Fasting reduces the rate of cortisone inactivation in rat liver slices; the inhibition of cortisone inactivation is greater in male than in female rats. The decline in steroid reduction occurs only if the glucose-6-phosphate content of the liver has reached one tenth of the control value. A significant decrease in liver glycogen and a twofold increase in liver glucose-6-phosphatase-activity alone are without influence on the rate of cortisone reduction. During the fasting periods of 42 and 60 hours the activity of the glucose-6-phosphate-dehydrogenase remains unchanged. Intraperitoneal injection of glucose normalizes the rate of cortisone inactivation in the course of 2 hours. The disturbed carbohydrate metabolism is not the only cause of the decreased cortisone reduction; almost one third can be accounted for by the lowered activity of the microsomal 5α-reductase.

No abstract

The documentation of illness-related data, e.g. repetitive recordings of pain parameters, medication or mood, is commonly accomplished by the use of questionnaires. Several disadvantages for both the patient and experimentor related to this method can be avoided by the application of specially designed data-loggers. The use of commercially available portable pocket computers is usually complicated because of the miniature full-range keybords. This paper describes a completely new design, which relies on the use of only four keys. All operations are imaged on an LCD display (4 lines with 16 signs). The Rating Box allows the presentation of visual analogue scales (VAS) of different step widths, movement of cursors, forced choice and multiple choice decisions, as well as the input of decimal numbers. Up to 11 scale types can be deliberately combined in a series of up to 27 items. The combination can be individually designed and edited by the experimentor. The results are stored together with the input time and date. Actual inputs are not influenced by comparison to earlier input, since data recall can only be accessed by the experimentor. The use of the Rating Box by a patient is called up by signal tones at individually given times of day. Additional inputs are possible when required. Warnings are presented for general malfunctions. The results can be transmitted to a personal computer and processed statistically or to daily or weekly profiles of mood, pain or disability scores, for example. A pilot study in elderly patients (42-76 years) with pain due to cancer gave promising results. The Rating Box was well accepted as opposed to a questionnaire. Nine out of 12 patients preferred the Rating Box both methods were judged to be equivalent by two patients and only one regarded the use as difficult and thus preferred the questionnaire. In addition, 5 out of 12 patients confessed by inquiry to have filled in the questionnaire forms retrospectively. This possibility is in principle excluded by the Rating Box.

In vitro perfusion experiments were carried out with adrenal glands surgically removed from a patient with Cushing's syndrome (hyperplasia of the adrenal cortex) and a patient with Conn's syndrome (adrenal cortical adenoma). From the perfusates the following steroids were extracted, estimated and identified: cortisol, corticosterone, 11β-hydroxyandrostenedione, cortisone and aldosterone. The secretion capacities of the right Cushing adrenal and of the adrenal gland bearing the adenoma were compared with each other. In both adrenals cortisol was the main secretion product and the secretion rates of aldosterone were lowest and practically equal. The Cushing adrenal differed from the adrenal gland with the adenoma in its higher secretion rate of all investigated steroids except aldosterone, in its higher cortisol/aldosterone ratio and in its response to the administration of ACTH. To this stimulus the aldosterone production of the Cushing adrenal reacted in the same rate as the cortisol release. The adrenal gland with the adenoma of the patient with Conn's syndrome had only a relatively higher aldosterone secretion rate in respect to its lower cortisol production (lower cortisol/aldosterone ratio). The total preparation consisting of the adrenal with the adenoma responded neither to ACTH nor to hypertensin. The missing response of the adrenal cortex not including the tumor to ACTH is explained by the structural change in the sense of the so called regressive transformation (small zona fasciculata with relative large zona glomerulosa and reticularis) which was found in our case. Dehydroepiandrosterone was demonstrable in none of the perfusate extracts even under the condition where the left adrenal of the Cushing patient was perfused with added 17α-hydroxy-pregnenolone.