Wallace W. McCrory

Metabolic balance studies in primary renal tubular acidosis: Effects of acidosis on external calcium and phosphorus balances†

The relationship between acidosis and calcium metabolism was investigated in a 4-year-old child with primary renal tubular acidosis uncomplicated by either skeletal changes or renal insufficiency. The results of metabolic balance studies obtained from an initial period of complete correction of the acidosis through the development of acidosis by cessation of alkali therapy and during the subsequent correction of the acidosis indicate that metabolic acidosis is associated with a negative calcium balance. An altered intestinal transport of calcium was found to be the major factor responsible for the negative calcium balance. Complete correction of the acidosis resulted in restoration of a positive calcium balance.

Cytotoxic effect of nephrotoxic serum on rat tissue culture.

Summary Rabbit antisera to both rat kidney saline homogenate and the tryptic digest of rat kidney adsorbed on streptococci caused cytotoxic effects upon rat kidney cells in tissue culture as well as renal pathology in vivo following intravenous injection of rats. The titers of the cytotoxic effect in tissue culture paralleled the nephrotoxic effect in vivo and the anti-kidney hemagglutinin titers in vitro. The kidney cells grown in tissue culture tubes were effective in absorbing the potent nephrotoxic factor from serum. The cytotoxic effect of the nephrotoxic serum appears to be markedly species specific.

Omphalocele with diaphragmatic defect and herniation of the liver into the pericardial cavity

Summary 1. Two cases of omphalocele with absence of the pericardial floor, intrapericardialherniation of the liver and severe congenital cardiac defects are reported. 2. The literature on the subject is reviewed. 3. The embryologic explanations of the mechanism responsible for the development of omphalocele are discussed.

Effect of aldosterone on renal tubular sodium resorption in congenital virilizing adrenal hyperplasia

A third group about which we have a question is one of children with malabsorption syndrome and failure of growth. We have 2 such children who fail to show growth hormone. It is interesting that one of our patients, with short stature, and no measurable growth hormone, on human growth hormone administration, despite increased nitrogen retention and increased hydroxyprollne excretion, still showed no increase in stature. DR. KAPLAN. We have not tested any patients with obesity. Since we have only tested one patient with hypothyroidism before and after treatment, I do not think we can comment beyond our own experience. I think that it is quite possible that the posttreatment response may not be observed immediately after institution of thyroid therapy. We have measured growth hormone in only 2 patients who had the malabsorption syndrome and in 2 patients who had severe malnutrition secondary to anorexia nervosa. In 3 of the 4 patients, the serum growth hormone levels were markedly elevated. In the fourth patient, the serum growth hormone concentration was within the normal range. Some of the differences in results obtained in our laboratory may be the result of methodology since you use the hemagglutination inhibition method as modified by Dominguez and Pearson for measuring human growth hormone and we use a radioimmunoassay procedure. DR. WILLIAM A. COGHRANE, The Childrens Hospital, University Ave., Halifax, Nova Scotia, Canada. Dr. Kaplan, I have two questions. One: Could you tell me if you had observed any change in serum growth hormone levels in normal children when the insulin was administered over 2 or 3 days? In other words, is there any suggestion that there is a reduction in terms of the release of growth hormone in a normal individual when they are retested over a 2 or 3 day period consecutively ? Second: Have you done any determinations in patients with idiopathic hypoglycemia and do you note any hyper rather than hypo response ? DR. KAPLAN. Three patients were tested on 2 consecutive days with no demonstrable evidence of differences in their serum growth hormone response. We have not completed our studies of the patients with hypoglycemia.