Bran in hypertriglyceridaemia: a failure of response.
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Biomedical subjects
Publications and source records attributed to T D Lawrie.
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The apolipoprotein A concentration in the plasma of ten healthy human subjects was measured immunologically on three occasions at monthly intervals and the following results recorded. 1. There was no difference between fasting and non-fasting apoprotein A concentrations. 2. Apoliportein A levels were higher in females than in males (p less than 0.001). 3. The correlation coefficient calculated for high density lipoprotein cholesterol and apolipoprotein A was 0.62. 4. The apoprotein values varied widely between subjects and ther were considerable concentration differences from month to month in the plasma of each individual.
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1. There is no known cause for the increased mortality due to ischaemic heart disease in soft water areas. Since the lead concentration of soft water is elevated in houses with lead plumbing, studies have been carried out to determine the effects of lead on the heart of rats. 2. Rats were given drinking water containing lead for 1 year at concentrations similar to those found previously in Glasgow, which has a soft water supply. 3. There was increasing deposition of lead in the heart and a fall in the cardiac levels of the enzymes ferrochelatase and delta-aminolaevulinic acid dehydratase. These changes are maximal after 6 months, when there were marked electron-microscopic changes in the myocardium and myocardial mitochondria. 4. Further studies are needed to determine whether lead is a cause of the increased mortality from ischaemic heart disease in soft water areas.
The systolic time intervals; total electro-mechanical systole (QS2), left ventricular ejection time (LVET), pre-ejection period (PEP), and ratio of PEP/LVET were measured from external readings in twenty hyperthyroid and fifteen hypothyroid patients. The hyperthyroid subjects showed shortening of the PEP and reduction in the PEP/LVET. The hypothyroid group showed lengthening of the PEP, shortening of the LVET and increased PEP/LVET. These changes returned towards normal in ten patients rendered euthyroid with appropriate therapy. The value of these measurements to predict the thyroid status was examined in a mixed group of seventy-four patients. There was close agreement between diagnosis predicted from systolic time intervals and that made independently from clinical and biochemical assessment, suggesting that the systolic time intervals may have been a useful place in the clinical assessment of thyroid patients.
Lipoprotein analyses were performed in 133 male patients and were correlated with the coronary arteriographic findings. The prevalence of hyperlipoproteinaemia was significantly higher in those patients with coronary artery disease (P less than 0-02). In addition, the more extensive the degree of coronary artery pathology the higher were the plasma concentrations of total cholesterol, triglyceride, and low density lipoprotein (LDL) cholesterol. Hyperlipoproteinaemia was more prevalent in the younger patients with coronary artery disease (P less than 0-02).
Organic disease of the tricuspid valve required surgery in 18% of all patients undergoing valve replacement over a five-year period. Differentiation of organic from functional disease is difficult and may be made only at open-heart surgery. The results of a series of 56 patients who underwent tricuspid valve replacement are presented; of these, 53 had organic disease. Operative mortality at the end of five years had fallen to 7% with significant clinical improvement in 79% of patients, a reduction in cardiothoracic ratio in 81%, and a low incidence of postoperative tricuspid incompetence.
The distribution of plasma total and low density lipoprotein cholesterol concentration was investigated in 158 first degree relatives (105 progeny, 53 siblings) of 55 index patients with mild type II hyperlipoproteinaemia. No evidence of bimodality was found. Our findings support the view that mild type II hyperlipoproteinaemia is inherited in a polygenic manner.
The operation on and subsequent course of 88 patients with valve replacements using Björk-Shiley tilting disc prostheses has been reviewed in terms of mortality, clinical results, and valve function. The follow-up period varied between 6 months and 2 years. The hospital mortality was 17% and late mortality 8%. Of those who left hospital, 75% returned to full normal activity and required less (or no) drug therapy other than maintenance anticoagulation. There was one transient embolic episode. Significant intravascular haemolysis does not occur with this prosthesis.
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Surveys of the apparently healthy working population of the West of Scotland have revealed a high prevalence of hyperlipoproteinaemia (HIP). In males, type IV occurred more frequently (12%) than in females (3.3%), although obesity played an important part in this finding. HLP also occurred frequently (61%) in survivors of myocardial infarction (type II 39%, type IV 22%) but less frequently in peripheral vascular disease (38%), although there was a higher prevalence in females (47%) than males (32%) largely due to an increased prevalence of type IIa (29.5% cf 7.5%). HLP did not appear to play a significant role in cerebrovascular disease.
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1 The effects of tolamolol on haemodynamics and myocardial contractility were investigated in two groups of six patients undergoing diagnostic cardiac catheterization.2 The intravenous administration of tolamolol (0.15 mg/kg) produced a significant fall in heart rate from a control value (87 +/- 7 to 62 +/- 3 beats/min) 5 min after administration and a concomitant fall in cardiac output from 4.7 +/- 0.9 to 3.5 +/- 0.8 litres/minute. There was no significant change in systemic blood pressure, pulmonary artery blood pressure or stroke volume.3 There was no change in left ventricular end diastolic pressure after tolamolol. There was a fall in the maximum rate of rise of the left ventricular pressure (LV dp/dt(max)) and the derived index of the left ventricular contractile state (V(max)).4 These results suggest that tolamolol has a predominantly negative chronotropic but also a lesser negative inotropic action on the heart.
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