technique described by San Pietro and Rittenberg (1) studies were made on six patients with primary myxedema, four of them before and during the administration of l-triiodothyronine.2 Five healthy volunteers, one of whom received 1-triiodothyronine, are also included in this report. The N-15 glycine method used in this study is based upon the assumptions that dietary amino acids interact with tissue constituents at a rapid rate (2) and that a dietary amino acid either is used for protein synthesis or is oxidized and its nitrogen excreted. Figure 1, modified from San Pietro and Rittenberg, illustrates the technique. The metabolic pool (P) is defined as the mixture of nitrogenous compounds derived from the diet and from the breakdown of tissues. Dietary nitrogen enters this pool where part of it is used for protein synthesis. Another part is converted to urea, mixes with the urea already present and is excreted in the urine. The small amount of non-urea nitrogen can be disregarded. The total urea in the body constitutes the urea pool. For the steady

Addison's disease associated with histoplasmosis:Report of four cases and review of the literature

Abstract 1.1. Four cases of Addisons disease associated with proved histoplasmosis are reported. Three of the patients are alive and in fair health five years, three years and three months, respectively, after the diagnosis of the two diseases had been established. The autopsy of the fourth case revealed destruction of the adrenal glands by caseation necrosis. The necrotic material contained H. capsulatum. 2.2. Two of the four cases reported were first diagnosed as sarcoidosis on the basis of lymph node biopsy. 3.3. Histoplasmosis should be considered as an etiologic agent in Addisons disease as suggested by these cases and by a review of 103 cases of histoplasmosis in which 35 per cent of the cases were found to have adrenal involvement. This is a higher incidence of adrenal involvement than in the other systemic mycoses.

Functioning metastatic carcinoma of the thyroid producing clinical hyperthyroidism

Abstract A patient with thyrotoxicosis secondary to hyperfunctioning distant metastases from carcinoma of the thyroid is presented. At no time could functioning thyroid tissue be identified in the neck, whereas the metastases avidly concentrated radioactive iodine. Therapy with I 131 resulted in decrease in size of some metastatic masses and return of the patient to the euthyroid state.

Clinical studyAddison's disease associated with histoplasmosis: Report of four cases and review of the literature

Abstract 1.1. Four cases of Addisons disease associated with proved histoplasmosis are reported. Three of the patients are alive and in fair health five years, three years and three months, respectively, after the diagnosis of the two diseases had been established. The autopsy of the fourth case revealed destruction of the adrenal glands by caseation necrosis. The necrotic material contained H. capsulatum. 2.2. Two of the four cases reported were first diagnosed as sarcoidosis on the basis of lymph node biopsy. 3.3. Histoplasmosis should be considered as an etiologic agent in Addisons disease as suggested by these cases and by a review of 103 cases of histoplasmosis in which 35 per cent of the cases were found to have adrenal involvement. This is a higher incidence of adrenal involvement than in the other systemic mycoses.

The Relation of Dietary Protein Consumption to N-15 Excretion in Normal Subjects and in Cushing's Syndrome Utilizing N-15 Glycine Orally and Intravenously

In a previous paper (1) we have reported studies on the percentage of N-15 excreted over a twenty-four hour period following the oral administration of N-15 glycine to normal subjects and to patients with Cushings syndrome in nitrogen equilibrium on diets containing approximately one gram of protein per kilogram of body weight. During this study it was noted that the level of protein intake influenced the percentage of N-15 excreted in the urine, an observation first reported by Sprinson (2) in animals and in a healthy volunteer. The present paper presents data on the influence of various levels of protein intake on the percentage of N-15 excreted in the urine over a twenty-four hour period following either oral or intravenous administration of N-15 glycine to healthy volunteers. Similar data from a patient with Cushings syndrome given N-15 glycine orally are also presented.

Coexistence of Cushing's syndrome and internal hydrocephalus produced by a cerebellar tumor.

Abstract A case history is presented of a patient who had a cerebellar tumor resulting in block of the ventricular system with marked internal hydrocephalus. He presented in addition the classical picture of Cushings syndrome. The possibility that hypothalamic damage may have resulted in Cushings syndrome is considered.

Alterations of protein metabolism in myxedema.

W I’IYH the exception of the reduction in total energy exchange, perhaps the most conspicuous alteration in the athyrotic state is that in protein metabolism.“’ This statement by Means clearly poses the problem which is the subject of this presentation. Protein abnormalities in myxedematous patients have interested investigators for some time, and it is the purpose of this communication to summarize some of these studies. An attempt will be made to correlate studies from our laboratory with those in the literature in an effort to formulate a working concept of abnormalities of protein metabolism in patients with myxedema. Experimental investigations in animals which apply to this problem will also be reviewed.