Effects of nafenopin, diphenylhydantoin, phenobarbitone and some acetylenes on body composition: is there a relationship between decreased carcass lipid and increased liver size and induction of drug metabolizing enzymes?

Administration of nafenopin, diphenylhydantoin, phenobarbitone or the acetylenes BRL 15268 and BRL 19001 in the diet or, in the case of phenobarbitone, in drinking water reduced the body-lipid content of genetically-obese (ob/ob) mice. These compounds also reduced food intake in ob/ob mice. However, dietary restriction had less effect on body-lipid content than did the compounds. Nafenopin, diphenylhydantoin and BRL 15268 reduced the body-lipid content of normal mice and had no effect on food intake. Each of the compounds that reduced body-lipid content increased the liver weight of normal and ob/ob mice. BRL 15268 and BRL 19001 increased the maximum activity of NADPH oxidase in liver. It is proposed that these reductions in body-lipid content result from the increased metabolic rate involved in enlarging the liver and maintaining its increased size.

Biotin-responsive alopecia and developmental regression

A 10-month-old boy presented with dermatitis and alopecia and became severely hypotonic. Screening for urinary organic acids revealed a large quantity of 3-hydroxyisovaleric acid and raised levels of beta-methylcrotonylglycine and 3-hydroxypropionate. Activities of propionyl CoA carboxylase, beta-methylcrotonyl CoA carboxylase, and pyruvate carboxylase in cultured fibroblasts were normal. Treatment with oral biotin resulted in a dramatic clinical improvement, which might therefore suggest a defect in biotin absorption or transport.

Sensitivity of glucose uptake and lipolysis of white adipocytes of the rat to insulin and effects of some metabolites

1. Insulin increased glucose uptake and inhibited lipolysis in white adipocytes of the rat over the same concentration range of the hormone: the half-maximal effects were observed at approx. 10 microunits of insulin/ml. Thus, contrary to previous reports, no difference in sensitivity of the two processes to insulin could be found, which suggests that both these effects of insulin are important in increasing the rate of glucose utilization after a meal. 2. Adenosine deaminase, which lowers the concentration of adenosine in the incubation medium, decreased the sensitivity of both processes (lipolysis and glucose uptake) to insulin: this suggests that adenosine increases the sensitivity of both processes. Similarly, lactate and 3-hydroxybutyrate increased the sensitivity of both processes (to the same extent) to insulin. It is suggested that this increased sensitivity will improve the response (of adipose tissue) to insulin on refeeding after a prolonged period of starvation (when the hydroxybutyrate concentration is high), and after a short burst of exercise, when the blood lactate concentration is high and when large amounts of glucose are produced from lactate via gluconeogenesis in the liver.

Studies of the HLA system and insulin-dependent diabetes mellitus

The relationship between the HLA system and insulin-dependent diabetes mellitus (IDDM) is reviewed. Data compiled by the HLA and Disease Registry reveal that HLA-B8 and/or Dw3 are associated with IDDM in all populations studied so far, but further population studies in non-Caucasian populations should be performed. In Caucasians, HLA-Dw2 renders protection against IDDM while HLA-Dw3 and Dw4 are associated with susceptibility to IDDM. The exact mode of inheritance of susceptibility to IDDM remains to be established. Involvement of at least two genes is likely. Heterogeneity of IDDM is highly possible and should be a matter of major interest in diabetes research.

Epidemiologic studies of insulin-dependent diabetes mellitus

The incidence of insulin-dependent diabetes mellitus (IDDM) in Denmark in the years 1970--1976 was 13.3 per 100,000 in the age group 0--29 yr. This incidence is almost identical to that found in 1924 in Denmark in the same age group. The prevalence of insulin-consumers is 3.2 per 1,000. Comparison is made with incidence and prevalence data from other studies of Caucasian populations.

Effects of acetylenedicarboxylate: relationship between decreased carcass lipid and increased liver size and lean body weight

Potassium acetylenedicarboxylate, when administered in the diet, reduced the body lipid content of normal mice, genetically obese (ob/ob) mice, and their lean (+/?) littermates, and mice made obese by treatment with goldthioglucose. Food intake was unchanged in the lean mice but decreased in the obese mice. Carcass lipid was decreased in genetically obese mice compared to pair-fed controls. Oxygen consumption per mouse was increased in normal mice. The reduction in carcass lipid was not produced in normal mice that were dosed orally or were fed on a diet containing 55 per cent sucrose. Nor was it produced in male castrated mice or streptozotocin-treated mice that were given daily injections of insulin. The reduction in body lipid weight in lean mice was correlated with an increase in liver weight. Liver weight was not increased in genetically obese mice, but there was an increase in lipid-free dry weight. Weight gain was increased in lean mice and decreased in the obese mice compared to ad lib-fed controls. A red colouration of the skin developed in situations where body lipid content was decreased; plasma histamine was increased in lean mice. It is proposed that increased histamine synthesis leads to increased protein turnover and decreased body lipid content.

Diabetes mellitus among first- and second-degree relatives of early onset diabetics

This study is based on a material consisting of all first-degree relatives and a group of second-degree relatives (all nieces and nephews) of 187 propositi affected by early onset (i.e. at or prior to 20 years of age) diabetes mellitus, diagnosed before 1946. The incidence of diabetes among the different groups of relatives is expressed as the risk of developing the disease at specified ages. It is concluded that the risk of siblings or children of early-onset diabetics developing the same disease is about ten times that of a normal population chosen for comparison, whereas the risk of siblings developing diabetes later in life does not differ from this normal population. On the basis of the data presented here, combined with reanalyses of previously published data from other authors, it is concluded that early onset and late onset diabetes cannot have an identical genetic background.

Task groups: "How they work in one vocational assessment unit"

The Vocational Assessment Unit at Chedoke Hospitals in Hamilton, Ontario, incorporated the use of weekly client group meetings approximately eighteen months ago. These groups proved themselves to be a valuable addition to the program.

“Task Groups: How They Work in One Vocational Assessment Unit”, was co-authored by five people involved with the conception and evolution of the groups. The paper described the group, elaborated on the role of the group leader and the issues and themes which emerge in groups. Finally, it discusses the impact and influences which have been observed on the clients and the therapists.

Il y a environ dix-huit mois, l'Unité d'Evaluation au Travail du Chedoke Hospital de Hamilton, a instauré des discussions de groupe hebdomadaires pour ses clients. Ces réunions se sont avérées une addition trés valable au programme thérapeutique. Le présent article a été écrit par cinq personnes impliquées dans la conception et l'évolution de ces groupes. On y décrit les groupes, le rôle du meneur et les questions et thémes abordés dans les réunions. Enfin, une discussion de l'impact et des influences observés chez les clients et les thérapeutes est présentée.

Suburbia: a small obstetric hospital in Brisbane

In a small suburban obstetric hospital, during the period from July 1, 1963 to December 31, 1970, 3760 private and intermediate patients were delivered by suburban general practitioners. The number of perinatal deaths in hospital were nine deaths per 1000 births, both live and still. During the same period, 4873 private and intermediate patients were delivered by suburban general practitioners in the private/intermediate section of a large centrally sited obstetric teaching hospital. The number of perinatal deaths in hospital were 18.9 per 1000 births, live and still. The reason for, and the implications of, these results are discussed.

Epipodophyllotoxin VM-26 in the treatment of childhood neuroblastoma

Thirteen children with disseminated neuroblastoma that had become refractory to conventional chemotherapy were treated with the epipodophyllotoxin VM-26. Three patients developed partial responses (greater than 50% reductions in tumors and in the proportion of tumor cells in bone marrow). Acute nonhematologic toxicity after treatment was minimal. Hematologic toxicity was observed but could not be assessed accurately since most patients had abnormal hematopoiesis due to extensive tumor involvement of bone marrow. These results demonstrate that VM-26, as a single agent, can produce measurable tumor responses in children with neuroblastoma.

Plasma and urine amino acid concentrations in children with chronic renal insufficiency

Amino acids were determined in plasma and urine from controls and children with chronic renal insufficiency. Significant differences were found in the mean plasma concentration of serine, threonine, glutamic acid, tyrosine, arginine, cystine and glycine in children with severe renal failure. There was a marked increase in clearance of the majority of amino acids when glomerular filtration rate (GFR) fell below 30 ml/min/1.73 m2: the exceptions were the basic amino acids and cystine which did not change. As GFR decreased there was a significant reduction in the percentage tubular reabsorption of individual amino acids. Children with severe renal failure excreted up to 40% of the filtered load of amino acids in the urine. This significant increase in urinary amino acid loss may contribute to the derangement of plasma amino acid conentrations found in uraemia.

Avidity of antibodies in SLE: relation to severity of renal involvement

The avidity of antibodies to DNA in the sera of 8 patients with SLE was determined by saturation analysis and Scatchard plots. Five of the patients had severe lupus nephritis; the other 3 had relatively mild or no kidney disease. The Scatchard plots revealed components with high relative avidity in the patients with severe nephritis (K values 4.4-10.4 X 10(5) M-1 for nDNA), compared with the patients who had mild or no kidney disease (K values 0.3-1.8 X 10(5) M-1 for nDNA). Avidity measurements may be helpful in the evaluation and treatment of patients with SLE.

Biopterin derivatives in normal and phenylketonuric patients after oral loads of L-phenylalanine, L-tyrosine, and L-tryptophan

Plasma biopterin derivatives studied in 10 normal and 21 phenylketonuric children showed a significantly high concentration in the latter group. Biopterin derivatives correlated with plasma phenylalanine concentration, but in normal adults given an oral phenylalanine load the rate of increase with phenylalanine differed from that in phenylketonuric patients. A patient with hyperphenylalaninaemia, not due to phenylketonuria, had an abnormal biopterin derivatives response to phenylalanine distinct from that of patients with classical phenylketonuria. This may be a useful investigation to differentiate some variants of phenylketonuria.

Necropsy as a control of death certification: some unexpected findings

A comparison of death certificates and necropsy findings in a group of premenopausal women suggests that a number of diseases are either underdiagnosed in life. Atypical cases of intracerebral haemorrhage are frequently misdiagnosed. These occur in the frontal, temporal or parietal lobes in non-hypertensive women and may be suitable for surgical treatment. Their aetiology remains obscure. Pulmonary embolus is habitually underdiagnosed in premenopausal women and myocardial infarcts appear to be overdiagnosed. The study reemphasizes that death certificates are inaccurate and that low necropsy rates render accurate statistics of diseases in the community difficult ot obtain.

Intestinal absorption, demethylation, and enterohepatic circulation of imipramine

The intestinal absorption and metabolism of single oral doses of imipramine (ip) have been studied in man by portal catheterization. The concentration of ip and the formed desipramine (dmi) was followed in blood-plasma obtained from the portal and cubital veins. The absorption of ip seemed to be completed 80 min after the administration of the drug. There was no sign of demethylation of ip during the passage across the intestinal wall. Evidence was found of an enterohepatic circulation of both ip and dmi.

[Treatment of posterior epistaxis by ligation of the internal maxillary artery in the pterygo-maxillany fossa]

The microsurgical, transantral ligature of the internal maxillary artery is the treatment of choice for recurring posterior epistaxis. An immediate success was obtained by this method in 5 out of 7 patients. In one case the concomitant coagulation of the ethmoidal arteries was necessary and in another instance a revascularization of the spheno-palatine artery could be visualized by arteriography.

Radioimmunoassay for nanogram quantities of DNA

A direct competitive binding radioimmunoassay for DNA has been developed, using 125I-iododeoxyuridine-labelled DNA as the antigen and the serum from a patient with systemic lupus erythematosus. The assay is sensitive in the range of 25 to 1000 ng/ml of DNA. The sensitivity is determined by the affinity of the antibody: this SLE serum contains a component with an association constant of 9.6 X 10(-5) l/mol active at high dilution (1/10,000). Any biological material, such as serum, synovial fluid or tissue extracts can be tested directly. No interference has been found by DNAse in normal serum, or inhibition by mononucleotides or RNA. Native or denatured DNA from different sources (Escherichia coli, salmon sperm, calf thymus and human placenta) either purified or not, competes equally well for the antibody in this system.