15N tracer kinetic investigations on the protein metabolism in a child with chronic renal failure fed a protein-restricted diet.

Administration of EAA and KA in patients with CRF on a protein-restricted diet led to a favourable influence on the plasma protein turnover. This was demonstrated by an increase in the half-life and a decrease in the breakdown rate of plasma proteins measured by the 15N tracer technique.

15N tracer techniques for the differential diagnosis of dwarfism and prediction of growth hormone action in children.

[15N]Glycine in a single oral dose was used to study nitrogen turnover in 18 short children, aged 3-14 yr. On the basis of their serum GH responses to insulin-induced hypoglycemia, the patients were divided into 3 groups: complete GH deficiency (GHD; n = 5); partial GH deficiency (pGHD; n = 6), and children with constitutional growth delay and familial short stature (CGD/FSS; n = 7). The mean 48-h renal excretion of 15N by patients with GHD was 66.09 +/- 14.12% (+/- SD) of the tracer dose. This decreased to 27.64 +/- 5.33% after two injections of 10 IU/m2 GH (P less than 0.001). 15N excretion by patients with pGHD was 47.19 +/- 13.42%, and it decreased after GH injection to 22.69 +/- 4.58% (P less than 0.005). Patients with CGD/FSS had 15N excretion of 37.27 +/- 5.68%, and it did not change in response to GH. The mean protein synthesis rate in GHD patients was extremely low, and it increased after GH injection from 0.99 +/- 0.46 to 3.53 +/- 0.43 g/kg X day. In pGHD patients the protein synthesis rate increased from 2.62 +/- 0.84 to 4.50 +/- 1.09 g/kg X day. The CGD/FSS patients had no change in protein synthesis rate after GH. Our results suggest that studies of the metabolism of [15N]glycine might be of value in predicting responsiveness to GH therapy.

15N tracer kinetic studies on the validity of various 15N tracer substances for determining whole-body protein parameters in very small preterm infants.

Reliable 15N tracer substances for tracer kinetic determination of whole-body protein parameters in very small preterm infants are still a matter of intensive research, especially after some doubts have been raised about the validity of [15N]glycine, a commonly used 15N tracer. Protein turnover, synthesis, breakdown, and further protein metabolism data were determined by a paired comparison in four preterm infants. Their post-conceptual age was 32.2 +/- 0.8 weeks, and their body weight was 1670 +/- 181 g. Tracer substances applied in this study were a [15N]amino acid mixture (Ia) and [15N]glycine (Ib). In a second group of three infants with a post conceptual age of 15N-labeled 32.0 +/- 1.0 weeks and a body weight of 1,907 +/- 137 g, yeast protein hydrolysate (II) was used as a tracer substance. A three-pool model was employed for the analysis of the data. This model takes into account renal and fecal 15N losses after a single 15N pulse. Protein turnovers were as follows: 11.9 +/- 3.1 g kg-1 d-1 (Ia), 16.2 +/- 2.5 g kg-1 d-1 (Ib), and 10.8 +/- 3.0 g kg-1 d-1 (II). We were able to demonstrate an overestimation of the protein turnover when Ib was used. There was an expected correspondence in the results obtained from Ia and II. The 15N-labeled yeast protein hydrolysate is a relatively cheap tracer that allows reliable determination of whole-body protein parameters in very small preterm infants.

[The effect of prednisolone bisuccinate on the prenatal development of the Wistar rat]. / Zur Wirkung von Prednisolonbisuccinat auf die pränatale Entwicklung der Wistar-Ratte.

The action of prednisolone bisuccinate (Prednisolut) was tested on Wistar rats during two stages of prenatal development (embryonal development and early fetogenesis). Prednisolone application leads to phase-specific and dose-dependent disturbances in normogenesis (increased rate of resorption and retardation).

15N-tracer-kinetic studies on the nitrogen metabolism of very small preterm infants on a diet of mother's milk.

Protein synthesis and breakdown, nitrogen flux and other parameters of nitrogen metabolism were measured in five male preterm infants with a mean gestational age of 30.4 +/- 1.95 complete weeks of gestation and a mean body weight of 1592 +/- 517 g. The infants were fed on mothers' milk; the measurements were made at a post-conceptional age of 31.6 +/- 1.9 weeks of gestation (Ia) and were repeated at 34.4 +/- 1.9 weeks of gestation (Ib). [15N]-glycine (95 atom per cent) was used as a tracer, administered as a single enteral dose of 20 mg/kg. Whole-body protein parameters were calculated from an assumed three-pool model. The results were compared with data from moderately small preterm (II) and full-term (III) infants measured at post-conceptional ages of 36.1 +/- 1.4 and 48.0 +/- 2.8 weeks respectively. Protein synthesis rates tended to decrease with increasing post-conceptional age: 14.3 +/- 4.5 g/kg/d (Ia); 11.8 +/- 2.9 g/kg/d (Ib); 7.9 +/- 2.7 g/kg/d (II); and 7.7 +/- 1.4 g/kg/d (III). Protein breakdown and nitrogen flux showed the same trends. Possible consequences for the appropriate nutrition of very small preterm infants are discussed.

Presentation and statistical examination of three-factor association in the HLA system.

Three-factor associations in the HLA system are frequently tested statistically by well-known procedures using 2 X 2 X 2 contingency table analysis. The coupling index DABC given in many publications is suitable for none of these procedures. A more meaningful statistical test for the index DABC is described.

[Theoretical principles and personal experiences in the use of a sequential stimulation test with arginine, gonadotropin-releasing hormone and thyrotropin-releasing hormone in healthy probands]. / Theoretische Grundlagen und eigene Erfahrungen beim Einsatz eines Sequentialstimulationstests mit Arginin, Gonadotropin-Releasinghormon und Thyreotropin-Releasinghormon bei gesunden Probandinnen.

The theoretical bases and the performance of a sequential stimulation test (SST) with 0.5 g arginine hydrochloride per kg body weight, 25 micrograms gonadotropin-releasing hormone and 200 micrograms thyreotropin-releasing hormone are described. The result of SST is shown for 17 healthy women with biphasic cyclus. Beside the basal hormone levels B (hypo-, normo- or hyperhormonal) the response A (no, inadaquate or adaquate response) to the stimulation resulting from the peak levels and netto increases is a valuation criteria.

[Determination of selected coagulation parameters in the amniotic fluid of gestosis patients]. / Bestimmung ausgewählter Gerinnungsparameter im Fruchtwasser von Gestosepatientinnen.

Clot determinations were done in plasma and in a mixture of amniotic fluid and plasma in relation 1:1 in 74 patients with toxemia of pregnancy and in 40 normal late pregnant women. Recalcification time was shortened. The activity of the factors of prothrobin complex was detectable in all normal and toxemic patients. Activity of factor V could be detected only in a few cases, plasminogen could not be deceted in the two groups. Clotting activity was stronger in patients with toxemia than in normal pregnant women.

Evaluation of different 15N-tracer substances for calculation of whole body protein parameters in infants.

The validity of using different 15N-tracer substances to measure whole body protein parameters, i.e., protein synthesis, protein breakdown, net protein gain, protein turnover, metabolic pool, and reutilization, was assessed by comparing the results obtained with: [15N]glycine, a mixture of 10 15N-labeled amino acids, and a 15N-labeled chicken egg protein in two infants, 9 and 12 weeks old, who were fed human milk. The tracer substances were fed orally as a single dose corresponding to a 15N-excess quantity of 0.2 mmol X kg-1 body weight. 15N Excretion in the urine was measured cumulatively by emission spectrometry, and the data on the protein metabolism were calculated by means of a three-pool model. All three tests yielded consistent net protein gains. The protein synthesis, protein breakdown, protein turnover, and nitrogen reutilization values produced by the [15N]glycine tracer study were higher than those produced by application of the 15N-amino acid mixture and the 15N-labeled egg protein. However, in our opinion, this discrepancy does not justify the replacement of [15N]glycine by expensive 15N-amino acid mixtures as tracer substances.

15N-tracer investigations into the nitrogen metabolism of preterm infants fed mother's milk and a formula diet.

Protein synthesis, protein breakdown, protein-N turnover, and other parameters describing the nitrogen metabolism were measured in five male preterm infants. The weight of the subjects at birth was 2,064 +/- 107 g and the measurements were performed at age 16.0 +/- 4.5 days in the case of the mother's milk diet and 27.4 +/- 6.8 days in the case of the formula diet containing 1.8% protein. The parameters were measured by means of the 15N-tracer technique using [15N]glycine (95 atom %) applied in a single oral dose of 20 mg/kg as a tracer. The three-pool model proposed by Winkler and Faust was used to calculate the whole body protein parameters. No difference in net protein gain, protein synthesis, protein breakdown, or the other protein metabolism parameters were recorded despite the different protein inputs. Renal nitrogen excretion and the rate of endogenous urea N excretion were significantly higher for the formula diet than for the mother's milk diet. The protein synthesis rate of 7.9 g X kg-1 X day-1 was, as has previously been observed, higher than in other age groups. The protein metabolism of the preterm infant older than 33 weeks of gestational age does not benefit from a formula diet based on cow's milk that is richer in protein than mother's milk.

[10-year analysis (1969-1978) of the results of treating children with acute lymphoblastic leukemia--therapeutic implications]. / 10-Jahres-Analyse (1969-1978) der Behandlungsergebnisse bei Kindern mit akuter lymphoblastischer Leukämie--therapeutische Konsequenzen.

The paper deals with the increasing improvement of results obtained in treating acute lymphocytic leukemia in childhood on the basis of own patients (55 children admitted to hospital from 1969 to 1978). The assessment of the results is made by life table analysis according to the method of Cutler and Ederer. In the group of patients with a low risk more than half the children in stable first remission will exceed the 5-year limit after being diagnosed. In the group of patients with a high risk the results are significantly worse and require an intensification of the initial therapy step by step by using an aggressive initial stroke of treatment which is taken into consideration in the last protocol of therapy elaborated by the working committee for paediatric haematology and oncology in the paediatric society of GDR.

[The indocyanine green (Ujoviridin) test in patients with hyperemesis gravidarum]. / Indocyaningrün (Ujoviridin)-Test ei Patientinnen mit Hyperemesis gravidarum.

A dose of 0.5 mg/kg body weight of indocyanine-green (Ujoviridin), a chromodiagnostic, was applied in one single injection under standardised conditions to 16 patients, aged between 21 and 31 years (25.9 years on average), with slight to moderate hyperemesis gravidarum, with the view to making an assessment of hepatic excretion.--Also determined were aminotransferases, alanine-aminopeptidase, and bilirubin in serum, accompanied by thymol turbidity tests.--The values of indocyanine-green half-life were all, but for one patient, within or at the upper limit of normal.--While the informative value of individual measurements is limited, the above findings seem to suggest that in cases of slight or moderate hyperemesis the laboratory parameters tested are unlikely to rise to pathological levels, except for slight increases which may be associated to certain individual cases.

The analysis of stain loading tests for the assessment of the liver function.

Stain loading curves are analysed by discriminant analysis. In this multivariate statistical method, the stain concentrations measured in the blood at defined intervals after injection are regarded as measurement vectors.

Studies on liver function under the influence of oral contraceptives.

The effects of two sequential therapies using mestranol as an estrogen and chlormadinone acetate and norethisterone acetate, respectively, as a gestagen on the aminotransferase (GOT and GPT), alkaline phosphatase and alpha-amylase activities, the cholesterol, total bilirubin and total protein contents and the indocyanine green (Ujoviridin, VEB Chemiekombinat Bitterfeld) half-life were studied in two groups, each comprising 12 women of fertile age. The serum protein was separated by paper electrophoresis and both the thymol turbidity and zinc sulphate tests were performed during the first treatment cycle. An estrogen-induced rise in alanine aminotransferase (GPT) activity from 6.31 U/liter to 12.14 U/liter was observed during application of the mestranol/chlormadinone acetate therapy. The value dropped to 5.34 U/liter when chlormadinone acetate was administered as a gestagen in addition to the estrogen. No significant changes were noted in the other biochemical parameters. Sequential therapy involving application of mestranol and norethisterone acetate produced only statistically secured rises in the alpha 1-globulin content and the GPT activity. All other changes in the different parameters remained within the normal range and were statistically insignificant.

[Gynecologic geriatric surgery at the University Gynecological Clinic Rostock during 1960--1974]. / Gynäkologische Altersoperationen an der Universitäts-Frauenklinik Rostock in den Jahren 1960 bis 1974.

There is reported about 2279 gynaecological operations at women, aged 60 years and more, in a period from 1960 to 1974, divided into three 5-years-groups. The part of geriatric operations increased from 5,3% to 7,0% of all operations. The division into high risk-groups took place after points given by Loskant. 41,1% of all patients where classified into group III. Group IV has the highest postoperative mortality rate (5,3%). The postoperative mortality rate altogether was 2,2%. In the years from 1960 to 1974 it decreased from 2,6% to 1,9%. 25,1% of the surgical operations where carried out abdominaly. The high part of vaginal operations comes off by placing curettages into the analysis. Under that aspect must be seen the postoperative mortality rate 7,1% at abdominal and 0,7% at vaginal operations. In the main point indications for operation were malignant tumours (37,3%), haemorrhages (25,4%), benign tumours (17,6%), and position variations of the genitals (10,6%).

Studies on liver functions under the effect of sequence drugs.

PIP: The effects of sequential therapy (mestranol alone, and combined with norethisteron acetate and chlormadinon acetate) on liver functions were studied in 2 groups of healthy females (16-32 years of age): the first group consisted of 15 subjects who were given 0.08 mg/day mestranol from the 5th to the 24th day of the cycle and 1 mg/day norethisterone acetate from the 15th to the 24th day of the cycle; the second group of 15 subjects were given 0.08 mg per day mestranol from the 5th to the 24th day of the cycle and 2 mg/day chlormadinon acetate from the 15th to the 24th day of the cycle. Blood samples were collected and Ujoviridine tests (indocyanine green tests) were done 3 times under standarized conditions in both groups during the 1st treatment cycle. Comparison of the 2 forms of sequential treatment using simple variance analysis showed no significant differences between the 2 gestagen phases (norethisteron acetate and chlormadinon acetate) or between the alkaline phosphatase and aminotransferases (the values for these 2 parameters however dropped after norethisterone acetate and rose after chlormadinon acetate). This was attributed to the observation that the 10-day estrogen phase followed by an estrogen-gestagen phase of identical length closely approximate the physiological cycle. The enzymatic results and the ICG half-life indicate that both sequential treatments have no serious toxic effects on the liver functions of healthy fertile women.^ieng