Role of the liver in metabolism of DL-norepinephrine-14C.
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Biomedical subjects
Publications and source records attributed to A Schirger.
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Antibiotic prophylaxis was employed in 21 patients with secondary lymphedema complicated by recurrent episodes of acute lymphangitis. Eighteen were completely free of subsequent attacks; the three others showed a marked reduction in the frequency and severity of subsequent attacks. Follow-up time averaged 30 months.
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To determine the usefulness of the cold pressor test as a predictor of hypertension, we compared the blood pressure recordings available from 142 patients in 1979 with readings obtained during performance of two cold pressor tests, the first in 1934 when these subjects were children, and the second in 1961. Forty-eight subjects were hyperreactors to the tests in either 1934 or 1961, and 94 were normoreactors. At last follow-up, blood pressures in 14 of the hyperreactors were between 140 and 160 mm Hg systolic or 90 and 100 mm Hg diastolic (Stratum 1) and in 20 exceeded 160 mm Hg systolic or 100 mm Hg diastolic (Stratum 2). Ten normoreactors had casual blood pressures in Stratum 1 and eight in Stratum 2. Hypertension had thus occurred in 71% of the hyperreactors and 19% of the normoreactors. Fifteen hyperreactors were receiving antihypertensive therapy, and this reduced the severity of the casual blood pressure elevation in most patients to Stratum 1. Antihypertensive therapy had been started in three normoreactors. The duration of follow-up, 45 years, and the mean age at follow-up, almost 57 years, were greater in this study than in any previously reported study. Early hyperreactivity was related to future hypertension in enough subjects to suggest that an abnormal response to an external cold stimulus may be useful as an indicator of future hypertension.
The number of elderly patients presenting with the difficult combination of renovascular hypertension and deteriorating renal function is increasing. The majority of these patients have diffuse cardiovascular disease requiring careful preoperative evaluation and stabilization. Adequate control of hypertension and preservation of renal function frequently requires bilateral renal procedures in addition to aortic replacement in patients with significant aorto-iliac disease or aortic aneurysms. Early and late results continue to justify prompt surgical consultation and revascularization of patients with combined renovascular hypertension and renal insufficiency.
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