Daily glucose and insulin rhythms in diabetic dogs on the artificial beta cell

The circadian periods of plasma glucose, insulin and alpha-amino nitrogen (alpha-AN) were studied in fed and fasting normal and diabetic dogs which were fed either beef or beef supplemented with carbohydrates (CH). The diabetics were either withdrawn from insulin supply or treated with an artificial beta cell (ABC) or infused a constant insulin dose (CI).--There was a significant daily glucose rhythm in normal fasting animals and in fasting diabetics on CI or on insulin withdrawal. In the fed controls, the phase of the rhythms depends on carbohydrate content of food. In CH-free fed controls the insulin maxima were related to alpha-AN but in CH-fed controls they were related to glycemia. Due to the mechanism of ABC-provided insulin dosage, the phases of glucose and of insulin oscillations were correlated in all diabetics on ABC. Thus even if the mean glucose level is normalized by ABC the intrinsic phase relations remain altered.--It is concluded that the daily glucose periodicity is based on endogenous rhythms in glucose production and utilization and is essentially independent of current insulin provision. But it is governed by the meals as main "Zeitgebers" and modified by the actual insulin supply.

The cells of the bovine outflow system in tissue culture

Meshwork cells from the bovine outflow system were grown in culture and their growth characteristics and behaviour in vitro reported. The cells were studied by inverted phase microscopy and time-lapse cinephotomicrography. It was found that plating efficiency was highest for third and seventh passage cells. These cells reached confluence within 2 weeks when plated out at 7.5 X 10(3) cells cm-2 in a conventional culture medium containing 10% serum. Third passage cells were studied in greatest detail. These cells exhibited postconfluence contact inhibition of division. By 2 weeks postconfluence the division rate decreased 10-fold to a level of less than six divisions per thousand cells per day. The contact inhibition was not overcome by increasing the serum content of the medium. On the other hand, a 30-fold increased division rate could be produced after scratching the culture flask. Postconfluent contact-inhibited cultures were considered to be a better reflection of the behaviour and activities of meshwork cells in vivo than cultures which retain a high level of division.

Adenylate kinase activity of cerebrospinal fluid in central nervous system disorders

Adenylate kinase activity was measured in 41 samples of cerebrospinal fluid in 34 patients with various neurological disorders or psychiatric symptomatologies. Activities of the enzyme showed to be linked to clinically estimated acuteness or progression of the changes in the central nervous system at the time of specimen collection. The findings suggest the conclusion that determination of adenylate kinase activity in cerebrospinal fluid is a meaningful tool for the evaluation of progression and/or acuteness of central nervous system disorders.

[Variant creatine kinase isoenzymes: frequency and clinical significance (author's transl)]

To estimate the incidence of variant creatine kinase (CK)isoenzymes, 1,191 unselected patients were screened by means of CK:CK - MB ratio. When CK - MB was higher than 20% of the total CK in the immunoinhibition test, and a myocardial infarction could be excluded, a CK-isoenzyme electrophoresis was performed. We found macro-CK-BB-emia in 13 patients, but only three of them had elevated total CK activity. All patients but two were at the typical age of over 60 years; two males were 2 and 9 years old. The clinical diagnosis in macro-CK-BB-emia was predominantly cardiocerebrovascular insufficiency due to arteriosclerosis. In 16 other patients, the presence of an isoenzyme migrating cathodically to CK-MM was found. In this group, a malignant metastatic tumor was found in eight cases, the rest predominantly suffered from severe liver disease. Presence of both variant CK isoenzymes may lead to diagnostic or therapeutic errors due to the altered CK:CK-MB ratio. According to our studies, a variant CK isoenzyme occurs in 2.6% of hospitalized patients, but this will lead to problems diagnosing acute myocardial infarction only in the group with elevated total CK (0.42% of our patients).

Immunoinhibition and automated column chromatography compared for assay of creatine kinase isoenzyme MB in serum

We examined sera from six different groups of patients for CK-MB activity by means of two commercially available tests, an immunoinhibition method (E. Merck) and the CK-MB test as used with the aca (Du Pont). In the first group of patients (suspicion of myocardial infarction) the correlation between the two methods was good: r = 0.9191, y = 1.068x -- 0.888, x = 18.7 U/L, y = 19.0 U/L. In the second group, patients with high adenylate kinase activity, no interference was detectable on the aca, whereas the immunoinhibition method yielded falsely high CK-MB values. The third group consisted of persons with macro-CK-BB in their serum. In the immunoinhibition test these patients usually showed a high CK-MB:total CK ratio, whereas such results were rarely found for the aca. The fourth group, patients with a different electrophoretic mobility of their CK-isoenzymes (migration of an active band towards the cathode), were detected by the immunoinhibition method (high ratio of CK-MB to total CK), but not with the aca. In the presence of free CK-BB (group five) the immunoinhibition test resulted in "falsely" high CK-MB values, whereas CK-BB was retained on the column of the aca. In skeletal muscle diseases (group six) results by the two methods differed, values for CK-MB on the aca being much higher. It was demonstrated experimentally that this was due to CK-MM with altered surface charge.

Immunoinhibition and automated column chromatography compared for assay of creatine kinase isoenzyme MB in serum

We examined sera from six different groups of patients for CK-MB activity by means of two commercially available tests, an immunoinhibition method (E. Merck) and the CK-MB test as used with the aca (Du Pont). In the first group of patients (suspicion of myocardial infarction) the correlation between the two methods was good: r = 0.9191, y = 1.068x -- 0.888, x = 18.7 U/L, y = 19.0 U/L. In the second group, patients with high adenylate kinase activity, no interference was detectable on the aca, whereas the immunoinhibition method yielded falsely high CK-MB values. The third group consisted of persons with macro-CK-BB in their serum. In the immunoinhibition test these patients usually showed a high CK-MB:total CK ratio, whereas such results were rarely found for the aca. The fourth group, patients with a different electrophoretic mobility of their CK-isoenzymes (migration of an active band towards the cathode), were detected by the immunoinhibition method (high ratio of CK-MB to total CK), but not with the aca. In the presence of free CK-BB (group five) the immunoinhibition test resulted in "falsely" high CK-MB values, whereas CK-BB was retained on the column of the aca. In skeletal muscle diseases (group six) results by the two methods differed, values for CK-MB on the aca being much higher. It was demonstrated experimentally that this was due to CK-MM with altered surface charge.

Agiolax bolus in the esophagus. Report of two cases

Two cases of intermittent obstruction of the esophagus by the laxative Agiolax, proven by endoscopy and barium swallow, are described. The patients took an overdose of one and two tablespoons of Agiolax, respectively; they had no disorders of the esophagus. Symptoms of obstruction subsided spontaneously after 24 and 36 hours respectively.

[Distraneurin (Chlormethiazol) as an anaesthetic for high-risk cases in ophthalmology (author's transl)]

A new anaesthesia, through Chlormethiazol i.v. is described, which is especially used in cataract (lens) operations. There is no excitation during induction and the depth of anaesthesia (stage) depends on dosage-time ratio. Recovery is calm without undesirable side-effects. The intraocular pressure is significantly diminished during anaesthesia.

Evaluation of a new method for the intragastric titration of gastric juice

A new method for the intragastric titration of hydrochloric acid with a pH sensitive telemetric antimone electrode connected via a receiver to an electronic trigger, which regulates a pump for the inflow of 1 M KHCO3 solution, was evaluated in 22 achlorhydric patients by a series of intragastric instillations of 0.1 N HCl. In vitro this procedure presented a high precision (r = 0.99). Under in vivo conditions a significant correlationship (r = 0.84, p = 0.001) between the input of hydrochloric acid and bicarbonate in a range from 1.4 to 16.7 mEq/30 min could be established in non-operated subjects. The average coefficient of variation was 34%. In subjects with partial gastrectomy (Billroth II) overtitration of 100% (y = 2.1 x -1.7, r = 0.78, p = 0.001) was recorded, suggesting an increased loss of bicarbonate related to the accelerated gastric evacuation.