Seymour H. Rinzler

Effect of a serum cholesterol-lowering diet on composition of depot fat in man.

W ITII the development and greater availability of gas liquid chromatography as an analytical tool, increasing evidence is appearing that various diets are capable of inducing specific changes in the pattern of fatty acids in the depot fat of man.’3 Hirsch et al.4 have developed a syringe technic for the aspiration of subcutaneous adipose tissue and have studied the depot fat composition patterns of normal subjects and patients on special diets. The Diet and Coronary Heart Disease Study Project (The Anti-Coronary Club) of the City of New York Department of Health and its procedures have been described previously [5-9]. The ultimate objective of this project is to determine whether a diet capable of lowering the level of serum cholesterol can favorably influence morbidity and mortality due to coronary heart disease when consumed for a prolonged period by a volunteer study population of middle-aged men. The composition of the Study Project diet is given in Table . It derives 30 to 33 per cent of calories from fat, compared to 40 to 44 per cent present in the “usual American diet.”

Effect of heparin in effort angina

ELIEF of angina pectoris by heparin was R first reported in 1951 by Graham and his co-workers.’ This finding was incidental to an investigation of the effects of heparin on the concentration of the serum lipoproteins (S, 1 Z-20 and 20-l 00). Efficacy of heparin in effort angina has since been reported by Engelberg, 2 while, on the other hand, no significant benefits were found by Russek3 or by Miller, Zinn and Griffith.4 The present study was undertaken first to evaluate heparin in effort angina by the double blindfold method and the daily report card system for collecting data,6 and secondly, to determine at the same time the effect of a course of heparin on the concentration of serum lipoproteins of the S, 12-20 and S, 20-l 00 classes.

Social Factors Affecting Participation in a Study of Diet and Coronary Heart Disease

In a long-term prospective study of the effects of dietary modification on the incidence of coronary heart disease, the characteristics of the subjects were examined to determine whether differences existed between those who remained in the study and those who dropped out. Statistically significant differences were elucidated between these two groups in terms of a cosmopolitan-parochial orientation, some demographic characteristics and how the subjects viewed the study and their role in the research aims. The implications of these findings for future research and public health application of the overall study findings are discussed.

Cardiac effects of nicotine in the rabbit with experimental coronary atherosclerosis.

Groups of male Dutch rabbits about 2 kg. in weight were started contemporaneously either on a stock diet or on the stock diet to which 2 per cent cholesterol, or 2 per cent cholesterol in 6 per cent corn oil, had been added.3 Serial electrocardiographic ergonovine tests3 s 4 z 5 were performed at monthly intervals to insure that coronary atherosclerosis had developed a t the time of coronary perfusion with nicotine. After intravenous ergonovine maleate (0.05 mg./kg.), positivity of the test is indicated by sagging depression of the S-T segment in about 3 to 5 min. In 16 such ergonovine-positive cholesterol-fed rabbits, nicotine was injected intravenously in a dose of 0.05 mg./kg., and the electrocardiogram followed for 30 min. Electrocardiographic effects of nicotine were similarly observed in 12 control rabbits fed the stock diet. Intravenous pentobarbital sodium

Cardiac pain: Present status of its mechanism and therapy

in a dose of 10 to 15 mg./kg. was adequate to keep the animal quiet fbr electrocardiography if it was not disturbed during this period of observation. For stabilization of heart rate and blood pressure, a t least 20 min. was allowed to elapse between intravenous injections of pentobarbital and nicotine. Perfusion studies. Langendorff coronary perfusion was carried out on 16 ergonovine-positive atherosclerotic and 14 normal isolated hearts. The heart was removed for perfusion under anesthesia with pentobarbital sodium, 15 to 20 mg./kg., intravenously. Single injections of drugs in a volume of 2 cc. were made into the perfusion system to simulate the peak concentration of an intravenous injection in the intact animal. Observations were made for 4 min. afterward, or longer if the effects lasted longer. The modified apparatus and method have been described in detaiL3

Weil's disease: Report of five cases

Abstract 1.1. The nervous system pathways involved in transmission of impulses of pain from the heart and to its regions of reference are described. 2.2. Stimulus for cardiac pain seems to depend on accumulation of metabolites in working cardiac muscle in the anoxic state. 3.3. The relative efficacy of such drugs as the nitrites, xanthines, papaverine, alcohol, androgens, thiourea compounds and others is discussed. 4.4. The surgical procedures for relief of cardiac pain, directed either at increasing the blood supply to the heart, or reducing the metabolic activity of the patient or interrupting the afferent pain pathways, are described.

Dietotherapy in hypertensive disease

Abstract 1.1. Five cases of Wells disease are presented, with postmortem findings in the one fatal case. 2.2. Diagnosis was accomplished by serum agglutination tests in four of the patients and by postmortem microscopic examination of lung scrapings in the fifth. 3.3. Unusual clinical features noted in one or more of the patients include maculopapular skin eruption, pyelonephritis, persistent impairment of urinary concentrating ability and severe alopecia. Optic neuritis complicated one case. 4.4. In two of the patients a clearcut contact with rats was indicated. 5.5. Penicillin treatment was employed in one patient.

PAIN AND DISABILITY OF THE SHOULDER AND ARM: TREATMENT BY INTRAMUSCULAR INFILTRATION WITH PROCAINE HYDROCHLORIDE

Abstract 1. 1. The blood pressure of the patient with hypertension can be lowered by different dietary methods. These include caloric reduction (controlled or unplanned semistarvation levels), the rice diet of Kempner, and the low-sodium diet. Weight reduction is responsible in part for the lowering of the blood pressure on the diets restricted in calories. The low-sodium content of the rice diet is the “hypotensive” factor since patients on this diet with a normal sodium intake do not have a fall in blood pressure. The low protein content (20 Gm.) of the rice diet is not essential to the lowering effects on the blood pressure, for similar falls in blood pressure have been recorded with a normal protein (70 Gm.) but a low-sodium content. 2. 2. Reductions of blood pressure to 155 100 mm. Hg from higher levels were recorded in 24 per cent of 874 patients on either the rice or low-sodium diet. Of these, 212 adequately controlled patients showed a similar reduction in blood pressure in 21 per cent of the instances. To assess the significance of such reductions in blood pressure, one must compare these figures to 18.4 per cent of the patients who had a fall in blood pressure to 150/100 mm. Hg or lower after sympathectomy, even though preoperative blood pressures were in approximately the same range as those treated by the rice or low-sodium diets. Further, spontaneous remissions of the blood pressure during the natural course of hypertension to levels of 144 99 mm. Hg or below were found by Bechgaard to occur in 2.4 per cent of 709 patients and to normal pressures in 15 per cent of the patients with uncomplicated essential hypertension by Perera. 3. 3. The mechanism of action of the rice and low-sodium diet has been attributed to the effect of the sodium ion on hypertension as mediated through the adrenals, to an effect of the sodium deprivation on lessening the humoral contribution to maintenance of an increased peripheral resistance, or to the decreased metabolic activities of the kidneys while on the rice diet. 4. 4. Toxic effects of the rice and low-sodium diets vary from such minor effects as muscular pains to collapse associated with a “low-salt syndrome” and characterized by azotemia and hyponatremia. Nitrogen balance, though negative during the first 2 weeks on the rice diet, reaches essential equilibrium after this.