tbuckley/cabot-search huggingface dataset:
Fat Transport in Lipoproteins — An Integrated Approach to Mechanisms and Disorders
Authors: Donald S. Fredrickson, Robert I. Levy, Robert S. Lees
Journal: New England Journal of Medicine (1967)

Type II Hyperlipoproteinemia159, 192 193 194 195 196 General Definitions. By the Type II lipoprotein pattern we mean an increase in the concentration of lipoproteins that have discrete β mobility by electrophoresis and the normal density and chemical composition of β-migrating lipoproteins. This kind of hyperbeta-lipoproteinemia must be distinguished from another in which the density of the β-migrating lipoproteins is abnormally low, giving rise to a pattern designated as Type III in this system for defining types of hyperlipoproteinemia. The bases for distinguishing the hyperbeta-lipoproteinemia of Types II and III arise from considerable clinical and genetic evidence that they are expressions of different inheritable . . .
Lupus Nephritis
Authors: G.A. SHOVE
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 November 1983Lupus NephritisG.A. SHOVE, M.D.G.A. SHOVE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-5-732_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article by Carette and associates (1) on the treatment of lupus nephritis leaves several questions in my mind. The authors' conclusion is that single-drug, oral immunosuppressive treatment combined with prednisone is the most beneficial in patients with lupus nephritis with intermediate chronic change shown by renal biopsy. Although this conclusion is attractive, a review of the study's progression since 1969 raises doubts.Were any of the patients who participated in the cyclophosphamide or placebo study (2) subsequently entered in the three-arm study? Because the three-arm study excluded patients with a creatine clearance greater than 4 mg/dL,...References1. CARETTE S, KLIPPEL J, and DECKER J. Controlled studies of oral immunosuppressive drugs in lupus nephritis: a long-term follow-up. Ann Intern Med. 1983;99:1-8. LinkGoogle Scholar2. STEINBERG A, KALTREIDER H, STAPLES P, GOETZL E, TALAL N, and DECKER J. Cyclophosphamide in lupus nephritis: a controlled trial. Ann Intern Med. 1971;75:165-71. LinkGoogle Scholar3. STEINBERG A and DECKER J. A double-blind controlled trial comparing cyclophosphamide, azathioprine and placebo in the treatment of lupus glomerulonephritis. Arthritis Rheum. 1974;17:923-37. CrossrefMedlineGoogle Scholar4. DECKER J, KLIPPEL J, PLOTZ P, and STEINBERG A. Cyclophosphamide or azathioprine in lupus glomerulonephritis: a controlled trial: results at 28 months. Ann Intern Med. 1975;83:606-15. LinkGoogle Scholar1. STEINBERG A, KALTREIDER H, STAPLES E, GOETZL E, TALAL N, and DECKER J. Cyclophosphamide in lupus nephritis: a controlled trial. Ann Intern Med. 1971;75:165-71. LinkGoogle Scholar2. DECKER J, KLIPPEL J, PLOTZ P, and STEINBERG A. Cyclophosphamide or azathioprine in lupus glomerulonephritis: a controlled trial: results at 28 months. Ann Intern Med. 1975;83:606-15. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: G.A. SHOVE, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1983Volume 99, Issue 5 Page: 732-733 Keywords Biopsy Creatine Cyclophosphamide Immunosuppressives Lupus nephritis ePublished: 1 December 2008 Issue Published: 1 November 1983 PDF downloadLoading ...
Point of care testing improves process but not outcome in patients in A and E
Journal: BMJ (1998)

Women who smoke have a greater risk of myocardial infarction than men who smoke Studies of smoking and cardiovascular disease may have underestimated the risk in women because until recently women's smoking habits have differed greatly from men's.During the past few decades, however, women have taken up smoking like men.Using data from three large prospective studies in Copenhagen that included many women who were heavy smokers, Prescott et al (p 1043) found that the smoking related risk of myocardial infarction was 50% higher in women than in men.This difference may be caused by interactions between components of tobacco smoke and hormonal factors.
Clinical tumour size and prognosis in lung cancer
Authors: None Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (gccb-S)
Journal: European Respiratory Journal (1999)

In the staging of lung cancer (LC), tumour size is a variable that can be used to separate primary tumour, regional nodes, metastasis (TNM), stages T1 and T2 (<3 or >3 cm). The objective of this study was to evaluate the prognostic value of tumour size before thoracotomy and to determine whether tumour size can be used to classify LC as T3. This multi-institutional cooperative longitudinal prospective study in Spanish hospitals located throughout the country, with a broad range of activity levels, included all consecutive cases of LC treated surgically from October 1993 to September 1996 (n=2,361). Four prognostic groups, characterized by tumour size, were identified according to the Schoenfeld procedure: a) 0-2 cm (n=173); b) 2.1-4 cm (n=542); c) 4.1-7 cm (n= 413); and d) >7 cm (n=77). The 2-yr survival rates by group were a=0.78 (95% confidence interval (CI) 0.71-0.84); b=0.67 (95% CI 0.62-0.71); c=0.58 (95% CI 0.53-0.63); d=0.41 (95% CI 0.29-0.52). The log-rank comparisons of the survival curves were significant for the four groups (a versus b=0.0008, b versus c=0.003, c versus d=0.016). The clinical tumour size of lung cancer defined four prognostic groups (0-2 cm, 2.1-4 cm, 4.1-7 cm; and >7 cm). Lung cancer with a diameter >7 cm had a prognosis similar to that of stage T3 or stage IIB.
Table of Contents
Authors: Rabi Yacoub, Christina Wyatt, Robert Weiss, Mark Haas, Germaine Wong, Jonathan Craig, Jeremy Chapman, Florian Kronenberg, Johannes Schwaiger, Timothy Goodship, H Cook, Fadi Fakhouri, Fernando Fervenza, Véronique Frémeaux-Bacchi, David Kavanagh, Carla Nester, Marina Noris, Matthew Pickering, Santiago Rodríguez De Córdoba, Lubka Roumenina, Sanjeev Sethi, Richard Smith, Leslie Gewin, Roy Zent, Ambra Pozzi, Jerome Lowenstein, Jared Grantham, Daniel Cattran, Paul Brenchley, Maria Fragiadaki, Morgane Lannoy, Madeleine Themanns, Barbara Maurer, Wouter Leonhard, J Dorien, Richard Peters, Albert Moriggl, Lin Lv, Ming-Kuen Patrick, Chun Tang, Yong Li, Jinhong You, Xiao-Ru Li, Jun Huang, Min Ni, Bi Feng, Hui-Yao Liu, T Cells, Ji-Jing Yan, Jae-Ghi Lee, Young Jang, Tai Koo, Curie Ahn, Jaeseok Yang, Isabel Schellinger, Nada Cordasic, Julian Panesar, Björn Buchholz, Johannes Jacobi, Andrea Hartner, Bernd Klanke, Joanna Jakubiczka-Smorag, Nicolai Burzlaff, Eva Heinze, Christina Warnecke, Uwe Raaz, Carsten Willam, Philip Tsao, Kai-Uwe Eckardt, Kerstin Amann, Karl Hilgers, Norihiko Sakai, Jerold Chun, Jeremy Duffield, David Lagares, Takashi Wada, Andrew Luster, Andrew Tager, Xuemin He, Rui Cheng, Kyoungmin Park, Siribhinya Benyajati, Gennadiy Moiseyev, Chengyi Sun, Lorin Olson, Yanhui Yang, Bonnie Eby, Kai Lau, Ma Open, Ryusei Sugimoto, Hiroshi Watanabe, Komei Ikegami, Yuki Enoki, Tadashi Imafuku, Yoshiaki Sakaguchi, Michiya Murata, Kento Nishida, Shigeyuki Miyamura, Yu Ishima, Motoko Tanaka, Kazutaka Matsushita, Hirotaka Komaba, Masafumi Fukagawa, Masaki Otagiri, Toru Maruyama
Journal: Kidney International (2017)
Observations ON THE NATURE AND SYMPTOMS OF CARDIAC INFECTION IN CHILDHOOD
Authors: F. J. Poynton
Journal: BMJ (1918)

First Attacks ofRhqumati-sm in Childhood.TH k B bring us to the threshold o! the early development of orgnic disease.Among such cases we find all grades, of 'severity, from those-fortunately rare-which prove' raly fatal, and in which the infective element reaches its acme of intensity, to those which are so transient and vage that we are left doubtful of their significance.From a Audyof the latter we realike that-a-& onqiderable number eliie discovery by parents and doctorsj and that as a result the early detection of cardiac affectiono can be.bui a rjfative accomplishment, the accuracy of which willonly b-.increased by continual improvement in the education of-thepublic and in our clinical methods.'It' is here that a general idea of the relative frequency- of'-the well recognized manifestations of the disease becOmes of some practical importance, and the following figures, based upon 524 examples which I believe to be first attacks, may be of service.These figures, however, can only be 'of relative value, for the proof that an attack was actually the first is often difficult.
Reflections on the postmortem audit
Authors: H. H. Friederici
Journal: JAMA (1988)

IN 1919, The Institute of Medicine of Chicago formed a committee on necropsies in the belief that "the interest of a hospital in necropsies is an important index of its efficiency in treating disease and of the grade of work done in the hospital."<sup>2</sup>For 69 years, this committee has compiled annual statistics on the frequency of autopsies in the metropolitan Chicago area. In 1967, Stenn<sup>3</sup>published a summary of the committee's activities and a graph illustrating the steady increase in autopsy rates in Chicago area hospitals over 50 years (Fig 1). From an overall rate of 11% in 1919, the number of necropsies performed in hospitals that reported had increased to 51.2% in 1965, when 14 506 postmortem examinations were performed on 28 350 patients who had died in the hospital. Stenn concluded that this interest in the postmortem audit meant that physicians were sincere in wanting
Explanation
Journal: JAMA (1883)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Subject Index
Authors: H Thomas, S Todo, K Tokuhara, D Tola, C Trautwein, Tre ´po, F Trevisani, C Triantos, D Trinder, M.-F Tripodi, M Trippler, O Tsedensodnom, E Tsianos, H Tsutsui, E Tuddenham, Y Uchida, K Ueda, N Umeda, U ¨nalp, J Underhill, S Urbani, M Uribe, L Valenti, M Valiga, D Valla, T Van Der Hoeven, T Van Gulik, A Van Wijk, Variceal Bleeding, R Vega, L Velloso, V Venard, Verga Falzacappa, M Vergara, A.-C Vergnaud, V Verkarre, P Veys
Journal: Journal of Hepatology (2008)
Controversy over Multiple Chemical Sensitivities
Authors: Raphael B. Stricker
Journal: Annals of Internal Medicine (1994)

Letters1 February 1994Controversy over Multiple Chemical SensitivitiesRaphael B. Stricker, MDRaphael B. Stricker, MDCalifornia Pacific Medical Center; San Francisco, CA 94120Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-3-199402010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The article by Simon and colleagues [1] on multiple chemical sensitivity reported an absence of significant immunologic abnormalities in the study patients. This conclusion was based on autoantibody testing combined with an analysis of lymphocyte subset numbers and function.We have seen at least three patients with multiple chemical sensitivity associated with IgG subclass deficiency, specifically, a lack of IgG2 or IgG3. Because IgG subclass, IgA, and complement deficiencies have each been associated with asthma and recurrent upper respiratory infections that may mimic chemical sensitivity [2-4], failure to test for such deficiencies significantly weakens the study. If ...References1. Simon GE, Daniell W, Stockbridge H, Claypoole K, Rosenstock L. Immunologic, psychological, and neuropsychological factors in multiple chemical sensitivity: a controlled study. Ann Intern Med. 1993; 119:97-103. Google Scholar2. Bjorkander J, Bengtsson U, Oxelius VA, Hanson LA. Symptoms in patients with lowered levels of IgG subclasses, with or without IgA deficiency, and effects of immunoglobulin prophylaxis. Monogr Allergy. 1986; 20:157-63. Google Scholar3. Hanson LA, Soderstrom R, Nilssen DE, Theman K, Bjorkander J, Soderstrom T, et al. IgG subclass deficiency with or without IgA deficiency. Clin Immunol Immunopathol. 1991; 61:S70-7. Google Scholar4. Spinozzi F, Cimignoli E, Gerli R, Agea E, Bertotto A, Rondoni F, et al. IgG subclass deficiency and sinopulmonary bacterial infections in patients with alcoholic liver disease. Arch Intern Med. 1992; 152:99-104. Google Scholar Author, Article, and Disclosure InformationAuthors: Raphael B. Stricker, MDAffiliations: California Pacific Medical Center; San Francisco, CA 94120 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1994Volume 120, Issue 3Page: 249-251KeywordsAsthmaAutoantibodiesLymphocytesUpper respiratory tract infections ePublished: 15 August 2000 Issue Published: 1 February 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Abstract O.59: Fate of Kawasaki disease giant coronary aneurysm: Analysis of the last 10 years nationwide survey in Japan
Authors: Ryuji Fukazawa, Kenji Hamaoka, Tsutomu Saji, Hitoshi Kato, Hiroyuki Suzuki, Etsuko Tsuda, Mamoru Ayusawa, Masaru Miura, Tohru Kobayashi, Shunichi Ogawa
Journal: Circulation (2015)

Background and Objective: Long term prognosis of Kawasaki disease (KD) with giant aneurysm is not yet well understood. We conducted a nationwide survey of KD with giant aneurysm for recent 10 years, and analyzed cardiac events of those patients. Methods: Nationwide epidemiological survey of KD has been conducted every 2 years since 1970 in Japan. We performed questionnaire survey based on 16th - 21th (1999 - 2010) nationwide epidemiological data. Results: We send questioners to 275 facilities asking about 415 patients who were reported to have giant aneurysm (&gt;=8mm), and collected the data of 334 patients (80.5%). We excluded 84 non-giant aneurysm patients and 36 duplicated cases and difined finally 214 patients. Out of 214 patients, 13 deaths and 32 AMIs were described (6.1% and 15.0%, respectively). The first AMI attack was mostly reported within a few months from KD onset (medium 5 months (0-85 months)). AMI was occurred one time in 26 patients, and two times in 6 cases. Myocardial ischemia was observed in 80% of AMI patients, and 12 patients were received coronary artery bypass graft. Thirteen patients were reported to be dead (medium 1 month (0-23 months) from KD onset). There were 6 cardiac deaths within 1 month from KD onset (5: rupture of aneurysm, 1: AMI). The others were all caused by AMI except for 2 accidental death. Four out of 6 AMI deaths were caused by the first AMI attack. For the remaining 2 AMI deaths, the period from the first AMI to second fatal AMI was 1 month and 6 month, respectively. There were no death reported byond 2 years from KD onset. Conclusion: AMI and cardiac death of KD with giant aneurysm occurred mostly in early phase of KD onset. Coronary rupture occurs within a month after onset, and 84% AMI and all AMI death occurs within 2 years after onset. Patients survival become promising after 2 years from onset. These evidences indicate that therapeutic strategy up to 2 years after onset is extremely important for prognosis of KD with giant aneurysm.
Documentary
Authors: John E. Ehiri
Journal: JAMA (2005)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Common bile duct obstruction and cholangiohepatitis in clonorchiasis
Authors: W. G. Sullivan
Journal: JAMA (1980)

This report describes a patient with common bile duct obstruction and cholangiohepatitis. Patients with clonorchiasis are usually asymptomatic and treatment is limited to complications. Treatment consists of cholecystectomy, choledochotomy, and T-tube drainage. A bypass procedure is indicated in cases of heavy infestation and recurrent disease. (<i>JAMA</i>243:2060-2061, 1980)
The role of the CCME in the distribution of residencies by specialty
Journal: JAMA (1979)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Helmets and preventing motorcycle- and bicycle-related injuries. Council on Scientific Affairs, American Medical Association
Journal: JAMA (1994)

RESOLUTION 423, as amended and adopted at the 1992 Interim Meeting, asked that the American Medical Association (AMA) evaluate the effectiveness of motorcycle and bicycle helmets in preventing injuries, determine the medical costs of not using helmets, and explore ways of ensuring the use of helmets by instituting incentives or disincentives such as insurance premium adjustments or licensing fees. This report responds to the medical science aspects of the resolution and considers the occurrence and prevention of motorcycle- and bicycle-related injuries and the efficacy of helmet use by motorcyclists and bicyclists. The AMA's Council on Medical Services is studying the use of incentives and disincentives and will report to the House of Delegates at a future meeting. See also pp 1506 and 1541. According to age-adjusted data, injuries are the third most common cause of death in the US population, with vehiclerelated deaths causing approximately half of all deaths.<sup>1</sup>
Chronic Severe Hemolytic Anemia from Phenazopyridine
Authors: Anand B. Karnad
Journal: Annals of Internal Medicine (1995)

Letters15 January 1995Chronic Severe Hemolytic Anemia from PhenazopyridineAnand B. Karnad and Robert J. ThomasAnand B. KarnadSearch for more papers by this author and Robert J. ThomasSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-2-199501150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We stand corrected. Pyridium itself is not available over the counter. However, the pharmacist who notified us of our patient's drug habit confirmed that our patient did purchase more than 12 boxes per week of one of several preparations available over the counter (Azostandard, Polymedica Pharmaceutical Inc., Woburn, Massachusetts; Reazo, Reese Chemical, Cleveland, Ohio; and Baridium, Pfeiffer Co., Wilkes-Barre, Pennsylvania) that contain 95 to 100 mg of phenazopyridine hydrochloride per tablet [1, 2].We had overlooked the classic paper by Gabor and colleagues[3] that was perhaps the first to thoroughly document hemolysis caused by phenazopyridine. Other reports[4] also ...References1. Physicians Desk Reference for Non-Prescription Drugs. 15th ed. New Jersey: Medical Economics; 1994:630, 647. Google Scholar2. Drug: Facts and Comparisons (Updates: Baridium). St. Louis: Wolter Kluwer; 1994. Google Scholar3. Gabor EP, Lowenstein L, De Leeuw NK. Hemolytic anemia induced by Phenylazo-Diamino-Pyridine (Pyridium). Can Med Assoc J. 1964; 91:756-9. Google Scholar4. Fincher ME, Campbell HT. Methemoglobinemia and hemolytic anemia after phenazopyridine hydrochloride (Pyridium) administration in end-stage renal disease. South Med J. 1989; 82:372-4. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrug‑induced hemolytic anemia 15 January 1995Volume 122, Issue 2Page: 156-157KeywordsBlood cellsCellsDrugsHabitsHemolytic anemiaOver the counter drugsPharmacistsRenal failure Issue Published: 15 January 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Adenosine 3',5'-monophosphate and mania
Authors: H. Meltzer
Journal: JAMA (1971)

Adenosine 3',5'-monophosphate (cyclic AMP) is currently of intense interest to scientists in many fields of biology and medicine. Cyclic AMP plays a central role in the mediation of hormonal actions and the regulation of metabolic processes.<sup>1</sup>There is considerable experimental evidence for an important role of cyclic AMP in brain function.<sup>2</sup>Intracellular cyclic AMP levels may be increased or decreased by a variety of hormones and neurotransmitters, probably through stimulation or inhibition of the activity of adenyl cyclase, the enzyme which synthesizes cyclic AMP.<sup>1,2</sup>The mode of action of theophylline and aminophylline in the treatment of heart failure and bronchial asthma has been attributed to the inhibition of phosphodiesterase (the enzyme which catabolizes cyclic AMP), producing increased intracellular cyclic AMP levels in the myocardium and bronchial muscle, which results in more vigorous myocardial contraction and in bronchial dilatation.<sup>3</sup> Studies of hormonal and neutrotransmitter excesses, deficiencies, and