bluuebunny/crossref_metadata_2025 huggingface dataset:
Further Observations on the Treatment of Superficial Thrombophlebitis with Phenylbutazone (Butazolidin)
Authors: STEIN IRWIN D.
Published: June 2012

Phenylbutazone is a potent anti-inflammatory agent. It was effective in modifying or causing the resolution of superficial thrombophlebitis in the extremities of 132 patients in whom this condition had proven refractory or difficult to manage. The short course of treatment which proved necessary to accomplish this end, makes this drug a practical and relatively safe addition to the management of superficial vein inflammation.
The Abnormal Ballistocardiogram in Mitral Stenosis
Authors: HENDERSON C. B.
Published: June 2012

Two abnormal waves present in the ballistocardiograms of 100 cases of mitral stenosis are described and the abnormality is classified into five grades. Evidence is presented which indicates that the abnormal waves are a result of ejection from the right ventricle and that the degree of abnormality of the ballistocardiogram bears a close relationship to the mean pulmonary artery pressure in mitral stenosis.
Three-Plane Ballistocardiography: The Effect of Age on the Longitudinal, Lateral, and Dorsoventral Ballistocardiograms
Authors: MARCH HAROLD W.
Published: June 2012

The motions of the thorax and of the shins were recorded by a technic which gives approximately the same size waves when a given force is applied to the thorax in each of three planes. Applied to a group of men and women under 30 years of age and another group of normals over 50, the variations in form and size of the ballistocardiographic forces in three planes were recorded. During expiration and as a result of aging, the lateral systolic wave, IJ, increases in size relative to the head-foot IJ. It is concluded that the classic head-foot ballistocardiogram yields inadequate information on the force liberated in systole, particularly in older men.
Pressor Mechanisms Induced by Intracranial Compression
Authors: RODBARD SIMON , STONE WALTER
Published: June 2012

A sudden rise in intracranial pressure initiates a three-fold cardiovascular response in the dog. Within one second after the onset of compression, the blood pressure rises sharply, presumably as a result of a direct neurogenic stimulus to the arterioles; the pressure then levels off in a few seconds. A second pressor effect is apparently due to the secretion into the blood stream of graded amounts of nor-epinephrine-like materials at the onset of compression; this rise is delayed about 12 seconds, a period perhaps associated with its circulation to the arterioles. In some experiments, a heart rate increase occurs at this time. It is shown by a special technique that the circulating blood volume increases about 10 per cent during this period. With the offset of compression all these effects disappear in the same order. The potential role of these mechanisms in the blood pressure regulating complex is discussed.
Alterations in Exchangeable Sodium Content, "Sodium
24
Space" and Body Weight During The Treatment of Congestive Failure
Authors: AIKAWA JERRY K. , FITZ REGINALD H. , LEVITT SEYMOUR H. , BLUMBERG AARON J. , RHYNE MARIE B.
Published: June 2012

Serial determinations of the exchangeable sodium content and sodium
24
(Na
24
) space were made by the radioisotope dilution method in patients with congestive failure during the course of intensive therapy. In most instances, the decrease in body weight was too great to be accounted for solely on the basis of the change in sodium
24
space or exchangeable sodium content. This excess weight loss is attributed to loss of intracellular fluid.
Reactivity to Pressor Agents in Hypertension
Authors: DOYLE AUSTIN E. , BLACK HAROLD
Published: June 2012

The pressor responses to intravenous injections of angiotonin and s-methyl
iso
-thiourea have been studied in 50 hypertensive subjects and 20 normotensive controls. The rises of blood pressure in the two groups were similar, being but slightly greater in the hypertensives. After the blood pressure has been reduced with hexamethonium, however, the pressor responses to angiotonin, s-methyl isothiourea and noradrenaline are much greater in hypertensives than normotensive subjects. The responses under these conditions to all three pressor agents run parallel to each other, suggesting that there is no specific increase in reactivity in hypertensive subjects, either to angiotonin or noradrenaline. It has been concluded that there is evidence of increased reactivity to pressor substances in hypertensive subjects but that this is not demonstrable until the blood pressure control mechanisms have been inactivated by hexamethonium.
Electrocardiographic Changes During Hypothermia and Circulatory Occlusion
Authors: HICKS CLARENCE E. , MCCORD MALCOLM C. , BLOUNT S. GILBERT
Published: June 2012

An analysis of the electrocardiograms from 25 patients during reduction of body temperature and total occlusion of circulation reveals marked abnormalities in conduction and rhythmicity. Hypothermia thermia was accompanied by slowing of the heart rate, depression of intracardiac conductivity, and by inhibition of the normal centers of impulse formation with resultant atrial arrhythmias. Circulatory occlusion during hypothermia was associated with a high incidence of ventricular arrhythmias. Changes noted in electric activity of the myocardium tended to return to normal with release of occlusion and warming of the patient.
Occlusion of a Renal Artery as a Cause of Hypertension
Authors: POUTASSE EUGENE F.
Published: June 2012

This paper presents three cases and the summary of a fourth case, in which occlusion of a renal artery was the cause of hypertension. Three patients were relieved of hypertension by nephrectomy. The literature on nonembolic renal artery occlusion with hypertension is reviewed, including 21 autopsy reports and 16 cases in which the patients were relieved of hypertension by nephrectomy or thromboendarterectomy. When a patient is found to have renal hypertension, the possibility of renal artery occlusion should be considered. Translumbar aortography currently is the best means of demonstrating renal artery occlusion.
The Effect of Intra-arterial Injections of Hydergine and Dihydroergocornine on the Peripheral Circulation in Man
Authors: GOETZ ROBERT H.
Published: June 2012

If given by the intra-arterial route, the immediate effect of the hydrogenated alkaloids of ergot is unpredictable. Vasodilation is obtained in some patients only. However, it was found that in those cases who do not react, the vessels respond more easily to the release of sympathetic tone, proving that, nevertheless, the drug has had an (potential) effect, probably on the neurovascular apparatus. This effect could be demonstrated for many hours and is, therefore, of considerable therapeutic interest. Even with the higher local concentrations possible by the intra-arterial route, the hydrogenated alkaloids of ergot still did not exhibit any adrenolytic action on the peripheral blood vessels in man.
Electric Instability of the Heart
Authors: BROFMAN BERNARD L. , LEIGHNINGER DAVID S. , BECK CLAUDE S.
Published: June 2012

Normally oxygenated dog hearts and hearts rendered uniformly anoxic exhibit electric stability: there is no difference in resting electric potentials, and spontaneous ventricular fibrillation does not occur. When an area of myocardium is rendered ischemic, the resulting "trigger" may destroy the coordinated mechanism of the heart. A current of oxygen differential is produced across the zone of contact between red and blue myocardium resulting in "electric instability." In the electrically stable, uniformly anoxic heart, perfusion of an area with red blood produces a "reverse trigger" and electric instability. Application of these concepts and therapeutic implications to human coronary disease appears justified.
Albuminuria in Congestive Heart Failure
Authors: RACE GEORGE A. , SCHEIFLEY CHARLES H. , EDWARDS JESSE E.
Published: June 2012

Albuminuria may be an integral part of the picture of congestive heart failure. Of 161 patients in whom the histologic renal findings were considered to be either normal or to be of such a nature as not to be responsible in themselves for albuminuria, and in whom clinically obvious causes for albuminuria had been eliminated, 141, or 88 per cent, had albuminuria. The incidence of albuminuria was about equal among the various types of heart disease when heart failure existed. A trend existed for the grade of albuminuria to parallel the grade of heart failure. Based on a study of 21 patients, there seemed to be a correlation between the grade of albuminuria and the group of hypertension, according to funduscopic examination. No correlation was found between the grade of albuminuria on one hand and the systolic or diastolic values for blood pressure, the known duration of elevated blood pressure, the grades of hematuria or the values for blood urea on the other hand. Among the 161 patients with heart failure in our group 1 (kidneys either normal or containing lesions not judged to be causes for albuminuria), there was no predominant renal lesion associated with any one cardiac lesion.
Occlusive Hepatic Venous Catheterization in the Study of the Normal Liver, Cirrhosis of the Liver and Noncirrhotic Portal Hypertension
Authors: TAYLOR W. JAPE , MYERS J. D.
Published: June 2012

The technic of occlusive venous catheterization has been applied to the liver. The pressure, measured in a small occluded hepatic vein and termed the wedged hepatic venous pressure, correlates well with the portal venous pressure in cats. An elevation of the wedged pressure in man, in the presence of a normal central venous pressure, is diagnostic of cirrhosis. This has proved to be of clinical value in the differentiation of intrahepatic from extrahepatic portal hypertension. The higher wedged hepatic venous pressures in cirrhosis are correlated with the presence of varices or jaundice, but not with the presence of ascites.
Concealed Conduction
Authors: LANGENDORF RICHARD , PICK ALFRED
Published: June 2012

Recognition of concealed conduction of the cardiac impulse is shown to be indispensable for the understanding of many cardiac arrhythmias. After a historical review of the concept of concealed conduction, records are presented to demonstrate established, as well as hitherto undescribed, aspects of concealed A-V conduction. Then, the manifestations of concealed intraventricular conduction are pointed out and, finally, the relationship of the phase of concealed conduction to the supernormal phase is discussed.
An Evaluation of a New Anticoagulant, Acenocoumarin (Sintrom)
Authors: WEINER MURRAY , JIMINEZ MARIANO , KATZKA IRWIN
Published: June 2012

A new coumarin anticoagulant, acenocoumarin (Sintrom) is compared with other hypoprothrombinemic agents in the same human subjects. Comparing doses which result in the same peak prothrombin time, both speed of onset and duration of effect are found to be a function of the rate of biotransformation. Rapid biotransformation results in fast onset and short duration of action and vice versa. Sintrom is intermediate between the slow, long-acting compounds (Dicumarol, Warfarin, Coumopyrin) and the fast, short-acting Tromexan. One 16 to 32 mg. dose of Sintrom rapidly results in a desirable hypoprothrombinemia which is maintained by a single daily dose of 2 to 10 mg.
Fluorescent Patterns of Intracutaneous Wheals in Normal and Edematous Extremities
Authors: GIFFORD RAY W. , WINDESHEIM JOHN H. , ESTES J. EARLE , ROTH GRACE M.
Published: June 2012

Intradermal injection of a fluorescent dye (riboflavin) and ultraviolet light were used to demonstrate cutaneous lymphatic capillaries. The extremities of a control group and the nonedematous extremities of patients with arteriosclerosis obliterans were studied together with edematous extremities of patients with lymphedema, acute thrombophlebitis, chronic venous insufficiency and various other conditions.

The lymphatic capillaries showed up more extensively after a higher percentage of injections into edematous extremities of patients with lymphedema than after injections into the other extremities. On the other edematous extremities except in the cases of nephrotic syndrome and on the normal extremities, either no lymph capillaries or only a few were visible after most of the injections.
Peripheral Venoconstriction in Human Congestive Heart Failure
Authors: WOOD J. EDWIN , LITTER JULIUS , WILKINS ROBERT W.
Published: June 2012

A method for measuring venous "tone" in the limb segment of man in vivo was used to study the problem of cardiac decompensation. Venoconstriction was present in patients with heart failure and it tended to remit as the patients improved.
Studies on the Control of Hypertension
Authors: PERRY H. MITCHELL , SCHROEDER HENRY A.
Published: June 2012

Because doses of antihypertensive agents necessary to control human arterial hypertension at relatively normotensive levels were observed to decrease with time, records of all patients in our series receiving oral hexamethonium chloride and hydralazine (but no other drugs) were analyzed (114 cases). After two years of therapy, those patients maintaining average diastolic pressures below 100 mm. Hg were found to require considerably less methonium ion while those unable or unwilling to control their pressures to this degree needed approximately their initial doses. Further decreases in drug requirements for the well-controlled group occurred after three years. Ten were able to discontinue all medication eventually and nine others needed only smaller doses of hydralazine; in these reversal of secondary changes was sometimes observed. Prolonged, continuous and adequate drug therapy is apparently associated with a change in the basic process producing hypertension.
Pectoralis Minor Tenotomy and Anterior Scalenotomy with Special Reference to the Hyperabduction Syndrome and "Effort Thrombosis" of the Subclavian Vein
Authors: LORD JERE W. , STONE PETER W.
Published: June 2012

Symptoms referable to the subclavian vessels or lowermost cord of the brachial plexus are frequently seen following repeated or prolonged hyperabduction of the arms. The sites of compression are thought to be the point at which these neurovascular structures emerge from beneath the pectoralis minor tendon and the interval between the clavicle and the first rib. Five patients presenting the hyperabduction syndrome have been subjected to pectoralis minor tenotomy and anterior scalenotomy with a good result in four cases, indicating the potential value of the procedure in this particular shoulder girdle syndrome.
The Spatial Ventricular Gradient: Intermittent Wolff-Parkinson-White Syndrome, Intermittent Left Bundle Branch Block and Ventricular Premature Contractions
Authors: BERKUN MORDECAI A. , KESSELMAN RUSSELL H. , DONOSO EPHRAIM , GRISHMAN ARTHUR
Published: June 2012

Criteria are given for testing the ventricular gradient concept. The spatial ventricular gradient is then determined in three types of intraventricular conduction disturbances using the cube system of orthogonal bipolar leads. Correction of the isoelectric baseline for the effect of T
P
on the QRS and T areas is made. The spatial ventricular gradient remains essentially constant both in magnitude and direction in intermittent Wolff-Parkinson-White syndrome and intermittent left bundle branch block despite marked changes in body surface electrocardiograms. Ventricular premature contractions produce marked deviations in the spatial ventricular gradient. The spatial ventricular gradient merits further study as one of the fundamental quantities in electrocardiography.
The Tissue Catechol Amine Concentration of the Human Heart Determined by the Aluminum Hydroxide-Arsenomolybdic Acid Method
Authors: BLOODWORTH J. M. B. , VON HAAM E.
Published: June 2012

With the aluminum hydroxide-arsenomolybdic acid method, which has recently been extensively modified in this laboratory, the tissue concentration of catechol amines was determined in 100 human hearts. The results were correlated with clinical history and autopsy findings. Previous work has suggested that cardiovascular disease and uremia were associated with an elevation in the heart catechol amine concentration, and that some cases of sudden death were associated with an elevated heart catechol amine concentration. In this study cardiovascular disease and uremia showed low or low normal values while not a single instance of sudden death could be explained by an abnormally elevated heart catechol amine concentration.
A Two-Dimensional Ballistocardiographic Study of the Relation of Body Size to Ballistic Amplitude in Children
Authors: MORRIS GWENDOLYN L. , SINGER MELVILLE I.
Published: June 2012

Simultaneous longitudinal and transverse ballistocardiograms were obtained from 20 normal boys and 20 normal girls ranging in age from 4 to 15 years. A highly significant correlation was found to exist between body surface area and the basal mean IJ amplitude.
Treatment of the Low-Salt Syndrome in Congestive Heart Failure by the Controlled Use of Mercurial Diuretics
Authors: RUBIN ALBERT L. , BRAVEMAN WARREN S.
Published: June 2012

The production of the low-salt syndrome in cardiac patients with refractory congestive heart failure is generally attributed either to fluid retention with electrolyte dilution or to excessive salt loss, induced by the frequent administration of mercurial diuretics. The former is often the important etiologic factor. In a study of a group of 25 refractory cardiac patients with normal plasma electrolyte patterns, a hyperchloremic acidosis was produced to restore a responsiveness to mercurial diuretics. During the mercurial-induced diuresis that followed, the urinary sodium concentration was significantly lower than the plasma sodium concentration in all instances. From these observations, a method of treatment of the low-salt syndrome, utilizing mercurial diuretics seemed feasible. This regimen was successfully carried out in two hyponatremic patients with return of plasma sodium to normal and striking clinical improvement.
A Comparative Study of Myocardial Infarction in the White and Negro Races
Authors: KEIL PHILIP G. , MCVAY LEON V.
Published: June 2012

A review of 519 consecutive cases of myocardial infarction reveals an unexpectedly high incidence in the Negro female. Not only does this catastrophe occur at an earlier age in the Negro woman, but also is less frequently associated with angina, pursues a more virulent course and is associated with a higher fatality rate than that recorded in the white race and in the Negro male. Comparative clinical features in the two sexes of the white and Negro races are presented.
Current Indications for the Use of Anticoagulant Drugs in Cerebrovascular Disease
Authors: SIEKERT ROBERT G. , MILLIKAN CLARK H. , SHICK RICHARD M.
Published: June 2012

Considerable variation exists in the interplay of the factors influencing the occurrence of strokes and their final outcome. A final statement about the usefulness of anticoagulant drugs in the treatment of cerebrovascular disease must await further study. The current indications for their use include: (1) intermittent insufficiency of the basilar arterial system, (2) intermittent insufficiency of the internal carotid system, (3) thrombosis within the basilar arterial system, (4) recurrent cerebral emboli associated with a likely cardiac source and (5) possibly, recurrent cerebral thromboses.
Portable Serial Roentgenkymography in Acute Myocardial Infarction
Authors: SAMPSON J. J. , FELTON L. R. , GOETZ A. A. , SOLOMON B. , AXELRAD B.
Published: June 2012

Serial roentgenkymographic records were taken at the bedside of 31 patients with acute myocardial infarction. Most such tracings are adequate for determining "ballooning" (systolic reversal) and other defects of left ventricular contraction and expansion. These abnormalities are observed frequently in this condition and fluctuate from day to day, appearing or disappearing at various rates. Ballooning is the most serious defect, in that it was observed in the roentgenkymograms of all the patients who died and in all those with severe shock. Serial roentgenkymograms are of value as diagnostic aids, as evidence of the immediate and changing functional state of the myocardium and as an index of prognosis. They may herald further extension of the infarct or ventricular rupture. Roentgenkymographic abnormalities, including ballooning, may persist after clinical recovery.
An Accurate, Clinically Practical System For Spatial Vectorcardiography
Authors: FRANK ERNEST
Published: June 2012

This paper describes a news improved system of spatial vectorcardiography that is practical for clinical use. It represents an optimum compromise among such factors as soundness of theoretic basis, accuracy, reproducibility, signal-to-noise ratio, and speed of application. Some of its advantages over currently employed systems include a rational physical basis, corrections for torso shape, avoidance of left arm, insensitivity to individual variability of ventricle location, and accuracy comparable to applicability of 3-dimensional torso-model data to the human subject. Detailed description of electrode placement, practical procedures, and useful technics is included.
Coarctation of the Aorta Associated with Patent Ductus Arteriosus
Authors: COOLEY JACK C. , KIRKLIN JOHN W. , CLAGETT O. THERON , DUSHANE JAMES D. , BURCHELL HOWARD B. , WOOD EARL H.
Published: June 2012

The combination of patent ductus arteriosus and coarctation of the aorta poses special anatomic, physiologic and surgical problems. An experience with 14 such cases is presented, which suggests that pulmonary hypertension occurs frequently in these cases. Physiologic data in cases having coarctation of the aorta, patent ductus arteriosus and pulmonary hypertension that underwent cardiac catheterization are presented. Clinical, anatomic, physiologic and surgical implications of this combination are discussed.
Observations on Vascular Sounds: The "Pistol-Shot" Sound and the Korotkoff Sound
Authors: LANGE RAMON L. , CARLISLE ROBERT P. , HECHT HANS H.
Published: June 2012

The similarity between spontaneous "pistol-shot" sounds heard over large vessels and the Korotkoff sounds heard distal to a partially inflated blood pressure cuff suggests that a similar mechanism is responsible for their occurrence. Simultaneous records of intravascular pressures and of the sounds demonstrate that the sounds generally precede the major rise in intravascular pressure. These observations cannot be explained by the existing theories of sound production. A possible mechanism based on rapid changes in flow pattern is advanced.
The Prevention of Thromboembolic Complications in Myocardial Infarction by Anticoagulant Therapy
Authors: GLUECK HELEN I. , RYDER HENRY W. , WASSERMAN PHILIP
Published: June 2012

Autopsy records of 151 patients dying of acute myocardial infarction, in a large private hospital, were reviewed. Half of the patients received anticoagulant therapy. Hemorrhage was not a significant cause of death in Dicumarol-treated patients. Embolic complications, often undiagnosed clinically, were of common occurrence. Adequate anticoagulant therapy effectively reduced, not only the total number of emboli, but also the number of serious or fatal emboli. In this role, anticoagulants serve a useful purpose in the treatment of myocardial infarction.
The Physiologic Effect of Contrast Media Used for Angiocardiography
Authors: ROWE GEORGE G. , HUSTON JOHN H. , TUCHMAN H. , MAXWELL GEORGE M. , WEINSTEIN ARVIN B. , CRUMPTON CHARLES W.
Published: June 2012

The deaths from angiocardiography at Wisconsin General Hospital were reviewed and found to be two per cent of 249 patients. These 5 deaths are reported briefly. Investigation was carried out to determine the hemodynamic effects of contrast substances on 12 dogs. In general, there was a temporary increase in right atrial and pulmonary arterial pressure followed by a rather marked decrease in systemic arterial pressure and tachycardia. The significance of these findings is discussed in relation to shunts within the heart or between the aorta and pulmonary artery.
Emetine Toxicity with Electrocardiographic Abnormalities
Authors: CERA LESLIE J.
Published: June 2012

Seven case histories are presented illustrating various aspects of the noxious effects of emetine on the heart. T-wave changes, S-T segment deviations, and partial heart block are demonstrated. A case of frank myocardial infarction in a young man occurring during the administration of emetine is described. Finally, both persistence and lability of emetine-induced changes are illustrated.
Comparison of Large and Small Doses of Hormones in the Treatment of Acute Rheumatic Carditis
Authors: ROY SUJOY B. , MASSELL BENEDICT F.
Published: June 2012

Disappearance of significant murmurs was twice as common in 47 rheumatic children treated with large doses of hormones as in a comparable group of 41 children treated with small doses of hormones. Results were also related to the duration of illness before therapy was started. The findings suggest that the divergencies of opinion regarding the efficacy of hormones in the treatment of acute rheumatic carditis may in part be explained on the basis of differences in doses of hormones, in duration of therapy, and in duration of illness before the beginning of therapy.
Hereditary Obesity: Relation to Serum Lipoproteins and Protein Concentrations in Swine
Authors: LEWIS LENA A. , PAGE IRVINE H.
Published: June 2012

The importance of heredity in determining the cholesterol, lipoprotein, and plasma protein levels has received insufficient attention. All of these have a greater concentration in the blood of short-fat (mesomorphic), castrate, male, miniature pigs than in long-lean (ectomorphic) animals. These differences seem to persist even when weight changes and growth are rapid. We believe that some of the wide variability of blood lipid levels in human beings is due to genetic factors in the heterogeneous human population on varied diets.
Results of Valvulotomy for Valvular Pulmonary Stenosis with Intact Ventricular Septum
Authors: HOSIER DON M. , PITTS JOHN L. , TAUSSIG HELEN B.
Published: June 2012

The analysis deals primarily with follow-up studies of patients who have had a valvulotomy for valvular pulmonic stenosis with an intact ventricular septum. In addition to observations on the subjective improvement, hemograms, and arterial oxygen saturation, the cardiac findings have been analyzed in detail. The changes in the size of the heart have been studied in relation to the growth of the patient and, wherever possible, these changes have been correlated with the postoperative right ventricular pressure. It was found that cardiac enlargement came to an end when the right ventricular pressure fell below 100 mm. Hg.
Cardiocirculatory Studies in Pulsus Alternans of the Systemic and Pulmonary Circulations
Authors: FERRER M. IRENÉ , HARVEY RÉJANE M. , COURNAND ANDRÉ , RICHARDS DICKINSON W.
Published: June 2012

Studies carried out in 21 patients have shown for the first time that alternation of the pulse pressure in man can occur independently in either the greater or the lesser circulation without appearing in the other. Even when bilateral alternation exists, this cyclic variation may disappear in one circulation while persisting in the other. Mechanisms responsible for pulsus alternans, in particular variations in stroke volume and vascular pressures, are considered, and no single explanation satisfies the facts revealed in this study.
An Evaluation of Starr's Equation for the Prediction of Stroke Volume
Authors: BRIDWELL TRAVIS , JENSS RACHEL M. , GREENE DAVID G.
Published: June 2012

Starr's formula for deriving stroke volume from pulse pressure, diastolic pressure, and age hasbeen tested experimentally in a group of miscellaneous hospital patients. Nearly simultaneous measurements of stroke volume by the direct Fick method and of brachial arterial pressure by direct puncture were analyzed. The measured stroke volume frequently differed considerably from the values calculated from the formula. Certain theoretic limitations of the application of multiple regression equations to this material are presented.
Fatal Congestive Heart Failure Associated with Cardiac Enlargement of Unexplained Origin
Authors: FRANCE RICHARD , ATHERTON CLIFFORD W. , ALSOBROOK WILLIAM L.
Published: June 2012

A case of progressive cardiac enlargement of unknown cause in a 22-year-old man is reported. Death from congestive failure occurred 18 months after the onset of symptoms. Postmortem examination showed only cardiac hypertrophy and dilatation as an explanation for the congestive failure.
Peripheral Vascular Spasm as a Prodrome of Herpes Zoster
Authors: BLUMBERG LEON , BEHREND ALBERT
Published: June 2012

A case of severe vascular spasm involving the major arterial circulation of the lower extremity has been reported. The unusual feature of this case is the fact that the arterial spasm apparently was a prodrome of herpes zoster, the cutaneous manifestations of which appeared 72 hours after the onset of vasospasm. Response of the vasospastic symptoms to non-operative therapy was good; the herpes zoster required roentgen therapy for relief.
Studies of the Mitral Valve
Authors: RUSTED IAN E. , SCHEIFLEY CHARLES H. , EDWARDS JESSE E.
Published: June 2012

Knowledge of the structural changes in the commissures, cusps, and chordae tendineae is important to the understanding of the pathologic physiology of mitral stenosis and its surgical correction. Study of 70 hearts with mitral stenosis disclosed that a frequent cause of the obstruction was commissural fusion or shortening of the chordae tendineae or both. In a small percentage of hearts, mitral stenosis appeared to result principally from rigidity of the valvular leaflets. Measurements of the various components of the mitral valve in normal hearts have been given in a previous paper. In this communication, comparable measurements for these structures in 50 hearts with mitral stenosis are presented.
Syndrome of Congenital Absence of the Spleen with Associated Cardiovascular and Gastroenteric Anomalies
Authors: AGUILAR MARY JANE , STEPHENS H. BRODIE , CRANE JACKSON T.
Published: June 2012

Survey of 27 cases in the literature and the authors' 3 cases reveals a characteristic syndrome of congenital absence of the spleen with certain cardiovascular and gastrointestinal abnormalities. The hematologic and other findings permit a presumptive antemortem diagnosis. More accurate prognosis is made possible and valuable information is afforded the cardiac surgeon, since the cardiac anomalies often follow a predictable pattern.
Radiologic Aspects of Operable Heart Disease
Authors: ABRAMS HERBERT L.
Published: June 2012

Patent ductus arteriosus and coarctation of the aorta are common causes of congestive heart failure in infancy, yet are more difficult to diagnose than in later life. Retrograde brachial aortography is a relatively simple method of establishing the diagnosis with assurance. A description ofthe technic is followed by a discussion of the normal aortogram in infancy. A relatively large series of cases, in which a high diagnostic yield was obtained, is analyzed. The hazards of the procedure are few if highly concentrated media are avoided and careful attention is paid to details of technic.
A Clinical Correlative Study of the Electrocardiogram in Electrolyte Imbalance
Authors: DREIFUS L. S. , PICK A.
Published: June 2012

There is no general agreement concerning the action of specific electrolyte disorders and acid-base balance upon the electrocardiogram nor concerning their interrelationships in this respect. In order to test the validity and limitations of the electrocardiographic diagnosis of such disorders in clinical practice, 133 records on 48 patients with suspected or established electrolyte imbalance were compared with chemical determinations, in part serial. Some difficulties encountered in the electrocardiographic diagnosis of mixed electrolyte disorders, and in the distinction of electrolyte from drug effects, are illustrated.
Diagnosis of Mitral Regurgitation by Cardioangiography
Authors: SMITH PHILIP W. , CREGG HUGH A. , KLASSEN KARL P.
Published: June 2012

To determine the feasibility of demonstrating mitral regurgitation by injection of contrast media into the left ventricle, percutaneous and subxiphoid left ventricular punctures were carried out in dogs and subsequently in human beings. Contrast media were injected and roentgenographic studies made. The correlation between the roentgenographic and subsequent anatomic findings at operation or autopsy is emphasized. The method appears to be relatively safe if proper safeguards are observed. The results indicate that the method is of value in determining the competence of the mitral valve and relative degree of insufficiency.
Morphologic Aspects of the Negativity of the U Wave and their Corresponding Electrocardiographic and Clinical Data
Authors: FURBETTA D. , SANTUCCI F. , BUFALARI A. , SOLINAS P.
Published: June 2012

The negative U wave has been studied in 200 electrocardiograms. Six different types of negativity of the U wave are recognized; a seventh type includes the alterations of the T-U segment. Electrocardiographic and clinical data are correlated with these changes. Two hypotheses to explain the varying morphology of the negative U wave are discussed.
Isolated Pulmonic Valvular Regurgitation
Authors: MORTON RALPH F. , STERN THOMAS N.
Published: June 2012

An extremely rare case of isolated organic insufficiency of the pulmonic valve is reported along with clinical and hemodynamic data.
Aorta-Pulmonary Artery Communication Through the Lungs
Authors: CLAIBORNE T. STERLING , HOPKINS WILLIAM A.
Published: June 2012

A case is reported of anomalous communication between the aorta and pulmonary artery by way of a pulmonary vascular mass. The left-to-right shunt was sufficient to cause typical circulatory dynamics and was demonstrated by cardiac catheterization and angiography. Complete cure was obtained by lobectomy.
Effect of Cardiac Contraction on Coronary Blood Flow
Authors: SABISTON DAVID C. , GREGG DONALD E.
Published: June 2012

In the experimental animal the basic and controversial problem was studied of the influence of cardiac contraction on coronary blood flow. Normally beating hearts were perfused at a constant pressure, and coronary inflow and outflow were determined. In order to assess the role of systole, prolonged periods of ventricular asystole and fibrillation were induced and observations were made of the changes in coronary flow. With the cessation of cardiac contraction blood flow in the coronary arteries and coronary sinus rose appreciably. The results of these studies support the concept that contraction of the heart muscle, by compression of the myocardial vascular bed, behaves as a throttling mechanism and impedes coronary flow. The method employed permits a separation and quantitation of the effects on coronary flow resulting from cardiac contraction and the vasomotor state of the coronary vessels.
Differential Effect of Dietary Fat and Weight Reduction on Serum Levels of Beta-Lipoproteins
Authors: WALKER WELDON J. , WEINER NORMAN , MILCH LAWRENCE J.
Published: June 2012

Twenty-five patients sustained an average weight loss of 21.7 pounds on a diet in which 73 per cent of total calories consisted of animal fat. Their "new" weight was maintained on this high-fat diet and subsequently on a low-fat diet. Standard S
f
0-12 lipoproteins were highly influenced by dietary fat intake independent of weight change. In contrast the S
f
20-400 fraction was lowered by negative caloric balance and weight reduction despite the ingestion of large amounts of animal fat. These changes were statistically highly significant. Divergent responses of different classes of beta-lipoproteins may be missed if only total beta-lipoprotein measurements are made.
Present Status of Diagnosis and Treatment of Pheochromocytoma
Authors: VON EULER U. S. , STRÖM G.
Published: June 2012

For detection and diagnosis of pheochromocytoma the method of urine analysis is considered the most convenient, safe, and accurate. Analysis of blood samples obtained by catheterization at different levels in the vena cava aids in localization. Some features of the clinical symptomatology and the pharmacologic and operative treatment of patients with chromaffin-cell tumors are given.
The Lewis A. Conner Memorial Lecture
Authors: EDWARDS JESSE E.
Published: June 2012

While there are many anatomic varieties of congenital malformations of the heart and great vessels, most may be divided, from a functional point of view, into 3 types: (1) communication between the ventricles or between the aorta and pulmonary arteries, (2) anomalous drainage of pulmonary venous blood into the right atrium, and (3) obstruction to pulmonary venous flow. In each of these categories the responses of the pulmonary vascular tree have to be considered in understanding the altered dynamics. Depending on the type and degree of response in the pulmonary vascular bed, there may be a varying functional picture among patients having the same anatomic or functionally comparable malformation.
Clinical and Anatomic Features in Five Hundred Patients with Fatal Acute Myocardial Infarction
Authors: LEE KYU TAIK , THOMAS WILBUR A. , RABIN ERWIN R. , O'NEAL R. M.
Published: June 2012

An autopsy series of 500 patients who died with anatomic evidence of acute Invocardial infarction is reviewed. The incidence of various clinical and anatomic features is presented. The clinical and anatomic features of patients who died from the first attack of myocardial infarction is compared with those of patients dying after repeated attacks. Similarly, various other features were studied, such as the time that clapsed between the onset of symptoms and death and also the presence or absence of old myocardial infarcts.
Effect of Cigarette Smoking on Coronary Blood Flow and Myocardial Metabolism
Authors: BARGERON L. M. , EHMKE D. , GONLUBOL F. , CASTELLANOS A. , SIEGEL A. , BING R. J.
Published: June 2012

The effect of smoking on the heart has been a controversial subject. The present studies were undertaken to investigate the effect of cigarette smoking on the coronary flow, myocardial usage of oxygen and myocardial extraction of glucose, pyruvate, lactate, and ketones. Catheterization of the coronary sinus revealed that cigarette smoking in patients without heart disease results in a significant rise in coronary blood flow and heart rate and a significant decline in coronary vascular resistance and myocardial extraction of oxygen and glucose. No evidence of coronary vascular constriction was detected.
Chest Pain in Patients with Isolated Pulmonic Stenosis
Authors: LASSER RICHARD P. , GENKINS GABRIEL
Published: June 2012

Chest pain like angina pectoris has been described in patients with pulmonary hypertension and cor pulmonale but its origin is obscure. In this article 5 patients are reported with isolated pulmonic stenosis and chest pain. On the basis of the clinical, electrocardiographic, hemodynamic, and pathologic findings the authors conclude that the chest pain is caused by ischemia of the right ventricular myocardium due to increased work and reduced coronary flow to the right ventricle.
Experimental Response of the Human Body to a Known Periodic Force as a Measure of Ballistocardiographic Fidelity
Authors: WILSON G. P. , CUNNINGHAM D. M. , GRISWOLD H. E.
Published: June 2012

The vibrational characteristics of the body and the support on which it rests were investigated by the direct approach of shaking it and measuring its motion and the motion of the support. Both a very stiff and a very weak, light support were used. Close correlation was obtained between body displacement and light support displacement; body motion greatly exceeded that of the stiff support. Single mass resonant frequency was set by the dorsal skin stiffness when the support was very stiff and by the support stiffness when the light support was used. With both supports the body exhibited multi-mass motion in the frequency range above 6 c.p.s.
Variations in Serum Glutamic Oxaloacetic Transaminase Activity in Experimental and Clinical Coronary Insufficiency, Pericarditis, and Pulmonary Infarction
Authors: NYDICK IRWIN , RUEGSEGGER PAUL , WRÓBLEWSKI FELIX , LADUE JOHN S.
Published: June 2012

Previous studies have demonstrated consistent rises in serum activity of the enzyme, glutamic oxaloacetic transaminase (SGO-T), following myocardial necrosis of various etiologies. The present study demonstrates markedly different findings in experimental and clinical coronary insufficiency, pericarditis, and pulmonary infarction unless concomitant myocardial necrosis was present. This seems to be a valuable means of differentiating clinical problems in which the presence of myocardial injury is suspected as the basis of the patient's chest pain.
Ventricular Dynamics in Atrial Fibrillation
Authors: DODGE HAROLD T. , KIRKHAM FREDERIC T. , KING CLARA V.
Published: June 2012

During atrial fibrillation there are beat-to-beat changes of ventricular rate, end-diastolic volume, end-diastolic pressure, and arterial pressure or resistance to ventricular ejection. The effect of these variables on left ventricular dynamics in man has been approached by studying single sequences of beats in patients with atrial fibrillation. An index of changes of left ventricular volume has been determined from the electrokymogram of left cardiac border. Left ventricular pressures have been measured at surgery or by the transbronchial technic. These studies provide a better understanding of the hemodynamics of the left ventricle during atrial fibrillation and demonstrate another approach to the study of left ventricular function in man.
Relationship of Platelet Serotonin to Disturbances of Clotting and Hemostasis
Authors: WEINER MURRAY , UDENFRIEND SIDNEY
Published: June 2012

The presence of serotonin (5-hydroxytryptamine) in high concentration in platelets and its absence from normal platelet-free plasma suggest the possibility that this vasoconstrictor substance may play a role in hemostatic mechanisms. Platelet serotonin content measured by a fluorometric method in 94 patients showed an average content of 0.22 µg./ml. blood. In none of the disease groups studied, including hypertension, was a significant alteration found in platelet serotonin. However, the administration of reserpine resulted in a marked and prolonged depletion of platelet serotonin that was not accompanied by any significant change in any of the clotting factors. The in vitro addition of serotonin in amounts up to 50 µg./ml. also failed to alter any of the clotting factors studied. Platelet serotonin did not correlate with diagnosis, age, weight, blood pressure, cephalin-fluocculation, or capillary fragility. However, markedly anemic patients (below 10 Gm. per cent hemoglobin) and patients whose blood urea nitrogen was above 30 mg. per cent, tended to have a low platelet serotonin content.
Cardiovascular Disturbances in Chronic Severe Anemia
Authors: SANGHVI L. M. , SHARMA R. , MISRA S. N.
Published: June 2012

Cardiovascular disturbances in 60 patients with chronic severe anemia have been studied. Although in a majority the classical hyperkinetic syndrome of anemia was seen, 40 per cent of the patients showed a different pattern that was characterized by absence of tachycardia, comparatively diminished velocity of the blood flow, and a normal or diminished cardiac output even in the presence of congestive failure. Other differences in the manifestations have been evaluated. No cause could be discovered for this difference and for the high incidence of congestive failure seen in this series.
Primary Mesothelioma of the Pericardium
Authors: THOMAS JOHN , PHYTHYON JAMES M.
Published: June 2012

Mesotheliomas of the pericardium are one of the causes of sanguineous pericardial effusion. Clinical and pathologic features of a case of this rare condition are presented. Certain clinical manifestations and laboratory findings that may serve as a basis for future antemortemn diagnosis are emphasized.
Congenital Absence of the Pulmonary Valve
Authors: CAMPEAU LUCIEN A. , RUBLE PAUL E. , COOKSEY WARREN B.
Published: June 2012

The autopsy on a 32-year-old man revealed an absence of the pulmonary valve, a ventricular septal defect, and a single coronary artery. Congenital absence of the pulmonary valve has not been previously reported. The diagnosis of the accompanying pulmonary incompetence is discussed in the light of the catheterization studies and clinical findings. The pathologic abnormalities as found at postmortem examination are described and the embryologic basis for the several congenital malformations found in this unusual case are discussed.
Hemodynamic Alterations in Hemorrhagic Fever
Authors: ENTWISLE GEORGE , HALE EDWARD
Published: June 2012

The cardiac output during the shock phase of hemorrhagic fever was very low. Increases in mean arterial pressure resulted from therapy with albumin or norepinephrine. With the former, this increase was associated with an increased cardiac output; with the latter, an increase in peripheral resistance. During the hypertensive phase, patients were found to have an increased cardiac output if they were also oliguric, and a relatively normal cardiac output if diuresis had begun. Some of the hypertensive patients presented the clinical syndrome of the "hyperdynamic state"; this occurred almost exclusively during the oliguric phase and was associated with high cardiac output and metabolic acidosis.
Clinical Evaluation of a New Oral Nonmercurial Diuretic
Authors: WAINFELD BENJAMIN , YARVIS JACOB J. , FANKHAUSER ARTHUR
Published: June 2012

The oral administration of the organomercurial drugs in patients requiring prolonged management of congestive failure has been rather unsatisfactory because of occasional toxic signs and symptoms. With the development of the pyrimidinedione derivatives as diuretic agents and encouraging pharmacologic studies in animals, clinical trial is warranted. A group of 24 patients who had received injections of mercurial diuretics for at least 6 months prior to study were treated with this new diuretic. Results of this experience are described.
Relationship of Left Atrial Volume to Pulmonary Artery and Wedge Pressures in Mitral Stenosis
Authors: SOLOFF LOUIS A. , ZATUCHNI JACOB , MARK GEORGE E.
Published: June 2012

The significance of left atrial volume has been studied in 20 consecutive patients with mitral stenosis. Cardiac catheterization was performed and resting pressures in the right atrium, right ventricle, and pulmonary artery, as well as wedge pressure, were determined. Angiocardiography was performed immediately after cardiac catheterization. On the basis of these data the relationship between the estimated left atrial volume and these pressures is stated.
Pulmonary Function in Left Ventricular Failure, Including Cardiac Asthma
Authors: COSBY RICHARD S. , STOWELL ELLERY C. , HARTWIG W. RAY , MAYO M.
Published: June 2012

Unusually comprehensive studies of pulmonary function in hypertensive patients during left ventricular failure and cardiac asthma are presented. These findings are compared to those in mitral stenosis with congestive failure and in pulmonary emphysema with right heart failure. All patients were severely dyspneic and bedridden.
Cardiovascular Function in Hypothermic Anesthetized Man
Authors: ROSE JOHN C. , MCDERMOTT THOMAS F. , LILIENFIELD LAWRENCE S. , PORFIDO FRANK A. , KELLEY ROBERT T.
Published: June 2012

Although hypothermia is being used as an adjunct to general anesthesia, its cardiovascular effects in man are not fully known. In this report the authors present the hemodynamic changes observed in patients undergoing hypothermia under the clinical conditions of its practical usage in the operating room. Considerable variability in vasomotor and cardiac responses was encountered, indicating that uniform behavior of patients to this agent is not to be expected in the relatively uncontrolled operating room setting; therefore, it should be used conservatively, particularly in critically ill patients in whom unexpected reactions may be disastrous.