Dynamic changes in the total fatty acids of diabetics during glucose challenge

Simultaneous determinations of blood glucose and total fatty acids were done in 20 diabetics and 20 non-diabetic Filipino patients undergoing glucose loading tests. The objective was to explore the interrelationship of glucose and fatty acids metabolism in the hope of establishing an explanation of the observation that Filipino diabetics in general are less prone to ketosis. Compared to foreign studies, this study disclosed a significantly different response of Filipino diabetics to the stress of induced hyperglycemia, i.e. high level of fasting FA. with delayed but sustained depression. The concomittant determination of the glucose tolerance curve and the F.A. profile aids in prognosticating the kelotic-prone diabetics

Clinical evaluation of norbolethone, a new anabolic steroid

Norbolethone may be considered an excellent metabolic activator due to the following reasons: 1. Substantial increase in lean body weight in a big majority of the subjects. 2. Stimulation of appetite in those suffering from chronic or refractory anorexia not affected by vitamins and other anabolics previously taken3. Improvement of the feeling of well-being in those patients even suffering from malignancies and intractable pain4. Increase of alertness and strength which would have taken a long time in convalescent subjects, post-infectious and post-surgical5. Persistence of excellent results even after administration of the drug had been terminated6. Reversal of negative nitrogen balance7. Insignificant effect on blood and urine values. SGOT values increased but were restored to normal8. Increase in serum protein and nitrogen balance positive of protein build up9. Side reactions that occur later with the drug are not severe enough to require suspension of therapy and disappear gradually even only on reduction of the dose. The 11 dropouts earlier in the study were not caused by intolerance to the drug but due to the fact that these subjects thought they had received enough of the drug when their conditions improved. (Conclusion)

Adrenal cortical steroid therapy of primary nephrotic syndrome among adult Filipinos: clinical, biochemical and histologic studies

An analysis of the response to corticosteroid therapy of 66 patients with primary nephrotic syndrome was presented in this paper. A summary of the clinical status and biochemical data before and after the initial course of corticosteroid therapy is shown in TABLE VIII. Forty three patients followed for 1 to 48 months was likewise analyzed; of these 44 patients, 26 were on intermittent steroids and 18 were not on the drugThe type of response obtained was classified into Grade A, B, C and D. Remission after the initial course was obtained in 62% of the cases treated. In the intermittent-treated group, 58% were in remission at the time of this study in contrast to 41% remission in patients who were not maintained on the drug. There were 15 deaths in this series, 7 occurred in the initial course of treatment and 8 in the follow-up period. All fatalities during the initial course were among uremic patients with endstage kidneys. In the follow-up period deaths were also due to uremia and were on patients who responded poorly do the initial courseCorticosteroids remain the drug of choice in the management of primary nephrotic syndrome and should be used whenever indicated. ACTH therapy is more expensive and requires the parenteral route for its administration. The routine administration of ACTH in the course of corticosteroid therapy was not utilized in this study as this has been shown to be of no value in preventing adrenal insufficiencyKidney biopsies are useful in diagnosis, prognosis and guide to therapy of nephrotic syndrome but should not supersede the clinical features and common laboratory procedures in the choice of patients for corticosteroid therapy as suggested by other authors. Eighteen patients in this study have kidney biopsies. Remissions were obtained in patients with "normal" and minimal degree of glomerular involvement; however; poor results were also seen in patients with minimal changesThe need to follow patients closely and with periodic determination of the common laboratory procedures as a guide to therapy was stressedFinally, corticosteroid therapy of primary nephrotic syndrome is most beneficial in patients ill with the disease for less than 6 months duration, without or with minimal azotemia, hypertension and hematuria, and in cases with "normal" and minimal glomerular changes. Adequate dosage and longer initial course of therapy of at least 6 weeks and possibly more in some cases will insure a higher incidence of remission. The duration of intermittent steroids therapy has not been conclusively settled but it is the general felling that it should be continued for 6 months to 1 year after a successful initial course of treatment in patients who remained in remission. (Summary and Conclusions)

Renal scintiscan: clinical applications

The radioisotope renal scintiscan has proved to be a diagnostic tool in the study of various kidney conditions. Because of the physical and pharmacologic properties of the Hg labeled Neohydrin to concentrate particularly in the cortical areas of the kidneys, test is an excellent one for the delineation of space-occupying lesions of the kidneys. It can also aid in proving whether a mass in the kidney area is in the kidney or not. It should be emphasized, however, that a negative renal scan does not necessarily rule out a tumor. The presence of a filling defect in the renal scan does not necessarily imply the presence of a tumor either. It can be an ischemic area, a renal cyst, or an infacted areaIt has been applied as an adjunct in the study of patients with anuria and azotemia. Because of its case of performance, without any added hazards to the already very ill patients it can be done readily and the results are immediately available. There is very little radiation hazards (0.9) rads per 100 microcuries of HgThe renal scintiscan has been extensively utilized as an auxilliary procedure in the diagnostic evaluation of hypertensive patients. It is a better guide in evaluating the relative kidney sizes. This test is capable of demonstrating the functioning state of the renal tissue, such as small areas of residual viable tissue, and areas of kidney infarction and ischemia of 2 cm or more in diameter. (Comment)

Renal arteriography

In selected and well-screened hypertensives, renal arteriography is an indispensable diagnostic tool for establishing a possible renovascular cause for the high blood pressure. Positive angiographic findings may be expected in 40% of renovascular suspects submitted to this procedure. At the present time we are getting more conclusive renal angiograms by the retrograde transfemoral route and have used this approach in fifteen instances. There has not been any noteworthy complication arising from transfemoral approach in those cases we have personally done. In most instances a positive renal angiogram not only concluded the study of the patient but it also provides the surgeon and the urologist with a pre-operative plan in dealing with the pathology in each individual case.(Summary)

Agnogenic lymphoid metaplasia of the spleen

A condition of lymphoid metaplasia of the spleen, accompanied by symptoms of hypersplenism arising from an unknown stimulus, is reported. As far as is known, this is the first reported case. The value of splenic and bone marrow puncture in diagnosing splenomegalies of obscure nature is pointed outAnother case was observed as early as the Japanese occupation. But as the chart was destroyed by fire, all reports were lost.(Summary)

Serum protein-binding of radioactive triiodothyronine in the evaluation of thyroid function using sephadex gel filtration

1. A new technique for the direct measurement of T3-serum protein complex has been devised and perfected. This procedure has several distinct advantages over the standard procedures: (a) previous iodide intake (inorganic or organic)does not vitiate the result, (b) no radioactivity is introduced into the system of the patient, (c) many variables connected with red cell or resin uptake procedures are obviated, and (d) a shorter period of time is required, 3 hours, to finish the test2. A total of 160 test runs were made on 136 subjects using this new procedure. Results revealed highly significant values for the evaluation of thyroid function3. In certain situations where probably either alterations in TBP thyroxine binding capacity or changes in the proportion of T4 and T3 are operative, T8-binding gives reliable results, where PBI does not .(Summary)

Chromosomes studies in heritable thyroid diseases

The thyroid disorders studied - hyperthyrodism, endemic goiter and non-endemic or sporadic goiters- are not associated with gross chromosomal abnormalities, either morphologically or numerically. This does not exclude, however, the possibility of minute alterations in the chromosomes not discernible by the human eye. The possibility of a defect at the biochemical or molecular level in these thyroid diseases remain to be explored. (Conclusion)

The measurement of free thyroid hormone in human serum

A method for determining circulating free thyroid hormone using Sephadex gel filtration is described. It differentiates clearly the euthyroid from the hyperthyroid states. Its most useful clinical application is in the diagnosis of clinically hyperthroid states with normal protein-bound iodine and radioactive iodine uptake. (Summary)

Clinical aspects, laboratory manifestation and serologic studies of a newly observed arbor a virus infection

18 cases of Chikungunya (or a very closely related virus) infection, a newly observed clinical entity in the Philippines, are presented. Diagnosis was established by serological studies consisting of hemagglutination-inhibition (HI) and complement fixation (CF) tests. (Summary)

Hypoglycemic accidents following oral anti-diabetic therapy

The authors experience on the dangers of oral hypoglycemic agents are discussed. Non-familiarity with the drug, patients non-cooperation, or inadvertence are the causes of accidents mentioned. Case reports of five patients who were given chlorpropamide and "anti-diabetic tablet" are cited. Recommendations regarding close supervision during treatment are also noted

Acute thrombo-embolic occlusions of the aorta and major arteries complicating arteriosclerotic heart disease (report of four cases)

The patho-physiology of mural thrombi and resulting peripheral systemic thrombo-embolic occlusions is presented. Four cases are discussed to demonstrate that embolectomy, carried out as early as possible, is probably the procedure of choice. All cases occurred in patients with serious cardiac or cardio-renal conditions. All patients were geriatric the oldest being 94 years old. The fact that they have lived this long probably indicate above-average constitutions, and age per se should not deter the properly trained and equipped surgeon from performing these life- or limb-saving procedures. (Summary)

An epidemiological, clinical and laboratory survey of goiter in Bay, Laguna

Goiter was found to be endemic in Bos. Bitin (upland), Calo (lowland), Dila (lowland) and San Antonio (lakeside) with the following respective prevalence rates: 47.5%, 23.8%, 19.5% and 25.9%. On the assumption of a completely randomized sample, the province of Laguna may be considered endemic and Bo. Bitin as a hyperendemic area. Female prevalence exceeded that of the males with a ratio of 1.8:1 to 5:1. The peak of prevalence among males fall under the age group 10-19 years while in females it follows a decade later (20-29). For the 4 barrios combined 11.3% of the males were found with Grade I goiter, 2.3 with Grade 2 and 0.2% with Grade 3. The females showed a higher proportion 23.6% with Grade I goiter, 12.2% with Grade 2 and 1.8% with Grade 33.8% of the surveyed households without any identified case of goiter had a familial history of thyroid enlargement as compared to 16.0% of the households with identified cases of goiter. Among the subjects tested for thyroid function, PBI values within the accepted normal range were maintained by a higher proportion of normal males in Bos. Bitin (55.0%), Calo (47.8%), Dila (55.2%) and San Antonio (73.2%) as compared to females (10.7%, 40.7%, 38.6% and 50.9% respectively). Reactors to the TA-Test were noted mostly among normal males in Bos. Dila 15.0%, Calo 37.5% and San Antonio 11.1% and also among normal females in Calo (20.0%). In contrast, a higher proportion of abnormal males and females in Co. Bitin reacted to the test. Normal RAIU values were seen in a greater proportion of normal males in the 3 lowland barros of Calo (61.3%), Dila (55.2%) and San Antonio (73.3%) as compared to normal females (52.5%), 32.6% and 50.9% respectively)The results show that the prevalence of goiter is definitely correlated with the female sex in the reproductive age groups and strongly suggests the possibility of low autoimmune proces which is accentuating the environmental differences of the surveyed population. On the assumption that our sampling is randomized, Bay, Laguna is endemic for goiter and Bo. Bitin is a hyperendemic area. (Summary)

Anorexia, weakness, restlessness and parkinsonism associated with hypokalemia following radioactive iodine therapy

This paper, however, deals with a set of symptoms observed in four of the 52 patients-symptoms which we feel are apart from those in the thyroxine release syndrome. The uniformity of the signs and symptoms presented by the four patients, the consistency in the time of appearance and the correspondence of the biochemical observations in all the patients excited our curiosity. It is possible that the four cases are those of a delayed, severe or atypical thyroxine release syndrome. They seem more likely to be what many would call cases of thyroid storm or thyroid crisis a vague and ill defined syndrome which has defied understanding. (Author)

CR-51 tagged red cell studies. II. The apparent half-survival time of erythrocytes

The use of tagged donor cells introduces many other factors, both extra and intra-corpuscular, which may invalidate the results of the recipients own survival time. Questions of incompatibilities and the danger of the transmission of serum jaundice also attend the use of the above methods. (Author)

CR-51 Tagged red cell studies. I. The red cell mass in Filipinos

The total circulating red blood cells, or the so-called cell mass, in human has been determined by a variety of methods using different red cell tags. Prominent among these are the hemoglobin precursors, the use of which has been based on the assumption that since they are integral parts of the red blood cells, they should be the tags of choice in the study of human erythrocytes. (Author)

Protein-bound iodine studies in Filipinos

The efficacy of protein-bound iodine (PBI) determination of the serum as an aid in evaluating thyroid function is presented. The study consists of 85 medical students and staff of the UP-PGH Medical Center who were clinically evaluated as euthyroid. Blood samples were taken and PBI was determined utilizing the procedure by Barker, Humphrey, and Soley. Twenty-four hyperthyroid and nine hypothyroid subjects were evaluated clinically. Basal metabolic rate (BMR) studies were doneThe PBI values obtained ranged from 3.9-9.6 gamma with a mean of 6.87 gamma . No significant difference was found between the student group and the non-student group. The scattergram showed definite elevation of PBI values in hyperthyroidism and lowering in hypothyroidism. A statistically significant difference was observed between hyperthyroid and hypothyroid values. Comparison of PBI and BMR values showed that PBI results were more consistent than BMR in evaluating euthyroidismThe study indicated that PBI determination has a definite use in the evaluation of thyroid function. Some advantages of PBI over BMR as well as extraneous factors influencing PBI are presented in the report

Cysts of the pancreas: a report of two cases

A case of pseudosyst of the pancreas is reported, demonstrating the successful use of marsupialization. Because of the relative rarity of this condition, special attention is called to the ease with which it can be mistaken for other more common causes of encysted fluids, and to the special means for differentiating it.

Gouty neuropathy

Gout produces not only an arthritis but also a form of kidney disease. Studies by Thannhauser show that the defect lies in the metabolic transport of uric acid in the kidneys, in which there is increased reabsorption of uric acid leading to hyperuricemia and deposition of urates.(Summary)