The value of renal angiography for revealing renovascular changes has been investigated in 126 patients with hypertension, and in 102 of them a comparison was made with i.v. urography. It was concluded that i.v. urography does not reveal renovascular changes and thus the primary investigation should be renal angiography, in some cases followed by urography in the same session.

Adult↗

PubMedDate not supplied

Sympathetic outflow to muscles during treatment of hypertension with metoprolol.

Microelectrode recordings of multiunit sympathetic vasoconstrictor activity were made in muscle branches of the peroneal nerve in patients with essential hypertension before and during long-term treatment with the cardioselective beta-adrenergic receptor antagonist metoprolol. Nerve activity was quantified by counting the number of sympathetic bursts in the mean voltage neurogram. Metoprolol treatment lowered blood pressure and heart rate in all subjects. During long-term treatment, nerve activity was reduced both when compared to the level of activity after the first dose of the drug (p less than 0.01) and when compared to the control level before treatment (p less than 0.05). It is suggested that the reduction of sympathetic vasoconstrictor outflow to muscles contributed to the blood pressure reduction.

Adult↗

PubMedDate not supplied

Ischemic edema in stroke. A parallel study with computed tomography and cerebrospinal fluid markers of disturbed brain cell metabolism.

Thirteen patients with stroke and one with TIA had repeated examinations with computed tomography (CT) of the head, examination of the cerebrospinal fluid (CSF) for adenylate kinase, glutathione, lactate, and albumin and clinical evaluations during the first fortnight after onset. In 9 patients with cerebral infarction edema shown on the CT scans was maximal on days 2--5, after which it diminished. In 2 patients with intracerebral hemorrhage the edema appeared early as a zone of low-attenuation around the high-attenuation area. Most patients with large lesions deteriorated clinically during development of the edema. In 3 patients the CT scans were inconclusive, probably because the lesion was too small. Adenylate kinase activity was present in all CSF samples during the period 6 hours-5 days, while glutathione was occasionally present in the CSF in 12 of the 14 patients. These findings are believed to indicate cell swelling and a leak in the plasma membrane. Based on these observations, it is suggested that initial ischemic edema is intracellular in patients with cerebral infarction, and that adenylate kinase in CSF is a sensitive marker for this type of edema.

Adenylate Kinase↗

PubMedDate not supplied

Progressive fibromuscular dysplasia of the renal artery. Angiographic and clinical follow-up.

Eight patients with unilateral and 12 patients with bilateral fibromuscular dysplasia of the renal arteries were re-examined after 3 to 11 (mean 6) years. Angiographic progression was evaluated in a score system and occurred in 19 of the 20 patients, 83 per cent had progression on the right and 54 per cent on the left side. The most frequent indications of progressive disorder were increase in the length of the lesion and the number of membraneous stenoses. Less sensitive was the determination of least luminal diameter, mainly due to difficulties in measuring this in the majority of cases. Nine of the patients had clinical progression of hypertension. These patients did not differ in angiographic score from the 11 without such progression. Because of the progressive nature of the disease and the existing problems to evaluate the hemodynamic significance of fibromuscular dysplasia, a frequent use of percutaneous transluminal angioplasty is recommended.

Adult↗