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1. Oral glucose-tolerance tests (100 g) were carried out in six patients with stable well-compensated cryptogenic cirrhosis and in 12 control subjects. 2. In confirmation of previous studies, patients with cirrhosis had high post-glucose serum insulin levels and were glucose intolerant (mean incremental glucose area 954 +/- 186 compared with 482 +/- 35 mmol 3 h-1 l-1 in controls; P < 0.05). 3. Forearm arteriovenous differences of glucose and forearm blood flow were measured to estimate the proportion of the glucose load metabolized in peripheral tissues. Values in cirrhotic patients and control subjects (5614 +/- 1630 compared with 5344 +/- 672 mumol of glucose min-1 l-1 of forearm in 3 h) were similar despite higher glucose levels and sustained high insulin levels in the cirrhotic patients. 4. Peak lactate concentrations after glucose were of similar magnitude in the two groups (0.66 +/- 0.12 compared with 0.62 +/- 0.75 mmol/l) but in the patients with cirrhosis the peak occurred later and was more sustained. 5. The glucose intolerance of cirrhosis is primarily due to impaired hepatic retention of the glucose load. Insulin resistance in peripheral tissues may also be important since the higher insulin concentrations found in cirrhotic patients failed to enhance peripheral glucose uptake.

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Summary. This paper describes some homofermentative lactobacilli, found in freshly pressed apple juice, which can be divided into two groups. One of these consists of strains identified as Lactobacillus plantarum, of which nearly all can metabolize quinic acid. The other group, which consists mainly of catalase positive bacteria, is composed of strains alike enough to be grouped together but sufficiently different from other lactobacilli to be proposed as Lactobacillus mali nov. spec.

1. When fat-cells are isolated from the epididymal adipose tissue of 24h-starved rats and incubated at 25 degrees C in the presence of dialysed serum, glucose, insulin, amino acids and heparin, the total clearing-factor lipase acitivity of the incubation system increases progressively over a period of several hours. 2. All of the increase in activity is accounted for by the appearance of enzyme in the appearance of enzyme in the incubation medium and the fat-cell activity does not change significantly. Cycloheximids, at a concentration that prevents protein synthesis, does not affect the appearance of enzyme in the incubation medium, but the fat-cell enzyme activity is decreased in its presence. 3. The magnitude of the increase in total clearing factor lipase activity is unaffected by the omission of heparin from the medium. However, less enzyme is extracted in tis absence and the fat-cell activity increases. Cycloheximide again only affects the rise in cell activity and does not alter the activity in the incubation medium. 4. When serum in the incubation medium is replaced by casein, the distribution of enzyme between the cells and the medium is changed, but the magnitudes of the increases in total enzyme activity are similar. 5. These characteristics of the clearing-factor lipase response of isolated fat-cells differ in several respects from those observed earlier with intact adipose tissue from 24h-starved rats (Robinson & Wing, 1971; Cryer et al., 1973). The differences could be due, in part, to changes in the relative amounts of two different molecular forms of the enzyme that occur during the isolation of the fat-cells.

Summary: Most heterofermentative lactic rods occurring throughout the cider industry are quite similar and form a fairly coherent group. The constituent bacteria are sufficiently different from other heterofermentative lactobacilli to be considered a new species. They have, therefore, been named Lactobacillus collinoides nov. spec. These occur most frequently in factories where sulphur dioxide, the only permitted preservative, is either used in small quantities or not at all.

The enzyme clearing-factor lipase, or lipoprotein lipase, is responsible for the removal of most of the plasma triglycerides from the bloodstream (Robinson, 1963). The main carriers of such triglycerides are the chylomicrons and the verylowdensity lipoproteins and these complexes are believed to be first sequestered by the enzyme at the lumen surfaces of the capillary endothelial cells of the extrahepatic tissues. Their constituent triglycerides are then hydrolysed at this site and the free fatty acids (FFA) produced are taken up by the tissues either for oxidation or for storage (see Fig. I). Chylomicron and verylow-density lipoprotein triglycerides.Present address:

Over the 10 year period 1987-1996, 328 children with type 1 diabetes mellitus presented in the city of Birmingham, England, of whom 27% had diabetic ketoacidosis. Asian children under the age of 5 had an eightfold increased risk of presenting in diabetic ketoacidosis compared with non-Asian children of the same age. (Arch Dis Child 2001;85:60-61)