Nathan Hiatt

Necessity for insulin in transfer of excess infused K to intracellular fluid.

Abstract Dogs respond to appropriate infusions of KCl with a rise of serum insulin and transfer of much of the infused K to ICF. The ability to transfer infused K to ICF is insulin dependent; it is abolished by pancreatectomy and fully restored by insulin. The actual level of serum insulin involved in K transfer is definitely influenced by the extent of urinary K loss. In dogs, it appears that insulin is indispensable to an adaptive mechanism that protects the heart from rapid additions of excess K to ECF.

The conquest of Addison's disease.

BACKGROUND A review of the understanding and treatment of adrenal insufficiency was undertaken to emphasize common themes in the history of endocrine disorders. METHODS Literature survey. RESULTS The presence of the adrenal glands, initially ignored by anatomists, was first described by Eustachius and later confirmed by Casserius. Bartholin identified the glands as ductless. In 1855, Thomas Addison described the clinical syndrome of adrenal insufficiency. Medullary hormonal effects were described by Oliver and Shäfer in 1895; epinephrine was isolated by Takamini, and the secretory patterns were characterized by Cannon. Cortical function was elucidated by Biedl and Stewart and Rogoff, and the first cortical hormones were synthesized by Reichenstein. Hormonal replacement therapy paved the way for the first bilateral adrenalectomy, which was performed in 1950. CONCLUSIONS This review underscores the historical themes in endocrine diseases: discovery of the glands, identification of their hormonal products, use of the hormones for therapy, and biosynthesis for pharmacologic applications.

Influence of Intestinal Content on Radiation Lesions of the Small Intestine

Summary The abdomens of dogs with T-V fistulas of the jejunum were irradiated with 1,000 and l,500r. The post-irradiation lesions in the small intestine in continuity were typical. Those in the fistulas, where intestinal content was absent, were considerably less intense.

Prolongation of Postirradiation Survival by Diversion of Intestinal Content

Diversion of the intestinal contents by converting 95% of the small intestine into a T-V fistula 3 to 5 days before x-irradiation of the abdomen (1500 R) prolongs the survival time of dogs receivin...

Modification of cardiac and hyperglycemic effects of epinephrine by insulin

Abstract After dogs are injected intravenously with epinephrine, there is considerable hyperglycemia and an increase in the rate and force of the heart beat. However, if dogs are injected with epinephrine five minutes after pre-treatment with insulin there is only a minimal rise in the blood glucose and no significant changes in the rate and force of the heart beat. Our results suggest that the insulin and epinephrine mechanisms may share a common site of action, not only in the liver but in the heart.

Cardiac sensitivity to hyperkalemia in adrenalectomized dogs.

Summary In dogs with bilateral adrenal-ectomy loaded with K by infusion of 2 mEq KCl/kg/hr there is a marked increase of cardiac sensitivity to hyperkalemia. Typical ECG changes begin at lower serum K levels (5-6 mEq/1) and the prelethal arrhythmias that signal the imminent onset of fatal ventricular fibrillation or asystole appear when mean serum K is 7.6 mEq/1, 2.9 mEq/1 above the average pre-infusion level. In control dogs, ECG changes start above 8 mEq K/liter, and prelethal arrhythmias appear between 9.5 and 10.2 mEq/1, a mean increase of 5.6 mEq/1 above the average preinfusion level. We wish to acknowledge our thanks to Mr. George Bonorris for the statistical analyses and Ms Eleanor Chapman for the chemical determinations.

Oxytetracycline and hypoglycemia with convulsions in pancreatectomized dogs.

Summary Addition of oxytetracycline to intravenous fluid used to maintain pancrea-tectomized dogs brings about a state of hypo-glycemia with staggering and convulsions that only infrequently responds to administration of glucose. The liver glycogen of these dogs is usually normal and occasionally elevated. During the state of hypoglycemia with staggering and convulsions the rise of the blood glucose following intravenous injection of adrenalin or glucose (glucose tolerance test) is transient; the rise of the blood glucose following intravenous injection of glucagon is large and sustained.

Acetazolamide impairment of the transfer of infused K from extracellular to intracellular fluid

Abstract In intact dogs K loaded by infusion with 2 mEq KC1/kg/hr, treatment with acetazolamide produces both a profound kaluresis and a marked impairment of the animals ability to transfer the infused K to intracellular fluid. The impairment is unrelated to kaluresis, since it is substantially the same in nephrectomized animals. Neither does the impairment stem fromacetazolamide induced acid- osis - there is a similar fall of blood pH in untreated control animals in which there is brisk transmembrane K transfer of infused K; and the ability to transfer K is relatively unimpaired in nephrectomized dogs rendered acidotic by HCl administration. Acetazolamide is an effective therapeutic and prophylactic agent in the treatment of hypokalemic periodic paralysis; the results of the present investigation suggest a possible explanation of its therapeutic efficacy.

Blood Glucose and Liver Glycogen Following Intravenous Injection of Amylase.

Summary Dogs and pigs were injected intravenously with crystalline hog amylase. Clearance of the amylase from the serum was associated with a rise in the level of the blood glucose. Simultaneously, the amylase activity of the liver rose and its glycogen content fell. The results in both species of animals were almost identical.

Heparin mediates transmembrane potassium transfer in hyperkalemic dogs.

Abstract Unheparinized, ureter-ligated control dogs that are potassium loaded, i.e., infused with 2 mEq of KCl/kg until prelethal electrocardiographic changes of hyperkalemic cardiotoxicity appear (end point), transfer 57 ± 4% (1.7 ± 0.1 mEq/kg) of administered potassium to intracellular fluid. Heparinized controls transfer 73 ± 1% (3.2 ± 0.2 mEq/kg); with simultaneous α-adrenoreceptor blockade, that proportion increases to 81 ± 2% (4.80 ± 0.7 mEq/kg) and with simultaneous β-receptor blockade it is 58 ± 3% (1.1 ± 0.1 mEq/kg). In potassium loaded, ureter-ligated dogs, heparin increases transmembrane potassium transfer as effectively as does a dosage of atropine large enough to cross the blood-brain barrier and its influence on potassium transfer, like that of atropine, is suppressed by β-adrenoreceptor blockade.