[Routine determination of HB A1 by micro-column technique (author's transl)]. / Ein Routineverfahren zur chromatographischen HB A1-Bestimmung mittells Mikrosäulentechnik.

For routine determination of glycosilated hemoglobin (HB A1) it is necessary to have a quick and easy assay which allows analysis of a greater number of samples. Taking into consideration known methods for hemoglobin chromatography a micro-column technique has been developed, which separates the glycosilated hemoglobins AIa+b+c from the main hemoglobin fraction HB AII. Micro-columns (7.0 x 1.3 cm) are filled up to a bed-height of 3 cm with Bio-Rex 70. Hemoglobin is given to these in hemolysate from (1,8 mg/200 microliter) and separated with two buffers of different ionic-strength and different pH-values into two fractions HB A1 and HB AII. With exact standardisation of the elution volumes (18 ml), the elution temperature (21.5 degrees C) and pH-value (6.74) of the first elution buffer a high reproducibility of the results is possible (Intraassay-VK: 2.38%; Interassay-VK: 3.68%). The optical density of the hemoglobin fractions is read for cyanhemoglobin at 413 nm or 415 nm or for cyanmethemoglobin at 419 nm. The HB A1-concentration is given as a percentage of the total hemoglobin. This method enables the determination of HB A1-value of 40 blood samples in triplicate within four hours. The normal value derived from 25 healthy and normal weight volunteers is 6.88 +/- 0.41% (mean +/- S.D.), from which an upper normal range of 7.7% has been calculated. In 103 patients with unimpaired glucose tolerance values were observed in similar range: 6.45 +/- 0.61% (mean +/- S.D.). In 121 diabetic patients with varying metabolic control HB A1-values up to 20.58% were noted.

The influence of high doses of oral medroxyprogesterone acetate on glucose tolerance, serum insulin levels and adrenal response to ACTH. A study of 17 patients under treatment for endometrial cancer.

Seventeen women aged 55 to 76 years who had been treated for endometrial cancer by surgery or radiotherapy or a combination of both were given 300 mg of medroxyprogesterone acetate (MPA) daily by mouth. Before treatment and again during the 3rd week of treatment an oral glucose tolerance test (with measurement of serum insulin levels) and an ACTH-stimulation test were done. All blood glucose levels tended to be higher with MOA therapy and serum insulin levels were significantly increased 3 h after a glucose load. The rise of serum cortisol 30 min after ACTH-stimulation was significantly less with MPA therapy. Oral MPA thus appeared to have a glucocorticoid-like action.

[Intravenous and oral TRH-stimulation test: comparison of the value of both tests concerning diagnosis and therapy of thyroid diseases (author's transl)]. / Intravenöser und oraler TRH-Stimulationstest: Verglich der Wertigkeit beider Tests in Diagnostik und Therapie von Schilddrüsenerkrankungen.

15 euthyroid patients, 15 patients with a so-called non toxic goiter, 7 patients with hypothyroidism and 14 patients with hyperthyroidism (Grave's disease and autonomous adenoma) were submitted to intravenous (200 micrograms) and oral (40 mg) TRH-stimulation tests. After the oral application of TRH the patients with a normal thyroid function and the patients with a goiter showed an increase of the concentration of TSH which was about 1 1/2 fold higher than after the intravenous application of TRH. The patients who suffered from hypothyroidism showed a different reaction after intravenous and oral application of TRH. The patients with a hyperthyroidism had neither after the intravenous nor after the oral application of TRH an increase of the peripheral concentration of TSH. Therefore both intravenous and oral TRH-stimulation tests seem to be apt in the same way for the diagnosis of thyroid diseases and for the control of the therapy when thyroid hormones are applied.

[TRH-test in hyperthyreoidism. Investigations of the TRH stimulated TSH-secretion in anti-thyroid drug treated primary hyperthyreoidism and in experimentally induced hyperthyreoidism (author's transl)]. / TRH-Test im Verlauf von Hyperthyreosen. Untersuchungen über die TRH-stimulierte TSH-Sekretion bei thyreostatisch behandelter primärer Hyperthyreose und Hyperthyreosis factitia

Determinations in 11 patients with anti-thyroid drug therapy of hyperthyreoidism showed, that a pronounced lag period exist between normalisation of thyroid hormone level and TRH responsiveness. The lag period range between 5 and 27 weeks. During this time it is not necessary to give simultaneously thyroid hormones in antithyroid drug therapy to compensate hyperresponsiveness of TSH. - Investigations in 12 volunteers with experimental hyperthyreoidism induced by administration of thyroxine suggest a longterm suppression of the hypophysis to be the cause of the lag period of TSH-secretion. There are some similarities to the ACTH-suppression in therapy with corticosteroids and to the so-called "syndrome of oversuppression" in long lasting treatment with contraceptive drugs.

[Value and relevance of metabolic function tests in the diagnosis of primary hyperparathyroidism (author's transl)]. / Wertigkeit verschiedener Stoffwechselparameter bei der Diagnostik des primären Hyperparathyreoidismus

Calcium, phosphate and alcaline phosphatase levels were determined in the serum of 29 patients with suspected primary hyperparathyroidism. Phosphate clearance according to Kyle, 24 hours urine hydroxyproline excretion during collagen free diet, the excretion of cAMP in the 24 h urine during calcium restricted diet were examined with regard to the diagnostic value and relevance as compared to the consumption of laboratory and staff time. The elevation of the serum calcium levels are not specific and only of minor diagnostic value. It has been found that the highest diagnostic value is given by the Kyle-test using 15 mg Ca ions/kg body weight. No false positive results were recorded. The excretion of hydroxyproline and calcium are only of limited value. Serum alcaline phosphatase and cAMP excretion have no diagnostic significance whereas concentration of serum phosphate may have some value.

[Mechanism of action of gliquidone (author's transl)]. / Untersuchungen zum Wirkungsmechanismus von Gliquidon. Vergleichende Untersuchungen zwischen Gliquidon und Glibenclamid nach oraler Gabe während kontinuierlicher Kohlenhydratzufuhr

A study of 13 metabolically normal persons, 12 patients with asymptomatic or latent diabetes and 11 with manifest diabetes showed that 30 mg gliquidone orally prevents or delays the blood sugar rise during repeated small carbohydrate meals with simultaneous stimulation of insulin secretion. This effect was less marked in the normal and asymptomatic or latent diabetic subjects than after glibenclamide 5 mg, while there was no difference between the two drugs in those with manifest diabetes.