Elmer Pader

DETERMINATION OF C-REACTIVE PROTEIN IN THE BLOOD OF PATIENTS WITH HODGKIN'S DISEASE

Excerpt Since the first description of C-reactive protein by Tillett and Francis in 1930, the occurrence of this substance, which is not present in the blood of normal individuals, has been noted b...

Primary sarcoma of the pericardium

Abstract A case of primary sarcoma of the pericardium occurring in a 19 year old male patient is presented. The initial manifestations were fever, chest pain and pericardial effusion which appeared to subside concomitantly with the administration of corticosteroids while the tumor mass was increasing in size. There was no reponse to radiotherapy. The diagnosis was established at exploratory thoracotomy, but close adherence of the tumor to the great vessels and the heart allowed only partial removal. The occurrence of a primary malignant tumor of the pericardium should be suspected in a young patient, particularly male, with an unexplained pericardial effusion and an unusual or bizarre configuration of the cardiac silhouette.

Clinical and electrocardiographic studies in complete heart block

IN THE past few years, the treatment of complete heart block has been radically changed by the introduction of artificial pacemakers. Formerly, complete heart block, with or without the Stokes-Adams syndrome, was managed by pharmacological agents to improve atrio-ventricular conduction and to stimulate the idioventricular pacemaker. With the advent of the implantable pacemaker, it was soon apparent that indications for its use would have to be precisely defined. Some investigators Il-31 have advocated the pacemaker in all cases of complete heart block especially with a histo’ry of even a single Stokes-Adams attack. Others 141 adopting a more conservative approach, reserve this instrument for patients with repeated, disabling episodes of syncope or intractable heart failure. In attempting to establish the value of and indications for the pacemaker, a study of the natural history of complete heart block would be invaluable as a basis for comparison. This report is an analysis of 99 cases of complete heart block encountered in clinical practice with particular reference to the clinical and elcctrocardiographic manifestations.

The effect of phenylethylhydrazine dihydrogen sulfate (nardil) on total serum cholesterol.

The recent reports of striking relief of anginal pain by monoamine oxidase inhibitors have stimulated us to evaluate one of the newer drugs of this group, phenylethylhydrazine dihydrogen sulfate (Nardil), for this purpose. Patients with a well documented anginal syndrome due to coronary artery sclerosis were given Nardil in a dosage of 45 mg a day in three divided doses of 15 mg each for a period of 3 weeks. At the end of 3 weeks the patients were re-evaluated with respect to the effect of the drug on the anginal syndrome as well as the occurrence of side effects. Because of the occasional occurrence of hepatic dysfunction following the use of some monoamine oxidase inhibitors, notably iproniazid, a battery of liver function tests was performed on each patient before starting Nardil and at 3 weekly intervals while taking the drug. Included were alkaline phosphatase, serum bilirubin, serum glutamic-oxaloacetic transaminase, cephalin flocculation and total serum cholesterol. In the course of this investigation we noted a significant lowering of the total serum cholesterol in almost one-half of the patients after 3 weeks of Nardil therapy, often with a further decrease as Nardil was continued. This effect on serum cholesterol was not accompanied by abnormalities in the other liver function tests or by clinical evidence of hepatic dysfunction. In the first 23 patients who have completed 3 weeks of Nardil a significant fall in total serum cholesterol was noted in 11 patients or 47.8 per cent, and the average fall in cholesterol in these 11 patients was 66 mg per 100 ml. In the remaining 12 patients the serum cholesterol showed no significant change. The largest decrease in cholesterol was 115 mg per cent from 335 to 220 mg per cent. The mechanism of the effect of Nardil on total serum cholesterol is obscure. In the absence of