摘要:

In this lecture a partial and tentative examination has been made of chemical factors possibly important in the pathogenesis of atherosclerosis. The discussion has centered about four observations concerning the incidence and extent of the disease. The first is that man appears to be unique among mammals in his predisposition; the second, that the condition is seldom if ever seen in the human infant at birth; the third, that healthy women are not likely to develop its complications before the time of the menopause; the fourth, that in man certain maladies and particularly diabetes, familial xanthomatosis, and nephrosis favor early and extensive atheromatous deposits.An attempt has been made to relate present knowledge of lipid composition of the blood to known variations in the degree of predisposition to the disease. This has included scrutiny of observations on concentration of cholesterol and the Sf10-20 bodies of Gofman, on cholesterol-phospholipid ratios and on the distribution of cholesterol between the lipoproteins of plasma.It has been shown that in mammals which never develop spontaneous atherosclerosis the values of all the criteria of concentration and distribution of lipids differ from those of man. Among human beings only the infant at birth has plasma which in its lipid composition closely resembles that of immune mammals. In young women the deviation is less than in other human adults. In groups of patients that display the greatest tendency to the development of atherosclerosis, the plasma lipid patterns differ most widely from those of other mammals.Among survivors of myocardial infarction many but not all display striking abnormalities in every one of the criteria of lipid concentration and distribution. Comparison of the different methods indicates that in survivors of infarction the distribution of cholesterol between the lipoproteins is more constantly disturbed than the other chemical factors. No test however deviates with sufficient constancy to permit its use in the clinical diagnosis either of the presence of atherosclerosis or of a tendency to its development.It has been shown that the lipid patterns in man are not immutable but can be manipulated to a considerable degree. Specifically, it has been demonstrated that the administration of estrogen can convert the highly pathologic patterns of survivors of myocardial infarction to normal adult human values, and that the use of methyl testosterone exaggerates the chemical pathology of myocardial infarction and may even produce deviant patterns in those who have been previously normal.Although the observations which have been reviewed offer strong evidence that predisposition to atherosclerosis is related to deviations in the lipid composition of the blood, they do not establish the chemical hypothesis of pathogenesis. Although at present they lead to no practical applications in therapy, they are regarded as worthy of further investigation with a justifiable hope that greater knowledge may offer new clues to prevention and control.

ISSN:0009-7322    

出版商:OVID    

年代:1953

数据来源: OVID

摘要:

The blood pressure cuff reveals higher values in complex societies than in simpler social environments. Evaluation of the importance of this fact necessitates a more exact use of such terms as "high blood pressure" or "hypertensive disease' as applied to an individual, and "mean blood pressure" or "incidence of hypertension" as applied to groups. The inadequacies of the cuff method of blood pressure determination are particularly evident in group studies. From the available facts, a few cautious conclusions may be drawn.

ISSN:0009-7322    

出版商:OVID    

年代:1953

数据来源: OVID

摘要:

This paper reports the clinical and pathologic manifestations of seven cases of platelet thrombosis syndrome. Evidence is presented to indicate that vascular damage precedes the formation of platelet thrombi. It is suggested that the syndrome may be secondary to a variety of underlying disease entities.

ISSN:0009-7322    

出版商:OVID    

年代:1953

数据来源: OVID

摘要:

This report is the first of a series on a method for treatment of hypertension by oral hexamethonium chloride and hydrazinophthalazine. When strictly followed blood pressure was maintained at reasonable or normal levels in 80 per cent of 258 cases of severe hypertension. The malignant stage, when present, was reversed. Renal insufficiency and severe cerebral atherosclerosis limit the effectiveness of the method for prolongation of life.

ISSN:0009-7322    

出版商:OVID    

年代:1953

数据来源: OVID

摘要:

Seven cases of patent ductus arteriosus with pulmonary hypertension and reversal of the usual direction of flow are described. Breathing of a low oxygen mixture either initiated or increased the reversed shunt, and breathing 100 per cent oxygen produced the reverse effect. Differences in oxygen saturation and dye-dilution curves recorded simultaneously from the radial and femoral arteries have allowed calculation of differences in the proportion of shunted blood flowing in these arteries and demonstrate that retrograde movement of blood in the aortic arch may occur.

ISSN:0009-7322    

出版商:OVID    

年代:1953

数据来源: OVID

摘要:

The hemodynamic findings in five patients are presented in order to demonstrate the variability in the clinical and physiologic patterns that may be encountered in restrictive disease of the pericardium. The mechanical effects of pericardial encasement previously described were confirmed. Furthermore, it was found that myocardial insufficiency and hypervolemia were not only important causative agents in the circulatory dysfunction but were in some measure reversible, thus permitting resolution of the congestive state and disappearance of the "typical" hemodynamic findings of constrictive pericarditis.

ISSN:0009-7322    

出版商:OVID    

年代:1953

数据来源: OVID

摘要:

Segmental obstruction due to arteriosclerosis may occur in peripheral arteries. Further experience in resection of these obstructed segments and their replacement by vein grafts is reported. Replacement of segments of the femoral artery has been accomplished in 30 patients. The proper selection of patients is essential for success. The various causes of failure and the limitations of the procedure are emphasized.

ISSN:0009-7322    

出版商:OVID    

年代:1953

数据来源: OVID

摘要:

By means of venous occlusion digital plethysmography, the authors have evaluated the peripheral vasodilating effect on normal and diseased arterioles of a new adrenergic blocking agent, Regitine, 2-[-(m-Hydroxy-N-p-tolylanilino)-methyl]-2-imidazoline. Results have been compared with the results of similar studies using Priscoline and indirect body heating to produce vasodilation. The effect of palrenteral Regitine on pulse and blood pressure has been noted as well as the clinical results obtained when this drug was used orally for the treatment of certain forms of peripheral vascular disease.

ISSN:0009-7322    

出版商:OVID    

年代:1953

数据来源: OVID

摘要:

The diurnal variability of several classes of serum lipoproteins and cholesterol has been measured in human subjects. The Sf12-20 class of lipoprotein and the cholesterol were found stable in reference to the technical limitation of the method, but the Sf20-100 class showed significant variation although without evidence of a trend. The effect of intravenous heparin treatment was described. The buccal administration of heparin had no effect. The heparinoid substance Treburon produced a decrease in the Sf20-100 material at three and five hours and decrease in serum total cholesterol and phospholipids at five and seven hours when administered buccally.

ISSN:0009-7322    

出版商:OVID    

年代:1953

数据来源: OVID

摘要:

The effects of changes in injection volume on the intramuscular radiosodium clearance rate was investigated in six normal young men. The clearance rate was found to be quite sensitive to the volume of solution injected, and an increase in the rate of clearance corresponding to a decrease in volume was uniformly noted. Rigid control of the injection volume is necessary when this method is used for regional blood flow measurements.

ISSN:0009-7322    

出版商:OVID    

年代:1953

数据来源: OVID