Treadmill exercise testing in patients with significant coronary artery disease.
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Biomedical subjects
Publications and source records attributed to C W Chiang.
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Clinical studies have given contradictory reports on the effect of smoking marijuana on the plasma levels of testosterone in males. A reanalysis of existing data established that testosterone levels are depressed both after smoking one marijuana cigarette and after intravenous infusion of delta-9-tetrahydrocannabinol, a pharmacologically active component of marijuana. Simulation of the marijuana interaction, under the assumption that delta-9-tetrahydrocannabinol inhibits testosterone production or secretion, suggests a minimum of 24 hours are required for testosterone to return to pre-smoking levels. A series of clinical studies are specified to clarify the nature of the interaction.
delta 9-Tetrahydrocannabinol was given by ophthalmic administration to the rabbit. Plasma concentrations were measured for two strengths of ophthalmic solution and compared with intravenous data to establish bioavailability. Absorption was variable, while maximum plasma levels were sustained for several hours.
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Six subjects each smoked a 1% marijuana cigarette and 2 hr later smoked a second one. Plasma levels of delta-9-tetrahydrocannabinol were measured for 9 hr with a radioimmunoassay. Heart rate and self-reported "high" were measured for 2 hr after each cigarette. All three measures showed a rapid increase after the start of smoking with Cmax occurring before the end of smoking. There was a strong correlation between decrease in heart rate and plasma levels from 10 min after smoking until 120 min. All pharmacodynamic response measures returned to baseline values within approximately 2 hr.
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14 bolus studies with probenecid in a dose range of 8.2--164 mg/kg were carried out in 3 monkeys. The protein binding of probenecid in the plasma was studied by an ultracentrifugation method. Plasma clearances of both total and unbound probenecid decreased with increasing doses, while the volume of distribution and fraction of metabolites excreted in the urine remained constant. The urinary excretion rates of probenecid and it metabolites were measured in a bladder-catheterized monkey and were found to be urine flow dependent. Since the rate-limiting step for the excretion of the metabolites did not depend on the formation rate only, biliary recycling was speculated.
The echocardiographic manifestations of pulmonic valvular endocarditis in a patient with underlying heart disease consisting of a ventricular septal defect and infundibular stenosis are reported. The abnormal shaggy echoes observed on the pulmonic valve were confirmed to be vegetations based on surgical and pathologic findings. This was further proven by the disappearance of the shaggy echoes after surgical excision of the vegetations. We conclude that echocardiograms can detect the presence and disappearance of pulmonic valvular vegetations, which may be of aid in the diagnosis of pulmonic valvular endocarditis.
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