This paper describes a new method for evaluating glucose metabolism in man using an oral glucose load. The procedure permits the calculation of a blood glucose disappearance rate constant (K) and thereby makes it possible to compare quantitatively the response to oral and intravenous glucose administration in a given individual. Ten metabolically normal adult humans were studied under carefully controlled conditions. Each received similar amounts (20 g) of glucose both orally and intravenously (2-7 days apart) by constant infusion for 1 hr. The effects on blood glucose disappearance rate constants (K) and plasma insulin concentrations (immunoassay) during and for 1 hr following the infusion were compared. Blood glucose concentrations and K values with the 2 routes of glucose administration were similar. In contrast, plasma insulin responses showed a significant difference: oral glucose resulted in a significant and sustained rise, whereas intravenous glucose was associated with a smaller and transient increase.The plasma insulin increase with intravenous glucose is considered to be due to the wellknown effect of hyperglycemia on insulin secretion. The greater and more sustained increase in plasma insulin with oral glucose is interpreted as evidence for an additional stimulus to insulin secretion, possibly a gastrointestinal or liver factor triggered by alimentary glucose. (J Clin Endocr 24: 1076, 1964 B OTH ORAL and intravenous glucose tolerance tests are widely used to evaluate glucose metabolism in man. Intravenous methods permit the calculation of a specific rate constant for glucose utilization (K) from a relationship of blood glucose and time, whereas present oral methods do not allow for such a quantitative expression of data and are handicapped by the variable of intestinal absorption. Thus, there are no published reports on a quantitative comparison of oral and intravenous glucose utilization in man.This paper describes a new method for

Metastasis from renal cell carcinoma (RCC) to the testis is rare. This case report presented an extremely rare case of simultaneous bilateral testicular metastases from RCC in a 65-year-old man who had experienced indolent scrotal enlargement over a period of several months. Scrotal ultrasonography showed 4.0- and 2.0-cm-sized masses in the left and right testes, respectively. Contrast-enhanced computed tomography identified multiple tumors in the kidneys, the pancreas and the left adrenal gland. Left orchiectomy and pathological examination were performed and indicated testicular metastasis from clear cell RCC. The patient underwent complete surgical resection of all residual lesions. Postoperative follow-up examination without adjuvant therapy identified no recurrence over 11 months. This study also reviewed existing literature and determined that retrograde venous spread from the primary kidney tumor to the testis may be an important pathway for testicular metastasis from RCC. In conclusion, RCC can result in testicular metastases not only unilaterally, but also bilaterally, as was observed in the present case.

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In this study, we observed that ADT significantly reduced TPV and improved LUTS in patients with PCa and moderate to severe LUTS, but increased nocturia in patients with mild LUTS.

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Evidence is presented to show that the extreme variation in rate constants for blood glucose disappearance reported by different laboratories is due to the use of an incorrect equation and/or an incorrect method of data analysis. It is demonstrated that graphic (semi-log) methods are too insensitive to be used to justify equations describing blood glucose disappearance. The correct equation is shown to be one of exponential form containing an added constant term which in the normal subject is significantly less than the fasting level of blood glucose. A new method of data analysis (slope analysis) is described which results in the same specific rate constant, K, regardless of the equation employed. This method is made practical by the introduction of a mechanical slope reader which eliminates excessive calculations.

In previous publications from this laboratory (1, 2) evidence was presented which indicates that glucagon enhances the peripheral utilization of glucose 1 in normal men and dogs as well as in the depancreatized dog. The purpose of this paper is to report experiments on the combined effect of glucagon and insulin on arterial and venous glucose levels in normal men, and to compare the magnitude of this effect with that observed in subjects given similar amounts of each hormone separately. ranging from 60 to 100 minutes. Insulin dosage ranged from 0.054 to 0.128 units per min. by constant intravenous infusion for periods ranging from 65 to 110 minutes. Mean insulin dosage for the subjects given insulin alone was .076 units per minute, for the subjects given insulin plus glucagon it was .071 units per minute. The dosage of insulin was arrived at by trial and error; the criteria used were that the dose be sufficient to cause a definite drop in blood sugar, but not so large as to result in hypoglycemic values. Data in which arterial blood sugar fell below 65 mg. per cent were discarded. In the subjects who received both insulin and glucagon, the insulin infusion was begun 15. to 25 minutes before the glucagon in order to obtain the maximum effect of each hormone (on blood sugar level) at approximately the same time. METHODS FiftyVenous and capillary (finger) blood specimens were drawn at five or ten-minute intervals, a total of 30 to 40 samples during each experiment Venous samples were obtained from the antecubital vein which carries mixed blood from the deep and superficial tissue of the forearm and hand (3,4). Capillary blood contains the same glucose concentration as arterial blood (5). Samples were analyzed for glucose content by the Nelson-Somogyi method (6). Sodium fluoride and immediate refrigeration were used to prevent glycolysis in the samples. Capillary samples were analyzed singly, venous samples in duplicate. In approximately 900 duplicate venous samples the maximum difference between any pair was 10 per cent, and the average was 2 per cent.The A-V/A data were subjected to a statistical analysis by means of a non-parametric median test (7); i.e., using the medians as a cutting point The data were placed in a 2 X 2 contingency table, and then subjected to a chisquare analysis. RESULTS