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Myocardial infarction is one of the major life-threatening diseases. The cause is atherosclerosis i.e. the occlusion of the coronary artery by deposition of plaque on its walls. The severity of plaque deposition in the artery depends on the characteristics of the plaque. Hence, the classification of the type of plaque is crucial for assessing the risk of atherosclerosis and predicting the chances of myocardial infarction. This paper proposes prediction of atherosclerotic risk by non-invasive ultrasound image segmentation and textural feature extraction. The intima-media complex is segmented using a snakes-based segmentation algorithm on the arterial wall in the ultrasound images. Then, the plaque is extracted from the segmented intima-media complex. The features of the plaque are obtained by computing Hu's moment invariants. Visual pattern recognition independent of position, size, orientation and parallel projection could be done using these moment invariants. For the classification of the features of the plaque, an SVM classifier is used. The performance shows improvement in accuracy using lesser number of features than previous works. The reduction in feature size is achieved by incorporating segmentation in the pre-processing stage. Tenfold cross-validation protocol is used for training and testing the classifier. An accuracy of 97.9% is obtained with only two features. This proposed technique could work as an adjunct tool in quick decision-making for cardiologists and radiologists. The segmentation step introduced in the preprocessing stage improved the feature extraction technique. An improvement in performance is achieved with much less number of features., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

A third of deaths in the world are due to cardiovascular diseases [1]. Atherosclerosis is the major cause of myocardial infarction, which occurs by deposition of plaque in the coronary artery. The chance of stroke rises with the thickening of carotid artery due to the plaque. Hence, accurate measurement of the intima-media thickness is necessary for predicting the chance of stroke. The stopping criterion and active resampling are incorporated in greedy snake segmentation technique. This modified algorithm segmented and extracted the intima-media complex in the ultrasound images. The snake control points obtained from the boundary of the region of interest forms the contour and demarcates the boundary of intima-media complex. The thickness ± standard deviation and the intra-observer error values obtained by modified algorithm are in conformity with the measurements by expert. The intra-observer error values for greedy snake segmentation methods were 0.10 and 0.09 for manual snake initialization and automatic snake initialization, respectively. Shapiro-Wilk test and One-way ANOVA test explains there is no statistical difference between group means obtained from these segmentation techniques and the expert measurement. The statistical analysis proves values of the intima-media thickness obtained from both snake segmentation techniques are very close to expert measurements., (© 2022. International Federation for Medical and Biological Engineering.)

The prevalence of peripheral neuropathy in general population is ever increasing. The diagnosis and classification of peripheral neuropathies is often difficult as it involves careful clinical and electro-diagnostic examination by an expert neurologist. In developing countries a large percentage of the disease remains undiagnosed due to lack of adequate number of experts. In this study a novel clinical decision support system has been developed using a fuzzy expert system. The study was done to provide a solution to the demand of systems that can improve health care by accurate diagnosis in limited time, in the absence of specialists. It employs a graphical user interface and a fuzzy logic controller with rule viewer for identification of the type of peripheral neuropathy. An integrated medical records database is also developed for the storage and retrieval of the data. The system consists of 24 input fields, which includes the clinical values of the diagnostic test and the clinical symptoms. The output field is the disease diagnosis, whether it is Motor (Demyelinating/Axonopathy) neuropathy, sensory (Demyelinating/Axonopathy) neuropathy, mixed type or a normal case. The results obtained were compared with the expert's opinion and the system showed 93.27 % accuracy. The study aims at showing that Fuzzy Expert Systems may prove useful in providing diagnostic and predictive medical opinions. It enables the clinicians to arrive at a better diagnosis as it keeps the expert knowledge in an intelligent system to be used efficiently and effectively.

Henoch-Schönlein purpura is an IgA-mediated, autoimmune, hypersensitivity vasculitis of childhood that results in a triad of symptoms, including a purpuric rash occurring on the lower extremities, abdominal pain or renal involvement, and arthritis. However, any of the triad may be absent, which often leads to a confusion in diagnosing the condition. Although the cause is unknown, Henoch-Schönlein purpura (HSP) is often associated with infectious agents, such as group A streptococci and mycoplasma. It has also been associated with food reactions, exposure to cold, insect bites, and drug allergies. The treatment is supportive and needs close followup of renal status. This report describes a rare presentation of Henoch-Schönlein purpura with coronary vasculitis which leads to myocardial infarction at the age of 53. Henoch-Schönlein purpura was diagnosed on the basis of no infection, accelerated ESR (35 mm/h), normal platelet count, positive skin biopsy, proteinuria, and negative searches for rheumatoid factor (RF), antinuclear antibody (ANA), antineutrophil cytoplasmic antibodies (ANCA), and anti-dsDNA.

The diagnosis of carpal tunnel syndrome, a peripheral nerve disorder, at the earliest possible stage is very crucial because if left untreated it may cause permanent nerve damage reducing the chances of successful treatment. Here a novel Fuzzy Expert System designed using MATLAB is proposed for identification of severity of CTS. The data used were the nerve conduction study data obtained from Kannur Medical College, India. It consists of thirteen input fields, which include the clinical values of the diagnostic test and the clinical symptoms, and the output field gives the disease severity. The results obtained match with the expert's opinion with 98.4% accuracy and high degrees of sensitivity and specificity. Since quantification of the intensity of CTS is a crucial step in the electrodiagnostic procedure and is important for defining prognosis and therapeutic measures, such an expert system can be of immense use in those regions where the service of such specialists may not be readily available. It may also prove useful in combination with other systems in providing diagnostic and predictive medical opinions and can add value if introduced into the routine clinical consultations to arrive at the most accurate medical diagnosis in a timely manner.

An automated diagnostic system for diabetes mellitus (DM), from heart rate variability (HRV) measures, using feed forward neural network has been developed. Changes in autonomic nervous system activity caused by DM are quantified by means of time domain and frequency domain analysis of HRV. Electrocardiograms of 70 DM patients and 65 healthy volunteers were recorded. Nine time domain measures-standard deviation of all NN intervals, square root of mean of sum of squares of differences between adjacent NN interval (RMSSD), number of adjacent NN intervals differing more than 50 ms. (NN50 count), percentage of NN50 count, R-R triangular index, triangular interpolation of NN intervals (TINN), standard deviation of the mean heart rate, mean R-R interval and mean heart rate-were used as the input features to the neural network. This diagnostic system classifies DM patients and normal volunteers from morphologically identical ECGs. Diagnostic results show that the system is performing well with an accuracy of 93.08%, specificity of 96.92% and sensitivity of 89.23%.

Heart rate variability (HRV), analysis gives an insight into the state of the autonomic nervous system which modulates the cardiac activity. Here a digital signal controller based handy device is developed which acquires the beat to beat time interval, processes it using techniques based on non-linear dynamics, fractal time series analysis, and information theory. The technique employed, that can give reliable results by assessing heart beat signals fetched for a duration of a few minutes, is a huge advantage over the already existing methodologies of assessing cardiac health, those being dependant on the tedious task of acquiring Electro Cardio Gram(ECG) signals, which in turn requires the subject to lie down at a stretch for a couple of hours. The sensor used, relies on the technique of Photoplethysmography, rendering the whole approach as noninvasive. The device designed, calculates parameters like, Largest Lyapunov Exponent, Fractal dimension, Correlation Dimension, Approximate Entropy and α-slope of Poincare plots, which based on the range in which they fall, the cardiac health condition of the subject can be assessed to even the extend of predicting upcoming disorders. The design of heart beat sensor, the technique used in the acquisition of heart beat data, the relevant algorithm developed for the analysis purpose, are presented here.

Reliable detection of arrhythmias based on digital processing of Electrocardiogram (ECG) signals is vital in providing suitable and timely treatment to a cardiac patient. Due to corruption of ECG signals with multiple frequency noise and presence of multiple arrhythmic events in a cardiac rhythm, computerized interpretation of abnormal ECG rhythms is a challenging task. This paper focuses a Fuzzy C- Mean (FCM) clustered Probabilistic Neural Network (PNN) and Multi Layered Feed Forward Network (MLFFN) for the discrimination of eight types of ECG beats. Parameters such as fourth order Auto Regressive (AR) coefficients along with Spectral Entropy (SE) are extracted from each ECG beat and feature reduction has been carried out using FCM clustering. The cluster centers form the input of neural network classifiers. The extensive analysis of Massachusetts Institute of Technology- Beth Israel Hospital (MIT-BIH) arrhythmia database shows that FCM clustered PNNs is superior in cardiac arrhythmia classification than FCM clustered MLFFN with an overall accuracy of 99.05%, 97.14%, respectively.

The EEG (Electroencephalogram) signal indicates the electrical activity of the brain. They are highly random in nature and may contain useful information about the brain state. However, it is very difficult to get useful information from these signals directly in the time domain just by observing them. They are basically non-linear and nonstationary in nature. Hence, important features can be extracted for the diagnosis of different diseases using advanced signal processing techniques. In this paper the effect of different events on the EEG signal, and different signal processing methods used to extract the hidden information from the signal are discussed in detail. Linear, Frequency domain, time - frequency and non-linear techniques like correlation dimension (CD), largest Lyapunov exponent (LLE), Hurst exponent (H), different entropies, fractal dimension(FD), Higher Order Spectra (HOS), phase space plots and recurrence plots are discussed in detail using a typical normal EEG signal.

This work was undertaken to study whether consumption of alcoholic beverage mixed with soft drinks could reduce the metabolic effect caused by ethanol. When 24 hr fasted rats were intragastrically fed rum (with 40% ethanol) diluted (1:1) with water, 3.0 ml (0.5 g ethanol) per 100 g body weight and sacrificed 12 hr later in fasting condition, exhibited higher levels of triacyl glycerol, glucose, total cholesterol, high density lipoprotein (HDL), aspartate amino transferase (AST), alanine amino transferase (ALT) and alkaline phosphatase (ALP) in serum, higher levels of total cholesterol, triacyl glycerol and thiobarbituric acid reactive substances (TBARS) in both liver and kidneys, and lower levels of serum albumin. When fasted rats were fed 3.0 ml soft drink (0.31 mg caffeine), they showed increased levels of triacyl glycerol, glucose, ALT and ALP in the serum, TBARS in liver and kidneys, triacyl glycerol and total cholesterol in kidneys and lower levels of serum albumin. Soft drink feeding did not reduce serum total cholesterol but reduced HDL levels. Also soft drink did not alter liver lipids. When a mixture of 1.5 ml diluted rum (0.25 g ethanol) and 1.5 ml soft drink (0.154 mg caffeine) were fed to the fasted rats, the serum parameters increased similar to rats fed rum only except that total cholesterol and HDL cholesterol were unaltered. TBARS in kidneys and liver were also increased but triacyl glycerol levels were not altered. Thus feeding ethanol with soft drink does not reduce the metabolic effects of ethanol but it will prevent ethanol induced serum HDL cholesterol rise.

The rapid increase in the use of mobile phones (MPs) in recent years has raised the problem of health risk connected with high-frequency electromagnetic fields. There are reports of headache, dizziness, numbness in the thigh, and heaviness in the chest among MP users. This paper deals with the neurological effect of electromagnetic fields radiated from MPs, by studies on heart rate variability (HRV) of 14 male volunteers. As heart rate is modulated by the autonomic nervous system, study of HRV can be used for assessing the neurological effect. The parameters used in this study for quantifying the effect on HRV are scaling exponent and sample entropy. The result indicates an increase in both the parameters when MP is kept close to the chest and a decrease when kept close to the head. MP has caused changes in HRV indices and the change varied with its position, but the changes cannot be considered significant as the p values are high.

Mutations causing familial hypertrophic cardiomyopathy (HCM) have been described in at least 11 genes encoding cardiac sarcomeric proteins. In this study, three previously unknown deletions have been identified in the human cardiac genes coding for beta-myosin heavy chain (MYH7 on chromosome 14) and myosin-binding protein-C (MYBPC3 on chromosome 11). In family MM, a 3-bp deletion in MYH7 was detected to be associated with loss of glutamic acid in position 927 (DeltaE927) of the myosin rod. In two other families (HH and NP, related by a common founder) a 2-bp loss in codon 453 (exon 16) of MYBPC3 was identified as the presumable cause of a translation reading frame shift. Taken together 15 living mutation carriers were investigated. Six deceased family members (with five cases of premature sudden cardiac death (SCD) in families MM and NP) were either obligate or suspected mutation carriers. In addition to these mutations a 25-bp deletion in intron 32 of MYBPC3 was identified in family MM (five carriers) and in a fourth family (MiR, one HCM patient, three deletion carriers). In agreement with the loss of the regular splicing branch point in the altered intron 32, a splicing deficiency was observed in an exon trapping experiment using MYBPC3 exon 33 as a test substrate. Varying disease profiles assessed using standard clinical, ECG and echocardiographic procedures in conjunction with mutation analysis led to the following conclusions: (1) In family MM the DeltaE927 deletion in MYH7 was assumed to be associated with complete penetrance. Two cases of reported SCD might have been related to this mutation. (2) The two families, HH and NP, distantly related by a common founder, and both suffering from a 2-bp deletion in exon 16 of MYBPC3 differed in their average phenotypes. In family NP, four cases of cardiac death were documented, whereas no cardiac-related death was reported from family HH. These results support the notion that mutations in HCM genes may directly determine disease penetrance and severity; however, a contribution of additional, unidentified factors (genes) to the HCM phenotype can-at least in some cases-not be excluded. (3) The deletion in intron 32 of MYBPC3 was seen in two families, but in both its relation to disease was not unequivocal. In addition, this deletion was observed in 16 of 229 unrelated healthy individuals of the population of the South Indian states of Kerala and Tamil Nadu. It was not seen in 270 Caucasians from Russia and western Europe. Hence, it is considered to represent a regional genetic polymorphism restricted to southern India. The association of the deletion with altered splicing in transfected cells suggests that this deletion may create a "modifying gene", which is per se not or only rarely causing HCM, but which may enhance the phenotype of a mutation responsible for disease.

Coronary artery ectasia, a variant of coronary atherosclerosis, is a relatively rare entity. Review of literature did not reveal an exclusive study on isolated ectasia. We decided to analyse the clinical presentation and angiographic prevalence of this subset. A retrospective study of patients who underwent coronary angiogram in our institute over the past six years was carried out and the epidemiological, clinical and angiographic characteristics of patients with isolated ectasia were analysed. Distribution of ectasia was with a modification of the Markis classification. Among 6938 angiograms analysed, 134 (2%) had isolated ectasia. Of the 118 symptomatic patients, 34 (25%) had a history of or presented with infarction, with correlation between the territory of infarction and the ectatic vessel in 32 patients. Of 62 patients with lipid abnormality, Hypertriglyceridemia in 42 (65%) was the most common. The left anterior descending artery was the most common vessel involved. Diffuse ectasia most commonly involved the right coronary artery. One patient had spontaneous coronary dissection. There is a relatively high prevalence of isolated coronary ectasia with predominant involvement of the right coronary vessel when diffuse and the left anterior descending artery when discrete. This entity is not innocuous and warrants a detailed study on the available management options.

The hyperlipidemia, fatty liver and the high levels of liver and kidney thiobarbituric acid reactive substances (TBARS) observed in rats which were fed ethanol for 45 days, could be significantly reduced by feeding diacetodibutyl disulphide (DADBDS). Ethanol-induced hypoproteinemia and the rise in serum enzymes like AST (EC 2.6.1.10), ALT (EC 2.6.1.2) and ALP (EC 3.1.3.1) could also be ameliorated by DADBDS. Feeding of this compound to normal rats did not produce any change in serum or tissue lipid levels or serum enzymes or tissue TBARS except a moderate reduction in serum triacyl glycerols. DADBDS feeding to rats maintained on a high lipid diet could also reduce the serum and tissue lipid levels and also reduce the serum transaminases.DADBDS which is an aliphatic disulphide could produce hypolipidemic effects in rats fed a single large dose of ethanol, whereas dimenthol disulphide which is an aromatic disulphide was not useful as a hypolipidemic agent. Perhaps hypolipidemic effects are shown only by aliphatic disulphides and not by aromatic disulphides. Feeding of 100 mg DADBDS per kg body weight to normal fasted rats produced a mild hypoglycemia, but higher doses produced a hyperglycemic effect. This dose of DADBDS increased the serum insulin levels and reduced blood glucose levels in fasted diabetic rats, but DADBDS feeding did not alter the serum insulin levels in fasted normal rats. DADBDS is odourless and tasteless in 1% solution and it could be a better substitute for garlic for hypoglycemic and hypolipidemic studies.

Background: It is unclear whether blood transfusion can overcome the negative impact of anemia before or during radiotherapy (RT) in patients with carcinoma of the cervix. The objective of this retrospective study was to examine the impact of anemia and blood transfusion on 605 patients with carcinoma of the cervix treated with radical RT at 7 centers across Canada in 1989, 1990, and 1992., Methods: The data collected included hemoglobin (Hgb) levels from the time of diagnosis to the end of therapy; blood transfusions administered; and identifiable patient-, tumor-, and treatment-related factors. Survival, disease free survival, and pelvic control analyses were evaluated by univariate and multivariate analysis., Results: The median follow-up was 41 months (range, 0-92 months). Presenting Hgb level, average weekly nadir Hgb (AWNH) during RT, and blood transfusion were correlated significantly with local control, disease free survival, and overall survival on univariate analysis. However, the AWNH remained significant on multivariate analysis, whereas Hgb at presentation and blood transfusion did not. The 5-year survival was 74% for patients with an AWNH >/= 120 g/L, 52% for patients with AWNH levels 110-119 g/L inclusive, and 45% for patients with AWNH levels < 110 g/L (P < 0.0001). At each Hgb level, patients who were transfused and maintained a specific Hgb level had a survival rate that was not significantly different from patients who were at that level spontaneously. There was a significant reduction in both pelvic and distant recurrence (P < 0.0001 and P < 0.0006, respectively) in patients whose AWNH level during RT was >/= 120 g/L compared with < 120 g/L. A reduction in the rate of distant recurrence was observed in patients with and without pelvic recurrence., Conclusions: AWNH is highly predictive of outcome for patients treated with RT for carcinoma of the cervix. Blood transfusion appears to overcome the negative prognostic effects of low presenting Hgb levels and AWNH levels., (Copyright 1999 American Cancer Society.)

Percutaneous transvenous mitral commissurotomy (PTMC) using the Inoue technique was performed in 557 patients with rheumatic mitral stenosis. Of these, 107 were children aged 10-18 years (mean +/- SD 14.5 +/- 2.3). All patients were symptomatic New York Heart Association (NYHA) Class II (n = 78) and Class III (n = 29). All were in sinus rhythm. Following PTMC, the mitral valve area (MVA) increased from 0.73 +/- 0.18 to 1.7 +/- 0.53 cm2 (P < 0.001). There was a significant fall in mean transmitral gradient from 15.6 +/- 5.2 to 5.1 +/- 2.3 mmHg, and in mean pulmonary artery pressure from 41 +/- 15 to 28.4 +/- 10 (P < 0.001). Cardiac tamponade developed in one patient. One patient developed severe mitral regurgitation requiring emergency mitral valve replacement. Five patients (4.7%) developed moderate mitral regurgitation. There was no mortality or cerebral embolism in any of the children. Four patients (3.7%) had oximetry evidence of atrial septal defect. Mean mitral valve area and transmitral gradient at 14 months mean follow up was 1.68 +/- 0.4 cm2 and 6 +/- 3.5 mmHg, respectively, and were comparable to the immediate post-PTMC results. Two patients (1.8%) developed restenosis. The immediate haemodynamic results in children were compared to 450 adult patients who underwent PTMC in the same period. The outcome was similar in both groups. Children were found to have significantly higher pulmonary artery pressure compared to adults. We found that PTMC using an Inoue balloon is very effective and safe in children, and consider that it should be the procedure of choice for young patients with symptomatic rheumatic mitral stenosis.

Carcinoma of the prostate is one of the leading causes of death in men. Patients with localised disease can be treated with radiotherapy, but controversy still exists regarding the most effective therapeutic technique. We report 180 patients with surgical stage A2-C prostate cancer treated between 1976 and 1986 by pelvic lymphadenectomy and radioactive gold seed implantation followed by external irradiation. Annual post-treatment biopsies were performed up to 5 years in most patients. Regular follow-up included a digital rectal examination, prostatic acid phosphatase and bone scan. One hundred and sixty-four patients had complete follow-up data at the end-point of data collection (December 1991). The actuarial 10-year cancer-free survival rates were 83.0% and 91.3% for stages A2 and B1 respectively. The incidence of positive biopsy at 2 and 5 years was 13% and 17.1% respectively for the whole series. A firm correlation was defined between biopsy result and subsequent development of local progression, distant metastases and overall survival. Combined interstitial gold seed implantation plus external beam irradiation represent a valid option for the treatment of patients with localised prostatic cancer.

Feeding of ethanol and a high fat-high cholesterol diet to rats markedly increased the total lipids in the liver, and cholesterol and triglyceride levels in the serum, liver and kidneys. However, when ethanol mixed with 0.5% garlic oil was fed to animals maintained on the high fat-high cholesterol diet, these lipid levels were significantly reduced to levels near to those seen in untreated control rats. Garlic oil did not reduce the serum albumin or the total proteins of liver, kidneys or serum when fed along with ethanol. Probably the garlic oil enhances the catabolism of dietary cholesterol and fatty acids.

The feeding of a high fat-high cholesterol (HF-HC) diet to normal rats for 1 month increased the lipid components cholesterol and triglyceride in serum, liver and kidneys and decreased the serum albumin very significantly. Administration of garlic oil (100 mg/kg b. wt/day) for 1 month together with the HF-HC diet to another group almost nullified the lipid-increasing and albumin-decreasing effects of that diet. The reduction in total lipids, cholesterol and triglycerides and the restoration to normal level of serum albumin were highly significant in the garlic oil group. Adipose tissue triglyceride lipase activity was significantly increased in both the above groups with a much greater rise in the oil group.

Significant rise in urea and D-aspartate aminotransferase and inhibition of alkaline phosphatase in serum were observed in rats fed garlic extract (2 ml/100 g body wt, intragastrically) for 10 days. The liver showed histological changes. Garlic oil feeding (10 mg/100 g body wt, intragastrically) after 24 hr fasting was found lethal. The cause of death appears to be acute pulmonary oedema. On histological examination, all the organs of the dead rats revealed severe congestion. However, similar feeding of garlic oil was well tolerated by rats in the fed state. Also, 24 hr fasted rats could tolerate this dose of garlic oil, provided they were previously adapted to garlic oil feeding.

Percutaneous transhepatic biliary drainage is usually used for preoperative decompression and for palliation in obstructive jaundice, but little attention has been focused on catheter complications. We retrospectively reviewed our experience with percutaneous transhepatic biliary drainage in 81 consecutive patients. There was a 10.0% failure rate and an 8.6% mortality rate. Four patients (4.9%) required emergency operations for complications and an additional ten patients (12.3%) required transfusions. The overall sepsis rate was 34.6%; prophylactic antibiotics decreased the sepsis rate. Thirty-eight patients (47.0%) required 68 manipulation procedures for catheter malfunctions. No distinguishing characteristics could be found to identify the subgroups having complications or mortalities. The efficacy of preoperative percutaneous transhepatic biliary drainage has not been proved, and the indications for palliation are not clearly defined. Further trials are needed to define the role of percutaneous transhepatic biliary drainage in patients with obstructive jaundice.

1. The activities of gluconeogenic and glycolytic enzymes and the concentrations of citrate, ammonia, amino acids, glycogen, glucose 6-phosphate, acetyl-CoA, lactate and pyruvate were measured in kidney cortex of normal, diabetic, cortisone-treated and growth hormone-treated rats. 2. In kidney cortex of diabetic, cortisone-treated and growth hormone-treated rats the activities of glucose 6-phosphatase (EC 3.1.3.9), fructose 1,6-diphosphatase (EC 3.1.3.11) and phosphopyruvate carboxylase (EC 4.1.1.32) were increased. 3. The activities of glutamate dehydrogenase (EC 1.4.1.3), alanine aminotransferase (EC 2.6.1.2), aspartate aminotransferase (EC 2.6.1.10) and pyruvate carboxylase (EC 6.4.1.1) were increased in diabetic and cortisone-treated rats. In growth hormone-treated rats the activity of aspartate aminotransferase was depressed but those of the other three enzymes were unchanged. 4. The activity of hexokinase (EC 2.7.1.1) was not altered in any of these conditions. Phosphofructokinase (EC 2.7.1.11) activity was depressed only in growth hormone-treated rats. Pyruvate kinase (EC 2.7.1.40) activity was depressed in cortisone-treated and growth hormone-treated rats but unchanged in diabetic rats. 5. Amino acids, acetyl-CoA and glucose 6-phosphate contents were increased in rat kidneys in all these three conditions. Ammonia content was increased in diabetic and cortisone-treated rats but was markedly diminished in growth hormone-treated rats. 6. The [lactate]/[pyruvate] ratio was elevated in diabetic and cortisone-treated rats but unchanged in growth hormone-treated rats. Citrate content was increased in the kidney cortex of diabetic and growth hormone-treated rats but was unchanged in cortisone-treated rats. The activity of ATP citrate lyase (EC 4.1.3.8) was depressed in diabetic and growth hormone-treated rats but was increased in cortisone-treated rats. 7. Glycogen content was moderately elevated in growth hormone-treated rats and markedly elevated in diabetic rats, whereas no change in glycogen content was observed in cortisone-treated rats. Glycogen synthetase (EC 2.4.1.11) activity was unchanged in all these three conditions. Phosphorylase (EC 2.4.1.1) activity was not affected in cortisone-treated rats but was depressed in diabetic and growth hormone-treated rats.