Non-suppressible insulin-like activity (NSILA) is a term used for a variety of substances in serum, excluding insulin, which promote glucose uptake of adipose tissue and diaphragm in vitro. NSILA-S is a peptide with a mole¬ cular weight of 7000 which is soluble in acid ethanol and which has been purified on a large scale from human serum. This study describes a simple Chromatographie one step procedure by which NSILA-S can be extracted and quantitatively measured in individual sera. Using Sephadex G-75 equilibrated with 1 M acetic acid, NSILA-S was detected only in one peak containing small molecular peptides. NSILA-S obtained with this one step Chromatographie procedure exerted all the effects of purified NSILA-S including sulphation activity on the rat cartilage. All Chromatographie fractions with NSILA-S also had sul¬ phation activity. Both, NSILA-S and sulphation activity were increased in acromegalics and decreased in pituitary dwarfs. It is suggested that one molecule in serum is responsible for both activities which are, at least in part, under the control of growth hormone.
We describe a 33-year-old woman with a bilateral fracture of the sacrum associated with pregnancy. Dual-energy X-ray absorptiometry of the lumbar spine and femoral neck showed normal bone mineral density, whereas bilateral osteopenic areas in the massae laterales were demonstrated by the initial CT-scan. The question remains whether the correct diagnosis is so-called insufficiency fracture due to transient osteoporosis of the sacrum associated with pregnancy or so-called fatigue fracture due to unaccustomed stress related to rapid and excessive weight gain in the last trimester of pregnancy.
Two patients developed a Guillaiq-Barre-like syndrome and a third suffered neuropathy and myokymia during therapy with sodium aurothiomalate. The cumulative dose at the time of development of neuropathy was different in all 3 cases. Evidence for gold toxicity was suggested by clinical, electromyographic, and histologic findings, as well as the disappearance of symptoms and signs on cessation of gold iqjjections.Gold neuropathy is a rare complication of gold therapy in rheumatoid arthritis (RA). This side effect has received little attention in textbooks of pharmacology and toxicology or in rheumatology (1-12). Even in recent publications on drug-induced neuropathies or in reviews of undesirable effects of gold, this side effect is hardly mentioned ( 1 3-20). Interestingly, the majority of the available case reports on this complication are found in journals of ). An early survey of the cases reported by French physicians was given by Lescher in 1936 (38
CASE REPORT Patient 1A 67-year-old man developed polyarthritis in autumn of 1977. This patient showed marked morning stiffness and symmetric joint swelling, including midphalangeal and mctacarpophalangeal joints. New joint involvement in all extremities progressed over the next 2 months. No typical extraarticular findings of rheumatoid disease could be detected. Latex fixation test (Singer-Plotz method) and sheep cell agglutination test (SCAT, Waaler-Rose) were both positive from the beginning of the arthritis. Gold treatment was started in November 1977, 2 months after the diagnosis was established.In May 1978 he was admitted with generalized weakness and speech difficulty. At the time of admission, a total amount of 1.6 gm gold (sodium aurothio-
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