bluuebunny/crossref_metadata_2025 huggingface dataset:
Effort and the Forced Expiratory Volume in One Second (FEV1)
Authors: Kemm J. R. , Kamburoff P. L.
Published: August 2015

1. The relationship between volumes expired and the maximum intrathoracic pressures developed within the first second of expiration was examined in a group of healthy subjects and patients with airways obstruction who exhaled with varying degrees of effort.

2. The body plethysmographic method was used to ensure that expirations started from total lung capacity.

3. Three different types of volume-effort curves could be distinguished: Type I; in this the volume expired increased with greater effort. Type II; after a phase in which the volume expired increased with effort, a plateau was reached after which increasing effort made no difference to the volume expired. Type III; this resembles Type II except that instead of a plateau being established at maximum expired volume, increasing effort resulted in diminishing expired volume. Correction for the degree of compression of the intrathoracic gas failed to account for this phenomenon. Type III curves were found in healthy subjects as well as in patients.

4. In most cases the maximum Forced Expiratory Volume in 1 s (FEV1) was not found to coincide with the maximum oesophageal pressure (Poes), nor was there a significant difference between the mean and the maximum FEV1 produced with an effort greater than 75% of maximum.

5. Blowing ‘half as hard’ is an unnatural procedure; all subjects tend to blow nearly as hard as possible or very gently. In the latter case, the resulting FEV1 tracing is easily recognizable as technically unsatisfactory.

6. We conclude that for practical purposes, measurements of FEV1 depend for their reliability upon ensuring that they are started from full inspiration; insistence upon maximum effort is less important because FEV1 is independent of effort for the greater part of the effort range.
The Physical Properties of Sebum in Acne Vulgaris
Authors: Burton J. L.
Published: August 2015

1. Methods are described for the collection of scalp sebum, and for the determination of the density, viscosity, surface tension, and freezing-point of sebum samples from individual subjects.

2. Data are presented from ten acne patients and seven normal subjects, of whom three previously had acne. No significant difference was demonstrated between the sebum from acne patients and controls. The sebum viscosity increased with fall in temperature, but sebum did not solidify at physiological skin temperatures, and it is concluded that sebum viscosity is unlikely to be important in the pathogenesis of acne.

3. There was no relationship between sebum excretion rate and viscosity in individual subjects and sebum viscosity is unlikely to play a major role in the normal regulation of sebum production.
The Hypocalcaemic Effect of Intravenous Phosphate Administration
Authors: Stamp T. C. B.
Published: August 2015

1. Sodium phosphate was infused intravenously over approximately 2½ h and produced a mean linear rise in plasma phosphorus levels of 9·1 mg/100 ml. Twenty-one infusions were performed in twelve control subjects and thirty-eight were carried out in thirty-two patients with disorders of calcium and phosphorus metabolism.

2. The fall in plasma calcium under these conditions was related to:

a. The initial height of plasma calcium. b. The rate of rise of plasma phosphorus. c. The initial level of plasma phosphorus and the theoretical renal phosphorus threshold. d. The presence of metabolic bone disease.

The fall in plasma calcium levels per mg rise in plasma phosphorus was greater in patients with hyperparathyroidism, osteomalacia, osteoporosis, Paget's disease and certain other rarer conditions than in the control group or in patients with hypoparathyroidism, whose plasma calcium levels changed least of all.

3. It was concluded that pre-existing increased bone resorption or osteoblastic activity may determine the degree of hypocalcaemia which occurs under these conditions.

4. Phosphate was also infused at a constant rate over 10 h in five tests on five patients with moderately severe hypercalcaemia (plasma calcium 14·0–17·3 mg/100 ml). Plasma calcium levels fell steadily, and small or negligible changes were seen in serial determinations of glomerular filtration, urine protein and cell excretion rate.
Urinary Excretion of Nitrogen from 15N-Labelled Amino Acids in the Malnourished and Recovered Child I. Glycine and Lysine
Authors: Read W. W. C. , McLaren D. S. , Tchalian Marie
Published: August 2015

1. Glycine and lysine with the α-amino nitrogen labelled with 15N were fed to marasmic and recovered infants. The excretion of total 15N and labelled urea in the urine was followed for 72 h.

2. Excretion of 15N was lower in marasmic than in recovered infants for both amino acids. This was mainly due to a smaller amount of [15N]urea excreted by the marasmic infants.

3. [15N]Lysine was retained to a greater extent than [15N]glycine in marasmus and after recovery. This difference was more marked in marasmus. 15N in urea excreted by marasmic subjects after feeding with [15N]lysine was less than 5% of the total isotope administered.

4. The results suggest that requirements of marasmic infants for individual amino acids may differ considerably from those of the healthy infant.
Metabolism of Autologous 131I-Labelled IgG in Patients after Renal Homotransplantation
Authors: Wells J. Vivian , Jeremy D.
Published: August 2015

1. The metabolism of autologous 131I-labelled IgG was studied in five patients after renal homotransplantation. Two patients had received grafts from related living donors and three from cadavers and all grafts were functioning. All five patients were on immunosuppressive therapy with prednisone and azathioprine. No episodes of rejection occurred during the study.

2. One patient had serum concentrations of IgG and IgA and IgM below normal; one had isolated IgM deficiency; one had isolated IgA deficiency; and two had increased serum IgM concentrations.

3. Plasma volume and distribution ratio were normal in all five patients; the plasma IgG pool was normal in four and significantly decreased in one. Fractional turnover rate was normal in four and increased in one; the plasma half life was normal in three and shortened in two.

4. The IgG synthesis rate was normal in two, at the lower limit of the normal range in two and decreased in one. There was no obvious correlation with the age of the patient, the dosage of prednisone or azathioprine, the incidence of infection, the survival and function of the graft or serum immunoglobulin concentrations.
Long-Term Therapy of Diabetes Insipidus with Oral Benzothiadiazine and Phthalimidine Diuretics
Authors: Lant A. F. , Wilson G. M.
Published: August 2015

1. The antidiuretic effects of oral therapy with benzothiadiazine and phthalimidine diuretics have been studied in seven patients with diabetes insipidus of pituitary origin.

2. The immediate and chronic phases of diuretic-induced antidiuresis differ in their characteristics. Immediate antidiuresis is closely related both to the saluretic action of the diuretics and to the level of fluid turnover prevailing before their administration. By contrast, the findings in four patients maintained on polythiazide or clorexolone for at least 4 years show that antidiuresis persists at a time when saluretic effects have ceased and there is no longer any detectable disturbance in body sodium metabolism. A change in mechanism of antidiuresis appears to occur with the passage of time.

3. There is a parallelism between the characteristics of the chronic antidiuretic and antihypertensive actions of diuretics. The mechanism of both effects remains obscure.

4. Despite uncertainty as to mechanism, diuretic therapy offers a reliable means of treating diabetes insipidus on a long-term basis. The only complication encountered was symptomless hypokalaemia which developed despite regular use of supplemental oral potassium. Combined administration of triamterene or amiloride with either polythiazide or clorexolone has been used with success as an alternative regime.
Renin and Aldosterone in Essential Hypertension
Authors: Kotchen T. A. , Mulrow P. J. , Morrow L. B. , Shutkin P. M. , Marieb N.
Published: August 2015

1. The renin-aldosterone system was studied in seventy-one selected hypertensive patients. Nine (13%) were diagnosed as having primary aldosteronism. Of the twenty-three patients who presented with a history of unprovoked hypokalaemia, the incidence of primary aldosteronism was 40%.

2. Renin and aldosterone responses to the combined stimuli of a low sodium diet and the upright posture were suppressed in patients with essential hypertension. There was no evidence that the suppression was due to abnormal adrenal function, sympathetic neuropathy, or the level of the blood pressure. The mechanism of the suppressed plasma renin activity response and its significance in the pathogenesis of hypertension are unknown.
Erythrocyte Protoporphyrin and Iron Uptake in Erythropoietic Protoporphyria
Authors: Clark K. G. A. , Nicholson D. C.
Published: August 2015

1. Erythrocytes from patients with erythropoietic protoporphyria (E.P.P.) were incubated with radioactive iron, washed and centrifuged. Serial layers were removed from the packed cell columns. The radioactivity and protoporphyrin content of each layer was measured. Blood and marrow aspirates were examined by fluorescence microscopy.

2. The youngest erythrocytes were most fluorescent and contained most protoporphyrin. The amounts present in the cells of different layers progressively decreased from top to bottom of the packed cell column. It is concluded that the protoporphyrin content decreases during the life of the erythrocytes, probably by a process of elution.

3. Although little 59Fe entering the erythrocytes is incorporated into haem, a relationship was observed between iron uptake and protoporphyrin content, which may not be entirely due to aging. This may reflect a mutual dependence of both variables on haem feed-back control.

4. Fluorescence of normoblasts was not detected, indicating that the chief accumulation of porphyrin occurs soon after loss of the nucleus. A hypothesis is suggested to explain these findings.
On the Mechanism of Hyperkalaemia Due to Hyperosmotic Expansion with Saline or Mannitol
Authors: Makoff D. L. , Da Silva J. A. , Rosenbaum B. J.
Published: August 2015

1. To investigate the mechanism of the hyperkalaemia that results from hyperosmotic infusions of saline or mannitol, nephrectomized dogs received hyperosmotic infusions of sodium chloride or mannitol with various amounts of sodium bicarbonate. Pa,co2 was held constant. Body spaces and mean whole-body intracellular hydrogen ion activity [H+]i were measured with tritiated water, Na36Cl, and [14C]5,5-dimethyl-2,4-oxazolidinedione (DMO).

2. The extracellular hydrogen ion activity after infusion varied, but all animals developed intracellular alkalosis ([H+]i-35 nmol/l, SEM±5, P<0.001). There was no net movement of Na+ across cell membranes. There was a significant negative correlation between the changes in extracellular hydrogen ion and that in extracellular potassium concentrations. A greater apparent cellular penetration of HCO3− resulted in less net loss of K+ from cells (r = 0.69, P < 0.01).

3. The results suggest that the hyperkalaemia secondary to hyperosmolar infusion of saline or mannitol is not due to extracellular acidosis, but cellular dehydration, altered cell metabolism or altered cell-membrane function may contribute to the leak of K+ from cells in these circumstances.
A Reinvestigation of Methylguanidine Concentrations in Sera from Normal and Uraemic Subjects
Authors: Baker L. R. I. , Marshall R. D.
Published: August 2015

1. A cation-exchange-chromatographic method for the determination of methylguanidine in serum is described.

2. In ten normal subjects, the mean serum methylguanidine concentration was 0.055 (SE 0.019) mg/100 ml and in ten uraemic patients it was 0.175 (SE 0.038) mg/100 ml. This difference is significant (P < 0.02).

3. Recent claims that methylguanidine is present in uraemic serum in much higher concentrations are shown to be due to artifactual conversion of creatinine when methods involving charcoal chromatography are employed.

4. The results of intoxication experiments, in which blood concentrations of methylguanidine similar to those found by charcoal-chromatographic methods have been reproduced, must be interpreted with caution.
Effect of Arterial Co2 Pressure on the Response of Cerebral and Hind-Limb Blood Flow and Metabolism to Isoprenaline Infusion in the Dog
Authors: Xanalatos C. , James I. M.
Published: August 2015

1. Cerebral blood flow, oxygen and glucose consumption, hind-limb blood flow and oxygen consumption, blood pressure and heart rate were measured in seven ventilated dogs.

2. Inhalation of 5% CO2 caused a significant increase in cerebral blood flow and a significant decrease in cerebral glucose utilization.

3. Isoprenaline infusion (0·4 μg kg−1 min−1) caused a rise in cerebral blood flow, oxygen and glucose consumption. There was also an increase in peripheral blood flow and in most instances an increase in peripheral oxygen utilization.

4. The inhalation of 5% CO2 during isoprenaline infusion abolished the increase in cerebral blood flow, in cerebral glucose consumption and heart rate. Cerebral oxygen consumption was significantly decreased to below control values. Once the administration of 5% CO2 was discontinued an increase in peripheral oxygen consumption became apparent.

5. The possible therapeutic implications of these findings are outlined.
Intracellular Buffering in the Dog at Varying CO2 Tensions
Authors: Gamble J. L. , Zuromskis P. J. , Bettice J. A. , Ginsberg R. L.
Published: August 2015

1. The effect of varying the Pco2 on the buffering of mineral acid has been investigated. HCl (6 mmol/kg) was infused into anaesthetized-paralysed dogs maintained on a respirator and changes in Pco2 (between 20 and 60 mmHg) were arranged by varying the stroke volume.

2. No significant interaction between buffering of respiratory and metabolic events was discerned. Variations in Pco2 did not alter the efficiency of the buffering of the HCl. The presence or absence of metabolic acidosis did not alter the magnitude of the effect of acute respiratory change on the concentration of extracellular bicarbonate. This response remained between 1·0 and 1·3 mmol/l for changes of 10 mmHg in the Pco2.

3. The buffering of HCl achieved outside the blood and extracellular fluids did not correlate with measured changes in extracellular pH or with predicted changes in intracellular pH. This buffering appears to be associated with changes in the H+ ion concentration gradient across the cell membranes.
Iron-Deficiency Anaemia: Its Effect on Transfer Factor for the Lung (Diffusing Capacity) and Ventilation and Cardiac Frequency during Sub-Maximal Exercise
Authors: Cotes J. E. , Dabbs J. M. , Elwood P. C. , Hall A. M. , McDonald A. , Saunders M. J.
Published: August 2015

1. Measurements of transfer factor and sub-maximal exercise ventilation and cardiac frequency have been made on twenty women with iron-deficiency anaemia (Hb 8–9 g/100 ml) before and after ‘treatment’ with iron or placebo tablets and on control subjects.

2. The exercise ventilation, cardiac frequency and oxygen uptake were independent of haemoglobin concentration but the transfer factor was lower in the test than in control subjects and was increased by iron but not by placebo treatment. The results support the validity of the reaction-rate data for carbon monoxide with oxyhaemoglobin of Roughton & Forster (1957) despite evidence to the contrary from other studies.

3. In interpretation of sub-maximal exercise ventilation and cardiac frequency in iron-deficiency anaemia no allowance need be made for variation in haemoglobin concentration in the range 8–15 g/100 ml. For transfer factor a correction should be made by using a variant of the relationship of Roughton & Forster (1957).
Multistage Treadmill Walking Performance and Associated Cardiorespiratory Responses of Middle-Aged Men
Authors: Adams W. C. , McHenry M. M. , Bernauer E. M.
Published: August 2015

1. Eighty apparently healthy sedentary males, aged 31–69 years, undertook a multistage treadmill walking test that was terminated at maximum tolerable effort.

2. An electrocardiogram (ECG), blood pressures and respiratory metabolism measures were taken at rest, during the walk and for 15 min post-exercise. The mean values for four age groups of twenty subjects each were analysed statistically.

3. A near rectilinear decrease in walk-time and maximum oxygen uptake (V̇o2max.) (ml min−1 kg−1) with advancing age was observed. A difference in V̇o2max. of 26·5% between the oldest and youngest groups was decreased to 17·7% when expressed in ml min−1 kg−1 of lean body weight (LBW). Heart rate (HR) and pulmonary ventilation (V̇e) at maximum tolerable effort also declined with age.

4. There were no age-related differences in V̇e and HR during submaximal work, whereas significant differences in V̇o2 were observed only during early stages.

5. It was concluded that the decline in maximum performance with age was not due to differences in the efficiency of aerobic energy utilization but to factors limiting energy production.

6. Prediction of walk-time utilizing anthropometric, resting and submaximal work, measurements proved unsatisfactory. Although an r value of −0·69 between age and walk-time was obtained, V̇o2max. and walk-time yielded an r or 0·93, thus indicating that chronological age alone was not adequate to assess work capacity.
A New Method for Assessing States of Acute Acidaemia in Man
Authors: Stoker J. B. , Kappagoda C. T. , Grimshaw V. A. , Linden R. J.
Published: August 2015

1. CO2 titration curves in vivo were determined at various degrees of acute non-respiratory acidaemia in man.

2. The slope of the CO2 titration curve was found to increase as the severity of the acute non-respiratory acidaemia increased.

3. A simple scheme based on the CO2 titration curves in vivo has been proposed for the assessment of acute acidaemia in man.
The Ventilatory Response to CO2 after Administration of Frusemide in Normal Man
Authors: Iff H. W. , Flenley D. C.
Published: August 2015

1. We have determined the ventilatory response to CO2 inhaled in 30% oxygen (balance nitrogen) in eight normal subjects (1) before and during 4 days of 80 mg of oral frusemide daily and (2) within 55–75 min of 80 mg of frusemide orally.

2. Over 4 days the drug decreased serum potassium concentrations, but increased end tidal (and arterial) Pco2 and serum bicarbonate, thus inducing a mild metabolic alkalosis with an appropriate but small shift in CO2 response to the right without a significant change in the slope of the response. The CO2 response was unaltered by oral frusemide 55–75 min earlier.

3. This slight rise in Pco2 during 4 days of frusemide therapy contrasts with the absence of rise in Pco2 after treatment with thiazide diuretics, as reported by others.

4. We discuss possible implications of these results for the selection of an appropriate diuretic in patients with CO2 retention at various phases of their illness.
Plasma Disappearance and Cerebral Effects of Chlorpromazine in Cirrhosis
Authors: Maxwell J. D. , Carrella M. , Parkes J. D. , Williams R. , Mould G. P. , Curry S. H.
Published: August 2015

1. The plasma disappearance and cerebral effects of chlorpromazine were studied in twenty-four patients with compensated cirrhosis and in matched controls using a sensitive gas-liquid chromatography (g.l.c) technique to measure chlorpromazine. Plasma disappearance followed a double-exponential decay curve. No difference could be detected between cirrhotic and control groups, even when the effect of prior treatment with inducing drugs was considered, and only minor differences were observed when the elimination rate constants (kel) were calculated.

2. Chlorpromazine caused drowsiness in all subjects, together with slowing of EEG activity. The slowest activity, which was accompanied by impaired cerebration, occurred in those patients with a past history of encephalopathy in whom the value for the pretreatment skew mean-dominant-frequency was abnormally low.

3. The susceptibility of some patients with cirrhosis to chlorpromazine is probably due to increased sensitivity of cerebral neurones, rather than impaired hepatic drug metabolism.
Faecal Sodium/Potassium Ratio and Aldosteronism in Experimental Hypertension in the Rat
Authors: Swales J. D. , Thurston H. , Queiroz F. P. , Tange J. D.
Published: August 2015

1. Renal artery constriction and sham operation produced a temporary fall in the faecal sodium/potassium (Na/K) ratio of rats. When contralateral nephrectomy had been performed, the ratio rose to normal with the development of hypertension. With an intact opposite kidney the ratio remained low, but was elevated by spironolactone. With or without contralateral nephrectomy, the ratio was normal in chronically hypertensive animals (>28 days).

2. Balance studies showed sodium depletion in hypertensive rats with a normal kidney in situ. It is suggested that this stimulates aldosterone secretion and the faecal electrolyte changes.
Late Hypoalbuminaemia and Albumin Metabolism in Paraplegic and Tetraplegic Patients
Authors: Ranløv P. , Rossing N. , Schwartz M. , Eskesen B. , Rasmussen G.
Published: August 2015

1. Plasma albumin concentration was decreased in thirty-five of eighty-six mobilized para- or tetra-plegic patients studied months or years after injury to the spinal cord causing a medullary cross-sectional syndrome. The colloid osmotic pressure was low in thirty-one of eighty-one patients in whom it was measured. Plasma volume was normal in thirty and slightly elevated in three of thirty-three patients in whom it was determined. None had oedema at the time of the investigation.

2. Albumin metabolism was studied in ten patients by means of 131I-labelled albumin. Six of these had a decreased plasma albumin concentration. This was probably caused by an increased fractional catabolic rate, although a statistically significant causal relationship could not be demonstrated.

3. in spite of the low plasma albumin concentration normal compensatory mechanisms such as an increase in rate of albumin synthesis and shift of albumin from the extravascular to the intravascular compartment were not found. On the contrary, for unexplained reasons, the average rate of synthesis and the ratio intravascular/total albumin mass were both decreased.
Sodium Conservation in Chronic Renal Failure: Studies Using Oral Diazoxide
Authors: Swales J. D. , Thurston H. , Pohl J. E. F.
Published: August 2015

1. The defect in sodium conservation shown by patients with advanced chronic renal failure has been studied during the administration of diazoxide.

2. All nine patients showed a reduction in urinary sodium concentration to levels substantially lower than those which can normally be produced in such patients even with prolonged sodium depletion. Seven patients produced a nearly sodium-free urine. In all patients this effect could be reversed by the administration of high doses of frusemide. The fall in urinary sodium concentration was associated with a sustained fall in creatinine clearance in only two cases.

3. One patient with salt-losing renal disease showed a more modest fall in sodium concentration on treatment with diazoxide.

4. It is concluded that since the defect in sodium conservation shown by patients with chronic renal failure can be corrected without diminishing the osmotic load, it cannot be solely due to the effect of the osmotic diuresis upon residual functioning nephrons. It is suggested that the distal tubular transport mechanism for sodium is saturated by the increased delivery of sodium from the proximal tubule.
Determination of Plasma Renin Activity by Radioimmunoassay of Angiotensin I
Authors: Fukuchi S. , Takeuchi T. , Torikai T.
Published: August 2015

1. A simple, rapid radioimmunoassay of angiotensin I has been applied to the measurement of plasma renin activity.

2. Antibody to angiotensin I was raised in rabbits by injecting angiotensin I conjugated with rabbit serum albumin.

3. Angiotensin I was generated in plasma by 3 h incubation at 37°C and pH 5.5 after adding EDTA and di-isopropylfluorophosphate (DFP).

4. The simple procedure of boiling for 10 min was performed to eliminate the inhibitory effect of plasma protein on immunoassay. After centrifugation, the supernatant was incubated for 18 h with 131I-labelled angiotensin I and antiserum. Free fractions of 131I-labelled angiotensin I were separated using dextran-coated charcoal, and compared with the standard curve.

5. Mean recovery of renin through the method was 91.8%; mean recovery of angiotensin I was 87.0%.

6. Normal values for plasma renin activity (estimated as the rate of generation of angiotensin I) was 1.17±0.90 ng ml−1 h−1; n = 21. Plasma renin activity was normal in essential hypertension; high in chronic glomerulonephritis with oedema; often high in renovascular hypertension; and low in primary aldosteronism.
A New Method for Monitoring Deep Body Temperature from the Skin Surface
Authors: Fox R. H. , Solman A. J. , Isaacs R. , Fry A. J. , MacDonald I. C.
Published: August 2015

1. A new technique for monitoring the deep body temperature is described. The technique depends on creating a zone of zero heat-flow across the body shell; this brings the deep body temperature to the skin surface where it is measured with a simple electronic thermometer.

2. The new device gives a temperature closely comparable with other methods for measuring the deep body temperature in the resting subject, and is simple to use and socially acceptable.
Lysine Infusion in Cystinuria: Theoretical Renal Thresholds for Lysine
Authors: Lester Frances T. , Cusworth D. C.
Published: August 2015

1. The renal handling of lysine was studied during the intravenous infusion of a lysine load given in such a way that the plasma lysine concentration was constantly increasing. Theoretical renal thresholds, and maximum rates of renal tubular reabsorption of lysine, have been determined in three normal adults, five homozygous cystinuric patients, and three persons, two ‘completely’ and the third ‘incompletely’ recessive, heterozygotes for cystinuria. All the cystinuric patients were found to have thresholds at less than 1 mg of lysine/100 ml of plasma; the thresholds of all three heterozygotes fell within the same range as those of the three normal persons, that is, at values only two to three times the fasting plasma lysine concentration.

2. Not only was the lysine load shown to greatly increase the excretion of cystine, arginine and ornithine in the normal and heterozygous persons, but it was also shown to increase the already high clearance of these three amino acids in three of the homozygous cystinuric patients.

3. It was shown that a water diuresis alone will not cause increased excretion of any amino acids except taurine.
The Point of Onset of ‘Airway Closure’ Measured with Argon and Nitrogen: A Comparison of Results Obtained by Two Methods
Authors: Farebrother M. J. B. , Martinez R. Paredes , Soejima R. , McHardy G. J. R.
Published: August 2015

1. The point of onset of ‘airway closure’ has been determined by simultaneous analysis of expired argon and nitrogen in twenty-five subjects studied in the sitting and supine postures.

2. Estimates of ‘closing volume’ derived from nitrogen analysis were less than those derived from argon analysis, the difference being partly attributable to a less readily defined inflexion in the record of expired nitrogen.

3. The relationship between the two estimates of ‘closing volume’ was linear and was not influenced by the age or posture of the subjects.

4. It is valid to use nitrogen as the tracer gas for the measurement of ‘airway closure’, despite the difference in the formation of the inspired bolus, but results should be compared with normal values established separately for this gas.
Renal Control of Changes in the Compliance of the Interstitial Space: A Factor in the Aetiology of Renoprival Hypertension
Authors: Lucas J. , Floyer M. A.
Published: August 2015

1. Measurements of plasma volume, haematocrit, extracellular fluid volume, blood pressure, venous pressure and interstitial tissue pressure were made in rats 4 days after unilateral nephrectomy. Measurements were repeated either 4 days after subsequent removal of the remaining kidney, or 4 days after anastomosis of the remaining ureter with the inferior vena cava. Extracellular fluid volume was expanded by giving 0.5% saline by mouth: in one series blood volume was expanded by injections of blood.

2. Plasma volume (PV) rose more after bilateral nephrectomy (BN), extracellular fluid volume (ECFV) more after unilateral nephrectomy and ureterocaval anastomosis (UNUCA). The PV/ECFV ratio was significantly higher after BN.

3. Blood pressure and venous pressure rose after BN but not after UNUCA. Interstitial tissue pressure (TP) rose more after BN in spite of greater expansion of interstitial fluid volume (IFV = ECFV-PV) after UNUCA. The ratio ΔIFV/ΔTP was several times less after BN than after UNUCA.

4. Interstitial space compliance was estimated by measuring changes in IFV and TP 10 min after a saline infusion (compliance = ΔIFV/ΔTP). After UNUCA there was little change from values obtained after unilateral nephrectomy alone; following BN compliance fell severalfold.

5. It is suggested that changes in compliance of the interstitial space may be brought about by a substance secreted by the kidney and represent a hitherto undetected mechanism by which plasma volume is maintained constant under different conditions of hydration. Changes in interstitial space compliance may also play a part in the aetiology of renoprival hypertension by raising tissue pressure, and thus venous pressure and cardiac output.
Acute Alcoholic Fatty Liver in the Rhesus Monkey
Authors: Nair C. R. , Saha S. , Chakravarti R. N. , Chhuttani P. N. , Datta D. V.
Published: August 2015

1. The effect of intravenous infusion of ethanol on the concentration of plasma free fatty acids (FFA) and triglycerides (TG) and on hepatic triglyceride content was studied in Rhesus monkeys.

2. A minor fall in the plasma FFA was observed after the infusion of ethanol, followed by a rise in FFA which was prevented by a beta-receptor blocking agent.

3. Ethanol administration increased the liver triglyceride level.

4. Prior treatment with a beta-receptor blocking agent which apparently blocked the adrenergic process did not prevent accumulation of triglycerides in the ethanol-treated animals.
Polycythaemia in a Selected Group of Patients with Chronic Airways Obstruction
Authors: Harrison B. D. W.
Published: August 2015

1. The relationship between hypoxaemia, as measured by arterial blood oxygen saturation, and red cell volume is reported in nineteen patients with chronic airways obstruction and raised peripheral venous haematocrit.

2. These patients showed an increase in red cell mass response to lowered oxygen saturations when compared with normal subjects living at high altitudes.

3. Comparison with previous studies suggests that such a significant linear relationship between arterial oxygen saturation and red cell mass only occurs in those patients suffering from chronic lung disease in whom the peripheral venous haematocrit is raised.

4. As arterial oxygen saturation is only one of six factors determining tissue oxygenation, the isolated relationship between red cell volume and oxygen saturation is likely to be an oversimplification.
Vasopressor-Induced Natriuresis and Altered Intrarenal Haemodynamics in Cirrhotic Man
Authors: Gutman R. A. , Forrey A. W. , Fleet W. P. , Cutler R. E.
Published: August 2015

1. The influence of two intravenous vasopressors (angiotensin II and norepinephrine) on renal function and intrarenal blood flow distribution was studied in thirteen cirrhotic subjects and the results compared with those from eight non-cirrhotics.

2. Increased sodium excretion occurred in four of eight cirrhotics with ascites who received comparable pressor doses of angiotensin II and one of five similar subjects who received norepinephrine. In contrast, sodium excretion fell or remained the same in all eight non-cirrhotics.

3. Renal plasma flow fell and filtration fraction rose in nearly all subjects who did not respond to vasopressors with a natriuresis but changed little in those who did.

4. Vasopressor-induced changes of the multicompartmental 133xenon washout curve were qualitatively different in the group who responded with a natriuresis in comparison to the others. Whereas the distribution of flow to the fastest component fell in the non-responder, it remained the same or rose in those who developed a natriuresis.

5. We interpret these results as suggesting a state of relative renal vasopressor resistance allowing the induced systemic hypertension to reduce tubular sodium reabsorption in some cirrhotics by influencing peritubular ‘physical factors’.
Synthesis and Release of Parathyroid Hormone by a Renal Carcinoma in Cell Culture
Authors: Greenberg P. B. , Martin T. J. , Sutcliffe Helen S.
Published: August 2015

1. A monolayer cell culture was established from a hypernephroma removed from a patient with the diagnosis of ectopic parathyroid hormone (PTH) production.

2. Culture media contained immunoreactive peptides of a similar size to PTH and several of smaller size.

3. [14C]Leucine and 75Se-labelled methionine added to the media were incorporated into those peptides in the cells and medium which behaved as PTH immunologically and physicochemically.

4. A basic peptide resembling proPTH (the biosynthetic precursor of PTH) was synthesized.

5. Labelled immunoreactive fragments of PTH were found in cells after incubation with radioactive amino acids.
Blood Pressure and Ageing; Results of a 15–17 Year Follow-Up Study in South Wales
Authors: Miall W. E. , Chinn Susan
Published: August 2015

1. Several recent studies of the relation between blood pressure and ageing have been re-examined, and it is concluded that none satisfactorily investigates the possibility of separate influences of age and attained pressure in determining the rate of change of pressure with time.

2. If the rate of increase of pressure is proportional to the attained pressure, pressure is an exponential function of age. An attempt has been made to determine the relation of blood pressure with age by fitting curves to individuals' measurements made over periods of 15 1/2 and 17 1/2 years in two epidemiological surveys in South Wales.

3. Three models were used: (1) a linear regression, (2) an exponential function, and (3) a model based on the hypothesis that an individual's pressure fluctuates about a constant mean until a variable age at which it increases at a constant rate. Neither model (2) nor model (3) was significantly better than model (1), but this may have been largely due to the small number of measurements (four) for each subject.

4. A positive slope to the linear regression of pressure on time was obtained for most adults. In middle-aged subjects the distributions of these regression coefficients appear unimodal. The rate of increase was higher in those with initially raised values but increased with age independently of the blood pressure level. In these populations some factor related to ageing appears to play a rôle in causing this increase in pressure in addition to any possible direct influence of the attained pressure.
Rapid Dehydration as a Measure of the Ability of the Kidney to Concentrate the Urine: Comparison with the Pitressin-Dehydration Test
Authors: Koutsaimanis K. G. , Tasker P. R. W.
Published: August 2015

1. A new test for measuring the ability of the kidney to concentrate the urine is described. The test is based on the administration of a diuretic followed by complete food and fluid deprivation for 16 h. Slow-release preparations of sodium and potassium are used to replace the loss due to the diuretic.

2. Values reached with the proposed test are not as high as those after the Pitressin-dehydration test, but the differences are small and not statistically significant.

3. The proposed test avoids the disadvantages of prolonged fluid deprivation or an injection of 5 units of Pitressin tannate in oil.
Peripheral Vascular and Sweat-Gland Reflexes in Diabetic Neuropathy
Authors: Goadby H. K. , Downman C. B. B.
Published: August 2015

1. In two groups of diabetic patients, one with and one without signs of peripheral neuropathy, reflex short vasoconstrictor responses to such stimuli as a cough, a sharp inspiration or sudden noise were recorded from a finger and both big toes by volume plethysmography. Simultaneous electrodermal responses to the same stimuli were recorded from a hand and a foot. Vasodilator responses to body warming were also recorded.

2. Significant impairment of these vasomotor reflexes in diabetic patients with neuropathy indicates that the sympathetic vasomotor system can be involved in diabetic peripheral neuropathy.

3. Loss of the reflex electrodermal responses is also evidence of impairment of another sympathetic function in such patients.

4. Because stimuli vary in their effectiveness in causing responses in both groups of subjects, it is suggested that changes of central nervous conductivity also occur in diabetes.
Intestinal Transport of Two Dipeptides Containing the Same Two Neutral Amino Acids in Man
Authors: Silk D. B. A. , Perrett D. , Clark M. L.
Published: August 2015

1. A double lumen perfusion technique has been used in man to study the absorption of the two neutral amino acids glycine and l-alanine from the two dipeptides, l-alanylglycine and glycyl-l-alanine and from an equivalent amino acid mixture.

2. Glycine was absorbed faster from the dipeptides than from the equivalent amino acid mixture, and the difference in absorption rates of glycine and alanine seen when the equimolar mixture of the amino acids was perfused, was abolished when either dipeptide was perfused. This suggests that dipeptides are taken up by the mucosal cell by a mechanism independent of the amino acid-transport system.

3. The presence of free amino acids in the lumen during perfusion of both dipeptides suggests that hydrolysis occurs at some stage in the uptake process. Intraluminal hydrolysis was insufficient to account for the concentration of the amino acids seen, and their presence is thought to be due to hydrolysis of the dipeptides at the brush border.

4. It is suggested that these results confirm that at least two modes of peptide absorption occur simultaneously, namely, direct peptide uptake, and peptide hydrolysis with subsequent absorption of the released amino acids by the amino acid transport system.
Interrelationships between Blood Pressure, Renin, Renin Substrate and Blood Volume in Terminal Renal Failure
Authors: Schalekamp M. A. D. H. , Schalekamp-Kuyken M. P. A. , de Moor-Fruytier M. , Meininger Th. , Vaandrager-Kranenburg D. J. , Birkenhäger W. H.
Published: August 2015

1. The effect of haemodialysis on blood pressure was assessed in forty-six patients with end-stage kidney disease, in relation to measurements of plasma renin concentration (PRC), plasma renin substrate (PRS) and blood volume. Parallel measurements of PRC and blood volume were carried out before and during the period of regular dialysis treatment. PRS was measured during this period only.

2. Both before and during regular dialysis PRC was higher in relation to blood volume in patients whose hypertension persisted after fluid withdrawal than in cases who became normotensive. PRS levels were similar in both groups.

3. The decrease of blood volume by regular dialysis led to a rise in plasma renin both in patients with controllable hypertension and in those with persistent hypertension. After at least 5 months of regular dialysis, the acute removal of 1.5 litres of body fluid caused a similar percentage rise in PRC in six patients with persistent hypertension and twelve patients with controllable hypertension. In three other patients with controllable hypertension and very low PRC, PRC was unresponsive both to the acute and the chronic volume depletion.

4. The pressor response to exogenous angiotensin in anephric patients, in whom no renin could be detected in the plasma, was decreased after ultrafiltration. This was caused by an increase in the threshold dose and not by a decrease in the slope of the dose-response relationship. This effect of ultrafiltration was due to fluid loss itself rather than to a rise in endogenous angiotensin.

5. The results indicate that the presence of hypertension in the face of fluid loss reflects a disturbance in renin release which is rather associated with the pathologic state of the kidney than with an excessive stimulus to the kidney. The decrease in sensitivity to angiotensin caused by fluid loss is presumably overridden by the effect of a high renin level.
The Effects of Pre-Existing Loads Upon Detection of Externally Applied Resistances to Breathing in Man
Authors: McCloskey D. I.
Published: August 2015

1. It was confirmed that normal subjects can detect an increase in airways resistance of 1.2 cmH2O 1−1 s when this is presented during a sequence of otherwise unresisted breaths.

2. In contrast when such subjects meet the same resistance presented unexpectedly during a sequence of breaths against a larger resistance (2.5 cmH2O 1−1 s), they commonly fail to detect it, indicating that they believe no external resistance remains.

3. Subjects breathing continuously against a given external resistance frequently during the course of the study indicate that they believe that a decrease in resistance has been made.
Results of Medical versus Surgical Treatment of Renovascular Hypertension
Authors: Peart W. S.
Published: August 2015

1. An analysis has been made of a series of hypertensive patients with renal artery stenosis treated medically.

2. Patients presenting with features of vascular disease other than renal had a high morbidity and mortality despite treatment; nevertheless, in these, medical as opposed to surgical treatment is advised.

3. No particular drug emerges as better than any other in individual patients.

4. Patients over 40 years of age are in general more suitable for medical than surgical treatment.
Treatment of Hypertension with Large Doses of the β-Adrenergic Blocking Drug Oxprenolol, Alone, and in Combination with the Vasodilatator Dihydralazine
Authors: Tuckman J. , Messerli F. , Hodler J.
Published: August 2015

1. The use of large doses of oxprenolol and a diuretic had a stronger antihypertensive action than the diuretic alone.

2. The combined use of oxprenolol and a diuretic had a strong antihypertensive effect in a majority of the mild, moderate and severe hypertensive patients studied.

3. Oxprenolol caused strikingly few side effects, and it especially did not cause cardiac insufficiency when used in combination with a diuretic.

4. When dihydralazine was added to oxprenolol, it did not cause a further significant fall in arterial pressure, except in a few impressive instances.
The Effect of Oral Diazoxide on Hypertension and Sodium Excretion in Chronic Renal Failure
Authors: Thurston H. , Pohl J. E. F. , Swales J. D.
Published: August 2015

1. Oral diazoxide was administered to a group of ninety-seven patients with renal failure and severe hypertension which had proved resistant to conventional drug treatment.

2. Hypertension was satisfactorily controlled in every case, and resistance to therapy did not occur.

3. Creatinine clearance showed a minor fall in the first week of treatment; however, by 3 months a significant improvement in renal function had occurred. This improvement was maintained at 6 months in the patients with primary hypertension and chronic pyelonephritis. In the chronic glomerulonephritic hypertensive patients, however, creatinine clearance was slightly lower at this stage.

4. Sodium retention was a conspicuous feature and required large doses of diuretics.

5. We suggest that vasodilatation leads to imbalance between filling pressure and capacity, so that volume receptors are stimulated. In addition, the decreased arteriolar resistance will lead to increased hydrostatic pressure in the capillary bed, and thus to increased fluid transudation.
Blood Pressure Over-Shoot Due to Acute Clonidine (Catapres) Withdrawal: Studies on Arterial and Urinary Catecholamines and Suggestions for Management of the Crisis
Authors: Hansson Lennart , Hunyor Stephen N.
Published: August 2015

1. Clonidine was withdrawn acutely in five hypertensive patients with a documented blood pressure over-shoot after previous temporary cessation of treatment.

2. In all patients a severe rise of systolic and diastolic blood pressure was seen (average 67/58 mmHg). This was accompanied by a number of ‘withdrawal symptoms’, e.g. restlessness, tremor, headaches and nausea.

3. Catecholamines in urine rose from 32 μg/l to 112 μg/l (001 < P < 0.02) and in arterial blood from 0.52 μg/l to 1.0 μg/l (not significant).

4. The crisis could be reversed acutely by α- and β-adrenergic blockade.

5. Catecholamine depletion with reserpine before the withdrawal of clonidine seemed to reduce the blood pressure rise and the withdrawal symptoms.
Haemodynamic Changes in Long-Term Therapy of Essential Hypertension: A Comparative Study of Diuretics, α-Methyldopa and Clonidine
Authors: Lund-Johansen P.
Published: August 2015

1. The effects of hypotensive therapy with three separate diuretics, methyldopa and clonidine were separately assessed.

2. All the treated groups showed a significant drop in blood pressure.

3. Polythiazide and hydrochlorothiazide each produced a significant fall in total peripheral resistance, whereas chlorthalidone did not.

4. Symptomless hypokalaemia was the only side effect seen with diuretics.

5. Methyldopa and clonidine reduced heart rate and cardiac index, but not total peripheral resistance.

6. The latter drugs also produced dry mouth, lassitude and drowsiness.
The Clearance of Endogenous Renin in the Anhepatic Anephric Dog
Authors: Fagard R. , Eyskens E. , Delooz H. , Fossion E. , Amery A.
Published: August 2015

1. A rapid fall in plasma renin concentration occurs not only in colonectomized but also in hepatectomized dogs after binephrectomy.

2. In the anhepatic anephric dog no renin extraction can be demonstrated across lungs, splanchnic region, spleen, inferior limb and head.

3. No renin inactivation occurs in blood kept in vitro at 37°C for 3 h taken from anaesthetized dogs and from the anhepatic anephric dogs.

4. We suggest that the clearance of renin in the anhepatic anephric dog is due to extraction or inactivation of renin by tissues in general.
Metabolic Clearance Rate of Angiotensin II in Arterial Hypertension
Authors: Coli A. , Donato L.
Published: August 2015

1. Plasma metabolic clearance rate of mono-[125I]iodoangiotensin II was measured in seventeen patients with various disorders of the renin-angiotensin-aldosterone system. The measurements were carried out by using a new method which accounts for the contribution of labelled split products.

2. A significant correlation was obtained (P < 0.01), when plasma metabolic clearance rate was related to mean blood pressure level and the correlation appeared independent of angiotensin II presumed concentration.

3. A possible additional control mechanism of angiotensin II degradation is suggested.

RIASSUNTO

1. Gli autori hanno misurato la clearance metabolica della mono-[125I]iodoangiotensina II in 17 pazienti con varie alterazioni del sistema renina-angiotensina-aldosterone. Il metodo impiegato permette la sottrazione diretta della radioattività plasmatica dovuta all'angiotensina, da quella dei frammenti marcati.

2. Si osserva una correlazione significativa (P < 0.01), quando i valori di clearance sono confrontati con quelli della pressione arteriosa media.

3. Viene supposto un ulteriore possibile sistema di controllo nella degradazione della angiotensina II.