Campbell Moses

Autopsy Studies in Atherosclerosis II. Distribution and Severity of Atherosclerosis in Patients Dying with Morphologic Evidence of Atherosclerotic Catastrophe

Gross lesions of atheroselerosis in many arterial sites were graded in 500 consecutive autopsies in a general hospital. The grading system used took into account both the total area of intimal involvement and the severity of individual lesions. The first report analyzes the distribution and severity of atherosclerosis in the 347 men and women of the study group who died without morphologic evidence of atherosclerotic catastrophe in the heart, aorta, or brain. The second report describes the atherosclerotic lesions in patients who died with evidence of atherosclerotic catastrophe. The third report carries out a similar investigation in those subjects who presented evidence of obesity, hypertension, nephrosclerosis, and rheumatic heart disease.

Autopsy Studies in Atherosclerosis

Gross lesions of atheroselerosis in many arterial sites were graded in 500 consecutive autopsies in a general hospital. The grading system used took into account both the total area of intimal involvement and the severity of individual lesions. The first report analyzes the distribution and severity of atherosclerosis in the 347 men and women of the study group who died without morphologic evidence of atherosclerotic catastrophe in the heart, aorta, or brain. The second report describes the atherosclerotic lesions in patients who died with evidence of atherosclerotic catastrophe. The third report carries out a similar investigation in those subjects who presented evidence of obesity, hypertension, nephrosclerosis, and rheumatic heart disease.

Development of Atherosclerosis in Dogs with Hypercholesterolemia and Chronic Hypertension

Hypercholesterolemia was induced in pure-bred dogs by cholesterol feeding and propylthiouracil or radioiodine. Hypertension induced by the injection of silica into the renal artery increased the severity of aortic atherosclerosis. Marked hypercholesterolemia increased the severity of aortic atherosclerosis even in normotensive dogs.

Hydrocortisone and/or desiccated thyroid in physiologic dosage

Abstract The administration of desiccated thyroid in dosages increasing to 16 grains per day to 4 patients with muscular dystrophy reduced abnormally high levels of serum creatine phosphokinase (CPK) to normal. This therapy was also accompanied by a decrease in the urine creatine and creatinine. These dosages of desiccated thyroid appeared to be relatively innocuous, judging from clinical indices and laboratory observations during the 8 months of therapy. However, certain changes associated with spontaneous or induced excesses of thyroid hormones such as tachycardia and systolic hypertension were noted. In 2 of the patients an increase in hand strength may have occurred, judging from serial contractions of a rubber bulb attached to a recording ergometer. However, it is more likely that this represented increased aptitude in manipulating the bulb rather than increased strength. This conclusion is supported by the fact that muscle strength as reflected by a single contraction of an individual hand or as estimated by a physical therapist did not increase in any of the patients. The improvement in the performance on the recording ergometer occurred when the daily dosage of thyroid reached 5 or 7 to 13 grains. The subsequent loss of a part of this increment or even a deterioration of muscle strength may have resulted from thyrotoxic myopathy or progress of the disease as the daily intake of desiccated thyroid was raised to 16 grains.

Correlation of serum lipids with uric acid and blood sugar in normal males

In a group of healthy adult males, the correlation of serum triglycerides with cholesterol, uric acid, blood sugar and obesity was not significant. The annual variation of these biochemical determinations was of a sufficient degree to warrant caution in designating an individual as being at risk of developing coronary artery disease on the basis of a single value. Until our knowledge concerning the basic factors predisposing to coronary artery disease is more fully developed, it would appear that multiple biochemical determinations related to lipid, protein and carbohydrate metabolism should be included at repeated intervals in any longitudinal study of this disease process.

Hydrocortisone and/or desiccated thyroid in physiologic dosage: X. Effects of thyroid hormone excesses on clinical status and thyroid indices☆

Desiccated thyroid (Proloid) administered to healthy adult male prisoners in dosages increased progressively during a 3-month period from 3 to 25 grains per day was surprisingly innocuous as judged by the variable production of nervousness, irritability, sweating, palpitations, chest pain, increased appetite, nocturia, diarrhea or constipation. However, tachycardia, and an increase in the systolic blood pressure developed consistently in the group. During such ingestion of desiccated thyroid, in addition to tachycardia, minor electrocardiographic changes were observed. Serum PBI levels during Proloid therapy did not follow the pattern of proportionate successive increases demonstrated by others during the administration of ordinary desiccated thyroid in comparable dosages. Instead, on 3 grains of Proloid per day the serum PBI decreased below starting values and with successive increments of Proloid rose only to 7 gamma per cent. This suggests that, compared to ordinary desiccated thyroid, the preparation of Proloid produced more of a triiodothyronine effect. Such a conclusion is also supported by the marked suppression of I131 uptake produced by the Proloid and the long interval before pretreatment PBI levels were reached following withdrawal of the medication. The serum BEI paralleled the PBI, though at a lower level; the binding of exogenous thyroxine to serum TBG and albumin as measured by electrophoresis was not affected. Proloid therapy produced an increase in triiodothyronine binding to blood cells in the group as a whole, but precise correlation in individual subjects was not evident. The contraction time of the Achilles tendon reflex as measured by the kinemometer, and contraction plus half of the relaxation time as measured by the photomotograph, indirect indices of the levels of thyroid hormones, were shortened in the groups as a whole, but again precise correlations in individual subjects were lacking. Maximal hand strength as measured by a recording ergometer was reduced during the ingestion of this preparation of desiccated thyroid on increasing dosages, indicating that a form of thyrotoxic myopathy may have been produced.

HYDROCORTISONE AND/OR DESICCATED THYROID IN PHYSIOLOGIC DOSAGE. XIV. EFFECTS OF THYROID HORMONE EXCESSES ON PRESSOR ACTIVITY AND EPINEPHRINE RESPONSES.

Abstract In experimental thyrotoxicosis induced in healthy adult volunteers by the administration of large dosages of purified desiccated thyroid (Proloid) up to 25 grains per day, increases in systolic blood pressure and tachycardia were accompanied by increases in the pressor activity (aortic strip assay) of urine. The suggestion that this increased pressor activity represents a potentiation of pressor amines by the thyroid hormone excess is supported by the demonstration that the systolic rise and tachycardia after epinephrine were greater during thyroid therapy than after withdrawal of the thyroid excess.

The effect of alpha tocopherol on experimental atherosclerosis.

Although sharp criticism of the value of alpha tocopherol in the treatment of arteriosclerotic vascular disease has appeared recently (1), the use of this drug in attacking peripheral vascular problems involving venous thrombosis has been recommended (2). Bruger (3) previously has demonstrated that 100 mg of oral vitamin E sharply increased the accumulation of cholesterol in the aortas of cholesterol fed rabbits. The study here reported was designed to demonstrate the effect of parenteral alpha tocopherol on the development of experimental aortic atheromatosis.

Effect of Cholesterol Feeding during Pregnancy on Blood Cholesterol Levels and Placental Vascular Lesions

After establishing the normal variations in blood cholesterol levels on a recorded dietary regimen during pregnancy, 2 Gm. of cholesterol in chocolate candy were fed daily without significant alteration in blood cholesterol levels or placental vascular lesions.

Hydrocortisone and/or desiccated thyroid in physiologic dosage: XI. Effects of tryroid hormone excesses on lipids and other blood and serum solutes☆

Abstract The ingestion of a preparation of desiccated thyroid (Proloid) during a 12-week period in dosages increasing progressively at 2-week intervals from 3 to 25 grains per day was accompanied by a 20 to 30 per cent decrease in the serum total and the alpha and beta lipoprotein cholesterol. These decreases were first noted at the 10 grains per day level and, except for transient escape in the case of the beta lipoprotein cholesterol, persisted as the dosage was further increased. Cessation of the desiccated thyroid therapy was followed by rebound increases in these lipid fractions to values above the pretherapy levels. Alpha lipoprotein triglycerides decreased during thyroid therapy, while the total and beta lipoprotein triglycerides remained unchanged or increased sporadically. Serum levels of NEFA did not increase. Serum sodium definitely decreased during the ingestion of 20 or 25 grains of thyroid per day, reflecting perhaps a decrease in cellular osmolarity. Relative hyperkalemia appeared during the ingestion of desiccated thyroid in large amounts. Serum albumin decreased by about 0.5 Gm. per cent in the course of thyroid feeding; a concomitant rise in the globulin levels during the ingestion of 20 grains per day did not persist when the dosage was further increased. A transient rise was recorded in serum calcium, reminiscent of the hypercalcemia which may appear in spontaneous thyrotoxicosis; also, a nonsustained lowering of the serum inorganic phosphorus occurred at the 10 grain dosage level. Whole blood NPN and levels of uric acid and of creatinine in serum decreased during therapy with large dosages of desiccated thyroid per day; serum creatine increased. Levels of the fasting blood sugar and the serum carbon dioxide and chloride did not change during the ingestion of desiccated thyroid. Alkaline phosphatase and creatine phosphokinase activity decreased during thyroid feeding; the levels of acid phosphatase and of lactic and malic acid dehydrogenase were not altered.