Showing papers in "The New England Journal of Medicine in 1967"
TL;DR: Intensive therapy may modify the acute syndrome so as to permit the development of a previously unrecorded abnormality of hyaline-membrane disease.
Abstract: ALTHOUGH hyaline-membrane disease, the respiratory-distress syndrome of the newborn infant, has been the object of increased clinical and research interest in the past ten years, little attention has been paid to its possible sequelae.1 , 2 It is stated that most of these infants who survive the first three days of life will recover completely, and by seven to ten days of life will have normal lungs radiographically.3 , 4 Recent experience with critically ill infants at the Stanford Premature Infant Research Center demonstrates that intensive therapy may modify the acute syndrome so as to permit the development of a previously unrecorded abnormality of . . .
2,671 citations
TL;DR: The Type II hyperlipoproteinemia as mentioned in this paper is defined as an increase in the concentration of lipoproteins that have discrete β-mobility, and is defined by the Type II lipoprotein pattern.
Abstract: Type II Hyperlipoproteinemia159, 192 193 194 195 196 General Definitions By the Type II lipoprotein pattern we mean an increase in the concentration of lipoproteins that have discrete β mobility b
1,721 citations
TL;DR: The interrelations between melanogenesis and extrapyramidal disease might be of fundamental importance and it was noted that chronic Parkinson's disease has a common precursor in the synthesis of both melanin and catecholamines.
Abstract: THE known biochemical abnormalities in Parkinson's disease consist of a decrease of melanin pigment in the substantia nigra1 , 2 and a decrease of some biogenic amines in the substantia nigra and the corpus striatum.3 These 2 defects might be interrelated, as suggested by the fact that in both melanocytes4 and sympathetic cells5 tyrosine is hydroxylated to dihydroxyphenylalanine, a common precursor in the synthesis of both melanin and catecholamines. Furthermore, both melanocytes and sympathetic cells originate from the neural crest.6 It was suggested earlier7 , 8 that the interrelations between melanogenesis and extrapyramidal disease might be of fundamental importance. It was noted that chronic . . .
1,407 citations
TL;DR: FABRY'S disease is a hereditary systemic disorder that was first recognized in affected males as a disease characterized by multiple small dark-purple macules and papules in the umbilical region.
Abstract: FABRY'S disease is a hereditary systemic disorder that was first recognized in affected males as a disease characterized by multiple small dark-purple macules and papules in the umbilical region, s...
980 citations
TL;DR: The pattern of left ventricular contraction is described as a "series of sequential fractionate contractions of muscle bundles" and the possibility that unco-ordinated contraction of the heart results from a combination of normal and abnormal muscle has received little attention.
Abstract: CONGESTIVE heart failure has usually been considered to be a global affection of the myocardium in which disturbance of contraction in one or both ventricles is generalized. On the other hand, abnormal myocardial contraction may be caused by local areas of malfunctioning myocardium interacting with other areas of completely normal muscle. The possibility that unco-ordinated contraction of the heart results from such a combination of normal and abnormal muscle has received little attention. In 1925 Wiggers1 described the pattern of left ventricular contraction as a "series of sequential fractionate contractions of muscle bundles." He suggested that disturbance in this temporal . . .
634 citations
TL;DR: The rise in blood lactate per units of work output per unit of time in the anxiety neurotics approximates that of patients with arteriosclerotic heart disease.
Abstract: FOUR investigations conducted in 4 countries during the past twenty-five years have shown excessive lactate production on standard exercise in patients with anxiety neurosis.1 2 3 4 The characteristic anxiety symptoms were often evoked by the exercise and appeared to be concomitant with the extremely rapid rise of blood lactic acid. In general, the patients were unable to perform as much work per unit of time or to maintain as great a workload as normal matched controls.4 5 6 The rise in blood lactate per unit of work output per unit of time in the anxiety neurotics approximates that of patients with arteriosclerotic heart disease . . .
603 citations
TL;DR: Patients requiring mechanical artificial ventilation have increasing reduction in pulmonary compliance and vital capacity, with consequent hypoxia, are difficult to wean from the ventilator and often die of pulmonary insufficiency.
Abstract: CLINICIANS concerned with the care of patients requiring mechanical artificial ventilation have been impressed by the occasional development of gradually progressive deterioration of pulmonary function, apparently unrelated to the disease that necessitated the respiratory assistance. These patients have increasing reduction in pulmonary compliance and vital capacity, with consequent hypoxia, are difficult to wean from the ventilator and often die of pulmonary insufficiency.1 Many have had no respiratory or cardiac disease before the use of the ventilator. Clinicians have referred to this symptom complex as the "respirator lung syndrome." At autopsy in such cases the unusual gross and microscopical appearance of . . .
483 citations
TL;DR: The purpose of this paper is to report specific rubella-virus hemagglutination and the development of a hemag glutination-inhibition test for antibody assay.
Abstract: THE isolation of rubella virus1 , 2 in 1961 opened a period of remarkable progress in studies of the virus,3 the disease4 and, recently, experimental vaccines for preventing the disease.5 , 6 Comparable progress has not been made in the development of simple, rapid serodiagnostic methods. Although virus neutralization,7 , 8 fluorescent antibody9 and complement fixation10 are being employed only the complex and time-consuming neutralization test has been capable of furnishing the epidemiologist with fully reliable information regarding rubella immunity. The purpose of this paper is to report specific rubella-virus hemagglutination and the development of a hemagglutination-inhibition test for antibody assay. Materials and Methods Virus Strains . . .
381 citations
TL;DR: LIDOCAINE (Xylocaine) has become one of the most frequently used drugs in the treatment of ventricular arrhythmias, particularly those associated with acute myocardial infarction.
Abstract: LIDOCAINE (Xylocaine) has become one of the most frequently used drugs in the treatment of ventricular arrhythmias, particularly those associated with acute myocardial infarction. It has been shown to terminate ventricular tachycardia, and it has been given to suppress multiple ventricular extrasystoles.1 , 2 The drug has been administered as an intravenous bolus or as a constant intravenous infusion. Although the use of lidocaine as an antiarrhythmic in postoperative cardiac surgery has been investigated,3 little objective information is available regarding the therapeutic and toxic doses in patients with myocardial infarction. Its effect on ventricular tachycardia can readily be shown, but the evaluation . . .
376 citations
TL;DR: In documenting the wide distribution and severity of the arterial disease in patients with angina and abnormal electrocardiograms at rest and after exercise the reports parallel earlier views based on comparisons between clinical and morbid findings.
Abstract: CINE coronary arteriography affords a means of correlating clinical manifestations of coronary heart disease with responsible vascular abnormality in the living patient.1 2 3 4 5 Several of the comparative analyses have indicated that obstructing atherosclerosis can be demonstrated in at least 2 major coronary arteries in most patients with angina and abnormal electrocardiograms at rest and after exercise.1 2 3 4 In documenting the wide distribution and severity of the arterial disease in these patients the reports parallel earlier views based on comparisons between clinical and morbid findings.6 Obviously, the correlation does not hold when a significant anomaly of the coronary arteries, aortic regurgitation, aortic stenosis . . .
369 citations
TL;DR: There should be little doubt that splenectomy may alter the ability to prevent or to suppress some infections in a child, however, the extent to which this change is clinically significant has been a source of continuing controversy.
Abstract: THE exact role of the spleen in preventing or suppressing bacterial infections in human beings is unknown. The spleen, an important part of the reticuloendothelial system, acts as a filter for circulating debris including bacteria and as an important source of lymphoid cells and antibody production. There should therefore be little doubt that splenectomy may alter the ability to prevent or to suppress some infections. However, in a child, the extent to which this change is clinically significant has been a source of continuing controversy. Since the initial report by King and Shumacker in 19521 a number of articles have . . .
TL;DR: A review of Greenberg's1 review of the literature regarding the frequency of resulting complications of vaccination against smallpox in the United States since 1800 concluded that vaccination should be considered as a single vaccination procedure.
Abstract: ALTHOUGH vaccination against smallpox has been practiced in the United States since 1800, little is known in this country regarding the frequency of resulting complications. Greenberg's1 review of ...
TL;DR: A standard scientific method of studying any system is to introduce a perturbation and to see what happens, and because salicylates — acetylsalicylic and salicylic acids – destroy the gastric mucosal barrier, the Gastric mucosa contains a barrier that prevents the digestive juice from attacking the wall of the stomach.
Abstract: EVER since Reaumur, more than two centuries ago, discovered that gastric juice digests meat, men have asked: "Why doesn't the stomach digest itself?" There are two answers to this question. One is, of course, that sometimes the stomach does digest itself, with disastrous consequences. The other is that the gastric mucosa contains a barrier that prevents the digestive juice from attacking the wall of the stomach. A standard scientific method of studying any system is to introduce a perturbation and to see what happens. Because salicylates — acetylsalicylic and salicylic acids – destroy the gastric mucosal barrier, I have used . . .
TL;DR: In patients with severe metabolic acidosis and serum pH values less than 7.0, the pH of the cerebrospinal fluid was normal or near to it, but in those in coma, it lay in the far acid range.
Abstract: RECENTLY, we have encountered a series of patients with severe metabolic acidosis and serum pH values less than 7.0. Although such severe acidosis is widely regarded as leading rapidly to delirium and unconsciousness, only some of these patients were in coma; the others were awake and alert. In the awake and alert patients, the pH of the cerebrospinal fluid was normal or near to it, but in those in coma, it lay in the far acid range. These observations combined with some previously made on patients with respiratory acidosis1 have led to the postulate that acidosis in the cerebrospinal fluid . . .
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TL;DR: An x-ray film of the chest showed a hazy density in the right-lower-lung field extending from the eighth rib posteriorly to the diaphragm, appearing most dense in its peripheral portion.
Abstract: Presentation of Case A forty-five-year-old man was admitted to the hospital because of episodic severe dyspnea. He had been well until six months previously, when a cough and low-grade fever developed. Demethylchlortetracycline (Declomycin) was administered. An x-ray film of the chest showed a hazy density in the right-lower-lung field extending from the eighth rib posteriorly to the diaphragm, appearing most dense in its peripheral portion. On admission to another hospital 25 ml of thin, amber fluid was aspirated from the right pleural space; routine cultures and cultures for tubercle bacilli were negative. On the fifteenth hospital day a portion of . . .
TL;DR: The purpose of the present report is to characterize red-cell production and destruction in a special group of patients with severe renal failure who have been stabilized at a similar degree of azotemia by repeated dialysis.
Abstract: THE anemia of renal insufficiency is associated with both increased red-cell destruction and impaired erythropoietic response to anemia. Variations in the relative importance of these 2 mechanisms and in the degree of the anemia observed may be due, at least in part, to the severity of renal disease in the patients studied. The purpose of the present report is to characterize red-cell production and destruction in a special group of patients with severe renal failure who have been stabilized at a similar degree of azotemia by repeated dialysis. An additional finding emerging from this study is the improvement in erythroid . . .
TL;DR: It is necessary to select patients suitable for surgery for vaginal or laparoscopic mesh placement for Hirschsprung's disease preoperatively on the basis of prior history and once they provide informed consent for surgery.
Abstract: ALTHOUGH Hirschsprung's disease (congenital intestinal ganglion-cell aplasia or aganglionosis) has been known clinically for nearly eighty years, only recently has progress been made in an understa...
TL;DR: An organized "science of nondisease" is proposed to deal with this sadly neglected problem of people living in an unnecessary limbo where they either perceive themselves or are perceived by others to have a nonexistent disease.
Abstract: CLINICAL medicine concerns itself mainly with the diagnosis and treatment of disease. Most physicians would agree, however, that their job properly entails promotion of positive health. The distinction is more than a semantic one. Too many people exist in an unnecessary limbo where they either perceive themselves or are perceived by others to have a nonexistent disease. Such a person may be as disabled or "unhealthy" as if he actually had the disease. In a classic satiric article, Meador1 proposed an organized "science of nondisease" to deal with this sadly neglected problem. Prevalence data on nondisease are lacking; appropriate epidemiologic . . .
TL;DR: In the setting of severe coronary-artery disease, the ability of the coronary vascular bed to dilate is limited so that methods designed to decrease myocardial oxygen requirements may provide a more fruitful approach.
Abstract: BECAUSE angina pectoris is a consequence of inadequate myocardial oxygenation, ideal therapy for this incapacitating symptom would be directed toward both increasing coronary blood flow and decreasing myocardial oxygen requirements. In the setting of severe coronary-artery disease, however, the ability of the coronary vascular bed to dilate is limited so that methods designed to decrease myocardial oxygen requirements may provide a more fruitful approach. Recent experimental studies have demonstrated that these oxygen requirements are directly related to the heart rate, to the inotropic state of the myocardium and to the intraventricular pressure, which is a reflection of the intramyocardial wall . . .
TL;DR: The administration of the pyrazolone derivatives, phenylbutazone and oxyphen butazone, to a patient already being treated with coumarin anticoagulant drugs can lead to serious hemorrhagic complications.
Abstract: THE administration of the pyrazolone derivatives, phenylbutazone and oxyphenbutazone, to a patient already being treated with coumarin anticoagulant drugs can lead to serious hemorrhagic complications.1 2 3 4 5 6 The means whereby these drugs potentiate the prothrombinopenic effect of the coumarins is not clear. It is not caused by impaired liver function or defective vitamin K metabolism since these drugs do not alter blood coagulation when given alone.7 , 8 In 1956 Sigg et al.1 reported a decrease in the disappearance rate of ethylbiscoumacetate in 1 of their patients when phenylbutazone was given. They attributed this to delayed renal excretion of the coumarin drug. Weiner and . . .
TL;DR: RNA Synthesis (Transcription) With the exception of a tiny fraction in the mitochondria, all the RNA is probably transcribed in the nucleus, though it appears in various forms throughout the cell.
Abstract: RNA Synthesis (Transcription) With the exception of a tiny fraction in the mitochondria, all the RNA is probably transcribed in the nucleus, though it appears in various forms throughout the cell. ...
TL;DR: Preoperative demonstration of the tumor radiographically, as by retroperitonea, indicates the presence of primary aldosteronism before operation.
Abstract: EVEN when the diagnosis of primary aldosteronism is obvious before operation, there is no way to localize the adenoma. Preoperative demonstration of the tumor radiographically, as by retroperitoneal pneumography and aortography, is rarely successful because of its relative avascularity and its small size (from a few millimeters to several centimeters in dimension), which may also cause it to escape notice during transabdominal exploration. A bilateral adrenalectomy may thus be necessary. A method is needed to improve preoperative diagnostic certainty in many ambiguous cases and to localize the tumor in one or, rarely, both adrenal glands. A comparison of aldosterone concentrations . . .
TL;DR: This report reviews 49 patients with Central-nervous-system disease associated with herpes-simplex virus studied in this laboratory in the past twenty-five years and recommends treatment with 5-iodo 2′-deoxyuridine (IUDR) is contemplated.
Abstract: HUMAN Central-nervous-system infection with Herpesvirus hominis (herpes-simplex virus), first described in 1941,1 is by no means rare. A number of reports describe the clinical, pathological and epidemiological aspects of encephalitis caused by this virus and its frequency in nonbacterial Central-nervous-system infections.2 3 4 5 Because of its sporadic occurrence and difficulties in establishing diagnoses during life, knowledge of the disease has been based upon histologic study. However, accurate and rapid diagnosis during life is required if treatment with 5-iodo 2′-deoxyuridine (IUDR) is contemplated. This report reviews 49 patients with Central-nervous-system disease associated with herpes-simplex virus studied in this laboratory in the past twenty-five . . .
TL;DR: The role of 5-hydroxytryptamine (serotonin, 5HT) in the pathophysiology of the carcinoid syndrome, and especially in flush production, has been seriously questioned and a likely result would be a better understanding of the clinical significance of serotonin.
Abstract: ALTHOUGH the role of 5-hydroxytryptamine (serotonin, 5HT) in the pathophysiology of the carcinoid syndrome, and especially in flush production, has been seriously questioned,2 the fact remains that increased production of serotonin is a hallmark of the condition. If it were possible effectively to inhibit the formation of this pharmacologically potent amine in patients with carcinoid tumors, a likely result would be a better understanding of the clinical significance of serotonin. A possibility of achieving this goal appeared with the studies of Koe and Weissman3 showing that para-chlorophenylalanine (PCP) is a potent and selective depletor of tissue serotonin in animals. It . . .
TL;DR: Fibrocystic fibrosis of the pancreas is the most recently recognized of the major chronic diseases of man.
Abstract: CYSTIC fibrosis of the pancreas is the most recently recognized of the major chronic diseases of man Reported for the first time by Fanconi1 in Switzerland in 1936, fibrocystic disease of the panc
TL;DR: CIGARETTE smoking has been recognized as "the most important of the causes of chronic bronchitis" and the pathogenic mechanisms of this relation are incomplete.
Abstract: CIGARETTE smoking has been recognized as "... the most important of the causes of chronic bronchitis. ..."1 Although knowledge of the pathogenic mechanisms of this relation is incomplete it is clear that cigarette smoke produces a variety of morphologic and physiologic changes in the lung. The association of both cigarette smoking and an increased susceptibility to bacterial infection with chronic bronchitis suggests that cigarette smoke directly inhibits antibacterial mechanisms of the bronchopulmonary tree. Defense of the lung against inhaled bacteria is achieved by the mechanism of bacterial clearance.2 A heavy dose of cigarette smoke inhibits bacterial clearance in mice.3 The . . .
TL;DR: Angiography is used in 2 patients to document complete resolution of emboli within twenty-five and a hundred and twenty-eight days and a clearer understanding of the natural course of pulmonary arterial blood flow in acute pulmonary embolism.
Abstract: ALTHOUGH the acute hemodynamic effects of massive pulmonary embolism1 and the sequelae of chronic obstruction of major pulmonary arteries2 have been defined, little is known about the rate of restoration of pulmonary arterial blood flow in acute pulmonary embolism. Recently, Sauter and his associates3 used angiography in 2 patients to document complete resolution of emboli within twenty-five and a hundred and twenty-eight days. Fred et al.4 reported similar findings in 7 patients. Technical complexity and the possible hazards of pulmonary arteriography have prevented its widespread application in serial studies of patients with pulmonary embolism. A clearer understanding of the natural . . .