The renal clearance of furosemide and tetraethylammonium (TEA) were compared in 10 patients with hypertensive nephropathy. BUN and creatinine ranges were 10 to 88 mg/dl and 0.9 to 3.8 mg/dl, respectively. Diuretics were discontinued 48 hr prior to the study, and 2 consecutive clearances (ml/min/1.73 m2BSA) of creatinine were performed. The patient then received a bolus followed by a constant infusion of furosemide-14C and tetraethylammonium-14C (analyzed by specific methodology for plasma and urine), both in subpharmacologic doses. After 40-min equilibration sequential 20-min clearance periods were obtained. Both the clearance of furosemide (range 17 to 133) and TEA (range 99 to 443) correlated negatively with BUN and serum creatinine and positively with creatinine and urea clearances. Thus, by using a constant-infusion technique we demonstrated that the renal clearance of furosemide is depressed by azotemia in man and that there was greater depression with furosemide than with TEA.
Serum levels of growth hormone (GH: arithmetic mean of three measurements eight hours apart), somatomedin C (SmC), alkaline phosphatase activity and the bone isoenzyme of alkaline phosphatase (as the liver/bone isoenzyme ratio) were measured in 26 patients with acromegaly (11 men and 15 women; mean age 45.5 [24-66] years), 18 in the active and eight in the nonactive phase of the disease. Activity was characterized by a raised (660 [330-1149] ng/ml), inactivity by a normal (186 [40-300] ng/ml) SmC concentration. All 18 patients with active acromegaly had an abnormally low liver/bone isoenzyme ratio (mean of 0.66 [0.01-1.28]). In seven of the eight patients with inactive acromegaly it was within normal limits. Thus measurement of bone alkaline phosphatase, which is significantly cheaper than that of SmC, is suitable for assessing activity.
94COMBINED CHOLESTEROL I N HUMAN BILE zfter removal of the liver. Fourteen minutes later there was profuse salivation and after a latency of 47 minutes it almost vomited; at the end of 2 hours it died in a vomiting-like convulsion. The fourth cat, in apparently good condition, received 0.25 mg. per kg. by muscle 7 hr., 45 min., after liver removal. Although the dose was repeated twice a half-hour or so after the first injection no emesis resulted ; however, there was marked tachypnoea.From the results of the denervation work it is probable that if actual complete denervation of the liver in the cat could be attained strophanthidin would still cause emesis ; the dehepatization experiments lend support to the conclusion. Although each of the 2 dehepatized cats which vomited received double the normal minimal emetic dose, in order to increase the probability of response, it does not necessarily follow that the operated cats were greatly depressed. Nevertheless, the negative results in the fourth cat suggest that the abnormal metabolic state had lowered the reactivity, as one would expect.
Conclusion. Strophanthidin can induce emesis in cats after veryextensive denervation of the liver, and also after dehepatization, thus confirming the results Hanzlik and Wood obtained with pigeons.Early reports of the presence of cholesterol esters in bile have been questioned because the methods used for the determination of esters were open to criticism. Later work by Thannhauser' indicates that human bile contains only free cholesterol. A recent paper by Wright' reported that the Cholesterol present in dog bile is also present as free cholesterol. He was unable, using an improved method of analysis, to find any evidence of cholesterol esters. In * Aided by a grant from the Josiah Macy, Jr., Fund.
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