Alfred M. Sellers

The Granularity of the Juxtaglomerular Cells in Human Hypertension: Histologic and Clinical Correlations

Excerpt Recent studies relating renin and angiotensin to the regulation of aldosterone secretion have stimulated renewed interest in the juxtaglomerular cells of the kidney and in their role in nor...

Roentgen Technics in the Diagnosis and Localization of Pheochromocytoma

The term pheochromocytoma is Used to designate the relatively rare functioning tumor arising from the chromaffin tissue of the adrenal medulla or from chromaffin tissue elsewhere in the body. Patients may present with either paroxysmal or sustained hypertension and a wide variety of bizarre symptoms. Slightly over 10 per cent of pheochromocytomas are multiple or extra-adrenal. The most frequent sites in such instances are the opposite adrenal, the sympathetic ganglia, and the organs of Zuckerkandl alongside of the terminal portion of the abdominal aorta. Paraganglioma and chromaffinoma are alternate terms used to describe the extra-adrenal tumors, but for the purpose of this discussion all functioning chromaffin tumors, either adrenal or extra-adrenal, producing hypertension and certain associated symptoms will be classified as pheochromocytomas. They are reported occasionally to arise from either normal or ectopic chromaffin tissue in the chest, neck, and bladder (29, 30, 42, 58). Incidence Estimates by ...

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...

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...

SYSTEMIC LUPUS ERYTHEMATOSUS AND HYPERTENSION WITHOUT RENAL INSUFFICIENCY

Excerpt In the evaluation of patients with hypertension, specific etiologic factors such as coarctation of the aorta, unilateral renal disease or polycystic disease of the kidneys have been sought,...

Significance and management of systolic hypertension

Abstract Systolic hypertension may occur early in the onset of essential hypertension when the cardiac output is increased and peripheral resistance is normal and only the systolic blood pressure is elevated. These patients seem to pursue a more benign course than those with true diasolic hypertension, and usually antihypertensive drugs are withheld unless there is evidence of vascular damage in the main target organs of hypertension. Probably the most common disease state with which systolic hypertension is encountered is that of arteriosclerosis of the aorta and its main branches. Here antihypertensive therapy, if effective, would be helpful in preventing the blood pressure peaks which are known to occur in this type of labile hypertension. Potent anti-hypertensive drugs are definitely contraindicated since they are not well tolerated and the effect of precipitous drops in blood pressure may be disastrous. Rauwolfia alkaloids and thiazide diuretics used conservatively may be helpful in reducing the blood pressure. The third and least common category of systolic hypertension concerns those patients who exhibit severe anemia, thyrotoxicosis, beriberi, arteriovenous fistula, complete heart block, aortic insufficiency, and coarctation of the thoracic aorta. Although there may be some variability in the mechanism for the production of systolic hypertension among these patients, they have in common the fact that treatment of the blood pressure elevation should be directed at the specific etiologic factor and should not be relegated to the use of nonspecific antihypertensive agents.

The adrenal cortex in hypertension: cause and effect.

Abstract Cushings syndrome, primary hyperaldo-steronism, congenital adrenal hyperplasia and Addisons disease are adrenal dysfunctional diseases usually associated with abnormal blood pressure levels. Adrenal regeneration hypertension and desoxycorticosterone hypertension represent experimentally induced adrenal dysfunction states in which hypertension occurs. Renal-adrenal relationships may result in the production of hypertension and secondary hyperaldosteronism in some patients. Adrenalectomy and subdiaphragmatic sympathectomy performed in 171 severely hypertensive patients have resulted in an excellent or good blood pressure response in 82 per cent of 105 survivors observed from 3 to 11 years after treatment.

Hypokalemia: A Clinical Sentinel of Renal Hypertension.

Excerpt The diagnosis of renal artery disease as a cause of hypertension usually depends upon renal arteriography. A low serum potassium in patients with hypertension may be an indication for this ...