ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A prospective, randomized, double-blind clinical trial of bovine and porcine heparin was conducted. One hundred forty-one patients were randomized, of whom 89 received heparin treatment for six or more days (mean, ten days). Two developed severe thrombocytopenia (platelet count less than 20,000 per μl); both were randomized to the bovine heparin group, but one inadvertently received two doses of porcine heparin. Laboratory investigation suggested that the thrombocytopenia in these two patients was immunologically mediated, and platelet reactivity to both bovine and porcine heparin was demonstrated. Twenty patients had a decline in platelet count of greater than 50,000 from baseline, although the total count remained above 150,000 per μl. In seven of these subjects, the platelet count returned to its original level while heparin therapy was continued. Of the 13 patients with a persistent decrease in platelet count, ten had received bovine heparin and their counts decreased by an average of 88,000 per μl; the reduction in the three porcine-treated patients was 68,000; this difference was not statistically significant. In the remaining patients, the post-treatment platelet counts in both groups were significantly higher than pre-treatment values (p < .005), perhaps indicating a cessation of the platelet consumption that accompanied the original thrombotic event. We conclude that a modest and persistent reduction in platelet count commonly occurs during heparin therapy (13/89 receiving treatment for six or more days), but that severe thrombocytopenia is relatively rare (2/89).

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To assess mechanisms associated with the pressor effects of a high sodium diet in susceptible individuals, the hemodynamic and hormonal effects of sodium depletion and repletion were studied in 33 normal subjects and 30 subjects with borderline hypertension. The hypertensive group had significantly higher mean arterial pressure, weight, hematocrit, and upright plasma renin activity. Forearm hemodynamics were measured during periods of ad lib diet, 10 mEq, and 200 mEq sodium diet. The fall in forearm resistance during reactive hyperemia was inversely related to mean arterial pressure at rest (R = .400, p < .005) and rose significantly in hypertensive subjects during salt depletion, 39±3.6 to 61±6.1 mmHg/ml/min/100 g (p < .05).Sodium sensitivity in either normotensive or borderline hypertensive subjects was defined as an increase in mean blood pressure of more than 5% when sodium repleted. The individuals who were sodium sensitive had a higher forearm vascular resistance during sodium depletion than those who were sodium resistant, 67±10.5 versus 45±4.1 mm/ml/min/100 g (p < .03). We conclude that young individuals with borderline hypertension already have alterations in vascular reactivity. This trait is shared by normotensive individuals whose blood pressure rises in response to sodium.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Lipid metabolism was investigated in a 4-year-old boy with alpha-1 antitrypsin deficiency (ZZ phenotype) and liver disease. Plasma cholesterol and triglyceride levels were 604 mg/dl and 336 mg/dl respectively. Both parents had normal plasma lipids. Lipoprotein X was present at a concentration of 855 mg/dl and levels of apoproteins A-I, A-II, B and C-III were elevated. The plasma free fatty acid pattern was normal. Plasma cholesterol esterification was greatly depressed. Cholesterol absorption on two occasions was reduced about 13% compared with adult controls. Neutral and total steroid excretion was normal with increased excretion of bile acids. A low-cholesterol, low-fat diet reduced plasma cholesterol to 374 mg/dl and triglyceride to 236 mg/dl in two months. Cholesterol and lipoprotein X concentrations were elevated far out of proportion to the severity of the liver disease (total bilirubin 3.7 mg/dl, SGOT 280 IU/L). This suggests that lipoprotein metabolism in patients with this disorder is unusual and may differ from the derangements seen in other forms of liver disease.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Three children with psychosocial growth retardation increased their serum somatomedin C levels from 0.20 ± .02 to 0.81 ± 0.2 U/ml in response to exogenous growth hormone. The pattern of somatomedin C response to growth hormone was no different from that seen in 11 prepubertal children with growth hormone deficiency who received growth hormone according to the same acute treatment regimen. This result suggests that the poor growth response of children with psychosocial growth retardation to exogenous growth hormone is not due to an inability to synthesize somatomedin C, and that it may represent a degree of resistance to the actions of somatomedin C.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Percutaneous transluminal coronary angioplasty appears to be an effective alternative to coronary artery bypass surgery in patients whose coronary artery anatomy is suitable—that is, an individual with single (or, at most, double) vessel coronary artery disease whose stenoses are proximal, discrete, subtotal, concentric and non-calcified. Since emergent coronary artery bypass surgery is required in 5% to 7% of patients even when angioplasty is attempted by an experienced physician, the patient should be an acceptable candidate for surgery from both a cardiac and noncardiac standpoint. Unfortunately, ideal angioplasty candidates are a distinct minority among those with coronary artery disease. If the procedure is reserved for ideal (or nearly ideal) candidates, the rate of success should approach 75% to 80%, and the incidence of major complications should be below 10%. Although the procedure appears to be effective in alleviating angina, it is unlikely that it will exert a beneficial effect on survival when compared to either medical therapy or coronary artery bypass surgery.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID