Norman H. Engbring

Azotemia and Glucose Intolerance

Excerpt The occurrence of glucose intolerance in patients with renal failure has been known for 50 years (1-3); however, the cause of this impaired tolerance is not yet established. Perkoff and col...

The incidence of skin reactivity to insulin in diabetic patients

Abstract Skin tests for the presence of skin reactivity to insulin were done on 168 diabetics and 20 nondiabetic individuals. The individuals were divided into 4 groups. Group I consisted of diabetics on insulin, Group II consisted of diabetics formerly on insulin, Group III consisted of diabetics who had never received insulin, and Group IV consisted of nondiabetic controls. Group I demonstrated 53 per cent with skin reactivity; Group II, 18.6 per cent; Group III, 10 per cent; and Group IV, none. There was no positive correlation with age, duration of diabetes, control, or history of allergic disease.

Neonatal Graves' Disease

Excerpt Since publication of C. H. Parrys original description of hyperthyroidism in 1825 (1), little attention has been given to neonatal hyperthyroidism until recently. White, in 1912, recorded ...

Insulin allergy and insulin resistance: Report of a case☆

Abstract A case is presented of a patient who exhibited local and generalized urticarial reactions, presumably due to insulin, associated with increasing insulin requirements and a delayed hypoglycemic response to intravenously administered insulin. The presence of skin-sensitizing antibodies to insulin of various animal species was demonstrated. Insulin-binding (blocking?) antibody was also demonstrated. Administered labeled insulin was largely retained intravascularly, the insulin space approximating the plasma volume. The role of insulin-binding antibody in retaining insulin within the vascular space was related to the diminished physiologic response to insulin. The significance of these immune phenomena in the genesis of frequently observed cases of relative insulin resistance is discussed.

The Diagnosis and Treatment of Toxic Nodular Goiter

Because toxic nodular gaiter occurs frequently in elderly persons who have associated degenerative diseases, it presents unusual problems in diagnosis and treatment. The difficulty in diagnosis may be compounded by the sporadic function of the toxic thyroid nodule with fluctuating clinical and laboratory findings.The pathogenesis of toxic nodular gaiter is reviewed, as are the clinical picture, laboratory findings, and choice of therapy. In general, surgical resection is the most effective definitive form of therapy, but it carries a significant risk which must be evaluated carefully.