Disturbances Of Fat Metabolism Research Articles

Physiological Chemistry of Lipids in Mammals.

What are the medium chain triglycerides, how can they be used, and how do they differ in their metabolism from long chain triglycerides and why? Or , since obesity is a disturbance of fat metabolism, how is a disturbance of adenosine triphosphate conversion involved therein? And , what electrolyte imbalance, aside from that of sodium, is involved in disturbance of fat metabolism? Also , what other metabolic functions are affected by a dysfunction of fat metabolism? It would seem to me that the practitioner is most likely to be interested in topics suggested by the above questions. Some questions such as these are answered in this book, others are not. Designed for the medical student, the book will also partially serve the practitioner. The reason it will not be substantially fulfilling to the practitioner or clinician is because it is not clinically or therapeutically oriented. Nonetheless, it provides a solid enough background of

Cybernetics of blood sugar and fat in health and disease

It is the Author's view that obesity, atherosclerosis and diabetes mellitus represent complications of a disturbance in the feedback control systems involved in the area of carbohydrate metabolism. Inappropriate insulin secretion causes counter regulatory release of growth hormone and the catecholamines, noradrenaline and epinephrine. Resulting is a disturbance in fat metabolism and hyperlipemia. Over the span of a lifetime these disturbances result in increasing frequency of diabetes mellitus and atherosclerosis with the aging process. The cybernetics of this derangement is discussed.

Partial Gastrectomy: Complications and Metabolic Consequences

In this very interesting book the authors have focused their attention upon the early and late complications and metabolic consequences of partial gastrectomy. Extensive original observations provide the basic material, though the discussion also includes a careful review of the literature. The senior author's descriptive terms (eg, loop syndrome, loop-the-loop obstructions, sumping) illuminate his great interest in the defects of Billroth II operations that often have been performed in a somewhat unorthodox fashion and referred to him for repair. When he converted to a Billroth I with vagotomy, the majority of his patients have been relieved completely. The late complications, mechanical embarrassment of the afferent and efferent loops, infection of the afferent loop, dumping, disturbances of fat metabolism leading to diarrhea, or malnutrition, iron deficiency, and defective calcium absorption) are all described in great detail. Severity of the sequelae are not under-emphasized; for example, anemia is estimated to

Über die Resorption pflanzlicher Sterine beim Menschen

2/3 of the probands showed small amounts of plant sterols like aj-sitosterol, stigmasterol and /?-sitosterol. All of the patients had a lower level of phytosterols than the controls. — Further, the influence of peroral doses of sitosterol on total lipids, cholesterol and the sterol composition of the serum was studied. In all cases, there was a small increase in the total phytosterols of the serum, with varying contributions from the individual phytosterol fractions. 8 patients with disturbances of fat metabolism were fed granulated sitosterol or plant oils rich in polyenoic acids and containing phytosterols daily for 3 months. There was a marked decrease in the levels of total lipids and cholesterol during the observation period, but no significant increase of phytosterols in the blood. The results show that healthy persons can absorb small amounts of plant sterols. This ability seems to be decreased or abolished in certain disorders of fat metabolism. On the other hand, our results could indicate that the decrease of blood cholesterol caused by plant sterols is due primarily to the inhibition of the enteric absorption of cholesterol.

Applications of Human Whole Body Counters in Nuclear Medicine

Human whole body counters have many practical applications to diagnosis in clinical medicine. Human counters in NIRS have been employed in a number of clinical tracer studies for measuring the whole body retention and absorption of very low levels of various isotopes and labelled compounds, such as NaI-131, Sr85, Na-22, Cr-51 labelled red cell, Fe-59 and Co-60 labelled VB12. The results obtained illustrate the potentialities of whole body counting in clinical diagnosis. Natural radioactive K-40, which is said to be approximately 0.0119% of the total potassium in the human body can be measured without any isotope ingestion using a human counter. Measurement of the total body potassium gives an important information on physiological and pathological body conditions as muscular development, lean body mass to fat ratio and electrolyte balance. The study was designed to estimate of the total body potassium in the patients with periodic paralysis and to know its relation to gross body composition. There was no significant difference between the lean body mass content of potassium in the periodic paralysis patients and that in the control subjects. There was a poor correlation of the total body potassium with gross body weight and a much better correlation in the both groups if the total body potassium is related to the lean body mass. Human whole body counter may play an important role in establishing the diagnosis of the neuromuscular diseases associated with potassium deficiencies and some hormonal diseases which cause disturbance of fat metabolism.

Ocular Lesions Related to Disturbances in Fat Metabolism

Ocular Lesions Related to Disturbances in Fat Metabolism

Lipemic nephrosis

Lipemic nephrosis

EFFECT OF FEEDING A LIPOTROPIC SUBSTANCE TO PATIENTS WITH XANTHELASMA

The association of hyperlipemia with xanthelasma is well known and has been the subject of study by several investigators. 1 The relation which the hyperlipemia has to cardiovascular disease, especially peripheral and coronary arteriosclerosis, is less well recognized but likewise has been found to be rather common. 1 From such observations, it would seem that the presence of these benign fatty lesions within the skin of the eyelids may suggest a disturbance in fat metabolism, in some persons severe enough to warrant further study in regard to the blood lipids, cardiac function and peripheral vascular sufficiency. If xanthelasma may at times be the herald lesions of disturbed fat metabolism, it then should be determined whether some of the lipotropic substances which have so pronounced an effect on several types of experimental and acquired disturbances in fat storage and metabolism might not be of value in lowering the blood

Glycogen storage disease: Observations on the pathologic physiology of two cases of the hepatic form of the disease

Summary Two cases of the hepatic form of glycogen storage disease (von Gierke's disease) have been studied in detail. Observations on liver slices freshly removed at biopsy have shown an abnormal stability of the glycogen, but a satisfactory glycogenolytic response was obtained upon admixture with fresh normal liver, confirming previous work that the glycogenolytic enzyme system is defective in this condition. Liver slices treated with various enzyme preparations, including phosphorylase and amylase, gave results which were inconclusive as to the nature of the enzyme defect. It was demonstrated that liver functions other than glycogenolysis may be affected in this disease, defective prothrombin formation and defective methylation being observed. In one patient a pronounced lipemia was present at the age of 2 years which had almost completely disappeared at the age of 6 years, suggesting that the associated disturbance of fat metabolism, which has been observed repeatedly in infants with this disease, may be a self-limited one. An unidentified reducing substance was found, probably belonging to the pentose group, in the urine of one of our patients. Particular attention is called to two indirect results of the impaired glycogenolysis: (a) an abnormal conversion of carbohydrate to fat, demonstrated by respiratory quotient studies, which leads to obesity; (b) impaired nitrogen retention, brought about apparently by excessive gluconeogenesis from protein in the effort to sustain blood sugar, a condition which may interfere with normal growth. We have shown that this latter condition may be satisfactorily treated by the administration of an extra protein meal at night.

TREATMENT OF PSORIASIS WITH LIPOTROPIC SUBSTANCES DERIVED FROM FOODSTUFFS

PSORIASIS AS A DISTURBANCE OF LIPID METABOLISM The conception of psoriasis as a metabolic disturbance of the skin has received increasing support in recent years. Madden's excellent histologic study 1 of the uninvolved skin of patients with acute guttate and generalized papular psoriasis has strengthened greatly the concept of this disease as a disturbance of fat metabolism. The histologic changes which Madden found in the uninvolved skin but at the sites of election for psoriasis were: an increase of extracellular fat around the pilosebaceous apparatus and sweat glands and throughout the corium and a constant leukocytic infiltrate in the papillary bodies and in the upper half of the cutis. When the infiltrate was great the capillaries were dilated and engorged and the papillary bodies elongated and pushed toward the surface. These findings confirmed and extended those of Kartamyshev. 2 One is tempted to conclude that the difference between the apparently

EFFECT OF THE ADMINISTRATION OF LIPOCAIC AND CHOLESTEROL IN RABBITS

If rabbits are fed cholesterol in excessive amounts, a marked and sustained elevation of the blood cholesterol level occurs, and after a few months progressive intimal changes appear in the aorta.1Cholesterol and other lipids2are deposited in the inner layers of the aorta, and gradually lesions develop which assume most of the characteristics of human arteriosclerosis.3These findings suggest that this disease may be the result of some metabolic defect and not a necessary accompaniment of the aging process. The abnormally high incidence of presenile arteriosclerosis in patients with diabetes mellitus supports this view. Here also there is evidence that some disturbance in fat metabolism resulting in sustained hypercholesteremia is involved. Rabinowitch,4Joslin5and others have demonstrated that high fat diets given to patients with diabetes favor, and that, conversely, low fat—high carbohydrate diets retard, the appearance of hypercholesteremia and arteriosclerosis. The discovery in

A PROPOSED CLASSIFICATION OF CUTANEOUS LIPOIDOSES

The lipoidoses, as one of us (E. U.) explained elsewhere, 1 are now classified in two large groups, namely, the general and the local lipoidoses. This division is based on demonstration of the fact that in the former there is a general, primary disturbance of fat metabolism, whereas in the latter there is a local disease of the tissue with secondary deposition of fat. The general lipoidoses represent a process of fatty infiltration; their further classification is based on clinical type, the nature of the lipoid (cholesterol ester, free cholesterol, phosphatide, lecithin or kerasin), the intracellular or extracellular presence of the lipoid and the histologic features. The table presents a summary of these items. The xanthelasmatoses (this term is preferable to xanthoma, because a blastomatous character is demonstrable only in extremely rare instances) can at present be classified only from a clinical point of view, because histologically and chemically no

The Experimental Use of Lipocaic in the Treatment of Psoriasis: A Preliminary Report ,

The role of lipid metabolism in relation to psoriasis has been the subject of numerous investigations since the work of GrUtz and BUrger (1) who found extreme hyper-cholesterolemia associated with the disease. They expressed the belief that a disturbance of fat metabolism was the cause of the skin lesions and obtained beneficial effects with low fat diets. Gate, Chanial, Vallet and Humbert (2) found an increase in serum cholesterol in 70 per cent of their patients who showed clinical evidence of psoriasis. Pulay (3) observed derangement of lipid metabolism in patients with psoriasis, but did not consider this as the cause of the disease. He was of the opinion, however, that an altered fat metabolism may play an important role in the pathogenesis of psoriasis. The cholesterol tolerance test as used by Grutz and Burger (1) was employed in ten psoriatic patients by Rosen, Rosenfeld and Krasnow (4). On the basis of this test the authors could not assume that a disturbance of fat metabolism was present, although they showed that hypo-cholesterolemia existed in patients with psoriasis. Hering (5) after studying this question denied that there was any relationship between fat metabolism and psoriasis. More recently Madden (6) concluded that

LIPOIDOSIS CUTIS ET MUCOSAE (LIPOID PROTEINOSIS OF URBACH)

Many contributions dealing with disturbances of fat metabolism have been published in recent years and have furnished much new and valuable information to both the internist and the dermatologist. Among these (to mention only a few) are the lipoid studies in xanthoma of Wile and his collaborators, 1 the investigations of Schaaf and Werner 2 in Bloch's clinic on the pathogenesis of xanthoma, several publications by Finney, Montgomery and New 3 and by Weidman and Schaffer, 4 dealing in part with xanthoma of the skin and the larynx, involvement of the latter being of particular interest in connection with other varieties of lipoid involvement of the mucosae. Urbach 5 in a scholarly exposition has added much to the knowledge of several new varieties of lipoid disturbances; these, together with lipoidosis cutis et mucosae, form a group of generalized lipoid diseases with cutaneous manifestations, embracing xanthomatosis, necrobiosis lipoidica diabeticorum and extracellular

Disturbance of fat metabolism under the influence of estrone: a tumorous fat accumulation in the parametrium experimentally produced by treatment with estrone on castrated guinea pigs1

Disturbance of fat metabolism under the influence of estrone: a tumorous fat accumulation in the parametrium experimentally produced by treatment with estrone on castrated guinea pigs¹

THE OBESITY AND ENERGY EXCHANGE IN A VERIFIED CASE OF PITUITARY BASOPHILISM

Obesity is frequently observed in patients who have lesions of the hypophysis. The adiposity associated with Frohlich's syndrome is well known. Cushing 1 recently described a clinical syndrome resulting from basophil adenoma of the pituitary gland. One of the features of this syndrome is adiposity, which is said to be confined characteristically to the face, neck, thorax and abdomen, sparing the extremities. The abdomen is usually protuberant and often pendulous. The feeling is prevalent that the obesity associated with dyspituitarism results from some unusual metabolic disturbance, which in a mysterious way causes an increased synthesis and deposition of body fat. The significance of hypercholesteremia, commonly present in cases of pituitary basophilism, has been variously interpreted. Kraus 2 suggested that a disturbance of fat metabolism with an associated hypercholesteremia may be the fundamental abnormality in Cushing's disease and that as a result of this metabolic disturbance lesions develop in the adenohypophysis (excess basophilia

Xanthomatosis Involving Bone (Lipoid Histiocytosis)

THE concept of xanthomatosis includes a series of pathological conditions, in which lipoid substances are deposited in certain tissues of the body as a result of a disturbance of fat metabolism, which may be an essential primary process or one secondary to other constitutional disease, such as diabetes mellitus. These accumulations are found in various tissues, the composite picture differing greatly over a rather wide range of clinical cases, but in general considered by present-day investigators to represent a fundamentally similar pathologic process in all. It has also been variously termed “lipoid granulomatosis,” “lipoid reticulo-endotheliosis,” “lipoid gout,” “lipoid histiocytosis,” and “generalized xanthomatosis.” Case Reports Case 1. F. B., R-3680, a white boy aged three and one-half years, was admitted to the hospital July 29, 1927, with the complaint of multiple abscesses of the skull, exophthalmos of the right eye, ankylosis of the left shoulder, and pain in the region of the right hip. With him came a history of his having injured the shoulder in a fall in March, 1926. An abscess of the left tonsil had been opened in October, 1926, and one in the right temporal region arising without history of injury or other apparent cause in January, 1927. Other swellings had since appeared on the head, but had not been opened. The right knee pained occasionally. He had been delivered normally at full term and breast fed. Scarlet fever had occurred at nine months and severe mumps in March, 1927, each with good recovery. There was no history of other infections. His father, 26 years of age, his mother, 25 years of age, and his six sisters were all in good health. Examination.—The right eye was displaced downward and outward, but was otherwise found normal upon examination by the division of ophthalmology. A soft, fluctuant, non-expansile mass about 5×6 cm. was present over the left parietal region, not inflamed. A soft mass 2.5 cm. in diameter underlay a sinus in the right temporalarea which was discharging a serous fluid. The left shoulder was ankylosed in a position of adduction. The patient limped on the right leg, with pain in the right hip on motion. The physical findings were otherwise of no significance. Laboratory study gave the following findings: Hemoglobin, 70 per cent; red blood cells, 3,700,000; white blood cells, 15,000 to 17,000 with polymorphonuclears (neutrophiles) 50 per cent, polymorphonuclears (eosinophils) 1 per cent, lymphocytes 41 per cent, large mononuclears and transitionals 8 per cent. Anisocytosis and poikilocytosis were present. The Wassermann (Kölmer technic) was negative on three examinations, the last two after provocative treatment. The von Pirquet skin test was negative.

LIPIN INTERSTITIAL KERATITIS

The condition under consideration may be defined as a deep interstitial fat and cellular infiltration of the cornea (usually vascular) and part of a disturbance in fat metabolism. The process is usually protracted, painless and bilateral, though a long interval may separate involvement of the second eye. EARLY, ACTIVE LESION The deep central area of the cornea or its margin may be affected first. Careful biomicroscopic methods usually show a deep peripheral feed in the central lesions. The earliest changes consist of fine droplets, varying in size, and cells infiltrating the substantia propria, associated with loss of transparency anterior to Descemet's membrane, and associated with endothelial pitting. A deep vascular loop composed of an entering small artery and a larger returning vein pushes in, preceded by an arc of loss of transparency. Adjacent to the loop may be seen the minute droplets. The cell stream in the early and

FAT AND THE DIABETIC PATIENT

Conventionally, diabetes is considered a disease involving, primarily, carbohydrate metabolism. The striking effect of insulin on the concentration of blood sugar has served to confirm the association. Nevertheless, the disturbance of fat metabolism plays no small part in the pathogenesis of this disease. In a recent review, Joslin¹has summarized various aspects of the significance of fat to the diabetic patient. He repeatedly points out the great change brought about in the outlook for the diabetic child by the introduction of insulin. Among the results of the prolongation of life of this younger group of patients is the realization not only that heredity plays an important part in the predisposition to the disease but also that obesity alone is probably a less significant factor than was formerly believed; it merits special attention when there is a hereditary tendency. Although the obese person may show a decreased pancreatic efficiency, the