Mildred R. Ziegler

Labeled Methionine as an Indicator of Protein formation in Children with Lipoid Nephrosis.

Summary 1. The rate of serum protein formation as indicated by the incorporation of methionine labeled with S35 was determined in 4 patients with lipoid nephrosis and in two control subjects. 2. The rate of serum protein formation thus determined would appear to be greater in the nephritic patients than in the control subjects.

Random notes concerning the etiological mechanisms and treatment of spontaneous hypoglycemia.

It has been estimated by some authorities ( 5 , 7 ) that the total number of persons afflicted with spontaneous hypoglycemia due to all causes is almost as great as the number suffering from diabetes mellitus. However this niay be for the adult population, our personal experience indicates clearly that hypoglycemia, exclusive of the transient form seen in newly born infants, occurs far more frequently than diabetes in infants and children under school age. Since this is the time of life when severe uncontrolled hypoglycemia has its most devastating effects on the brain, the clinical problem must be regarded as one of exceedingly great significance. The clinical states in which abnormally low blood glucose levels2 are encountered may be listed as follows: 1. transiently in newly born normal infants, 3. more severe form in some infants born of diabetic mothers (islet hyperplasia? ), 3 . essential glycogenosis or glycogen storage disease of von Gierke of hepatic type, 4. congenital galactosemia (galactosuric “diabetes”) with hypoglycosemia, 5. adrenocortical insufficiency or Addison’s disease, 6. anterior pituitary insufficiency, 7 . hypothyroidism, 8. extensive cirrhosis or other destructive disease of the liver, 9. post prandial, alimentary or “functional” hyperinsulinism, 10. gastrointestinal disturbances: extreme inanition, severe vomiting, diarrhea, or moribund state, 11. periodic or recurrent hypoglycemia, 13. severe renal glycosuria, 13. islet cell tumor of the pancreas (beta cell), 1.1. hypertrophy or hyperplasia of pancreatic islands (beta cells), 15. intraeranial disease (e.g, hypothalamic or diencephalic syndrome), and 16. infantile idiopathic hypoglyceniosis. The causative mechanisms or functional disturbances, which are responsible for the subnormal blood glucose level in the foregoing clinical conditions, differ widely. The nature of the therapy varies accordingly. Tn many of these

Effects of Pituitary Adrenocorticotropic Hormone (ACTH) in Children with Non-Addisonian Hypoglycemia

Summary The effects of ACTH on the fasting blood sugar level and glucose tolerance test; on the potassium and inorganic phosphorus content of the serum; on the nitrogen, phosphorus, chloride, sodium and potassium balances; on the urinary excretion of uric acid, creatinine and adrenal corticosteroids and on the blood eosinophil counts were determined in 5 young children with non-Addisonian (familial) hypoglycemia. The type of response to ACTH was similar in all respects to that of the normal adult. However, under the conditions of this experiment, instead of producing a transient state of diabetes mel-litus, as it does in the normal subject, the ACTH appeared merely to reverse the hypoglycemic tendency, with return of the fasting blood sugar level and the glucose tolerance curve to normal. While the eosinophil count returned to normal promptly upon withdrawal of ACTH, the blood sugar remained above the threshold for hypoglycemic reactions for at least 10 days without ACTH in the most severe case in the series (Fig. 1). Administration of 18 mg of ACTH in one dose every 48 hours thereafter served to maintain this one-year-old patient in an essentially non-hypoglycemic state for more than three additional weeks. Results of the study suggest that ACTH may prove to be as effective in the control of this non-Addisonian hypoglycemic disorder as insulin is in the control of diabetes mellitus.

Untersuchungen über den Mineralhaushalt nach Zufuhr von Hypophysenhinterlappensubstanz

ZusammenfassungUnter dem Einfluß von Hypophysenhinterlappensubstanz findet eine abnorme Kalium-Natrium- und Chlorausschwemmung statt, die auch während der Diuresehemmung zu einer negativen Bilanz im Mineralhaushalt führen kann. Die Ausscheidung von Calcium, Magnesium, Phosphor, Schwefel und Stickstoff bleibt weitgehend unbeeinflußt.

Mechanism of Insulin Convulsions. III. Effects of Varying Partial Pressures of Atmospheric Gases After Adrenalectomy

Conclusions Anoxic anoxia (breathing 5% O2 plus 95% N2) causes hypoglycemia in adrenalectomized dogs without insulin in contrast to the hyperglycemia observed in normal animals. Insulin convulsions are prevented by anoxia of this degree even when the fall in blood sugar is maximal. Breathing 15% CO2 likewise tends to prevent insulin convulsions from occurring.

Effects of Desoxycorticosterone Acetate on Water and Electrolyte Content of Brain and Other Tissues

In a previous study on the antagonistic action between pitressin and desoxycorticosterone acetate in epileptic subjects, the authors 1 found the latter substance to have a striking anti-convulsive effect for both spontaneously occurring and pitressin-induced seizures. The principal experimental subject involved- in that investigation, a young man with extremely severe epilepsy, has remained essentially free from convulsive attacks during the intervening 3 years while continuing to receive this synthetic hormone sublingually or by subcutaneous pellet implantation. The present experimental study was undertaken with the hope of obtaining some information regarding the physiological or pharmacological mechanism responsible for this effect. Our immediate objective was to determine the effects of the hormone on the water and electrolyte content of the brain tissue of normal animals. It has been abundantly demonstrated by Darrow and Miller 2 , 3 , and by Ferrebee and co-workers 4 that the potassium content of skeletal muscle, as well as that of blood plasma, is greatly reduced and the sodium content is somewhat increased by daily injections of comparatively large doses of desoxycorticosterone acetate. Heart muscle and liver showed much less, or (in some animals) no alteration. 3 Data regarding the brain were not reported by these authors. In the present study, changes in skeletal muscle, liver and heart muscle were determined for the purpose of comparison. Eighty young hooded rats (initial weights, 150 to 200 g each) maintained continuously from the time of weaning and throughout the experiments on a standard rat diet containing 0.605 g of K, 0.565 g of Na, and 1.155 g of CI per 100 g, were divided into two equal groups.

Mechanism of Insulin Convulsions. II. Effects of Varying Partial Pressures of Atmospheric O2, N2 and CO2

In connection with a study on the relationship between the levels of potassium, inorganic phosphorus and glucose in the blood and the occurrence of insulin convulsions 1 dogs were subjected to atmospheres varying greatly in their partial pressures of O2, N2 and CO2. The finding by Glickman and Gellhorn 2 that rats subjected to lowered O2 tension (air in low pressure chamber at 460 mm Hg) became more sensitive to insulin and had convulsions sooner than they did in ordinary air, suggested the use of induced anoxic anoxia as an additional means of modifying our experimental conditions. The fact that the convulsions of epilepsy 3 and those of hypoparathyroidism can not infrequently be prevented or aborted by the subjects breathing a gaseous mixture containing 10% CO2 and 90% O2 further suggested the desirability of investigating the influence of such alterations in the air breathed on the various constituents of the blood and on the occurrence of convulsions following the administration of insulin. The method used was that of determining the effects of insulin administration, first, when the experimental animal was allowed to breath room air, and again, one week later when the same animal was kept in an ordinary oxygen tent containing O2, N2 and CO2 at different partial pressures. The insulin was given subcutaneously in large single doses (10 to 25 units per kilo of body weight). In addition to the preliminary control experiments performed on all animals, the following studies were carried out : 17 experiments with low O2 percentages; 4 with high O2; 4 with high O2 plus high CO2; 4 with low O2 plus high CO2, and 10 with high CO2 plus 20% 02. The specific effects of the various gaseous mixtures per se were determined before insulin was administered in some instances.

Calcium enriched meat compared with milk as source of calcium, phosphorus and protein.

Summary The nutritional value of a Ca-enriched meat diet has been investigated from the viewpoint of protein, Ca and P utilization. This has been compared experimentally with a milk diet containing the same quantities of essential food constituents. Balance studies were carried out in 2 young hospital patients. Total carcass and separate femur analyses were also made in rats on the 2 types of diet. The results of these studies indicated clearly that the Ca-supplemented meat diet was equally good as the milk diet as a source of Ca, P, and protein.

Effect of Anoxia on Blood Sugar in Adrenalectomized-Pancreatectomized Dogs.

Conclusions Since pancreatectomy has been shown to abolish the hypoglycemic response of the adrenalectomized animals to anoxic anoxia, it may be concluded with Gellhorn that anoxia normally stimulates the parasympathetic (insulin response) as well as the sympathetic (adrenal response) system.

Plasma Electrolytes as Affected by Insulin and by Varying Partial Pressures of Atmospheric Gases

In recent studies on the mechanism of insulin convulsions in which the decreases in plasma potassium and inorganic phosphorus, as well as the degree of hypoglycemia, were measured at regular intervals, it was found that the level of blood sugar alone bears a constant relationship to the convulsion. 1 Further experiments on the effects of varying partial pressures of atmospheric gases, O2, N2 and CO2, showed that a drastic lowering of the O2 content or a marked increase in the CO2 of the respired air tended to prevent insulin convulsions entirely or greatly to delay their onset in the normal fasting dogs, even when the blood sugar was depressed to levels as low as or lower than those previously observed in the same animals before convulsions. 2 The latter finding indicates that some other factor in addition to hypoglycemia plays a role in the mechanism of insulin convulsions. In the hope of obtaining further information on this phase of the problem, the present studies pertaining to changes in the plasma electrolyte patterns under the foregoing conditions were undertaken. The procedure followed was that of determining the various electrolytes of the plasma before and at regular intervals after administration of convulsive doses of insulin to fasting unanesthetized dogs, first in room air and subsequently in the various abnormal atmospheres referred to above. No 2 experiments on the same animal were carried out at intervals shorter than one week. The plasma electrolyte patterns were determined as follows: 12 times in 5 normal fasting dogs in room air; 3 times in 3 of the same dogs between 210 and 240 minutes after administering convulsive doses of insulin but before convulsions occurred; twice in 2 of the dogs 15 minutes following the insulin convulsion; 3 times in 3 of these animals after 150 minutes in a tent containing approximately 5% O2 and 95% CO2; twice under the latter conditions on 2 of the same dogs but with the administration of previously determined convulsive doses of insulin; twice in 2 dogs after 150 minutes in an atmosphere containing approximately 15% CO2, 20% O2 and 65% N2 and twice in the latter animals under the same conditions but with the administration of large doses of insulin.