Further studies on the 2060 virus isolated from persons with mild respiratory illnesses

130

Southern

Society

a renal effect of glycosides, it has not been possible to exclude the influence of changes in hemodynamics and filtered load of electrolytes. Chickens possess a renal-portal circulation. The peritubular concentration of a test substance can be maintained higher on the experimental than on the contralateral control side. Since changes in filtrate composition are equal and bilateral, unilateral changes in urine composition on the experimental side are due to alterations in tubule function. The administration of strophanthidin into one leg of a chicken induces a prompt unilateral increase in Naf excretion and urine pH. If initially elevated, K+ excretion decreases. If initially low, K+ excretion either is unaffected or rises. The increase is less than observed when Na+ excretion is elevated with sodium sulfate. The marked increase in Na+ excretion and associated fall in the excretion of Kf and H+ ions following strophanthidin are presumably due to inhibition of the transport system whereby Naf is reabsorbed in exchange for K+ and H+ ions. PANCREATIC

DISEASE:

EFFECTS

UPON

THE

LIPIDS

Harold H. Orvis, Richard C. Fowler and John M. Evans.* Dept. of Medicine, The George Washington Univ. School of Medicine, Washington, D. C. AND

PANCREATIC

ENZYMES

OF

THE

SERUM.

A study of serum lipoproteins and pancreatic enzymes in thirteen patients with pancreatic disease was undertaken to evaluate the role of the pancreas in lipid metabolism. Ten of the patients had acute pancreatitis, one had chronic pancreatic insufficiency, and two had been pancreatectomized for cancer. In most of the patients serum total lipid and cholesterol were normal. However, two of the patients had gross hyperlipemia upon admission for pancreatitis. The percentage of cholesterol in the beta lipoprotein fraction was increased in nine of ten patients with acute pancreatitis, the peak elevation occurring within one to eight days from onset; and, in contrast, was low in the patients with chronic pancreatic disorders. Similarly, the serum lipase was elevated in all patients with acute pancreatitis, was low in the patient with pancreatic insufficiency, and absent in the patients after pancreatectomy. The peak values for lipase preceded those for beta lipoprotein cholesterol in patients with pancreatitis studied serially. Serum amylase was normal in two patients after pancreatectomy. Serum tributyrinase was elevated in only one patient with acute

for Clinical

Research

pancreatitis but was otherwise normal in the presence of pancreatic disease or after pancreatectomy. On the basis of these findings it is concluded that pancreatic lipase may influence transport of lipoprotein cholesterol, that serum amylase may be normal after pancreatectomy, and that serum tributyrinase is an unsatisfactory indicator of pancreatic disease. RENAL

TUBULAR

CHANGES

IN

ACUTE

GLOMERULO-

Alvin E. Parrish,* John S. Howe and Mary F. Watt. Dept. of Medicine and Pathology of The George Washington Univ. School of Medicine and the V. A. Hospital, Washington, D. C. NEPHRITIS.

Tubular changes, although recognized, have not been emphasized in acute glomerulonephritis. The circulation of the kidney is such that with severe glomerular disease, when glomerular capillary lumens are diminished, tubular lesions would be anticipated. In twenty patients with acute glomerulonephritis, a correlation was attempted between the pathologic condition seen in needle biopsy material, renal functions (inulin, urea clearances and phenolsulfonphthalein excretion or Tm PAH), and the clinical course. Renal biopsy was performed initially in all patients and repeated in thirteen, one to three times. Inulin and PAH clearances and Tm PAH were determined in eleven patients, and repeated in eight of these two to three times. The patients have been followed up for a maximum of five years clinically and for three years by biopsy. All have shown tubular pathologic conditions at some time during their disease. Early, within the first two weeks, pyknosis and vacuolization were present in tubular cells. In two instances this was pronounced and associated with a clinical picture of anuria. Renal functions early show depression of phenolsulfonphthalein excretion, Tm PAH, and a low urinary specific gravity. Later, tubular dilatation became the predominant lesion. Tubular dilatation was not associated with decreased Tm PAH unless other abnormalities were also present. Tm PAH and inulin clearance seemed to be related in the acute stage of the disease. FURTHER FROM

STUDIES

PERSONS

ON

WITH

THE

MILD

2060

VIRUS

RESPIRATORY

ISOLATED ILLNESSES.

W. Pelon and W. J. Mogabgab. * Dept. of Medicine, Tulane Univ. School of Medicine, New Orleans, La. Previous

investigations AMERICAN

have

JOURNAL

shown OF

that

MEDICINE

131

Southern Society for Clinical Research neutralizing antibody to 2060 virus, isolated from Naval recruits with mild respiratory illnesses, was prevalent in the population of the Chicago area. A broad distribution of neutralizing antibody against this agent in the New Orleans area was also found; 50 per cent of randomly selected serums currently tested had titers of 1 to 40 or greater. In addition, 2060 was isolated from persons with mild afebrile illnesses who later demonstrated increments in neutralizing antibody to the virus. Recent studies have shown that 2060 was unrelated to Sabin’s chimp rhinitis virus (ECHO ll), Harrington virus (ECHO 16) or the Cochrane virus. However, similar growth and cytopathogenic characteristics as well as features of the associated illness have suggested relationship to JH virus. Cross neutralization studies with the latter have confirmed this, but have also demonstrated indicating that these are antigenic differences, representative types of a larger group. Studies of the metabolic requirements of 2060 in monkey kidney cultures, and aspects of the associated clinical illness will be presented. MUCIN OF HUMAN SYNOVIAL FLUID. Ward Pigman, Edgar Gramling, Howard L. Halley * and David Platt. Medical College of Alabama, Birmingham, Ala.

The mucins of human tissues comprise an important group of ill-defined biological substances which appear to be carbohydrate-protein comThe mucin of synovial plexes or compounds. fluid is precipitated by acetic acid and has been used for differentiating normal from arthritic synovial fluids. In the present paper studies of the composition of synovial mucin prepared from postmortem and arthritic synovial fluids are reported. These studies were made by electrophoretic analysis at pH 8.6, ionic strength 0.1, in Verona1 buffer. The addition of acetic acid apparently caused complete precipitation of hyaluronic acid, and the polysaccharide could not be detected in the supernatant. The redissolved mucin was always characterized by the presence of hyaluronic acid, albumin and an a-globulin, probably the as-globulin. “Mucin” has been postulated to be almost wholly responsible for the viscosity of synovial fluid. The mucin obtained in the present work had a viscosity which was never more than 60 per cent of that of the original diluted synovial fluid, under comparable conditions. Synovial mucin seems to be an easily dissociable complex (salt), mainly of albumin and hyaluronic acid. JULY,

1958

A STUDY

OF THE

MEANS

CREASES THE PULMONARY

BY WHICH

EXERCISE

DIFFUSING CAPACITY

INFOR

MONOXIDE. J. C. Ross, R. Frayser and J. B. Hickam. * Dept. of Medicine, Duke Univ. School of Medicine, Durham, N. C.

CARBON

It is well established that the diffusing capacity of the lung for 02 and CO (Dee) increases during exercise, but the phenomenon is poorly understood. In normal subjects D,, depends largely on the size of the pulmonary capillary bed in contact with well ventilated alveoli. Conceivably, exercise might increase D,, by (1) effects secondary to increased cardiac output, such as enlargement of the pulmonary capillary bed, or (2) effects secondary to increased ventilation. To separate these factors, D,, (Filley) and cardiac output (dye method) were measured in normal recumbent subjects during rest, exercise, infusion, and hyperventilation, epinephrine both voluntary and on 5 per cent COZ. In four subjects, exercise increased D,, (+79 per cent), cardiac output (+120 per cent) and ventilation (+170 per cent); while epinephrine infusion increased cardiac output (+90 per cent), but had little effect on ventilation (+20 per cent) or D,, (+ 17 per cent). In four additional subjects, voluntary and hypercapneic hyperventilation ($240 per cent and 270 per cent, respectively) increased D,, (+70 per cent and +50 per cent) with little change in cardiac output (+ll per cent and +32 per cent). These results suggest that the effect of exercise on D,, may depend much more on changes in ventilation than on changes in output. Increased amplitude and rate of ventilation may increase D,, by enlarging the capillary bed which is effectively ventilated or by improving distribution of air to the existing capillary bed. COMPARISON ORINASE “PLASMA

OF

REGARDING INSULIN

INDOLE-3-ACETIC HYPOGLYCEMIC ACTIVITY”

IN

ACID

AND

EFFECT

AND

JUVENILE

AND

Holbrooke S. Seltzer. Dept. of Medicine, The Univ. of Texas Southwestern Medical School, and V. A. Hospital, Dallas, Texas. ADULT

DIABETES.

Indole-3-acetic acid (IAA), a physiological end-product of tryptophane metabolism, induces hypoglycemia in normal subjects and in patients with mild diabetes. Mirsky attributes this phenomenon to anti-insulinase activity. Conversely, orinase (tolbutamide) probably causes hypoglycemia by stimulating endogenous insulin secretion. The effects of these supposedly differently-acting substances on blood glucose and