bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary Compliance in Patients with Periodic Breathing
Authors: LYONS HAROLD A. , BURNO FRANK , STONE RICHARD W.
Published: June 2012

A study of pulmonary compliance in patients with periodic breathing was made. The elastic properties of the lung were found to be normal in some patients and grossly decreased in others. Two types of periodic breathing mechanics were found: in one there are similar variations of tidal volumes and unchanged pulmonary compliance; in the other a constant fluctuation of the intraesophageal pressure associated with the variations in tidal volume.
Anomalous Origin of the Left Coronary Artery
Authors: CASE ROBERT B. , MORROW ANDREW G. , STAINSBY WENDELL , NESTOR JOHN O.
Published: June 2012

Anomalous origin of the left coronary artery from the pulmonary artery is a rare and almost universally fatal form of congenital heart disease. It has usually been assumed that flow in the aberrant artery is from the pulmonary artery toward the myocardium and efforts at surgical correction have been directed at increasing the perfusion pressure or the oxygen content of pulmonary artery blood. Evidence is presented, that flow in the aberrant artery is
into
the pulmonary artery and that ligation of the vessel at its origin should be carried out before irreversible myocardial damage has occurred.
Clinical Observations with the Frank Precordial Lead System
Authors: ABILDSKOV J. A. , STREET W. W. , SOLOMON N. , TOOMAJIAN A. H.
Published: June 2012

Several new lead systems for electrocardiography and vectorcardiography have been proposed. Clinical evaluation of these systems is necessary to determine whether they yield useful information in addition to that furnished by conventional leads and whether the same information obtained from conventional leads appears in recognizable form in the new leads. This study is a step toward such an evaluation of one of the proposed lead systems.
Nonpenetrating Traumatic Injury of the Aorta
Authors: PARMLEY LOREN F. , MATTINGLY THOMAS W. , MANION WILLIAM C. , JAHNKE EDWARD J.
Published: June 2012

Rupture or laceration of the aorta is a more common result of nonpenetrating traumatic injury than is generally appreciated. Approximately 15 per cent of individuals with traumatic rupture survive temporarily. If the lesion is promptly diagnosed appropriate surgical treatment may be life-saving. Diagnosis may be difficult and at times the rupture may remain clinically silent for variable periods. The natural course from aortic rupture to false aneurysm formation with secondary rupture of the aneurysm may be brief or extend over many years. Surgical treatment of a false aneurysm that has remained stable for a prolonged period has been successful, but in some instances conservative management may be the treatment of choice.
Steady-State Cardiac Output Determination During Combined Right and Left Heart Catheterization
Authors: SAMET PHILIP , BERNSTEIN WILLIAM H. , LITWAK ROBERT S. , TURKEN H. , SILVERMAN LEONARD
Published: June 2012

Interpretation of the meaning of a mean diastolic atrioventricular gradient or a mean systolic ventricular-great vessel gradient requires simultaneous determination of the level of the gradient, the heart rate, and the cardiac output. The feasibility of steady-state Fick principle cardiac output determination during combined right and left heart catheterization is investigated.
Clearing Factor Inhibitor in Human Atherosclerosis
Authors: DAY ALLAN J. , WILKINSON GRAHAM N. , Peters J. A.
Published: June 2012

A reduction in heparin-activated clearing factor has been demonstrated in individuals with atherosclerosis or conditions related to it. The recent isolation from normal plasma of an inhibitor to clearing factor suggested that the reduction described might be due to an increased level of inhibitor. This possibility was therefore investigated by determining the inhibitor effect of the plasma of atherosclerotic, diabetic, and nephrotic individuals on the in vitro clearing activity of post-heparin plasma.
Electrocardiographic Diagnosis of Ventricular Hypertrophy in the Presence of Right Bundle-Branch Block
Authors: BOOTH RICHARD W. , CHOU TE-CHUTAN , SCOTT RALPH C.
Published: June 2012

Forty-nine autopsied cases of complete and incomplete right bundle-branch block were studied with correlation of the electrocardiographic and anatomic diagnosis of ventricular hypertrophy. Twenty-six (53 per cent) of the cases showed anatomic evidence of right ventricular hypertrophy. The cases were studied for right ventricular hypertrophy according to the criteria of Barker and Valencia and of Milnor. Milnor's criteria resulted in frequent overdiagnosis while those that met Barker and Valencia's criteria usually but not invariably showed anatomic right ventricular hypertrophy. The electrocardiographic diagnosis of left ventricular hypertrophy was masked by the bundle-branch block in anatomically proved cases.
Effect of Cooling and of Smoking Tobacco upon the Blood Flow of Reactive Hyperemia of the Foot
Authors: COFFMAN JAY D. , WOOD J. EDWIN , WILKINS ROBERT W.
Published: June 2012

Tobacco smoking and body cooling have been shown to decrease the "resting" blood flow to the foot. The present study was designed to determine whether either of these 2 stimuli also affects the increased blood flow that follows a period of ischemia (reactive hyperemia). Blood flows to the foot were measured in subjects with and without vascular disease by the venous occlusion, water plethysmographic method in a warm and a cool environment before and during smoking. Patients with bilaterally and unilaterally sympathectomized limbs were also studied to determine the mechanism of the observed responses.
Congenital Complete Atrioventricular Block: Problems of Clinical Assessment
Authors: PAUL MILTON H. , RUDOLPH ABRAHAM M. , NADAS ALEXANDER S.
Published: June 2012

The diagnosis of congenital complete atrioventricular block usually offers little difficulty. There remains, however, the problem of interpreting certain clinical findings, including systolic and diastolic murmurs and cardiomegaly, which are sometimes falsely suggestive of an associated congenital heart lesion. The clinical, radiologic, and electrocardiographic findings in 27 children with congenital complete heart block have been analyzed in terms of the hemodynamic abnormalities found at cardiac catheterization in 12 of these patients.
Sodium Chloride Excretion Following Salt Loading in Hypertensive Subjects
Authors: COTTIER PAUL T. , WELLER JOHN M. , HOOBLER SIBLEY W.
Published: June 2012

Patients with essential hypertension show an altered renal excretory response to sodium chloride loading. Hypertensive patients acutely eliminate a greater proportion of a salt and water load than do normotensive subjects. This renal abnormality appears to be due to an augmented tubular rejection of sodium chloride and water. This study further defines the nature and extent of this alteration in electrolyte and water metabolism.
Persistence of Fetal Ductus Function after Birth
Authors: ABRAMS HERBERT L.
Published: June 2012

Within recent years there has been increasing interest in the presence of reversed flow through the ductus arteriosus. Most reported cases have been in older children and young adults. There is a group of cases in which the ductus serves as a site of a veno-arterial shunt in infancy, and thus continues to perform its fetal function. The conditions under which veno-arterial shunting persists after birth are illustrated and analyzed, and an effort is made to clarify the common features of these lesions.
Pulse Pressure Response to a Standard Exercise Stress
Authors: HEIDORN G. H.
Published: June 2012

The response of pulse pressure to a standard exercise stress was utilized as the basis for an exercise tolerance test measuring left ventricular efficiency. Clinically normal individuals and asymptomatic individuals who had had a myocardial infarction were studied. Significant differences were noted between these groups. A phenomenon described as a "lag in response" was detected in many subjects with coronary artery disease. This may be a reflection of the delay in oxygen use and in other metabolic activities demonstrated by diseased myocardial tissue after an exercise stress.
Lead Field Scalar and Loop Spatial Electrocardiography
Authors: JORDAN R. C. , BESWICK F. W.
Published: June 2012

Spatial electrocardiography based on the lead field concept of McFee and Johnston appears to be theoretically more satisfactory than other systems of vectorcardiography. To determine the normal range of planar loop patterns to be expected with this technic and to compare them with those derived by previous methods, a survey of young adult males has been carried out with particular reference to the sagittal plane. The possible relationship between loop orientation and anatomic cardiac position has been investigated and a comparison made of main loop axes and the corresponding electric axes as calculated from scalar tracing areas.
A Study of the Manifestations of Rheumatic Fever Following Cessation of Therapy
Authors: FISCHEL EDWARD E. , FRANK CHARLES W. , BELLOWS MARJORIE T.
Published: June 2012

Following cessation of therapy for acute rheumatic fever manifestations of rheumatic activity frequently reappear. The incidence of these manifestations and their severity were studied during the 3-week observational period in 257 patients treated as part of the Cooperative Clinical Trial on the treatment of rheumatic fever. From the analysis of these manifestations certain concepts may be derived concerning diagnostic and therapeutic criteria.
An Electrocardiographic Analysis of Sixty-Five Cases of Mitral Regurgitation
Authors: BENTIVOGLIO L. G. , URICCHIO J. F. , WALDOW A. , LIKOFF W. , GOLDBERG H.
Published: June 2012

The detailed electrocardiographic analysis of a large series of patients with proved, dynamic mitral regurgitation is lacking in the medical literature. The present report intends to fill the gap and to point out and discuss some discrepancies observed between the current concepts and the results of the study.
Electrocardiographic Changes in Acute Subendocardial Infarction
Authors: COOK RODERICK W. , EDWARDS JESSE E. , PRUITT RAYMOND D.
Published: June 2012

Among 24 cases of small subendocardial infarctions included in this report are 10 cases of anteroseptal distribution in which the electrocardiogram was characterized by the presence of deeply inverted T waves in some or all of the precordial leads. Two other types of change encountered among the remaining 14 cases are described. Electrocardiographic changes in this group of 24 cases are compared with changes encountered in 5 cases of large and near circumferential acute subendocardial infarction described in part I of this study.
Quantitation of Valvular Regurgitation from Multiple Indicator-Dilution Curves
Authors: LANGE RAMON L. , HECHT HANS H.
Published: June 2012

Dye-dilution curves obtained simultaneously from the pulmonary artery and from the femoral artery following an intravenous injection of T 1824 or Indocyanine Green in normal subjects and in patients with nonregurgitant heart disease yielded a similar contour. This suggested that in the absence of regurgitation the parameters of the distal (arterial) curve can be predicted from the proximal (pulmonary artery) curve. The distortion of the arterial curve by regurgitation can therefore be compared with the undistorted pulmonary artery curve. To the extent that 2 identifiable and measurable flow rates exist between the sites of sampling, a theoretical basis for quantitation of the degree of valvular regurgitation may be derived.
Technic for Non-Surgical Insertion of Large Polyethylene Tubing into Blood Vessels
Authors: DOTTER CHARLES T. , SMITH JOSEF R.
Published: June 2012

A simple technic is presented for the nonsurgical insertion into blood vessels of large bore polyethylene tubing.
Patent Ductus Arteriosus with Pulmonary Hypertension Simulating Ventricular Septal Defect
Authors: GONZALEZ-CERNA JUAN L. , LILLEHEI C. WALTON
Published: June 2012

The classic findings of a patent ductus arteriosus in a young individual are familiar to most physicians. However, it has been appreciated that several factors, principally pulmonary hypertension or pulmonary artery dilatation in the absence of appreciable hypertension, may significantly alter the classic image and lead to the erroneous diagnosis of ventricular septal defect. In 10 surgically proved cases a patent ductus arteriosus was the sole malformation and so closely simulated a septal defect that extracorporeal circulation was initially considered for each of the patients. Division of the ductus resulted in a complete cure in all 10 patients. Those findings of value in differential diagnosis are analyzed.
Endocardial and Intimal Lesions (Jet Impact) as Possible Sites of Origin of Murmurs
Authors: EDWARDS JESSE E. , BURCHELL HOWARD B.
Published: June 2012

This series of papers constituted the second Symposium on Cardiovascular Sound conducted in association with the Scientific Sessions of the American Heart Association. The symposium took place on Friday, October 25, 1957, at the Hotel Sherman in Chicago. The chairman of the morning sessions was Dr. Hans H. Hecht of Salt Lake City; Dr. J. Willis Hurst of Atlanta was chairman for the afternoon sessions. The first symposium was published in Circulation
16
: 270, and 414, 1957. This publication was made possible by a grant-in-aid front the National Heart Institute, U.S. Public Health Service, and by contributions from Mr. Arthur L. Humphries, The Rena and Walter Burke Foundation, Lakeside Laboratories, Burroughs-Welcome Company, and the Wyeth Laboratories.
Radiologic Technic for Qualitative and Quantitative Study of Blood Flow
Authors: DOTTER CHARLES T. , FRISCHE LOUIS H.
Published: June 2012

This preliminary report deals with the direct radiographic study of discrete, relatively small spots of artificial radiopacity during their passage through the cardiovascular structures and offers a new and promising technic for studying the motion of blood. As used here, motion refers to movement of and within the blood stream. So defined, it is fundamental to the subject-matter of hemodynamics. Continuing studies are focused upon two major hemodynamic parameters: 1.
The velocity, acceleration and deceleration of circulating blood.
Through appropriate specialized radiographic technics, it is possible to measure the movement of blood as a function of time. Observations may be completed in 1 msec., repeated in rapid sequence and made simultaneously at many different points within the cardiovascular system. 2.
Flow characteristics of circulating blood.
The graphic study of flow patterns at multiple points within the blood stream can be carried out simultaneously with blood velocity observations. By analogy, in this technic the blood vessels and chambers of the heart serve as wind tunnels; the blood is the wind, the spots of opacity are smoke tracers and the myocardium is the source of power.

The results of extensive experimental studies indicate that the above goals are achievable and warrant the considerable effort and costs involved. It is hoped that this preliminary report will encourage others to explore the possibilities of the method and thereby hasten its perfection.
Relation between Structural Changes in the Small Pulmonary Arteries and the Immediate Reversibility of Pulmonary Hypertension Following Closure of Ventricular and Atrial Septal Defects
Authors: HEATH DONALD , HELMHOLZ H. FREDERIC , BURCHELL HOWARD B. , DUSHANE JAMES W. , KIRKLIN JOHN W. , EDWARDS JESSE E.
Published: June 2012

The relative importance of organic changes and vasoconstrictive influences in the production of increased pulmonary vascular resistance in congenital heart disease is problematic. With use of a grading system previously described, a study was made of the relation between each of the grades of hypertensive pulmonary vascular disease associated with ventricular or atrial septal defects and the change of pulmonary artery blood pressure immediately following closure of the abnormal communications. The immediate reversibility of the pulmonary hypertension varies inversely with the severity of the structural changes.
Suprasternal Transaortic Coronary Arteriography
Authors: LEMMON WILLIAM M. , LEHMAN J. STAUFFER , BOYER RANDAL A.
Published: June 2012

Opacification of the coronary arteries has been accomplished by direct needle puncture of the ascending portion of the thoracic aorta via a suprasternal approach and injection of highly-concentrated radiopaque medium. Experience with 35 attempts in 31 patients at such coronary opacification is described. The electrocardiographic observations, the reactions, and the complications incident to the study are discussed. Thirteen of the 31 patients had some type of intrapericardial cardiac surgery subsequent to this procedure, and the surgical observations regarding the status of the coronary arteries are compared with the coronary arteriographic findings.
Fibrinolytic (Plasmin) Therapy of Experimental Coronary Thrombi with Alteration of the Evolution of Myocardial Infarction
Authors: RUEGSEGGER PAUL , NYDICK IRWIN , HUTTER ROBERT C. , FREIMAN ALVIN H. , BANG NILS U. , CLIFFTON EUGENE E. , LADUE JOHN S.
Published: June 2012

To explore the possibilities of fibrinclytic therapy of coronary thrombosis, experimental studies were carried out to document lysis of coronary thrombi and to investigate the effect of fibrinolytic blood upon myocardial infarction. Serum-induced coronary thrombi were produced by a new technic and were followed by serial coronary arteriography. Control animals were compared to animals in which significant fibrinolytic activity had been induced by systemic infusions of plasmin. Tissue studies suggest that plasmin may change the evolution of early infarction. Whether these changes will ultimately result in salvage of ischemic tissue will be determined by studies now in progress.
Congenital Aneurysms of the Coronary Arteries with Report of a Case
Authors: GORE IRA , SMITH JOHN , CLANCY ROBERT
Published: June 2012

A case is presented of congenital aneurysm of a coronary artery in a patient with angina pectoris and myocardial infarction. Etiologies other than coronary atheroselerosis should be considered in young patients with clinical coronary disease; they include syphilitic ostial stenosis, coronary embolization, pulmonary origin of a coronary artery, and necrotizing arteritis in addition to aneurysm of a coronary artery. In this instance the aneurysm caused a shadow that was seen by x-ray but was not identified during life.
Cardiac Chamber Volumes and their Significance in Rheumatic Heart Disease with Isolated Mitral Stenosis
Authors: SOLOFF LOUIS A. , ZATUCHNI JACOB
Published: June 2012

The total capacity of the heart and the volume of each of its chambers were determined by the technic of simultaneous biplane stereoscopic venous angiocardiography in 18 persons with surgically confirmed, isolated severe mitral stenosis. Although cardiac capacity and chamber volumes varied greatly, the left atrium was almost always the largest chamber. The left ventricle was not always the smallest chamber. In fact, it was larger than the right ventricle in 7 of the 18 and was the only chamber to be significantly correlated with total cardiac capacity greater than 1,000 ml. The right ventricular volume was found to be significantly correlated with its systolic pressure, or with the pulmonary artery systolic or mean pressures. Disproportionate enlargement of the right atrium can occur in the absence of tricuspid stenosis. Finally, atrial fibrillation was commonly present in patients with a large total cardiac capacity.
Atypical Patent Ductus Arteriosus
Authors: CREVASSE LAMAR E. , LOGUE R. BRUCE
Published: June 2012

Approximately 95 per cent of patients with patent ductus have characteristic machinery murmurs. Five per cent have only systolic murmurs. In such patients, the intravenous or intramuscular administration of a pressor substance, mephentermine, may bring out a continuous murmur. This simple test is a useful adjunct in diagnosis.
A Mechanism of Chlorothiazide-Enhanced Effectiveness of Antihypertensive Ganglioplegic Drugs
Authors: DUSTAN HARRIET P. , CUMMING G. R. , CORCORAN A. C. , PAGE IRVINE H.
Published: June 2012

Chlorothiazide decreases plasma volume, heart size, and cardiac output. The oligemia stimulates vasomotor tone; this tends to maintain arterial pressure because chronic arterial hypertension is characteristically self-sustaining and homeostatic. This oligemic stimulation of vasomotor tone results in increased sensitivity to the antihypertensive effect of drugs depressing or blocking vasomotor function.
The Forces Needed to Evoke Sounds from Cardiac Tissues, and the Attenuation of Heart Sounds
Authors: DOCK WILLIAM
Published: June 2012

There has been no study of the efficiency of any sound-producing system. Here there is a description of a device that records the force of each pull applied to a valve segment or strip of myocardium while the sound evoked is recorded. The relation of force to sound intensity, and the attenuation of sounds in air, blood, and ventricular and chest walls provide some quantitative data on a neglected phase of cardiac physiology.
Blood Pressure Studies in Rural and Urban Groups in Delhi
Authors: PADMAVATI S. , GUPTA SAVITRI
Published: June 2012

Very little data exist about blood pressure levels in Indians although it is generally believed that they are lower than among Western peoples. There also seems to be an impression that hypertension is rarer among poor Eastern populations. This study was carried out on 1,132 persons of poor economic status and 224 persons of good social class in Delhi. The results showed some striking differences between the two groups and from Western figures. Factors influencing the blood pressure levels, such as age and body weight, were also evaluated.
False "Coronary Patterns" in the Infant Electrocardiogram
Authors: DOMINGUEZ P. , LENDRUM B. L. , PICK A.
Published: June 2012

Electrocardiographic patterns of myocardial infarction are rarely found in infancy and suggest, in the first place, an anomalous origin of the left coronary artery. Five infants with such electrocardiograms are reported. In all coronary heart disease could be ruled out, in 4 by autopsy and in 1 by the clinical course. Comparison of these 5 cases with previously reported cases with similar electrocardiograms and autopsy control revealed that coronary patterns in infancy occur in a true and false variety. Some distinguishing features are discussed.
Blood Pressure and Obesity
Authors: WHYTE H. M.
Published: June 2012

Previous surveys have shown that height of observed blood pressure and degree of overweight are related. However, excess weight does not necessarily mean excess fat and the possibility of error in the measurement of blood pressure due to variations in the size of the arm has not been excluded. The present survey, taking these factors into account, shows that blood pressure is influenced by the total bulk of the body but not especially by fat except insofar as it contributes to total bulk. A possible explanation of the findings is offered.
"Peripheral Resistance" in Hypertension Following the Abolition of Local Sympathetic Tone
Authors: CALIVA FRANCIS S. , HARRIS JAY F. , LYONS RICHARD H.
Published: June 2012

Blood flows of the toe were studied before and after nerve block in normotensive and hypertensive patients, and an estimate of peripheral resistance was made. It was found that in all hypertensive patients there was an increased "peripheral resistance" at rest in the skin of the toe. Following abolition of sympathetic tone, the "resistance" in some individuals fell to a normal level, in others the "resistance" dropped less. The possible significance of these facts is discussed in the light of the etiologic factors responsible for the vasomotor tone.
Normal Response Curve to Exercise of Relative Cardiac Output Measured with Radioiodinated Serum Albumin
Authors: WEINBERG SYLVAN L. , GROVE G. RICHARD , ZIPF ROBERT E. , DANIELS DAVID C. , MURPHY JAMES P.
Published: June 2012

A simple, relatively precise, and clinically applicable indirect method of determining relative cardiac output is presented. The principle involved is a modification of the dye-dilution principle and is performed by external monitoring of intravenously injected radioiodinated serum albumin combined with a standard detecting and recording device. This procedure was performed serially before and after a standard Master test, and the results in 19 healthy individuals describe a relative cardiac output exercise response curve for normal individuals. The utilization of cardiac output in the manner presented may add another clinical measurement of cardiac function.
Effects of Intravenous Hydration and Pitressin on Renal Function in Subjects with Essential Hypertension
Authors: HOLLANDER WILLIAM
Published: June 2012

Various abnormalities in metabolism of water and electrolytes have been noted in patients with arterial hypertension and have variously been considered as causes or results of the hypertension. In this paper new data on these relationships are presented by a study of the changes in renal function produced by intravenous hydration, Pitressin, and lowering of the blood pressure.
Action of Nitroglycerin on the Coronary Circulation in Normal and in Mild Cardiac Subjects
Authors: BRACHFELD NORMAN , BOZER JOHN , GORLIN RICHARD , Smith Morris H. , Aleranderson Elin
Published: June 2012

Nitroglycerin has been used extensively as a coronary vasodilator. Its remarkable clinical effect has been presumed to be related to a direct action on the smooth muscle of the coronary arteriole. No observations have been made of nitroglycerin action on the coronary circulation in man. This report presents studies of changes induced by the drug in 10 normal or nearly normal subjects. The authors present evidence that although coronary vasodilatation does indeed occur, it appears to be secondary to changes in myocardial oxygen requirements. Hemodynamic observations revealed a general decrease in pressures in both peripheral and pulmonary circuits; caution is urged concerning the occasional severe hypotensive effects of nitroglycerin.
Spinal Epidural Hematoma during Anticoagulant Therapy
Authors: WINER BERTRAM M. , HORENSTEIN SIMON , STARR ALBERT M.
Published: June 2012

Spinal epidural hematoma complicated the course of anticoagulant therapy of cerebrovascular disease in a patient in whom observations of multiple aspects of coagulation had been obtained. Examination of this case and a review of the literature allow delineation of a syndrome that should aid in early diagnosis of spinal epidural hematoma. It is clear that coumarin derivatives induce multiple coagulation defects, which vary quantitatively and qualitatively with time. Contemporary evaluation of the benefits and risks of long-term anticoagulants is beset by many problems that have not been fully resolved.
Pericardial Tamponade Following Percutaneous Left Ventricular Puncture
Authors: BOTHAM RICHARD J. , ROWE G. G. , YOUNG W. P.
Published: June 2012

A case of pericardial tamponade following percutaneous left ventricular puncture for the assessment of aortic stenosis is presented. Technical factors pertinent to the etiology of the complication are discussed. Emphasis is placed on the fact that current enthusiasm for percutaneous ventricular puncture should be tempered with an awareness of the associated complications that may ensue and require immediate definitive therapy in an environment well equipped for their management.
Evaluation of Operability in Patients with Pulmonary Hypertension by Catheterization and Occlusion of Patent Ductus Arteriosus
Authors: ACTIS-DATO A. , TARQUINI A.
Published: June 2012

The authors describe a technic of temporary occlusion of the patent ductus arteriosus during right heart catheterization by a balloon filled with contrast medium connected to the tip of the catheter. This procedure is a valuable aid in the selection of patients with patent ductus arteriosus and severe pulmonary hypertension for operation.
Relationship between Diuretic and Antihypertensive Effects of Chlorothiazide and Mercurial Diuretics
Authors: HOLLANDER WILLIAM , CHOBANIAN ARAM V. , WILKINS ROBERT W.
Published: June 2012

Both chlorothiazide and parenteral mercurial diuretics have an antihypertensive as well as a natriuretic action. Previous observations have suggested that the antihypertensive effect is not due solely to sodium depletion. This paper expands these observations on a larger group of normotensive and hypertensive subjects and presents new studies on the effects of fluorohydrocortisone and SC-8109 (a "steroidal antagonist"), upon the sodium excretion and blood pressure of hypertensive patients during treatment with one of the diuretics.
Left Ventricular Activation Time in Left Ventricular Hypertrophy and in Left Bundle-Branch Block
Authors: WADA TAKASHI
Published: June 2012

Simultaneous tracings of right and left ventricular leads were taken in 6 dogs with experimentally produced left bundle-branch block, and in 30 clinical cases of left ventricular hypertrophy. In the experimental study it was found that the initial phase of the QRS complex in the right epicardial lead did not change its configuration or its duration after the production of left bundle-branch block. This observation offers a new concept of the septal and left ventricular activation in left bundle-branch block. It was concluded that a considerable portion of the left ventricle is activated normally in some cases of left bundle-branch block.
Studies of Fat Lipolysis by Post-Heparin Human Plasma Lipoprotein Lipase and by Human Pancreatic Lipase
Authors: ENGELBERG H.
Published: June 2012

Many studies indicate that unsaturated fats may lower serum cholesterol whereas saturated fats of animal origin usually increase it. The mechanism of these differing actions is unexplained, however. It has also been demonstrated that alimentary lipemia is cleared largely by an enzymatic lipolytic mechanism in which heparin is involved (heparin lipoprotein lipase). In this paper differences in hydrolysis of saturated and unsaturated fats by the heparin lipolytic factor are studied.
Extrapulmonic Stenosis of the Pulmonary Veins
Authors: BERNSTEIN JAY , NOLKE ANTHONY C. , REED JOSEPH O.
Published: June 2012

A case is reported of a 6-year-old boy who had developed pulmonary hypertension because of obstruction to the pulmonary venous flow by severe stenosis of the pulmonary veins at their junction with the left atrium. The development of collateral circulation through the bronchial vessels led to early, severe hemoptysis. The course was complicated by the development of pulmonary arterial and venous thrombi and hypertensive arteritis.
Use of a Calcium Chelating Agent(NaEDTA) in Cardiac Arrhythmias
Authors: COHEN BURTON D. , SPRITZ NORTON , LUBASH GLENN D. , RUBIN ALBERT L.
Published: June 2012

The interrelated effects of digitalis and various cations on cardiac rhythmicity are the subject of much recent interest. This paper presents additional data on this subject that carry important therapeutic implications. The chelating agent, disodium ethylene diamine tetra acetate (NaEDTA), has been used intravenously in 14 instances of supraventricular and ventricular arrhythmia. Digitalis had been administered previously in 13 instances, and various degrees of digitalization were encountered. This report summarizes our experience with NaEDTA as a test of the degree of digitalis therapy and as treatment of the arrhythmias observed.
A Large Whale Heart
Authors: RACE GEORGE J. , EDWARDS W. L. JACK , HALDEN E. R. , WILSON HUGH E. , LUIBEL FRANCIS J.
Published: June 2012

A large whale heart weighing 256 pounds (116 Kg.) was dissected. The coronary arteries had extremely large right and left marginal branches, which supplied the major lateral mass of the right and left ventricles. The venous system was similar to other mammals. Crude ventricular volume and cardiac output was calculated to be 453 L. per minute based on a rate of 10 per minute. The size of the cardiac muscle fiber was similar to the human myocardium except in a fetal whale heart (wt. 1,600 Gm.) in which very small fibers were found. The aorta was found to be 20 cm. in diameter and the wall to consist of very large interwoven bundles of elastie tissue and fibrous tissue apparently devoid of muscle. There was no evidence of arteriosclerosis. Comparative estimated cardiac output/body weight ratios and heart weight/body weight ratios were made between the whale and the human.
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 (1) the following features of left bundle branch block suggesting anteroseptal infarction—QS or qrS patterns in leads from the right precordium or localized to intermediate leads and/or cove plane inversion of the T waves near the transitional zone; (2) the following features of right bundle branch block suggesting infarction—pseudo Q waves, elevated RS-T segments and inverted T waves in right precordial leads, prominent Q waves in leads from the left precordium.
Blood Lipids and Human Atherosclerosis
Authors: GOFMAN JOHN W. , JONES HARDIN B. , LINDGREN FRANK T. , LYON THOMAS P. , ELLIOTT HAROLD A. , STRISOWER BEVERLY
Published: June 2012

The transport of cholesterol and other lipids of serum is almost wholly in the form of very large molecular complexes of these lipids with variable amounts of protein. The exact components present in the blood of a particular individual may be quantitatively described both as to character and concentration by ultracentrifugal flotation of these components in the analytic ultracentrifuge. With this technic it is possible to demonstrate the presence of certain lipid and lipoprotein components which are related to coronary atherosclerosis, to hypertension and to other diseases associated with atherosclerosis, such as diabetes mellitus, the nephrotic syndrome and hypothyroidism. The blood level of these components may be influenced by dietary means. The blood level of these components is poorly correlated with the analytic serum cholestrol determined by the Schoenheimer-Sperry method.
Changes in the Ballistocardiogram after Exercise in Normal and Abnormal Subjects
Authors: MAKINSON DONALD H.
Published: June 2012

Ballistocardiograms were taken before and at intervals after mild exercise. The normal response has been ascertained by a statistical study of results obtained on 40 healthy subjects. The response of patients varies widely; in some the change after exercise is much diminished, but in others the response is abnormally increased. In some the form of the ballistocardiogram, normal at rest, becomes abnormal after exercise, so the exercise test will often bring out abnormalities not detected by observations made at rest. Additional evidence was secured that the ballistocardiogram may become abnormal before the clinical picture of coronary heart disease develops.
Studies on Blood Coagulation and the Effect of Digitalis
Authors: SUTTON GEORGE C.
Published: June 2012

Preceding the study of the effect of digitalis upon coagulation of the blood, the reliability of the Lee and White method was determined in 173 normal adults. The effect of digitalis was then studied in cardiac patients before and after compenation and with normal controls in eacgroup: digitalis in clinical doses; addition of heparin to the blood; the heparin tolerance curve; the substitution of methyl methacrylate (Lucite) tubes; liver function as determined by excretion of bromsulfalein; prothrombin times.
The Electrical Conductivity of Living Tissues as it Pertains to Electrocardiography
Authors: BENJAMIN J. MALVERN , SCHWAN HERMAN , KAY CALVIN F. , HAFKENSCHIEL JOSEPH H.
Published: June 2012

Field analysis methods provide a convenient mathematical process for organization of electrocardiographic observations. The degree of divergence of calculated spatial orientations of heart forces from true orientations is dependent upon the magnitude of inaccuracy of the assumption that body tissues are electrically homogeneous. Preliminary to undertaking quantitative measurements of tissue resistivities in situ, technical difficulties of the problem have been surveyed, and previous studies have been analyzed. It is concluded that an accurate, quantitative measurement of such resistivity has not been made. If major inhomogeneity were found, current methods of application of field theory to electrocardiography might require extensive modification.
Effect of Khellin on Coronary Artery Insufficiency as Evaluated by Electrocardiographic Tests
Authors: BEST MAURICE M. , COE WALTER S.
Published: June 2012

The effectiveness of khellin in 9 patients with angina pectoris was evaluated electrocardiographically by means of the exercise tolerance, anoxemia and ergonovine tests. Normalization occurred in the majority of the previously abnormal tests following khellin therapy. A beneficial effect was noted on symptoms accompanied by a reduction in nitroglycerin requirement. Mild toxicity, as a result of khellin therapy, was observed in 3 cases.
The Isolation of Hypertensin from the Circulating Blood of Dogs by Dialysis in an Artificial Kidney
Authors: KAHN JOSEPH R. , SKEGGS LEONARD T. , SHUMWAY NORMAN P.
Published: June 2012

A vasopressor substance has been dialyzed out of the circulating blood of dogs by means of an artificial kidney. This substance is similar to hypertensin. It has been recovered from normotensive and hypotensive dogs and from animals with malignant hypertension. The method for concentration of this substance in the dialyzate is described and concentration data which, due to the loss in recovery, is only roughly quantitative, is given.
The Relationship between Prothrombin Time and Bleeding in the Clinical Use of Dicumarol after Operation
Authors: HOGBEN C. ADRIAN M. , ALLEN EDGAR V.
Published: June 2012

Experienced clinicians have known for some time that bleeding owing to the use of dicumarol is not entirely a measure of the degree of prothrombin deficiency. This presentation emphasizes that bleeding may occur when prothrombin deficiency is not great and that bleeding may fail to occur when prothrombin deficiency is marked. Nonetheless great prothrombin deficiency causes bleeding more frequently than lesser degrees of prothrombin deficiency. Time is an important factor, for patients are much more apt to bleed when prothrombin deficiency has endured for several days than when it has been present only a day or so.
Circulatory Dynamics in Spontaneous and Nephrogenic Hypertensive Dogs during the Depressor Response to Acute Inflammation
Authors: STAMLER J. , FISHMAN A. P. , KATZ L. N. , RODBARD S. , Ellis A. , Williams F.
Published: June 2012

Cardiac output and blood voluine are at control levels in unanesthetized hypertensive dogs during the depressor response to acute inflammation. Hence the fall in blood pressure is due to a decreased total peripheral resistance. The accompanying renal hyperemia indicates that decreased resistance in the renal vascular bed accounts for a significant portion of the fall in total peripheral resistance. Drug studies further suggest that acute inflammation operates to lower blood pressure in hypertensive dogs via mechanisms other than complete paralysis of autonomic vasomotor activity.
Antidiuretic Action of the Urine of Patients in Cardiac Failure
Authors: BERCU BERNARD A. , ROKAW STANLEY N. , MASSIE EDWARD
Published: June 2012

Stimulated by the increasing interest in the operation of antidiuretic principles and the recent development of new concepts of the mechanism of heart failure, this investigation was planned to study antidiuretic effects of the urine of patients with heart failure. It is noteworthy that an antidiuretic effect was induced in hydrated dogs by the intravenous injection of concentrated dialyzed urine of 12 of 15 patients with congestive heart failure. No such effect was exerted by urine from normal controls. Additional studies indicated that the antidiuresis could not be attributed to a substance with the characteristics of commercial Pitressin.
Arterioles of Kidney and Pancreas in Cases of Cardiac Hypertrophy of Undetermined Causation
Authors: FERRIS HAROLD A.
Published: June 2012

The arterioles in the kidneys and pancreas in 50 consecutive necropsy cases of cardiac hypertrophy of undetermined cause and in 50 control cases were measured and studied histopathologically in an effort to determine the cause of the cardiac hypertrophy. The weight of the heart, the ventricle affected by hypertrophy and the age of the patient also were recorded in each case and correlated with the changes in the ratio of the wall to lumen in the arterioles. This study revealed that in about 40 per cent of cases the cardiac hypertrophy was probably due to antecedent hypertension.
Valvular Pulmonic Stenosis with Intact Ventricular Septum and Patent Foramen Ovale
Authors: ENGLE MARY ALLEN , TAUSSIG HELEN B.
Published: June 2012

In this malformation the difficulty in sending blood through the stenosed pulmonary valve leads to right heart enlargement and to functional patency of the foramen ovale, through which a venousarterial shunt occurs. The onset of symptoms and their severity depend on the size of the opening in the pulmonary valve. Characteristic physical findings and results of fluoroscopy, electrocardiogram, circulation time, arterial blood studies, exercise test, angiocardiogram, and cardiac catheterization are presented. Diagnosis is important because these patients develop cardiac failure following at Blalock-Taussig operation, but may be greatly helped by pulmonic valvulotomy.
A Hypertensive Syndrome with Relative Adrenal Cortical Overactivity
Authors: DAVIES DEAN F. , CLARK HELEN E.
Published: June 2012

The authors have used the concentration of salt in sweat as an objective test to demonstrate the existence of a group of hypertensive patients with clinical signs of hyperadrenocortical function. The significantly lower concentration of salt in the sweat of patients with this endocrine hypertensive syndrome distinguishes them from other hypertensive patients who show no significant difference from normal. That this difference reflects an adrenal pathway is further suggested by Conn's demonstration that hypoadrenal activity is associated with high concentrations, and hyperadrenal function with low concentrations of salt in sweat.
Efficiency of Heparin in Retarding Media on the Maintenance of a Decreased Coagulability of the Blood
Authors: GLUECK HELEN I. , PODORE CLARENCE J. , LEVINSON JOSEPH E.
Published: June 2012

Heparin/Pitkin menstruum has been advocated in the therapy of a variety of thromboembolic disorders. The clinical properties of two such mixtures each with and without vasoconstrictor agents is evaluated and it is demonstrated that a significant prolongation of the clotting time beyond 24 hours cannot be obtained. A comparison between the one tube and the three tube methods for the determination of the coagulation time of blood reveals that both procedures yield comparable data.
Hemodynamic Study of a Case of Anomalous Pulmonary Venous Drainage
Authors: HWANG W. , PREC O. , KURAMOTO K. , SEGALL S. , KATZ L. N.
Published: June 2012

Complete drainage of the pulmonary veins into the right heart is one of the rarest and most severe congenital cardiac anomalies. The X-ray studies may suggest this diagnosis if pulmonary veins enter either coronary sinus or inferior vena cava. In the case reported, right heart catheterization and angiocardiography were used and the diagnosis of persisent left superior vena cava and partial direct drainage of the pulmonary veins into right auricle was made.
Survival to the Age of Seventy-Five Years with Congenital Pulmonary Stenosis and Patent Foramen Ovale
Authors: WHITE PAUL D. , HURST JOHN W. , FENNELL ROBERT H.
Published: June 2012

It is very rare for a person with cyanosis and finger clubbing due to congenital heart disease to reach old age. Survival beyond the age of 50 has been noted only a few times and, as far as we are aware, survival of a person with morbus caeruleus beyond 70 years is unique. The patient reported below showed at autopsy marked pulmonary stenosis and patency of the atrial septum simulating the tetralogy of Fallot. One of the reasons for the long survival was undoubtedly a markedly developed collateral bronchial circulation.
The Renal Excretion of Digitoxin in the Normal Subject after Single and Continuous Administration of the Drug
Authors: FRIEDMAN MEYER , BINE RENÉ , BYERS SANFORD O. , BLAND CATHERINE
Published: June 2012

By employing the embryonic duck heart method to assay digitoxin quantitatively in extracts of human urine, it was found that, contrary to previous opinion, a large percentage of ingested or in-injected digitoxin is excreted via the kidney in a physiologically active state. Approximately 40 per cent of a digitalizing dose (1.2 mg.) is excreted over a period of 12 to 24 days. The average rate of renal excretion in theoretically digitalized normal young individuals was found to vary from 30 to 50 µg. of digitoxin per day, while those showing signs or symptoms of overdosage excreted significantly greater amounts of digitoxin.
Cardiac Performance Capacity and the Effect of Exercise on Renal Plasma Flow in Aortic Insufficiency
Authors: GIBBONS THOMAS B. , HENSCHEL AUSTIN , TAYLOR HENRY LONGSTREET , CHAPMAN CARLETON B.
Published: June 2012

Maximal oxygen intake and renal plasma flow at rest and in work were measured in normal subjects and patients with aortic valve insufficiency; the tests measure some aspects of cardiovascular function. The lower maximal oxygen intake and renal plasma flow at rest and in work in these cardiac patients indicate a decreased cardiovascular performance capacity even though the patients were asymptomatic and their daily physical activity was not restricted.
The Effect of Posture and of Congestion of the Head on Sodium Excretion in Normal Subjects
Authors: LEWIS J. M. , BUIE R. M. , SEVIER S. M. , HARRISON T. R.
Published: June 2012

In healthy young subjects the sodium excretion is decidedly less in the sitting than in the recumbent posture. The difference can be partially overcome by compression of the neck in the sitting position. Some possible implications of these observations will be considered in the subsequent communications.
Experimental and Clinical Evaluation in Man of Hexamethonium (C6), A New Ganglionic Blocking Agent
Authors: FINNERTY FRANK A. , FREIS EDWARD D.
Published: June 2012

In man, C6, a new ganglionic blocking agent (50 mg. intravenously) produced inhibition of the Valsalva, tiltback and cold pressor vasopressor responses. Marked increases in digital blood flow and skin temperature with inhibition of digital reflexes to "noxious" stimuli were consistently observed (room temperature 70 F.). The increase in skin temperature was greater and more lasting than following Priscoline or tetraethylammonium chloride. Except for severe postural hypotension, side effects were minimal. Clinically the drug may be useful in the evaluation of sympathetic vasoconstriction in peripheral vascular disease as well as in the treatment of acute neurogenic vasospasm.
Oxygen Tension of Tissues by the Polarographic Method
Authors: MONTGOMERY HUGH , ZINSSER HARRY F. , HORWITZ ORVILLE
Published: June 2012

Normal individuals breathing pure oxygen obtain full saturation of their hemoglobin, whereas those with right to left shunts do not. Oxygen hemoglobin dissociation curves indicate that increases to full oxygen saturation of hemoglobin are accompanied by marked increases of the oxygen tension. When breathing oxygen fails to produce full saturation, relatively little change in oxygen tension occurs. When the cutaneous circulation is rapid, changes in skin oxygen tension have been shown to vary directly with changes in blood oxygen tension. Taking advantage of these facts the authors have described a method of detecting significant right to left shunts by polarographic measurements of skin oxygen tension.