Biomedical subjects
Publications and source records attributed to G Simon.
A 75 year old man, treated with ajmaline, was admitted with malaise, fever, acute renal failure and cholestatic jaundice. Haemolytic anaemia and thrombocytopaenia were also found with a positive indirect Coomb's test in the presence of ajmaline. The immunological and haematological data are discussed in the light of previously published cases.
Transfontanellar ventricular puncture and intermittent lumbar punctures were carried out in 10 patients affected by intraventricular haemorrhage during the period between 1980 and 1983. In only three of them was later a shunt necessary for treatment of hydrocephalus. Six children developed normally, in two severe mental retardation ensued, and two died later, one of heart failure after cardiac surgery and one of ventriculitis following shunt implantation. Puncture therapy can be recommended for intraventricular haemorrhage of the neonate.
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The effect of long-term treatment with nitrendipine on systemic pressor responses to norepinephrine (NE) and angiotensin II (AII) was evaluated in 11 subjects with mild, uncomplicated hypertension. Pressor responses to NE and AII were measured at the end of a 4-wk placebo period and after 5 wk treatment with nitrendipine (final dose 16 mg twice daily; range 5 to 20 mg/day) or placebo. In subjects who received nitrendipine, clinic supine blood pressure was reduced from 152 +/- 12/96 +/- 4 mm Hg to 134 +/- 11/84 +/- 5 mm Hg and pressor responses to NE but not to AII were attenuated. Endogenous plasma levels of NE and renin activity were not changed by nitrendipine. Data suggest that noradrenergic blood pressure control mechanisms depend more on cellular calcium transport than do AII-mediated ones and may help explain the greater effectiveness of calcium entry blockers in the treatment of low-renin hypertension.
The water and sodium content of the saphenous vein was measured in 26 dogs with one-kidney, one wrapped hypertension. For comparison, the same measurements were performed on the contralateral saphenous vein which was removed prior to the induction of hypertension. Malignant hypertension characterized by blindness and a rise in plasma renin activity, developed in 10 dogs. The course of hypertension in the remaining 16 dogs was benign. In benign hypertension, the water and sodium content of the saphenous vein was increased. In contrast, the water content of the saphenous vein was unchanged and its sodium content fell in dogs with malignant hypertension. The dogs with malignant hypertension had a greater sodium content of the saphenous vein prior to the induction of hypertension than the dogs with benign hypertension. The findings indicate that the loss of body water and sodium that has been described in malignant hypertension also affects the composition of blood vessels. The sodium content of blood vessels may be a predictor of the dog's response to a hypertension-producing stimulus.
The pathophysiologic significance of increased serum and urinary N-acetyl-beta-D-glucosaminidase (NAG) activity in hypertension was investigated. The subjects were 32 male patients, aged 40-65 years, with mild or borderline, uncomplicated hypertension and 26 age-matched, male normotensive volunteers. Compared to values in control subjects, NAG activity in the serum, spot and 24-hour urine samples of hypertensive subjects was increased (p less than 0.01). Serum NAG activity in hypertensive subjects was inversely correlated with glomerular filtration rate (r = -0.49, p less than 0.01, N = 31) and renal plasma flow (r = -0.56, p less than 0.02, N = 19) and positively correlated with mean arterial blood pressure (r = 0.40, p less than 0.05). The elevation of serum NAG activity in hypertension is a biochemical marker of the reduction in glomerular filtration rate and renal plasma flow.
To investigate the role of decreased venous distensibility in the regulation of cardiac output, cardiopulmonary hemodynamic measurements were performed at rest and after a volume load (6% dextran in saline, 12 ml/kg iv) in 18 awake dogs with chronic one-kidney, one-wrapped hypertension and 9 normotensive control dogs. The distribution of blood volume between the peripheral and cardiopulmonary vascular beds and the increase in cardiac output after volume load in the two groups of dogs were the same. There was no echocardiographic evidence of left ventricular dysfunction (shortening fraction) in hypertensive dogs. The rise of heart rate after volume load in hypertensive dogs, 17 +/- 3 beats/min (mean +/- SE), was attenuated compared to that of control dogs, 38 +/- 4 (p less than 0.001). Compared to values in normotensive dogs, the in vitro left atrial pressure-volume curves of hypertensive dogs were shifted in the direction of the pressure axis (p less than 0.02). The findings do not provide a role for decreased venous distensibility in the regulation of cardiac output in chronic renal hypertension. Decreased distensibility of the left atrium may play a role in the pathogenesis of the attenuated Bainbridge effect in hypertensive dogs.
Compared to values obtained in healthy normotensive control subjects, the serum activity of the lysosomal enzymes N-acetyl-beta-D-glucosaminidase (NAG) and beta-glucuronidase, was found to be elevated in patients with mild or borderline hypertension. The serum activity of the cytosolic enzyme lactate dehydrogenase was the same in the two groups. Serum NAG activity in hypertension was inversely correlated with glomerular filtration rate and renal plasma flow. Because of the greater variability of beta-glucuronidase activity, there were no such correlations between the serum levels of this enzyme and the measurements of renal function.
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The authors present a case of haemoptysis which caused tracheo-bronchial inundation and which was treated by the insertion of a Fogarty catheter. They describe the technique and discuss its advantages and disadvantages.
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We studied the pharmacokinetics of ticarcillin in cystic fibrosis patients. Concentrations of ticarcillin were assayed in serum and sputum samples from 11 children. We found that antibiotic serum concentrations were consistent with those reported in the literature. Ticarcillin half-life was shorter in patients than in controls. No direct correlation was found between concentrations in serum and those in sputum. Among six children with P. aeruginosa infection, ticarcillin levels in sputum were sufficient to eliminate P. aeruginosa in 50% of cases.
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In 16 children and adolescents suffering from mucoviscidosis the ammonia concentration of the plasma determined by a modified ion exchange method was compared with the clinical degree of severity. The ammonia values of the plasma were compared with several parameters, such as Shwachman stage, the presence of cardio-respiratory insufficiency, blood gas values and liver function tests. In 5 children with cystic fibrosis and cardio-respiratory insufficiency high plasma ammonia values were found. In older children with the disease lasting for a longer time with medium Shwachman stage (stage III) but without cardiorespiratory insufficiency the ammonia values were also relatively high. Cardiorespiratory insufficiency and disturbance of the liver function may play a role in the development of hyperammonemia. A distinct hyperammonemia refers to a bad prognosis in children with cystic fibrosis.
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