bluuebunny/crossref_metadata_2025 huggingface dataset:
Vasomotor Responses in the Extremities of Subjects with Various Neurologic Lesions
Authors: REDISCH WALTER , TANGCO FRANCISCO T. , WERTHEIMER LOTHAR , LEWIS ARTHUR J. , STEELE J. MURRAY , Andrews Dorothy
Published: June 2012

Vascular responses to warming were studied in hemiplegic patients and after sympathectomy, using venous occlusion plethysmography of foot and leg. Comparisons were made with corresponding age groups. The pattern of response was essentially unchanged in hemiplegic patients, but was altered substantially where sympathetic pathways had been interrupted.
High Anterior Myocardial Infarction
Authors: PRINZMETAL MYRON , KENNAMER REXFORD , MASSUMI RASHID A.
Published: June 2012

Out of a large series of patients with coronary artery disease 6 were selected with high anterior myocardial infarction. These cases are presented in detail and their special electrocardiographic characteristics are described. The difficulty in making the diagnosis of infarction by the usual leads and the need for special leads are pointed out.
Treatment of Gangrene of the Feet and Legs by Walking
Authors: FOLEY WILLIAM T.
Published: June 2012

In addition to the usual procedures in the treatment of arterial insufficiency with gangrene of the feet or legs, the author suggests exercise to stimulate collateral blood flow and improve the metabolic state of the involved tissues. After careful protection of the damaged parts, patients were encouraged to stand and walk. The results of this ambulatory regimen in 22 patients are presented.
Clinical Evaluation of a New Oral Anticoagulant "Sintrom"
Authors: NEILL EMMETT C. , MOON RICHARD Y. , VANDER VEER JOSEPH B.
Published: June 2012

The clinical results in 100 patients treated for thromboembolic disorders were compared with 100 similar patients treated with Dicumarol. The rate of induction, ability to maintain a constant therapeutic level, and duration of action were especially considered. Induction and maintenance dosage were determined by clinical trial.
Serum Lipoprotein and Cholesterol Concentrations
Authors: SCRIMSHAW NEVIN S. , TRULSON MARTHA , TEJADA CARLOS , HEGSTED D. MARK , STARE FREDRICK J.
Published: June 2012

A previous study indicated that Guatemalan Indians, both male and female, tended to maintain low levels of serum cholesterol throughout adulthood but that beta-lipoprotein fractions increased with age, as is usually the case in populations in the United States. To investigate whether race was of importance in this unexpected dissociation between these lipid fractions, a similar study was done with a rural group in Costa Rica, which was comparable in the diet consumed and in many other environmental factors, but of pure European origin. At all ages the cholesterol values were slightly higher but the same type of dissociation was observed.
Obliterative Brachiocephalic Arteritis
Authors: GIBBONS THOMAS B. , KING ROBERT L.
Published: June 2012

Although a newcomer to American medical literature, this strange vascular disease of young adult women has been recognized abroad for many years. The etiology is obscure, but the pathologic findings are fairly well documented and the clinical picture is unusually consistent. An obliterative arteritis of the branches of the aortic arch results in severe ocular and cerebral damage. The disease process is relentlessly progressive and the prognosis for sight and life is poor. The present case was treated with corticosteroids and anticoagulants with apparent benefit. This disease should be considered when cataracts are encountered in young people and when arterial pressures and pulses in the upper extremities are absent.
Significance of Pulmonary Elastic and Viscous Resistance in Orthopnea
Authors: CHERNIACK R. M. , CUDDY T. E. , ARMSTRONG J. B.
Published: June 2012

The mechanical properties of the lungs were measured in the sitting and supine positions in 5 normal subjects and in 5 patients with orthopnea due to congestive heart failure. The patients had higher elastic and viscous resistances in the sitting position. Recumbency increased both resistances in both groups but there was a disproportionate increase in the viscous resistance of the patients. This increase was most marked in late expiration and early inspiration. The significance of these findings to orthopnea is discussed.
Atrial Dissociation and Uniatrial Fibrillation
Authors: DEITZ GEORGE W. , MARRIOTT HENRY J.L. , FLETCHER EVAN , BELLET SAMUEL
Published: June 2012

Three cases of atrial dissociation are illustrated with electrocardiograms. The coexisting atrial rhythms observed in published cases permit us to offer a convenient classification. Two possible explanations of this rare phenomenon are discussed.
Cancellation of Esophageal Electrocardiograms
Authors: MORTON RALPH F. , ROMANS WILLIAM E. , BRODY DANIEL A.
Published: June 2012

Cancellation of juxtacardiac esophageal electrocardiograms, as demonstrated in this study, indicates certain limitations of the equivalent cardiac dipole hypothesis. A new and more fundamental theory developed here shows that in large measure cancellation occurs because the cancellation network is in effect a relatively insensitive electrocardiographic connection, and because there is always prior assurance that a given complex can be completely canceled at any 2 desired instants during the cycle. The new theory also explains the paradox that proximity electrocardiograms can be canceled even though local action currents exert a relatively powerful influence on such leads.
Diagnostic Value of Translumbar Aortography
Authors: KOSZEWSKI B. J. , REEDY W. J.
Published: June 2012

A historical review of aortography is made that substantiates its present status as a diagnostic tool, particularly in angiology and urology. The technic, premedication, and anesthesia are discussed in detail. The hazards of the procedure and their prevention are reviewed. The reactions to contrast media are enumerated. Aortography plays a selected but important role in the evaluation of aortic aneurysms, arterial occlusion, and stenosis of major vessels. Its value in the diagnosis of abdominal abnormalities is less encouraging. Numerous urologic disorders are discussed in their relationship to angiographic study.
Acute Reversible Heart Failure in Africans
Authors: GRUSIN H.
Published: June 2012

Sixteen cases of acute reversible heart failure were observed in the native African. On the basis of their responses to dietary and vitamin therapy they were divided into various etiologic groups. The clinical manifestations are described and the relationship of these cases to idiopathic cardiac hypertrophy of Africans is discussed.
Tricuspid Stenosis
Authors: KILLIP THOMAS , LUKAS DANIEL S.
Published: June 2012

Physiologic criteria for the diagnosis of tricuspid stenosis have not been satisfactorily established. In an attempt to define these criteria the pressure gradients across the tricuspid valve during right ventricular diastole were analyzed in 10 patients with tricuspid stenosis and compared with the gradients in a group of patients who did not have this lesion. The diagnostic importance of the mean gradient is emphasized. The hemodynamic abnormalities associated with the tricuspid stenosis are presented and discussed.
Cardioaortic Fistula
Authors: BROFMAN BERNARD L. , ELDER JOHN C.
Published: June 2012

Rupture of a sinus of Valsalva aneurysm into the right ventricle produces a dramatic clinical syndrome characterized by a rapid and relentlessly unfavorable course. Early diagnosis is essential for surgical repair before an irreversible stage is reached. Cardiac catheterization and retrograde aortography confirmed the diagnosis in the case reported. With the aid of temporary circulatory occlusion, the fistula was demonstrated by contrast material injected via an aortic catheter. Although the fistula and the accompanying ventricular septal defect were closed at open-heart surgery, the markedly enlarged heart could not resume its function.
The Normal Vectorcardiogram and a System for the Classification of Vectorcardiographic Abnormalities
Authors: MILNOR W. R.
Published: June 2012

The essentially 3-dimensional nature of the spatial vectorcardiogram (sVCG) requires that it be studied as a vector sequence in space, and not merely in its projections on the arbitrary frontal, sagittal, and transverse planes. One striking characteristic of the normal QRS sÊ-loop is that it lies approximately in a single "plane of predilection," which does not coincide with any of these 3 arbitrary planes. This paper describes the variations observed in the sVCG, recorded by a cubical lead system, with particular reference to the "QRS plane," in a group of normal subjects and suggests a system for classifying abnormalities of the sVCG, based on the QRS plane.
Clinicopathologic Correlations of Renal Biopsies from Essential Hypertensive Patients
Authors: SALTZ MYRON , SOMMERS SHELDON C. , SMITHWICK REGINALD H.
Published: June 2012

The pathologic findings of kidney biopsies in an extensive series of patients undergoing sympathectomy are reported. The findings are correlated with the clinical status, level of hypertension, postoperative course, and length of survival.
Use of Different Tissue Thromboplastins in the Control of Anticoagulant Therapy
Authors: VERSTRAETE MARC , CLARK PATRICIA A. , WRIGHT IRVING S.
Published: June 2012

As anticoagulant therapy has become more widespread and a greater knowledge has been accumulated regarding the mode of action of coumarin derivatives, problems arising from the use of different thromboplastin preparations have been subjected to greater scrutiny. This paper presents an evaluation of the dependability and significance of different types of tissue thromboplastin in the determination of effects of coumarin derivatives. The main difference between thromboplastin extracts seems to be that brain preparations have a factor VII-like activity. As the exact evaluation of factor VII activity appears to be of primary importance in patients treated with coumarin derivatives, a thromboplastin preparation that does not contain factor VII activity is recommended.
Serotonin and Antiserotonins
Authors: HOLLANDER WILLIAM , MICHELSON ALAN L. , WILKINS ROBERT W.
Published: June 2012

Serotonin, (5 hydroxy-tryptamine), a naturally occurring compound, is pharmacologically active on intravenous injection in man. It consistently increases the pulse rate but has a variable pressor depressor, or biphasic effect on the arterial pressure. The mode of action of serotonin on these functions is not clear. Serotonin consistently and characteristically increases ventilation. However, it does not cause striking circulatory changes in the kidney although it usually produces moderate antidiuresis. The benzyl analog of serotonin (BAS) (1-benzyl-2-methyl-3-methoxy-tryptamine), both intravenously and orally, reduces or prevents the symptoms caused by serotonin. Intravenously, BAS in addition has demonstrable "antiserotonin" effects on the characteristic blood pressure and respiratory responses to serotonin.
Clinical and Hemodynamic Studies of Myocardial Fibrosis
Authors: NYE ROBERT E. , LOVEJOY FRANK W. , YU PAUL N.
Published: June 2012

In many instances myocardial fibrosis mimics constrictive pericarditis so closely, both hemodynamically and clinically, that the diagnosis can be made with certainty only at operation or autopsy. In the 3 cases presented here certain distinctions can be made that suggest that the differentiation can sometimes be made by careful analysis of pressure contours from the right heart.
Comparison of Fat Intake of American Men and Women
Authors: FRIEDMAN MEYER , ROSENMAN RAY H.
Published: June 2012

A detailed dietary survey of 46 women and their husbands belonging to an upper economic stratum was obtained. The caloric and percentage fat intakes of the sexes were almost identical. The data concerning the possible relationship of hormonal, dietary, and socioeconomic factors to the pathogenesis of coronary artery disease are reviewed.
Ventricular Septal Defects in the Infant Age Group
Authors: ZACHARIOUDAKIS STELLA C. , TERPLAN KORNEL , LAMBERT EDWARD C.
Published: June 2012

An analysis was made of the 23 cases of isolated ventricular septal defects seen at autopsy over a 20-year period at a children's hospital. All of the deaths occurred during the first 15 months of life. In addition to the clinical and morphologic findings, cardiac catheterization data obtained on 6 of the infants are presented. A wide range of electrocardiographic variation with respect to ventricular hypertrophy was found. No simple relationship between the size of the defect and the clinical manifestations could be demonstrated. The surgical implications of the findings are discussed.
Change in Relationship of Blood Volume to Weight in Congestive Heart Failure
Authors: FUNKHOUSER ROBERT K. , PRITCHARD WALTER H. , LITTELL ARTHUR S.
Published: June 2012

Blood volume has been estimated in a small group of nonedematous hospitalized patients and in cardiac patients in severe congestive failure by both Cr
51
-labeled red cells and iodinated (I
131
) human serum albumin. In the analysis of the data attention is directed to a fallacy inherent in the usual ratio method of relating blood volume to weight. An alternative method of analysis is proposed that not only yields greater accuracy, but makes the analysis more sensitive. The authors present their interpretation of the effects of tissue wasting and accumulation of edema fluid on the changes in the relationship between blood volume and weight in congestive heart failure. Analyzing other data from the literature by this method the authors have demonstrated a relationship between the amount of edema fluid and the increase in blood volume in congestive failure.
A Clinical Study of the Brachial Arterial Pulse Form
Authors: HANCOCK ERNEST W. , ABELMANN WALTER H.
Published: June 2012

A survey was made of the clinical usefulness of pulse forms from direct brachial arterial puncture of 250 patients. A prolonged duration of systolic upstroke and an anacrotic notch were found in most instances of severe aortic stenosis, but also frequently in patients with insignificant degrees of aortic stenosis, and occasionally in normal subjects. Characteristic, but nondiagnostic changes in the pulse form were noted in aortic insufficiency, mitral insufficiency, anemia, hyperthyroidism and exercise. The diagnostic significance of these findings is discussed.
Truncus Arteriosus
Authors: ANDERSON RAY C. , OBATA WILLIAM , LILLEHEI C. WALTON
Published: June 2012

We have encountered difficulty in recognizing and identifying clinically true truncus arteriosus with pulmonary arteries (type 1) because of its resemblance to correctable cardiac defects such as patent ductus arteriosus, aortic-pulmonic defect, and ventricular septal defect. In the present report we are presenting clinical information on 14 patients with this anomaly, both to supplement the scanty data available in the literature and to emphasize the need for correct diagnosis.
Hemodynamic Aspects of Diffuse Myocardial Fibrosis
Authors: ROBIN EUGENE D. , BURWELL C. SIDNEY
Published: June 2012

The circulatory changes associated with diffuse myocardial fibrosis have been studied in 11 patients. The characteristics of this form of congestive failure and its similarities to those manifested by constrictive pericarditis and endocardial fibroelastosis are discussed.
Raynaud's Disease Among Women and Girls
Authors: GIFFORD RAY W. , HINES EDGAR A.
Published: June 2012

The diagnosis of Raynaud's disease was suspected in 756 female patients at the Mayo Clinic from 1920 through 1945. The diagnosis was substantiated from the records of the initial examination or from the follow-up data or examination in 474. The clinical characteristics, including diagnostic criteria, clinical course, complications, and sequelae are discussed.
Nonparoxysmal A-V Nodal Tachycardia
Authors: PICK ALFRED , DOMINGUEZ PEDRO
Published: June 2012

Acceleration of impulse formation in the ordinarily subsidiary A-V nodal pacemaker is manifested in clinical electrocardiograms in a paroxysmal and a nonparoxysmal variety. The former occurs as a rule in normal hearts, the latter in pathologic conditions, frequently, but not invariably also causing A-V block. The electrocardiographic and clinical aspects of nonparoxysmal nodal tachycarida were studied in 30 cases and the relative importance of the disturbance was evaluated in 3 conditions in which it is found most frequently, namely, digitalis effect, acute rheumatic fever, and recent posterior wall infarction.
Left Heart Catheterization by the Transbronchial Route
Authors: MORROW ANDREW G. , BRAUNWALD EUGENE , HALLER J. ALEX , SHARP EDWARD H.
Published: June 2012

Left heart catheterization is proving of increasing importance in the study of a variety of congenital and acquired cardiovascular defects. More than 500 left heart catheterizations have been performed by the transbronchial method without death or serious sequelae. This technic and its usefulness in clinical investigation and in the assessment of valvular heart disease are described.
Pulmonary Vascular Resistance in Man at Different Intravascular Distending Pressures Measured in a Case of Mitral Stenosis Complicated by Anomalous Pulmonary Venous Connection
Authors: LENDRUM B. L. , LICHTMAN A. M.
Published: June 2012

The factors capable of altering pulmonary vascular resistance in man have not been entirely clarified despite numerous studies. The authors have studied this problem in an unanesthetized human and demonstrated that one mechanism altering human pulmonary vascular resistance is change in venous pulmonary intravascular distending pressures.
Water Metabolism after Cardiac Operations Involving a Gibbon-Type Pump-Oxygenator
Authors: STURTZ GEORGE S. , KIRKLIN JOHN W. , BURKE EDMUND C. , POWER MARSCHELLE H.
Published: June 2012

Daily water metabolism of 21 patients was studied for 3 days after intracardiac surgery and whole-body perfusion. The average obligatory water losses of these patients were approximately 500, 750, and 750 ml. per M.
2
of body surface per day on the first, second, and third postoperative day, respectively. A simple system, which combines knowledge of the estimated postoperative water requirement with the known daily change in body weight, was devised to manage accurately water metabolism after intracardiac surgery.
Predictive Value of Lipoprotein and Cholesterol Determinations in Diabetic Patients who Developed Cardiovascular Complications
Authors: LOWY ALEXANDER D. , BARACH JOSEPH H. , Hrubec Zdenek
Published: June 2012

A follow-up study was performed on 690 white diabetic patients 2 to 5 years after their blood had been analyzed for lipoprotein and cholesterol to determine if these lipid measures had any predictive value for development of future cardiovascular complications. The work was done in parallel to the national project in which 15,000 normal persons were followed for 1 to 2 years.
5
Massive Occlusion of the Main Pulmonary Artery and Primary Branches
Authors: LEINASSAR JORMA M. , NILES NELSON R.
Published: June 2012

This case of massive thrombotic occlusion of the main pulmonary artery is reported because of the size, extent, and duration of the process, because of the prominent findings leading to the correct clinical diagnosis, and, finally, because of the interesting secondary pathologic changes including myocardial infarction without significant coronary arteriosclerosis or occlusion.
Intravenous Protein-Free Pyrogen
Authors: VON KAULLA KURT N.
Published: June 2012

Administration of a variety of nonfibrinolytic, nonenzymatic substances induces fibrinolysis in man. The most potent materials of this type known at present are purified protein-free pyrogens. Their action after intravenous injection on the human fibrinolytic system, on some of its components, and on the clotting system of 67 individuals has been studied. The possible therapeutic implications are discussed of the marked fibrinolysis.
Severe Hemoptysis During Pregnancy Treated by Mitral Commissurotomy
Authors: FULTON WILLIAM F. M. , SMITH GEORGE
Published: June 2012

Pulmonary bleeding in mitral stenosis is not commonly regarded as an indication for operation. A case is reported in which mitral commissurotomy was performed during pregnancy primarily because of recurrent profuse hemoptysis. Some relevant points are briefly discussed.
Clinicopathologic Correlations of Renal Biopsies in Hypertension with Pyelonephritis
Authors: MERRIAM JOSEPH C. , SOMMERS SHELDON C. , SMITHWICK REGINALD H.
Published: June 2012

Analysis has been made of the responses to sympathectomy for hypertension and certain other aspects of 120 cases whose renal biopsies showed pyelonephritis as well as arteriolar nephrosclerosis. The sex incidence, mortality, average diastolic blood pressures, and post-operative kidney function tests differed from findings in larger hypertensive group without pathologic evidence of pyelonephritis.
Reliability of Electrocardiographic Diagnosis of Left Ventricular Hypertrophy
Authors: SELZER ARTHUR , EBNOTHER CARL L. , PACKARD PETER , STONE ARTHUR O. , QUINN JOHN E.
Published: June 2012

This is an electrocardiographic-pathologic study in which presence and degree of left ventricular hypertrophy found at necropsy were correlated with electrocardiographic abnormalities suggesting the diagnosis of left ventricular hypertrophy. The nonspecificity of some electrocardiographic findings is emphasized by the occasional erroneous diagnosis of left ventricular hypertrophy.
Influence of an Oscillating Bed on Cutaneous Temperature and Oxygen Tension of Ischemic Toes
Authors: FORNO CARLOS , MONTGOMERY HUGH , HORWITZ ORVILLE
Published: June 2012

Measurements of temperature and oxygen tension of the skin demonstrated that treatment with an oscillating bed increases the circulation to ischemic toes. When the angle and duration of the dependent position of the foot of the bed were increased, further increments in circulation resulted.
Coexistence of Patent Ductus Arteriosus and Congenital Aortic Valvular Disease
Authors: MARK HERBERT , JACOBSON BELLE , YOUNG DENNISON
Published: June 2012

Congenital aortic or subaortic stenosis was demonstrated in 7 of 50 patients with patent ductus arteriosus. In addition to the murmurs characteristic of each lesion and diagnostic carotid artery pulse tracings, inordinate enlargement of the left ventricle with a small shunt through the patent ductus should suggest involvement of the aortic valve. The clinical findings associated with this combination of lesions are clear cut and awareness of them should lead to more frequent identification than has been reported previously.
The George E. Brown Memorial Lecture
Authors: BARKER NELSON W.
Published: June 2012

The pathogenesis of intravascular thrombosis involves 1 or a combination of 3 factors: an endothelial lesion, a disturbance of blood flow, and hypercoagulability of the blood. The fate of fresh thrombi is probably dependent on the fibrinolytic activity of the plasma. While some tests for coagulation factors have given some positive results among patients with various types of thrombosis, no test has consistently demonstrated its value in predicting a thrombosing tendency. Carefully administered anticoagulant therapy has been effective in the prevention of thrombosis in many patients. Such therapy requires individualization on the basis of frequent laboratory tests and is usually justified only after the patient has suffered one or more episodes of clinical thrombosis. Treatment of acute thrombosis by intravascular injections of fibrinolysins is still in the experimental stage. Recent advances in surgical technic have led to successful restoration of continuity of some of the large arteries previously occluded by thrombosis.
Treatment of Hypercholesterolemia with Nicotinic Acid
Authors: ACHOR RICHARD W. P. , BERGE KENNETH G. , BARKER NELSON W. , MCKENZIE BERNARD F.
Published: June 2012

Nicotinic acid was administered orally to 33 patients with hypercholesterolemia in doses varying from 1.5 to 6.0 Gm. per day for periods of 3 months to 1½ years. Significant, sustained, and reproducible decreases in the concentration of cholesterol and total lipids in the plasma and of serum beta-lipoprotein cholesterol were observed in a majority of patients. This form of therapy appears to be effective, practical, and probably free from serious harmful effects.
Studies in Peripheral Arterial Occlusive Disease
Authors: WESSLER STANFORD , SHEPS SHELDON G. , GILBERT MARVIN , SHEPS MINDEL C. , Ho Carol , Silver Helen , Ward Kathleen
Published: June 2012

Material for an analysis of the pathogenesis and course of acute peripheral arterial occlusion was provided by patients with acute arterial occlusion in a lower extremity, special arterial injection studies of amputated limbs, arteriograms performed on cadavers, and data from an experimental investigation of acute femoral artery embolism in dogs. This correlative study offers a basis for the evaluation of procedures recommended for the prophylaxis and treatment of acute ischemia.
Cardiovascular Hemodynamic Functions in Complete Heart Block and the Effect of Isopropylnorepinephrine
Authors: STACK MARIA F. , RADER BERTHA , SOBOL BRUCE J. , FARBER SAUL J. , EICHNA LUDWIG W.
Published: June 2012

In 8 patients with complete heart block, cardiac and hemodynamic functions were determined by methods based on cardiac catheterization. The data characterize the impairment in these functions in asymptomatic subjects and indicate, in addition, the further changes over the course of several years in the same subject, the deleterious effects associated with congestive heart failure, and the changes toward normal induced by isopropylnorepinephrine, a sympathomimetic amine known to stimulate the heart and increase ventricular rate in heart block.
Unilateral Pulmonary Artery Absence or Hypoplasia
Authors: ELDER JOHN C. , BROFMAN BERNARD L. , KOHN PAUL M. , CHARMS BERNARD L. , Lawrence Joan , Godfrey Autie Belle
Published: June 2012

The clinical entity of unilateral pulmonary artery absence or hypoplasia can be readily diagnosed on the basis of routine clinical evaluation. This report is based upon 5 patients in whom the diagnosis was suspected and eventually confirmed with the aid of special studies. Characteristic hemodynamic findings were demonstrated by means of cardiac catheterization and contrast visualization of the cardiopulmonary system.
Muscular Dystrophy
Authors: GAILANI S. , DANOWSKI T. S. , FISHER D. S.
Published: June 2012

In an attempt to explain the electrocardiographic and other cardiac abnormalities in patients with muscular dystrophy, hemodynamic studies by right heart catheterization were done on 12 patients with muscular dystrophy. The study indicated the presence of latent congestive failure in some patients. An attempt to explain the abnormal QRS complexes and leads from the right side of the precordium in some of those patients is also made.
Studies Made by Simulating Systole at Necropsy
Authors: STARR ISAAC
Published: June 2012

The background of basic conceptions underlying this paper is familiar to everyone by experience. The powerful automobile, when the light turns from red to green, can make a "jack-rabbit start" which leaves the less powerful cars far behind. If the engine of the big car is weakened, as by a cylinder gone dead, it can still do 50 miles per hour on the parkway and get you to your destination, but the jack-rabbit start is no longer possible. The first sign of weakness manifests itself more conspicuously in differences in acceleration than in differences in speed or in the distance that can be traveled; indeed the effect on acceleration may be the only manifestation of weakness. There is every reason to expect that this analogy would hold for the cardiac performance also and that the first sign of a weakening myocardium might well manifest itself by a change in acceleration of the ejected blood. This paper is chiefly concerned with the development of a simple method, available to clinicians, which would aid in the detection of changes in the acceleration of the aortic blood. This opportunity has also been used to answer certain criticisms of our previously published work, some, we believe, due to misunderstanding of the mathematical background of statistical procedures, and others due to a frank difference of opinion concerning the accuracy of the Fick method used to test the results secured by one of our formulas published previously.
Studies on Renin Antibodies
Authors: HELMER OSCAR M.
Published: June 2012

Intramuscular injection of various kidney extracts containing renin in several animal species caused the appearance in sera of a substance which neutralized renin. The antirenin titers of the antisera were determined by assaying the quantity of unneutralized renin. The assay was based on the production of angiotonin. The dog differs from the other species studied in that heterologous kidney extracts cause a production of antibodies against the treated animal's own renin.
Antibodies to Renin as Proof of the Pathogenesis of Sustained Renal Hypertension
Authors: WAKERLIN GEORGE E.
Published: June 2012

Antirenin to hog renin produced in the dog neutralizes the acute pressor effect of dog as well as hog renin. A course of intramuscular injections of hog renin in chronic renal hypertensive dogs produces an antihypertensive effect which is correlated with the antirenin titers of the plasma. Passive transfer of high titer homologous antiserum to hog renin produces an antihypertensive effect in chronic renal hypertensive dogs which is correlated with the antirenin titer. The results suggest a pathogenetic role for renin in experimental renal hypertension in the dog.
Synthesis and Properties of Angiotonin
Authors: BUMPUS F. MERLIN , SCHWARZ HANS , PAGE IRVINE H.
Published: June 2012

Angiotonin has been shown to be formed by a converting enzyme in blood by the splitting off of the 2 amino acids histidine and leucine from the inactive decapeptide (asp-arg-val-tyr-ileu-his-prol-phe-his-leuc). The synthesis of the active octapeptide is described and its pharmacologic resemblance to the natural product is demonstrated.
Conference on the Role of the Renal Pressor System in Maintenance of Experimental Renal Hypertension
Authors: GOLDBLATT HARRY
Published: June 2012

The hypothetical presence of increased circulating renin or hypertensin in chronic renal hypertension was debated; eventually it was agreed that methods were too insensitive for accurate assay. Pressor amounts of infused renin could not be detected by some methods of bioassay (Dr. Wakerlin). Hypertensinase activity in blood may destroy the end product before the assay can be performed (Dr. Blaquier). Perhaps rapid tissue removal from circulating blood may account for the inadequacy of the results (Dr. Skeggs). Previous experiments to detect these substances in circulating hypertensive blood have been indecisive (Dr. Braun-Menéndez) or only weakly positive (Drs. Goldblatt and Skeggs) and the clear-cut depressor effects of antirenin might act on a hypothetical nonpressor action of renin (Dr. Wakerlin). Dr. Helmer commented on the sustained pressor substance found in renal vein blood of hypertensive rats. Dr. Grollman believed chronic renal hypertension to be due to interference with an essential function of the kidney which in the normal animal prevents the blood pressure from rising. The failure of the blood pressure to rise when the kidneys from renal hypertensive dogs were perfused in situ by normotensive recipients was again discussed by Drs. Surtshin, Goldblatt and Grollman, and the possible fallacies involved in reasoning from such acute experiments were brought out.

The nature of the stimulus to renin release was discussed again by Dr. Kolff. Non pulsatile flow was probably not a requirement (Dr. Kolff), nor was renal ischemia (Dr. Wakerlin), but some alteration in renal function seemed to be necessary (Dr. Goldblatt). Dr. Wakerlin and Dr. Rodbard advocated, respectively, the view that the primary stimulus might be the volume pulse or the transmural pressure in the renal arterial bed.

An objection to renin as the cause of chronic hypertension based on tachyphylaxis experiments was raised by Dr. Findley. Dr. Goldblatt denied the presence of true tachyphylaxis and was supported by Drs. Helmer and Wakerlin. Dr. McCubbin suggested it might occur only with cruder preparations of renin, and Dr. Braun-Menéndez theorized that receptor sites might be occupied for a time after restoration of normal blood pressure, thus giving rise to a transient tachyphylaxis. Dr. Bumpus supported this explanation by reporting that a pressor response to crude angiotonin can sometimes not be maintained, while the response to pure angiotonin is persistent.

Considerable discussion ensued between Drs. Goldblatt and Grollman concerning the mechanism of blood pressure reduction by removal of a single ischemic kidney. The human renal biopsy and autopsy studies suggesting the primacy of renal arteriolosclerosis in human hypertension were reviewed by Dr. Goldblatt.
Introductory Remarks Concerning the Urologic Aspects of Hypertension
Authors: NESBIT R. M.
Published: June 2012

Urologic experience with uninephrectomy for renal hypertension is reviewed and a case with a prolonged postoperative period of normotension is presented. In certain instances aortograms are necessary to identify vascular lesions in the kidney causing hypertension, but renograms using radioactive I
131
may be of value as a screening procedure. An unusual case is described in which contrast material injected into the bladder could be seen to enter the renal pelves. The child went for prolonged periods without voiding and had demonstrable pyelonephritis. When antibiotics and a program of frequent voiding were commenced the blood pressure fell toward normal and has remained at only minimally elevated levels for the subsequent 2 years.
Reduction of Experimental Renal Hypertension by Kidney Perfusion
Authors: KOLFF W. J.
Published: June 2012

Normal kidneys were transplanted to the neck of 15 dogs with experimental renal hypertension. In 6 a reduction of blood pressure of 52 mm. Hg (32-102) took place during the first 2 hours of perfusion. It is hypothesized that renin or angiotonin in minute amounts impairs, blunts or frustrates the normal blood pressure reducing function of the kidney.
Evidence for Humoral Factors in Renoprival Hypertension
Authors: RONDELL PAUL A. , MCVAUGH RUTH B. , BOHR DAVID F.
Published: June 2012

Plasma of renoprival hypertensive rats was found to have an exaggerated constrictor effect on isolated rat aorta strips, however, no pressor effect was produced in acutely nephrectomized rats cross-circulated with renoprival hypertensive animals. It is suggested that if the constrictor element of the plasma from renoprival hypertensive rats is not just an artifact of the aorta strip assay technic but does exist and play a role in renoprival hypertension, it does so by acting on arterioles sensitized by the chronic a-renal condition.
Panel Discussion on Genetic and Environmental Factors in Human Hypertension
Authors: KOHLSTAEDT K. G. , MOSER M. , FRANCIS T. , NEEL J. , MOORE F.
Published: June 2012

The high incidence of hypertension in the Negro in the West Indies and United States and the infrequency of the disease in the African Negro were the focal point of Dr. Moser's presentation. The coincidence of a high salt intake in the Bahama population which he studied was emphasized as a possible "lead" for further study.

Dr. Francis emphasized the value of a longitudinal and complete epidemiologic study in uncovering etiologic factors in hypertension. A definition of hypertension should not be based on any arbitrary blood pressure, but frequency distribution curves for an entire population should be studied together with selective group characteristics which might lead to a definition of susceptibles. Then a follow-up program might be devised which would identify the factors involved in the appearance or progression of hypertensive disease in the susceptible individual or the mild case. From this standpoint the situation in the Bahamas, where the life history of the disease was telescoped into a shorter time span, seemed ideal.

Dr. Neel emphasized the almost certain heterogeneity of the hypertensive trait, as proposed by Professor Pickering, and other difficulties in making genetic studies in this field: variations in blood pressure readings, effects of acquired diseases, and environmental influences such as the acculturation process at work in certain African populations.

Prof. Moore reviewed the current surveys of the incidence of hypertension in certain populations. These support the concept of a continuous distribution of the blood pressure, of varying sex incidence depending on the age of the sample, and of a tendency to find an increase in the proportion of hypertensive subjects in older age groups. The failure of diastolic blood pressure to follow these patterns was an interesting and unexplained phenomenon. The value of longitudinal studies as in the Framingham survey, was demonstrated by the evidence of the reduced life expectancy which even mild degrees of hypertension imposed on the individual.

In subsequent discussion, further information about blood pressure in East African populations was contributed by Drs. Perry and Grollman, and on blood pressure and dietary habits and diseases of Japanese, Eskimo, Central American, and Formosan populations were discussed by Drs. Kirkendall, Rodbard, Grollman, Stamler and Moser.
Effect of Electrolytes on Arterial Muscle Contraction
Authors: BOHR DAVID F. , BRODIE DONALD C. , CHEU DONALD H.
Published: June 2012

The effect of specific electrolyte changes and of desoxycorticosterone on the responsiveness of vascular smooth muscle to epinephrine was studied using rabbit aortic strips. Low sodium increases, while high sodium decreases the epinephrine response. Conversely, low potassium decreases, while high potassium increases the epinephrine response. Desoxycorticosterone potentiates the epinephrine response in a manner qualitatively similar to that of high potassium, but different from that of low sodium potentiation.
Serum Magnesium and Plasma Sodium Levels in Essential Vascular Hypertension
Authors: ALBERT DONALD G. , MORITA YOSHIKAZU , ISERI LLOYD T.
Published: June 2012

The mean serum magnesium concentration in 26 uncomplicated hypertensive patients was found to be significantly lower than that in 43 normal individuals. The mean plasma sodium concentration in these patients was significantly higher than that in a normal group. The mean plasma potassium levels were not significantly different. It is suggested that a possible explanation for these electrolyte changes is excessive adrenal cortical activity.
Contribution of the Adrenal Cortex to Renal and Renoprival Hypertension
Authors: DUSTAN HARRIET P. , MASSON GEORGES M. C.
Published: June 2012

Association of the adrenal cortex with renal hypertension lead to the conclusion that several mechanisms are operating. First, hypertension is not, or is poorly sustained in true adrenal failure, and mild failure seems to impair vascular responsiveness. This indicates a permissive function of the adrenal in renal hypertension. Furthermore, degrees of renal injury or of hypercorticoidism which are not of themselves very pressor may cause severe hypertension when they are added together. This additive aspect is probably closely related to the sensitizing effect of adrenal steroids on renal pressor activity and underlies the so-called renin-DCA syndrome. It may involve not only an enhanced pressor responsiveness but also a weakening of vessel walls. Lastly, the effects of renin and renal hypertension on the zona glomerulosa suggest that the renal pressor system has a direct effect on the adrenal cortex which would tend to add cortical pressor to existing renal pressor activity and thus sustain renal hypertension.
Introductory Remarks Concerning Neural Factors in Essential Hypertension
Authors: KAHN EDGAR A.
Published: June 2012

The vasoconstrictor effect of neural stimuli from frontal and hypothalamic centers to the blood vessels, including the renal arterioles, is reviewed. Such a theory of the pathogenesis of hypertension is probably deficient, since humoral or atherogenic factors also play a part. Nevertheless, splanchnicectomy may sometimes alleviate superimposed vasoconstriction and help in treatment of the patient.
Effect of the Autonomic Nervous System on Arteriolar Tone in the Experimental Animal
Authors: BECK LLOYD
Published: June 2012

Evidence obtained from experiments involving perfusion of vascular beds and cardiac output studies with controlled filling pressure of the right heart before and during ganglionic blockade support the view that the heart of the dog is tonically stimulated by its sympathetic innervation. The blockade of this tonic stimulation to the heart permits a reduction in cardiac output. The fall in cardiac output results in a decrease in passive stretch of the arterial system which permits a passive rise in peripheral resistance thus compensating for the loss of arteriolar tone so that the peripheral resistance may be unchanged during ganglionic blockade despite a reduction in neurogenic arteriolar tone.
Conference on Neural Control of the Circulation in Hypertension
Authors: HOOBLER SIBLEY W.
Published: June 2012

Dr. Conway reviewed his test for differentiating hypertensive patients into those with and without altered vascular elasticity. The discussion then turned to the role of the nervous system in hypertension. Experiments concerning the role of neural influences in initiating permanent hypertension were reviewed by Drs. McCubbin, Wakerlin, Langford, and Stamler. The Dock experiment of pithing hypertensive animals was then considered. His results seemed to indicate the importance of neural influences in maintaining experimental renal hypertension, but it was agreed that it was not justifiable to conclude from this work that renal hypertension was maintained by elevated neural tone (Drs. Braun-Menéndez, Bohr, Goldblatt, Kezdi, and Sapirstein). The conferees then examined the question of increased neurogenic arteriolar tone in human essential hypertension. The lack of evidence for increased neural tone, based on the failure of greater dilation following ganglionic blockade in the hypertensive subject was supported by Dr. Hoobler and opposed by Dr. Kirkendall. Most agreed that inferences from changes in peripheral resistance after blockade were fraught with error, due to the intrinsic elasticity of the arterioles (Dr. Beck), the predominance of venomotor blockade (Dr. McCubbin), the "break through" of buffer reflexes (Drs. McCubbin, Kezdi, Stamler), and the effects of varying types of anesthesia in animal experiments (Dr. Stamler). Finally, in reply to a question concerning ways to produce chronic, sustained, experimental, neurogenic hypertension, Dr. McCubbin mentioned the experiments of Taylor and Page, and Dr. Wakerlin concluded with a description of a technic for producing in dogs chronic neurogenic hypertension which had persisted in excess of 4 years. This consisted in applying a constricting plastic clamp to the carotid sinus area bilaterally, so as to reduce the volume pulse of the arterial branches of the sinus by two-thirds.
Regression after Open Valvotomy of Infundibular Stenosis Accompanying Severe Valvular Pulmonic Stenosis
Authors: ENGLE MARY ALLEN , HOLSWADE GEORGE R. , GOLDBERG HENRY P. , LUKAS DANIEL S. , GLENN FRANK
Published: June 2012

Three patients operated upon under hypothermia for severe valvular pulmonic stenosis had right ventricular pressures in excess of 100 mm. Hg after open valvotomy. The residual obstruction, localized by pressure measurements to the subvalvular region, appeared to be due to greatly hypertrophied musculature in the outflow tract of the ventricle. Infundibular resection was not attempted. Electrocardiographic signs of right ventricular hypertrophy gradually disappeared, and cardiac catheterization about 1 year after surgery showed normal or nearly normal right ventricular pressures. Postoperative improvement is attributed to regression of hypertrophy of the right ventricle consequent to relief of obstruction at the valve.
A Method for the Electrocardiographic Recognition of Atrial Enlargement
Authors: MACRUZ RADI , PERLOFF JOSEPH K. , CASE ROBERT B.
Published: June 2012

New criteria for the electrocardiographic recognition of right atrial enlargement, left atrial enlargement, and combined atrial enlargement were studied in 110 patients with congenital and acquired heart disease. Precise physiologic data were available in all cases. The method of analysis was designed for application to conventional scalar electrocardiography and hence can be used without modification for routine clinical purposes.
Response of Serum Lipids and Lipoproteins of Man to Beta-Sitosterol and Safflower Oil
Authors: FARQUHAR JOHN W. , SOKOLOW MAURICE
Published: June 2012

Previous studies in man have indicated that administration of either plant sterols or unsaturated dietary fats causes decreases in certain serum lipids. This report presents the results of a long-term 7-phase study of the comparative effects of the single and combined administration of plant sterols (β-sitosterol) and a highly unsaturated vegetable oil (safflower oil) in 15 ambulatory subjects. The serum lipid changes observed indicate that both agents act on the same low-density lipoprotein fraction, that the changes produced by β-sitosterol and by safflower oil are similar in magnitude, but that the combination has a 55 per cent greater effect than either agent alone, that the mechanisms of action of these 2 agents probably differ, and that the action of the safflower oil is probably not due to the amount of sitosterol it contains.
Radioiodine Treatment of Paroxysmal Supraventricular Tachycardia in the Euthyroid Patient
Authors: CORDAY ELIOT , GOLD HERBERT , JAFFE HENRY L.
Published: June 2012

Twenty-five euthyroid patients subject to recurrent paroxysmal supraventricular tachycardias, which were resistant to usual prophylactic therapy, were treated with radioactive iodine. In many of the patients, with follow-up ranging up to 6 years, there were no recurrences of the tachycardia subsequent to the isotope therapy. Two patients were considered refractory to this therapy.
Intramural Hemorrhage in Coronary Atherosclerosis
Authors: BLAKE THOMAS M. , SPRINGER PHILIP K.
Published: June 2012

The mechanism of the development of acute occlusion of the coronary arteries is subject to considerable discussion. Intramural hemorrhage has been suggested as a cause of acute occlusion by the hematomatous enlargement of atheromata without associated thrombosis. By a systematic study of coronary arteries with a special technic of injection and clearing of the vessels the frequency of this mechanism was determined.
Total Electrical Alternation in Pericardial Disease
Authors: LITTMANN DAVID , SPODICK DAVID H.
Published: June 2012

Simultaneous electrical alternation of atrial and ventricular components can occur in malignant and sometimes tuberculous pericardial disease and is due, apparently, to a rotary pendular movement of the heart at a rate that differs from the pulse. This oscillation occurs only during effusion with tamponade and clears with paracentesis. It is thought to be the result of unusual freedom or release from the normal pulmonary and thoracic restraints.
Observations on the Mechanism of Atrial Gallop Rhythm
Authors: LEONARD JAMES J. , WEISSLER ARNOLD M. , WARREN JAMES V.
Published: June 2012

An atrial gallop sound is a frequent finding in hypertensive cardiovascular disease, myocardial infarction, and in the presence of a prolonged atrioventricular conduction time. In view of evidence relating this sound to a ventricular pressure wave resulting from atrial contraction, modification of this hemodynamic event was studied by means of tourniquet pooling of blood in the extremities. In the 18 patients studied, this maneuver caused striking changes in the intensity and timing of the atrial gallop. Analysis of these changes helps explain the frequent appearance of this triple rhythm in severe hypertensive cardiovascular disease.