Familial insulin-resistant diabetes secondary to an affinity defect of the insulin receptor.

We describe three siblings with a mild diabetes mellitus in combination with acanthosis nigricans and multiple minor physical abnormalities. Fasting plasma insulin was elevated up to 100-fold as compared with normal values, and the diabetes was classified as insulin resistant. Insulin-binding studies on erythrocytes, monocytes, and cultured fibroblasts disclosed an abnormally reduced binding capacity, as compared with that of healthy controls, which was most prominent at low concentrations of insulin.

The syndrome of diabetes insipidus, diabetes mellitus, optic atrophy, deafness, and other abnormalities (DIDMOAD-syndrome). Two affected sibs and a short review of the literature (98 cases).

We describe two sibs with DIDMOAD-Syndrome, a 19-year-old girl with diabetes mellitus (type I), optic atrophy, inner-ear deafness, and atonia of the urinary tract, and her 5-year-old brother with diabetes mellitus (type I) and optic atrophy. Studies of red blood cell insulin receptors revealed a normal number of receptors per cell and normal affinity to insulin. The syndrome represents an autosomal recessively inherited type of diabetes mellitus, which remains often undiagnozed since most of the symptoms except diabetes mellitus and optic atrophy occur with varying expressivity.

[The value of morphology in the diagnosis of chronic polyarthritis].

The clinician's question concerning the value of morphological findings in diagnosis of rheumatoid arthritis is answered by the pathologist. After a short discussion of clinical problems and the ARA-criteria, at first the diagnostic importance of synovial cytology in RA is dealt with. The patient's history, biopsy technique and methods are the most important prerequisites of an optimal assistance of the pathologist to a definite diagnosis; they are reviewed in short paragraphs.

[Caffeine and bile secretion. Experimental studies in the unanaesthetized piglet (author's transl)].

We investigated the distribution and excretion of 8-14C-caffeine as well as the effects of caffeine on bile secretion in the unanaesthetized piglet after intravenous and intraduodenal application. The findings confirm a) data known from other species concerning the intestinal absorption, distribution and excretion of 8-14C-caffeine, b) the delayed plasma disappearance of 8-14C-caffeine known in the pig following an initial rapid disappearance rate and c) a hydrocholeresis, so far only known from rats. However, the increase in bile flow accompanied by an increase of urine flow was noticed not before 3--4 h after caffeine application.