[Gastric disorders in renal insufficiency and their treatment with methochlopramide].
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Biomedical subjects
Publications and source records attributed to D Fritel.
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The levels of free and sulfoconjugated catecholamines were measured in the plasma of fasting, recumbent normal subjects before and after an oral load of the catecholamine precursors tyrosine or L-dopa. Basal values of sulfoconjugated catecholamines, measured in plasma samples diluted 1:100 were 7998 +/- 540 pg/ml for dopamine sulfate, 2938 +/- 281 pg/ml for norepinephrine sulfate, and 2958 +/- 288 pg/ml for epinephrine sulfate (n = 37 tests in 15 men); these basal values are higher than those reported previously. Neither free nor sulfoconjugated catecholamine concentrations were changed by a tyrosine load (100 mg/kg) that induced a doubling of the plasma tyrosine level or by a meal low in phenylalanine and tyrosine (but otherwise supplying constituents of normal nourishment) that induced a greater than 50% reduction in the plasma tyrosine concentration. After an oral load of L-dopa (125 mg) the following were observed. (1) An extremely large increase (greater than 100-fold) in dopamine sulfate levels was noted, an increase that was less marked in the same subjects given L-dopa (125 mg) plus the peripheral dopa-decarboxylase inhibitor carbidopa (12.5 mg); as expected, free dopamine concentration also was increased. (2) Neither free nor sulfoconjugated norepinephrine concentrations were altered. (3) Epinephrine sulfate but not free epinephrine concentration was increased (more than ten-fold) after L-dopa ingestion alone; this result was unexpected and has to be confirmed before considering its physiological meaning, if any.
21 patients with essential sustained mild or moderate hypertension were treated with timolol for an average of 6 months at a mean dosage of 3,14 tablets per day. The mean decreases of supine systolic and diastolic blood pressures were respectively of 17,8 and 7,3 mm Hg. The efficacy of timolol was considered excellent or good in 11 cases (52,4 p. cent) and its tolerance perfect in 15 cases (71,4 p. cent). The study was extended in 15 cases with one dose of timolol per day. Effectiveness remained excellent in 12 cases. There was neither orthostatic hypotension nor brady-cardia of less than 55 beats per minute nor water retention. Side effects appeared in 6 cases requiring discontinance of therapy in only one case (exertional dyspnea).
Computarized axial tomography has shown the localization of adrenal lesions in four cases of hypertension of adrenal origin: two phaeochromocytomas, one primary hyperaldosteronism, one Cushing's syndrome. This method has the advantage of being neither invasive, nor time-consuming. Unfortunately, it cannot localize tumors smaller than two cm in diameter. It seems to be highly beneficial in phaeochromocytoma, where it can advantageously take the place of arteriography. It is less fruitful in primary hyperaldosteronism and in Cushing's syndrome because lesions are smaller.
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