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Studies of hepatic function in patients on the “rice diet”
Southern Society for Clinical Research flow is increased by the use of dinitrophenol and decreased following sciatic nerve stimulation. No evidence was found to support the hypothesis of “renal bypasses.” STIJDIESOF HEPATIC FUNCTION IN PATIENTS ON THE “RICE DIET.” J. 0. Myers, MB.
and (by invitation) R. J. F. Murphy, M.D. Dunham, N.C. (From the Department of Medicine,
Duke
University
School
af
Medicine.) ‘The hepatic blood flow, splanchnic oxygen consumption, net splanchnic glucose output and the hromsulfalein clearance have been estimated in a. group of subjects treated with the Kempnet “rice diet.” The data so obtained have been compared with similar figures obtained on control individuals without significant disease and with another series of patients with arterial hypertension but not receiving the rice diet. The hepatic blood flow and splanchnic oxygen consumption have been found normal in the subjects on the rice diet. The net splanchnic qiucose production is reduced in some individuals. A decided decrease in bromsulfalei~ clearance makes its appearance during the first several weeks on the diet and persists thereafter for as long as three months. The BSP clearance is reduced not only in comparison to normal subjects but in comparison with the non-treated hypertensives, also. The disability in removal of RSP from the blood parallels in general the reduction in serum cholesterol which these patients characteristicaliy show. Supplementation of the diet with cholesterol has thus far not prevented the fall in either BSP clearance or in serum cholesterol values. _A POSSIBLE MECHANISM FoR 'rLiETYPO-
TISNSIVEEFFECT OF THIOCYANATES. #orman S. Olsen, M.D. (introduced by Henry A. S~.h~oeder,M.D.) St. Louis, MO. {From the Hypertension Internal
Division,
Medicine,
Department Washington
of Uni-
versity School of Medicine.) Thiocyanates have been used successfully in therapeutically lowering blood pressure in selected hypertensive patients. Inasmuch as little is known concerning its mechanism of action, the effect of this ion was studied in vi&~. Two distinct actions of thiocyanate have been found in this study. The first, a general toxic effect on tissue oxidation, is probably a reflection of the untoward symptoms noted in patients. 1% z&o the toxic effect is obtained at levels of about SEPTEMBER.
1950
9%
O.lM thiocyanate. It was also found that cyanide in concentrations of 0.001 A4 produced the same result and a mixture of the two inhibitors results in no further action. The second action seems to be an inhibition of amino acid oxidation at a concentration of about 0.0005M thiocyanate. at which concentration little change is found in basal tissue oxidations. At these concentrations cyanide produces no inhibition of amino acid oxidation. Thiocyanate exerts no effect on the oxidation of added amines at these low concentrations. It has been postulated that faulty amino acid and amine metabolism are important in the pathogenesis of essential hypertension. If pressor amines are of significance in causing or maintaining hypertension, any agent which diminishes the production of amines from this parent amino acid should produce a hypotensive effect. It is found that thiocyanate produces a hypotensive effect at concentrations five times greater than those required to inhibit amino acid metabolism.
RELATION OF PLASMA CELI. GROWTH TO ABNORMAL SERUM PROTEIN COMPONENTS .4NDBENCEJONES PROTEINIJRL~IN MULTIPLE MYELOMA. R. IV. Rundles, .21.D. and (by invitation) M. L. Dillon, M.D., Edith S’. Di~~ou, M.D. and G. R. Cooled, :M.D. Durham, ,V.C. (From the Department of Medicine.
Duke
University
School
of’
Medicine.) The relationship of plasma cell proliferatioil to the abnormal serum proteins and to Bencc _Jones proteinuria in multiple myeloma has been studied during urethane therapy. In most patients 90 to 300 gm. of urethane given in a period of six to ten weeks reduces the nurnhet of abnormal plasma cells in the bone marrow and produces tnorphologic changes indicative of arrested or retarded growth. Sixty electrophoretic analyses of the serum proteins were tnade in eleven patients followed from three to twenty-eight months. Six patients with hyperproteinetnia had large peaks of abnormal protein with gamma mobility. After two to four months of therapy
three of them had virtually
normal patterns, only slight homogeneity remaining in the gamma globulin. In a fourth patient protein with gamtna mobility was reduced about 50 per cent. In two there was no change. One patient had a large protein increment with mobility intermediate between gamma and
and (by invitation) R. J. F. Murphy, M.D. Dunham, N.C. (From the Department of Medicine,
Duke
University
School
af
Medicine.) ‘The hepatic blood flow, splanchnic oxygen consumption, net splanchnic glucose output and the hromsulfalein clearance have been estimated in a. group of subjects treated with the Kempnet “rice diet.” The data so obtained have been compared with similar figures obtained on control individuals without significant disease and with another series of patients with arterial hypertension but not receiving the rice diet. The hepatic blood flow and splanchnic oxygen consumption have been found normal in the subjects on the rice diet. The net splanchnic qiucose production is reduced in some individuals. A decided decrease in bromsulfalei~ clearance makes its appearance during the first several weeks on the diet and persists thereafter for as long as three months. The BSP clearance is reduced not only in comparison to normal subjects but in comparison with the non-treated hypertensives, also. The disability in removal of RSP from the blood parallels in general the reduction in serum cholesterol which these patients characteristicaliy show. Supplementation of the diet with cholesterol has thus far not prevented the fall in either BSP clearance or in serum cholesterol values. _A POSSIBLE MECHANISM FoR 'rLiETYPO-
TISNSIVEEFFECT OF THIOCYANATES. #orman S. Olsen, M.D. (introduced by Henry A. S~.h~oeder,M.D.) St. Louis, MO. {From the Hypertension Internal
Division,
Medicine,
Department Washington
of Uni-
versity School of Medicine.) Thiocyanates have been used successfully in therapeutically lowering blood pressure in selected hypertensive patients. Inasmuch as little is known concerning its mechanism of action, the effect of this ion was studied in vi&~. Two distinct actions of thiocyanate have been found in this study. The first, a general toxic effect on tissue oxidation, is probably a reflection of the untoward symptoms noted in patients. 1% z&o the toxic effect is obtained at levels of about SEPTEMBER.
1950
9%
O.lM thiocyanate. It was also found that cyanide in concentrations of 0.001 A4 produced the same result and a mixture of the two inhibitors results in no further action. The second action seems to be an inhibition of amino acid oxidation at a concentration of about 0.0005M thiocyanate. at which concentration little change is found in basal tissue oxidations. At these concentrations cyanide produces no inhibition of amino acid oxidation. Thiocyanate exerts no effect on the oxidation of added amines at these low concentrations. It has been postulated that faulty amino acid and amine metabolism are important in the pathogenesis of essential hypertension. If pressor amines are of significance in causing or maintaining hypertension, any agent which diminishes the production of amines from this parent amino acid should produce a hypotensive effect. It is found that thiocyanate produces a hypotensive effect at concentrations five times greater than those required to inhibit amino acid metabolism.
RELATION OF PLASMA CELI. GROWTH TO ABNORMAL SERUM PROTEIN COMPONENTS .4NDBENCEJONES PROTEINIJRL~IN MULTIPLE MYELOMA. R. IV. Rundles, .21.D. and (by invitation) M. L. Dillon, M.D., Edith S’. Di~~ou, M.D. and G. R. Cooled, :M.D. Durham, ,V.C. (From the Department of Medicine.
Duke
University
School
of’
Medicine.) The relationship of plasma cell proliferatioil to the abnormal serum proteins and to Bencc _Jones proteinuria in multiple myeloma has been studied during urethane therapy. In most patients 90 to 300 gm. of urethane given in a period of six to ten weeks reduces the nurnhet of abnormal plasma cells in the bone marrow and produces tnorphologic changes indicative of arrested or retarded growth. Sixty electrophoretic analyses of the serum proteins were tnade in eleven patients followed from three to twenty-eight months. Six patients with hyperproteinetnia had large peaks of abnormal protein with gamma mobility. After two to four months of therapy
three of them had virtually
normal patterns, only slight homogeneity remaining in the gamma globulin. In a fourth patient protein with gamtna mobility was reduced about 50 per cent. In two there was no change. One patient had a large protein increment with mobility intermediate between gamma and