Abnormalities in N15 excretion rates after ingestion of tagged glycine in Cushing's syndrome and following ACTH administration

Metabolic changes in patients severely affected by tetanus

Metabolic changes in six severely affected tetanus patients suffering from characteristic labile hypertension (maximum systolic blood pressure greater than 200 mmHG, maximum diurnal change in systolic pressure greater than 100 mmHg) were investigated. Daily urinary excretion of urea nitrogen increased gradually from the onset of opisthotonus, reached a peak value (10.4 to 15.4 g/m2) in 8 to 20 days, and decreased subsequently. Average cumulative excretion in 30 days reached 239.6 +/- 32.7 g/m2. Urine catecholamine excretion was elevated in each patient and remained elevated during this period. Plasma cortisol and glucagon concentrations were not increased markedly except in a case complicated other systemic bacterial infection. Increased protein catabolism in these patients could not be explained by the metabolic effects of 'stressed hormones' alone, and neurologic factors must be considered.

Combined hormonal infusion simulates the metabolic response to injury

To investigate the role of hormones as mediators of the metabolic response to injury, nine normal male volunteers received a continuous 74-hour infusion of the three 'stress' hormones: cortisol, glucagon, and epinephrine. As a control, each subject received a saline infusion during another 4-day period. Diets were constant and matched on both occasions. Hormonal infusion achieved hormone concentrations similar to those seen following mild-moderate injury. With this alteration in the endocrine environment significant hypermetabolism, negative nitrogen and potassium balances, glucose intolerance, hyperinsulinemia, insulin resistance, sodium retention, and peripheral leukocytosis were observed. Additional studies with single hormone infusions indicated that these responses resulted from both additive and synergistic interactions of the hormones. Triple hormone infusion simulated many of the metabolic responses observed following mild-moderate injury and other catabolic illnesses.

Prednisolone effects upon body and organ weights, water intake, and several behaviors

Various behavioral sequelae have been noted in patients receiving prolonged, high-dose glucocorticoid therapy. The present study assayed several behavioral dimensions of rats receiving daily intramuscular injections of the synthetic glucocorticoid, prednisolone. Specifically, assessments of water intake, nociception, locomotion, and the grasping responses were conducted; measures of gonadal, adrenal, and total body weights were also taken. Twelve daily injections were given to four groups (N = 6/group) of immature male rats with each group receiving a different dose of drugs (0.0, 8.0, 16.0, 32.0 mg/kg). Prednisolone generally suppressed home-cage water intake, and latencies to hind paw-lick in the hot-plate assay. Measures of wheel running and the grasping response were generally enhanced. Absolute gonadal and adrenal weights as well as total body weights were decreased. Relative organ weights suggested that daily prednisolone treatments had produced suppression of the pituitary-adrenal axis. It was concluded that prednisolone is active in these assays and that such measures may be useful in studies of drug interaction with this agent.

Metabolic effects of exogenous glucocorticoids in fasted man

The influence of administering excessive amounts of glucocorticoids on circulating substrates and hormones and on urinary excretion of nitrogenous compounds and ketone bodies was examined in man after prolonged starvation. After 35 days of total caloric deprivation the administration of high physiologic doses of glucocorticoids increased circulating glucose and insulin levels without intensifying total urinary nitrogen excretion. The increased blood glucose seemed to be due to diminished peripheral uptake rather than augmented gluconeogenesis. A small, transient increase in circulating plasma amino acids was observed. However, the secondary rise in serum insulin seemed to block the proteolytic effect(s) of glucocorticoids, preventing them from mobilizing body protein stores during starvation. There was no change in circulating free fatty acids or glycerol. Thus, it appeared that the potential catabolic action of excessive glucocorticoids was offset by the anabolic effect of insulin, and a new state of homeostasis was established.An additional effect of glucocorticoid administration was a marked diminution of renal excretion of ketone bodies.