Robert A. Nordyke

Preparation and Use of I131 Labeled Sodium Iodohippurate in Kidney Function Tests

Summary I131 labeled sodium o-iodohippurate (I131 Hippuran) has been prepared by 2 methods. This compound eliminates major disadvantages of currently used radioactive substances for individual kidney function testing. There is no complication due to liver uptake. It is more rapidly and completely removed, thereby reducing the time for test by 100% or more. Clinical studies with patients having known urinary tract pathology indicate that I131 Hippuran demonstrated comparative differences more sensitively than other labeled “renographic’ substances(5).

Clinical experiences with reserpine (serpasil) in hypertension; a preliminary report.

ture of India for centuries as a useful agent in the treatment of anxiety and hyperactive mental states. Although its use in the treatment of hypertension was first described in 1933 (1), it received little attention in the American literature until very recently. Attempts to isolate the active principle from crude Rauwol~a serpentina began at the end of the last century, but the first crystalline alkaloid was not isolated until 1931 (2). Today, some 14 substances have been extracted from the crude plant. Most of these have proved to be pharmacologically inert. In 1952, however, Muller, Schlittler, and Bein (3) isolated an active alkaloid from the plant which they named reserpine. Reserpine possesses both the sedative and hypotensive properties of the whole root and is believed to be the principal active component (4).

Long-term administration of reserpine in hypertension; report of 79 patients.

The Veterans Administration Center, Los Angeles, and the Department of Medicine, University of California Medical Center, Los Angeles, California. The purpose of this communication is to present the results of long-term administration of reserpine to patients with essential hypertension. It will serve to supplement and expand the results previously submitted in a preliminary report (1). The number of patients studied has been increased and the average duration of observation has been lengthened by more than a year. Since the interesting history of Rauwolfia and its active principles and the pharmacology of reserpine has been thoroughly discussed by many other investigators (2 to 4), it is unnecessary to review them here. It seems worth while, however, to emphasize that there appears to be general agreement that the site of action of this drug is in the hypothalamus. Experimental and clinical evidence (5 to 8) indicates that reserpine lowers the blood pressure through a central

The case for restructuring health care in the United States: the Hawaii paradigm

Health care in the United States is plagued by many problems. This includes excessive specialization with too few generalists, burdensome bureaucratic federal rules and regulations, and outlandish malpractice awards—all contributing to costs of care that exceeds all other nations. Cost has erroneously been identified as the cause of the problem rather than being one of many results of a failing system. Rather than repetitive unsuccessful efforts to tinker with cost as the cause, it makes far more sense to design and build a better structure of health care including expanding the existing biomedical model into a broader biomedical-psychosocial model. Hawaii, with virtually 100% of its population insured, is closer to this model than most states. It also manages to be ranked the healthiest state with one of the lowest health care costs in the nation.

Clinical Evaluation of Chlorisondamine (Ecolid) in the Treatment of Hypertension

* From the Veterans Administration Center, Los Angeles, and the Department of Medicine, University of California Medical Center, Los Angeles, Calif. In the search for an antihypertensive drug that is &dquo;more potent, long-lasting, and regularly and readily absorbed by oral administration,&dquo; Plummerl tested a series of asymmetrical bisquaternary ammonium compounds on animals and found that 4 , ~ , 6 , 7-tetracholore-2-(2-dimethylaminoethyl) isoindoline dimethocholride, subsequently called chlorisondamine or Ecolid (Ciba Pharmaceutical Products, Inc.), had the most potent ganglionic blocking effect with the least peripheral antiparasympathetic effect. Grimson2 carried on further investigation with animals and tested it on a few patients with encouraging antihypertensive effect. Several larger,