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Thallium-201 stress scintigraphy (TSS) and echocardiography were performed on 60 consecutive black male hypertensives and compared to 60 sex-, race-, and age-matched controls. We found a higher prevalence of left ventricular hypertrophy with repolarization abnormality in the hypertensive group; 32 of 60 (53%), compared to 10 of 60 (17%) of the controls, P < .05. Echocardiographically determined left ventricular mass index revealed a significantly higher mean value in the hypertensive group of 147 +/- 57 compared to 124 +/- 34 in the control group, P < .001. Thirty-one of 60 (52%) of the hypertensive group had a normal TSS compared to 22 of 60 (37%) of the controls. A total of 68 (38 fixed and 30 reversible) perfusion defects were noted in the hypertensive group compared to 74 (55 fixed and 19 reversible) in the controls. The severity of clinical syndromes associated with myocardial ischemia were noted in increased incidence in the presence of left ventricular hypertrophy and left ventricular mass index was noted to be predictive of severity of coronary disease independent of the standard risk factors.

The court-ordered sterilization of a normal 18-year-old black female in North Carolina focused attention on the unfortunate impact of eugenic statutes that allow sterilization as a method of social control. The existence of these laws in many states allows misapplication and abuse of authority which, not infrequently, is directed liberally to blacks and other minority groups.Eugenic sterilization is, at this time, a legally accepted form of "medical treatment." The justification of such sterilization is the vague concept that the presumed "mentally deficient" individual is probably a potential parent of socially inadequate offspring who would likewise be socially inadequate.Since there never has been factual substantiation of whether the sterilization of these individuals will diminish the incidence of mental retardation, it is necessary to focus attention on the concept of eugenic sterilization and point out its many fallacies.

A simple method is described for predicting a desired steady-state phenytoin plasma level based on two steady-state phenytoin plasma levels achieved at different daily doses. In this graphic method, radial vectors corresponding to specific concentrations are plotted on a clearance-versus-dose graph. These vectors are used to determine a new phenytoin dose that will predict a desired level directly from the graph. Evaluation in an office practice of this method and a computerization of the equation on which it is based demonstrate that it is a practical aid in individualizing phenytoin therapy.

Barbiturates alter cardiovascular function, in part by an effect on vascular cells. However, a biochemical mechanism for the effect is unknown. We have, therefore, studied the effect of barbiturates on inositol phospholipid hydrolysis in cultured rat aortic endothelial cells. Hydrolysis was stimulated by angiotensin II, norepinephrine and phenylephrine. Pentobarbital, and other barbiturates, inhibited hydrolysis at pharmacological and clinical concentrations (0.1-0.5 mM). The inhibition by pentobarbital was concentration-dependent, reversed by washing, and was decreased by high concentrations of angiotensin II. Kinetic studies gave an apparent Km of hydrolysis by angiotensin II of 1.2 nM, which showed mixed inhibition by pentobarbital (Ki = 0.45 mM). Schild analysis of data obtained from pentobarbital inhibition curves also showed a deviation from a competitive type inhibition. [125I]Angiotensin II was bound to a high-affinity receptor (Kd = 1.2 nM), which showed a competitive type inhibition of binding by pentobarbital (0.5 mM). Although inhibition of [125I]angiotensin II binding appeared to be competitively inhibited by pentobarbital, the data, taken together, point to a deviation from a simple competitive type inhibition.