Day 252 - 20 May 96 - Page 09
1 finds what it was you have been referring to, does one not,
2 a short piece by Plotnik and others.
3 A. Yes, it is, this is an abstract of a paper that was
4 presented at a very large meeting.
5
6 Q. American College of Cardiology meetings at Orlando,
7 Florida, during May 1996, according to the writer of the
8 letter?
9 A. Yes.
10
11 Q. Have you given consideration to this abstract, or whatever
12 it is, summary?
13 A. Yes, I have.
14
15 Q. Can you tell us, please, what conclusion, if any, we may
16 safely base upon it?
17 A. Well, yes, the first thing I would say about both of
18 these papers is that they are short abstracts of
19 communications at very large meetings. They are not full
20 papers. They are not peer reviews. They have not been
21 published in reputable scientific journals. That does not
22 necessarily mean that a paper that they present at a
23 scientific meeting is of no value, but the problem is so
24 much information one would want to have is not there
25 because of the shortness of the paper itself. Now, having
26 said that, which applies to both of the papers, I can
27 comment on the paper from Professor Vogel and his
28 colleagues.
29
30 The first point I would make is that this is a piece of
31 work that had been done on 5 subjects, which is a very
32 small number of people to study, and essentially what they
33 were doing was feeding these people a breakfast which is an
34 enormous breakfast. This may be typical of Americans, but
35 certainly it is not one I could face, an enormous breakfast
36 which is high in fat, probably about four to five percent
37 fat in that breakfast, compared with a breakfast which is
38 virtually devoid of fat. It is essentially carbohydrate
39 with some protein. Then they make a measurement of what
40 they refer to as vasco activity. I must admit that is an
41 area with which I was not familiar, so I consulted a
42 colleague in Kings College who is Director of the Vascular
43 Biology Unit to explain to me exactly what was going on,
44 and what is going on is that measurements were made not in
45 a coronary artery but in the artery of the arm, the
46 brachial artery, and the procedure is to measure by an
47 indirect procedure, which is ultrasound, to measure the
48 diameter of the brachial artery and then a cuff is put on
49 the arm to completely cut off the blood supply as one
50 experienced with blood pressure is measuring it. That is
51 left on for 5 minutes, during which time the vessel expands
52 with the accumulation of blood and the maximum expansion,
53 according to the document here, is 20 percent.
54
55 Now, I would make the point that this is an extremely
56 unphysiological thing to do, but it is apparently a
57 measurement that cardiologists make. Now, what they were
58 doing was to measure the expandability of the blood vessel
59 before a meal was given and then either a high fat or a
60 fat-free meal was provided and this was followed up over a
