Direct comparative effects of isoflurane and desflurane on sympathetic ganglionic transmission.

Although the sympathetic ganglion is an important site of peripheral regulation, few studies have examined the effect of anesthetics on synaptic transmission. In the present study we compared the actions of desflurane with those of isoflurane on synaptic transmission and neurotransmitter release in the stellate ganglion. In the electrophysiologic group, 14 stellate ganglia were isolated from adult mongrel dogs after halothane anesthesia, desheathed, and superfused with Krebs' solution.

Apparent focal motor seizure with a jacksonian march induced by fentanyl: a case report and review of the literature.

This report describes an unusual presentation of focal motor activity resembling Jacksonian march, which developed during fentanyl induction of general anesthesia. Simultaneous spectral-edge activity recording of electroencephalography (EEG) failed to show evidence of an epileptic focus. A negative history of previous seizures, as well as failure to show postoperative postictal symptoms or seizure activity by 16-lead EEG, suggested a myoclonic rather than epileptic nature of the observed muscle activity.

Presynaptic modulation of ganglionic ACh release by muscarinic and nicotinic receptors.

The present experiments were undertaken to investigate the effects of atropine and d-tubocurarine on acetylcholine (ACh) release and ganglionic synaptic transmission in the isolated cat stellate ganglion. Ganglionic release of picomole amounts of ACh was measured by radioenzymatic assay, and ganglionic transmission was estimated on the basis of the compound action potential recorded from the postganglionic stellate cardiac nerve. Atropine (5 microM) produced a significant increase in both spontaneous and evoked ACh release from the ganglion while depressing synaptic transmission.

Decreased cyclic guanosine 3',5' monophosphate and guanylate cyclase activity in leprechaunism: evidence for a postreceptor defect.

Patients with leprechaunism have hyperinsulinemia and extreme insulin resistance. The mechanism of the insulin resistance has not been delineated. To examine postreceptor events in this unusual syndrome we have assayed the enzyme guanylate cyclase [E.

Trimethylaminuria.

Abnormal urinary excretion of trimethylamine (TMA) signals the presence of trimethylaminuria, an inborn error of metabolism presenting with body odor of putrid fish. This article summarizes the nine reported cases (including three studied in our laboratory) and describes a rapid quantitative assay. Values of TMA are presented for 95 controls (72 children), three cases of TMA uria, and two mothers.

Endocrine-metabolic relationships in patients with leprechaunism.

Leprechaunism is a rare, heritable syndrome, associated with multiple dysmorphic and pathologic features, suggestive of an endocrine dysfunction. Few endocrine and metabolic studies have been obtained because of the rarity of the syndrome, and the small size and early demise of these infants. The authors present here the clinical, anatomic, and endocrine-metabolic studies of three patients, with a view toward careful delineation of the syndrome and further characterization of the metabolic defect.

Glucocorticoid effects on the embryonic chick heart. I. Glucocorticoid enlargement of the heart.

Cortisol increases the heart weight relative to body weight following injection of growth suppressing amounts of the hormone on incubation days 9, 10, 13, and 15. Hormone administration increases glycogen, glycosaminoglycan (GAG), and total lipid concentration in the embryonic myocardium. Deoxyribonucleic acid (DNA) and protein concentration are decreased proportionally.

Hepatic ultrastructure in leprechaunism. Hepatic ultrastructural evidence suggesting a syndrome with defective hepatic glucose release.

Leprechaunism is a congenital syndrome with characteristic habitus and facies, with fasting hypoglycemia and hyperinsulinism. In response to a glucose challenge there is prolonged severe hyperglycemia with an increased hyperinsulinemia. Our studies on such a patient showed a normal response of the serum glucose to glucagon stimulation in the fed state but no response in the postabsorptive state.

Glycogenosis type IB: possible membrane transport defect.

We have described a 20-month-old child with type IB glycogen storage disease, based on clinical and biochemical manifestations. Functional testing data were similar to those found in glucose-6-phosphatase deficiency, but in vitro studies showed normal hepatic glucose-6-phosphatase activity. Disruption of membranes with deoxycholic acid was followed by an increase in enzyme activity compared to a control liver tissue, suggesting "latency" of enzyme.

Testicular leydig cell hyperplasia as a cause of familial sexual precocity.

Testicular Leydig cell hyperplasia was observed in two brothers presenting with progressive sexual precocity at 2 yr of age. Virilization was shown to result from increased secretion rather than decreased clearance of gonadal testosterone. Testosterone hypersecretion appeared to be gonadotropin independent, as basal and gonadotropin-releasing hormone-induced serum LH concentrations were low by both RIA and bioassay.

Glucose kinetics in leprechaunism: accelerated fasting due to insulin resistance.

Postprandial and postabsorptive glucose metabolism was studied in a 3-yr-old girl with leprechaunism by substrate and hormonal measurements and by quantifying hepatic glucose output during continuous infusion of D-[6-6-2H2]-glucose. Hepatic glucogen content and the activity of glycogen synthase and phosphorylase were also measured in the post-prandial state on a separate occasion. During the 4-h postprandial state, plasma glucose, alanine, lactate, beta-hydroxybutyrate, and glycerol were normal, as were hepatic glycogen, glycogen synthase, phosphorylase, and hepatic glucose output of 7.

Diabetes mellitus in a pig-tailed macaque (Macaca nemestrina).

An eight-year-old male pig-tailed macaque developed clinical signs of diabetes mellitus: constant glucosuria, uriposia, fasting hyperglycemia, hypertriglyceridemia, marked pre-beta-hyperlipoproteinemia, glucose intolerance, hypoinsulinemia and hyperglucagonemia during intravenous glucose tolerance tests (IVGTT). During a ten-month period of intensive surveillance, the monkey's body weight decreased, but ketonemia or ketonuria were never observed. Exocrine pancreatic functions remained normal.

Impaired growth in hyperkinetic children receiving pemoline.

Decreased longitudinal growth was observed in 24 hyperkinetic children receiving pemoline therapy. Mean height velocity was 3.67 +/- 0.

Alterations in cartilage metabolism by neurostimulant drugs.

Suppression of growth without significant alterations in hormonal patterns has been demonstrated for the neurostimulant drug pemoline. Comparison of the in vitro effect of pemoline, methylphenidate, and methamphetamine on somatomedin-stimulated sulfate uptake by cartilage showed all three drugs to be inhibitory. Sulfate uptake by cartilage can be directly related to growth and glycosaminoglycan biosynthesis.

Parathormone and perinatal calcium homeostasis.

Plasma parathormone (PTH) and calcium concentrations were measured in 309 specimens collected from 190 newborns during the first 7 days of life. The patient material consisted of 51 preterm, 130 term, and 9 postterm infants, including 22 infants of diabetic mothers (IDM), 38 infants with hypocalcemia, and 25 asphyxiated infants. PTH was detectable, although in low concentrations, in cord blood samples despite the presence of elevated calcium concentrations.

The determination of bone age in the elbow as compared to the hand. A study in 390 children.

In a prospective study, bone age (BA) from both hand and elbow was assessed in 390 children, aged 6-15 years, in order to determine: (a) whether or not BA assessment from the hand and from the elbow give comparable results, and (b) whether the accuracy of predicting skeletal age from the hand may be improved by the additional BA determination in the elbow. BA assessment in the hand was performed according to the method of Greulich and Pyle while the standards of Schinz and Baensch were used for the elbow. Statistical analysis of data was carried out according to age groups as well as according to groups of clinical diagnoses.

Improved iodination of peptides for radioimmunoassay and membrane radioreceptor assay.

Generally applicable methods for iodinating and purifying small peptide radiolabels for radioimmunoassay and membrane radioreceptor are described in detail. Resulting improvements in radioreceptor assay and radioimmunoassay, as well as results of analyses of specific activity, separation from unlabeled peptide, and storage characteristics, are presented for luliberin, corticotropin, melanotropin, and calcitonin.

Differential effects of cranial radiation on growth hormone response to arginine and insulin infusion.

The growth hormone responses to arginine infusion and to insulin-induced hypoglycemia were studied in 13 patients with neoplastic disease after treatment with radiation and chemotherapy. Patients who received intensive cranial radiation (greater than 2,400 rads) had no response to either arginine or insulin; those who received moderate cranial radiation (greater than or equal to 2,400 rads) had GH response to arginine but not to insulin; patients receiving no cranial radiation responded to both arginine and insulin. These data support the hypothesis that GH secretion in response to arginine infusion has a different mechanism in contrast to the response to insulin-induced hypoglycemia and that the latter is more vulnerable to cranial radiation.

Experience with jejunoileal bypass for obesity.

Fifty-eight patients less than 30 years old but who are more than 300 pounds in weight were considered for investigation of jejunoileal bypass. Thirty patients had operations, and the functioning bypass included 40 centimeters of jejunum and 10 centimeters of ileum. In 14 patients, intestinal continuity was restored by either end-to-end or end-to-side anastomosis according to random choice, and in 16 patients, end-to-end anastomoses were used.