Arteritis and venulitis in systemic lupus erythematosus resulting in massive lower intestinal haemorrhage.

A case of systemic lupus erythematosus with massive haemorrhage from the colon is described. Histological examination showed ulceration of the mucosa of the ascending colon with necrotizing vasculitis of the submucosal veins. Adjacent arteries were normal apart from one which had ruptured on the surface of an ulcer.

Potentiation of ACTH hypertension in man with salt loading.

ACTH 1 mg/day for 5 days raises systolic blood pressure (SBP) in normotensive and hypertensive subjects on a fixed electrolyte intake of 100 mmol/day sodium (Na) and potassium (K) (Whitworth et al. 1983). The present study examined the effect of Na intake in the high normal range on the haemodynamic and metabolic responses to ACTH.

Prostacyclin infusion does not prevent ACTH-induced hypertension in sheep.

The present experiments examine the hemodynamic effects of an intravenous infusion of prostacyclin on the development of ACTH-induced hypertension in conscious sheep. Prostacyclin was infused at either 0.01 microgram/kg min-1 for 9 days or 0.

Angiotensin converting enzyme inhibition does not prevent development of ACTH-induced hypertension in sheep.

The role of the renin-angiotensin system in the onset of ACTH-induced hypertension was examined in five conscious sheep. Captopril infusion alone (15 mg/kg per day) for 2 days produced a small fall in blood pressure. After 2 days of captopril ACTH was infused (20 micrograms/kg per day) for 3 days together with captopril.

Ketanserin does not prevent ACTH-induced hypertension in sheep.

The role of serotonin (5HT) in the pathogenesis of ACTH-induced hypertension in sheep has been examined. The pressor responses to injections of 5HT (0.1-30 micrograms/kg) were similar in normotensive and hypertensive sheep.

Onset and dose relationships of ACTH effects on blood pressure in sheep.

The threshold and dose-response relationships for the blood pressure and metabolic effects of adrenocorticotropic hormone (corticotropin, ACTH) were examined in conscious sheep. Corticotropin was infused at five rates (0.5 micrograms/kg/day, n = 4; 1 micrograms/kg/day, n = 4;2 micrograms/kg/day, n = 6; 5 micrograms/kg/day, n = 5; and 10 micrograms/kg/day, n = 5) for 3 days, and the time of onset of the rise in blood pressure was assessed with a computer-based system.

Blood pressure and metabolic effects of 9 alpha-fluorocorticosterone and 9 alpha-fluorodeoxycorticosterone in sheep.

9 alpha-Fluorocortisol has been postulated to have 'hypertensinogenic' as well as 'mineralocorticoid' and 'glucocorticoid' activity. The present study examined the blood pressure and metabolic effect in sheep of the structurally related steroids 9 alpha-fluorodeoxycorticosterone (9 alpha-FDOC) and 9 alpha-fluorocorticosterone (9 alpha-FB). Infusions of these fluorinated steroids at 0.

Effect of impairment of renal function on the accumulation and disposition of isoxicam.

The accumulation and disposition of the non-steroidal antiinflammatory drug isoxicam were investigated following its oral administration to 6 subjects with normal renal function and 13 patients with diminished renal function. Isoxicam was given daily as a single oral dose for 14-15 consecutive days. Steady-state plasma levels were achieved after 13 days.

Malignant hypertension due to an aldosterone producing adrenal adenoma.

Malignant hypertension in Conn's syndrome is rare. We report an 18 year old boy who presented with visual and renal impairment due to malignant hypertension which subsequently proved to be secondary to an aldosterone secreting adrenal adenoma. Diagnosis was delayed in this patient as plasma renin concentrations (PRC) were not invariably low and it is emphasized that suppression of PRC is not always a feature of primary hyperaldosteronism.

[Hypertension induced by adrenocorticotropin (ACTH)].

Studies of ACTH-induced hypertension in sheep have enabled the hypertensinogenic actions of steroid hormones to be separated from their classical glucocorticoid and mineralocorticoid actions. In man ACTH produces systolic hypertension which can be reproduced by infusion of cortisol, but not deoxycorticosterone, at rates appropriate for conditions of ACTH stimulation. Whether steroids raise blood pressure in man by a hypertensinogenic action distinct from their glucocorticoid and mineralocorticoid activities remains to be determined.

The effects of ACTH on the renin-aldosterone system in normotensive man.

The present study examined the effects of low dose ACTH administration (0.1 mg/day for 2 days) on plasma renin concentration, (PRC), activity (PRA) and substrate (PRS), cortisol and aldosterone in man. Six healthy male volunteers on a diet calculated to contain 150 mmol Na/day received an infusion of 5% dextrose (6 ml/h) for 24 hours, then ACTH (Synacthen, Ciba-Geigy) was added to the infusion at the rate of 100 micrograms per day, for 48 h.

Ketanserin in the acute management of severe hypertension.

Ketanserin is a 5-HT2 antagonist with alpha-adrenoreceptor blocking activity. This study examines the efficacy and safety of ketanserin in the control of severe primary and secondary hypertension, including renal hypertension. Patients with uncontrolled hypertension were admitted to hospital and entered the study if the supine diastolic blood pressure phase V (SDBP) was greater than 110 mm Hg after 2 h continuous BP monitoring (Dynamap).

Serotonergic mechanisms and blood pressure in sheep.

This study examined the effects of the serotonergic (5-HT2) antagonist ketanserin in sheep on haemodynamic responses to infused serotonin (5-HT), development of adrenocorticotrophin (ACTH)-induced hypertension, and the effect of ACTH on in vivo pressor responsiveness to 5-HT. Serotonin produced a dose-related increase in mean arterial pressure and heart rate. These increases in mean arterial pressure were attenuated or abolished by ketanserin, but increases in heart rate were enhanced.

Steroid antagonism of the 'hypertensinogenic' activity of 9 alpha-fluoroprednisolone.

We have previously reported that adrenocortical steroids raise blood pressure by a 'hypertensinogenic' mechanism of action which is not simply related to their classical 'mineralocorticoid' or 'glucocorticoid' actions. This study presents evidence for specific antagonism of this 'hypertensinogenic' activity. The effects of separate IV infusions of prednisolone (P) 100 mg/d and 9 alpha-fluoro-prednisolone (9 alpha F-P) 0.

Hydralazine and lupus nephritis.

Renal involvement is uncommon in the hydralazine induced systemic lupus erythematosus syndrome. Six women with hypertension are described who developed an immune complex glomerulonephritis after taking 50-300 mg hydralazine daily for 6 months to 7 years. Associated features were anemia (100%), hypocomplementemia (50%), a positive antinuclear antibody test (100%) and antibodies to double-stranded DNA (66%).

Demonstration of alpha-adrenoceptor antagonism by the 5HT2 antagonist, ketanserin (R49945), in sheep.

Serotonin causes a dose related (0.1-20 micrograms/kg i.v.

Effects of beta-adrenoceptor blockade on prostacyclin mediated renin release in sheep.

The effect of prostacyclin (PGI2) infusion on plasma renin concentration (PRC) was examined before and after propranolol treatment in sheep. Increasing doses of prostacyclin (0.05, 0.

Failure of neomycin to modify ACTH induced hypertension in sheep.

Studies in rats have shown that neomycin administration attenuates certain types of adrenocortical steroid dependent hypertension, including ACTH hypertension. The effects of oral neomycin on ACTH induced hypertension were examined in conscious sheep. Neomycin has no effect on the blood pressure or metabolic responses to ACTH in sheep.

A comparison of the haemodynamic effects of dietary sodium restriction and acute sodium depletion in the conscious sheep.

The use of a low Na, low K sorghum grain diet supplemented with intraruminal electrolyte infusions has enabled dietary manipulation of sodium status to be studied in the sheep. Dietary sodium restriction reduced urinary sodium excretion within 24 h with maximal retention after 3 days. There were no other substantial metabolic or haemodynamic changes.

Diuretic and haemodynamic effects of MK 447 in normotensive and hypertensive sheep.

The short term effects of the novel diuretic MK 447 were examined in both normotensive and hypertensive (ACTH treated) conscious sheep. The drug had profound diuretic, natriuretic and kaliuretic effects in both groups. Plasma sodium was unchanged but plasma potassium fell and haematocrit increased.

The effect of potassium loading and sodium depletion on DOC induced hypertension in sheep.

This study examines the physiological effects of 11-deoxycorticosterone (DOC) at 2 rates of continuous iv infusion for 5 days in conscious sheep. DOC treatment, in sheep on Na and K intake 80 and 120 mmol/day respectively, increased mean arterial pressure (MAP) by 12 mmHg at 50 mg/day and by 10 mmHg at 5 mg/day. Both rates of infusion raised plasma [Na] and lowered plasma [K].

Medical foster family care: a cost-effective solution to a community problem.

In response to the special needs of a small number of abused and neglected children who were being cared for by unnecessary extended hospitalization, a medical foster family care program was established, at much lower cost, to provide the children with a home environment and assist their parents so that family reunification was possible.