Showing papers by "Baylor College of Medicine published in 1982"
TL;DR: The enzymatic 32P-postlabeling method appears applicable to the ultrasensitive detection of a large number of carcinogen--DNA adducts of diverse structure without requiring radioactive carcinogens or specific antibodies.
Abstract: A newly developed enzymatic /sup 32/P-postlabeling method was applied to the analysis of DNA's containing non-radioactive arylamine, arylamide, and polycyclic aromatic hydrocarbon adducts. DNA reacted in vitro with N-hydroxy-2-amino-fluorene, N-acetoxy-2-acetylaminofluorene, and 7 beta,8 alpha-dihydroxy-9 alpha,10 alpha-epoxy-7,8,9,10-tetrahydrobenzo(a)pyrene, respectively, as well as DNA preparations from the liver of rats treated with N-hydroxy-2-acetylaminofluorene and benzo(a)pyrene, respectively, were enzymatically digested to deoxyribonucleoside 3'-monophosphates, which were then converted to (5'-/sup 32/P)deoxyribonucleoside 3',5'-bisphosphates by T4 polynucleotide kinase-catalyzed (/sup 32/P)phosphate transfer from (gamma-/sup 32/P)ATP. The /sup 32/P-labeled nucleotides were resolved by anion-exchange t.l.c. on polyethyleneimine-cellulose and detected by autoradiography. Aromatic adduct nucleotides were found to be retained at the origin in aqueous electrolyte solutions, but to migrate as distinct spots in solvents containing 7-8.5 M urea. Advantage was taken of this observation to remove /sup 32/P-labeled normal DNA nucleotides from adduct nucleotides. This purification enabled the detection of a single adduct in 10(7)-10(8) normal nucleotides. The method appears applicable to the ultrasensitive detection of a large number of carcinogen--DNA adducts of diverse structure without requiring radioactive carcinogens or specific antibodies.
670 citations
TL;DR: During the remainder of the nineteenth century, a number of investigators reported observations on the pathology, histoanatomy, and pathogenesis, further clarifying the nature of the disease, and much of this was resolved in 1934 by Shennan4* in his classical treatise on the subject.
661 citations
TL;DR: A plate method is described which allows rapid detection and measurement of the extracellular activity in a number of clinical isolates and a large variation in phospholipase activity is found between different isolates of C. albicans, however the Pz value is constant for any one isolate regardless of the site from which it is recovered in the patient.
Abstract: Intracellular phospholipase activity has previously been detected in Candida albicans. A plate method is described which allows rapid detection and measurement of the extracellular activity in a number of clinical isolates. The ratio of colony diameter to diameter of the dense white zone of precipitation around phospholipase positive colonies, (Pz value), correlates with hydrolysis of [14C]phosphatidylcholine by concentrated culture filtrates of selected test isolates. A large variation in phospholipase activity is found between different isolates of C. albicans, however the Pz value is constant for any one isolate regardless of the site from which it is recovered in the patient. Fifty five % of fresh blood isolates are positive and these are also the most potent phospholipase producers. Fifth % of wound isolates and 30% of urine isolates are also positive. A larger sample group must be studied, however, before it can be determined whether these differences are highly significant.
618 citations
TL;DR: The importance of calmodulin for G1-S progression is suggested by the ability of the anticalmodulin drug W13 to elicit specific and reversible progression delays into and through S phase.
402 citations
TL;DR: In this review, only complete disappearance of the gallstones is accepted as a successful result, since reduction of size during treatment does not guarantee that continued treatment will result in complete dissolution.
Abstract: Effectiveness Dissolution of Gallstones. In almost every report of treatment of patients with cholesterol gallstones with UDCA, the calculation of the success rate is based on the sum of the complete and partial dissolutions, in this review~ only complete disappearance of the gallstones is accepted as a successful result, since reduction of size during treatment does not guarantee that continued treatment will result in complete dissolution. Data from publications which do not distinguish between partial and complete dissolution in presenting the rate of successful treatment are therefore not included in the tabulations. Furthermore, some of the authors display their data in a way which makes it impossible to understand their results. This is attributable in no small measure to changes of dosage during the trial instead of continuing with a given dose in a given patient. Where the dose is stated in mg/kg/day, it was certainly not prescribed that way. The investigators prescribed the number of tablets or capsules to be taken daily, then calculated the dose on a weight basis. The smallest number of patients in any series was 12 (140), the largest 106 (145), the latter a multicenter study. The total number of patients entered in all series (Table 18) was 852, of whom 128 (15%) dropped out. Drop-outs are defined in this review as
328 citations
TL;DR: The purpose of this review is to compare the findings on various steroid receptors and to suggest that there may be certain broad similarities about these receptors.
Abstract: I. Introduction Steroid hormones act on a wide variety of target cells to alter their structure and function in remarkably diverse ways. However, much evidence has accumulated to suggest that the different steroid hormones, and even the sterol 1,25-dihydroxyvitamin D, act via similar pathways to produce the same general effects, i.e. the induction of RNA and protein synthesis. These effects are mediated by specific, high affinity hormone-binding proteins termed “receptors.” Steroid receptors have been described in many different target tissues, and they often seem to display as many differences as similarities in both their native structure and their various in vitro physicochemical transformations. Yet the homologies of structure of the different steroid hormones, and the similarities in their effector pathways and general metabolic effects, suggest that there may be certain broad similarities about these receptors. It is the purpose of this review to compare the findings on various steroid receptors and...
314 citations
TL;DR: The reciprocal interaction between psychotherapy and theoretical assumptions is illustrated through observations of anorexia nervosa and traditional psychoanalysis was found to be rather ineffective, whereas an approach evoking active participation on the part of the patient led to better treatment results.
Abstract: The reciprocal interaction between psychotherapy and theoretical assumptions is illustrated through observations of anorexia nervosa Traditional psychoanalysis, with its emphasis on interpretation of unconscious processes, was found to be rather ineffective, whereas an approach evoking active participation on the part of the patient led to better treatment results The experience of being listened to appeared to be of utmost importance The characteristic deficits in self-concept and body awareness could be related to a paucity or an absence of confirming responses in the early mother-child interactions This concept reinforced the focus on encouragement of initiative and autonomy during therapy
305 citations
TL;DR: The immunologic system in human milk undergoes remarkable changes which may represent adaptations for the recipient infant, and secretory IgA antibody titers to E. coli increased in some individuals studied longitudinally suggesting that the enteromammary gland pathway of SIgA antibody production was active after several weeks of lactation.
291 citations
TL;DR: The utilization of dopamine in the adult human retina was examined by using high‐affinity uptake, localization, synthesis, and release as neurotransmitter‐specific physiological probes to demonstrate that mechanisms for dopamine neurotransmission are present in the human retina.
Abstract: The utilization of dopamine in the adult human retina was examined by using high-affinity uptake, localization, synthesis, and release as neurotransmitter-specific physiological probes. Autoradiographic and histochemical studies have shown that dopamine-accumulating and dopamine-containing cells of the human retina belong to a population of neurons whose somata are located in the proximal regional of the inner nuclear layer. Some of these are amacrine cells which are pre- and postsynaptic to other amacrine cells exclusively in the inner plexiform layer. However, evidence is presented which indicates the existence of interplexiform dopaminergic neurons which send processes to both plexiform layers of the retina. These neurons contain a high concentration of dopamine, take up 3H-dopamine by a hig-affinity mechanism, and release endogenous or accumulated dopamine by a Ca2+-dependent mechanism upon depolarization with high extracellular K+. An endogeneous level of about 20 pmoles dopamine per mg protein was measured in freshly isolated retina using high-pressure liquid chromatography with electrochemical detection. These results demonstrate that mechanisms for dopaminergic neurotransmission are present in the human retina.
271 citations
TL;DR: Variceal hemorrhage may serve as a prototype for problems of survival analysis of diseases with early high mortality and time, as a variable factor both for randomization and therapeutic intervention, has been largely ignored.
261 citations
TL;DR: The regulation of flagellar motility in cAMP and calcium includes mechanisms involving the control of the phosphorylation state of sperm proteins, some of which may be axonemal components.
Abstract: Motility and protein phosphorylation have been measured under identical experimental conditions in ejaculated dog sperm lysed with low concentrations of Triton X-100 and reactivated with [gamma-32P]ATP. Cyclic AMP stimulates motility and protein phosphorylation while calcium inhibits motility and the overall incorporation of phosphate into endogenous proteins. Analysis of 32P-labeled sperm proteins on 1- and 2-dimensional polyacrylamide gels demonstrates that an enhanced phosphorylation of a defined number of specific proteins is associated with cAMP-stimulated motility. A major axonemal proteins, namely tubulin, has been tentatively identified as a phosphoprotein subject to regulation by cAMP. The phosphorylation of tubulin is almost completely dependent upon cAMP and is not affected by microM calcium. On the other hand, the cAMP-dependent stimulated phosphorylation of the other sperm proteins still occurs, but in most instances at a reduced rate in the presence of calcium. Two high molecular weight (Mr) phosphoproteins (350,000 and 260,000 daltons) whose phosphorylation states are modified by cAMP and calcium also were identified. It is suggested that 1 or both these proteins may be high Mr subunits of dynein. The phosphorylation of 1 of these proteins is stimulated by cAMP, but not affected by calcium; the other is stimulated by cAMP and inhibited by calcium. Three major cAMP-independent phosphoproteins of Mr 98,000, 43,000 and 26,000 have been identified. The phosphorylation of the 98,000 Mr protein is markedly reduced by micromolar calcium and not restored by cAMP. Using anticalmodulin drugs to inhibit motility, we suggest that the inhibitory effects of calcium on flagellar motility may be mediated in part by calmodulin. We conclude that the regulation of flagellar motility in cAMP and calcium includes mechanisms involving the control of the phosphorylation state of sperm proteins, some of which may be axonemal components.
TL;DR: Although the degree of renal dysfunction on admission was independent of the severity of metabolic acidosis, it was responsible for the variable retention of plasma ketones: the more severe the volume depletion on admission, the greater the ketone retention and the less prominent the hyperchloremic acidosis.
Abstract: In a study of the types of plasma acid-base patterns present at 196 admissions for diabetic ketoacidosis we found no relation between the initial level of serum total carbon dioxide and the plasma anion gap; instead, there was a broad spectrum of acid-base patterns, ranging from pure anion-gap acidosis to pure hyperchloremic acidosis. Although the degree of renal dysfunction on admission, which reflected the magnitude of volume depletion, was independent of the severity of metabolic acidosis, it was responsible for the variable retention of plasma ketones: the more severe the volume depletion on admission, the greater the ketone retention and the less prominent the hyperchloremic acidosis. Recovery from acidosis was significantly slower in patients admitted with pure hyperchloremic acidosis. After therapy, hyperchloremia developed in most patients at four to eight hours after admission, because of the retention of chloride in excess of sodium and the excretion of ketones by the kidney.
TL;DR: In this article, synchronized cultures of V79-8 Chinese hamster lung fibroblasts were used to identify the bromodeoxyuridine-containing chromosome bands by fluorescence microscopy.
TL;DR: It is concluded that interstitial retinol-binding protein is the best candidate for a transport protein carryingretinol between the rod outer segments and the pigment epithelium.
TL;DR: A prospective trial was performed in which biopsy and cytology specimens were obtained on 202 consecutive patients including 47 with esophageal or gastric carcinomas, and seventeen percent of all lesions subsequently proven to be malignant were thought to be benign, endoscopically.
TL;DR: A simple, rapid procedure for obtaining partial peptide maps from nanogram quantities of protein in gel slices using the selective tryptophanyl peptide bond cleavage reagent N-chlorosuccinimide/urea is presented.
TL;DR: Two cyclic peptides containing disulphide bonds are synthesized from a hydrophilic region of the major viral polypeptide of hepatitis B virus, which elicited an antibody response in mice after a single injection without linkage to a protein carrier.
Abstract: A formalin-inactivated hepatitis B virus (HBV) vaccine has been produced in several laboratories (for review, see ref. 1). The sole source of material for these vaccines has been 22-nm lipoprotein particles composed of hepatitis B surface antigen (HBsAg) and derived from plasma of persons chronically infected with HBV. Such a source presents potential hazards in view of unknown factors that may be present in the plasma, and as high-risk populations are immunized, sources of plasma containing large quantities of HBsAg will become scarce. In addition, no tissue culture system has been developed for the propagation of HBV. The possibility of a synthetic peptide vaccine2,3 for HBV had been suggested2,3 following studies carried out with tobacco mosaic virus4,5 and MS-2 coliphage6. This possibility recently became a reality when the amino acid sequence for HBsAg was deduced from the nucleotide sequence of the cloned HBV genome (for a review, see ref. 7). More recently a portion of the major polypeptide derived from HBsAg, with a calculated molecular weight of 25,000 (P25), has been sequenced8. Lerner et al.9 have described a similar approach towards HBV synthetic peptides. Antibody to HBsAg (anti-HBs) was raised in rabbits inoculated with three or four doses of a series of peptides, each containing 14–15 amino acid residues, but only after covalent linkage of the peptides to a carrier protein. Activity was also found after multiple injections of a peptide containing 34 amino acids. We have now synthesized two cyclic peptides containing disulphide bonds, both unrelated to those prepared by Lerner, from a hydrophilic region of the major viral polypeptide, which elicited an antibody response in mice after a single injection without linkage to a protein carrier.
TL;DR: The massive triglyceride accumulation produced in macrophages by hypertriglyceridemic VLDL is a direct consequence of uptake via specific receptors that also recognize cholesteryl ester-rich V LDL and LDL but are distinct from the acetyl LDL receptor.
Abstract: A B S T R A C T Triglyceride-rich lipoproteins may be responsible for the lipid accumulation in macrophages that can occur in hypertriglyceridemia. Chylomicrons and very low density lipoproteins (VLDL, total and with flotation constant [Sf] 100-400) from fasting hypertriglyceridemic subjects induced a massive accumulation of oil red 0-positive inclusions in unstimulated peritoneal macrophages. Cell viability was not affected. The predominant lipid that accumulated in cells exposed to hypertriglyceridemic VLDL was triglyceride. Hypertriglyceridemic VLDL stimulated the incorporation of [14C]oleate into cellular triglyceride up to ninefold in 16 h, but not into cholesteryl esters. Mass increase in cellular triglyceride was 38-fold. The stimulation of cellular triglyceride formation was dependent on time, temperature, and concentration of hypertriglyceridemic VLDL. By contrast, VLDL, low density, and high density lipoproteins from fasting normolipemic subjects had no significant effect on oleate incorporation into neutral lipids or on visible lipid accumulation. 1251-Hypertriglyceridemic VLDL (Sf 100-400) were degraded by macrophages in a dose-dependent manner, with 50 and 100% saturation observed at 3 and 24 Ag protein/ml (2.5 and 20 nM), respectively. Hypertriglyceridemic VLDL inhibited the internalization and degradation of '251-hypertriglyceridemic VLDL (4 nM) by 50% at 3 nM. Cholesteryl ester-rich VLDL from cholesterol-fed rabbits gave 50% inhibi
TL;DR: In three patients who underwent transvenous balloon catheter dilation of the pulmonary veins the procedure provided immediate but transient relief of the stenosis.
Abstract: Congenital stenosis of the pulmonary veins is a rare but frequently lethal congenital cardiac abnormality. Eight patients with this malformation were diagnosed, evaluated and treated. All eight patients had associated congenital cardiac defects. Two of the eight died, one of sepsis and one after operative pulmonary venoplasty. In three patients who underwent transvenous balloon catheter dilation of the stenosis the procedure provided immediate but transient relief of the stenosis. The prognosis for symptomatic infants with pulmonary vein stenosis is poor and its treatment an enigma.
TL;DR: Findings support observations that the timing and nutrient composition of meals have acute and demonstrable effects on behavior.
TL;DR: The previously advanced hypothesis that desiccation resistance involves the replacement of water adjacent to intracellular surfaces with polyhydroxy compounds has been supported by experiments on cysts of the brine shrimp, Artemia, and in a model system of albumin--glycerol--water, using nuclear magnetic resonance spectroscopy, microwave dielectrics, and density measurements.
TL;DR: The applicability of a general theory of deviant behavior to explaining drug use among junior high school students is tested using data from a three-wave panel and the results are consistent with the representation of drug use as the outcome of student's recognition of the self-devaluing implications of membership group experiences.
Abstract: The applicability of a general theory of deviant behavior to explaining drug use among junior high school students (N=3,148) is tested using data from a three-wave panel. The five-stage path model consists of eleven constructs measured at two points in time and one construct (drug use) measured at three points in time. The results of the analyses are consistent with the representation of drug use as the outcome of: (1) student's recognition of the self-devaluing implications of membership group experiences, (2) exacerbation of the self-esteem motive; and of the effects of these two concurrent processes, including decreased identification with the normative structure, increased perception of the self-enhancing potential of deviant responses, increased perception of the prevalence of drug use, and increased association with friends who use drugs.
TL;DR: Familial cavernous angioma should be included in the differential diagnosis of all young persons presenting with cerebrovascular impairment, seizures, intracranial calcifications or hemorrhage, and for at-risk and affected patients early and sequential CCTs are necessary.
Abstract: In a kindred of 122 individuals we found 5 individuals with cerebral vascular malformation, 3 representing typical cavernous angiomas. The condition was inherited as an autosomal dominant trait with variable expressivity. Forty-three relatives were examined prospectively by cranial computed tomography (CCT) and lesions were found in 15; 7 were followed prospectively with CCT scans for 5 years. Angiography in 5 of these cases failed to demonstrate the lesion. In 3 patients with previously normal CCT scans a change in blood volume or membrane permeability allowed visualization of the lesion on contrast scans. In 2 individuals, both parents of affected children, a normal CCT scan was found. This emphasizes the limitations of CCT in detecting this disorder. Biochemical and red blood cell immunological genetic linkage studies were done in 36 persons. No linkage was found with any of the markers. The natural history of this disorder, characterized by marked clinical and radiographic variation in site of lesion, and the timing and severity of intracranial hemorrhage, make it a useful model for investigating contributing factors and consequences of intracranial hemorrhage in general. For at-risk and affected patients early and sequential CCTs are necessary. Familial cavernous angioma should be included in the differential diagnosis of all young persons presenting with cerebrovascular impairment, seizures, intracranial calcifications or hemorrhage.
TL;DR: Of the preselected factors studied, only hemodialysis and parenteral hyperalimentation correlated with an increased incidence of endophthalmitis and preliminary data indicate the test may prove to be of clinical value.
TL;DR: The results from this study suggest that the lipoproteins extracted from the human aorta may represent either the preferential retention of a subclass of plasma LDL with slightly different characteristics from the average but with greater affinity for intimal material, or the products of modification of normal plasma LDL following retention by extracellular components of the aortic intima.
TL;DR: The average location of the fovea in relation to the optic nerve head was determined on fixation photographs from both eyes of 50 non-strabismic subjects and it was found to be 0.3 disc diameters below a horizontal line extended through the geometric center of the optic disc.
TL;DR: It is suggested that the greatest benefit in terms of improved survival may come from the first two to three grafts placed in patients with two- and three-vessel disease.
Abstract: ,SUMMARY Todetermine theindependent influence oftheextentandsite ofresidual disease on late survival, we analyzed thefate of1448consecutive patients whohadcoronary arterybypass surgery during 1968-1974. There were 1274males, mean age53.4+ 8years(range 24-75years). Females were excluded fromfurther analysis. Twohundred twenty-six patients (17.7%) hadone-vessel disease, 492(38.6%)had two-vessel disease, 408(32.0%) hadthree-vessel disease and148(11.6%) hadleft mainstenosis. Survival was determined ata follow-up ofatleast 5years. Survival data wereanalyzed byKaplan-Meier survival curvesforthepatients withtwo-andthree-vessel disease according totheextent ofresidual disease. Forpatients withtwo-vessel disease andgoodventricular function, survival was similar at5years,89.1 % and87.7 % forno andone residual lesion; forthose with two-vessel disease andpoor ventricular function, 5-year survival was 84.5%and52.6%forno andone residual lesion; forthose withthree-vessel disease andgoodventricular function, itwas 92.0%,83.4 %, and 75.0 % forno,oneandtworesidual lesions, respectively. Withpoorventricular function, thecorresponding results were 83.1%,72.5%and23.1%. TheCoxmultivariate analysis technique was usedtoanalyze theinfluence ofage atoperation, numberof vessels diseased preoperatively, preoperative left ventricular function, period ofsurgery,andthenumber andsite ofresidual lesions after operation. Residual disease, ageatoperation andleft ventricular function werethemostimportant variables affecting survival ofpatients withtwo-andthree-vessel disease. Residual lesions oftheleft anterior descending orcircumflex coronaryarteries werethemostimportant predictors of survival; residual lesions oftheright coronaryartery exerted a lesser influence. Theresults ofthis study suggest thatthegreatest benefit intermsofimproved survival may come fromthefirst twotothree grafts placed. EARLYinourexperience withcoronary bypass, we observed, asdidothers, that operation inpatients with multivessel coronary disease appeared tohaveamore favorable outcome whenmultiple grafts wereplaced.'-' Thus, theconcept developed that ifall significant coronarylesions werebypassed, i.e., complete revascularization wasachieved, superior relief ofsymptoms and enhanced survival wouldresult. However, thevalidity ofthis concept isdifficult to prove, particularly withregard tosurvival. Incomplete revascularizatio n hasbeenmorelikely tooccurinpatients withother variables knowntoaffect survival adversely, suchasextensive multivessel coronary disease, which itself isassociated withhigher prevalence ofpoorleft ventricular function.7 Therefore, despite observations that suggest thebenefits ofcomplete revascularization,6 'analysis oftheinfluence ofresidual disease onsurvival according tothepresence orabsence ofresidual disease alone, without adjustment for other variables, maynotprovide anaccurate assessmentoftheinfluence ofresidual disease onsurvival. Furthermore, theinfluence ofresidual disease ofspecific vessels hasnotbeenexamined. Theaimofthisstudy wastodetermine whether
TL;DR: Immunoreactive PTH (iPTH) was detectable in 85 of 92 normal subjects, with a normal range of about 0.1–0.5 µU/ml hPTH Research Standard 75/549, and iPTH values in hypercalcemia due to malignancy or other nonparathyroid causes were indistinguishable...
Abstract: A new type of RIA for human parathyroid hormone (hPTH) is described. The antiserum was generated in a goat against hPTH, and the radioligand is a carboxy-terminal fragment of bovine PTH (bPTH). Although the antiserum is bivalent, use of the fragment as tracer yields an assay monospe-cific for the midregion of the PTH molecule. The assay can detect 0.3 fmol/tube of intact hPTH-(l–84) or 0.1 fmol synthetic hPTH-(44–68), but does not detect hPTH-(l–34), hPTH-(53–84), or bPTH-(28–48). Immunoreactive PTH (iPTH) was detectable in 85 of 92 normal subjects, with a normal range of about 0.1–0.5 µU/ml hPTH Research Standard 75/549. iPTH was undetectable in 22 consecutive severely hypoparathyroid patients and was above normal in 147 of 158 patients with primary hyperparathyroidism. In 60 patients with nonparathy-roid hypercalcemia, iPTH averaged 20% lower than in normal subjects, but was still detectable in 80%. Mean iPTH values in hypercalcemia due to malignancy or other nonparathyroid causes were indistinguishable...
TL;DR: Human α1-antitrypsin and chicken ovalbumin show significant sequence homology and belong to a common protein super-family, yet the number, position and size of intervening sequences reveal that the two genes are dissimilar.
Abstract: The human chromosomal α1-antitrypsin gene has been cloned. This gene is approximately 5 kilobase pairs long and contains three intervening sequences in the peptide-coding region. DNA sequences coding for the amino and carboxyl termini of α1-antitrypsin have been identified. Human α1-antitrypsin and chicken ovalbumin show significant sequence homology and belong to a common protein super-family. Yet the number, position and size of intervening sequences reveal that the two genes are dissimilar.
TL;DR: Forty-five millimoles of phosphate prevented severe hypophosphatemia in all but one patient and produced substantially higher phosphate levels at 8, 16, and 24 hours, and phosphate therapy is not an essential part of the therapy for DKA in most patients.
Abstract: To determine the efficacy of phosphate replacement in the therapy for diabetic ketoacidosis (DKA), 44 patients were randomly assigned to three treatment groups: those who received no phosphate replacement, those who received 15 mmole of sodium phosphate at the fourth hour, or those who received 15 mmole of sodium phosphate at 2, 6, and 10 hours. All patients were treated with intravenous insulin injection (0.1 units/kg/hr), fluids, and potassium. Four hours after a 15-mmole sodium phosphate infusion, the serum phosphate level was 2.8 ± 0.8 mg/dl vs 2.1 ± 0.8 mg/dL in the control patients; however, this dose was insufficient to maintain the serum phosphate level at 16 and 24 hours. Forty-five millimoles of phosphate prevented severe hypophosphatemia in all but one patient and produced substantially higher phosphate levels at 8, 16, and 24 hours. Phosphate therapy did not affect the duration of DKA, dose of insulin required to correct the acidosis, abnormal muscle enzyme levels, glucose disappearance, or morbidity and mortality. Although theoretically appealing, phosphate therapy is not an essential part of the therapy for DKA in most patients. (Arch Intern Med1982;142:517-520)