The Clinical Study Center is a 5 bed multicategorical research unit with specialized nursing, dietary, and supportive staff to provide optimal control of diet, activity and continued careful observations required for clinical investigation. The principal areas of research are in hypertension, adrenal disorders, chronic renal failure with hyperkalemia, clinical pharmacology, alcoholic hepatitis and lipoprotein metabolism. Endocrine parameters in the regulation of blood pressure are examined in hypertensive disorders. Components of the renin-angiotensin system and the hormones of the mineralocorticoid pathway are measured. Precise definition of subsets of hypertension are established and the distinction between adrenal adenomas and hyperplasia and hyperaldosteronism is reaching almost certainty. Chronic renal failure with life threatening hyperkalemia due to defects in renin and/or aldosterone production is studied for the defects of acid formation, renal response to aldosterone, and the nature of the reduction of renin and aldosterone production. Mineralocorticoid metabolism is examined in experimental potassium depletion. Pharmacological studies include: an evaluation of dehydroergotamine as a treatment modaliity for orthostatic hypotension, effects of disulfiram in blood pressure, cardiovascular effects of nicotine, and the use of alphamethyldopa in opiate withdrawal. The problem of alcoholic hepatitis and subsequent cirrhosis is addressed by therapeutic interruption with cholchicine as an inhibitor of collagen formation. Metabolism of drugs such as naproxen and sulfisoxazole are being examined in alcoholic cirrhosis. Lipoprotein metabolism as effected by diet, and modification of apoprotein labeled with I-31, is studied in normal subjects and patient's with disorders of lipoprotein and atherosclerosis.
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