摘要:

Summary1) 50 mg of ACTH injected to normal and diabetic subjects induce an adrenal cortex reaction, which is characterized by a drop in the eosinophil count and a rise in the urinary 17 ketosteroids. The intensity of the response is the same in both groups of subjects.ACTH provokes in normal subjects a small increase in the blood sugar level; on the contrary, in diabetics treated or untreated by insulin, the rise of glycemia and of glycosuria after injection of ACTH is important; this last action is not due to an exaggerated reaction of the adrenal cortex of these patients.2) Injections of ACTH decrease in normal and diabetic subjects the sensitivity to insulin; this action of ACTH is more important in diabetics than in normal subjects.3) Hypoglycemia due to insulin stimulates the adrenal cortex of normal and diabetic subjects. In diabetics, a decrease in the glycemia does not stimulate the adrenal cortex as long as the blood sugar level remains above 0,70 gr. 0/00.4) Transient or prolonged hyperglycemia has no action on adrenal cortex activity of normal and diabetic subjects.5) In diabetics treated by insulin, the suppression of this treatment has no action on the activity of the adrenal cortex if it is only followed by hyperglycemia; if acidosis and acetonuria occur, the adrenal cortex stimulation is characterized by a drop in the eosinophil count, if the acetonuria is small, bv a drop in the eosinophil count and a rise in the urinary 17 ketosteroids if acetonuria is marked; as stimulation of the adrenal cortex causes an increase of acetonuria, the suppression of insulin in such patients induces a vicious circle which leads them into diabetic coma.6) In severe diabetics, acute infections, traumatisms, cerebral accident and acute cardiac failure stimulate the adrenal cortex; this is shown by a drop in the eosinophil count, a rise in the 17 ketosteroids and, at the same time, an increase of blood sugar and acidosis. Some days later, there occurs a depression of adrenal cortex activity (rise of the eosinophil count, decrease of 17 ketosteroids) and at the same time, hypoglycemia.7) During diabetic coma, adrenal cortex activity is stimulated; this increased activity is followed by a period of adrenal cortex hypeactivity; during this period, the sensitivity to insulin is increased.These facts explain why it is often difficult to determine the insulin dose, to be administred to diabetic subjects during acidosis, infections and traumatisms and why these patients easily pass from hyperglycemia to hypoglycemia.In diabetic subjects, it is useful during critical circumstances, such as acidosis, infections, traumatisms, to study at the same time the variations in the blood sugar and in the adrenal activity; it is possible, by this procedure, to determine the periods during which it is necessary to increase or to decrease the insulin dose.

ISSN:1784-3286    

DOI:10.1080/17843286.1953.11717253

出版商:Taylor&Francis    

年代:1953

数据来源: Taylor

摘要:

SummaryIt is generally held that, besides changes in insulin activity, clinical doses of cortisone have no definite effect on carbohydrate metabolism of normal subjects.By mathematical analysis of intravenous glucose tolerance tests, it is possible to calculate a glucose assimilation coefficient and to detect thereby changes in carbohydrate metabolism which escape other methods of investigation.The alterations induced by cortisone administration arc important and depend on duration of treatment. In the early stages, glucose assimilation is depressed. After 3 weeks, it returns to normal values. Later, in spite of continued treatment, the glucose assimilation coefficient rises above the initial figures.

ISSN:1784-3286    

DOI:10.1080/17843286.1953.11717254

出版商:Taylor&Francis    

年代:1953

数据来源: Taylor

摘要:

SummaryRelation of a case of acute tuberculous septicaemia (sepsis tuberculosa gra- V’ssima) accompanied by a panmyelophtisic syndrome.General description of the anatomo-clinical picture of the disease. Discussion of its relation with Landouzy’s typhobacillosis. Recalling of the principal pathogenetical theories. Bibliography.

ISSN:1784-3286    

DOI:10.1080/17843286.1953.11717255

出版商:Taylor&Francis    

年代:1953

数据来源: Taylor

摘要:

AbstractEn 1888 déjà, S. Askanazy décrivait l’observation anatomo-clinique d'un cas de tuberculose ganglionnaireàévolution aiguё, s'accompagnant d’unétat pseudo-leucémique. Depuis lors, un certain nombre de cas analogues ontétérapportés dans les littératures anglo-saxonne, française et germanique. Il y a deux ans, Desclin et Gepts présentaient ici même un cas de ce genre.Bien que la possibilitéd'une association de tuberculose et d’unétat pseudo-leucémique soit bien connue, nous croyons utile de vous en présenter une nouvelle observation anatomo-clinique, parce qu’elle pose d'importants problèmes de pathogénie et de diagnostic. En effet. le pathologiste doit connaître ces formes relativement rares et paradoxales de tuberculose et, lorsque la chose est possible, en faire le diagnostic différentiel d’avec les leucémies vraies. Par ailleurs, de tels cas posent, du point de vue pathogénique, toute une série de questions sur lesétats réactionnels des tissus hématopoiétiques. Nous aurons l’occasion d’y revenir brièvement dans la discussion.

ISSN:1784-3286    

DOI:10.1080/17843286.1953.11717256

出版商:Taylor&Francis    

年代:1953

数据来源: Taylor

摘要:

SummaryFour cases of«septicemia tuberculosa acutissima»are reported. Characteristic necrotic abcesses (without the common signs of focal reaction : Lang- ans’s and epetheloid cells) were found in the lungs, the liver, the spleen, the kidneys, the lymph nodes, the bone marrow, and even the nervous system.Hematologic changes were observed in all cases. In one, this type of tuberculous disease appeared as a complication of a chronic myeloid leukemia. In two other cases the infection developped together with signs of acute leucemia and it was impossible to recognize which of these disease appeared to be the primary one. In the fourth patient evidence was obtained that tuberculosis acutissima was the primary disease, acute leucemia appearing as a terminal complication responsible for death.Pathological examination disclosed extensive tuberculosis of the lymph nodes in three cases. Large fibrous scars were found in visceral nodes in three cases and, besides, in peripheral nodes in two of them.As a hypothesis, it is suggested that the extensive lymphatic involvment was responsible for the necrotic form of tuberculosis observed in these patients. Several experimental observations suggest that lymphoid tissue plays an important role in tuberculous defense : irradiation of lymphoid tissue as well as cortisone therapy increase the severity of experimental infection in animals. Besides, extensive tuberculosis of the lymph nodes is frequently associated with hematologic changes. Therefore it may be suggested that the large reduction of lymphoid tissue in our cases was responsible for the particular features of the tuberculous infection as well as for the leucemic changes of the bone marrow.

ISSN:1784-3286    

DOI:10.1080/17843286.1953.11717257

出版商:Taylor&Francis    

年代:1953

数据来源: Taylor

摘要:

SummaryThe purpose of this work was to study the hemodynamic characteristics of 10 cases of mitral stenosis.All presented a sometimes important increase in the systolic pressure in the right ventricule, in the pulmonary and also capillary pulmonary pressure.In three cases the pressure in the right auricule was also raised. The gra- diant between the pressure in the pulmonary artery and the pressure in the pulmonary capillaries was generally low. The resistance in the small pulmonary arteries was low in 3 cases, high in 4 cases and very high in 1 case.The mitral valve had a surface, calculated from the Gorlin’s formula, of 2 cm2and 2,4 cm2in two subjects, and the figures varied from 0,9 to 1,6 cm2in six other subjects. In 4 patients, these figures were checked during the operation.

ISSN:1784-3286    

DOI:10.1080/17843286.1953.11717258

出版商:Taylor&Francis    

年代:1953

数据来源: Taylor