No abstract

The deaths from angiocardiography at Wisconsin General Hospital were reviewed and found to be two per cent of 249 patients. These 5 deaths are reported briefly. Investigation was carried out to determine the hemodynamic effects of contrast substances on 12 dogs. In general, there was a temporary increase in right atrial and pulmonary arterial pressure followed by a rather marked decrease in systemic arterial pressure and tachycardia. The significance of these findings is discussed in relation to shunts within the heart or between the aorta and pulmonary artery.D EATH following administration of a contrast substance for the purpose of angiocardiography leaves an indelible impression upon the clinician and radiologist. Several investigators have evaluated this problem as related to specific angiocardiographic contrast substances and considerable experimental work has been done. It has been shown that Diodrast in high concentration produces an increase in the heart's force of contraction' and an increase in coronary blood flow in the isolated rabbit heart. In dogs, Diodrast given intravenously in doses equivalent to those used in clinical angiocardiography produces a fall in peripheral arterial pressure, a rise in heart rate, an increase in venous pressure and transient changes in the QRS complex

Although pentolinium tartrate is widely used in the treatment of hypertension, there are no reports available regarding some of its cardiovascular effects and its influence on water and electrolyte excretion. The results of the present study indicate that this drug is of value in reducing the mean arterial blood pressure in hypertensive patients. However, the data also indicate the necessity for caution in the use of this agent and the need for a continuing search for newer agents in the treatment of this disease.P ENTOLINIUM tartrate (Ansolysen), a ganglionic-blocking agent, has been widely used in the treatment of human hypertension.'-3 Although adequate clinical information is available in these studies, there are no available reports describing the effects of this agent on systemic and renal hemodynamics and metabolism, as well as on water and electrolyte excretion. The following investigation reports the acute responses in these functions following the intravenous administration of this drug to hypertensive patients. METHODSTen patients with arterial hypertension and 1 normotensive subject, obtained from the medical wards of the University Hospitals, were studied in the supine position in a fasting state. Complete data and diagnoses are given in tables 1-4. Systemic hemodynamics alone were determined in 3 patients, systemic hemodynamics and renal functional changes in 6 subjects, and renal studies

No abstract

Since 1945 sodium para-aminohippurate (PAH) (1) has been widely used for the measurement of renal blood flow (2). Since the urinary output of PAH must be measured in this procedure, the errors inherent in urine collection contribute to the error in the determination of renal blood flow. Furthermore, the need to obtain values of urinary concentrations in the calculation of renal blood flow precludes the use of PAH, and therefore of this method, in the study of patients with oliguria or anuria. Recently, Conn, Anderson, and Arena (3) adapted the nitrous oxide method of Kety and Schmidt (4) to the determination of renal blood flow in dogs. The following is a description of the adaptation of this method to the estimation of renal blood flow in man as well as of the utilization of this method for the calculation of renal weight i,n zavo. METHODSFive normotensive fasting subjects without clinical evidence of renal disease and seven patients from the medical wards of the University Hospitals were studied. As noted in Table II, the latter presented a great variation in renal functional impairment.In the five normotensive subjects renal hemodynamics and metabolism were studied by means of standard clearance techniques and right renal vein catheterization (2,5). In these individuals three fifteen-minute control clearance periods were followed by the determination of renal blood flow by the nitrous oxide method (see below).In the seven patients demonstrating a variety of renal disease states as well as different degrees of renal functional impairment the method of study was similar to IThis investigation was supported in part by grants from the Wisconsin Heart Association, Wisconsin Alumni Research Foundation, and National Heart Institute of the National Institutes of Health (H-1495-C), Public Health Service.2Heart Trainee of the National Heart Institute, U. S. Public Health Service, 1955. 3 Wisconsin Heart Association Research Fellow.that described for the normotensive subjects with the exception that following the first nitrous oxide determination the study was continued for three additional fifteen-minute periods (45 minutes), at which time a second nitrous oxide renal flow study was performed. This part of the study was designed to determine the reproducibility of the technique.Renal blood flow by the nitrous oxide method. Renal blood flow was determined by the nitrous oxide method using a modification of the method of Kety and Schmidt (4). A mixture containing approximately 15 per cent nitrous oxide, 20 per cent oxygen and 65 per cent nitrogen was delivered into a 150-liter bag which in turn was attached to a large-bore corrugated rubber tubing through a three-way valve for respiratory gases. The valve was arranged so that the investigators could change the patient's inspiratory gases from room air to the nitrous oxide mixture without the patient's knowledge. Delivery was made to the patient through a rubber mouthpiece attached to the corrugated tubing. The nose was clamped to avoid all leaks. Arterial blood was ...