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Rolf Luft

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Denis Ikkos and Rolf Luft

The demonstration of a species specificity of growth hormone (GH) made it possible to examine the metabolic action of this hormone in man by the use of human growth hormone preparations. The results obtained in our trials will be presented under the subheadings: protein metabolism, calcium metabolism, sodium and chloride metabolism, fat metabolism, ketogenesis, and finally carbohydrate metabolism.

Protein metabolism. Human GH caused protein anabolism as shown by retention of nitrogen, phosphorus and potassium in proportions similar to those found in protoplasm. Retention of these elements appeared promptly upon GH administration and persisted during the whole treatment period. Upon withdrawal of GH the balances of nitrogen, phosphorus and potassium became negative, but the losses during the post-treatment period were smaller than the gains under GH. Previous pathological creatinuria disappeared, and NPN concentration in blood decreased on GH administration.

Calcium metabolism. Increased calciuria appeared in all instances and the calcium balance

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In a recent paper (Luft, Santesson & Sjögren, 1948) the authors described the hypertensive effect of DCA and sodium chloride in a case of postural hypotension. In a second paper (Luft & Sjögren, 1948), the therapeutic effect of DCA and sodium chloride was demonstrated in postural hypotension and arterial orthostatic anemia, the most common type of postural reaction.

Postural hypotension is a term used in the present work to describe a condition reported by Bradbury & Eggleston in 1925. Arterial orthostatic anemia denotes a clinical condition that has been described chiefly by the Swedish investigators Bjure & Laurell (1927), and corresponds to what Schellong (1936) called »hypotonic regulatory disturbance«. The latter is a type of postural reaction, frequently observed, and common in asthenic persons with poor tone of muscles and tissues.

1) The DCA used in the present study, viz. Percorten Ciba, was kindly supplied by Ciba Produkter A. B.,

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This study concerns the metabolic effect of cortisone, 17-hydroxy-11-dehydrocorticosterone. It is a continuation of our earlier work on the metabolic effect of ACTH peptides (Luft et al., 1949) and ACTH protein (Luft et al., 1950). The aim of the work has been to study the metabolic effect of cortisone under conditions identical with those in the previous work with ACTH, and also to compare the effect of these two hormones.


Three patients were studied and were kept under careful observation in a metabolic unit in the hospital. They were given a constant diet and a constant supply of fluid during the control and experimental periods. Cortisone was administered in a daily dose of 200 mg., divided into 4 injections, i. e.,

1) These studies were aided by grants from the Medical Research Council of Sweden.

2) The Cortisone was kindly supplied by Ciba Produkter AB, Stockholm.


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It has been shown both in man and animals that the endocrine glands affect the renal function. This effect includes both specific functions, such as the absorption of electrolytes in the tubules, and unspecific factors, i. e. glomerular filtration rate and renal blood flow. In the present paper, only the effect of the endocrine factors on the last-mentioned functions will be discussed.

Destruction of the hypophysis in man is followed by a decrease in glomerular filtration rate and renal blood flow (Beaumont & Robertson, 1943, Talbott et al., 1942, McGavack et al., 1946, Waterhouse & Keutmann, 1948, Luft & Sjögren, 1949 a).

White et al. (1940—1950) found that hypophysectomy in dogs, reduced the glomerular filtration rate and the renal blood flow without changing the filtration fraction. These authors believed that »the result is not secondary to thyroid or adrenal cortical atrophy but an expression of a loss of a spe

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Adrenal cortical tumours are sometimes capable of elaborating excessive amounts of oestrogens both in males and females (Burrows, Cook & Warren, 1936, Mason & Kepler, 1945, Roholm & Teilum, 1947). However, in the majority of cases the nature of the oestrogens excreted was incompletely studied. Since in the present case preliminary bioassays indicated a daily excretion of several thousand mouse units of oestrogenic substances, we have attempted to measure the excretion of oestradiol, oestrone and oestriol using the counter current distribution technique and fluorimetric analysis.


Case report. — Male patient born 1895. Since 1949 anemia, a tumour mass in the left upper abdomen and gynecomastia. At operation in March 1950 a large adrenocortical adenoma was extirpated. The patient died in November 1950, and at autopsy a diffuse spreading mass from an adrenocortical carcinoma was found. A detailed report on this case will be published by Arner, Diczfalusy,

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Denis Ikkos and Rolf Luft

Conard (Conard et al., 1953, Conard, 1953) using the single injection technique studied the volume of distribution of glucose in man. In simultaneous measurements he found that the volume of distribution of glucose was equal to the volume of distribution of thiocyanate. He therefore concluded that the volume of distribution of glucose corresponded to the volume of the extracellular fluid, the latter being taken as equal to the thiocyanate space. Glucose, however, disappears rapidly from the blood in non-diabetic subjects. Therefore the measurement of the volume of distribution of glucose by the single injection technique might be subjected to errors similar to those found for the volume of distribution of other rapidly eliminated substances as, for example, thiosulfate (Ikkos et al., 1956 b).

Jokipii & Turpeinen (1954), using a different technique, found that the volume of distribution of glucose was much lower in three diabetic subjects. than in a control

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Erol Cerasi and Rolf Luft


In a previous paper it was shown that 15 out of 85 healthy subjects with a normal intravenous glucose tolerance demonstrated a low plasma insulin response to glucose infusion which was similar to that obtained in diabetic subjects. In the present paper it has been shown that the type of insulin response to glucose infusion was the same when the test was repeated.

Low insulin responders to glucose infusion, as a group, also showed low insulin response to intravenous tolbutamide and oral glucose. This indicates that the type of insulin response is characteristic for a given subject irrespective of the stimulation used.

There seemed to be no difference in the occurrence of diabetes in the family history of the groups of low and high insulin responders.

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Simmonds' disease denotes a clinical syndrome, caused by a decrease in all the functions of the adenohypophysis. It has also been called panhypopituitarism. This name is not entirely satisfactory as it also includes a decreased activity of the neurohypophysis. We have preferred to introduce the term panhypoadenopituitarism in our case, as no histological examination could be made, and no signs of deranged function of the neurohypophysis could be found.

In animals the most important effects of hypophysectomy

1) The desoxycorticosterone acetate and testosterone propionate used in this work was Percorten and Perandren, and was kindly put at our disposal by Ciba Produkter A. B., Stockholm.

2) This case was kindly referred to us for treatment by Dr. Gustaf Myhrman, director of the medical department of the military hospital of Boden.

can be eliminated by the administration of pituitary extracts. In cases of panhypoadenopituitarism different types of pituitary