Results of treatment in coronary arteriosclerosis with lipotropic agents

Western Society for Clinical Research these were apparently size of the animal. RESULTS

OF

best correlated

TREATMENT

IN

with the

CORONARY

ARTERIOSCLEROSIS WITH LIPOTROPIC AGENTS. Lester M. Morrison, M.D. and (by

invitation) William F. Gonzales, M.D. Los Angeles, Calij. (From Los Angeles County General

Hospital

Internal

Medicine,

and

Department

College

of

of

Medical

Evangelists.) Clinical experiences are reported with the use of various lipotropic agents such as choline, methionine and inositol in the treatment of coronary arteriosclerosis. In one group a series of 115 patients with proved coronary thrombosis and myocardial infarction were treated with choline after recovery from the acute attack and discharge from the hospital. These patients were divided into three groups: (1) fifty-two patients given choline for one year, (2) a group of thirty-five given choline for two years and (3) a group of twenty-eight patients given choline for three years. The dosage of choline varied from 6 to 32 gm. daily. These series of patients were compared with a group of “alternate controls” consisting of 115 patients with proved coronary thrombosis and myocardial infarction who were discharged from the hospital under identical conditions. The patients in this series were observed over the same period of time and did not receive choline. Detailed analyses of each choline-treated group as compared with its “control” series revealed that the subsequent mortality rate of patients was significantly reduced under choline treatment. One mode of action of choline in the treatment described is demonstrated through its effect in increasing the phospholipid turnover by the liver, and increasing the serum lipid phosphorus levels in these patients. In this way the phospholipids maintain the serum lipids in finer dispersion and suspension and increase the

ANALGESIC EFFECTS MEPERIDINE,

541 OF NITROUS OXIDE

ALONE AND

AND

COMBINED WITH

Mark Afickerson, Ph.D., Salt Lake City, Utah. (From the DepartAMPHETAMINE. ment

of

Pharmacology,

University

of

Utah College of Medicine.) Potentiation of morphine analgesia by amphetamine suggested a study of the effect of this central nervous system stimulant on the analgesia produced by other agents. Experiments were carried out on groups of eight to ten medical students. Pain thresholds were determined by two methods: (1) the time required for deep pain to develop in a hand placed in water at 4“~. after prior equilibration at 30”~. and (2) the Hardy-Wolff-Goode11 radiant heat technic for cutaneous pain. Control thresholds and their normal variation without medication were first determined. Meperidine (100 mg. orally) or NXO (33 per cent in 02 by face mask) was then administered with or without amphetamine (20 mg. orally) or dextro-amphetamine (10 mg. orally). Pain thresholds were redetermined at half-hour intervals after the administration of meperidine or after equilibration to NzO for fifteen minutes. Both meperidine and N,O produced a statistically significant analgesic response. However, their relative effectiveness cannot be adequately evaluated from these data as different groups of students were involved in experiments with the two agents. Both caused a greater percentage increase in the threshold for deep pain than in that for superficial pain. The difference was considerably greater with N,O than with meperidine and is believed to be related to the greater subjective factor in the interpretation of deep pain. Concomitant administration of amphetamine caused a significant increase in the analgesic action of meperidine, particularly when measured by the response to deep pain, but largely eliminated

stability of the serum lipo-protein complexes and the colloidal plasmatic stability. It is sug-

that of NzO. It is concluded that the site or mechanism of action of meperidine in producing analgesia is different from that of NzO, that the action of

gested from this evidence,

NzO is largely

as well as from that

previously presented, that in this way the further development of arteriosclerosis is arrested. These studies suggest that the lipotropic agent, choline, is of value in the treatment of coronary arteriosclerosis and merits further trial and observation in this disease. APRIL,

1950

higher

dependent

levels of the central

upon a depression nervous

of

system and

that the NzO action can be effectively antagonized by amphetamine. EXPERIMENTAL PRODUCTION OF A NUTRITIONAL MACROCYTIC

Jefress

ANEMIA IN SWINE.

G. Palmer, M.D.

(by

invitation),