We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......


Arch Surg. 1949;59(3):507-513. doi:10.1001/archsurg.1949.01240040515015.
Text Size: A A A
Published online

IN 1924, just two years after the discovery of insulin by Banting and Best,1 Harris2 published his report on "Hyperinsulinism and Dysinsulinism," having noted in several patients a clinical picture similar to that caused by overdosage of insulin. Nicholls,3 in 1902, first described the finding at autopsy of an islet cell tumor, but the possible clinical significance was not recognized until this syndrome simulating insulin shock was described by Harris. In 1926 Warren4 reviewed 20 cases of islet cell hypertrophy observed at autopsy, in only a few of which were there significant symptoms of hyperinsulinism. According to Bockus,5 an estimated 80 per cent of proved cases of islet cell tumors are clinically silent lesions, giving no symptoms of hyperinsulinism. The first case in which operation was done for an islet tumor was reported by Wilder, Allan, Power and Robertson6 in 1927. An extensive islet


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.