Postoperative hemostatic profile in relation to gram-negative septicemia.

Gram-negative septicemia presents a particular problem in the ICU. Septicemia is usually diagnosed by fever, chills, and shock. Results of blood cultures become available a few days later.

Sulfinpyrazone: an antiarrhythmic drug?

To determine whether a direct antiarrhythmic effect could explain the claimed beneficial effect of sulfinpyrazone on the sudden death rate in postmyocardial infarction patients, we performed a double-blind, randomized trial in 20 patients with impulse-formation and conduction defects. The patients were studied by intracardiac electrocardiography and programmed stimulation before and after an intravenous bolus injection of either 500 mg sulfinpyrazone or a placebo. We found no consistent clinical or statistical effects of sulfinpyrazone on sinus rate, sinus node recovery time, sinoatrial conduction time, conduction intervals during spontaneous cardiac activity and atrial pacing.

Salt handling in patients with chronic renal insufficiency.

In 7 patients with moderate degrees of renal insufficiency the effect of high and low salt intake on renal NaCl handling was investigated by means of clearance techniques. After a steady state had been reached at low (1 g NaCl daily) and high (10 mmol NaCl daily for every ml X min-1 glomerular filtration rate) salt intake, proximal and distal fractional salt reabsorption (FSRprox and FSRdist) were estimated, maximal free water clearance being taken as an index of distal NaCl reabsorption. Mean FSRprox during low salt intake was 86.

Changes in intrarenal uric acid handling during chronic spironolactone treatment in patients with essential hypertension.

Intrarenal handling of uric acid was studied in 12 patients with essential hypertension under spironolactone treatment (200 mg/day). The degree of volume depletion during treatment was assessed from the changes in body weight and plasma renin activity (PRA). The results are compared with those in patients treated with chlorthalidone (50 mg/day).

Determination of glomerular filtration rate by 111In-DTPA.

To evaluate the use of 111indium-diethylenetriamine pentaacetic acid (111In-DTPA) for determination of the glomerular filtration rate (GFR), the results of 60 standard 111In-DTPA clearances were compared with 24-h urine endogenic creatinine clearances obtained on 3 successive days (r = 0.97, P less than 0.001) and with endogenic creatinine clearances obtained during 111In-DTPA determinations (r = 0.

The isolation of Theileria? Taurotragi in South Africa.

In 3 out of 4 attempts strains of a Theileria sp. of low virulence were isolated in the laboratory by feeding adult Rhipicephalus appendiculatus collected from the field on susceptible cattle. One of the strains, previously identified as Theileria? taurotragi (Tzaneen), was found to be serologically cross reactive with the other 2 strains.

Systemic hemodynamic and hormonal responses during angiotensin II blockade with saralasin.

The effect of saralasin infusion on systemic hemodynamics, plasma renin activity (PRA), and aldosterone levels was studied under various conditions of sodium balance in 25 patients with essential hypertension. The results of 66 paired observations were statistically analyzed, to elucidate some controversial aspects of the mechanisms of saralasin action. The total peripheral resistance index (TPRI) increased when saralasin had an agonistic effect on blood pressure (BP) and decreased when it acted as an antagonist.

Clinical significance of exercise-induced ST segment elevation. Correlative angiographic study in patients with ischaemic heart disease.

We have examined the relation between electrocardiographic ST elevation during treadmill exercise (greater than or equal to 1 mm, using the conventional 12 leads), the severity of coronary artery disease, and left ventricular wall motion abnormalities in 680 patients. They were divided into three groups: (1) 218 patients with clinically significant coronary artery disease, (2) 178 patients with clinically significant coronary artery disease, and (3) 284 patients with clinically significant coronary artery disease and previous myocardial infarction. ST elevation during exercise (predominantly in lead V2) was seen in two patients (1%) in group 1, three patients (2%) in group 2, and 147 patients (52%) in group 3.

Clinical evaluation of His-bundle electrogram recorded from the body surface.

A noninvasive method of recording His-bundle activity was developed in our laboratory. This technique is based on the principle of high-gain amplification of the external signals, use of appropriate filters to eliminate random noise, and averaging of the amplified signals over 200-500 cardiac cycles to improve the signal-to-noise ratio. Using this technique we were able to demonstrate external His-bundle activity and to measure the extent His-bundle-ventricular (H-V) interval in 29 of 51 (60%) patients referred to our unit for evaluation of conduction abnormalities or history of collapse.

Observations on the transmission of Theileria mutans in South Africa.

Four isolates of Theileria mutans obtained from geographically distant parts of South Africa by subinoculation of infected blood were found to be readily transmitted by the bont tick Amblyomma hebraeum. All attempts to transmit these isolates with Rhipicephalus appendiculatus were unsuccessful. Possible explanations for differences between these results and those reported by earlier workers in this country are discussed.

Left ventricular aneurysm: pre- and postoperative haemodynamic studies at rest and during exercise.

We studied 9 men with antero-apical left ventricular aneurysms. All suffered from incapacitating angina pectoris without heart failure. Aneurysmectomy was done in 4 patients as the sole procedure while it was combined with revascularisation of the residual myocardium in the other 5.

Metabolic myocardial imaging with 123I-labeled heptadecanoic acid in patients with angina pectoris.

The potential value of 123I-heptadecanoic acid (123I-H degree A) in myocardial scintigraphy has recently been assessed in patients with acute myocardial infarction (AMI) by studying regional myocardial metabolism (Van der Wall et al. 1981 a). To determine the metabolic behavior of 123I-H degree A in patients with stable angina pectoris (AP) as well, 30 patients with AP were included in this study: 18 patients were exercised and 12 patients were studied at rest.

Dynamic myocardial scintigraphy with 123I-labeled free fatty acids in patients with myocardial infarction.

We have already shown that myocardial imaging properties of radio-iodinated long-chain free fatty acids (123I-FFA) and thallium 201 (201TI) are comparable in detecting areas of inadequate myocardial perfusion (van der Wall et al. 1980). Besides confirming our earlier observations, the present study tests the potential of 123I-FFA, hexadecenoic acid (123I-16-ha), and heptadecanoic acid (123I-17-H degree A), in assessing regional myocardial metabolism in 30 patients within a week of proven myocardial infarction.

Haemodynamic and hormonal changes during acute and chronic diuretic treatment in essential hypertension.

The short- and long-term effects of diuretic treatment with chlorthalidone 50 mg/day on haemodynamic and hormonal parameters in patients with essential hypertension (WHO grade I) were investigated. After three days of treatment, all patients showed a rise in plasma renin activity (PRA), plasma aldosterone (PA), urinary norepinephrine excretion (UNE) and heart rate (HR), and a decrease in body weight (BW) and extracellular volume (ECV) and blood volume (BV); the change in blood pressure (BP) was variable. The changes in BP were correlated with those in BV.

Involvement of the adrenals in ovulation induced by unilateral ovariectomy in the rat.

The aim of this study was to investigate the mechanisms of the stress-related ovulatory effects of unilateral ovariectomy (ULO) when performed on diestrus III at 10.00-11.00 hr in 5-day cyclic female rats.

Renin and body fluid volumes in chronic renal disease. Relations between arterial pressure, plasma renin activity, blood volume, and extracellular volume in chronic renal disease, as compared with essential hypertension.

In 47 patients with hypertension and chronic renal insufficiency (CRI) and 38 patients with essential hypertension (EH), the following parameters were measured under moderate salt restriction: plasma volume (PV), blood volume (BV), extracellular fluid volume (ECFV), ratio of blood volume to insterstitial fluid volume (BV/IV), recumbent plasma renin activity (PRA), increase in PRA upon standing (delta PRAst), creatinine clearance (Ccr), and mean arterial pressure (MAP). Mean PRA, ECFV, and MAP values did not differ significantly between the two groups. In the CRI group, MAP showed a weak positive correlation with ECFV (r = 0.

Changes in intrarenal sodium handling during saluretic treatment in patients with essential hypertension.

The effect of 50 mg chlorthalidone on blood pressure, body fluid volumes and renal functional parameters was determined in 8 patients with essential hypertension. After 3 days there were signs of volume depletion with little change in mean arterial pressure (MAP). Maximal free water clearance (CH2O) was decreased and fractional proximal sodium reabsorption was increased, but no correlations between these parameters were found.