Water and Solute Movement in the Small Intestine of Patients with Sprue

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Abstract

Water and electrolyte movement in the jejunum of normal subjects and patients with sprue was measured during perfusion with isotonic electrolyte solutions. Normal subjects absorbed water, sodium, and potassium. By contrast, in patients with sprue (seven with adult celiac sprue and one with tropical sprue) who had diarrhea and steatorrhea, these substances were secreted into the intestinal lumen. This indicates that the jejunal mucosa of these patients was in a secretory state with respect to water and electrolytes.

Authors

John S. Fordtran, Floyd C. Rector, T. Ward Locklear, Maynard F. Ewton

The Mechanics of Left Ventricular Contraction in Acute Experimental Cardiac Failure

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Abstract

The effects of acute cardiac failure induced by pentobarbital or pronethalol on the basic mechanical properties of the intact left ventricle were examined in the dog, and the influence on auxotonic and isovolumic contractions of the increase in end-diastolic volume that usually accompanies cardiac failure was assessed. The right heart bypass preparation was employed, and isovolumic beats were induced by sudden balloon occlusion of the aortic root. The ventricular pressure-volume curve was determined directly, and the mechanical responses of the myocardial fibers and contractile elements were calculated.

Authors

John Ross Jr., James W. Covell, Edmund H. Sonnenblick

Studies on the Metabolic Error in Refsum's Disease

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Abstract

Studies utilizing mevalonic acid-2-14C and D2O as precursors failed to provide evidence for an appreciable rate of endogenous biosynthesis of phytanic acid in a patient with Refsum's disease.

Authors

Daniel Steinberg, Charles E. Mize, Joel Avigan, Henry M. Fales, Lorentz Eldjarn, Kenneth Try, Oddvar Stokke, Sigvald Refsum

Insulin Secretion in Response to Glycemic Stimulus: Relation of Delayed Initial Release to Carbohydrate intolerance in Mild Diabetes Mellitus

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Abstract

Insulin secretory responses to paired intravenous and oral glucose loads were determined in 38 nonobese individuals classified as normal (nondiabetic) subjects, “mild” diabetics (fasting blood glucose below 105 mg per 100 ml), or “moderate” diabetics (fasting glucose below 192 mg per 100 ml). Studies were also performed in 29 obese persons who were similarly grouped. The intravenous load was given to assess the alacrity of hormonal release after glycemic stimulus, and the oral glucose to determine how the speed of initial insulinogenesis modifies the disposition of ingested carbohydrate.

Authors

Holbrooke S. Seltzer, E. William Allen, Arthur L. Herron Jr., Mildred T. Brennan

Nature of the Renal Concentrating Defect in Sickle Cell Disease

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Abstract

Free water reabsorption (TcH2O) measured during 10% mannitol diuresis and subsequently during 3% saline diuresis was compared in patients with sickle cell anemia and in normal subjects. During mannitol infusion, TcH2O progressively rose with increasing osmolar clearance (Cosm) and reached a maximal level in both groups studied. During hypertonic saline diuresis, TcH2O progressively rose in the normal subjects and exceeded the maximal levels attained during mannitol diuresis, with no evidence of a maximal TcH2O level appearing. In contrast, none of the saline curves significantly exceeded the mannitol curves in the sickle cell patients but tended to parallel the mannitol curves at comparable rates of solute clearance.

Authors

Fred E. Hatch, James W. Culbertson, Lemuel W. Diggs

The Production of Carbon Monoxide from Hemoglobin In Vivo

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Abstract

Dogs anesthetized with pentobarbital were shown to produce carbon monoxide at an average rate of 0.21 ± (SD) 0.05 ml per hour. After intravenous injection of erythrocytes damaged by incubation with N-ethylmaleimide, CO was produced in excess of base-line production for 3 to 4 hours with an average yield of 0.89 ± (SE) 0.046 μmole of carbon monoxide to 1 μmole of heme degraded.

Authors

R. F. Coburn, W. J. Williams, P. White, S. B. Kahn

Peroxidative Hemolysis of Red Blood Cells from Patients with Abetalipoproteinemia (Acanthocytosis)

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Abstract

The effect of peroxidative stress on tissue was studied by exposure of red blood cells (RBC) from patients with abetalipoproteinemia to minute amounts of H2O2in vitro. Red blood cells from untreated patients showed a marked sensitivity to H2O2, as evidenced by hemolysis and lipid peroxidation (peroxidative hemolysis).

Authors

James T. Dodge, Gerald Cohen, Herbert J. Kayden, Gerald B. Phillips

The Effects of Chronic Hypoxemia on Electrolyte and Acid—Base Equilibrium: An Examination of Normocapneic Hypoxemia and of the Influence of Hypoxemia on the Adaptation to Chronic Hypercapnia

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Abstract

We have carried out balance studies in normal dogs in order to appraise the effects of chronic hypoxemia on acid—base and electrolyte equilibrium. During the first phase of observation we produced a state of “pure” hypoxemia by reducing the oxygen concentration (utilizing nitrogen as a diluent) and by adding carbon dioxide to the environment in a concentration sufficient to keep arterial CO2 tension (PCO2) within normal limits. The data demonstrate that such a 9-day period of normocapneic hypoxemia has no effect on electrolyte excretion and is virtually without effect on plasma composition.

Authors

Daniel G. Sapir, David Z. Levine, William B. Schwartz

The Renal Lesion Associated with Hemoglobinemia: A Study of the Pathogenesis of the Excretory Defect in the Rat

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Abstract

The role of renal ischemia in the pathogenesis of the renal failure produced by hemoglobin injection in the rat is evaluated. The data indicate that in the initial hours of this lesion renal blood flow is consistently reduced and that during its subsequent evolution blood flow rises towards normal levels, in some animals, while inulin clearance remains severely depressed. Volume expansion during the initial stage of the lesion may effect a rise in renal blood flow to normal levels with little effect on inulin clearance rate, further demonstrating the relative lack of dependence of the excretory defect on concomitant renal ischemia. These observations indicate that renal ischemia is probably a necessary factor in the initial production of the lesion; that it persists during its initial phase, up to 24 hours in most rats; and that, although it may contribute to the observed excretory defect, it is not the predominant etiologic factor.

Authors

John R. Jaenike

Uphill Transport of Urea in the Dog Kidney: Effects of Certain Inhibitors

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Abstract

To study the renal medullary transport and accumulation of urea in dogs independent of water transport, we obliterated the medullary electrolyte gradient by a sustained ethacrynic acid diuresis. Infusions of urea were also given at various rates to vary urinary urea concentration. In the steady state, the kidneys were removed, and slices were analyzed for water, urea, and electrolytes. In every experiment in 15 dogs over a range of urinary urea concentration from 19 to 230 mmoles per L and urine flow from 0.5 to 9.7 ml per minute per kidney, an intrarenal urea gradient persisted, and urinary urea concentration was always lower than papillary water urea concentration. The magnitude of this uphill urinary-papillary gradient (mean ± SE = - 21 ± 2.9 mmoles per L) was not affected by hemorrhagic hypotension or a nonprotein diet.

Authors

Martin Goldberg, Andrzej M. Wojtczak, Manuel A. Ramirez

Studies of Cryoproteins in Systemic Lupus Erythematosus

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Abstract

Cryoproteins observed in patients with systemic lupus erythematosus were shown to be of “mixed type,” consisting largely of IgG and IgM. The IgM moiety possessed anti-IgG globulin reactivity and precipitated in the cold after mixing with a source of IgG. The IgM fraction of one cryoprotein precipitated only with the same patient's IgG. Antisera prepared against purified cryoproteins regularly recognized IgM, IgG, the 11 S component of C′, and α2-macroglobulin. C′4 (β1E) and C′3 (β1C) were recognized by four and two antisera, respectively. Antisera prepared against two cryoproteins reacted (after absorption) only with the sera of origin. These “unique” antigens were associated with IgM, were destroyed by mercaptoethanol treatment, and, in one patient, were shown to disappear subsequent to clinical improvement.

Authors

Lonnie B. Hanauer, Charles L. Christian

Studies on Human Platelet Glycolysis. Effect of Glucose, Cyanide, Insulin, Citrate, and Agglutination and Contraction on Platelet Glycolysis

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Abstract

Evidence for a metabolically active plasma-free platelet system is presented. Glycogenolysis was found to be a potent pathway for lactate production. Aerobic glycolysis constituted a major fraction of glucose metabolized. Both insulin and cyanide increased lactate production in the presence of glucose. The Krebs cycle appeared to be operative for ATP synthesis when citrate was used as substrate. The first stages of gluconeogenesis were noted to be present. Glucose uptake contributed to increased lactate production.

Authors

Simon Karpatkin

Postural Augmentation of Plasma Renin Activity and Aldosterone Excretion in Normal People

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Abstract

Peripheral plasma renin activity and aldosterone excretion rates have been measured in normal people during recumbency, recumbent exercise, tilting, and continuous ambulation. Upright posture induces a prompt elevation in peripheral plasma renin activity beginning in 15 minutes and peaking between 60 and 120 minutes. Aldosterone excretion is increased during 120 minutes of upright posture and correlates directly with the elevation in renin activity. Upright posture induces increased plasma renin activity regardless of the level of sodium intake in the preparatory diet. Concomitant measurements of endogenous creatinine clearance and the rates of excretion of sodium and potassium suggest that a fall in renal arterial perfusion resulting from upright posture induces increased release of renin and the subsequent secondary stimulation of aldosterone secretion. Our data indicate that the changes in plasma renin activity are due to changes in the amount of the enzyme rather than to changes in other elements of the reninangiotensin systm. This report discusses the physiologic importance of postural augmentation of renin production, emphasizing that for proper interpretation of values of plasma renin activity, posture as well as dietary factors must be considered and controlled.

Authors

E. L. Cohen, J. W. Conn, D. R. Rovner

Studies on Auditory Thresholds in Normal Man and in Patients with Adrenal Cortical Insufficiency: The Role of Adrenal Cortical Steroids

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Abstract

Auditory thresholds for sinusoidal tones were determined in eight patients with adrenal cortical insufficiency (four with Addison's disease and four with panhypopituitarism) and compared to those in normal volunteers. In adrenal cortical insufficiency (ACI) the auditory detection sensitivity is significantly more acute than that of normal subjects over most of the frequency range, but especially in the region of greatest hearing sensitivity of normal subjects, 1,000 to 2,000 cycles per second (cps).

Authors

Robert I. Henkin, Robert E. McGlone, Robert Daly, Frederic C. Bartter

Portal Blood Flow in Cirrhosis of the Liver

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Abstract

Direct measurements of portal flow and pressure in a relatively large number of patients with cirrhosis show a marked reduction in flow associated with a nearly constant plateau of portal pressure. This lack of correlation indicates the complex relationships of resistances in the splanchnic, collateral, and hepatic circuits determining the division of the available splanchnic flow between the portal vein and the collateral pathways. Subtracting the measured portal flow from well-established estimates of total hepatic blood flow in cirrhosis suggests that the hepatic artery contributes more than one-half of the blood perfusing the cirrhotic liver. There was no instance of retrograde portal flow during the preshunt measurements, although such reversal was frequent after side-to-side portacaval anastomosis. Attempting to explain the plateau of portal pressure in the face of an increasing outflow resistance presumably associated with progress of the disease, we postulate that an augmented inflow resistance to the splanchnic chamber reduces splanchnic flow in cirrhosis. End-to-side portacaval anastomosis did not return normal portal flow, although it decreased pressure to accepted control levels. The assumption is that most of the splanchnic blood was flowing through the shunt, leading to a high splanchnic resistance in the immediate postshunt status. If this resistance was previously elevated, as suggested by the plateau of portal pressure, the mechanism responsible for the elevation was not immediately deactivated after the shunt, and the true effect of the operation upon splanchnic flow may not be measurable at such time.

Authors

Augusto H. Moreno, Albert R. Burchell, Louis M. Rousselot, William F. Panke, S. Frederick Slafsky, Jean H. Burke

Bacterial Interference in Chick Embryos

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Abstract

Chick embryos infected intra-allantoically with nonvirulent staphylococci are protected from death due to infection with virulent staphylococci. The protection is associated with a delay in growth of the challenge strain and a delay in the production of toxic substances in the allantoic fluid. The protection is influenced by the number of bacteria in the protecting and challenge inocula and by the interval between the administration of the protecting and challenge strains. Protection cannot be transferred by administration of sterile filtrates of allantoic fluid in which the protecting strain has grown.

Authors

John C. Ribble, Henry R. Shinefield

Bacterial Interference Induced in Embryonated Eggs by Staphylococci

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Abstract

Studies of experimental infections in embryonated eggs demonstrated that prior allantoic infection with avirulent staphylococci afforded significant protection against subsequent challenge with virulent strains. All strains of coagulase-positive and coagulase-negative staphylococci tested that were relatively avirulent for embryonated eggs were capable of producing interference. The interference induced afforded protection not only against challenge with virulent staphylococci, but also against Diplococcus pneumoniae, Salmonella typhimurium, Escherichia coli, Proteus mirabilis, and one strain of influenza virus (A2J 305). Prior allantoic infection with avirulent staphylococci also protected against intravenous as well as allantoic infection with challenge strains.

Authors

William R. McCabe

Determination of Distribution of Diffusing Capacity in Relation to Blood Flow in the Human Lung

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Abstract

A method for appraising the distribution of diffusing capacity of the lungs (DL) in relationship to pulmonary capillary blood flow ([unk]QC) in normal human subjects was derived from measurements of oxygen diffusing capacity (DLO2) and carbon monoxide diffusing capacity (DLCO) performed during breath holding. This method utilizes the fact that the observed DLO2 is considerably reduced in value if uneven distribution of DL with respect to [unk]QC (uneven DL/[unk]QC) is present. In contrast, DLCO is barely affected by uneven DL/[unk]QC, and from its measured value one can calculate the value DLO2 would have if no uneven DL/[unk]QC were present (true DLO2). Once observed DLO2 and true DLO2 are known, the degree of uneven DL/[unk]QC in the lung can be calculated.

Authors

Richard W. Hyde, Richard Rynes, Gordon G. Power, Jean Nairn