bluuebunny/crossref_metadata_2025 huggingface dataset:
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

Each of 21 patients was noted to have a low concentration of water in the serum immediately after whole-body perfusion. This indicated a loss of water either by the patient or the pump-oxygenator. Investigation suggested that the patient, and not the pump-oxygenator, was the source of water loss. Two of the 21 patients had a profuse, short-lived solute diuresis in the immediate postperfusion period. These phenomena are apparently benign and they require no specific treatment.
Significance of the Pulmonary Vascular Bed in Congenital Heart Disease
Authors: FERENCZ CHARLOTTE , DAMMANN J. FRANCIS
Published: June 2012

A microscopic study was made of the lungs of 18 patients with congenital malformations of the heart in which there was obstruction of pulmonary venous drainage. Alterations in various components of the pulmonary vascular bed and of the lung parenchyma were described and correlated with the clinical course and the type of malformation present. A quantitative evaluation of the pulmonary arterial thickening was made by determining the lumen:wall ratio of small vessels. The anatomic alterations found in these children were compared to those of adults with acquired mitral stenosis.
Ebstein's Anomaly
Authors: MAYER FLORENCE E. , NADAS ALEXANDER S. , ONGLEY PATRICK A.
Published: June 2012

Ten cases of Ebstein's anomaly are presented and the literature is reviewed. Certain diagnostic features of the clinical profile, in particular the auscultatory findings, are emphasized.
Mast Cells in the Circulatory System of Man
Authors: POLLAK O. J.
Published: June 2012

This report is based upon a study of multiple segments of the cardiovascular system of 200 deceased persons and selected surgical specimens. Mast cells are present in the adventitia of all blood vessels. Only the largest vessels have mast cells in the intima and subintima as well. In this location the number of mast cells is highest in grossly normal but microscopically edematous areas. Mast cells are rarely present in early and are never present in advanced atheromatous lesions. The theory is advanced that mast cells are attracted by plasma insudate to release heparin for degradation of lipoproteins. Thus, mast cells might play a role in atherogenesis.
Endocardial Fibroelastosis
Authors: LINDE LEONARD M. , ADAMS FORREST H. , O'LOUGHLIN BERNARD J.
Published: June 2012

Endocardial fibroelastosis is an important cause of congestive heart failure and death in infancy and early childhood. Four cases of this entity are described, with particular attention to the unique angiocardiographic features. This graphic portrayal of the functional derangement may be of great help in the clinical diagnosis of fibroelastosis.
Pulmonary Heart Disease
Authors: ARMEN ROBERT N. , KANTOR MILTON , WEISER NELSON J.
Published: June 2012

The diagnosis of cor pulmonale presents considerable difficulty in its earlier stages. Clinical symptoms are not available until the right heart fails and the only reliable sign is right ventricular hypertrophy, which is not easy to demonstrate. The purpose of this investigation is to evaluate electrocardiographic patterns of these patients as a more practical means of diagnosis. Sixty-seven patients with cor pulmonale are included in this study, which endeavors to point out degrees of correlation between various electrocardiographic patterns and clinical factors, such as stages of the disease, its severity, its etiology, and the anatomic changes of the right ventricle. It also evaluates the degrees of specificity of the various patterns encountered in these patients.
Serum Cholesterol in Pentolinium -Treated Arterial Hypertension
Authors: ORVIS HAROLD H. , TAMAGNA IRENE G. , EVANS JOHN M.
Published: June 2012

Serum lipids were serially determined in 11 patients receiving pentolinium therapy to evaluate changes secondary to blood pressure effects. Substantial reduction in total Cholesterol was observed, which in some cases was independent of the hypotensive effect of the drug. Fat absorption, studied in 6 patients, revealed diminished postprandial lipemia in each as compared to placebo determinations. However, few patients showed appreciable weight change during a year of therapy. The evidence suggests that the serum lipid changes secondary to pentolinium administration are due to a qualitative change in fat absorption.
Pulmonic Stenosis with Intact Ventricular Septum
Authors: MCGOON DWIGHT C. , KIRKLIN JOHN W.
Published: June 2012

Pulmonic stenosis unassociated with a ventricular septal defect of significant size is often a complex abnormality. The stenosis may be valvular, infundibular, or both, and may be associated with an atrial septal defect or even with a small ventricular septal defect. Preoperative studies cannot accurately predict these variations. The surgical approach selected for such patients should permit the correction of each of the cardiac defects encountered. That this can be accomplished by means of extracorporeal circulation and open cardiotomy is demonstrated by the presented series of 10 cases without operative mortality.
Inaccuracy of Wedge Pressure as an Index of Pulmonary Capillary Pressure
Authors: MURPHY JEROME P.
Published: June 2012

The wedge and left atrial pressures were compared in 12 subjects with congenital and acquired heart disease; all experiments were carried out with closed chest under basal conditions. A poor correlation between the wedge and left atrial pressures was noted in over half the patients. The wedge pressure is especially inaccurate in mitral stenosis with marked elevations in left atrial pressure.
Corrected Transposition of the Great Vessels, Atrioventricular Heart Block, and Ventricular Septal Defect
Authors: WALKER WELDON J. , COOLEY DENTON A. , MCNAMARA DAN G. , MOSER ROBERT H.
Published: June 2012

Three cases with the triad of ventricular septal defect, atrioventricular heart block, and corrected transposition of the great vessels are presented. In each instance the patient successfully underwent open heart surgery on the pump-oxygenator for closure of the ventricular septal defect. A review of the literature suggests a frequent association of these 3 congenital anomalies. In our experience atrioventricular heart block is rarely encountered with simple ventricular septal defect. The finding of atrioventricular heart block in a patient with an interventricular septal defect warrants consideration of an associated corrected transposition of the great vessels.
Dextrocardia with Pulmonary Stenosis and Functionally Single Right Ventricle
Authors: FISHER JOSEPH , SUH SOON KYU
Published: June 2012

An unusual case of congenital heart disease is reported which, despite numerous circulatory abnormalities, permitted a life span of 34 years.
Bronchoscopic Method for Measuring Left Atrial Pressure
Authors: GUNNING A. J. , LINDEN R. J.
Published: June 2012

The possibility is examined that measurements from the records of left atrial pressure obtained by direct puncture of the left atrium through the bronchoscope might help in the diagnosis of mitral disease. The left atrial pressure records of 156 patients have been analyzed and the results are presented.
The Concept of "Masquerading" Bundle-Branch Block
Authors: UNGER PAUL N. , LESSER MILTON E. , KUGEL VICTOR H. , LEV MAURICE
Published: June 2012

This is a clinicopathologic study of 2 patients who electrocardiographically presented so called "masquerading" bundle-branch block. The conduction systems and the entire hearts of these patients were studied pathologically by methods especially devised by Lev for electrocardiographic correlation. This report is part of a long-term project attempting to ascertain the anatomic substrate of electrocardiographic abnormalities.
Systolic Murmurs
Authors: LEATHAM AUBREY
Published: June 2012

The graphic registration of heart sounds and murmurs (phonocardiography) has greatly facilitated analysis of their pattern, timing, and relation to hemodynamics. Many of the principles and facts so established are being applied to auscultation with great benefit to that art.

Systolic murmurs fall into 2 main groups, ejection murmurs and regurgitant murmurs, according to their shape and relation to the heart sounds.

Ejection systolic murmurs
are separated from the first heart sound by the isometric contraction time; they are crescendo-diminuendo in pattern (diamond shaped) and finish appreciably before the second heart sound. They are due to ejection of blood from the left or right ventricle into the aorta or pulmonary artery when there is stenosis of the appropriate valve or outflow tract, valve disease without stenosis, or—without valve disease-increased forward stroke flow or dilatation of the aorta or pulmonary artery. Small ejection vibrations can be recorded in normal subjects and their physiologic accentuation is probably responsible for most systolic murmurs that prove to be innocent.

Regurgitant systolic murmurs
are pansystolic for they start with the first heart sound and finish with the second; the volume of sound emitted is relatively constant throughout systole or increased in late systole. They are caused by backflow of blood through the mitral or tricuspid valve or by a left-to-right shunt of high velocity through a ventricular septal defect or patent ductus arteriosus.
Renal Pressor System in Hypertension
Authors: SKEGGS LEONARD T. , KAHN JOSEPH R.
Published: June 2012

Hypertensin has been found in the circulating arterial blood in dogs with experimental renal hypertension and in human beings with essential hypertension. Two different chemical forms of the material have been obtained in purified form and their chemical constitution determined. The decapetide hypertensin I is the initial product of the action of renin on its substrate. This material is transformed to the vasoconstrictor octapeptide hypertensin II by a chloride activated enzyme of the plasma.
Effect of an Intravenous Sodium Chloride Load on Renal Hemodynamics and Electrolyte Excretion in Essential Hypertension
Authors: COTTIER PAUL T. , WELLER JOHN M. , HOOBLER SIBLEY W.
Published: June 2012

Excretion of infused sodium, chloride, and water increased proportionately in patients with progressively more severe grades of hypertension and of increased renal vascular resistance. These relationships held so long as renal plasma flow and glomerular filtration rate were not greatly impaired. The abnormality was characterized by increased renal tubular rejection of sodium, chloride and water.
Conference on Electrolyte and Adrenal Factors in Human and Experimental Renal Hypertension
Authors: BOHR DAVID F.
Published: June 2012

In addition to reviewing evidence bearing on the broad relationship of adrenal and electrolyte changes to the pathogenesis of hypertension, this conference considered more specifically the changes in vascular reactivity and electrolyte excretion in hypertension.

Supporting the theory of an adrenal mechanism in hypertension was evidence that the development of adrenal-regeneration hypertension in different species may bear a direct relationship to the degree of adrenal regeneration (Dr. Skelton), and that a steroid having electrolyte action opposite to that of desoxycorticosterone is hypotensive in action both in DCA and renal ischemic hypertension, but not in normotensive animals (Dr. Sturtevant). On the other hand, it was observed that adrenalectomy does not alter the development of hypertension produced by kidney encapsulation in the rat (Dr. Fregly).

Although it is probable that constrictor agents cause a greater increment in vascular resistance in hypertension than in normotension, the interpretation of this relationship in terms of responsiveness of vascular smooth muscle is fraught with difficulties: 1. The base line of vascular resistance in hypertension is different from that in normotension, and it is possible that the increment in resistance for a given amount of smooth muscle shortening is greater in the constricted than in the normal vessel (Dr. Tobian). 2. It is possible that the increase in resistance in hypertension is due to the encroachment of the edematous blood vessel wall into the lumen without an increase in tone of vascular smooth muscle (Dr. Tobian). 3. The responsiveness to epinephrine of aortic strips from hypertensive animals is less than (Dr. Bohr) or no greater than (Dr. Tobian) that from the nor mal animal. The pertinence of the aortic strip studies was questioned, both because the aorta differs in function (Dr. Sancetta) and responsiveness (Dr. Bohr) from the arteriole and because epinephrine was used in these studies (Dr. Skeggs). The problem of tachyphylaxis of the isolated artery strip in response to angiotonin may not yet be resolved (Drs. Bohr and Helmer).

In hypertension there is an increase in sodium excretion by the kidney which is accentuated by the administration of a sodium chloride load. This abnormality reflects an impairment of the tubular reabsorption of sodium which is related to an impaired reabsorption of water (Dr. Sapirstein) and is a direct function of the arterial blood pressure (Drs. Hollander and Weller).
Baroceptor and Sympathetic Activity in Experimental Renal Hypertension in the Dog
Authors: KEZDI PAUL , WENNEMARK JAMES R.
Published: June 2012

Response to tetraethylammonium chloride was studied in normal and renal hypertensive dogs in which the carotid sinus was isolated and intrasinusal pressure was maintained by a pump. Normal, chronic, and acute renal hypertensive animals differed in their response at different intrasinusal pressure levels and indicated resetting of the baroceptors in the chronic hypertensive phase but not in the acute phase. This resetting may play a role in the maintenance of chronic renal hypertension.
Vascular Reactivity in Experimental Hypertension Measured after Hexamethonium
Authors: CONWAY JAMES
Published: June 2012

The characteristics of the response to pressor and depressor drugs in hypertensive animals suggest that structural changes in the arteriole play an important role in the development of hypertension.
Effectiveness of an Oral, Nonmercurial Diuretic
Authors: WAINFELD BENJAMIN , YARVIS JACOB J. , SCHWARTZ I. RICHARD
Published: June 2012

In a previous trial of aminometramid on 30 patients with peripheral edema, 19 became refractory to the drug. These 19 patients and another group of 16 with peripheral edema or ascites were placed on another nonmercurial diuretic aminoisometradine, which had shown promise in previous studies in animals and man. This group of 35 patients who had previously required frequent injections of mercurial diuretics were treated with the new diuretic for at least 8 months. Conclusions of this study are presented.
Primary Aortic Thrombosis
Authors: GAYLIS H.
Published: June 2012

Primary arterial thrombosis is a rare lesion and may be defined as thrombosis of a vessel without any obvious underlying cause. The condition has been described in the peripheral arteries of the upper and lower extremities but there are few authenticated reports of the condition affecting the aorta. A case of primary aortic thrombosis occurring in a man aged 32 is reported.
Serum Lipids in South African Bantu and White Subjects
Authors: BLOOMBERG B. M. , LAZARUS F. , MROST IRENE , SCHNEIDER RHODA
Published: June 2012

Normal South African Bantus differ from white Europeans in lipoprotein pattern as well as in total serum cholesterol. Urban Bantus have higher α-lipoprotein cholesterol concentrations and lower β-lipoprotein cholesterols than whites. Young rural Bantus have lower α-lipoprotein cholesterols than young urban Bantus, and both have lower β-lipoprotein cholesterols than old urban Bantus. These differences may be related to standards of living and are thought to be of value in defining the "ideal" levels for both cholesterol fractions.
Serum Lipid and Estrogenic Effects of Manvene, a New Estrogen Analog
Authors: COHEN WILLIAM D. , HIGANO NORIO , ROBINSON ROGER W.
Published: June 2012

Estrogenic side-effects and serum lipid changes were studied in middle-aged men with coronary heart disease during a 6-month period with varying dosage levels of Manvene, a new estrogen analog. Although significant lipid-shifting effects were noted at 5 and 10 mg. daily, these were not comparable with those of 10 mg. of Premarin. Analysis of scattergrams of individual estrogenic and lipoprotein responses of both Manvene-treated and Premarin-treated patients revealed a favorable dissociation of these effects in 5 of the 29 men in the Manvene groups.
The Syndrome of Dextroversion of the Heart
Authors: GRANT ROBERT P.
Published: June 2012

On the basis of 3 personal cases and 119 additional cases collected from the literature the difference between dextroversion and mirror-image dextrocardia is outlined. It is concluded that dextroversion is a part of an exceedingly primitive arrest in development that frequently includes other thoracic and abdominal organs as well as intracardiac structures. The defect is altogether different in embryogenesis and anatomic findings from mirror-image dextrocardia.
Changing Frequency of Arteriosclerosis in Mammals and Birds at the Philadelphia Zoological Garden
Authors: RATCLIFFE H. L. , CRONIN M. T.I.
Published: June 2012

From 1901 through 1932 arteriosclerosis was found in less than 3 per cent of autopsies on mammals and birds at the Philadelphia Zoological Garden, but thereafter its frequency has increased to about 20 per cent. This study has attempted to identify factors that may be associated with this change in frequency.
Pulmonary Valve Obstruction During Cardiac Catheterization
Authors: PAUL MILTON H. , RUDOLPH ABRAHAM M.
Published: June 2012

The clinical and hemodynamic responses to acute pulmonary valve obstruction during cardiac catheterization in patients with severe pulmonary valve stenosis are presented to illustrate the serious nature of this complication.
Nephrogenic Hypertension (Goldblatt Kidney) Following Operative Trauma to the Renal Artery
Authors: MCDONALD RICHARD T. , SZILAGYI D. EMERICK , SMITH ROGER F.
Published: June 2012

The thrombosis of the right renal artery following operative injury set off a chain of events closely duplicating the arterial hypertension observed by Goldblatt after constriction or occlusion of the renal arteries in experimental animals. The resulting hypertension was severe, fulminating, prolonged, and resistant to treatment by hypotensive and ganglion-blocking agents; it was associated with pulmonary edema, myocardial infarction, and impairment of the renal function. Nephrectomy brought about a return of the blood pressure to normal levels. The concentration of renin in the removed kidney was 34 times greater than normal.
Electrocardiographic Changes during Hemodialysis with the Artificial Kidney
Authors: RUBIN ALBERT L. , LUBASH GLENN D. , COHEN BURTON D. , BRAILOVSKY DAVID , BRAVEMAN WARREN S. , LUCKEY E. HUGH
Published: June 2012

Rapid alteration of plasma, electrolyte concentrations during dialysis with the artificial kidney may be associated with changes in the electrocardiogram and in cardiac function. In this study, the electrocardiographic changes encountered during 33 hemodialyses are described and correlated with abnormal electrolyte patterns and their correction.
Serum Phospholipids
Authors: SCHAEFER LOUIS E. , ADLERSBERG DAVID , STEINBERG ARTHUR G.
Published: June 2012

Serum phospholipid levels were determined in 1,067 healthy persons aged 2 to 77 years. Phospholipid levels increased with age but in a different way for each of the sexes. The age-sex changes of serum phospholipids were similar to those observed for serum cholesterol. Correlation coefficients in members of 156 families indicated that the genetic factor is of importance in determining the serum phospholipid level in health. Because of the age-sex variations of serum phospholipid and serum cholesterol levels, no single arbitrary line can be drawn between normal and abnormally elevated levels of these 2 serum lipid fractions.
Nonpenetrating Traumatic Injury of the Heart
Authors: PARMLEY LOREN F. , MANION WILLIAM C. , MATTINGLY THOMAS W.
Published: June 2012

The misconception that nonpenetrating trauma to the heart is relatively rare, is primarily due to the fact that myocardial contusion or traumatic pericardial lesions are usually well tolerated and the clinical findings transient and often difficult to recognize. However, the sequelae of this type of cardiac trauma may be serious. Therefore, a careful evaluation of every traumatized individual for cardiovascular injury is essential if the more serious complications are to be recognized and treated effectively. The most commonly encountered cardiac lesion at necropsy was myocardial rupture of a septum or a chamber wall. Now that surgical therapy is available for certain types of cardiac rupture, early diagnosis is essential. Thrombosis of a major coronary artery as a direct result of nonpenetrating trauma was not found in this study and is considered rare. Nevertheless, a previously diseased heart appears to be more vulnerable to trauma. Under these circumstances, it is often difficult to assess properly the extent to which trauma may aggravate a pre-existent disease.
Plasma Turbidity Changes and Electrocardiographic Alterations Induced by Alimentary Hyperlipemia in Anginal Patients before and after the Administration of Gastric Mucin
Authors: RULLI VINCENZO , ROSSI BALDO
Published: June 2012

The hyperlipemia induced by a fat meal in anginal patients is frequently associated with clinical and electrocardiographic changes suggesting transient coronary insufficiency. Gastric mucin administered to 10 anginal patients at the same time as a fat meal invariably prevented the hyperlipemia, evaluated as increase of plasma optical density, and in one half of the cases it reduced the magnitude of the electrocardiographic changes as compared with the changes found in control experiments. Gastric mucin therefore exerts a powerful antilipemic and clearing action. Its inhibitory effect on the electrocardiographic changes associated with alimentary hyperlipemia is less evident than that of heparin.
Late Hemodynamic Complications of Anastomotic Surgery for Treatment of the Tetralogy of Fallot
Authors: ROSS RICHARD S. , TAUSSIG HELEN B. , EVANS MELVIN H.
Published: June 2012

Seventeen patients with late hemodynamic complications of anastomotic surgery for the tetralogy of Fallot have been studied. Two syndromes have been noted and both seem related to shunts of greater than ideal size. The clinical characteristics of these syndromes are delineated.
The Splanchnic Blood Volume in Congestive Heart Failure
Authors: RAPAPORT ELLIOT , WEISBART MYRON H. , LEVINE MILTON , Cifarelli Pasquale , Renjilian Armen
Published: June 2012

Little data have been accumulated regarding the contribution of regional volumes to the increased total blood volume observed in congestive heart failure. This report deals with the measurement of splanchnic blood volume in 12 patients in congestive heart failure compared with results obtained in 10 control subjects similarly studied.
The Tricuspid Component of the First Heart Sound in Mitral Stenosis
Authors: HULTGREN HERBERT N. , LEO THOMAS F.
Published: June 2012

The sound of tricuspid valve closure has been identified in 35 of 40 phonocardiograms of patients with mitral valve disease. Identification of the sound is facilitated by the delay of closure of the mitral valve thus separating these 2 components of the first heart sound. When the ventricular rhythm is irregular due to atrial fibrillation, the intensity of the sound is inversely proportional to the length of the preceding diastolic interval. When the sound of tricuspid closure is accentuated, it may be identified by auscultation as the initial component of a split first sound mesial to the apex. Measurement of the interval from the onset of the QRS complex of the electrocardiogram to the "first heart sound" should be made to the mitral component of the first sound when this can he identified on the phonocardiogram.
Work and Heart Disease
Authors: FORD AMASA B. , HELLERSTEIN HERMAN K.
Published: June 2012

Sixty-two factory workers, 36 with heart disease, and 26 healthy control subjects, were studied during a typical day's work. Observations of energy expenditure, pulmonary ventilation, pulse rate and electrocardiogram are reported and analyzed in relation to the type of work, the influence of heart disease, and possible objective evidence of fatigue.
The Diagnosis of Circulatory Shunts by the Nitrous Oxide Test
Authors: SANDERS RICHARD J. , MORROW ANDREW G.
Published: June 2012

The nitrous oxide test for the detection and localization of left-to-right shunts has previously been studied clinically. Further experience with the method has shown that a higher N
2
O concentration and an earlier sampling period result in a larger arteriovenous N
2
O difference that increases the sensitivity of the test and further minimizes the importance of possible analytic errors. In addition, a method is described of determining the magnitude of the shunt from the results of a N
2
O test. The results of 150 N
2
O tests performed with the improved technic are presented, and compared to the results obtained with the O
2
method in a group of patients on whom both tests were carried out.
Acute Myocardial Infarction Revealed in an Isolated Premature Ventricular Beat
Authors: KATZ KERMIT H. , BERK MORTON S. , MAYMAN CHAIM I.
Published: June 2012

Electrocardiograms of 2 patients, suspected instances of acute myocardial infarction, offered an early diagnostic clue in that there were isolated premature ventricular beats manifesting the characteristic changes produced by infarction of the myocardium. In each instance these features were present before the remainder of the electrocardiographic record was conclusive.
Traumatic Rupture of Interventricular Septum Proved by Cardiac Catheterization
Authors: INKLEY SCOTT R. , BARRY FRANK M.
Published: June 2012

A rare complication of trauma to the heart is rupture of the interventricular septum. The diagnosis of an acquired lesion of the septum can be reasonably made from history and cardiac catheterization and early recognition is of importance if immediate surgical correction is indicated.
Studies of the Arterial Pulse Wave
Authors: FEINBERG ARTHUR W. , LAX HENRY , Urban William
Published: June 2012

Previous studies have shown abnormalities of the arterial pulse wave in hypertensive subjects of all age groups. The major change has been diminution to disappearance of the dicrotic wave. The pharmacologic differences between epinephrine and norepinephrine offer a means of studying the mechanism of this change in the dicrotic wave. In the present study, normotensive subjects have had transient hypertension induced by the infusion of epinephrine and norepinephrine. The different effects of these drugs on their arterial pulse waves have been recorded.
Observations on Aberrant Renal Arteries Curving Around and Compressing the Renal Vein
Authors: NATHAN HILEL
Published: June 2012

Some conditions, considered idiopathic or of only partially known etiology, may have an anatomic basis. Among such conditions are possibly certain postural or orthostatic syndromes related to the kidney such as orthostatic proteinuria and orthostatic hypertension. In the present work some anatomic observations on the renal pedicle are presented that seem to give support to this concept.
The P Wave, P-R Interval, and Q-T Ratio of the Normal Orthogonal Electrocardiogram
Authors: PIPBERGER HUBERT V. , TANENBAUM HERBERT L.
Published: June 2012

The shortcomings of electrocardiographic time measurements from single leads have been noted before. With the use of simultaneously recorded corrected, orthogonal leads it is possible to evaluate better the time phase relationships of the electrocardiogram. The present study involves a statistical analysis of measurements of the P-wave duration, P-R interval, P-R segment, Q-T duration, and Q-T ratio of a group of 133 normal subjects.
Familial Pseudoxanthoma Elasticum and Valvular Heart Disease
Authors: COFFMAN JAY D. , SOMMERS SHELDON C.
Published: June 2012

The clinical and pathologic findings are presented of a patient with pseudoxanthoma elasticum leading to fatal valvular heart disease. The literature concerning the involvement of the heart by this disease is reviewed and reveals that valvular heart disease has not been described as a clinical problem heretofore. The occurrence of the condition in the relatives of the patient is described.
So-Called Primary Venous Obstruction in the Upper Extremity
Authors: PHELAN JOHN T. , CRUMPTON CHARLES W.
Published: June 2012

A case is reported of primary venous obstruction in the upper extremity, the Paget-Schroetter syndrome. The literature of this unusual condition is reviewed and the mechanism of its development and its treatment is discussed.
High-Voltage QRS Complexes in the Absence of Left Ventricular Hypertrophy
Authors: CUMMING GORDON R. , PROUDFIT WILLIAM L.
Published: June 2012

Of an unselected group of otherwise normal electrocardiograms in which the sum of S in V
1
and R in V
5
exceeded 35 mm., 39 per cent came from patients with no clinical evidence of cardiac disease. Of electrocardiograms in which R in AV
L
exceeded 11 mm., 29 per cent were from patients without cardiac disease. All of the cases in which the voltage was abnormal in both lead aV
L
and the precordial leads had evident or possible heart disease. Thus, while the voltage indexes for left ventricular hypertrophy of Sokolow and Lyon are useful and easy to apply, the lack of specificity of voltage changes limits clinical application.
Biochemical Studies in Full-Blooded Navajo Indians
Authors: STRAUS REUBEN , GILBERT JARVEY , WURM MOSES
Published: June 2012

The Navajo Indians, who have a low incidence of coronary artery disease and a high fat intake, have also been shown to have significant elevation of serum gamma globulins. In this electrophoretic study of patterns of serum proteins it was found that adult Indians had elevated gamma globulins but that Indian children had electrophoretic patterns similar to white children. These observations indicate that the gamma globulin elevation is not an inherited characteristic in this Indian race and is probably not related to the low frequency of coronary disease.
Electrocardiographic Changes during Hemodialysis with the Artificial Kidney
Authors: LUBASH GLENN D. , COHEN BURTON D. , BRAVEMAN WARREN S. , RUBIN ALBERT L. , LUCKEY E. HUGH
Published: June 2012

In a series of 63 hemodialyses with the artificial kidney, digitalis had been administered 30 times. The occurrence of digitalis intoxication is discussed and the results of treatment are analyzed.
Capacity of Human Coronary Arteries
Authors: RODRIGUEZ FELIX L. , ROBBINS STANLEY L. , Connolly Olga F.
Published: June 2012

A postmortem study of the capacity of the coronary arteries of 100 human hearts is presented. The volume of Schlesinger's barium sulfate-gelatin injection mass entering the coronary arterial tree under standard conditions was taken as a measure of its capacity. The factors analyzed include the weight of the heart in the normal and diseased state, the cross-sectional dimensions of the main coronary arteries near their origins, and the sex, age, and nutrition of the subjects.
Vasomotor Responses to Cooling in the Extremities of Subjects with Neurologic Lesions
Authors: DE CRINIS K. , REDISCH W. , ANTONIO A. , BOGDANOVITZ A. , STEELE J. M. , Gilbert Gordon , Wheeler Raleigh
Published: June 2012

Reflex vascular responses to cooling were studied in subjects with neurologic disorders, with a younger and an elderly "normal" group being used for comparison. By and large the responses were mirror images of those described for the Gibbon-Landis procedure. It was demonstrated that normal reflex responses to cooling as well as to warming are dependent upon the integrity of sympathetic innervation.
Plasma Catechol Amine Concentrations in Myocardial Infarction and Angina Pectoris
Authors: GAZES P. C. , RICHARDSON J. A. , WOODS E. F.
Published: June 2012

Urinary catechol amines have been shown to be increased in a few cases of acute myocardial infarction. The present study shows that patients with acute myocardial infarction and with angina pectoris (after exercise) have an increase in plasma catechol amines as compared to normal subjects before and after exercise and as compared to patients with noncardiac types of pain. The significance of these findings is discussed.
Studies of Blood Coagulation and Fibrinolysis in Patients with Idiopathic Hyperlipemia and Primary Hypercholesteremia before and after a Fatty Meal
Authors: NITZBERG SAUL I. , PEYMAN M. ANTHONY , GOLDSTEIN ROBERT , PROGER SAMUEL
Published: June 2012

In view of the current interest in the possible relationship between elevated serum lipid levels, increased coagulability of the blood (or decreased blood fibrinolysis) and ischemic heart disease, the clotting and fibrinolytic activity of the blood were studied before and after a fatty meal in 9 patients with idiopathic hyperlipemia, 10 patients with primary hypercholesteremia, and 10 normal subjects. Six patients had evidence of coronary heart disease. The methods of study included procedures designed to assess the over-all coagulability of the blood as well as the measurement of specific clotting factors. Blood fibrinolytic activity was measured by both direct and indirect methods. Serum lipid studies were performed simultaneously.
Water and Salt Excretion after Intravenous Salt Load in Hypertensive Subjects
Authors: ULLMANN T. D. , BLONDHEIM S. H. , DIKSTEIN S. , BEN-ISHAY D.
Published: June 2012

Intravenous salt-loading tests were performed in 20 hypertensive and 31 normotensive subjects. During the following 5 half-hour collection periods both water and salt excretion by the hypertensive subjects was higher than by the normotensive ones. The diuretic response was much more prolonged and more pronounced than the saluretic response and appears to be a primary response to the salt load, characteristic of the hypertensive state. The increased salt excretion is in part to be explained as the consequence of the increased water excretion. At moderate flow rates a salt-retaining mechanism could be demonstrated which is obscured at the higher rates of urinary flow that usually follow the salt load.
Differential Lung Function in Atrial Septal Defect
Authors: FLEMING H. A.
Published: June 2012

Studies of atrial septal defect have considered the total pulmonary blood flow and the contribution to the left-to-right shunt made by each lung. No studies have been reported of the separate flows through the 2 lungs. The present study in 25 cases was planned to investigate the differential pulmonary blood flow by bronchospirometry.
Changes in Proteins and Lipoproteins in Diabetes and their Relationship to Vascular Degeneration
Authors: DEMANET J. C. , GREGOIRE P. E. , BASTENIE P. A.
Published: June 2012

The cause of atherosclerosis and reason for its high incidence in diabetes are not known. In this study proteins and lipoids of serums of patients with diabetes or atherosclerosis are examined by paper electrophoresis to determine whether such changes may be a common factor for both of these conditions.
Left Ventricular Activation Time in Normal Men
Authors: WADA TAKASHI
Published: June 2012

Simultaneous recordings from right and left precordial leads in 50 normal individuals were obtained. The duration of rS in lead V
1
, was always equal to or greater than the duration of qR in lead V
7
. Evidence is presented to support the thesis that the duration of rS in lead V
1
, is a more accurate index of left ventricular activation time than the duration of qR in the left precordial leads.
Intracardiac and Intravascular Potentials Resulting from Electrical Activity of the Normal Human Heart
Authors: KOSSMANN CHARLES E. , BERGER ADOLPH R. , RADER BERTHA , BRUMLIK JOSEPH , BRILLER STANLEY A. , DONNELLY JOHN H.
Published: June 2012

Electrical records were made from the interior of the right heart and attached vessels in 14 normal subjects. Technics differed somewhat from those previously reported in that simultaneously recording string galvanometers were used exclusively, and tracings were made whenever the catheter-electrode was moved within the heart. Previously unreported large positive QRS deflections were found in records from the lower part of the right atrium, from the pulmonary artery, and in two instances from within the right ventricle itself close to the base. The possible anatomical origin of these is discussed.
Chronic Pericarditis with Effusion
Authors: BARKER PAUL S. , JOHNSTON FRANKLIN D.
Published: June 2012

Pericarditis with effusion is sometimes a chronic disease, an exception to the general rule that it is acute rather than chronic. Illustrative cases are described. Features of interest are the prominent third heart sound, the large P waves, the thrombi in the right atrium, the progression to constrictive pericarditis, and the resemblance in several respects to mitral stenosis.
Studies in Intracardiac Electrography in Man
Authors: LEVINE HAROLD D. , GOODALE WALTER T. , Gilman Eunice
Published: June 2012

Two parallel researches in progress at the Brigham Hospital, one an investigation of intracardiac electrography in general, the other a long-term study of heart muscle metabolism with the aid of the venous catheter, converge, resulting in the interesting practical and theoretical findings reported here. The authors show how the electrogram may help establish the position of the catheter in the coronary venous system and indicate the type of potential variations recorded in the coronary sinus, in its continuation, the great cardiac vein, and in its tributary, the middle cardiac vein.
Cinical Electrocardiography—Its Present Position and Possible Potentialities
Authors: KATZ LOUIS N.
Published: June 2012

The present role of the electrocardiogram in clinical medicine is discussed and its limitations as a diagnostic tool are pointed out. Its particular usefulness in the analysis of arrhythmias and the value of certain specific empirically derived patterns are discussed. The misuse of the term "unipolar" is explained, the actual conditions present being only crude approximations of the assumptions upon which the equilateral triangle theory rests. The role of multiple V chest leads and the aV limb leads in clinical electrocardiography is outlined. A brief explanation of stereovectorcardiography and the great promise it holds for the future is presented.
Effect of Potassium and of Desoxycorticosterone Acetate in Acute Heart Injury in the Rat
Authors: CAMPBELL CHARLES G. , FRIEDMAN SYDNEY M.
Published: June 2012

The rat myocardium was injured by means of a hot probe applied to the exposed surface of the left ventricle and the sequence of electrocardiographic changes was studied. Administered potassium as potassium chloride aggravated the electrocardiographic changes, while the administration of DCA improved the cardiographic picture. It is suggested that the beneficial action of DCA may be due to its plasma potassium lowering effect.
Arrhythmias during Intracardiac Catheterization
Authors: MICHEL J. , JOHNSON A. D. , BRIDGES W. C. , LEHMANN J. H. , GRAY F. , FIELD L. , GREEN D. M.
Published: June 2012

This paper summarizes the incidence of various arrhythmias in an unselected series of cardiac catheterizations and presents evidence for their reflex origin in some instances. The hazards are discussed and comments made about prophylaxis and treatment.
Sodium Gentisate in the Treatment of Acute Rheumatic Fever
Authors: SCHAEFER LOUIS E. , RASHKOFF IRA A. , MEGIBOW RAYMOND S.
Published: June 2012

Five patients with acute rheumatic fever were treated with gentisate, the biologic oxidation product of salicylate. The clinical course of this group was contrasted with that of five patients who received salicylate. It was found that, in the doses employed, gentisate had an effect on the symptoms of acute rheumatic fever equal to that of salicylate, but that it produced none of the toxic reactions which were commonly found after salicylate administration. An oral dose of 2.0 Gm. of gentisate, every three hours, continued for at least ten days after the temperature became normal, was sufficient to control the symptoms of the disease.
Pericardial Effusion Mistaken for Cardiac Enlargement in Severe Anemia
Authors: SOLOFF LOUIS A. , BELLO C. T.
Published: June 2012

Anemia is sometimes the sole cause of enlargement of the so-called cardiac silhouette. Successful treatment of the anemia may then restore the silhouette to normal. The enlargement has been attributed to cardiac dilatation. Because of the recognized difficulty in distinguishing pericardial effusion from cardiac dilatation, direct puncture was attempted in two instances of anemia with the silhouette enlarged presumably due to dilatation. In each instance, the enlargement was demonstrated to be due almost exclusively to pericardial effusion.
Some Characteristics of Certain Reflexes Which Modify the Circulation in Man
Authors: PETERSON LYSLE H.
Published: June 2012

Records are presented which have been obtained from man by direct intra-arterial catheterization and electrocardiography. These records have been selected (1) because they offer evidence for the validity of Starling's law in intact man and (2) because they demonstrate that when the heart is influenced by activity of the so-called "intrinsic" reflexes these manifestations of Starling's law are modified. It appears from these types of data that ventricular activity may be directly affected independently of influences upon the pacemakers of the heart.
Cholesterol, Cholesterol Esters and Phospholipids in Health and in Coronary Artery Disease
Authors: GERTLER MENARD M. , GARN STANLEY MARION , SPRAGUE HOWARD B.
Published: June 2012

Employing the Sheldon method of physique classification, it has been shown that a definite relationship exists between the various physiques and the level of lipids in the serum of a coronary disease group and a control group. Positive correlations existed between endomorphy and serum lipids, negative correlations existed between ectomorphy and serum lipids. There were negligible correlations between mesomorphy and the serum lipids. Intragroup comparison in the coronary disease patients showed that the general trend of endomorph-ectomorph differences continued, but that the lipid values in coronary mesomorphs were higher than in the coronary endomorphs.
The Effect of Exercise on the Plasma Volume of Patients with Heart Failure
Authors: GILBERT ROBERT P. , LEWIS J. K.
Published: June 2012

Exercise performed in the supine position by patients with congestive failure was found to cause not only a greater elevation of the peripheral venous pressure than it causes in normal persons, but also a proportionately greater fall of the plasma volume.
Paroxysmal Ventricular Tachycardia with Second Degree V-A Block and Reciprocal Rhythm
Authors: GRAU SIDNEY , GOUAUX JAMES L.
Published: June 2012

An instance of paroxysmal ventricular tachycardia with retrograde conduction is presented. This occurred in a patient in the terminal stage of arteriosclerotic heart disease. The electrocardiograms obtained during this period, representative portions of which are illustrated, were unique in that reciprocal beats and fusion beats were noted; the latter being unusual because of the origin and site of fusion of the impulses. A hitherto unreported abnormality of the retrograde P wave is also described and illustrated.
The Metabolism of Lactate and Pyruvate in Children with Congenital Heart Disease
Authors: HAVEL RICHARD J. , WATKINS ELTON , Gullixson Katharine S.
Published: June 2012

Venous blood lactic acid and pyruvic acid concentrations and lactate-pyruvate ratio were studied in 42 normal adults, 16 normal children and 18 children with congenital heart disease. There was elevation of resting values in children as compared with adults, but no significant change of values of resting children with congenital heart disease as compared with normal children. Following a standard exercise test, children with patent ductus arteriosus showed a time curve comparable to normal children, but children with cyanotic heart disease showed a persisting elevation of all values. The lactate-pyruvate ratio varied inversely with calculated mean capillary blood pO
2
.
Pulmonary Artery Aneurysms
Authors: BLADES BRIAN , FORD WILLIAM , CLARK PATRICK
Published: June 2012

The successful surgical treatment of an aneurysm of the left main pulmonary artery is reported. It appears that, after ligation of the main pulmonary artery, it is desirable not to remove the lung but preserve it as a space occupying organ which will retain some function. Literature on the subject of pulmonary aneurysms is reviewed.
Diet, Serum Cholesterol and Coronary Artery Disease
Authors: GERTLER MENARD M. , GARN STANLEY MARION , WHITE PAUL DUDLEY
Published: June 2012

Diet, particularly the ingestion of cholesterol and fats, has been considered as causally related to the increasing incidence of coronary heart disease and atherosclerosis. This communication presents evidence which is not consonant with this viewpoint. The evidence presented here is based upon dietary and serum cholesterol studies of 97 males who had experienced coronary heart disease prior to the age of 40 and, for purposes of comparison, 146 healthy, nonhospitalized males. The evidence shows clearly that (a) there is virtually no correlation between ingested cholesterol and the level of cholesterol in the serum, and (b) there is virtually no difference, on the average, in the amount of cholesterol ingested by patients of the coronary disease group and the individuals of the control group. A discussion of the "dietary theory" of atherosclerosis is included in this presentation.
The George E. Brown Memorial Lecture
Authors: ALLEN EDGAR V.
Published: June 2012

In the course of this presentation I hope it has become evident that the professional life of George Brown could well serve as a model for the activities of the American Heart Association, which has made astonishing and gratifying progress in a few years. The advances in physiology, anatomy, surgery and medicine, as related to cardiovascular diseases, are justifiable reasons for pride. Yet pride in the past can produce no results in the future. Progress in the future must be supported by a tripod, such as has supported it in the past; one leg of the tripod is zeal, another is utilization of skill and knowledge, and another is money. We must furnish all three. The unsolved problems are unsolved not only because they are difficult but because we have not yet achieved a coordinated program of investigation. We must abandon all feelings of futility and avoid tedium. I can find no logical reason to believe that any important cardiovascular disease cannot be largely or wholly vanquished. If the conquest of these diseases continues at the rate which characterized the fifteen years just past, within the lifetime of physicians now living there will be no cardiovascular disease which cannot be prevented or corrected. If we remain imbued with untiring resolution to attack vigorously and with persistent zeal the greatest destroyers of health and life in America, such a program will be continued. We must hold forever before ourselves the truism that scientific research is progress.

Because this is the George Brown Memorial Lecture, I may appropriately quote from another "Brown," although spelled Browne, Sir Thomas, the author of "Religio Medici," who, in 1643, wrote as follows:

"The World which took but six days to make, is like to take six thousand to make out: meanwhile old Truths voted down begin to resume their places, and new ones rise upon us.... Men disparage not Antiquity, who prudently exalt new Enquiries, and make not them the Judges of Truth, who were but fellow Enquirers of it.... Despise not the obliquities of younger ways nor despair of better things whereof there is yet no prospect."