Cadmium is a metallic element which is placed between Zn and Hg in Group I IB of the Periodic Table. It is divalent, as are the Group I IA elements Ca and Mg. In order of electropotential, Zn, Cd and Hg fal I below Ca and Mg but above the transition elements, with which they do not have close relationships. They have low melting points so their volatility, as in the case of Pb, is an industrial hazard. Cd has recently received prominence as a cause of environment pollution due to its accumulation in water supplies and crops from Zn mining operations and industrial effluents.

The biochemistry of the steroids is of unique interest; no other group of relatively simple substances plays so versatile a role in biology. On the one hand are many highly potent steroids occurring in minute quantities e.g. sex hormones, corticosteroids, the vitamins D and the cardiac glycosides. In sharp contrast are certain sterols, exemplified in the animal kingdom by cholesterol - familiar, abundant, easily determined, yet singularly obscure in their physiological significance. In some restricted fields the functions of cholesterol are known. It is a precursor of the adrenocortical hormones (perhaps not an obligatory one ), and is probably important in the biosynthesis of sex hormones too. Present in the skin is 7-dehydrocholesterol, converted to vitamins D by ultraviolet light. Cholesteryl esters are found in large quantities, together with sphingomyelin, in the myelin sheaths of nerve fibres, where these lipids may have an insulating function necessary at least for saltatory conduction.

Fifty years ago, Ignatowski (1908) produced atherosclerotic lesions in rabbits by feeding them with a diet containing meat, milk and eggs. Since then, interest in the diet as a possible atherogenic factor has waxed and waned, but has never been greater than at present. Much of the credit for the present surge of interest is due to the Professor Ancel Keys of the University of Minnesota, who since 1952 has produce considerable evidence relating the development of coronary heart disease and the diet. His epidemiology surveys and his dietary experiments led him to favor the hypothesis which he summarized in the following terms (Keys, 1952).

The purpose of this project has been to test the postulate that high blood levels of pyruvate encountered in certain conditions such as steroid excess, diabetes mellitus under certain circumstances, and thiamine deficiency, are due to defective removal of pyruvate rather than excessive production. Specific methods of assay and direct studies of pyruvate tolerance were used. Intermediary carbohydrate metabolism was studied in a total of 109 subjects. The history of thiamine deficiency and of the concept of ensymes is outlined and the literature on pyruvate estimation and study in various clinical conditions is reviewed. Direct tests of pyruvate tolerance are discussed and the biochemistry if glucose breakdown is described. the history of analytical methodology for pyruvate is recounted.

Includes bibliographical references (leaves 67-80). / Although the treatment of gestational impaired glucose tolerance (GIGT) has been shown to be beneficial, the cost implications in treating GIGT in resource constrained economies needs examination. Thus this study assessed: (i) pregnancy outcomes in pre-gesational types 1 and 2 diabetes (DM) with particular emphasis on the modality of therapy for pregnant women with type 2 DM, (ii) pregnancy outcomes in subjects with gestational diabetes (GDM) and the effect of stratification by fasting plasma glucose (FPG) and 2 hour oral glucose tolerance test (OGTT) plasma glucose values, and (iii) the effect of OGLAs on pregnancy outcomes in GDM.

The work to be presented in this thesis took pl ace while I was working as a registrar in the department of radio-isotope diagnosis at Groote Schuur Hospital. During this period, I became interested in the ferrokinetic technique for attempting to quantitate normal and abnormal erythropoietis, and the possible development of these techniques so as to allow more accurate quantitation of the data. At the time the study started, the department was offering standard ferrokinetic investigations to aid in the diagnosis of abnormal haematological states. These studies did not, I felt, provide adequate information for the referring clinician, particularly in regard to ineffective erythropoietic activity.

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