Comparison of oral glucose tolerance tests and mixed meals in patients with apparent idiopathic postabsorptive hypoglycemia: absence of hypoglycemia after meals.

The relationship between symptoms of idiopathic postabsorptive hypoglycemia and glucose homeostasis was evaluated by giving oral glucose tolerance tests (OGTT) and mixed meals to 18 patients and 16 controls. Chemical hypoglycemia after OGTT occurred as often in patients referred because of possible hypoglycemia symptoms, 18 out of 80 (23%), as in controls, 4 out of 16 (25%). After glucose, patients showed both clinical and chemical hypoglycemia (mean +/- SE plasma glucose, 48 +/- 3 mg/dl), but insulin, glucagon, and growth hormone responses were similar to controls. After mixed meals, no chemical hypoglycemia occurred in patients (mean plasma glucose, 79 +/- 3 mg/dl), yet 14 out of 18 (78%) had symptoms and/or signs consistent with hypoglycemia. No abnormality of glucose homeostasis was observed after meals that could account for symptoms or signs experienced by patients with idiopathic postabsorptive hypoglycemia. Since factors other than hypoglycemia appear to be involved, the disorder should be termed the idiopathic postprandial syndrome to avoid the connotation of chemical hypoglycemia.

Evidence for a small anion-selective channel in the cell wall of Mycobacterium bovis BCG besides a wide cation-selective pore.

Two channels were observed in extracts of whole Mycobacterium bovis BCG cells using organic solvents and detergents. The channels derived from organic solvent treatment had a single-channel conductance of about 4.0 nS in 1 M KCl in lipid bilayer membranes with properties similar to those of the channels discovered previously in Mycobacterium smegmatis and Mycobacterium chelonae. The channel was in its open configuration only at low transmembrane potentials. At higher voltages it switched to closed states that were almost impermeable for ions. Lipid bilayer experiments in the presence of detergent extracts of whole cells revealed another channel with a single-channel conductance of only 780 pS in 1 M KCl. Our results indicate that the mycolic acid layer of M. bovis BCG contains two channels, one is cation-selective and its permeability properties can be finely controlled by cell wall asymmetry or potentials. The other one is anion-selective, has a rather small single-channel conductance and is voltage-insensitive. The concentration of channel-forming proteins in the cell wall seems to be small, which is in agreement with the low cell wall permeability for hydrophilic solutes.

[Differential arthrographic diagnosis of the painful shoulder joint]. / Arthrographische Differentialdiagnose des schmerzhaften Schultergelenkes.

60 arthrograms of the shoulder were explored under morphologic and pathologic-anatomic aspects. Differentiation was made between acute and chronic pain. The possible findings in leaking of the contrast material out of the joint capsule are shown and discussed. Signs are quoted of degeneration of soft tissue and bone. The findings in patients with rheumatoid arthritis and a history of shoulder dislocation are summarised. Distension of the joint capsule without shoulder dislocation is described. Filling of the periarticular lymphatics is mentioned in different cases.

Total protein concentration in selectively collected secretions from the middle and inferior meatus of the nose.

To clarify the characteristics of nasal secretions, a method for collecting human nasal secretion was devised. Total protein concentration in selectively collected secretions from the nasal cavity was determined using biochemical techniques. Dry absorbent cotton was inserted in each middle and inferior meatus of the nasal cavity for 30 min, and put in a test tube with a plastic sieve for centrifugation. After centrifugation at 5,000 rpm for 20 min, 10 microliters were obtained to measure the protein concentration the nasal secretions was made using spectrophotometry. The amount of nasal secretion samples collected was 50 to 400 microliters per site. Nasal secretions collected from the right middle and inferior meatus contained 80 to 2,450 mg/dl and 260 to 3,270 mg/dl of protein, respectively, while those from the left middle and inferior meatus contained 80 to 2,200 mg/dl and 175 to 3,050 mg/dl, respectively. It was concluded that this new method was clinically useful for collecting nasal secretions, and it permitted selective collection from predetermined sites in the nasal cavity. The total protein concentration level of nasal secretions collected by this method was higher in the inferior meatus than in the middle meatus of the nose, with statistical significance.

[About the estimation of human parotid gland amylase in fractionated secretions (author's transl)]. / Zur Sekretion der Amylase im fraktioniert gewonnenen menschlichen Ohrspeicheldrüsensekret unter Berücksichtigung verschiedener Bestimmungsmethoden.

The amylases are the main proteins in parotid secretions. In 30 probands the amylase secretion is observed under rest and gustatoric and parasympathicomimetic stimulation. A stimulation specific behaviour of amylase secretion is found. Under parasympathicomimetic stimulation by subcutaneous injection of Pilocarpin a high increase of amylase concentration is observed, in comparison to gustatoric stimulation where the concentration doesn't change. Different enzymatic activities of amylase under rest- and stimulation-conditions couldn't be found.

[New methods in ear drum photography (author's transl)]. / Neue Möglichkeiten der Trommelfellfotografie

A new optic system, developed in collaboration with Fa. Wolf is introduced. This new optic facilitates diagnostic and demonstration of eardrum findings. The 6.8 mm Lumina-optic has an air channel for avoiding efflorescence of the optic. By adapting the optic system with a camera good, large and easy reproducible pictures were got.

[Protein composition of human saliva under rest and stimulation and its changes in salivary gland diseases]. / Zur Protein-Zusammensetung des menschlichen Aarotissekretes unter Ruhe- und Reizbedingungen und seine Veränderung bei Drüsenerkrankungen.

In 153 probands the following parameters of normal parotid gland secretion were examined: flow-rate, total protein excretion, lysozyme, amylase, phosphatase, BAEE-esterase, immunglobulin A and trypsin-inhibitor. The results were compared with secretions of parotid glands with tumors (51 patients), sialadenitis (22 patients) and sialadenosis (12 patients). Thereby differential diagnosis in sialotumors was found possible. The mose important parameters are flow-rate, protein and immunglobulin A-concentrations, Moreover it is possible to differentiate in sialadenitis and sialadenosis: lysocym secretion gives besides flow--rate protein and immunglobulin A-concentration a good parameter in differentiating both pathological findings. Discelectrophoretic and immunoelectrophoretic separations supplement the differential diagnosis in sialotumors, sialadenitis and sialadenosis. The results are discussed.

[Acrylamid- and immunelectrophoretic separations of human parotid secretions from individuals with parotid tumors, chronic parotitis and sialadenosis (author's transl)]. / Elektrophoretische und immunelektrophoretische Befunde des menschlichen Parotissekretes bei verschiedenen Ohrspeicheldrüsenerkrankungen

After previous examinations in normal parotid glands in this paper secretion of proteins in parotid glands with pleomorphic adenomas, Whartin tumors, parotid carcinomas, chronic parotitis and sialadenosis should be studied. Different discelectrophoretic and immunelectrophoretic runs were done. Thereby we got the following changes in electrophoreses: Pleomorphic adenomas generally show a more palid pattern in band-structure, caused by the diminished proteinconcentration in the secretions. Most remarkable are thereby the c1 and d1-4-bands. Immunelectrophoretic separations are normal. Whartin tumors show a different bandpattern in the anodal near gel region, which is enpowered by immunelectrophoretic runs. Secretions from parotid carcinomas show a characteristic change in bandstructure. There are found added bands which result from serumproteins as immunelectrophoretic examinations proof. The same is found in glands with parotitis in contrary to glands with sialadenosis.

A new optical system in tympanic membrane and middle ear endoscopy.

In cooperation with the firm of Richard Wolf, a new ear telescope has been developed which facilitates the diagnosis and documentation of tympanic membrane lesions. This 6.8 mm telescope of the Lumina type is prevented from misting up by a stream of air directed across the distal viewing window. This 6.8 mm Lumina telescope also formed the basis for a completely newly developed optical system for middle ear endoscopy. This combined optical system comprising a mother and baby scope has been undergoing trials for the past 18 months. The baby scope can be passed through the mother scope, thus permitting inspection of the tympanic cavity, under direct vision and unaffected by involuntary movements of the patients. The particular configuration of this system makes it easy for the endoscopist to apply his eye first to one and then to the other telescope. The 6.8 mm mother scope and the 2.7 mm baby scope can both be connected to a camera which provides high-quality pictures the dimension of which are only a little smaller than those of a slide.

[New aspects in ENT-Endoscopy (author's transl)]. / Neuere endoskopische Möglichkeiten im Hals-Nasen-Ohren-Bereich.

There are introduced three optic-systems, which have been developed and proved in our clinic. First is a optic for ear drum and middle ear endoscopy, second is the "lupenlaryngoepipharyngoscope", third is a lumina-vario-optic for documentation of findings in the larynx and the proximal trachea.

[A new method to get pure nasal secretions (author's transl)]. / Eine neue Methode zur Gewinnung von Nasensekret und erste Untersuchungen zur Eiweisszusammen-setzung des Nasensekretes mittels Diskelektrophorese.

A new method to get pure nasal secretions is introduced. In comparison to the other methods, which are described in the literature, by this method it is possible to get qualitative and quantitative estimable amounts of nasal secretions. The advantage of this method is discussed. First results are reported about protein concentration and diskelectrophoretic separations of the nasal secretions.