bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrocardiograms of Deceptive Form in Ventricular Hypertrophy
Authors: KOSSMANN CHARLES E.
Published: June 2012

(Since 1911, a monthly clinical or clinical pathologic conference has been held for the clinical clerks—volunteer third and fourth year medical students—and staff of the oldest known clinic for the care of ambulatory cardiac patients in existence.
1
At each of the conferences held on Oct. 30, 1952 and Nov. 20, 1952, a case was presented which displayed during life an electrocardiogram with a configuration quite the opposite of what might be expected from the type of ventricular hypertrophy found after death. Since in one instance the hypertrophy was of the right ventricle and in the other of the left, the fortuitous and instructive coincidence seemed worth recording especially for the purpose of re-emphasizing the undesirability of making anatomic deductions from a purely physiologic method. The proceedings of the two conferences have been condensed into one.)
The Relation of Age to Certain Electrocardiographic Responses of Normal Adults to a Standardized Exercise
Authors: SILVER HAROLD M. , LANDOWNE MILTON
Published: June 2012

To demonstrate what may be expected in individuals who do not show clinical evidences of heart disease, the authors present a quantitative evaluation and physiologic interpretation of data obtained from 60 male subjects. Age differences are described. Decreases in S-T and in T occurred in most subjects. The S-T depression is not necessarily ascribable to injury, and no discontinuity of distribution is discovered to justify calling any of the observed responses "abnormal." The results emphasize the limitations to interpretation of information which is not highly specific, in subject material where no primary standard of diagnosis has been established.
The Kinetocardiogram
Authors: EDDLEMAN E. E. , WILLIS KATHRYN
Published: June 2012

The distribution of the various motions of the anterior chest wall during the cardiac cycle has been studied, with particular reference to their magnitude in normal subjects. A few recordings of the posterior chest wall motions are included. Analysis of the type of distribution and localization of certain motions suggest their origin in terms of response of the chest wall to cardiac forces.
A Method of Securing the Direct Body Ballistocardiogram by Means of a Microscope, Giving a Record Readily Calibrated
Authors: BIXBY E. W. , HENDERSON C. B.
Published: June 2012

We describe a simple method of recording the direct body ballistocardiogram by means of a microscope and a powerful light source. The beam passes through a slit attached to the body, and the image of this moving slit is magnified by the microscope and focused on moving photographic paper. When a static force is applied to the body, the base line of the record is permanently displaced and so the amplitude of the ballistocardiogram can be calibrated. By superimposing a ballistocardiogram obtained by means of the electrocardiogram on the same film, accurate comparisons of the two records and a calibration of the electrical instrument can be obtained.
Torsion Ballistocardiography: With Special Reference to Patterns in Surgically Amenable Cardiovascular Diseases
Authors: REISSMANN KURT R. , DIMOND E. GREY
Published: June 2012

The recoil forces generated in the circulatory system were converted into a momentum (torque) by using a table supported by a single steel bar in its center. With such a torsion ballistocardiograph, information can be obtained on the site of origin of the forces and on their direction, because the amplitude of the table is proportional to the product force times lever arm (distance from the center of rotation), and the latter can be varied by placing the subject in various positions relative to the center of rotation. The limitations of ballistocardiography in general arise mainly from the complexity of the system of three oscillators (heart, body, table) in which the elastic and damping properties of the body are presently unknown. These limitations are discussed.
The Significance of the Intermediate Korotkoff Sounds
Authors: RODBARD SIMON
Published: June 2012

Except for those sounds that mark the systolic and diastolic blood pressure levels, the murmurs during sphygmomanometry are generally ignored. Our studies suggest that the intensity and duration of these murmurs provide an appraisal of the blood flow into the part beyond the cuff under certain conditions.
The George E. Brown Memorial Lecture
Authors: BARR DAVID P.
Published: June 2012

In this lecture a partial and tentative examination has been made of chemical factors possibly important in the pathogenesis of atherosclerosis. The discussion has centered about four observations concerning the incidence and extent of the disease. The first is that man appears to be unique among mammals in his predisposition; the second, that the condition is seldom if ever seen in the human infant at birth; the third, that healthy women are not likely to develop its complications before the time of the menopause; the fourth, that in man certain maladies and particularly diabetes, familial xanthomatosis, and nephrosis favor early and extensive atheromatous deposits.

An attempt has been made to relate present knowledge of lipid composition of the blood to known variations in the degree of predisposition to the disease. This has included scrutiny of observations on concentration of cholesterol and the S
f
10-20 bodies of Gofman, on cholesterol-phospholipid ratios and on the distribution of cholesterol between the lipoproteins of plasma.

It has been shown that in mammals which never develop spontaneous atherosclerosis the values of all the criteria of concentration and distribution of lipids differ from those of man. Among human beings only the infant at birth has plasma which in its lipid composition closely resembles that of immune mammals. In young women the deviation is less than in other human adults. In groups of patients that display the greatest tendency to the development of atherosclerosis, the plasma lipid patterns differ most widely from those of other mammals.

Among survivors of myocardial infarction many but not all display striking abnormalities in every one of the criteria of lipid concentration and distribution. Comparison of the different methods indicates that in survivors of infarction the distribution of cholesterol between the lipoproteins is more constantly disturbed than the other chemical factors. No test however deviates with sufficient constancy to permit its use in the clinical diagnosis either of the presence of atherosclerosis or of a tendency to its development.

It has been shown that the lipid patterns in man are not immutable but can be manipulated to a considerable degree. Specifically, it has been demonstrated that the administration of estrogen can convert the highly pathologic patterns of survivors of myocardial infarction to normal adult human values, and that the use of methyl testosterone exaggerates the chemical pathology of myocardial infarction and may even produce deviant patterns in those who have been previously normal.

Although the observations which have been reviewed offer strong evidence that predisposition to atherosclerosis is related to deviations in the lipid composition of the blood, they do not establish the chemical hypothesis of pathogenesis. Although at present they lead to no practical applications in therapy, they are regarded as worthy of further investigation with a justifiable hope that greater knowledge may offer new clues to prevention and control.
Platelet Thrombosis Syndrome
Authors: VASSAR PHILIP S. , SPAIN DAVID M.
Published: June 2012

This paper reports the clinical and pathologic manifestations of seven cases of platelet thrombosis syndrome. Evidence is presented to indicate that vascular damage precedes the formation of platelet thrombi. It is suggested that the syndrome may be secondary to a variety of underlying disease entities.
Studies of Human Peripheral Blood Flow: The Effect of Injection Volume on the Intramuscular Radiosodium Clearance Rate
Authors: WARNER GEORGE F. , DOBSON ERNEST L. , PACE NELLO , JOHNSTON MURIEL E. , FINNEY CAROLINE R.
Published: June 2012

The effects of changes in injection volume on the intramuscular radiosodium clearance rate was investigated in six normal young men. The clearance rate was found to be quite sensitive to the volume of solution injected, and an increase in the rate of clearance corresponding to a decrease in volume was uniformly noted. Rigid control of the injection volume is necessary when this method is used for regional blood flow measurements.
Magnetic Tape Recording Electrocardiograph
Authors: PROUDFIT WILLIAM L. , DOBOSY JOSEPH F.
Published: June 2012

A method of recording the electrocardiogram on magnetic tape is described and possible applications are mentioned.
A Ballistocardiographic Study of Healthy Young Adult Males
Authors: ABRAMS WILLIAM B. , EDGER HERBERT D.
Published: June 2012

Ballistocardiograms were obtained from 319 well-screened young soldiers on an electrically equalized electromagnetic ballistocardiograph. The records were analyzed for the basic pattern and for variations. The conventional criteria of normal were confirmed. The most frequently observed variation consisted of changes in complexes written during expiration which, when of sufficient degree, resemble those described as abnormal. Prominent L waves were also common. Variations of the J and K waves were rare. A grade 1 or 2 abnormality was noted on 22 records, but when respiration was suspended, only three remained questionably abnormal.
Further Studies in High Fidelity Electrocardiography: Myocardial Infarction
Authors: LANGNER PAUL H.
Published: June 2012

High fidelity electrocardiography employing the cathode ray oscillograph with an expanded time scale reveals considerable high frequency notching, slurring, beading, and other peculiarities not seen in the conventional electrocardiographic records on the same individuals. Although some of these cathode ray records contain components whose frequencies are well in excess of 1000 cycles per second, in this paper a frequency analysis will not be reported but rather the electrocardiograms will be presented as patterns with unique detail that is readily apparent even to the casual observer. Using this technic it was found that 14 of 21 individuals with healed myocardial infarction had a greater incidence of obvious high frequency components in their cathode ray electrocardiograms than was found in a series of 60 normal controls. The possible significance of this finding and the need for further study are discussed.
Intermittent Claudication of the Hip and the Syndrome of Chronic Aorto-Iliac Thrombosis
Authors: DEWOLFE VICTOR G. , LEFEVRE FAY A. , HUMPHRIES ALFRED W. , SHAW MALIN B. , PHALEN GEORGE S.
Published: June 2012

It is the purpose of this paper to report the not too widely known clinical symptom of hip claudication and its relationship to aortic and iliac artery occlusions. The importance of aortography in the diagnosis of this syndrome is stressed and a technic is described. The results and findings differ from previous reports in the literature and these variations are discussed.
The Spatial QRS and T Vector in 178 Normal Middle-Aged Men
Authors: SIMONSON ERNST , KEYS ANCEL
Published: June 2012

From the means and standard deviations of the coordinates of the spatial QRS and T vectors in 178 normal middle-aged men, preliminary normal range limits were calculated for the total group, three positional subgroups, and three relative body weight groups. The superiority of spatial vector analysis over analysis of the scalar electrocardiogram made it possible for the first time to investigate meaningful correlations between electrocardiographic variables, such as the relationship between the magnitude of QRS and T vectors. The relationship between fundamental constitutional variables and spatial vectors was also investigated as background necessary for the diagnostic use of spatial vectors.
Commissurotomy for Rheumatic Aortic Stenosis
Authors: BAILEY C. P. , BOLTON H. E. , JAMISON W. L. , NICHOLS H. T.
Published: June 2012

As long ago as the middle of 1949 it had been demonstrated by the senior author that any blunt dilating mechanism applied within the stenotic aortic orifice would, upon expansion, force the separation of one or more of the fused commissures. Thus the diminutive valve orifice could be enlarged without the creation of additional insufficiency and with the restoration of such part of the original valve function as the pathologic distortion of the leaflets would permit. In other words the principles and effectiveness of such an aortic commissurotomy would be comparable to those of the similarly named operation for mitral stenosis. It has remained for us finally to develop an instrument and a technic capable of implementing these concepts, and this has at last been accomplished.
Clinical Evaluation of Combined Hydrogenated Ergot Alkaloids (Hydergine) in Arterial Hypertension
Authors: TANDOWSKY RALPH M.
Published: June 2012

One hundred patients suffering from sustained arterial hypertension were studied over a period of two years during which time the action of parenterally administered hydrogenated ergot alkaloids (Hydergine) constituted the main drug therapy. An immediate transient reduction of both the arterial blood pressure and the pulse rate was demonstrated in over 80 per cent of the entire group within a period of two hours. The average reduction in systolic and diastolic pressure was 36 mm. and 12 mm., respectively, and the pulse rate was reduced 6 beats per minute. Of interest was a group of 22 patients presenting evidence of early central vascular derangement in whom these alkaloids seemed to accomplish their best therapeutic action and possibly aborted what may have been a sustained cerebral accident. Untoward effects were minimal because of rapid dissipation of the drug, and its use in all types of hypertensive disease was deemed safe in the recommended dosage.
Dibucaine Hydrochloride in the Control of K-Strophanthoside-Induced Ventricular Tachycardia and Other Toxic Manifestations
Authors: HARRIS A. SIDNEY , BISTENI ABDO , PETTIT GEORGE A. , HOFFPAUIR CALVIN W.
Published: June 2012

Dibucaine hydrochloride in relatively small doses terminated high frequency ventricular tachycardia induced by toxic doses of K-strophanthoside in 9 of 10 dogs. Dibucaine was antidotal to glycoside-induced vagotonia and improved the alertness and apparent general condition of the animals that received it. One death occurred in the 10 strophanthoside tachycardia animals treated with dibucaine, a mortality rate of 10 per cent. Four deaths occurred in seven dogs that received similar doses of strophanthoside but no dibucaine, a mortality rate of 57 per cent.
Quantitative Studies in Man of the Cardiovascular Effects of Reflex Vagal Stimulation Produced by Carotid Sinus Pressure
Authors: LINENTHAL ARTHUR J. , CAPLITZ LEE
Published: June 2012

In each of three individuals, carotid sinus pressure produced a shift of the control of the heart beat from the dominant pacemaker to an ectopic, slower or faster, site of impulse formation. In each instance, it was possible to measure the fundamental rates of the two practically simultaneous pacemakers over fairly wide ranges of variation in rate. A direct, linear relationship was found to exist.
A Clinical Estimation of the Blood Pressure in the Minute Vessels of the Human Skin by the Method of Elevation and Reactive Hyperemia
Authors: GILFILLAN RUTHERFORD S. , FREEMAN NORMAN E. , LEEDS FRANK H.
Published: June 2012

The filling pressure in the minute vessels of the skin of the foot has been estimated by a method of elevation and reactive hyperemia. A series of 90 observations was made on 78 patients. This test has been found helpful in evaluating the degree of arterial insufficiency, permitting a more accurate selection of patients to be treated by conservative methods, local amputation or more radical procedures.
Tumor Metastasis to the Heart
Authors: YOUNG J. M. , GOLDMAN I. RALPH
Published: June 2012

This article is a survey of 476 consecutive cases of tumor death for heart involvement. The somewhat selected group of cases (from a Veterans Administration hospital) shows an incidence of cardiac metastasis of 19.1 per cent. The bulk of tumors metastasizing to the heart were bronchogenic carcinoma, malignant melanoma, malignant lymphoma, and carcinoma of the pancreas and esophagus. Electrocardiographic changes were frequent and correlated fairly closely with the anatomic extent of the disease. The related literature is reviewed.
Clinical Experience with a New Anticoagulant, Dipaxin (2-diphenylacetyl-l,3-indandione)
Authors: PASCALE LUKE R. , OLWIN JOHN H.
Published: June 2012

Prothrombin levels as measured by the one-stage whole-plasma and the two-stage technics were followed in 80 patients receiving Dipaxin. The induction period is similar to that for Tromexan, namely, 48 to 60 hours and the recovery period 10 to 15 days which is somewhat longer than in the case of either Tromexan or Dicumarol. This recovery period is hastened to some degree by the administration of water-soluble vitamin K preparations and materially accelerated by vitamin K
1
. The prothrombin level during maintenance therapy is unusually stable. Transient bleeding occurred in two patients. No other toxic effects were observed.
Sympathetic Denervation in the Treatment of Acute Arterial Occlusion
Authors: FLASHER JACK , WHITE ALBERT E. , DRURY DOUGLAS R.
Published: June 2012

The effect of sympathectomy on the size of the collateral vessels in acute arterial ligation in a hind limb was measured by an angiographic angiometric technic and by noting the pressure in the ligated artery distal to the ligature. The size of the largest collateral vessel present on the sympathectomized side was the same as that on the innervated side. The blood pressure in the ligated artery distal to the ligature was quite similar on the sympathectomized and innervated sides. The usual increase in temperature on the sympathectomized side was noted. This must be due to a shift of blood from the deeper tissues of the hind limb to the arteriovenous shunts of the skin of the toes, rather than to an increase in collateral blood flow.
Electrocardiographic Leads
Authors: MCFEE RICHARD , JOHNSTON FRANKLIN D.
Published: June 2012

In this second paper of a series of three on electrocardiographic leads, presented primarily from the standpoint of an electrical engineer or physicist, the concept of the lead field introduced in the first paper is considered in detail and several necessarily indirect methods for the estimation of these fields are presented.
Atherosclerotic Popliteal Aneurysm in a Man Thirty-five Years Old
Authors: GIFFORD RAY W. , PARKIN THOMAS W. , JANES JOSEPH M.
Published: June 2012

This case of atherosclerotic aneurysm of the popliteal artery is of interest because the patient was a man 35 years old and because the condition was discovered only because palpation of the peripheral arteries was included as a part of routine examination. Only after the aneurysm had been found was a history of intermittent claudication elicited. The indications for the surgical treatment of popliteal aneurysms are discussed.
The Spatial Vectorcardiogram and Mean Spatial Ventricular Gradient in Normal Pregnant Women
Authors: BURCH G. E. , ABILDSKOV J. A. , CRONVICH J. A.
Published: June 2012

The spatial vectorcardiogram and the spatial ventricular gradient of normal subjects in the last trimester of pregnancy and in some of the same subjects following delivery have been studied. It was found that the vectorcardiograms could be divided into two groups on the basis of the form of the QRS sÊ-loops, as has been previously reported for other normal subjects. In some instances records taken after delivery or records taken during pregnancy with the subject in deep inspiration altered both the orientation and the form of the QRS sÊ-loop. Since these alterations were most likely due to changes in position of the heart and extracardiac tissues, it is suggested that these are factors determining the configurations of the two types of normal QRS sÊ-loops.
Studies Utilizing the Portable Electromagnetic Ballistocardiograph
Authors: MANDELBAUM HARRY , MANDELBAUM ROBERT A.
Published: June 2012

The ballistocardiograph records the vigor of cardiac ejection and the speed of diastolic filling. It provides a practical means of studying the physiologic response of the heart in its adjustment to the stress of exercise. The application of the light ballistocardiographic exercise test to subjects without clinical or electrocardiographic evidence of heart disease, to hypertensive subjects, to patients with coronary artery disease and to those suspected of having myocarditis has provided information of clinical importance which cannot be obtained from any other means of physical diagnosis or from the ballistocardiogram at rest.
The Ballistocardiogram in Acute Rheumatic Fever
Authors: ABRAMS WILLIAM B. , CHESLEY GEORGE L.
Published: June 2012

Sixty-four ballistocardiograms were obtained on a portable equalized electromagnetic ballistocardiograph from 18 young adult males with acute rheumatic fever. Thirteen of these subjects had clinical findings suggestive of heart involvement and five did not. Abnormal records were obtained from only one patient in each group. It appears, therefore, that abnormal ballistocardiograms are not often found in acute rheumatic fever even when evidences of cardiac involvement are present.
Stages of Salt Exchange in Essential Hypertension
Authors: GREEN D. M. , JOHNSON A. D. , BRIDGES W. C. , LEHMANN J. H.
Published: June 2012

The relation of sodium to hypertension remains one of the most fascinating problems in medicine. The results accumulated over a five-year period of study of this relationship are presented in the paper which follows. In these investigations the appetite for salt and the output of sodium under a variety of loading conditions have been correlated with cardiac and renal function and compared with the patterns found in experimental corticoid and renal hypertensions.
Acute Pericarditis
Authors: MCGUIRE JOHNSON , KOTTE J. HAROLD , HELM ROBERT A.
Published: June 2012

Statistical studies of the frequency of the different etiologic types of acute pericarditis may be misleading because of an increasing recognition of nonspecific pericarditis. In our experience this form is the most common in private practice, while on the wards of a general hospital, tuberculous pericarditis is the most frequent variety. Despite improvements in diagnostic technics there still remains a significant number of patients with acute pericarditis, the etiology of which cannot be categorized accurately. This latter group will be narrowed only after further clinical description and laboratory study.

The diagnosis of nonspecific pericarditis should be made carefully because of similarity of its onset to that of myocardial infarction and its benign course with tendency to relapse. Tuberculous pericarditis merits early recognition because of the improved prognosis following prompt treatment. Rheumatic pericarditis is often a problem in children and adolescents and indicates serious cardiac involvement; in adults the clinical course is generally more benign. Pericarditis occurring in uremia and myocardial infarction is usually an incidental finding in the course of a more important disease. Pyogenic pericarditis is now a rare occurrence except in certain infectious states.

The treatment of acute pericarditis has been considerably improved by the introduction of the antibiotic drugs. The judicious use of pericardial paracentesis may be life-saving in certain instances or it may yield diagnostic information from which effective therapy can be instituted.
A Clinical Appraisal of Pentapyrrolidinium (M&B 2050) in Hypertensive Patients
Authors: FREIS EDWARD D. , PARTENOPE EDWARD A. , LILIENFIELD LAWRENCE S. , ROSE JOHN C.
Published: June 2012

The new ganglionic blocking agent, pentapyrrolidinium or M&B 2050, appears to have several distinct advantages over hexamethonium in the treatment of severe hypertension. These advantages include longer duration of action, greater potency, less tolerance, less interference with intestinal motility, and, most important, a more uniform response from day to day on oral administration. However, critical adjustment of dosage is necessary and side effects are not infrequent, the most disturbing being postural faintness and impotence.
Arterial Supply to the Nodal Tissue in the Dog Heart
Authors: HALPERN MYRON H.
Published: June 2012

A study of the hearts of 107 dogs revealed that the blood supply to the sinoatrial node was from three sources: right coronary artery, left coronary artery, and right internal mammary artery. A dominant pattern of supply was found in 90 hearts. Three variations are described. The importance of arterial anastomoses to the sinus node and their role in the formation of an extracardiac coronary arterial system are discussed.
The Effect of Prolonged Sodium Depletion and of Hydrallazine Hydrochloride and Hexamethonium Bromide on the Digital Vascular Resistance in Primary Hypertension
Authors: EURMAN GERALD H. , MENDLOWITZ MILTON
Published: June 2012

The effect of dietary sodium depletion and of oral hydrallazine hydrochloride and parenteral hexamethonium bromide on the digital circulation was studied by repeated measurements of pressure and flow before and after inhibition of sympathetic nerve discharge in a small series of hypertensive patients. Sodium depletion had no demonstrable effect on neurogenic digital vasoconstriction but produced either a decrease in intrinsic digital vascular resistance, a decrease in intrinsic flow, or both. The chief effect of the drugs studied, in contrast, was elimination of neurogenic digital vasoconstriction.
Total Urinary Catechol Excretion in Cardiovascular and Other Clinical Conditions
Authors: RAAB WILHELM , GIGEE WILDA
Published: June 2012

Although colorimetry (method of Shaw) permits neither a differentiation of epinephrine and norepinephrine nor their separation from other catechols, it reveals the total urinary catechol excretion, including those portions which were inactivated in the body. No significant abnormalities were found in arterial hypertension, in congestive heart failure, after myocardial infarction and during emotional stress. Thoracolumbar sympathectomy depressed total catechol excretion temporarily. In renal uremia, the regularly demonstrable elevation of the blood catechols was paralleled by a diminution of the conjugated catechols in the urine. It appears to be due to renal retention.
The Response of the Renal Circulation in Man to Constant-Speed Infusions of
l
-Norepinephrine
Authors: PULLMAN THEODORE N. , MCCLURE WILLIAM W.
Published: June 2012

The effects of constant-speed intravenous infusions of
l
-norepinephrine in man have been studied with reference to the changes produced in the renal circulation. The responses to four rates of infusion were studied both qualitatively and quantitatively in each of nine normal men. As dosage was increased glomerular filtration rate changed little if at all, effective renal plasma flow diminished, and filtration fraction rose. Both afferent and efferent glomerular arteriolar resistances sharply increased, but the latter did so much more markedly than the former.
Studies on the Renal Circulation and Renal Function in Mitral Valvular Disease
Authors: WERKÖ LARS , VARNAUSKAS EDVARDAS , EK JAN , BUCHT HÔRJE , THOMASSON BENGT , BERGSTRÖM JONAS , ELIASCH HARALD
Published: June 2012

In a study of the nature of the renal changes in patients with mitral stenosis, lowered renal function and reduced renal circulation the effect of Apresoline, given during heart catheterization to 12 patients with mitral stenosis of varying severity, was studied. The drug was found to increase renal blood flow (and decrease arterial blood pressure), showing that the renal changes in mitral stenosis are reversible. The two effects of Apresoline were shown to be independent of each other.
The Circulation in Cold Acclimatization
Authors: BROWN G. MALCOLM , BIRD G. S. , BOAG T. J. , BOAG L. M. , DELAHAYE J. D. , GREEN J. E. , HATCHER J. D. , PAGE JOHN
Published: June 2012

The hand and forearm blood flow of the Eskimo has been found to be greater than that of a control group of white persons in a temperate climate both at rest at an ambient temperature of 20 C. and during acute cold exposure. Under cold stress, rectal temperature was better maintained in the Eskimos, though certain deep muscle temperatures fell more than they did in the white men because of the greater blood flow through exposed parts. The Eskimos showed an elevation of basal metabolic rate and of plasma and total red cell volume. There are similarities between the circulatory changes found in the Eskimo and those found in hyperthyroidism.
Long-Term Anticoagulant Therapy
Authors: TULLOCH JOHN , WRIGHT IRVING S.
Published: June 2012

Experience with long-term anticoagulant therapy during the past seven years has been summarized. This report is based on the records of 227 individuals treated as private or outpatient clinic patients for from four weeks to seven years. Where adequate laboratory facilities are available outpatient long-term therapy may be satisfactorily controlled by physicians familiar with the use of anticoagulant drugs. Their correct use will lessen the incidence of thromboembolic episodes in patients who have previously suffered from such complications.
Electrocardiographic Leads
Authors: MCFEE RICHARD , JOHNSTON FRANKLIN D.
Published: June 2012

This concluding paper of a series of three on electrocardiographic leads indicates how leads that should be superior to many now in use may be constructed. The design of leads to obtain accurate representations of the mean cardiac vector in the usual planes of reference, methods for the improvement of several of the conventional leads, and a unipolar lead of a new type are emphasized.
Fatal Myocardial Sarcoidosis
Authors: STEPHEN J. D.
Published: June 2012

The case history of a 47 year old white man who died suddenly is given. At autopsy extensive replacement of the myocardium by sarcoid granulation tissue was found. The lesions of sarcoidosis were also present in the lungs, the spleen, the hilar and mesenteric lymph nodes.
Indicator-Dilution Curves in Acyanotic Congenital Heart Disease
Authors: BROADBENT JAMES C. , WOOD EARL H.
Published: June 2012

Dye dilution and cardiac catheterization technics were used to study 36 patients with a central left-to-right shunt due to patent ductus arteriosus, atrial septal defect or ventricular septal defect. The configuration of dilution curves following injection of dye into an antecubital vein was similar in all instances. Principal abnormalities of the curve were a prolongation of its disappearance slope and a relative reduction in the peak concentration of dye. Quantitatively expressed, these abnormalities could be correlated with the magnitude of the left-to-right shunt. Curves of normal contour were observed following surgical closure of the ductus arteriosus, and in patients with isolated pulmonary stenosis.
Role of Arterial Wall Secretion in the Regulation of Blood Pressure
Authors: DIAZ C. JIMÉNEZ , BARREDA P. , MOLINA A. F. , ALCALÁ R.
Published: June 2012

The authors present experiments demonstrating that the hypertension produced by the stimulation of the central end of the vagus nerve is brought about by the appearance of a pressor substance in the circulating blood. The results of these experiments show that such a substance does not come from any gland nor from the central nervous system. The observed facts indicate that its origin is the arterial wall proper, from which it is directly liberated into the circulation. The pharmacologic proofs suggest that this substance is noradrenaline.
Auricular Fibrillation and Mitral Stenosis in Bacterial Endocarditis
Authors: WALLACH JACQUES B. , GLASS MACELLIS , LUKASH LESLIE , ANGRIST ALFRED A.
Published: June 2012

The infrequent association of bacterial endocarditis with auricular fibrillation and with severe mitral stenosis is noted. The relevant literature is reviewed. Eighty-two cases of bacterial endocarditis superimposed on rheumatic heart disease and 47 examples of bacterial endocarditis without underlying rheumatic valvulitis are studied. Auricular fibrillation and severe mitral stenosis occurred less frequently in these groups than in patients with rheumatic heart disease without bacterial endocarditis. Various theories to account for these observations are analyzed and an alternative explanation is offered.
Mediators of the hypotensive response to increased renal perfusion in rabbits.
Authors: Christy I J , Woods R L , Anderson W P
Published: June 2012

We have previously shown that increasing the renal perfusion pressure by using an extracorporeal circuit in anesthetized rabbits resulted in a progressive fall in systemic arterial pressure. Prior ablation of the renal medulla with 2-bromoethylamine abolished the hypotensive response. In the present study, we investigated whether vasodilator prostanoids or platelet activating factor (PAF), both known to be produced in the renal medulla, were responsible for the hypotensive response to increased renal perfusion pressure. Anesthetized animals were treated with indomethacin (5 mg/kg + 0.5 mg/kg per hour), the PAF antagonist WEB 2086 (0.5 mg/kg + 0.5 mg/kg per hour), enalaprilat (2 mg/kg + 10 micrograms/kg per hour), or all three agents. In response to acute elevation of renal artery pressure to 170 mm Hg, systemic mean arterial pressure fell at 0.76 +/- 0.17, 0.59 +/- 0.08, and 0.76 +/- 0.17 mm Hg/min in the indomethacin, WEB 2086, and enalapril groups, respectively. These responses were not significantly different from the rate of 1.00 +/- 0.21 mm Hg/min in a control group that received vehicle infusion alone. Renal blood flow and the diuretic and natriuretic responses were also similar in all groups. Thus, increased renal perfusion pressure resulted in a progressive fall in systemic arterial pressure that was not mediated by PAF, prostaglandins, or suppression of renin release and angiotensin II production.
Bradykinin peptides in kidney, blood, and other tissues of the rat.
Authors: Campbell D J , Kladis A , Duncan A M
Published: June 2012

The bradykinin peptide system is a tissue-based system with potent cardiovascular and renal effects. To investigate the regulation of this system, we developed a highly sensitive amino terminal-directed radioimmunoassay that, with high performance liquid chromatography, enables the measurement of bradykinin-(1-7), bradykinin-(1-8), and bradykinin-(1-9). Together with a carboxy terminal-directed radioimmunoassay, we characterized bradykinin peptides in rat kidney and blood. The predominant bradykinin peptides in kidney were bradykinin-(1-9) (approximately 100 fmol/g wet weight of tissue) and bradykinin-(1-7) (approximately 70 fmol/g), with low levels of bradykinin-(1-8) (approximately 8 fmol/g) and bradykinin-(4-9) (approximately 12 fmol/g) detectable; bradykinin-(2-9) and bradykinin-(3-9) were below the limits of detection. In blood, the levels of bradykinin-(1-9) were very low (approximately 2 fmol/ml), and other bradykinin peptides were below the limits of detection. Ile,Ser-bradykinin and Met,Ile,Ser-bradykinin were below the limits of detection in both kidney and blood, indicating that T-kininogen makes no detectable contribution to renal or circulating bradykinin peptides. Administration of the angiotensin converting enzyme inhibitor perindopril was associated with an approximate twofold increase in renal levels of bradykinin-(1-8) and bradykinin-(1-9) and a decrease in the bradykinin-(1-7)/bradykinin-(1-9) ratio. The amino terminal-directed radioimmunoassay was also applied to heart, aorta, brown adipose tissue, adrenal lung, and brain. For these tissues, bradykinin-(1-7) and bradykinin-(1-9) were of similar abundance (16-340 fmol/g), with lower levels of bradykinin-(1-8). These studies demonstrate that tissue levels of bradykinin peptides are much higher than circulating levels, consistent with their formation at a local tissue site. Of peptides derived from K-kininogen, bradykinin-(1-9) is the predominant bioactive peptide in all tissues, and a major pathway of bradykinin-(1-9) metabolism involves the formation of bradykinin-(1-7). In kidney, angiotensin converting enzyme plays an important role in bradykinin-(1-9) metabolism, and increased bradykinin-(1-9) and bradykinin-(1-8) levels may mediate in part the renal effects of converting enzyme inhibition.
Regional angiotensin II production in essential hypertension and renal artery stenosis.
Authors: Admiraal P J , Danser A H , Jong M S , Pieterman H , Derkx F H , Schalekamp M A
Published: June 2012

To study regional metabolism and production of angiotensin II, we measured steady-state plasma levels of 125I-angiotensin I and II and endogenous angiotensin I and II in the aorta and the antecubital, femoral, renal, and hepatic veins during systemic infusion of 125I-angiotensin I or II. Extraction of arterially delivered angiotensin II ranged from 30-50% in the limbs to 80-100% in the renal and hepatomesenteric vascular beds both in essential hypertension (n = 13) and in unilateral renal artery stenosis (n = 7). Across the limbs, 20-30% of arterially delivered angiotensin I was converted to angiotensin II in both groups, and there was no arteriovenous gradient in endogenous angiotensin II. No conversion of arterially delivered angiotensin I was detected across the renal and hepatomesenteric beds, and there was net extraction of angiotensin II from the systemic circulation by these beds. Although regional production of angiotensin I at tissue sites made a significant contribution to its level in the veins, little of this locally produced angiotensin I reached the regional veins in the form of angiotensin II, even in the kidney with artery stenosis, where the venous levels of locally produced angiotensin I were particularly high. These results provide no evidence for a source of circulating angiotensin II other than blood-borne angiotensin I and illustrate the high degree of compartmentalization of angiotensin I and II production.
Coronary vascular response to the cerebral ischemia reflex.
Authors: De Boel S L , Gutterman D D
Published: June 2012

Most centrally mediated sympathoexcitatory reflexes produce increases in arterial pressure, heart rate, and peripheral vascular resistance, including coronary vasoconstriction. Cerebral ischemia also causes large increases in arterial pressure and peripheral vasoconstriction but with modest or variable changes in heart rate. To examine the effect of cerebral ischemia on coronary vascular resistance, we produced cerebral ischemia in 14 cats by occluding the right brachiocephalic and left subclavian arteries for 30 seconds. After vagotomy and beta-blockade, a marked increase in arterial pressure (89 +/- 14%) and coronary vascular resistance (52 +/- 7%) was seen. After inhibition of the carotid baroreceptor reflex by surgical denervation and application of topical lidocaine, the increase in arterial pressure to cerebral ischemia was not affected, but the increase in coronary vascular resistance was attenuated (33 +/- 6%; p < 0.05 versus before denervation) to a level expected with autoregulation. To evaluate the possible contribution of the chemoreflex on coronary blood flow during cerebral ischemia, we conducted separate experiments in which nicotine was injected into both carotid arteries. Coronary constriction was not observed. Adrenalectomy and upper extremity ischemia likewise did not alter coronary vascular resistance. We conclude that cerebral ischemia elicits neurally mediated coronary vasoconstriction as a result of baroreceptor hypotension rather than directly. The relative absence of neurogenic coronary constriction and changes in heart rate suggest that sympathoexcitation during cerebral ischemia is directed more toward the peripheral vasculature than the heart.
Effect of reduced alcohol consumption on blood pressure in untreated hypertensive men.
Authors: Ueshima H , Mikawa K , Baba S , Sasaki S , Ozawa H , Tsushima M , Kawaguchi A , Omae T , Katayama Y , Kayamori Y
Published: June 2012

Fifty-four untreated, mildly hypertensive men whose daily alcohol consumption was > or = 28 ml ethanol and who drank at least 4 times per week took part in a randomized, controlled crossover trial. The purpose of the trial was to test the effects of alcohol reduction on blood pressure. After a 2-week familiarization period, the participants were assigned to either a reduced alcohol drinking group or a usual drinking group for 3 weeks (experimental period 1). The situation was then reversed for the next 3 weeks (experimental period 2). The participants were requested to limit their daily alcohol consumption to zero or reduce it as much as possible for the reduced alcohol consumption period. The self-reported alcohol consumption was 56.1 +/- 3.6 (SEM) ml/day during the usual alcohol drinking period and 26.1 +/- 3.0 ml/day during the period of reduced alcohol consumption. Systolic and diastolic blood pressures in the intervention group were found by analysis of variance to be significantly lower (2.6-4.8 and 2.2-3.0 mm Hg, respectively) than those in the control group during experimental period 2 for systolic blood pressure and experimental period 1 for diastolic blood pressure. Significant (3.6 mm Hg) and nonsignificant (1.9 mm Hg) decreases in systolic and diastolic blood pressure, respectively, were observed. The method of Hills and Armitage was used, reducing ethanol in daily alcohol consumption by 28 ml. The lowering effect of reduced alcohol consumption on blood pressure was independent of changes in salt consumption, which were estimated by 24-hour urine collection and body weight.(ABSTRACT TRUNCATED AT 250 WORDS)
Women's Health in
Circulation
and the
Circulation
Subspecialty Journals
Authors:   The Editors
Published: June 2012

The following articles are being highlighted as part of
Circulation's
Topic Review series. This series will summarize the most important manuscripts, as selected by the editors, published in
Circulation
and the
Circulation
subspecialty journals. The studies included in this article represent the articles related to women's health that were published in
Circulation
and the
Circulation
subspecialty journals in 2010 and 2011.
Differential Reports of Pain and Depression Differentiate Mild Cognitive Impairment From Cognitively Intact Elderly Participants
Authors: Kruger T. M. , Abner E. L. , Mendiondo M. , Schmitt F. A. , Smith C. D. , Jicha G. A.
Published: June 2012

Background: Positive associations between pain and depression in the general population have been well characterized; however, the interplay between pain, depression, and early cognitive decline, characterized as mild cognitive impairment (MCI), is poorly understood. Methods: The current study examined the association of self-reported pain complaints (measured by the 36-item Short Form Health Survey) and self-reported depressive symptoms (measured by the 30-item Geriatric Depression Scale) in cognitively intact participants (n = 492) and participants with a clinical diagnosis of MCI (n = 83). Results: Depressive symptoms and subjective reports of pain were significantly associated in the entire sample ( r = .29; P < .0001). Multiple logistic regression modeling (adjusted for age, education, and APOE4 status as covariates) demonstrated that while depressive symptoms were positively associated with the diagnosis of MCI ( P < .001), subjective pain reports were negatively associated with MCI ( P < .002). Conclusion: While the negative association of subjective pain complaints with MCI might arguably be explained by the development of anosognosia, self-reports of depressive symptoms were actually increased in these participants, suggesting preserved insight into cognitive decline–associated symptoms. It is possible that preferential involvement of limbic circuitry in MCI could explain these findings. Future studies are needed to elucidate the reasons for the dissociation of pain and depressive symptoms in MCI described in the present article.
Reflections and speculations on teaching and learning in public administration
Authors: Diamond John , Liddle Joyce
Published: June 2012

The scale and impact of the current global financial and economic crisis affect not just the public and political institutions established to manage the economy, but also those programmes in institutions of higher education which seek to work with professionals, practitioners and decision makers. If we can witness a public crisis of confidence in the capacity of our existing family of institutions to manage the change, then we might expect to observe similar changes in universities, too. This article reflects upon the nature of the relationships between universities (business and management schools) and the wider public and political community. It also attempts to anticipate some of the potential consequences of the crisis in terms of how the academy might reflect upon its assumptions concerning teaching and learning approaches, and expectations within the discipline of public administration. We suggest that the present crisis is an opportunity to think about the curriculum and pedagogic choices we make and to promote a more collaborative approach to learning, drawing upon models of reflection and professional practice to be found across different disciplines including social work and teaching.
Redox interactions of technetium with iron-bearing minerals
Authors: McBeth J. M. , Lloyd J. R. , Law G. T. W. , Livens F. R. , Burke I. T. , Morris K.
Published: June 2012

Iron minerals influence the environmental redox behaviour and mobility of metals including the long-lived radionuclide technetium. Technetium is highly mobile in its oxidized form pertechnetate (Tc(VII)O4–), however, when it is reduced to Tc(IV) it immobilizes readily via precipitation or sorption. In low concentration tracer experiments, and in higher concentration XAS experiments, pertechnetate was added to samples of biogenic and abiotically synthesized Fe(II)-bearing minerals (bio-magnetite, bio-vivianite, bio-siderite and an abiotically precipitated Fe(II) gel). Each mineral scavenged different quantities of Tc(VII) from solution with essentially complete removal in Fe(II)-gel and bio-magnetite systems and with 84±4% removal onto bio-siderite and 68±5% removal onto bio-vivianite over 45 days. In select, higher concentration, Tc XAS experiments, XANES spectra showed reductive precipitation to Tc(IV) in all samples. Furthermore, EXAFS spectra for bio-siderite, bio-vivianite and Fe(II)-gel showed that Tc(IV) was present as short range ordered hydrous Tc(IV)O2-like phases in the minerals and for some systems suggested possible incorporation in an octahedral coordination environment. Low concentration reoxidation experiments with air-, and in the case of the Fe(II) gel, nitrate-oxidation of the Tc(IV)-labelled samples resulted in only partial remobilization of Tc. Upon exposure to air, the Tc bound to the Fe-minerals was resistant to oxidative remobilization with a maximum of ∼15% Tc remobilized in the bio-vivianite system after 45 days of air exposure. Nitrate mediated oxidation of Fe(II)-gel inoculated with a stable consortium of nitrate-reducing, Fe(II)-oxidizing bacteria showed only 3.8±0.4% remobilization of reduced Tc(IV), again highlighting the recalcitrance of Tc(IV) to oxidative remobilization in Fe-bearing systems. The resultant XANES spectra of the reoxidized minerals showed Tc(IV)-like spectra in the reoxidized Fe-phases. Overall, this study highlights the role that Fe-bearing biogenic mineral phases have in controlling reductive scavenging of Tc(VII) to hydrous TcO2-like phases onto a range of Fe(II)-bearing minerals. In addition, it suggests that on reoxidation of these phases, Fe-bound Tc(IV) may be octahedrally coordinated and is largely recalcitrant to reoxidation over medium-term timescales. This has implications when considering remediation approaches and in predictions of the long-term fate of Tc in the nuclear legacy.