Department of Medicine faculty members published more than 3,300 peer-reviewed articles in 2016-2017.
Combined propranolol and digoxin therapy in angina pectoris.
The effects of oral propranolol and digoxin and digoxin alone and in combination on angina frequency, heart size, systolic time intervals and treadmill exercise tolerance, were assessed in 20 patients with coronary heart disease. Oral propranolol alone reduced the average frequency of angina pectoris from 16 to 7 attacks per week (P less than 0.02). However, the mean duration of exercise was not significantly improved because 8 patients with abnormal left ventricular function exhibited a decrease in exercise tolerance. Combined propranolol and digoxin improved exercise tolerance in these patients, and, consequently, mean exercise duration in all patients increased significantly from the control value of 390 +/- 42 to 458 +/- 46 s (P less than 0.01). Propranolol alone also resulted in a significant increase in left heart size from 46.5 +/- 1.3 to 47.7 +/- 1.5 mm/m2 (P less than 0.001), which was reversed by the addition of digoxin. Therefore, oral propranolol combined with digoxin is advantageous in patients with angina pectoris who have abnormal ventricular function or large hearts.View on PubMed
Prolonged Q-T interval syndrome. Successful treatment with combined ventricular pacing and propanolol.
A case of the sporadic variety of the prolonged Q-T interval syndrome without deafness is presented. The patient is unusual because of a long survival to age 13, despite progressive worsening of her disease, and the presence of marked atrioventricular conduction abnormalities in addition to the usual ventricular trachyarrhythmias. Successful therapy was finally achieved with a combination of permanent pervenous ventricular pacing and propranolol.View on PubMed
Evaluation of left ventricular performance in acutely ill patients with chronic obstructive lung disease.
Among 28 patients with chronic obstructive pulmonary disease (COPD) with increasing dyspnea, the resting mean pulmonary arterial wedge pressure was elevated (greater than 12mm Hg) in 4 and became abnormal with exercise in 3 other subjects. Stroke volume index was reduced (less than 36 ml/beat/M2) in 16 of 26 patients (62 percent). The resting pre-ejection period index was prolonged (greater than 144 msec) in 17 patients (65 percent), while the left ventricular (LV) ejection time index was reduced (less than 408 msec) in 23 patients (88 percent). The ratio of the pre-ejection period to the LV ejection time was within the normal range (0.309 to 0.381) in only 3 of 26 patients (12 percent). Echocardiographic measurements of LV function were normal in nine patients, seven of whom had one or more abnormal values for systolic time intervals (STIs). These data suggest that reduced LV filing results in abnormal values for STIs in patients with COPD, and therefore that in such patients STIs are not accurate indices of LV function.View on PubMed
A role for cytochalasin-sensitive proteins in the regulation of calcium transport in activated human lymphocytes.
Concanavalin A-induced histamine release from normal rat mast cells.
Concanavalin A- (con A) induced release of histamine from normal rat mast cells was studied. In the presence of phosphatidylserine (PS) con A induced a concentration and temperature-dependent, noncytotoxic histamine release at con A concentrations ranging from 0.1 to 100 mug/ml. The optimal con A concentration, 100 mug/ml, caused a 27.3% (+/- 2.7 S.E.M.) net histamine release. Release began approximately 30 sec after addition of con A and was complete within 45 min. In the absence of PS, no net con A-induced release occurred. The effect of PS was concentration dependent from 1 to 100 mgg/ml. PS alone, however, did not cause histamine release. Binding studies indicated that mast cells bound up to 16 X 10(6) con A molecules per cell without histamine release. Upon removal of unbound con A and the addition of PS, normal histamine release occurred. Alpha-Methyl-D-mannose (50 mM) prevented both con A binding and histamine release and if added after Con A, caused a rapid cessation of histamine release and a reversal of con A binding. This study indicates several important advantages of the con A-induced histamine release system. Binding of con A to mast cells can be dissociated from histamine release by omitting PS from the medium. Release can then be induced by the addition of PS. Alpha-Methyl-D-mannose can be used to terminate rapidly the ongoing release reaction at any phase of the interaction. This system is potentially very useful for investigation of metabolic events during histamine release.View on PubMed
Effects of oral propranolol in normal subjects.
The effects of oral propranolol were evaluated in 10 normal volunteers. The resting heart rate decreased from the mean control value of 68 plus or minus 3.3 (SE) to 56 plus or minus 2.8 beats per minute (bpm) on propranolol (p smaller than 0.001, paired test). Mean systolic blood pressur also decreased from 125 plus or minus 5.0 to 114 plus or minus 4.2 mm Hg (p smaller than 0.03). Resting systolic time intervals were unaffected by propranolol. Mean maximal treadmill exercise tolerance time was not significantly altered by propranolol although the mean heart rate systolic blood pressure product a maximal exertion was markedly decreased (1.91 plus or minus 0.17 vs 2.62 plus or minus 0.17 times 10-4, p smaller than 0.004) . The nonsignificant effect of oral propranolol on resting systolic time intervals and maximum exercise tolerance despite significant changes in heart rate and blood pressure at rest and duringexercise stand in contrast to the reported effects of intravenous propranolol. Explantations for this difference between the effects of oral and intravenous propranolol in normal subjects are examined.View on PubMed
Primary care in the academic medical centers: A report of a survey by the AAMC.
Comparative effectiveness of exercise testing and continuous monitoring for detecting arrhythmias in patients with previous myocardial infarction.
Epithelial cell specialization within human Peyer's patches: an ultrastructural study of intestinal lymphoid follicles.
Rectal and pharyngeal gonorrhea in homosexual men.