bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Severity of Organic Occlusive Disease and Comparison of the Effectiveness of Various Procedures in Relaxing Peripheral Vasospasm
Authors: GREEN HAROLD D. , PERKINS WILLIAM , ABERNETHY JOSEPH
Published: June 2012

Both organic occlusion and vasospasm are usually present in peripheral arterial vascular diseases. The degree of occlusion and the probable effectiveness of treatment designed to relax vasospasm can both be determined by measurement of the maximum increase in cutaneous blood flow produced by suitable vasodilator procedures. These studies included warming the torso and/or injections of tetraethylammonium chloride or benzylimidazoline, and administration of spinal anesthetic. The effects obtained with all three methods were closely comparable. Cutaneous blood flow was estimated from recordings of skin, room and body temperatures.
The Q-T Interval in Rheumatic Fever
Authors: CRAIGE ERNEST , ALIMURUNG MARIANO M. , BLAND EDWARD F. , MASSELL BENEDICT F.
Published: June 2012

In 143 rheumatic children the Q-T interval was found to be normal in those with quiescent rheumatic heart disease. In 29 with fatal pancarditis the average Q-T was above the average normal, though not beyond the upper limit of normal. Although parallel changes in the Q-T interval and the clinical manifestations of rheumatic fever occurred in about 66 to 75 per cent of cases, there were significant number of instances where changes in the Q-T and in the clinical course of the disease were in opposite directions.
Penicillin Treatment of Patients with Cardiovascular Syphilis in Congestive Failure
Authors: EDEIKEN JOSEPH , FORD WILLIAM T. , FALK MORTIMER S. , STOKES JOHN H.
Published: June 2012

Congestive failure has been considered a relative contraindication to antisyphilitic therapy in cardiovascular syphilis since the arsphenamine era, when severe reactions were reported following administration of this vasculotoxic drug. After having observed no severe reactions to penicillin in a series of patients with cardiovascular syphilis, it was decided to administer the antibiotic as initial therapy for individuals in congestive failure. This report summarizes observations on twelve such patients. There were no severe reactions during the course of treatment in the entire group. Digitalis and other measures to restore compensation were used concomitantly with penicillin. All the patients were improved upon completion of therapy. Case histories of 2 patients who died two months after treatment, are given. The significance of observations on the entire group is discussed.
Development of Hypertensive Manifestations after the Disappearance of Hypertension
Authors: PERERA GEORGE A.
Published: June 2012

The accelerated ("malignant") phase of hypertensive vascular disease is more common in men; sympathectomy may modify some of its signs and symptoms even in those cases in which hypertension is not modified. Six instances are reported herewith in which patients in the accelerated phase have developed retinopathy and papilledema during a sustained period of normal blood pressure brought on by a vascular accident or sympathectomy. Therefore factors other than the intensity of the hypertension may be involved in the pathogenesis of this phase.
Lack of Correlation between Rales and Arterial Oxygen Saturation in Patients with Pulmonary Congestion and Edema
Authors: VITALE ALBERT , DUMKE PAUL R. , COMROE J. H.
Published: June 2012

It is generally believed that pulmonary edema impairs the diffusion of oxygen from alveoli to pulmonary capillary blood and produces anoxemia. However, some patients who apparently have widespread pulmonary edema, as judged by the extent of rales heard over the lung fields, still have normal arterial oxygen saturation. Explanations are advanced for the lack of correlation between extent of rales and arterial oxygen saturation.
Serum Lipid and Protein Fractions
Authors: LEINWAND IRVING , MOORE DAN H.
Published: June 2012

Ninety-six patients were observed at intervals for as long as three and one-half years in some cases. In most instances multiple determinations were made during this time using the electrophoretic pattern of the proteins before and after cold ether extraction (McFarlane method), to measure lipid transport. Hyperlipemia usually produced an increased in beta globulin. A varying decrease in albumin accompanied any increase in globulin. Phosphate and barbiturate buffers were used in this study. In setting up a control group, it was noted that the sera from professional blood donors contained relatively less albumin and more globulin than the sera of the nondonor group of hospital personnel.
The Clinical Determination of Mitral Insufficiency when Associated with Mitral Stenosis
Authors: JANTON O. HENRY , HEIDORN GUENTHER , SOLOFF LOUIS A. , O'NEILL THOMAS J. E. , GLOVER ROBERT P.
Published: June 2012

A review of 200 consecutive operated cases of pure mitral stenosis and 47 consecutive operated cases of mitral stenosis with an associated mitral insufficiency indicates that careful evaluation of the history, auscultatory findings, electrocardiogram and fluoroscopy permits a correct diagnosis of associated insufficiency in a majority of instances. History and auscultation remain the internists' most valuable tools despite a large array of as yet incompletely evaluated mechanical measures.
Effects of Cortisone, Hydrocortisone and Corticotropin on Lipemia, Glycemia and Atherogenesis in Cholesterol-Fed Chicks
Authors: STAMLER JEREMIAH , PICK RUTH , KATZ LOUIS N.
Published: June 2012

Hydrocortisone markedly affected carbohydrate, protein, lipid and electrolyte metabolism of cholesterol-fed cockerels (intact, alloxanized and depancreatized). Despite steroid-induced diabetes and hyperadrenalism, associated with enhancement of hypercholesterolemic hyperlipemia, no hypertension or intensification of atherogenesis (aortic or coronary artery) supervened. Corticotropin (ACTH) produced similar effects. Cortisone was relatively inactive as a glycocorticoid in this avian species. Despite its apparently slight metabolic activity, however, it moderately elevated blood pressure and intensified atherogenesis.
Prolonged Observations of the Cardiovascular Status in Essential Hyperlipemia
Authors: SOFFER ALFRED , MURRAY MARTIN
Published: June 2012

Study of the natural course of essential hyperlipemia discloses that this disease is frequently associated with premature atherosclerosis. It is, therefore, our contention that we can no longer regard essential hyperlipemia as a benign disease. Heparin administered intravenously to patients with essential hyperlipemia produces dramatic though transient lowering of total lipids. This is due predominantly to heparin's effect upon neutral fat. Normal controls show no significant differences in their lipid response to heparin, though of course the degree of these changes is comparatively smaller.
A Comparison of the Cerebral Hemodynamic Response to Aramine and Norepinephrine in the Normotensive and the Hypotensive Subject
Authors: MOYER JOHN H. , MORRIS GEORGE , SNYDER HARVEY , SMITH C. POLK
Published: June 2012

Previous observations have demonstrated a depression in cerebral blood flow during controlled hypotension with ganglionic blocking agents. Cerebral blood flow is also decreased when normotensive individuals are made hypertensive by the administration of vasopressor agents. The opposite response is observed when hypotensive individuals are made normotensive by the administration of these same agents, in which circumstance cerebral blood flow is increased.
Syndrome of Short P-R Interval with Abnormal QRS Complexes and Paroxysmal Tachycardia (Wolff-Parkinson-White Syndrome)
Authors: WOLFF LOUIS
Published: June 2012

The syndrome of short P-R interval with abnormal QRS complexes and paroxysmal tachycardia occurs in otherwise healthy individuals in all age groups. Its interest and importance are related to our knowledge and concepts of the cardiac mechanism, the prevalence and clinical manifestations of paroxysmal tachycardia, the masking of the electrocardiographic signs of heart disease, and the serious consequences involved in making an incorrect diagnosis of heart disease.

A single mechanism is in all probability responsible for the abnormal electrocardiogram and the paroxysmal tachycardia. Premature activation of a small fraction of ventricular musculature shortens the P-R interval and lengthens the QRS interval, thus accounting for the electrocardiographic peculiarities of the syndrome. Whether an anomaly of impulse formation or an anomaly of conduction is responsible for pre-excitation is not known, and the propensity to paroxysmal tachycardia can be explained on either basis. There is no evidence that hitherto unknown phenomena are responsible for the syndrome. The disorder is probably congenital in nature.

A noteworthy feature is the spontaneous or induced shift, back and forth, from the abnormal to the normal type of electrocardiogram. Many drugs and procedures are available for this purpose. This is of immeasurable help in establishing the diagnosis of the Wolff-Parkinson-White syndrome in doubtful cases, and in unmasking the many abnormalities which anomalous excitation conceals.

Diagnostic errors are common, and the reasons for these have been discussed. Myocardial infarction, mitral stenosis, congenital heart disease, right and left ventricular hypertrophy, myocarditis, and bundle-branch block are the mistaken diagnoses most commonly made. Myocardial infarction, right and left ventricular hypertrophy, and right bundle branch block are the conditions most commonly concealed by the anomalous electrocardiogram.

The most important problems still requiring elucidation are those related to etiology, and to the mechanisms responsible for the abnormal electrocardiogram and paroxysmal rapid heart action.
The Effect of Intravenous Trypsin Administration on the Electrocardiogram of the Rabbit
Authors: LIEBERMAN JERROLD S. , TAYLOR ALEXANDER , WRIGHT IRVING S.
Published: June 2012

The intravenous injection of trypsin into rabbits resulted in marked changes in the rhythm and alteration in the P, QRS, S-T and T deflections of the electrocardiogram.
Effects of an Adrenergic Blocking Agent (Dibenzyline) upon Clinical Manifestations of Arterial Insufficiency in the Extremities
Authors: WERTHEIMER LOTHAR , REDISCH WALTER , STEELE J. MURRAY
Published: June 2012

Adrenergic blocking with Dibenzyline measurably enhances the healing of ischemic ulcers. Eleven cases of obliterative arterial disease and two cases of Raynaud's disease were closely observed and are reported in detail. In six of the individuals suffering from obliterative arterial disease, changes in blood flow were documented by plethysmography. Dibenzyline measurably influenced intermittent claudication only after prolonged administration (three to four months) in four out of eight closely observed patients without ulcers. The results of the physiologic tests suggest that during the early phases of adrenergic blocking the increase in blood flow is mostly in the skin, while in the later phases increase in blood flow through the muscle predominates.
Electrocardiography in the Selection of Royal Canadian Air Force Aircrew
Authors: MANNING G. W.
Published: June 2012

The electrocardiograms of 5000 healthy adult male applicants for aircrew training have been reviewed. Abnormalities were observed in the tracings of 158 subjects and these were further investigated. T-wave abnormalities occurred in 95 applicants, prolongation of the QRS (including the Wolff-Parkinson-White syndrome) in 28, prolongation of the P-R interval in 23, and miscellaneous changes in a group of 12 men. In many instances the apparent abnormality could be explained as a variation of normal on repeat study (including multiple lead electrocardiograms). In 27 men (0.54 per cent), 15 of whom revealed some associated clinical cardiovascular findings, a significant abnormality persisted and these were considered as unfit for pilot training.
Prevention of Systemic Arterial Embolism in Chronic Rheumatic Heart Disease by Means of Protracted Anticoagulant Therapy
Authors: WOOD JOHN C. , CONN HADLEY L.
Published: June 2012

Seven clinic outpatients with mitral stenosis and auricular fibrillation complicated by systemic embolism have been maintained on Dicumarol for periods of 20 to 48 months. None has had a recognized embolism while on therapy. Dicumarol administration has been interrupted in each case for periods of six days to four months. Three additional systemic embolic episodes in two individuals occurred during this interval. Hemorrhagic manifestations have occurred on three occasions. The study suggests that: (a) protracted Dicumarol therapy is an effective means of preventing recurrent embolism in individuals with chronic rheumatic heart disease; (b) it is applicable to the average clinic outpatient.
The Presence of Venoarterial Shunts in Patients with Interatrial Communications
Authors: SWAN H. J. C. , BURCHELL HOWARD B. , WOOD EARL H.
Published: June 2012

Evidence is presented which indicates that shunting of small amounts of blood from right to left occurs frequently through interatrial communications. Such right-to-left shunts are of small magnitude in the usual case of atrial septal defect, but it appears that of the fractions of blood shunted, a greater proportion has originated from the inferior vena cava than from the superior vena cava.
The Effect of Oral Iodide on Serum Butanol-Insoluble Protein-Bound Iodine in Various Species
Authors: BROWN HELEN B. , PAGE IRVINE H.
Published: June 2012

It is possible that there is an association between the butanol-insoluble protein-bound iodine developed in plasma when potassium iodide is fed and the reduction of serum and hepatic cholesterol. This fraction constitutes most of the protein-bound iodine increase observed in iodide-fed rabbits, dogs, rats and hypertensive human beings. It appears a few days after iodide feeding is begun and disappears four to eight weeks after discontinuing iodide. The dose required to produce minimum and maximum concentrations has been determined in all of these animals and in men. Further, it was found that hypothyroidism reduced the iodide requirement to one-tenth that necessary to produce comparable amounts of butanol-insoluble protein-bound iodine in normal animals.
Prostigmine Inhibition of Ventricular Fibrillation in the Hypothermic Dog
Authors: MONTGOMERY A. V. , PREVEDEL ARTHUR E. , SWAN HENRY
Published: June 2012

This study shows that when prostigmine is given via coronary perfusion in the hypothermic dog, cardiac surgery can be performed without ventricular fibrillation resulting. This action of prostigmine seems to be due to an accumulation of acetylcholine, since prostigmine's antifibrillatory action can be reproduced by a continuous coronary perfusion of acetylcholine or by stimulation of the vagus nerve. A possible relationship between potassium and ventricular fibrillation is discussed.
Myocarditis
Authors: DE LA CHAPELLE CLARENCE E. , KOSSMANN CHARLES E.
Published: June 2012

A review of selected papers on myocarditis published during the past decade and an analysis of some original data together with personal experiences have been presented.

All of these indicate that the clinical diagnosis of myocarditis is made far too infrequently as contrasted with the high incidence of this disease as recognized by pathologists. It is estimated that approximately 10 per cent of all patients coming to necropsy will demonstrate some evidence of myocarditis.

The discrepancy between the clinical and the pathologic incidences can possibly be ascribed to two factors, namely, (a) the relatively innocent nature of the clinical and laboratory findings in many cases, and (b) the apparent reluctance of the clinician to make the diagnosis.

It is likely that a correct diagnosis of myocarditis will be made more often and cardiac catastrophies avoided if the clinician will consider the possibility of the diagnosis, particularly in the course of all types of infectious diseases.
Repeat Variability of Spatial QRS and T Vectors
Authors: SIMONSON ERNST , KEYS ANCEL
Published: June 2012

In spite of the increasing literature on spatial electrocardiographic vectors, no information on their repeat variability is available. Such data are presented in this paper and compared with the repeat variability of conventional electrocardiographic items, as background for interpretation of changes in direction and magnitude of spatial vectors in patients.
The Effect of Congestive Heart Failure on Blood Volume as Determined by Radiochromium-Tagged Red Cells
Authors: EISENBERG SEYMOUR , MCCALL MARY SUE
Published: June 2012

Total blood volume, red cell mass and plasma volume have been determined with radiochromium in subjects with congestive heart failure, before and after treatment. All functions were significantly increased during the congestive state and all decreased as compensation was achieved. The magnitude of the hypervolemia and the changes incident to treatment were apparently related to alterations in heart size. Selective expansion of the plasma volume was not encountered.
Arterial Malformations which Cause Compression of the Trachea or Esophagus
Authors: GROSS ROBERT E.
Published: June 2012

In recent years observations have shown that there are certain arterial malformations in the superior mediastinum which bring about significant compression of either the trachea or esophagus, or both of these structures. If the arterial derangements are of such a nature that symptoms are produced by obstruction of the esophagus and particularly by the impairment of the tracheal airway, it is of prime importance to recognize the underlying vascular malformation because surgical approach to the problem has a great deal to offer either by division of an offending vessel or by displacement of an artery in such a manner that more room is provided for the esophagus and trachea.

Roentgenographic examination of the esophagus and trachea with contrast media usually gives a fairly clear impression of the arterial derangement and leads to accurate diagnosis. Visualization of the aortic pathways by angiocardiography or by retrograde aortography is seldom necessary.

At operation, all these anomalies can be exposed through a left anterolateral transpleural approach to the superior mediastinum. Most of the thymus gland can be dissected off and discarded, allowing good visualization of the region.

Emphasis must be placed upon the fact that constrictions of the esophagus or trachea are not caused solely by vessels or ligaments, but that constriction is likewise produced by fibrous bands or sheaths which accompany these vessels and ligaments. Hence, it is important, not only to divide or displace the appropriate vessel or ligament, but also to cut any strands or bands of tissue which accompany these structures and which form a part of a constricting mechanism.

In a series of cases in which surgical therapy has been undertaken for alleviating compression of the esophagus or trachea for the various vascular anomalies under consideration, it has been shown that the risks of surgery can be kept relatively low and that the benefits which accrue from such treatment are real and well worth seeking.
Studies on the Mechanism of Ventricular Activity
Authors: BORDUAS JEAN LOUIS , RAKITA LOUIS , KENNAMER REXFORD , PRINZMETAL MYRON
Published: June 2012

Seven clinical cases with electrocardiographic patterns of constant or variable short P-R interval are reported. The QRS complex was either normal or aberrant. These abnormalities were reproduced experimentally in dogs by the injection of various drugs into the region of the A-V node. The theories advanced to explain these phenomena are discussed. The results indicate that accelerated A-V nodal conduction is responsible for the short P-R interval. The form of the ventricular complex may be dependent upon synchronous or asynchronous activity of the A-V node. A classification of A-V nodal dysfunction is presented.
Left Ventricular Hypertrophy
Authors: SCOTT RALPH C. , SEIWERT VINCENT J. , SIMON DAVID L. , MCGUIRE JOHNSON
Published: June 2012

The current electrocardiographic criteria for the diagnosis of left ventricular hypertrophy have been analyzed in 100 cases of pure left ventricular hypertrophy proved at autopsy. Only those cases were used in which the greatest thickness of the left ventricle was 13 mm. or more, the right ventricle did not exceed 4 mm. in thickness, and the heart weight exceeded the upper limit of the expected normal. Also, only those cases were studied on whom multiple lead electrocardiograms were available. Conclusions are presented as to which sets of electrocardiographic criteria give the greatest accuracy in the diagnosis of left ventricular hypertrophy.
The Circulatory Effects of Reserpine
Authors: MCQUEEN E. G. , DOYLE A. E. , SMIRK F. H.
Published: June 2012

The effects of large doses of reserpine have been compared in hypertensive and normotensive patients. The falls of blood pressure are larger in the hypertensives than in the normotensives. In normotensive animals small falls of blood pressure occur. Evidence is presented which suggests that the fall of blood pressure in animals is in part mediated through the sympathetic nervous system. There seems also to be a direct vascular action in animals. In man, evidence is presented which suggests that part at least of the hypotensive action is mediated through the sympathetic nervous system.
Experimental Bacterial Endocarditis Due to Streptococcus Mitis
Authors: RABENS ROBERT A. , KARLSON ALFRED G. , GERACI JOSEPH E. , EDWARDS JESSE E.
Published: June 2012

Pathologic and bacteriologic studies were carried out in all 24 dogs subjected to arteriovenous anastomoses and bacteremia. The single etiologic agent,
Streptococcus mitis
, was stained and cultured from 10 of the 11 hearts with active endocarditis (one animal had a healed tricuspid valvulitis) and from 16 of 17 animals with patent fistulas and active caval vegetations. The latter lesions occurred shortly after the initiation of injections and served as an important source of bacteria to the blood stream and heart valves. The endocarditis resembled that found in human cases with destructive and reparative phenomena coexisting. Focal myocarditic lesions and cardiac failure were noted only in animals with endocarditis. The other secondary (embolic) lesions were similar to those seen in man with the exception that in the dog the lesions had a suppurative tendency. Acute diffuse proliferative glomerulonephritis was found in animals with endocarditis and in those with infected fistulas and bacteremia.
The Effects of Intravenous Hexamethonium on Venous Pressure of Normotensive and Hypertensive Patients with and without Congestive Heart Failure
Authors: BURCH ROBERT R.
Published: June 2012

The response of atrial pressure, venous pressure, pulse and respiratory rates to intravenous hexamethonium in 38 selected patients was studied. The drug seemed more effective where vascular tone was greater. Increased venous tone was indicated in congestive heart failure. The possible useful role of intravenous hexamethonium as an adjunct in the treatment of congestive heart failure was concluded from the objective and subjective observations made.
Flow Through Collapsible Tubes: Augmented Flow Produced by Resistance at the Outlet
Authors: RODBARD SIMON
Published: June 2012

The physical laws describing the character of flow through blood vessels may depart radically from those which have been developed by engineers and physicists for uniform flow through rigid tubes of uniform diameter. These deviations are marked in the case of flow through collapsible tubes,such as blood vessels and valves. At critically high velocities, the flow pattern may be transformed from a quiet, uniform smooth-flowing stream to an interrupted series of jets with the production of audible sound and with marked energy losses. The present study deals primarily with the "paradoxically" increased flow which may take place through collapsible tubes when a resistance is added to the outlet from the system. This marked deviation from the laws for rigid tubes is attributed to the vessel-distending effects of the added resistance, and to the inhibition of the phenomenon of recurrent collapsibility. The present
in vitro
experiments are used to attempt to explain certain paradoxical findings in flow through the collapsible tube systems of the body.
The Effect of Intravenous Protoveratrine on Digital Pulse Volume and Digital Skin Temperature in Hypertensive Patients
Authors: CURRENS J. H. , MCGINTY J. F. , KHAMBATTA R. B. , GORDON IDA
Published: June 2012

The change in digital pulse volume and skin temperature was observed after intravenous protoveratrine in 25 studies. A significant increase in the average pulse volume of the finger was noted but the range of change was large. The average change of pulse volume in the toe was not significant. A slight increase in the finger skin temperature was noted. "Vasodilatation" of the hand and feet was not the only factor resulting in a fall in blood pressure since it did not occur in all patients.
Certain Clinical States and Pathologic Changes Associated with Deeply Inverted T Waves in the Precordial Electrocardiogram
Authors: PRUITT RAYMOND D. , KLAKEG CLAYTON H. , CHAPIN LEMUEL E.
Published: June 2012

A correlation of the clinical and electrocardiographic findings was undertaken in 110 cases which had in common the presence of deeply inverted T waves in central terminal leads centered about position 3 on the precordium. The results of this study are reviewed. A summary is presented of changes encountered at the time of necropsy in nine cases in which electrocardiographic changes of similar type had been recorded. These observations are integrated with concepts derived from the dipole theory. The total evidence is viewed in relation to observations reported by other investigators.
Dipaxin—2-Diphenylacetyl-1,3-Indandione; Clinical Evaluation of a New Anticoagulant
Authors: FIELD JOHN B. , GOLDFARB MARTIN S. , WARE ARNOLD G. , GRIFFITH GEORGE C.
Published: June 2012

In the course of development of new anticoagulants, an indandione derivative has been subjected to a clinical evaluation. The new agent is one of the most potent hypoprothrombinemic substance known but it is readily counteracted with vitamin K. The agent was administered to a large series of patients with thromboembolic diseases and control of anticoagulant therapy was observed to be simple, reproducible, with a good predictability of response as well as with absence of toxic phenomena and a low order of bleeding complications. It has been administered to 11 patients for ambulant anticoagulant care for periods up to 18 months with satisfactory results and it appears to be especially suitable for long-term maintenance therapy.
Observations on the Hyponatremia following Mitral Valvulotomy
Authors: GOODYER ALLAN V. N. , GLENN WILLIAM W. L.
Published: June 2012

Thirty-seven patients subjected to mitral valvulotomy were studied before and after operation with regard to the incidence, extent, and mechanism of postoperative hyponatremia. Balances of water, sodium, and chloride were carried out on 27 patients. The serum sodium fell below 131 mEq. per liter in 16 cases in the immediate postoperative period, the serum chloride fell below 99 mEq. per liter in all cases but one and below 90 mEq. per liter in 11 cases. The small negative balances of sodium and chloride were inadequate, by themselves, to account for the observed hyponatremia in any case. Appreciable (over 100 mEq.) intracellular shifts of sodium (using the chloride space as a reference) were associated with hyponatremia in only three cases. The retention of water during the immediate postoperative period (allowing for insensible losses) was enough to explain the observed hyponatremia in all but three cases, although the level of fluid
intake
was not well correlated with the occurrence of hyponatremia. These results indicate the presence of an unusually prolonged antidiuretic stimulus in these patients, the etiology of which remains uncertain. Except in a few cases it is unnecessary to correct the hyponatremia with hypertonic salt, since it is usually a transient, limited, and essentially asymptomatic phenomenon.
Electrolyte Studies in Heart Failure
Authors: ISERI LLOYD T. , BOYLE ALBERT J. , CHANDLER DOUGLAS E. , MYERS GORDON B.
Published: June 2012

Muscle analyses for water, potassium, and chloride were made in 10 cardiac patients during and after congestive heart failure. The potassium content per unit of wet tissue during failure was 30.1 per cent less than that during compensation. The concentration of potassium in the intracellular water increased from 116 mEq. per liter to 151 mEq. per liter with compensation. Calculated extracellular water decreased, but no change in intracellular water per unit of tissue solids was found.
Electrolyte Studies in Heart Failure
Authors: ISERI LLOYD T. , MADER IVAN J. , BOYLE ALBERT J.
Published: June 2012

Indirect metabolic studies and direct muscle biopsy studies have indicated diminution of intracellular electrolyte concentration during congestive heart failure explainable by extrusion of these electrolytes due to increase in osmolarity within the cells. Acute and chronic physical and circulatory stress in cardiac patients produced an elevation of plasma sodium concentration indicative of a concomittant increase in osmolarity of the extracellular fluid.
Nomogram for Simple Calculation of Cardiac Output
Authors: JACKSON CHARLES EUGENE
Published: June 2012

A nomogram is presented which facilitates the determination of cardiac output from blood pressure measurements and the patient's age using the formula presented by other authors.
Serum Transaminase Levels in Experimental Myocardial Infarction
Authors: AGRESS CLARENCE M. , JACOBS HOWARD I. , GLASSNER HARVEY F. , LEDERER MARIANNE A. , CLARK WM. G. , WROBLEWSKI FELIX , KARMEN ARTHUR , LADUE JOHN S.
Published: June 2012

Serum glutamic oxalacetic transaminase concentrations rise sharply after myocardial infarction produced by bead embolization of the coronary tree in the closed chest dog. The peak concentration is reached in 9 to 23 hours post injury. Rises 20 to 30 times greater than normal may be obtained and are directly correlated with the amount of infarction estimated at autopsy. Serial serum transaminase levels may provide a clinical tool to supplement the electrocardiogram in the diagnosis of acute myocardial infarction as well as provide a roughly quantitative estimate of the amount of myocardium involved.
Effect of Estrogenic Hormone on Serum Lipids in Patients with Coronary Arteriosclerosis
Authors: STEINER ALFRED , PAYSON HENRY , KENDALL FORREST E.
Published: June 2012

The oral administration of large amounts of ethinyl estradial daily to patients with coronary arteriosclerosis and to control subjects consistently produced a favorable effect upon the serum lipid pattern. However, toxic effects of the estrogen prohibited its prolonged use. The clinical status of the patient as evidenced by the incidence of chest pain or the electrocardiogram were not altered during the period of the study.
Electric Alternans in Pericardial Effusion
Authors: MC GREGOR MAURICE , BASKIND EUGENE
Published: June 2012

Evidence is presented which indicates that electric alternation is frequently associated with pericardial effusion; that this alternation is of a unique type; and that it is caused by movement of the heart in the fluid filled pericardial sac.
On Cardiovascular Sound
Authors: MCKUSICK VICTOR A. , WEBB GEORGE N. , HUMPHRIES J. O'NEAL , REID JAMES A.
Published: June 2012

Spectral phonocardiography, an adaptation of the method of sound spectrography devised at the Bell Telephone Laboratories, differs from conventional oscillographic phonocardiography principally in the fact that frequency spectrum is displayed as well as the dimensions of time and intensity. The display of frequency spectrum is responsible for three advantages of the method: (1) Quality, or timbre, is given physical definition, (2) resolution in the time dimension is improved, and a (3) a better display of the wide dynamic range of cardiovascular sound is attained. This method can do, or can be made to do, all the ear can, and can probably emulate the performance of the ear because 1) it is not wed to a particular frequency-intensity response curve, 2) it suffers from no "psychoacoustic" impediments, 3) it provides better resolution in the time dimension, and 4) it produces permanent, quantifiable records. Discussed here are selected features of mitral valve disease, aortic valve disease, gallops, systolic clicks, and extracardiac sounds. In general, intensity and peak frequency (or frequency range) vary in a parallel manner in sound of cardiovascular origin. Artefacts due to noncardiovascular ambient noise and to electrical interference can be identified and disregarded in the heart sound analysis.
Studies of Circulation Time During the Valsalva Test in Normal Subjects and in Patients with Congestive Heart Failure
Authors: STUCKI PAUL , HATCHER J. D. , JUDSON WALTER E. , WILKINS ROBERT W.
Published: June 2012

Circulation times (P
32
from the antecubital and femoral veins to a peripheral artery) and roentgenographic studies of the pattern of venous distribution of a radio-opaque substance (Diodrast introduced through a cardiac catheter into the axillary vein and the inferior vena cava below the diaphragm) have been performed during the expiratory effort of the Valsalva maneuver. In normal subjects the circulation times were increased by the duration of the expiratory effort and the Diodrast injections were stagnated in the veins outside the thoracic cavity. These effects were in striking contrast to those in patients with congestive failure in whom the circulation times were retarded only partially if at all and the Diodrast injections continued to flow freely towards the right atrium during the expiratory effort. Thus, in patients with congestive failure the Valsalva maneuver does not interrupt the venous return to the right atrium as it does in normal subjects.
Arteriosclerotic Occlusion of Cerebral Arteries: Mechanism and Therapeutic Considerations
Authors: BRUETSCH WALTER L.
Published: June 2012

The brains of 20 patients with cerebral arteriosclerosis have been studied with regard to the exact mechanism of occlusion of the arteries in encephalomalacia. The histologic material has convinced the author that the concept of "cerebral thrombosis" in its present wide application is erroneous; there is arterial occlusion but the mechanisms of its production, which are discussed, are not the usually accepted ones.
The Effects of Repetitive Electric Cardiac Stimulation in Dogs With Normal Hearts, Complete Heart Block and Experimental Cardiac Arrest
Authors: STARZL T. E. , GAERTNER R. A. , WEBB ROSCOE C.
Published: June 2012

Direct cardiac stimulation was conducted in the open chest. In normal animals, auricular stimulation at frequencies faster than the spontaneous rate caused little change in vascular pressures or cardiac output. Comparable ventricular stimulation in the same animals caused falls in cardiac output and blood pressure, with elevations in venous pressure. In contrast, ventricular stimulation in animals with complete heart block caused elevations in cardiac output and blood pressure, and declines in venous pressure. A study was also made of repetitive stimulation in experimental cardiac arrest. Occasionally pacemaking was of value in the resuscitation, but in most cases effective contractions could not be induced with stimulation.
Experiences with a New Oral Mercurial Diuretic—Merpurate
Authors: KAUFMAN JEROME G. , BERNSTEIN ARTHUR , WEISS FRED , KLOSK EMANUEL , FELDMAN HAROLD S.
Published: June 2012

A new oral mercurial diuretic, Merpurate, was studied in dogs for chronic toxicity and in humans for effectiveness. It was found that this product was effective as a diuretic in the doses used and gave a minimal number of undesirable reactions.
Circulatory Effects of Mitral Commissurotomy with Particular Reference to Selection of Patients for Surgery
Authors: FERRER M. IRENÉ , HARVEY RÉJANE M. , WYLIE ROBERT H. , HIMMELSTEIN AARON , LAMBERT ADRIAN , KUSCHNER MARVIN , COURNAND ANDRÉ , RICHARDS DICKINSON W.
Published: June 2012

Of 60 patients with mitral stenosis referred as proper candidates for commissurotomy, less than half (27) proved suitable after further study. One half of these (13) had a good postoperative result as judged not only clinically but by objective physiologic measurements. The latter represent the best criteria for the effects of surgery since subjective impressions may be unreliable. Eight subjects originally advised to undergo surgery would now be rejected inasmuch as myocardial insufficiency and not mitral block was their predominant difficulty. Clinical criteria appear as yet inadequate for the selection of the proper candidate for mitral commissurotomy, as there is no good clinical means of establishing in every instance the presence of pulmonary hypertension which remains the best evidence of a significant degree of mitral block.
The Effect of Exercise on the Excretion of Water by Patients with Congestive Failure
Authors: DUNCAN LEROY E. , PONDER KATHERIN
Published: June 2012

Some patients with congestive cardiac failure maintain hyponatremia by the excretion of only small amounts of hypertonic urine. In the present study it is shown that following exercise the experimentally overhydrated patient with congestive cardiac failure excretes a very small amount of urine which may be hypertonic. This is in accord with the hypothesis that events which increase the severity of failure increase the tendency to the development of hyponatremia.
Circulatory Dynamics in Osteitis Deformans
Authors: LEQUIME J. , DENOLIN H.
Published: June 2012

In Paget's disease the peripheral blood flow is increased in the bones affected by the disease. Nevertheless the circulatory dynamics of the patients studied
at rest
are usually not modified significantly. But during
exercise
, an abnormal augmentation of the cardiac output in regard to the metabolic needs is observed. These findings are similar to those the authors have observed in patients suffering from systemic arteriovenous aneurysms.
Rauwolfia Serpentina in the Treatment of High Blood Pressure
Authors: VAKIL RUSTOM JAL
Published: June 2012

The root of the
Rauwolfia serpentina
Benth (N. O. Apocyanaciae) has been in use in India for hundreds of years for a host of unrelated ailments. Since 1949, after the English publication of a clinical report by the author on
Rauwolfia serpentina
therapy in fifty cases of essential hypertension, the plant has gained universal acclamation as a useful therapeutic weapon in high blood pressure states. The whole subject of
Rauwolfia serpentina
therapy in hypertension has been reviewed up to the present time, including discussions on the history of the plant, its various species and types, nomenclature, geographic distribution, chemistry, pharmacologic actions and clinical studies, reported on the subject from all over the world.
Atypical Tetralogy of Fallot: A Noncyanotic Form with Increased Lung Vascularity
Authors: ROWE RICHARD D. , VLAD PETER , KEITH JOHN D.
Published: June 2012

Only recently has the association of pulmonic stenosis with increased pulmonary blood flow been recognized. Four symptomatic infant cases are described in which the clinical diagnosis was large interventricular septal defect. Hemodynamic study showed the presence of associated pulmonic stenosis. Features suggesting that there is an overriding aorta in these patients, and that they, therefore, form an atypical group within the tetralogy of Fallot, are presented. The diagnosis has been confirmed in one case at autopsy. Their differentiation from clinically similar malformations as well as the surgical problem they pose is discussed.
Subacute Bacterial Endocarditis Arising in Mural Thrombi Following a Myocardial Infarction: A Case Report
Authors: JOFFE SEYMOUR , FEIL HAROLD
Published: June 2012

A case of subacute bacterial endocarditis arising in a thrombus covering myocardial infarction, with a necropsy, is reported. The patient died after an illness of four months duration. The clinical course was characterized by a low fever, congestive failure, petechiae, purpura, and ulceration of the skin. The rarity of this clinical picture is emphasized.
Angiocardiographic Demonstration of Occlusive Auricular Thrombi in Dogs
Authors: READ JOHN L. , BOSHER LEWIS H. , FERRARU FELIX , RICHMAN SAMUEL , PORTER RENO R.
Published: June 2012

Simulated occlusive auricular thrombi were produced in six dogs by surgically invaginating the left auricular appendage. Angiocardiographic studies were performed in five of the dogs and in each case revealed these thrombi as clear cut filling defects. The significance and clinical application of these observations is discussed.
Occlusive Auricular Thrombi
Authors: READ JOHN L. , PORTER RENO R. , RUSSI SIMON , KRIZ JOSEPH R.
Published: June 2012

The literature on occlusive thrombi of the auricles has been reviewed in order to identify the symptom complex attributed to this condition. The clinicopathological findings are presented in four new cases which fit this symptom complex. Two cases are notable in that one is that of a ball thrombus occurring in the absence of mitral stenosis and another the first reported case of pedunculated thrombus of the right auricle.
A Study of the Spatial Vectorcardiogram in Normal Subjects over the Age of Forty Years
Authors: ABILDSKOV J. A.
Published: June 2012

The spatial vectorcardiograms of 114 normal subjects over the age of 40 years have been studied. Differences in the form, orientation and magnitude of the QRS loops of these records and those of younger normal subjects recorded with the same techniques were found. The study represents a further step in defining the normal spatial vectorcardiograms.
An Evaluation of the Effect of Continuous Long-Term Anticoagulant Therapy on the Prognosis of Myocardial Infarction
Authors: SUZMAN M. M. , RUSKIN H. D. , GOLDBERG B.
Published: June 2012

Eighty-two patients who survived a myocardial infarct were treated continuously with anticoagulants for periods of 3 to 76 months. Another 88 patients whose treatment with anticoagulants was limited to the acute phase of an infarction and who were observed for similar periods acted as a control group. The group treated continuously exhibits a lower mortality rate with fewer recurrences of infarction. Among the factors subjected to statistical analysis and found to influence the ultimate prognosis unfavourably and which therefore serve as indications for long-term anticoagulant therapy, are a severe presenting attack and a history of previous infarction.
A Study of the Spatial Vectorcardiogram in Subjects with Posterior Myocardial Infarction
Authors: BURCH G. E. , HORAN LEO , ABILDSKOV J. A. , CRONVICH J. A.
Published: June 2012

A study of 45 spatial vectorcardiograms of patients with posterior myocardial infarction revealed a characteristic upward displacement of the early portion of the QRS sÊ-loop. Changes in the later portion of the QRS sÊ-loop may occur as a result of infarction. The possible utilization of such findings in the diagnosis of infarction is discussed.
Vectorcardiographic Investigations on the Auricles
Authors: WENGER RUDOLF , HUPKA KLEMENS , WICK ERWIN
Published: June 2012

Vectorcardiography demonstrates very clearly the method of auricular activation and shows its spatial development. This is illustrated and discussed in this paper as it occurs in normal subjects, in a patient with an ectopic auricular pacemaker, and in patients with pulmonary heart disease. Changes similar to those seen in patients with cor pulmonale have been observed in dogs after partial occlusion of the pulmonary artery. Remarkable alterations of the auricular vectorcardiogram have been seen in patients with mitral heart disease after commissurotomy.
A Study in Frontal Plane Vectorballistocardiography
Authors: MORRIS GWENDOLYN L. , BRAUNSTEIN JOHN R.
Published: June 2012

Frontal plane ballistocardiograms obtained from 10 normal subjects were analyzed and compared with abnormal records obtained from patients with known cardiovascular disease. The normal vector loop is described, and the importance of the transverse ballistocardiogram is discussed. It is suggested that the orientation of the J loop may be related to the anatomic position of the heart. No such relationship was noted with the frontal plane H, I or K vector loops.
Cardiocirculatory Performance in Atrial Flutter
Authors: HARVEY RÉJANE M. , FERRER M. IRENÉ , RICHARDS DICKINSON W. , COURNAND ANDRÉ
Published: June 2012

Data obtained in 12 patients with atrial flutter indicate that this arrhythmia was associated with a low cardiac output in those subjects with intrinsic heart disease. Furthermore, the resting level of blood flow increased somewhat when the cardiac mechanism of five patients with atrial flutter was converted to sinus rhythm. In two cardiac patients, the response to exercise in flutter as compared to normal sinus rhythm was little different. Lesser circulation pressures in the absence of heart failure were not abnormal in atrial flutter but, in general, when failure existed, the type of pulmonary hypertension noted in subjects with flutter, differed from those in sinus rhythm. Tricuspid insufficiency did not occur in atrial flutter in contrast to its almost constant appearance in atrial fibrillation. Atrial systolic pressure waves, associated with each electric flutter wave, were ubiquitously present in all lesser circulation pressure curves. Their origin is discussed.
The Neurogenic Component in Hypertension
Authors: DOYLE A. E. , SMIRK F. H.
Published: June 2012

The magnitude of the blood pressure falls, in the horizontal posture, following intravenous hexamethonium, shows that an important part of the blood pressure elevation is neurogenically maintained in essential hypertension. When the blood pressure is first raised by angiotonin or by other pressor agents, the subsequent response to hexamethonium is much reduced. Similar responses are observed in normotensive and hypertensive subjects. This is due to the reaction of the regulating centers which compensate for the effect of the pressor agent by reducing the neurogenic component. The resulting decrease in the neurogenically maintained fraction of the blood pressure diminishes the response to hexamethonium. It is suggested that, in the course of time, long exposure to pressor stimuli induces the vasomotor centers to exercise their regulating function at a higher than normal level.
Electrolyte Changes in Ileal Contents and in Feces during Restriction of Dietary Sodium with and without the Administration of Cation-Exchange Resin
Authors: FIELD HENRY , SWELL LEON , DAILEY R. E. , TROUT E. C. , BOYD R. S.
Published: June 2012

Sodium and potassium levels of the contents of the terminal ileum and feces were determined for four dogs at different dietary sodium intakes, both before and during administration of a carboxylic cation-exchange resin. With restriction of dietary sodium, there was more sodium bound by the resin in the terminal ileum than was provided by the diet. There was considerable conservation of sodium in the upper gastrointestinal tract, but the colon always absorbed a major part of the sodium presented to it. During resin administration with very low sodium diets there was more sodium in the feces than in the diets.
The Relationship of Sodium Retention and Venous Pressures to Edema Formation
Authors: GOLDMAN RALPH , BASSETT SAMUEL H.
Published: June 2012

Two patients with congestive cardiac failure were placed on a metabolic balance regimen and supplemental sodium chloride was administered. Weight changes in these patients could be closely correlated with the amount of sodium retention and appeared to be initially independent of brachial venous pressure thus supporting the concept that edema in congestive failure results from prinmary sodium retention rather than primary elevation in venous pressure.