bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraindividual Variation in Plasma 25-Hydroxyvitamin D Measures 5 Years Apart among Postmenopausal Women
Authors: Meng Jennifer E. , Hovey Kathleen M. , Wactawski-Wende Jean , Andrews Christopher A. , LaMonte Michael J. , Horst Ronald L. , Genco Robert J. , Millen Amy E.
Published: June 2012

Background: Current literature examining associations between vitamin D and chronic disease generally use a single assessment of 25-hydroxyvitamin D [25(OH)D], assuming the 25(OH)D concentration of an individual is consistent over time.

Methods: We investigated the intraindividual variability between two measures of plasma 25(OH)D concentrations collected approximately five years apart (1997–2000 to 2002–2005) in 672 postmenopausal women participating in the Women's Health Initiative. Plasma 25(OH)D was assessed using the DiaSorin LIAISON® chemiluminescence immunoassay. The within-pair coefficient of variation (CV) was 4.9% using blinded quality control samples. Mean and SDs of 25(OH)D at the two time points were compared using a paired t test. An intraindividual CV and intraclass correlation coefficient (ICC) were used to assess intraindividual variability. A Spearman correlation coefficient (r) assessed the strength of the association between the two measures, and concordance in vitamin D status at two time points was compared.

Results: Mean 25(OH)D concentrations (nmol/L) significantly increased over time from 60.0 (SD = 22.2) to 67.8 (SD = 22.2; P < 0.05). The CV was 24.6%, the ICC [95% confidence interval (CI)] was 0.59 (0.54–0.64), and the Spearman r was 0.61 (95% CI = 0.56–0.66). Greater concordance over five years was observed in participants with sufficient compared with deficient or inadequate baseline 25(OH)D concentrations (weighted kappa = 0.39). Reliability measures were moderately influenced by season of blood draw and vitamin D supplement use.

Conclusion: There is moderate intraindividual variation in 25(OH)D concentrations over approximately five years.

Impact: These data support the use of a one-time measure of blood 25(OH)D in prospective studies with ≤ five years of follow-up. Cancer Epidemiol Biomarkers Prev; 21(6); 916–24. ©2012 AACR.
Patterns of Colorectal Cancer Test Use, Including CT Colonography, in the 2010 National Health Interview Survey
Authors: Shapiro Jean A. , Klabunde Carrie N. , Thompson Trevor D. , Nadel Marion R. , Seeff Laura C. , White Arica
Published: June 2012

Background: Recommended colorectal cancer (CRC) screening tests for adults ages 50 to 75 years include home fecal occult blood tests (FOBT), sigmoidoscopy with FOBT, and colonoscopy. A newer test, computed tomographic (CT) colonography, has been recommended by some, but not all, national organizations.

Methods: We analyzed 2010 National Health Interview Survey data, including new CT colonography questions, from respondents ages 50 to 75 years (N = 8,952). We (i) assessed prevalence of CRC test use overall, by test type, and by sociodemographic and health care access factors and (ii) assessed reported reasons for not having a CRC test.

Results: The age-standardized percentage of respondents reporting FOBT, sigmoidoscopy, or colonoscopy within recommended time intervals was 58.3% [95% confidence interval (CI), 57.0–59.6]. Colonoscopy was the most commonly reported test [within past 10 years: 54.6% (95% CI, 53.2–55.9)]. Home FOBT and sigmoidoscopy with FOBT were less frequently used [FOBT within past year: 8.8% (95% CI, 8.1–9.6); sigmoidoscopy within past 5 years with FOBT within past 3 years: 1.3% (95% CI, 1.0–1.6)]. CT colonography was rare: 1.3% (95% CI, 1.0–1.7). Increasing age, education, income, having health care insurance, and having a usual source of health care were associated with higher CRC test use. Test use within recommended time intervals was particularly low among individuals ages 50 to 64 years without health care insurance [21.2% (95% CI, 18.3–24.4)]. The most common reason for nonuse was “no reason or never thought about it.”

Conclusions: About 40% of Americans ages 50 to 75 years do not meet the recommendations for having CRC screening tests.

Impact: Expanded health care coverage and greater awareness of CRC screening are needed to further decrease CRC mortality. Cancer Epidemiol Biomarkers Prev; 21(6); 895–904. ©2012 AACR.
Expression of Myosin Heavy Chain Isoforms in the Human Supraspinatus Muscle: Variations Related to Age and Sex
Authors: Potau J.M. , Artells R. , Muñoz C. , Díaz T. , Bello-Hellegouarch G. , Arias-Martorell J. , Pérez-Pérez A. , Monzó M.
Published: June 2012

The contractile function of skeletal muscles is primarily regulated by the expression of myosin heavy chain (MHC) isoforms. Adult human skeletal muscles express three MHC isoforms (MHC-I, MHC-IIa and MHC-IIx). The muscles mainly expressing MHC-I are slow but resistant to fatigue, while those with major expression of MHC-IIa and MHC-IIx are fast and powerful but less resistant to fatigue. In this study, mRNA levels of the MHC isoforms were assessed in 24 human supraspinatus muscles by reverse-transcription polymerase chain reaction. The average expression of the MHC-I isoform was 36.72%, that of the MHC-IIa isoform was 33.52%, and the average expression of the MHC-IIx isoform was 29.76%. The higher average expression of the two MHC-II isoforms taken together (63.28%) indicates that the human supraspinatus muscle is a powerful, fast muscle with relatively low resistance to fatigue, in accordance with its role in the elevation of the upper extremity. In women, and more markedly in older women, the trend towards upregulation of the fast MHC-II isoforms and downregulation of the slow MHC-I isoform, which is absent in males, may improve our understanding of possible causes of the subacromial impingement syndrome.
A Mixture Model of Ductus Venosus Pulsatility Index in Screening for Aneuploidies at 11–13 Weeks’ Gestation
Authors: Maiz Nerea , Wright David , Ferreira Ana Fatima A. , Syngelaki Argyro , Nicolaides Kypros H.
Published: June 2012

Objective: To assess the value of ductus venosus pulsatility index for veins (DV PIV) in screening for aneuploidies at 11–13 weeks’ gestation. Methods: Fetal DV PIV was measured in singleton pregnancies undergoing first-trimester screening for aneuploidies. In euploid (n = 44,756) and aneuploid (202 cases of trisomy 21, 72 cases of trisomy 18 and 30 cases of trisomy 13) fetuses, DV PIV was best described by a mixture model of distributions. Performance of screening for aneuploidies by DV PIV alone and in combination with fetal nuchal translucency (NT) thickness and serum free β-hCG and PAPP-A was estimated. Results: In euploid pregnancies there was a bimodal distribution of DV PIV with a dominant crown-rump length (CRL)-dependent part, accounting for around 97% of cases in Caucasians and around 93% in Afro-Caribbeans, and a smaller CRL-independent distribution. In aneuploidies the dominant part was the CRL-independent distribution, which accounted for around 85% cases of trisomies 21 and 18 and 70% of cases of trisomy 13. In screening for trisomy 21 by maternal age, NT and biochemistry at a risk cutoff of 1 in 100, the detection rate was 89.7% and false positive rate was 2.74%; with addition of DV PIV, the values were 93.5 and 1.63%, respectively. Conclusions: Measurement of DV PIV improves the performance of first-trimester combined test for aneuploidies.
Podocalyxin-Like Protein 1 Expression and Correlation with Clinical Characteristics in Epithelial Serous and Mucinous Ovarian Carcinoma and Tumor-Like Lesions
Authors: Ye Feng , Hu Ying , Zhou Caiyun , Hu Yuting , Chen Huaizeng
Published: June 2012

Objective: Podocalyxin-like protein 1 (PCLP1) may be involved in the invasion and metastasis of tumors. However, to date the role of PCLP1 in the progression of epithelial ovarian carcinoma has not been investigated. Methods: PCLP1 expression was examined by immunohistochemistry in 471 cases with various degrees of ovarian epithelial lesions, including 46 cases of normal ovarian epithelial tissue, 105 benign serous tumors, 74 borderline serous tumors, 94 serous carcinomas, 58 benign mucinous tumors, 50 borderline mucinous tumors and 44 mucinous carcinomas. Associations between PCLP1 expression and various clinical characteristics were analyzed. Results: PCLP1 expression in mucinous carcinoma and borderline mucinous tumor tissues was found to be significantly lower than that observed in normal and benign mucinous tumor tissue. In addition, PCLP1 expression was significantly lower in mucinous carcinoma patients in advanced clinical stage and with poor differentiation of tumor cells. No positive results were observed in serous carcinomas. Conclusions: Our findings suggest that PCLP1 may be involved in the progression of ovarian mucinous lesions but not in serous lesions. Low PCLP1 expression may be a potential predictor of a poor prognosis in mucinous carcinomas.
Aurora Kinase B Expression in Breast Carcinoma: Cell Kinetic and Genetic Aspects
Authors: Hegyi Katalin , Egervári Kristóf , Sándor Zsuzsa , Méhes Gábor
Published: June 2012

Background: Mitotic deregulations may contribute significantly to cell division errors and the development of aggressive tumor cells. The mitotic kinase Aurora B is essential for chromosome segregation. Its gene is located at 17p13 in close proximity to the TP53 gene. Although the frequent alteration of this locus is well known, the information about the AURKB status and protein expression is limited. Methods: 50 breast carcinoma cases were evaluated for 17p13 status and chromosome 17 ploidy by FISH and for Aurora B protein by immunohistochemistry. Results: Aurora B protein expression showed a strong correlation with cell proliferation (regression coefficient = 0.77). Therefore, the Aurora B/MIB-1 index was used as a measure of expression, which showed a wide range (1–35%, mean 0.32, SD ± 0.28). A gain in the 17p13 chromosome locus could not be shown while a deletion was stated in 10/50 cases including a subset with TP53 and AURKB codeletion in 6/10 cases. The loss of TP53/AURKB loci strongly correlated with aneusomy (p < 0.0001). Conclusion: Elevated Aurora B expression frequently occurs due to an increased cell proliferation rate in breast carcinoma. Codeletion of TP53 and AURKB at 17p13 indicates a concerted mechanism leading to the survival of cell clones with deficient mitotic kinase function which could contribute to the formation of aneuploid cells and an aggressive tumor phenotype.
Both Pulmonary and Extra-Pulmonary Factors Predict the Development of Disability in Chronic Obstructive Pulmonary Disease
Authors: Singer Jonathan P. , Katz Patricia P. , Iribarren Carlos , Omachi Theodore A. , Sanchez Gabriela , Yelin Edward H. , Cisternas Miriam G. , Blanc Paul D.
Published: June 2012

Background: Although chronic obstructive pulmonary disease (COPD) is a major cause of disability worldwide, its determinants remain poorly defined. Objective: We hypothesized that both pulmonary and extra-pulmonary factors would predict prospective disablement across a hierarchy of activities in persons with COPD. Methods: Six hundred and nine participants were studied at baseline (T₀) and 2.5 years later (T1). The Valued Life Activities (VLA) scale quantified disability (10-point scale: 0 = no difficulty and 10 = unable to perform), defining disability as any activity newly rated ‘unable to perform' at T1. Predictors included pulmonary (lung function, 6-minute walk distance and COPD severity score) and extra-pulmonary (quadriceps strength and lower extremity function) factors. Prospective disability risk was tested by separate logistic regression models for each predictor (baseline value and its change, T₀-T1; odds ratios were scaled at 1 standard deviation per factor. Incident disability across a hierarchy of obligatory, committed and discretionary VLA subscales was compared. Results: Subjects manifested a 40% or greater increased odds of developing disability for each predictor (baseline and change over time). Disability in discretionary activities developed at a rate 2.2-times higher than observed in committed activities, which was in turn 2.5-times higher than the rate observed in obligatory activities (p < 0.05 for each level). Conclusions: Disability is common in COPD. Both pulmonary and extra-pulmonary factors are important in predicting its development.
A Familial History of Pulmonary Fibrosis in Patients with Chronic Hypersensitivity Pneumonitis
Authors: Okamoto Tsukasa , Miyazaki Yasunari , Tomita Makoto , Tamaoka Meiyo , Inase Naohiko
Published: June 2012

Background: Hypersensitivity pneumonitis (HP) is an immunologically mediated lung disease induced by the inhalation of a variety of antigens. Patients with chronic HP often have a family history of pulmonary fibrosis. This strongly suggests that both genetic and environmental factors play an important role in the pathogenesis of chronic HP. Objectives: We aimed to investigate the epidemiology and clinical features of chronic HP patients with a family history of pulmonary fibrosis. Methods: We retrospectively reviewed the clinical information of 114 cases diagnosed with chronic HP with insidious onset between 1992 and 2009. Results: Twenty cases (17.5%) were identified as having a family history of pulmonary fibrosis. All of these patients had lived apart from their afflicted relatives for at least several decades. The familial cases were younger than the nonfamilial cases at onset (57.5 ± 9.6 vs. 64.0 ± 7.0 years old, p = 0.008). The predicted vital capacity percentage and partial pressure of oxygen in arterial blood gas were significantly higher in the familial cases. There were no differences between the 2 groups in gender, smoking history, bronchoalveolar lavage fluid profile, radiologic findings or other clinical features. Conclusions: We found a familial clustering in patients with chronic HP. Various factors including genetic susceptibility to pulmonary fibrosis and environmental factors may contribute to the development of familial chronic HP.
TP53 Codon 72 and Intron 3 Polymorphisms and Mutational Status in Gastric Cancer: An Association with Tumor Onset and Prognosis
Authors: Neves Filho Eduardo Henrique Cunha , Cordeiro Denise Ellen Francelino , Vieira Ana Patrícia Freitas , Rabenhorst Silvia Helena Barem
Published: June 2012

Although TP53 alterations have been studied in human tumors, data considering the role of two common TP53 polymorphisms (Pro72Arg in codon 72 and Ins16bp in intron 3) and their associations with TP53 mutations in gastric cancer are very limited. Thus, we analyzed these parameters taking into consideration the clinicopathological data. DNA from 106 gastric tumor samples was available for TP53 Pro72Arg and TP53 Ins16bp polymorphism genotyping by PCR-RFLP and PCR, respectively. The mutational status of the TP53 exons 5–7 was assessed by the single-strand conformational polymorphism test. The TP53 72ArgArg genotype was statistically associated with patients aged ≥65 years (p = 0.039), and the intron 3 A2A2 genotype was correlated with late-stage tumors (III and IV; p = 0.043). Considering both polymorphisms, a negative correlation between the TP53 Pro-A1 haplotype and age <65 years (r = –0.211; p = 0.030) was found. Taking into account the TP53 mutations, the Pro/Pro genotype was positively correlated with the presence of exon 7 mutations (p = 0.049), and a correlation between this genotype and the number of mutations in TP53 was observed (p = 0.019). This study corroborates the understanding of TP53 polymorphisms in gastric carcinogenesis, especially regarding the genetic features in tumor onset and prognosis.
Myocardial Infarction-Prone Watanabe Heritable Hyperlipidemic Rabbits with Mesenteric Fat Accumulation Are a Novel Animal Model for Metabolic Syndrome
Authors: Shiomi Masashi , Kobayashi Tsutomu , Kuniyoshi Nobue , Yamada Satoshi , Ito Takashi
Published: June 2012

Objectives: To examine whether the myocardial infarction-prone Watanabe heritable hyperlipidemic (WHHLMI) rabbit with visceral fat accumulation is a new animal model for human metabolic syndrome, we examined the relationship between mesenteric fat accumulation and insulin resistance, hyperlipidemia and atherosclerosis. Methods: Glucose tolerance tests were performed using adult (11- to 15-month-old) and middle-aged (17- to 21-month-old) WHHLMI rabbits fed standard chow restrictedly. In addition, lipoprotein lipid levels, serum C-reactive protein (CRP) levels, mesenteric fat weight and physical and physiological parameters were measured. Mesenteric fat was stained immunohistochemically. Results: The mesenteric adipose tissue was positive for monoclonal antibodies against macrophages, C-reactive protein and monocyte chemoattractant protein. In adult rabbits, mesenteric fat correlated to aortic lesion area, insulin resistance, fasting immunoreactive insulin, serum CRP, abdominal circumference and body weight. In middle-aged rabbits, mesenteric fat correlated to lipoprotein lipid levels in addition to the parameters showing a significant correlation in adult rabbits, excluding aortic lesion area. Conclusions: The WHHLMI rabbit with visceral fat accumulation is a new animal model for metabolic syndrome.
Coarctation of the Aorta
Authors: GROSS ROBERT E.
Published: June 2012

Coarctation of the aorta can be recognized in most instances by simple findings of physical examination. The anomaly is one which carries a variable prognosis. The condition may be tolerated through a long life with little incapacitation or may be accompanied by early and serious complications in the form of cardiac failure, aortic rupture, or intracranial hemorrhage. In a high percentage of patients it is possible to remove the aortic block and establish a pathway of satisfactory size. A series of cases shows that there is an excellent chance of relieving hypertension by such surgery. Mortality rates for these operations have not been unduly high. Certain complicated types of cases carry too high a risk and should not be accepted for surgery.
The Intermediary Metabolism of Cholesterol
Authors: BLOCH KONRAD
Published: June 2012

Animal tissues synthesize cholesterol from metabolities of small molecular size, principally cholesterol. This synthetic process is known to take place in the liver but may also occur in other organs. In all tissues, with the exception of brain and nerve, cholesterol is continually regenerated. Cholesterol is the parent substance which the animal organism uses to produce bile acids, progesterone and possibly also other steroid hormones. The catabolism of cholesterol leads to the formation of several saturated, metabolically inert sterols, cholestenone presumably being the common intermediate.
Resection of an Aneurysm of the Arch of the Aorta with Preservation of the Lumen of the Vessel
Authors: MONOD OLIVIER , MEYER ANDRÉ
Published: June 2012

A case is reported of a 20 year old woman, without history, stigmata, or serologic evidence of syphilis, who presented a mediastinal mass just above and lateral to the arch of the aorta which was originally mistaken for tuberculous lymph nodes. The diagnosis of saccular aneurysm was made after direct puncture of this mass under pleuroscopy. Exploratory thoracotomy was performed and a saccular aneurysm of the terminal part of the arch of the aorta was found. The aneurysm was removed and the aorta sutured without interrupting the continuity of the artery or narrowing its lumen. The authors believe that this is the second successful resection of an aortic aneurysm and the first in which resection was accomplished with preservation of the lumen of the aorta.
Failure of Alpha Tocopherol to Influence Chest Pain in Patients with Heart Disease
Authors: RINZLER SEYMOUR H. , BAKST HYMAN , BENJAMIN ZACHARY H. , BOBB AUDRIE L. , TRAVELL JANET
Published: June 2012

Claims for vitamin E in angina pectoris have not been based on controlled observations. Even some negative reports have not been adequately controlled as to nonspecific factors. Hence, this study of the effects of alpha tocopherol on cardiac pain used a method of investigation carefully controlled as to psychologic factors which might affect the patient's response or the examiner's interpretation of results. The dose of synthetic alpha tocopherol acetate (300 mg. by mouth daily for two or more months) was the same as that recommended by advocates of this form of therapy as optimum in most cases. The results failed to indicate that the vitamin possessed any advantage over the placebo for treatment of either effort angina or mixed types of cardiac and somatic chest pain.
Commissurotomy for Mitral Stenosis
Authors: GLOVER ROBERT P. , O'NEILL THOMAS J. E. , BAILEY CHARLES P.
Published: June 2012

The term "mitral commissurotomy" has been suggested to designate a procedure in which the individual anatomic leaflets of the stenotic mitral valve are surgically separated. By incising the angles or commissures of the mitral slit ("fish-mouth") a considerable degree of valve function can be re-established without the production of additional significant regurgitation. Commissurotomy, as described below, was performed in 8 cases of advanced mitral stenosis. Results in 5 were most satisfactory. There were three deaths early in our experience during the period when our technic was being perfected. (Noted in addendum are 22 cases undergoing the operation since this article was submitted for publication, and bringing the total series to 30.)
Catheterization of the Left Side of the Heart in Man
Authors: ZIMMERMAN HENRY A. , SCOTT ROY W. , BECKER NORMAN O.
Published: June 2012

The technic employed in catheterization of the left heart in man is described. A catheter is introduced into the left ulnar artery and passed through the brachial, axillary and subclavian arteries into the arch of the aorta. With the tip of the catheter at the root of the aorta, we have succeeded in entering the left ventricle only in patients with free aortic insufficiency due to syphilis. Failure to pass the aortic valves in normal subjects is discussed.
A Study of the Venous Pulse in Tricuspid Valve Disease
Authors: MESSER ADDISON L. , HURST JOHN WILLIS , RAPPAPORT MAURICE B. , SPRAGUE HOWARD B.
Published: June 2012

Diagnosis of lesions of the tricuspid valve is often difficult. Mechanically, however, the action of this valve is capable of study through its effect upon the peripheral veins, somewhat as the disturbances of the aortic valve are reflected in the peripheral arteries. The conditions to be differentiated are "organic" versus "functional" regurgitation, and obstruction of the valve from rheumatic stenosis. Graphic records of the venous pulse with suitable reference tracings may make this possible.
Myocardial Lesions Produced by Digitalis in the Presence of Hyperthyroidism: An Experimental Study
Authors: DEARING WILLIAM H. , BARNES ARLIE R. , ESSEX HIRAM E.
Published: June 2012

Calculated therapeutic doses of digitalis and its derivatives did not produce demonstrable microscopic changes in the myocardium of experimental animals. Toxic doses of digitalis (twice a therapeutic dose) induced myocardial lesions in animals. In those animals with experimentally induced mild to moderate hyperthyroidism, calculated therapeutic doses of digitalis did produce myocardial lesions. Toxic doses of digitalis administered to animals with mild to moderate hyperthyroidism caused extensive degenerative changes in the myocardium or promptly killed the animals without associated microscopic lesions.
The Relationship between the Arterial Oxygen Saturation and the Cardiovascular Response to Induced Anoxemia in Normal Young Adults
Authors: PENNEYS RAYMOND , THOMAS CAROLINE BEDELL
Published: June 2012

The induced anoxemia test of cardiovascular function has been standardized according to the
degree of anoxemia
rather than the oxygen concentration of the gas mixture administered. The cardiovascular response of normal subjects at 80, 75 and 70 per cent arterial oxygen saturation is described. The changes can be closely correlated with the degree of anoxemia, as measured by the oximeter.
Correlation of the Oxygen Saturation of the Blood and Changes in the Electrocardiogram, Blood Pressure, and Heart Rate During the Anoxemia Test
Authors: MATHERS JAMES A. L. , LEVY ROBERT L.
Published: June 2012

During the performance of a series of anoxemia tests the oxygen saturation of the blood has been determined by means of the Millikan oximeter. The levels of hypoxemia induced have been correlated with various other factors. The results are considered with particular reference to a possible critical range, within which changes in the circulation occur.
Peripheral Circulatory Changes as Criteria for Hemorrhagic Shock Therapy
Authors: ZWEIFACH B. W.
Published: June 2012

This study of hemorrhagic shock syndrome in dogs evaluates commonly used therapeutic procedures on the basis of ability to correct specific vascular decompensatory episodes associated with progressive refractoriness to blood transfusion. Using specific criteria (vasomotion, responsiveness to vasoconstrictor stimuli, tone of arterioles and venules and capillary blood flow), it was found that pressor drugs improved blood pressure only at the expense of peripheral circulation. However, drugs such as angiotonin and especially pitressin, when added to the transfusion medium in subpressor concentrations sufficient to produce only a tonic narrowing of the terminal arterioles, brought sustained improvement in blood flow through the omental vessels. That the prognosis for successful treatment of the circulatory collapse closely parallels the sequential changes which occur in the terminal vascular bed, adds further significance to the probable causal relationship between the observed vascular derangements and the ultimate collapse of the peripheral circulation.
Studies of the Renal Circulation
Authors: KAHN JOSEPH R. , SKEGGS LEONARD T. , SHUMWAY NORMAN P.
Published: June 2012

This work represents an attempt to confirm reported observations of a juxtamedullary by-pass in the kidneys of animals subjected to various physiologic procedures and to shock. Rabbits injected with epinephrine, pitressin, renin and hypertensin, made hypotensive by bleeding and inhalation of amyl nitrite, and after stimulation of one sciatic nerve, were injected with india ink. The kidneys were removed and studied for the paths of blood flow. No evidence of a by-pass mechanism through the juxtamedullary glomeruli was found.
The Effect of Meals on the Electrocardiogram and the Ballistocardiogram in Patients with Angina Pectoris
Authors: BERMAN BERNARD , BRAUNSTEIN JOHN R. , MCGUIRE JOHNSON
Published: June 2012

The effect of meals on the electrocardiogram and the ballistocardiogram was studied in 59 patients with angina of effort. Approximately one-fourth of the group showed a 0.5 to 1.0 mm. depression of the S-T segment, while the normal controls did not show this change. Premature ventricular contractions and inversion of the T wave were found more frequently in patients with angina following meals than in normal individuals. The patients with angina were unable to increase the cardiac output significantly following meals as compared to normal individuals. It is suggestetd that these findings may prove to be of value in evaluating cardiac function in patients with angina.
A New X-ray Technic for Visualization of the Heart and Great Vessels
Authors: MCALLISTER FERDINAND F. , BECK CLAUD S.
Published: June 2012

A new roentgenographic technic is described, utilizing a balloon fitted over the opening of a cardiac catheter; the latter may then be threaded into the heart chambers via a superficial vessel. Momentary inflation of the balloon with air or a contrast medium outlines the heart chambers for x-ray exposure.
Tracer Studies of the Urinary Excretion of Radioactive Mercury following Oral Administration of a Mercurial Diuretic
Authors: OVERMAN WILLIAM J. , GORDON WILLIAM H. , BURCH G. E.
Published: June 2012

This report presents experimental evidence of the inefficient intestinal absorption of mercury following the oral administration of a mercurial diuretic. Radiotracer technic was employed using a diuretic prepared with radioactive mercury. Both control subjects and subjects with congestive heart failure were shown to absorb only a small percentage of the mercury administered by the oral route.
Experience with Thiomerin, A New Mercurial Diuretic
Authors: STEWART HAROLD J. , MCCOY HERBERT I. , SHEPARD EDWARD M. , LUCKEY E. HUGH
Published: June 2012

Thiomerin, a new mercurial diuretic, was given subcutaneously to 109 patients in whom fluid accumulations were present. Most patients suffered from congestive heart failure. It was used first under close supervision in hospitalized patients and later in ambulatory patients. In certain patients it was possible to compare the diuretic response to Thiomerin given subcutaneously with that to Mercuzanthin and/or Mercuhydrin given intramuscularly or intravenously. The untoward effects of these mercurial diuretics were compared with those caused by Thiomerin. The advantages of a subcutaneous mercurial diuretic are pointed out.
A Comparison of Electrokymography and Roentgenkymography in the Study of Myocardial Infarction
Authors: DACK SIMON , PALEY DAVID H. , SUSSMAN MARCY L.
Published: June 2012

The authors present two cases of myocardial infarction to demonstrate that electrokymography is superior to roentgenkymography as a method for detecting localized areas of myocardial damage. This superiority is based principally on greater ease of exploration of the ventricular pulsations, clearer delineation of the kymographic curve as a result of greater magnification, and more accurate analysis of the phases of the cardiac cycle by simultaneous recording and integration with other graphic tracings.
Studies of Plasma Quinidine Content
Authors: KALMANSOHN RICHARD W. , SAMPSON JOHN J.
Published: June 2012

The plasma quinidine curves obtained by the oral and intramuscular routes of administration of 0.6 Gm. quinidine sulfate and 0.65 Gm. quinidine lactate, respectively, were generally similar. Maximal concentration, averaging 3.2 mg. per liter in the former group occurred from one-half hour to four hours after administration, and in the latter averaged 2.6 mg. per liter in one to three hours. Significant quantity of quinidine remained at eight hours, and small amounts at twenty-four hours. Rectal administration of 0.6 Gm. quinidine sulfate resulted in lower concentrations, the maximum averaging 0.89 mg. per liter. The chief value of intramuscular quinidine therapy appears to be the avoidance of gastrointestinal irritation, but hypotensive reactions were relatively frequent in the small series of patients studied.
Congenital Heart Disease with Septal Defects in which Paradoxical Brain Abscess Causes Death
Authors: SANCETTA SALVATORE M. , ZIMMERMAN HENRY A.
Published: June 2012

The presence of septal defects in congenital heart disease makes for a direct shunting of particulate matter from the venous to the arterial side of the circulation. In reviewing the literature we have been surprised to find that this phenomenon, with resultant brain abscess, has been second only to bacterial endocarditis as a septic cause of death. The subject deserves attention from the view-point of early diagnosis and cure, since the reported mortality has been almost 100 per cent.
Spontaneous Rupture of a Peripheral Artery: Report of Case
Authors: POLLACK ALBERT A. , HINES EDGAR A. , JANES JOSEPH M.
Published: June 2012

The case history of a patient with apparent spontaneous rupture of the posterior tibial artery is presented, with a brief review of the previously reported cases.
The Relationship of the Degree of Coronary Atherosclerosis with Age, in Men
Authors: WHITE NEIL K. , EDWARDS JESSE E. , DRY THOMAS J.
Published: June 2012

The amount of coronary atherosclerosis in each decade from 30 to 89 years of age, in the male, is evaluated. A large number of hearts were examined in great detail to increase accuracy. The results reveal that the degree of coronary atherosclerosis is not primarily related to age as is commonly assumed. The effect of cardiac hypertrophy on coronary atherosclerosis is also discussed.
The Use of Tetraethylammonium Chloride as a Vasodilator in Peripheral Vascular Disease; Its Effect on Sympathectomized Extremities
Authors: MASSELL THEODORE B. , ADOLPH WILLIAM E. , FRENCH JAMES B.
Published: June 2012

The thermometric and plethysmographic response to Etamon administration was studied in 13 patients with peripheral vascular disease, comparing it with that of procaine injection into the sympathetic ganglia. The administration of Etamon caused an average temperature rise of 7 degrees F. and a pulse volume increase of 1.3 cu. mm. per 5 cc. of part. Procaine block resulted in a temperature rise of 13.5 degrees F. and a pulse volume increase of 5.5 cu. mm. Etamon was given to 11 vascular patients after sympathectomy and caused an average temperature rise of 0.5 degrees F. in the sympathectomized extremities, while the pulse volume actually decreased by an average of 0.7 cu. mm. per 5 cc. of part.
Erythromelalgia Treated with Posterior Pituitary Extract: Report of a Case
Authors: METZ M. HILL
Published: June 2012

Erythromelalgia is a rare vasomotor neurosis of the extremities, with no accepted form of treatment. Posterior pituitary desiccated powder administered by nasal insufflation has a vasoconstricting action lasting for eight to twelve hours. With the use of this agent, one patient was protected from the incapacitating symptoms of erythromelalgia during the summer months.
Sensitivity of the Supraventricular Pacemakers to Acetylcholine in Acute Hypoxemia
Authors: CALLEBAUT C. , RODBARD S. , KATZ L. N.
Published: June 2012

Severe hypoxemia enhances the effect of endogenous and exogenous acetylcholine to depress the supraventricular pacemakers and conduction pathways, as shown in experiments on dogs.
Bernheim's Syndrome: Report of a Case
Authors: ATLAS DONALD H. , EISENBERG HERMAN L. , GABERMAN PETER
Published: June 2012

In the controversial Bernheim's syndrome, right ventricular failure can be produced by hypertrophy and dilatation of the left ventricle with encroachment of the intraventricular septum into the cavity of the right ventricle, forming a barrier to the flow of blood into the right ventricle. A case is reported in which this syndrome was diagnosed during life and confirmed at autopsy. Hearts of similar weight with left ventricular hypertrophy were sectioned in the same plane for comparative purposes.
Rupture of a Papillary Muscle of the Heart; Report of Two Cases
Authors: SMITH JOHN CHANDLER
Published: June 2012

The paper presents clinical and pathological data on 33 cases of ruptured papillary muscle of the heart as revealed by review of the literature. All of the known causes of this event are listed and the characteristic clinical features are emphasized by including two additional typical case reports.
Sarcoidosis of the Heart
Authors: KULKA WILLIAM E.
Published: June 2012

Sarcoidosis (Benier-Boeck's disease) is not limited to skin or eye as once thought. Now it is known to be a chronic granuloma of the reticulo-endothelial system, dispersing tubercle-like nodes over all organs. Assumption of benignity had to be abandoned. Supporting proof that it can be the cause of death is this report of an autopsy of a young woman following sudden death due to extensive sarcoidosis of the heart, with miliary nodes scattered in most of the organs. No signs of tuberculosis could be found.
A Case of Marked Dilatation of the Pulmonary Arterial Tree Associated with Mitral Stenosis
Authors: SEGALL S. , RITTER I. I. , HWANG W.
Published: June 2012

A case which was studied with the technic of catheterization is discussed as a problem in the diagnosis of this syndrome.
Primary Myosarcoma of the Heart
Authors: FRIEDLANDER SAUL , HEIN GORDON E. , SIEMENS JOHN C.
Published: June 2012

Precordial pain and pericarditis were the early manifestations of this cardiac tumor. Discovery of bony metastases preceded detection of a rapidly growing intrathoracic mass, erroneously considered a bronchiogenic carcinoma invading the heart. Changing murmurs, chest pain, transient arrhythmia, intermittent fever, and progressive weight loss were the outstanding clinical features. Necroscopy revealed a primary cardiac tumor with metastases to pelvic bones, vertebrae, and lung, as well as malignant carcinoids and heterotopic pancreatic tissue.
Studies of Tissue Response to Injections of Enzymes
Authors: SCHLAMOWITZ SAMUEL T. , MORRISON EVELYN , SCHUBERT MAXWELL
Published: June 2012

Hyaluronic acid, a mucopolysaccharide, is present in a variety of tissues, including the skin, vitreous humor, and synovial fluid. It is depolymerized and hydrolyzed by hyaluronidase, with the liberation of a hexosamine and glucuronic acid. A significant elevation of tissue hexosamine occurred at the injection sites and in the subsequent "nodules" following the subcutaneous injection of trypsin. The subcutaneous injection of hyaluronidase alone caused no change; it was rapidly and completely diffused. The subcutaneous "nodules" and significant hexosamine changes which developed at the sites where trypsin was injected into a hyaluronidase-treated area closely resembled those which occurred with tryspin alone. Of interest is the significant leukocytosis which occurred
only
in those rabbits which received both hyaluronidase and trypsin.
QRS-T Patterns in Multiple Precordial Leads that May Be Mistaken for Myocardial Infarction
Authors: MYERS GORDON B.
Published: June 2012

The electrocardiograms of patients in whom myocardial infarction was excluded at autopsy are presented to bring out the following features of left ventricular hypertrophy that may be mistaken for myocardial infarction: (1) QS patterns and/or abnormal RS-T elevation in leads from the right precordium; (2) abnormal Q waves, multiphasic QRS and/or cove plane inversion of the T waves in leads from the transitional zone; (3) prominent Q waves, marked RS-T depression and/or sharply inverted T waves in leads from the left axilla.
The Relationship of Unipolar Chest Leads to the Electrical Field of the Heart
Authors: GRANT ROBERT P.
Published: June 2012

Using a method for measuring the electrical forces of the human heart in three dimensional space, studies of the precordial leads are reported which were designed to determine whether these deflections are principally measurements of the electrical field of the heart as a whole or are dominated by the forces from the region of the heart immediately beneath the electrode. It was found that the former was the case, which leads to a simpler and more rational method for interpreting the electrocardiogram than has been available heretofore.
A Study of the Spatial Vectorcardiogram in Left Bundle Branch Block
Authors: PANTRIDGE J. FRANK , ABILDSKOV J. A. , BURCH G. E. , CRONVICH J. A.
Published: June 2012

A method of vectorcardiography, in which the projections of the spatial vectorcardiogram in various planes of an equilateral tetrahedron reference system are recorded, has been applied to the study of left bundle branch block. Results suggest that the method employed may provide information relative to the state of the myocardium and the extent of myocardial lesions which is not evident from electrocardiographic examination.
Factors Influencing the Time of Appearance of Premature Systoles (Including a Demonstration of Cases with Ventricular Premature Systoles due to Re-entry but Exhibiting Variable Coupling)
Authors: MACK I. , LANGENDORF R.
Published: June 2012

The genesis of the most common cardiac arrhythmia, that due to premature systoles, still remains obscure. Observations made upon two patients with ventricular premature systoles are reported because of some unusual features of their timing which shed some light upon the mechanism behind the appearance of premature systoles, regardless of the extrasystolic impulse. The theories of the extrasystolic irregularities are reviewed with particular attention to the criterion of "fixed coupling" generally used to distinguish between premature systoles explained by a re-entry mechanism and those explained by a parasystolic pacemaker.
A Case of Paroxysmal Auricular Tachycardia with Block Present almost Continuously for Twenty-Five Years
Authors: SCHWARTZ WILLIAM B. , LEVINE SAMUEL A.
Published: June 2012

The following case report is that of a man who showed electrocardiographic and clinical evidence of paroxysmal auricular tachycardia with block most of the time during a twenty-five year period of observation. The auricular rate was almost always in the vicinity of 200 per minute and the A-V ratio varied between 1 to 1 and 1 to 4. On only one brief occasion was there evidence of congestive failure. He was able to go through two major surgical operations without any difficulty and at present at the age of 79 years he is still ambulatory without cardiac symptoms.
Paroxysmal Tachycardia
Authors: BELL GEORGE O. , BRADLEY ROBERT B. , HURXTHAL LEWIS M.
Published: June 2012

An interesting case of recurrent paroxysmal tachycardia is presented. The patient had had a previous coronary thrombosis, leaving in its wake a residual left bundle branch block. Three episodes of paroxysmal tachycardia were observed, the longest one of sixty-three days' duration. Although ventricular origin of the tachycardia was thought to be most likely, a nodal origin was also considered. All forms of therapy were tried but only intravenous quinidine proved to be successful. Experiences with massive doses of quinidine intravenously are presented.
Direct Electrocardiograms from the Human Heart in Situ. Comparison of Direct Leads with Precordial Leads
Authors: HEIN GORDON E. , REAVIS JAMES C.
Published: June 2012

The clinical value of multiple precordial leads has been proved abundantly and they are now used routinely in many electrocardiographic laboratories. The experimental background was based upon the correlation of precordial leads with direct leads in dogs. Direct leads from the surface of human hearts have rarely been reported. The present study is presented to add further justification to the use of precordial leads as "semidirect" leads in the human being.
Electrocardiographic Changes in a Case of Left Ventricular and Septal Hypertrophy Resembling Anterior Myocardial Infarction
Authors: BENCHIMOL AARON BURLAMAQUI , SCHLESINGER PAUL
Published: June 2012

In certain instances of left ventricular hypertrophy, deep Q waves observed in the precordial electrocardiogram may resemble those of anterior myocardial infarction. Such a case is reported in a patient with syphilitic aortic insufficiency. Pathologic examination ruled out the diagnosis of infarction and revealed marked hypertrophy of left ventricular wall and the interventricular septum. The latter was of unusual degree and was probably responsible for the presence of large Q waves in precorldial leads representing, the normal activation of the upper part of the interventricular septum which in cases of septal hypertrophy presumably originates a vector of greater magnitude.
Electrocardiographic Changes in Pulmonary Collapse Therapy
Authors: SILVERBERG CHARLES , FELDMAN DAVID
Published: June 2012

The effect of thoracoplasty and phrenemphraxis upon the electrocardiographic pattern of tuberculous patients was studied. Alteration in the size of QRS complexes resulted in variable changes in the mean electrical axis. Some alterations in T waves occurred in all leads, occasionally resulting in inversion of the T waves in Leads CF
2
, CF
4
and/or CF
5
. There was no pattern characteristic of any of the collapse procedures studied.
Long-Term Dicumarol Therapy to Prevent Recurrent Coronary Artery Thrombosis
Authors: NICHOL E. STERLING , BORG JOSEPH F.
Published: June 2012

Seventy-eight patients were given long-term dicumarol therapy after one or more attacks of myocardial infarction to see whether recurrent attacks could be warded off. Encouraging results ensued over periods up to five years. Protocols of 12 fatal cases are given, only 4 of whom had recurrent acute coronary thrombosis. Hemorrhagic complications met with are analyzed. Ambulatory treatment is shown to be feasible if patients are painstakingly followed.
Hypothyroidism Produced by Radioactive Iodine (I
131
) in the Treatment of Euthyroid Patients with Angina Pectoris and Congestive Heart Failure
Authors: BLUMGART HERRMAN L. , FREEDBERG A. STONE , KURLAND GEORGE S.
Published: June 2012

Hypothyroidism, induced by I
131
to lessen the work of the heart, is proposed as a means of treating certain patients with angina pectoris and congestive failure who are refractory to the standard medical measures. Eighteen such patients have been treated. The period of follow-up averages thirteen months. Eight of the 13 patients with angina pectoris and 3 of 5 patients with congestive failure showed worthwhile improvement. In 6 of the 18 patients, the improvement was striking. Tentative criteria for the selection of patients, their pre- and post-treatment management, and detailed descriptions of the results are presented.
Review of Single Coronary Artery with Report of 2 Cases
Authors: SMITH JOHN CHANDLER
Published: June 2012

The paper includes a discussion of all published cases of single coronary artery and a consideration of the embryologic development and physiologic significance of this anomaly. The incidence and types of associated cardiac diseases are reviewed. Two additional case reports of this anomaly are included.
Heparin in Experimental Myocardial Infarction
Authors: ROBERG NORMAN B. , REQUARTH WILLIAM H.
Published: June 2012

Heparinization, started one hour following coronary ligation, was maintained for twenty-four hours. One week after recovery the hearts were perfused in vivo with india ink. After clearing, the proportion of ventricular mass infarcted was determined. No appreciable difference from the control series was found.
Preliminary Report on the Clinical Use of a New Anticoagulant, Phenylindandione
Authors: BLAUSTEIN ANCEL U. , CROCE JAMES J. , ALBERIAN MARIE , RICHEY NEIL
Published: June 2012

Heparin and dicumarol are both useful drugs but each has its limitations and accordingly search goes on for newer drugs that lack some of these limitations. A new anticoagulant, phenylindandione produces a prothrombopenia more rapidly than dicumarol and its catabolism is equally more rapid. This, therefore, aroused interest in clinical trials utilizing this new prothrombopenic agent. The drug is a light yellow, crystalline compound put up in tablet form and administered by mouth.
Augmentation of Vasoactive Substances by Tetraethylammonium Chloride
Authors: PAGE IRVINE H. , TAYLOR ROBERT D.
Published: June 2012

This investigation attempts to demonstrate the mechanism by which substances that block autonomic ganglionic transmission increase the pressor and depressor activities of a variety of drugs. Short-lived hypertension and a high degree of vascular responsiveness is induced by combining cord destruction, inactivation of the carotid sinus mechanism and nephreetomy. The increased responsiveness is found to be due to removal of the compensatory nervous mechanisms which tend to oppose changes in blood pressure. It may be reduced or abolished by hepatectomy, severe hypotension and shock.
A Comparison of Cardiac Output Determined by the Fick Procedure and a Direct Method Using the Rotameter
Authors: SEELY ROBERT D. , NERLICH WILLIAM E. , GREGG DONALD E.
Published: June 2012

Experiments were performed on the anesthetized dog to determine the accuracy of the widely used Fick procedure. Cardiac output values, recorded by an optical rotameter, served as a reliable standard for comparison. Under the conditions of these experiments, comparisons showed excellent agreement. The average variation between the two series of the measurements was ±5 per cent. Twelve of thirteen comparisons agreed within less than ±8 per cent. This small deviation was within the range of error which might have existed on the basis of known technical inaccuracies.