Vincent P. Dole

ELECTROPHORETIC CHANGES IN THE PLASMA PROTEIN PATTERNS OF PATIENTS WITH RELAPSING MALARIA.

Numerous studies of the serum or plasma proteins in malaria have shown that there is a depression of albumin and a relative rise of globulins following paroxysms. Two workers (1), from a review of the earlier literature and from experimental studies with monkey malaria, concluded that, while the changes were not specific for malaria, the amount of change generally correlated with the intensity of an attack. In the interval between relapses, the serum total protein and albumin:globulin values tended to return toward normal, an improvement that was accelerated by treatment. Later observations on human subjects (2 to 4) have also been in accord with these findings. Although it has been suggested (5) that the increase in the serum fraction precipitable by 13.5 per cent sodium sulfate might be sufficiently characteristic of the disease to be the basis of a diagnostic test for malaria, the subsequent use of this test (6) indicated that similar increases would also be encountered in a variety of other diseases. All previous studies have been made with some type of salt fractionation. The purpose of the present study was to supplement these earlier observations by electrophoretic analyses, and to ascertain whether or not any test based upon changes in the plasma protein pattern might be of diagnostic use in the group of patients with relapsing malaria.

DIODRAST AND INULIN CLEARANCES IN NEPHROTIC CHILDREN WITH SUPERNORMAL UREA CLEARANCES

Elevation of the urea clearance above the calculated normal value has been frequently observed in our clinic in children with the nephrotic syndrome. Previous studies of this phenomenon have shown it to be related to the intake of protein, but not induced by the oral administration of urea (1). Glomerular filtration, measured by inulin clearance, has been found by Emerson, Futcher, and Farr (2) to be elevated as much or more than the urea clearance. The present study is an attempt to answer the question raised in the last report (2) as to whether renal blood flow is elevated proportionately to the glomerular filtration rate. Evidence presented by Goldring, Chasis, Ranges, and Smith (3) and by White and Heinbecker (4) indicates that the diodrast clearance approximates the renal blood flow in man. In order to obtain some indication as to whether the high urea and inulin clearances observed in nephrosis are probably due to filtration of an increased fraction of plasma water or to an increased renal blood flow, we have therefore, in 4 cases, made a series of simultaneous determinations of the clearances of urea, inulin, and diodrast.