Evaluation of an improved rapid coagglutination method for the serological grouping of beta-hemolytic streptococci

Grouping of beta-hemolytic streptococci was performed with the Phadebact Streptococcus Test, a coagglutination method, and the results compared with serological grouping by the standard Lancefield precipitin method. Of 171 clinical specimens examined, 169 (98.8%) were grouped correctly by the Phadebact Test after 24 h of continuous growth in Todd-Hewitt broth. In a parallel study, 96.9% of specimens that grew after only 4 h of incubation in broth were grouped correctly by the coagglutination method. In both studies, the accuracy of the coagglutination test was increased significantly by elimination of multiple-agglutination reactions through centrifugation of cultures and utilization of the supernatant fluid in the Phadebact Test.

Plasma potassium changes following suxamethonium and suxethonium in normal patients and in patients in renal failure

Fifty-four healthy patients and 21 patients with chronic renal disease received either suxamethonium 100 mg or suxethonium 150 mg for neuromuscular blockade during endotracheal intubation. A significant increase in plasma potassium concentration was observed following the administration of suxamethonium. No increase occurred in patients who received suxethonium. It is concluded that suxethonium may be preferable to suxamethonium in patients who are at risk from an increase in the plasma potassium concentration.

Explanations for weight loss after ileojejunal bypass in gross obesity

Twenty grossly obese patients underwent ileojejunal bypass operations. Measurements of calories lost in faeces showed that the malabsorption could not account for the weight loss. Furthermore, the malabsorption was not decreased two years after bypass, when weight was no longer being lost. Dietary restriction is therefore largely responsible for the weight loss and increased food intake for weight maintenance.

Effect of changes in feeding schedule on the diurnal rhythms and daily activity levels of intestinal brush border enzymes and transport systems

The activities of rat intestinal enzymes, sucrase, lactase, maltase, trehalase, gamma-glutamyltransferase, leucylnaphthylamide-hydrolyzing activity, and the transport system for glucose follow diurnal rhythms on ad libitum and restricted feeding regimes. In response to 6 days of restricted feeding, food available between 1400 and 1800 Eastern Standard Time, all rhythms shifted in time and the daily levels of activities were changed. Alkaline phosphatase activity followed a diurnal rhythm only in restricted fed animals. In restricted fed rats several activity patterns were observed, some with short periods of maximum activity, 3 h or less, and some with plateaus of maximum activity, 5-9 h long. In respect to the time of day of the synchronizer, sucrase peaked before feeding, glucose transport peaked during feeding, alkaline phosphatase peaked after feeding, and the other enzymes had higher levels of activity before, during and after feeding. The effect of restricted feeding on the daily activity levels were: a decrease in leucylnaphthylamide-hydrolyzing activity, no change in alkaline phosphatase, and increases in the others. These enzyme and transport systems exhibit a large amount of individual regulation or control as reflected by the lack of a uniform activity pattern and response to the synchronizer, and the variation in direction and magnitude of the adaptations to restricted feeding.

Treatment of gross obesity by jejunal bypass

Jejunal bypass operations were performed on 47 grossly obese patients. The results were disappointing in three patients who had a standard "14 in/4 in" Payne and DeWind procedure and therefore a more radical operation was performed, joining four inches (10.2 cm) of proximal jejunum to 10 inches (24.4 cm) of terminal ileum. Two years after the modified operation a mean of 44.2 kg had been lost and the weight tended to stabilize. This weight loss was due mainly to inadequate calorie intake. The appetite became more controlled so that if weight was regained this was small in amount. Metabolic sequelae and their symptoms also settled by two years. The physical, psychological, and social outcome was good. The postoperative period was stormy and required close medical and psychiatric supervision. There were two deaths.

Dietary diabetes. The influence of a low carbohydrate diet on forearm metabolism in man

Forearm glucose uptake and lactate balance across the forearm were determined in normal subjects during 100-gm. oral glucose tolerance tests (GTT) before and after a lowcarbohydrate diet; in addition, β-hydroxybutyrate and acetoacetateresponses were measured following carbohydrate restriction. After a low-carbohydrate diet, glucose tolerance was significantly impaired (dietary diabetes) and the rise in seruminsulin levels was frequently, but not invariably, delayed. Forearm glucose utilization, however, was not significantly decreased at any phase of the GTT or during the GTT as a whole.

With a normal diet, lactate levels rose immediately after glucose loading, reaching peak concentrations at sixty minutes and falling progressively thereafter; this rise was associated with lactate utilization by the forearm and the subsequent fall in plasma concentrations with lactate release. In contrast, following carbohydrate restriction lactate concentrations were initially reduced by glucose administration, this reduction taking place despite continuing lactate release from the forearm. These results suggest that after glucose loading the shape of the lactate response curve is not determined primarily by changes in peripheral lactate balance.

Marked elevation in basal FFA, β-hydroxybutyrate, and acetoacetate levels accompanied carbohydrate restriction. FFA and β-hydroxybutyrate concentrations were immediately decreased and acetoacetate levels initially increased by glucose loading, the latter declining only during the second hour of the GTT; throughout the test, acetoacetate was taken up by the forearm while β-hydroxybutyrate was released. Basal FFA and β-hydroxybutyrate concentrations were not correlated with the degree of glucose intolerance induced in the volunteers.

The results show that the impairment of glucose tolerance following carbohydrate restriction is not the result of decreased peripheral glucose utilization. It is suggested that the major cause of dietary diabetes is a delay in the hepatic uptake of the glucose load and that this is primarily the. result of low hepatic glucokinase activity rather than delayed insulin secretion.