Intramural pure pigment gall­stones, a case report

A case of intramural pure pigment gallstones, which were fortuitously found in post-mortem examination, is presented. The incidence, mechanism of formation of the stones and roentgenological diagnosis of the intramural gallstones, porcelain gall bladder, are mentioned.</p

Changes of the endogenous lipoprotein lipase activity during oral glucose tolerance test

Since Hahn's observation of the postalimentary lipemia clearing actIvity following the injection of heparin, physiological, biochemical and clinical significances of the postheparin lipoprotein lipase have been well clarified. The presence of the endogenous lipoprotein lipase in human blood, which was at first doubted, has been repeatedly confirmed2&#8764;8. Recent papers9,10 described elevated endogenous lipoprotein lipase activity in patients with essential hyperlipemia after ample fat uptake. In this preliminary report, changes of the lipoprotein lipase activity during oral glucose tolerance test is illustrated.</p

A case of left atrial myxoma accompanied by pancytopenia and pathological findings suggestive of pulmonary hypertension

A case of left atrial myxoma accompanied by peculiar symptoms is reported. A 15-year old boy had progressive congestive heart failure and three episodes of acute attacks of panctyopenia. The anemia was accompanied by helmet-shaped, broken red blood cells, erythroid hyperplasia and elevation of indirect bilirubin. The thrombocytopenia gave rise to hemorrhagic tendency of the skin and mucous membrane. The leukocytopenia was seen at the same time. The patient also had general constitutional disturbances showing generalized malaise, persistent fever, elevation of erythrocyte sedimentation rate, positive C-reactive protein, pulmonary infection and anginal attacks. Postmortem examinations revealed a left atrial myxoma and intricated pulmonary changes. There was obliterative endarteritis of the left coronary branch and pulmonary arteries. The interstitial pulmonary fibrosis was also prominent. The pancytopenia should have been induced by the mechanical damage of circulating blood cells by the left atrial myxoma. The pathological findings of the lungs were highly suggestive of pulmonary hypertension, which was assumed to be due to mitral block caused by the atrial myxoma.</p

Paroxysmal bundle branch block a case of two to one right bundle branch block followed by intermit­tent right bundle branch block

A case of paroxysmal bundle branch block, two to one right bundle branch block followed by intermittent right bundle branch block, which is associated with chronic cor pulmonale secondary to active, far advanced pulmonary tuberculosis, is presented. The incidence and mechanism of the paroxysmal bundle branch block have been discussed.</p

An inhibitory substance of glyceraldehyde 3-phosphate dehydrogenase in urine of diabetic patients

In urine of diabetics, a significantly great inhibitory activity of glyceraldehyde 3-phosphate dehydrogenase (GAP-Dehyd) was observed compared with that of normal subjects. The 0.2 ml of urine from 41 patients with diabetes mellitus inhibited 0.5 units of GAP-Dehyd by 27.2 +/- 3.0% (mean +/- S.E.M.), while that from 17 normal volunteers inhibited only by 9.0 +/- 1.0% (P less than 0.05). This inhibitory substance was extracted by 90% ethanol from diabetic urine and partially purified by anion exchange chromatography using Dowex-1 (HCOO type). The molecular weight of this substance was confirmed to be 100--300 daltons by an analysis on Biogel P-4 gel filtration chromatography. And analysis by thin layer chromatography using silicagel plate showed that this inhibitor was a ninhydrin reactive substance which has not been reported previously. From the above facts, it was assumed that the inhibitory substance of GAP-Dehyd in urine of diabetics was a new acidic compound of low molecular weight containing an amino residue in the molecule.</p

Lipoatrophic diabetes. Report of a case

The female patient initially showed the acquired type of total lipoatrophy at about 8 years of age. At 12 years of age, the onset of diabetes mellitus was speculated from advanced pyodermia and dedentition. At 29 years of age, glucosuria was found, and she developed proteinuria, ascites, and pretibial edema. The physical examination revealed: hepatosplenomegaly, complete absence of subcutanous fat, cutaneous xanthomas, and emaciated facies with pronounced zygomatic arches. Diabetic retinopathy was revealed in the ophthalmological examination, and nephropathy was evident in renal biopsy specimens. She also had peripheral diabetic neuropathy. No adipose tissue was found in the mesenterium under peritoneoscopy. The hepatic biopsy specimen revealed advanced portal liver cirrhosis. Laboratory findings included: hyperlipidemia, elevation of BMR without evidence of hyperthyroidism, impaired renal function, and undetected anti-insulin antibodies and anti-insulin antibodies. Endocrinological examinations revealed normal value, except for an impaired hGH response in the arginine test. C-peptide immunoreactivity was high. Her condition was fairly well controlled by 140 units of insulin injection daily.</p

[Glucose tolerance abnormalities in mice actively immunized with components of bovine pancreatic hormones (author's transl)]

The relationship between immune insulitis and glucose tolerance was investigated in three groups of mice following active immunization with different components of bovine pancreatic hormone. An abnormal blood glucose level was observed in the three groups ranging from 33.3% to 87.5% of sensitized mice. A relationship was not present between the glucose tolerance response and the presence of insulitis or anti-insulin antibody in the blood of sensitized mice. However, all sensitized mice with a marked decrease in glucose tolerance were found to have insulitis. In animals without established insulitis and with no demonstrable anti-insulin antibody, abnormal glucose tolerance was noted. This latter condition occurred more frequently with recrystallized insulin than with a-component and did not occur with monocomponent insulin. These findings seemed to indicate that two distinct processes involving some circulating antibodies with anti-insulin antibody and insulitis might be involved in the development of the observed glucose tolerance abnormality.</p