W Rothenberger’s research while affiliated with Hamburg University and other places

Panchondritis is a rare disease with a paroxysmal course, characterized by inflammatory cartilaginous changes mainly of the ears, the nose, the ribs and the tracheobronchial system. As a rule, there are at the same time arthritis, inflammatory changes of the eyes, anemia, fever and a marked acceleration of the erythrocyte sedimentation rate. In the case reported of a 54 yr old woman, the main symptoms were inflammation of the cartilage of the left ear, a unilateral right exophthalmus, conjunctivitis, scleritis, and episcleritis, as well as alternating attacks of arthritis and arthralgia. The patient died suddenly from a myocarditis. In the discussion of the case special attention is given to the relationships to clinical pictures of the rheumatic syndrome, and the possibility of a pathogenetic significance of cell mediated immune reactions is raised.

In the present study the pressure response in pulmonary and systemic circulation to vasoconstricting agents was examined in healthy subjects and in those with chronic cor pulmonale. Infusion of angiotensin and norepinephrine elevated the systemic arterial pressure markedly. In order to induce the same systemic and pulmonary pressor reaction in cases of cor pulmonale larger doses were necessary because of the relative insensitivity of lung and systemic vessels to vasoconstrictive agents. The difference in pressure response might have been caused by the higher concentrations of renin and catecholamines in these cases. The amount of increase in pulmonary pressure caused by angiotensin was very small. With norepinephrine the mean increment in pulmonary vascular response exceeded that with angiotensin. But on a weight and a molar basis angiotensin is a more potent vasoconstrictor than norepinephrine in systemic as well as in pulmonary vessels. The extent of pressure response following equivalent doses of the drugs was greater with angiotensin than with norepinephrine, although at first there was an impression to the contrary. A linear relationship existed between the pressor response induced by infusion of norepinephrine in pulmonary and systemic circulation. No correlation was found between the pressor responses recorded during administration of angiotensin. No remarkable difference in pulmonary pressure reaction caused by vasoactive agents was found between healthy subjects and patients suffering from cor pulmonale.

The influence of Propranolol and Orciprenaline on pulmonary artery pressure, forced expired volume, vital capacity and blood gas-tension has been studied on seven persons without respiratory or circulatory diseases. The results of our examinations showed that the „v. Euler-Liljestrand Mechanism“ is no longer effective when Orciprenaline has been used. In consideration of the different behaviour of oxygen-tension in blood, forced expired volume during air-breathing and 10% oxygen-breathing after application of 1 mg Propranolol, and the competitive effect on pulmonary circulation of Orciprenaline and hypoxia, the following problems are discussed: Does hypoxia increase the effect of β-blocking substances? Are the receptors for β-blocking substances and hypoxia identical as to the regulation of smooth muscles of the airways and the pulmonary vessels?