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Comparison of different thyroid preparations by nitrogen balance study
Southern
Society for Clinical
significant inflammatory but not rheumatoid disease and (3) patients with rheumatoid arthritis. Protein fractions were precipitated at 37”~. and 5”~. from plasma, with and without added chondroitin sulfate at pH 6.0 to 6.4. The protein content of all fractions was determined, and glucuronic acid was measured in those fractions to which chondroitin sulfate had been added. The amount of glucuronic acid closely paralleled in direction of change the protein content of each fraction, suggesting that the added chondroitin sulfate was associated at least in part with the protein precipitated. Both the subjects in the inflammatory and the rheumatoid groups yielded fractions which were larger than those of the control group. Both also showed a cold precipitable fraction which was equal to or larger than the corresponding 37”~. fraction, unlike the control group. All fractions from plasma plus chondroitin sulfate were significantly larger in all groups than those from plasma alone, except the cold precipitable fractions from subjects in the inflammatory and rheumatoid groups. No significant differences were noted between the data of rheumatoid arthritis and the inflammatory control groups. COMPARISONOF DIFFERENT THYROID PREPARATIONSBY NITROGENBALANCE STUDY. L. H. Kyle, * J. J. Canary and R. J. Meyer. Dept. Medicine, Georgetown University School of Medicine, Washington, D. C. As judged by oxygen consumption and certain clinical observations there appears to be substantial variation in rapidity of action and duration of effect among different types of thyroid hormone. This study concerns comparison of triiodothyronine, thyroxin and desiccated thyroid on nitrogen balance in three euthyroid and three myxedematous subjects. In both types continual daily administration of desiccated thyroid caused increased nitrogen excretion within two days and a maximal effect in two weeks. In the euthyroid subject nitrogen equilibrium was regained within four days after cessation of medication. Single doses of triiodothyronine, thyroxin and desiccated thyroid caused a nearly identical pattern of response with regard to rapidity of action and duration of effect. The intensity of the catabolic response was greater in myxedema. In one obese patient large doses of desiccated thyroid caused marked weight loss and increased nitrogen excretion, both of which terminated abruptly upon cessaJUNE,
1956
Research
953
tion of treatment. It appears from these studies that the variation in response observed with different thyroid preparations is related to dosage rather than to any specific feature of the individual preparation. Measurement of nitrogen excretion appears valuable for quantitative comparison of the degree of metabolic acceleration induced by different types of th)-roid hormone. THE EFFECTOF A FACTORON INTRACELLULARDIGESTIONOF BACTERIA BY HUMAN LEUKOCYTES. S. P. Martin* and R. Green. Dept. Medicine, Duke University School of Medicine, Durham, N. C. The intracellular destruction of bacteria by human leukocytes was studied, and the effect of a dialyzable factor in human serums was measured. Human leukocytes were obtained by dextran sedimentation in a siliconed system. Micrococcus aureus or Staphylococcus marcestens were phagocytized by these cells, and greater than 90 per cent were destroyed within one hour. If cells were washed with saline after phagocytosis had been completed, the bactericidal capacity of the leukocyte dropped to less than 10 per cent. The bactericidal capacity could be restored by addition of human plasma, a dialysate of plasma, or serum. Restoration also occurred with a dialysate of bovine plasma, or of liver, spleen and kidneys of guinea pigs or rats. The active factor in the dialysate was destroyed by heat at 75”~. for thirty minutes or by strong acids. It can be isolated by chromatography. This factor increased the lactic acid production of leukocytes. Work is in progress on the nature and metabolic activity of the dialyzable factor involved in intracellular destruction of bacteria. RECURRENT CRISES IN SICKLE CELL ANEMIA RESPONDING TO CHOLECYSTECTOMY:A SYNDROMEAPPARENTLY BASEDON CHOLECYSTO-AND CHOLEDOCHO- STASIS. E. E. Muirhad,” E. R. Halden and B. J. Wilson. Dept. Medicine and Surgery, University of Texas Southwestern Medical School, Dallas, Tex. Cholecystic disease and choledochal obstruction by stones have been described in hemolytic anemias. The authors wished to consider a syndrome in sickle cell anemia related to the gallbladder but unattended by stones. This disturbance includes mild to severe epigastric pain, at times into the right upper quadrant and infrascapular area. Chills, fever, nausea, vomit-
Society for Clinical
significant inflammatory but not rheumatoid disease and (3) patients with rheumatoid arthritis. Protein fractions were precipitated at 37”~. and 5”~. from plasma, with and without added chondroitin sulfate at pH 6.0 to 6.4. The protein content of all fractions was determined, and glucuronic acid was measured in those fractions to which chondroitin sulfate had been added. The amount of glucuronic acid closely paralleled in direction of change the protein content of each fraction, suggesting that the added chondroitin sulfate was associated at least in part with the protein precipitated. Both the subjects in the inflammatory and the rheumatoid groups yielded fractions which were larger than those of the control group. Both also showed a cold precipitable fraction which was equal to or larger than the corresponding 37”~. fraction, unlike the control group. All fractions from plasma plus chondroitin sulfate were significantly larger in all groups than those from plasma alone, except the cold precipitable fractions from subjects in the inflammatory and rheumatoid groups. No significant differences were noted between the data of rheumatoid arthritis and the inflammatory control groups. COMPARISONOF DIFFERENT THYROID PREPARATIONSBY NITROGENBALANCE STUDY. L. H. Kyle, * J. J. Canary and R. J. Meyer. Dept. Medicine, Georgetown University School of Medicine, Washington, D. C. As judged by oxygen consumption and certain clinical observations there appears to be substantial variation in rapidity of action and duration of effect among different types of thyroid hormone. This study concerns comparison of triiodothyronine, thyroxin and desiccated thyroid on nitrogen balance in three euthyroid and three myxedematous subjects. In both types continual daily administration of desiccated thyroid caused increased nitrogen excretion within two days and a maximal effect in two weeks. In the euthyroid subject nitrogen equilibrium was regained within four days after cessation of medication. Single doses of triiodothyronine, thyroxin and desiccated thyroid caused a nearly identical pattern of response with regard to rapidity of action and duration of effect. The intensity of the catabolic response was greater in myxedema. In one obese patient large doses of desiccated thyroid caused marked weight loss and increased nitrogen excretion, both of which terminated abruptly upon cessaJUNE,
1956
Research
953
tion of treatment. It appears from these studies that the variation in response observed with different thyroid preparations is related to dosage rather than to any specific feature of the individual preparation. Measurement of nitrogen excretion appears valuable for quantitative comparison of the degree of metabolic acceleration induced by different types of th)-roid hormone. THE EFFECTOF A FACTORON INTRACELLULARDIGESTIONOF BACTERIA BY HUMAN LEUKOCYTES. S. P. Martin* and R. Green. Dept. Medicine, Duke University School of Medicine, Durham, N. C. The intracellular destruction of bacteria by human leukocytes was studied, and the effect of a dialyzable factor in human serums was measured. Human leukocytes were obtained by dextran sedimentation in a siliconed system. Micrococcus aureus or Staphylococcus marcestens were phagocytized by these cells, and greater than 90 per cent were destroyed within one hour. If cells were washed with saline after phagocytosis had been completed, the bactericidal capacity of the leukocyte dropped to less than 10 per cent. The bactericidal capacity could be restored by addition of human plasma, a dialysate of plasma, or serum. Restoration also occurred with a dialysate of bovine plasma, or of liver, spleen and kidneys of guinea pigs or rats. The active factor in the dialysate was destroyed by heat at 75”~. for thirty minutes or by strong acids. It can be isolated by chromatography. This factor increased the lactic acid production of leukocytes. Work is in progress on the nature and metabolic activity of the dialyzable factor involved in intracellular destruction of bacteria. RECURRENT CRISES IN SICKLE CELL ANEMIA RESPONDING TO CHOLECYSTECTOMY:A SYNDROMEAPPARENTLY BASEDON CHOLECYSTO-AND CHOLEDOCHO- STASIS. E. E. Muirhad,” E. R. Halden and B. J. Wilson. Dept. Medicine and Surgery, University of Texas Southwestern Medical School, Dallas, Tex. Cholecystic disease and choledochal obstruction by stones have been described in hemolytic anemias. The authors wished to consider a syndrome in sickle cell anemia related to the gallbladder but unattended by stones. This disturbance includes mild to severe epigastric pain, at times into the right upper quadrant and infrascapular area. Chills, fever, nausea, vomit-