J. Edwin Wood

Effect of Aminophylline on Urinary Excretion of Epinephrine and Norepinephrine in Man

The excretion of catecholamines and the changes in plasma concentration of free fatty acids during aminophylline administration were explored. The relationships between cardiac arrhythmia, cardiac rate, and change in blood pressure under the conditions of these experiments were defined. Eighteen experiments were performed on eight volunteers. Blood pressures and heart rates before and during aminophylline infusion were recorded at frequent intervals, and urine and blood were collected during the control and infusion periods and in some subjects after the infusion. Loading with ethanol, glucose, or placebo before administration of aminophylline was used.These studies demonstrated that intravenous infusion of aminophylline increases the urinary excretion of epinephrine and norepinephrine in man, the rate of excretion of epinephrine being greater than that of norepinephrine. This increase was accompanied by an increase in the concentration of free fatty acids in the plasma.

THE MANAGEMENT OF MYOCARDIAL INFARCTION WITH PARTICULAR REFERENCE TO THE CHAIR TREATMENT

Excerpt The time-honored treatment of acute myocardial infarction at complete bed-rest has been challenged recently and evidence presented that many patients do at least as well if allowed to sit i...

Hypertension with Arteriolar and Glomerular Changes in the Albino Rat Following Subtotal Nephrectomy

Chanutin and Ferris 1 have already reported hypertension and renal insufficiency in rats following partial nephrectomy. This report describes briefly the histological changes in the kidney stump of rats at intervals after subtotal nephrectomy and records additional blood pressure observations. In this experiment 184 Wistar strain albino rats were studied. In 157 of these, approximately two-thirds of the left kidney was removed by polar ligation, and the remaining right kidney was excised one week later. Of 27 control animals, each had 2 laparotomies (one week apart) when the kidneys were exposed, handled and replaced intact. After the operative procedures all of the animals were fed on a normal balanced diet containing approximately 20% protein. At intervals varying from one to 281 days after second operation, a direct carotid blood pressure reading was made (ether anesthesia), and autopsy then performed. Infection was not encountered except in rare instances, and did not affect the results reported below. Tissues were fixed variously in formol, mercuric chloride, and Hellys fluid. Frozen and paraffin sections were stained with Scharlach-R, Mallory-Heidenhain, and other usual methods. The blood pressure in the 27 control rats ranged from 100 to 140 mm. Hg., with an average of 120 mm. Hg. (a figure already fully established by Chanutin and Ferris). Of 157 animals with subtotal nephrectomy, 10 had blood pressures ranging from 70 to 99 mm. Hg.; 57, from 100 to 139 mm. Hg.; 45, from 140 to 169 mm. Hg.; 34, from 170 to 199 mm. Hg.; and 11, from 200 to 230 mm. Hg. In general, the test animals with subnormal blood pressures were acutely ill. The higher blood pressure levels were found in rats with subtotal nephrectomy of 60 days or longer.

Surgical Relief of Aortic Insufficiency by Direct Operation on the Aortic Valve

The natural history of patients with aortic insufficiency and the previous experimental and clinical operations devised for its relief are reviewed. Methods that have been used at the University of Virginia Hospital for treatment of aortic insufficiency are reported. These procedures include the release of the fixed valve leaflet and removal of calcium from it, aortic valve leaflet extension with suture of a small piece of compressed polyvinyl sponge or Teflon fabric to the edge of one of the leaflets, excision and replacement of a portion of the valve with a synthetic leaflet, and complete subcoronary replacement of the valve with a prosthesis. To relieve isolated rheumatic aortic insufficiency, an annulus has been constricted or a bicuspid aortic valve has been created. Insufficiency resulting from perforation of one or more valve leaflets by subacute bacterial endocarditis has been treated by closure of the perforations. Nineteen patients underwent 21 operations for the correction of aortic insufficiency. All had been in, or were in, heart failure, and several had significant coronary artery disease or multivalvular disease. Eleven of the 19 patients are well or markedly improved. Eight died during or after the operative procedure. It is concluded that a direct attack upon the insufficient aortic valve is the procedure of choice at the present time.

THE RELATIONSHIP BETWEEN HEART DISEASE AND GALL-BLADDER DISEASE

Excerpt INTRODUCTION The purpose of this report is to survey the relationship between heart disease and gall-bladder disease. A review of the American literature will be presented and the physiolog...

Vasomotor Response of Non-Hypertensive Individuals to a Standard Cold Stimulus

Hines and Brown 1 have described a standard test for the study of vasomotor reactions based on the responses of the blood pressure to a cold stimulus. They are of the opinion that “excessive” responses to this test indicate a hypersensitive sympathetic nervous system. Assuming that the principal abnormality in essential hypertension is a hypersensitive sympathetic nervous mechanism, they have considered non-hypertensive individuals with “excessive” responses potential candidates for hypertension. They suggest that essential hypertension develops only in individuals manifesting “excessive” responses; that these abnormal responses depend upon an hereditary factor, and that they appear early in life. If these theories are correct, it is apparent that in advanced age periods where actual essential hypertension has already developed in many of the potential hypertensives, there should be a lower percentage of “excessive” responses in the individuals of the same age period with normal blood pressures. Also, it would follow that the average response of non-hypertensive people in the advanced age periods would be lower than the average response of non-hypertensives in younger age groups. It is the purpose of this study to investigate the incidence of “excessive” responses in a group of non-hypertensive subjects; and, to compare the average response of this group with the series reported by Hines and Brown. 2 Two hundred and five subjects with a systolic blood pressure below 140 mm. Hg. and a diastolic blood pressure below 90 mm. Hg. have been chosen at random. The ages of the individuals selected have varied from 8 to 70. Each subject has been tested according to the technic described by Hines and Brown. 1 The upper limit of normal response was first arbitrarily placed by Hines and Brown 1 at 15 mm. Hg., but in a subsequent publication 2 they raised their limit of normal to 22 mm. Hg.

Effect of high-protein diet and urea administration on the blood pressure of normal dogs and of dogs with experimental renal hypertension

Abstract The administration of a high-protein diet (lean raw meat) to normal and hypertensive dogs for a long or short period of time failed to produce a consistent rise or fall in systolic or diastolic blood pressure. The administration of urea, intravenously or by stomach tube, to normal and hypertensive dogs likewise failed to produce any significant change in blood pressure. In one hypertensive dog there was a slight to moderate rise of systolic and diastolic blood pressure after each of the four experimental procedures.