A decreased metabolic clearance of glucose is involved in the hyperglycemic effect of a serum temperature induced factor (TIF)

We have studied the effects of a hyperglycemic temperature induced factor (TIF) on glucose metabolism, in 3 groups of Wistar rats: 10 rats injected with non-heated serum, 10 rats injected with heated serum and 10 rats injected with semi-purified TIF. Seric levels of insulin and glucagon were not modified in rats injected with heated serum. The injection of heated serum induced hyperglycemia (p < 0.0001), a decrease of lactate (p < 0.001) and pyruvate (p < 0.05) levels, and an increase of acetoacetate level (p < 0.001). The levels of beta hydroxybutyrate and amino acids (alanine and glutamine) were not changed. Glucose turn over rate (12.3 +/- 1.3 g/min/kg) and metabolic clearance of glucose (10.0 +/- 0.8 ml/min/kg) were significantly lower in rats treated with heated serum and purified TIF than in controls (respectively, p < 0.05 and p < 0.001). These data suggested that the hyperglycemic effect of heated serum and isolated TIF could correspond to an impaired metabolic clearance of glucose and to an increased gluconeogenesis.     

The fundamental and clinical studies on PT-122M (doxycycline) in the otorhinolaryngological field (author's transl)

As the results of laboratory and clinical investigation with a new tetracycline derivate, PT-122M (doxycycline) was performed with the results which may lead to the following conclusions. 1) In vitro antibacterial activity: The minimal inhibitory concentration of doxycycline (DOTC) was measured by an agar plate dilution method. The MIC of DOTC against 60 strains of coagulase-positive Staphylococcus aureus isolated from otorrhoea was distributed over a range of 0.2 approximately 1.56 mcg/ml and 12.5 approximately 50 mcg/ml. Furthermore, Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae was 3.13 to 100 mcg/ml. 2) Concentration in blood: The blood level of DOTC in healthy adults who were given 100 mg of DOTC intravenous reached maximum of 1.97 mcg/ml on the average 15 minutes after injection. Even at 12 hours after intravenous injection clinically effective serum DOTC concentration of 0.47 mcg/ml was still demonstrable. 3) Clinical results: PT-122M (DOCT) was intravenously injected into 30 cases with typical infection in the field of otorhinolaryngology. It was excellent in 15 cases, good in 10 cases, fair in 3 cases, and poor in 2 cases. When the cases in which it was excellent and good were considered together, good results were obtained in 25 cases, a ratio of effectiveness being 83 per cent. 4) Side effect: The comparative examination of hepatic function, electrolyte and auditory acuity before and after injection showed no significant disturbance. No side effect was shown with the intravenous injection.     

Endocrine effects of oestrogen treatment in patients with prostatic cancer

In 36 men with prostatic cancer, the following findings were obtained: intravenous administration of 12.0 g diethylstilboestrol diphosphate (DSDP) induced a relatively slight decrease of the LH plasma level from 22.7 +/- 11.8 to 7.7 +/- 3.6 mIU/ml (34%), whereas the total testosterone plasma level decreased from 435.3 +/- 187.8 to 29.9 +/- 16.4 ng/100 ml (6.7%) suggesting a direct inhibitory effect of the oestrogen on testicular testosterone secretion. The apparently free, biologically active testosterone plasma level even decreased from 6.2 +/- 3.7 to 0.21 +/- 0.16 ng/100 ml (3.4%), due to the oestrogen-induced increase of the concentration of testosterone-binding beta-globulin (from 9.6 +/- 4.4 to 20.6 +/- 10.7-10(-8) M). 3--7 days after additional orchidectomy plus subcutaneous implantation of 100 mg dienoestrol diacetate a further decrease of the apparently free testosterone plasma level from 0.21 +/- 0.16 to 0.14 +/- 0.07 ng/100 ml was found. In contrast, 6 weeks after orchidectomy without oestrogen implantation a significant increase of th- apparently free testosterone plasma level -rom 0.21 %/- 0.16 to 0.34 +/- 0.15 ng/100 ml was observed (p less than 0.01). In view of these findings the biologically active free testosterone plasma level appears to be even more suppressed by intravenous administration of high DSDP than by orchidectomy. The most effective suppression of apparently free testosterone was achieved, however, by oestrogen treatment combined with orchidectomy.     

Studies on mushroom flavours 2. Flavour compounds in coprinus comatus

Within 3 hours, 10 healthy male volunteers were infused 500 ml of a 5 percent emulsion in which 25 percent of the fat proportion had been replaced by MCT-fats. As expected, the ketone body concentration in the blood rose, while pyruvate remained constant and lactate dropped. The results show that, basically, a MCT-containing fat infusion is suited for parenteral nutrition and, because of their specific properties, medium chain triglycerides may be used as rapid energy donators.     

Effect of maltose, following long-term intravenous infusion, on the metabolism

6 healthy subjects received a 20% electrolyte containing maltose solution over a period of 6 hours. The concentration of maltose rose up to 109 (76-215 mg/100 ml). During the infusion period 3,7 (1,9-7,7) g maltose were excreted. The concentration of glucose and insulin was not altered, although the renal glucose loss was 20,2 (7,5-38,7) g. In the same period 49,8 +/- 13,2 mval potassium and 135,4 +/- 35 mval sodium were eliminated. Maltose induced an osmotic diuresis which was not caused by hyperglycemia. Such a type of osmotic substance has not been described before.     

Adrenergic regulation of human adipose tissue metabolism in situ during mental stress

The adrenergic regulation of adipose tissue lipolysis and glucose metabolism was investigated in situ during a standardized mental stress test in 11 nonobese, healthy subjects, using microdialysis of the extracellular water space in sc adipose tissue. Microdialysis probes were inserted in the abdominal sc fat, and were perfused using solvents with or without adrenoceptor blocking agents. The tissue dialysate concentrations of glycerol (lipolysis index) glucose, lactate, and pyruvate were determined. The glycerol concentration in adipose tissue increased markedly during the stress test and decreased in the poststress period. A similar kinetic pattern was observed in blood. In situ administration of the nonselective beta-adrenoceptor blocking agent propranolol almost completely prevented the stress-induced increase in adipose tissue glycerol levels, whereas a nonselective alpha-adrenoceptor blocking agent (phentolamine) was ineffective in this respect. Plasma levels of glucose and lactate remained unaltered during and after the stress test; at the same time plasma pyruvate decreased moderately. By contrast, glucose, lactate, and pyruvate in adipose tissue increased by 25-30% during or after the stress (P < 0.05). The increase in lactate and pyruvate in adipose tissue after the stress was completely off-set by alpha-adrenoceptor blockade in situ, whereas beta-adrenoceptor blockade in situ did not influence the kinetic pattern of these metabolites. It is concluded that the lipolytic activity in human adipose tissue is markedly enhanced during mental stress, owing to adrenergic mechanisms that are mediated via beta-adrenoceptors. After mental stress, adipose tissue glucose utilization is decreased and routed toward nonoxidative pathways. The latter seems to involve adrenergic effects that are mediated via alpha-adrenoceptors.     

The prognostic value of the lactate concentration and lactate/pyruvate ratio in cerebrospinal fluid following acute cerebral circulatory disorders

The study was conducted in 80 patients with ischaemic and 29 with haemorrhagic cerebral stroke. Lactate, pyruvate, the lactate/pyruvate ratio and glucose were determined in the arterial blood and lumbar CSF. A high prognostic value of the CSF lactate content was found in cases of ischaemic stroke. According to the data obtained, an elevation of the CSF lactate concentration above 4.0 mEq/l should be considered life-threatening. Haemorrhagic stroked was found to be accompanied by a reduced CSF glucose level and an elevated lactate content, as well as by a significant proportional elevation of the lactate and red blood cells count in the CSF. The conducted calculations demonstrated that 1/4 to 1/3 of the CSF lactate is formed at the expense of the glycolytic metabolism in the CSF erythrocytes. This constitutes the main reason of the discordance between the CSF lactate content in haemorrhagic stroke and the routine criteria of prognosis in ischaemic stroke. The lactate/pyruvate ratio in the CSF is of no prognostic importance in both forms of cerebral stroke.     

Radiotherapy results in early stage low grade nodal non-Hodgkin''s lymphoma

Severe lactic acidosis usually accompanies intense endurance exercise. It has been postulated that glycogen depletion working in concert with elevated muscle and plasma lactate levels lead to a concomitant reduction in pH. Their cumulative effect during prolonged physical exertion now leads to muscular fatigue and eventually limit endurance capacity. Therefore in the present study, dichloroacetate (DCA), a compound which enhances the rate of pyruvate oxidation thus reducing lactate formation, has been evaluated in a validated rat model of sub-maximal exercise performance. Male rats (350 g) were divided into two groups (control-saline, i.v. and DCA 5 mg/kg, i.v.) and were exercised to exhaustion in a chamber (26 degrees C) on a treadmill (11 m/min, 6 degrees incline). When compared to controls, the DCA-treated rats had longer run times (169 vs 101 min) and a decreased heating rate (0.020 vs 0.029 degrees C/min). In addition, DCA attenuated the increase in plasma lactate (28 vs 40 mg/dl) and significantly reduced both the rate and absolute amount of depletion of muscle glycogen stores. These results suggest that the activation of pyruvate dehydrogenase activity by DCA resulted in a reduction in the rate of glycogenolysis in addition to decreasing lactate accumulation by presumably limiting the availability of pyruvate for conversion to lactate, therefore increasing muscle carbohydrate oxidation via the TCA cycle. Thus DCA effected a significant delay in muscle fatigue.     

Acute renal failure in patients with acute pancreatitis

We describe five patients with acute pancreatitis in whom acute renal failure developed in the absence of hypotension. Pancreatitis was diagnosed clinically, with mean serum and urinary amylase levels of 766 +/- 197 (SE) and 2,378 +/- 572 units/100 ml, respectively. Acute renal failure developed within 24 hours after admission in all patients. It was manifested by oliguria, elevated levels of serum creatinine (mean, 6.9 +/- 1.1 mg/100 ml) and BUN (105 +/-28 mg/100 ml); a urinary sodium level of 72.0 +/- 6.6 mEq/liter; and isosmotic urine (355 +/- 31 mOsm/liter). The mean uric acid level was 18.6 +/- 1.6 mg/100 ml. Blood pressure was recorded frequently, and the lowest mean diastolic pressure was 96 +/- 6 mm Hg. The duration of the oliguric phase of acute renal failure was 8.2 +/- 1.7 days, and all patients recovered from both the acute pancreatitis and acute renal failure. In summary, acute pancreatitis, per se, can precipitate acute renal failure. It occurs early in the course of the pancreatitis, and extreme hyperuricemia is frequent finding that does not adversely affect the recovery of renal function.     

A fully enzymatic triglyceride determination in a continuous flow 12-channel analyzer (author's transl)

A fully enzymatic triglyceride determination utilizing enzymatic hydrolysis with a lipase-esterase mixture and subsequent enzymatic glycerol determination, has been adapted for use in a continuous flow 12-channel-analyzer. The method is linear up to 7.9 mmol/l (700 mg/100 ml). The analytical precision in the concentration range of 1.5 to 5.4 mmol/l (133 to 478 mg/100 ml) is characterized by relative standard deviations of 0.8 to 4.8%. In the lower measuring range at concentrations around 0.7 mmol/l (62 mg/100 ml) a mean relative standard deviation of 7.2% is found for 1140 measurements under routine conditions. For triglyceride concentrations of 0.9 to 7.7 mmol/80 to 680 mg/100 ml) a mean relative coefficient of verspill Q = 2.0 is determined. Bilirubin caused no observable interference in the determination. In comparison with the manual method by Eggstein & Kreutz (1966) Klin. Wochenschr. 44, 262-267) the results from the fully enzymatic method on the 12-channel-analyzer were lower by approximately 16%, corrected by an additive factor of 0.029 mmol/l (2.59 mg/100 ml). The accuracy controls with controls sera showed a difference of 10%.     

Antibodies to pyruvate dehydrogenase in primary biliary cirrhosis: correlation with histology

Antimitochondrial antibodies to pyruvate dehydrogenase are the hallmark of primary biliary cirrhosis. Their pathogenic role has not been proven, although antibodies to pyruvate dehydrogenase are bound to biliary epithelium. The aim of this study was to characterize serum IgA antibodies to pyruvate dehydrogenase and to evaluate their response to different treatment regimens. We also compared the level of antibodies with severity of histological lesions and the data of biochemical liver tests. Serum samples were collected at baseline and after 24 months from 61 primary biliary cirrhosis patients, whereas 23 patients were treated with ursodeoxycholic acid, 20 with colchicine, and 18 with placebo. ELISA was used to detect antibodies to pyruvate dehydrogenase. IgA and IgG were separated with jacalin and protein-A, respectively. Capacity of immunoglobulins to inhibit enzymatic activity was detected by spectrophotometric observation of the rate of enzyme reaction. 49 (80.3%) of the 61 patients possessed IgA antibodies to pyruvate dehydrogenase. Significant decrease in IgA antibodies was observed only in the ursodeoxycholic acid group (p<0.05). 15 of 18 IgA preparations and all 24 IgG preparations of patients' sera were inhibitory towards pyruvate dehydrogenase (mean inhibitory percent +/-SD: 42+/-33.4% and 79+/-22.4%, respectively, at a protein concentration of 100 microg/ml). The level of serum antibodies to pyruvate dehydrogenase correlated with several histological parameters (fibrosis, inflammatory infiltrate), but not with biochemical parameters. Our data reveal that IgA antibodies to pyruvate dehydrogenase inhibit enzyme function. The correlation between antibodies to pyruvate dehydrogenase and histological parameters might suggest the pathogenic role of these antibodies.     

High-altitude acclimatization and proteinuria in East Africa

Seven climbers spent 6 weeks in the East African mountains, at heights of up to 5890 m. The mean protein urine concentration in morning specimens was over 100 mg/100 ml after climbs during the first 12 days but fell to 15 mg/100 ml during subsequent climbs. The highest concentrations (100-300 mg/100 ml) were in 5 climbers with peripheral oedema, 3 with obvious high-altitude illness. The findings implicate the kidney in high altitude acclimatization and illness.     

Double-blind evaluation of the safety and pharmacokinetics of multiple oral once-daily 750-milligram and 1-gram doses of levofloxacin in healthy volunteers

The safety and pharmacokinetics of once-daily oral levofloxacin in 16 healthy male volunteers were investigated in a randomized, double-blind, placebo-controlled study. Subjects were randomly assigned to the treatment (n = 10) or placebo group (n = 6). In study period 1, 750 mg of levofloxacin or a placebo was administered orally as a single dose on day 1, followed by a washout period on days 2 and 3; dosing resumed for days 4 to 10. Following a 3-day washout period, 1 g of levofloxacin or a placebo was administered in a similar fashion in period 2. Plasma and urine levofloxacin concentrations were measured by high-pressure liquid chromatography. Pharmacokinetic parameters were estimated by model-independent methods. Levofloxacin was rapidly absorbed after single and multiple once-daily 750-mg and 1-g doses with an apparently large volume of distribution. Peak plasma levofloxacin concentration (Cmax) values were generally attained within 2 h postdose. The mean values of Cmax and area under the concentration-time curve from 0 to 24 h (AUC0-24) following a single 750-mg dose were 7.1 microg/ml and 71.3 microg x h/ml, respectively, compared to 8.6 microg/ml and 90.7 microg x h/ml, respectively, at steady state. Following the single 1-g dose, mean Cmax and AUC0-24 values were 8.9 microg/ml and 95.4 microg x h/ml, respectively; corresponding values at steady state were 11.8 microg/ml and 118 microg x h/ml. These Cmax and AUC0-24 values indicate modest and similar degrees of accumulation upon multiple dosing at the two dose levels. Values of apparent total body clearance (CL/F), apparent volume of distribution (Vss/F), half-life (t1/2), and renal clearance (CL[R]) were similar for the two dose levels and did not vary from single to multiple dosing. Mean steady-state values for CL/F, Vss/F, t1/2, and CL(R) following 750 mg of levofloxacin were 143 ml/min, 100 liters, 8.8 h, and 116 ml/min, respectively; corresponding values for the 1-g dose were 146 ml/min, 105 liters, 8.9 h, and 105 ml/min. In general, the pharmacokinetics of levofloxacin in healthy subjects following 750-mg and 1-g single and multiple once-daily oral doses appear to be consistent with those found in previous studies of healthy volunteers given 500-mg doses. Levofloxacin was well tolerated at either high dose level. The most frequently reported drug-related adverse events were nausea and headache.     

Cerebral blood flow and oxidative brain metabolism during and after moderate and profound arterial hypoxaemia

In anaesthetized artificially ventilated dogs, the effect of graded arterial hypoxaemia on cerebral blood flow (CBF) and on the oxidative carbohydrate metabolism of the brain was tested. It is shown that the hypoxic vasodilatory influence on cerebral vessels is present even at moderate systemic hypoxaemia, provide that PaCO2 is kept within normal limits. At PaO2 of about 50 Torr, CBF increased from 56.6 to 89.7 ml/100g/min. With increasing cerebral hyperamia (CBF increased to 110.9 ml/100g/min, at PaO2 of 30 Torr), CMRO2 (4.2 ml/100g/min) was not significantly raised above its normal level (4.7 ml/100g/min) even with profound arterial hypoxaemia. This shows that CMRO2 levels are poor indices of hypoxic hypoxia. A disproportionately high increase in cerebral glucose uptake (CMR glucose levels rose from 4.4 to 10.4 mg/100g/min) and enhanced cerebral glycolysis (CMR lactate changed from 0.2 to 1.6 mg/100g/min) at moderately reduced PaO2 (50 Torr) indicated early metabolic changes which became more marked with further falls in arterial oxygen tension. However, 60 minutes after restoration of a normal PaO2 level, CBF and brain metabolism were found to have completely recovered. It is concluded that a short period of profound systemic hypoxaemia does not produce long lasting metabolic and circulatory disorders of the brain provided the cerebral perfusion pressure does not vary, and is kept at normal levels.     

Creatine content in erythrocytes and blood plasma of chickens before and following stimulation of erythropoiesis by anemia

The red blood cells of chicken have a lower creatine concentration than those of man (1 mg/100 ml vs 5-6 mg/100 ml cells). No creatine phosphate was found in either erythrocytes or reticulocytes. With anemia produced by phenylhydrazine and bleeding a young cell population appeared with a higher creatine concentration.     

The effect of therapeutic doses of paracetamol on liver function in the rat perfused liver

The isolated liver perfusion technique was used to study the effect of therapeutic doses of paracetamol on hepatic gluconeogenesis and bromosulphthalein clearance from the perfusate and biliary excretion of the dye in the rat. Six groups of rats were studied; those in the three experimental groups were given 0.02 g kg-1 paracetamol daily for ninety days. The livers of animals in the control group and in one of the experimental groups were perfused with a medium containing pyruvate. The animals in the second experimental and control group were perfused with a medium containing bromosulphthalein (10 mg/100 mL). The livers of the third experimental and control group were subjected to histological examination. The rate of glucose formation and glucose concentrations were decreased, while, lactate levels and lactate: pyruvate ratios were increased in paracetamol-treated rats. The mean concentration of bromosulphthalein in the perfusate and biliary excretion of the dye were decreased. Macro and micro vesicular fatty change was present in the livers of paracetamol-treated rats. This study demonstrates that chronic administration of therapeutic doses of paracetamol to rats adversely affects liver function, as evidenced by impaired gluconeogenesis and bromosulphthalein clearance from the perfusate, and excretion of the dye into the bile, and provides histological evidence of hepatic damage in rats.     

Influence of a pressure agent on blood concentrations of glucose, lactate, pyruvate and free fatty acids (author's transl)

In 34 unselected patients blood concentrations of glucose, lactate, pyruvate and free fatty acids (FFA) were determined after i.v. injection of a pressure agent containing theophylline esterified with norephedrine and theophylline esterified with norepinephrine (Akrinor) with and without beta-adrenergic blockade. After Akrinor a significant increase of FFA concentration of 32% is observed, which can be abolished by beta-receptor blocking agents. Our findings indicate that the Akrinor-induced lipolysis is mainly due to a direct sympathomimetic effect on the beta-receptors of adipose tissue. there are only slight effects on carbohydrate metabolism (decrease of pyruvate concentration, increase of lactate/pyruvate ratio) which are not influenced by beta-receptor blockade. According to our results there are important metabolic differences between Akrinor and the classical catecholamines.     

Blood xylose as a screening test for malabsorption in jejunal mucosa abnormalities; importance of diet in interpretation

Blood xylose level 60 min. after an oral dose of 10 g/m2 xylose was compared with the histology of the jejunal mucosa in 56 children. Ninety-two percent of children with blood xylose below 20 mg/100 ml had an abnormal jejunal mucosa; 98% of children with a normal mucosa had a blood xylose above 20 mg/100 ml. In children with coeliac disease the following observations were made: 1) blood xylose was above 20 mg/100 ml in 50% of children with flat mucosa; all were given a diet excluding gluten; 2) blood xylose levels which were initially below 20 mg/100 ml were found above this level 3 to 12 days after the onset of the diet; 3) all the histological relapses following re-introduction of gluten in the diet were not associated with a decrease of blood xylose level below 20 mg/100 ml.     

The outbreak of an epidemic of tick-borne encephalitis in Kielec province induced by milk ingestion

New liquid UHT milks supplemented with iron (0.9-1.4 mg/100 ml), vitamin C (1-7 mg/100 ml), lactose (2-4 g/100 ml) and linoleic acid (200-400 mg/100 ml), named growth milks, have recently become available to satisfy the specific nutritional needs of children aged 1-3 years. But the iron-vitamin C mixture could activate the lactose-induced Maillard reaction and tryptophan (Trp) oxidation in proteins. We have therefore examined the Amadori product and Trp concentrations of these milks. Forty-two commercial growth milks from five firms were analysed for the Maillard reaction and the soluble protein Trp content and compared with 64 UHT milks. The furosine concentration of total proteins was two to four times higher in 'growth' milks than in standard UHT milks, indicating a proportional loss of available lysine. The Trp fluorescence of undenatured proteins soluble at pH 4.6 was almost three times lower in 'growth' than in standard milks and Trp concentration 36% lower suggesting destruction of this oxidation-sensitive amino-acid. The mechanism of Trp destruction remains to be elucidated, and the roles of iron and Amadori products determined.     

Studies on androgen transport into canine prostate in vitro

Significant rise of fructose in the blood plasma of cattle resulted from an application of sorbite solution (0.5 g sorbite per kg live weight), with its onset as early as during the infusion. The highest concentration was reached 15 minutes after completion of infusion. Rise in glucose (11 mg/100 ml plasma on average) failed to prove statistically significant and dropped temporarily (after 60 to 120 minutes) below the original value. The lactate level in the blood went up temporarily and reached its maximum 30 minutes from the end of infusion. Sorbite solution (1 g/kg live weight) was intravenously applied to sheep and tock fructose to its maximum after 30 minutes. Intraperitoneal application of sorbite solution (1 g/kg live weight) was tolerated well also by piglets and triggered an age-dependent decline of glucose in blood plasma.