A. Gorman Hills

Albright's Hereditary Osteodystrophy Comprising Pseudohypoparathyroidism and Pseudo-pseudohypoparathyroidism: With a Report of Two Cases Representing the Complete Syndrome Occurring in Successive Generations

Excerpt Some 20 years ago Albright, Burnett, Smith, and Parson (1) first called attention to a syndrome in which certain skeletal abnormalities coexist with chemical and clinical findings character...

The effect of phosphate infusions upon renal phosphate clearance in man: Evidence for tubular phosphate secretion

Abstract Renal excretion of phosphate was investigated in 7 normal subjects and 24 patients with diseases associated with abnormal phosphate excretion. Infusions of neutral phosphate solution were given in such a fashion as to produce an approximately constant rate of increase of serum phosphate concentration. In no case was a maximum rate of tubular reabsorption (TmP) sustained. The maximal reabsorption occurred in most studies during the preinfusion periods or early in the infusion. Regression lines relating excreted to filtered phosphate had a slope greater than unity in 22 of 31 studies, significantly so (p

pH and the Henderson-Hasselbalch equation

From the Departments of Physiology and Medicine, Medical College of Ohio, Toledo, Ohio 43614. Requests for reprints should be addressed to Dr. A. Gorman Hills, Professor of Physiology and Medicine, Medical College of Ohio, Arlington and South Detroit Avenues, Toledo, Ohio 43614. Manuscript accepted April 6, 1973. * Deceased June 16,1973. The two foundations of analysis of acid-base equilibria in solution are the (1) law of mass action and (2) the concept of acidification as protonation, achieved by dissociation of a proton donor. Transfers of protons by proton donors to the conjugate bases of other buffer pairs are treated as reversible reactions subject to quantitative analysis by the Henderson-Hasselbalch equation, a deduction from the mass law; this type of kinetic analysis has enabled us for nearly a century to relate theoretically the changes of the acidic intensity of dilute solutions to a quantity of acid or base added or subtracted. The contemporary form of the Henderson-Hasselbalch equation:

The clinical course following adrenal resection and sympathectomy, of 82 patients with severe hypertension.

Excerpt INTRODUCTION Previous reports of our testing of operations for hypertension, combining adrenal resection with sympathectomy, have indicated encouraging results.1, 2, 3, 4The number of patie...

Quantitative evaluation of primary adrenal cortical deficiency in man

Abstract 1.1. A method designed to afford a quantitative appraisal of adrenal cortical functional capacity has been devised. It consists of a two-fold test: (1) a standard metabolic regimen capable of provoking acute adrenal insufficiency in the severely adrenal-deficient individual; and (2) powerful adrenal cortical stimulation by means of intravenous corticotrophin. 2.2. Classification of patients into one of four separate grades of adrenal cortical functional capacity is proposed on the basis of multiple criteria of response to each portion of the test. Intrinsic and extrinsic grounds for confidence in the accuracy of the method are presented.

Further observations on patients with severe hypertension subjected to adrenal resection and sympathectomy.

Excerpt INTRODUCTION It has now been four years since our first patient was submitted to adrenal resection and three years since the first report to this College.1We are aware that it may well requ...

Untreated Addison's Disease Complicated by Pulmonary Congestion due to Left Ventricular Failure

Excerpt Although dyspnea on mild exertion is sometimes present, signs of frank heart failure—pulmonary edema, venous distention, hepatomegaly, peripheral edema—are rarely seen in untreated patients...

pH DEFENDED—IS IT DEFENSIBLE?

Excerpt To the Editor:The article by Drs. Lennon and Lemann (1) published in the August issue of the ANNALS OFINTERNALMEDICINEmakes a further contribution to quantification of the compensatory adju...

Clinical experience with chlorpropamide in the management of diabetes mellitus.

This report is based upon our observations of the compound l-propyl3-(

Authors, Readers, and Editors—A Postscript

-chlorobenzenesulfonyl)urea (chlorpropamide) orally administered as an agent for the control of glycosuria and hyperglycemia as tested in 49 patients with diabetes mellitus for periods of 2 to 5 months. The drug has been found to be effective for this purpose in 76 per cent of this group, most of whom were patients whose diabetes began in their fifth decade or later. The data have been analyzed in terms of an arbitrary system for grading the degree of control achieved with the aid of the drug, and an appraisal on this basis of clinical factors influencing the effectiveness of the drug has been made. The concentration of chlorpropamide in blood serum attained a t various dosage levels has been determined also, and the relation of these two factors to the effectiveness and toxicity of the drug has been evaluated.