Robert S. Gordon

Production of unesterified fatty acids from isolated rat adipose tissue incubated in vitro.

Summary Adipose tissue from rats, incubated in vitro in a medium of known composition, was found to release unesterified fatty acids (UFA). The rate of evolution of UFA was increased by the addition of epinephrine to the medium or by fasting the donor animal. It was decreased by the addition of glucose and insulin to the medium, or by feeding the donor animal with carbohydrate.

p-Chlorophenylalanine-Induced Chemical Manifestations of Phenylketonuria in Rats

p-Chlorophenylalanine, a potent inhibitor of phenylalanine hydroxylase in vivo, has been used to simulate phenylketonuria in rats. This inhibitor, when administered with phenylalanine, produces marked elevation of blood and tissue phenylalanine without an increase in tyrosine. Disproportionate ratios of phenylalanine to tyrosine are characteristic of phenylketonuria in humans. The use of p-chlorophenylalanine permits the production of this characteristics amino acid imbalance in experimental animals.

Studies on the metabolism of the serum proteins and lipids in a patient with analbuminemia

Abstract An intravenous infusion of 350 gm. of albumin was given to a patient with analbuminemia and the effect on the elevated serum globulin and lipid concentrations and the metabolism of I 131 albumin studied. Following the albumin infusions there was an approximately 50 per cent reduction in the serum concentration of cholesterol, phospholipids, fibrinogen, gamma globulin and iron-binding protein, at a time when the plasma volume was increased only 25 per cent. The return to normal serum concentrations of these substances suggests that the elevations were secondary to the hypoalbuminemia. Prior to the albumin infusions the half-life of survival of I 131 albumin was markedly prolonged (fifty-five days) compared to thirteen to twenty days in control subjects. The half-life of survival of I 131 gamma globulin was normal (twenty-eight days), indicating that the survival of albumin and gamma globulin may vary independently and suggesting that part of the catabolism of these proteins is by pathways unique for the given protein and that nonspecific factors, such as bulk loss of serum into the intestinal tract, are not the sole mechanisms of serum protein catabolism. Following infusion of 350 gm. of albumin, the I 131 albumin survival was still markedly prolonged (half-life forty-two to forty-eight days), indicating that the reduced albumin pool size, present prior to the infusions, was only a minor factor in the prolonged albumin survival observed. Thus there was a defect in the mechanism of albumin catabolism, as well as in the mechanism of albumin synthesis, in the patient with analbuminemia studied.

IDIOPATHIC HYPOALBUMINEMIAS: CLINICAL STAFF CONFERENCE AT THE NATIONAL INSTITUTES OF HEALTH

Excerpt Dr. Robert S. Gordon, Jr.: I should like to begin this discussion on hypoalbuminemia by showing an illustrative case (figure 1). This two year old child was the product of an apparently nor...

Sickle cell anemia simulating poliomyelitis in a white adult

Abstract A case of sickle cell anemia is reported in a white male of Greek extraction during a crisis simulating poliomyelitis, with a brief discussion of the symptomatology.

A PERSPECTIVE ON AIDS CASES AMONG HEALTH CARE WORKERS

It has been common knowledge at least since early 1982 that the epidemiology of AIDS is similar in many ways to that of hepatitis B. As a result, transmission of the disease to health care workers or laboratory staff handling materials from AIDS patients has been a constant concern. Formal recommendations for the protection of clinical and laboratory workers were drawn up by consensus among US. Public Health Service agencies and published in November, 1982.’ In mid-July, 1983, the Centers for Disease Control (CDC) published abstracts of four cases of AIDS among health workers who did not appear to belong to any of the recognized high-risk groups? Although the editor concluded that “these four cases provide no new information regarding occupational risk related to health-care personnel,” the anecdotal reports have heightened anxiety among persons whose responsibilities include caring for AIDS patients, or analyzing biological specimens derived from them. Before one attempts to consider the significance of the observation of four AIDS cases among medical personnel, it is necessary to estimate how many cases might have been expected merely on the basis of chance. In mid-July, 1983, the total number of AIDS cases that had been reported to the CDC was 1902, of whom 110 could not be assigned to any of the designated high-risk groups. The four health workers were among this group of 110. According to the 1980 census, the U.S. population in the age span 18-64 totaled 137.2 million.’ This age group encompasses almost all employed persons, and virtually all AIDS cases. The National Center for Health Statistics reports that in 1980 there were approximately 7.38 million persons employed in the health i n d ~ s t r y . ~ If, then, employment in the health industry bears no relationship to risk of AIDS, the number of health workers that would be expected among the 110 “unexplained” cases = 110 X 7.38A37.2 = 5.9, which exceeds the four observed. No elaborate statistical analysis is required to realize that this comparison does not support a hypothesis that health workers are at increased risk for the acquisition of AIDS. On the other hand, neither does it argue for cavalier disregard of common-sense precautions.

Issues in Human Experimentation

The current status of two difficult and controversial issues--confidentiality of preliminary results of clinical studies and compensation for research-related injuries--is outlined. The principle of not publicizing results of clinical research until enough data have been accumulated to give statistically valid support for conclusions is in conflict with the principle of ready availability to the public of results of government-conducted and government-sponsored research. New legislation may be required to resolve the problem. The lack of a mechanism to compensate research subjects for unanticipated injuries that are not the result of negligence is a barrier to obtaining truly informed consent. A plan for overcoming this problem through Department of Health, Education, and Welfare regulations has been proposed and awaits implementation.