Energy metabolism in feasting and fasting.

During feasting on a balanced carbohydrate, fat, and protein meal resting metabolic rate, body temperature and respiratory quotient all increase. The dietary components are utilized to replenish and augment glycogen and fat stores in the body. Excessive carbohydrate is also converted to lipid in the liver and stored along with the excessive lipids of dietary origin as triglycerides in adipose tissue, the major fuel storage depot.

Effects of a protein meal, intraduodenal HCl, and oleic acid on portal and peripheral venous secretin and on pancreatic bicarbonate secretion.

We have studied the effect of a protein meal on secretin (IRS) concentration in dogs and humans using a radioimmunoassay of improved sensitivity (8 pg/ml). After a meal, pancreatic bicarbonate secretion (PBS) increased markedly and proximal duodenal pH decreased from 6.2 to 4.

Pancreatic polypeptide responses to a meal and to intraduodenal amino acids and sodium oleate.

Serum concentrations of immunoreactive pancreatic polypeptide (IR-PP) were measured in dogs in response to a meal and to intraduodenal infusions of amino acids, Na oleate, and HCl. In addition, the effects of somatostatin on meal-stimulated IR-PP concentrations were studied. In response to a meal, IR-PP rose from 151 +/- 19 pg/ml to 296 +/- 35 pg/ml (P less than 0.

A test of the hypothesis that the rate of fall in glucose concentration triggers counterregulatory hormonal responses in man.

The hypothesis that the rate of fall in glucose concentration triggers counterregulatory hormonal responses was tested in five subjects following one hour of sustained hyperglycemia. Despite a rapidly falling blood glucose concentration, no increase in plasma growth hormone, cortisol, glucagon, or catecholamines occurred as long as the blood glucose concentration remained above fasting levels. Plasma growth hormone, cortisol, and catecholamines were not released until the mean blood glucose reached 28 mg.

Bile-fat relationships in gastric secretory inhibition and bile flow stimulation.

The effect of intraduodenal infusion of olive oil, bile, or a mixture of olive oil and bile on pentagastrin-stimulated gastric secretion, bile flow, and serum immunoreactive secretin levels was studied in dogs. Bile alone had no effect on gastric secretion, but the mixture of bile and olive oil induced prompt, statistically significant gastric secretory inhibition. Bile had the early choleretic effect that would be expected to result from the absorption of bile salts, whereas the bile--olive oil mixture brought about a delayed amd much greater increase in bile flow rates.

The role of some polar amino acid residues in secretin.

Three analogues of S5-27, the tricosapeptide with the carboxyl-terminal sequence of secretin, were studied. In the analogues, the acidic residues at positions 9 and 15 of S5-27 were replaced by the neutral residues glutamine and asparagine. These changes resulted in a decrease in immunoreactivity.

Human splanchnic metabolism during diabetic ketoacidosis.

Splanchnic exchange rates of glucose, acetoacetate, beta-hydroxybutyrate, lactate, pyruvate, glycerol, alanine, glutamine, glutamate, free fatty acids, and triglycerides were measured in eight patients during moderate to severe diabetic ketoacidosis. Their arterial glucose concentration was 20.68 (9.

Familial hyperglucagonemia--an autosomal dominant disorder.

Basal immunoreactive glucagon was elevated in four of nine asymptomatic relatives of a patient with glucagonoma. Immunoreactive glucagon remained elevated throughout 22 to 25 hours of continuous observation. Glucagon responses to intravenous glucose and arginine or mixed meals (or both) were abnormal, whereas glucose and insulin responses were normal.

An islet cell carcinoma containing glucagon and insulin. Chronic glucagon excess and glucose homeostasis.

Described here is a patient who had an islet cell carcinoma containing both glucagon (glucagonoma) and insulin (insulinoma). Complete removal of the tumor was possible. Immunoreactive glucagon (IRG) could be extracted from all parts of the tumor (approximately 50 mug.

Effect of somatostatin on meal-stimulated pancreatic exocrine secretions in dogs.

The effect of exogenously administered somatostatin (SRIF) on meal-stimulated secretions of the exocrine pancreas was studied in dogs with chronic pancreatic fistulas. Dogs were fed 600 gm. of raw meat, and pacreatic output of water, bicarbonate, and protein was measured.

Effect of nicotine on serum secretin and exocrine pancreatic secretion.

The effect of nicotine (100 mug/kg hr-1) on serum secretin and pancreatic secretions was studied in dogs with chronic pancreatic fistulas. Release of immunoreactive secretin (IRS) was stimulated by intraduodenal infusion of HCl (9.6 mEq/30 min).

Managing insulin-dependent diabetic patients.

About 95% of insulin-dependent diabetics can be managed satisfactorily with one or a combination of the follwoing insulin preparations: single-peak U-100 beef-pork NPH, Lente, and Regular. Complications of insulin therapy are commonly attributable to poor regulation of insulin dosage, irregular or excessive food intake, or unusual physical activity. One form of hyperglycemia is induced by insulin.

Somatostatin suppresses secretin and pancreatic exocrine secretion.

Somatostatin, a hypothalamic peptide, suppresses hydrochloric acid-stimulated release of secretin, pancreatic flow rate, and bicarbonate and protein secretion in fasted, conscious dogs. It also reduces nonstimulated pancreatic exocrine secretion but does not affect basal secretin concentrations. Suppression of HCl-stimulated secretin release is complete, whereas pancreatic flow rate and bicarbonate and protein secretions are only partially inhibited.

Reversibility of pyloric sphincter dysfunction in gastric ulcer.

To investigate both the cause and reversibility of pyloric sphincter dysfunction in patients with gastric ulcer, pyloric sphincter pressures were measured in 10 normal subjects and 13 patients with gastric ulcer before and during gastric acidification. Fasting serum gastrin concentration was significantly higher in patients with gastric ulcer than in normal subjects. Compared to normals, patients with gastric ulcer had significantly lower pyloric pressures in response to intraduodenal amino acids and sodium oleate.

Hepatic ketogenesis and gluconeogenesis in humans.

Splanchnic arterio-hepatic venous differences for a variety of substrates associated with carbohydrate and lipid metabolism were determined simultaneously with hepatic blood flow in five patients after 3 days of starvation. Despite the relative predominance of circulating beta-hydroxybutyrate, the splanchnic productions of both beta-hydroxybutyrate and acetoacetate were approximately equal, totaling 115 g/24 h. This rate of hepatic ketogenesis was as great as that noted previously after 5-6 wk of starvation.

Effects of intraduodenal administration of HCl and glucose on circulating immunoreactive secretin and insulin concentrations.

A new radioimmunoassay for secretin was used to investigate (a) serum secretin responses to intraduodenally infused HCl and glucose, (b) the metabolic half-life and the volume of distribution of exogenous secretin and (c) the effect of endogenously released secretin on insulin secretion in 25 anesthetized dogs. Portal and femoral venous blood samples were taken simultaneously before, during, and after intraduodenal infusion of HCl (21 meq/30 min) and glucose (131 ml/30 min). Control experiments were performed with intraduodenal infusion of saline.

Rapid intravenous sodium acetoacetate infusion in man. Metabolic and kinetic responses.

The metabolic and kinetic responses to rapidly intravenously administered sodium acetoacetate (1.0 mmol/kg body wt) was studied after an overnight fast in 12 male and female adults weighing between 88 and 215% of average body weight. Blood was obtained before, during, and after the infusion for determination of circulating concentrations of immunoreactive insulin, glucose, acetoacetate, beta-hydroxybutyrate and free fatty acids.