bluuebunny/crossref_metadata_2025 huggingface dataset:
Myocarditis in Acute Infectious Diseases
Authors: FINE IRVING , BRAINERD HENRY , SOKOLOW MAURICE
Published: June 2012

Serial clinical and electrocardiographic studies were carried out on 84 patients suffering from a variety of acute infectious diseases. About one-third were found to have myocarditis on the basis of abnormal electrocardiograms. Abnormal physical findings were usually present. Evidence of congestive heart failure was uncommon. A group of patients subjected to artificial fever therapy did not manifest similar abnormalities.
The Ventricular Electrokymogram
Authors: AKMAN L. C. , MILLER A. J. , SILBER E. N. , SCHACK J. A. , KATZ L. N.
Published: June 2012

Over 200 left ventricular electrokymographic tracings were obtained in 32 normal adults, averaging more than six sites explored per individual. Records were analyzed with respect to the relationship of certain designated points to simultaneously recorded heart sounds. Considerable variability was demonstrated in these relationships both in tracings from different ventricular sites in the same individual and between comparable tracings from different individuals. The meaning of the ventricular electrokymogram and its clinical applicability are discussed in the light of these findings.
Aortography in Infants
Authors: KEITH JOHN D. , FORSYTH CONSTANCE
Published: June 2012

Making a diagnosis of a patency of a ductus arteriosus is often difficult in the first few months or first year of life. When the diagnosis is in doubt, one may profitably turn to angiocardiography for help. In this paper a method of demonstrating the patent ductus by the injection of contrast medium is described. The practical importance of the correct diagnosis is presented with reference to 4 cases treated surgically in the early months of life. Demonstration of coarctation of the aorta by this method is also discussed.
The Nature of the RS-T Segment Displacement as Studied with Esophageal Leads
Authors: SANDBERG AVERY A. , SCHERLIS LEONARD , GRISHMAN ARTHUR , WENER JOSEPH
Published: June 2012

The electrocardiographic changes, with particular reference to the RS-T segment and T wave, in surface leads and in esophageal leads reflecting left ventricular cavity potentials, are studied in 7 persons with and without heart disease, before and after the administration of digitoxin. After the administration of digitoxin, the RS-T segment depression in precordial leads and in esophageal leads reflecting the potentials of the posterior surface of the left ventricle, are regularly associated with RS-T segment elevation in esophageal leads reflecting left ventricular cavity potentials. The possible roles played by myocardial involvement due to digitalis, modification of the monophasic curves, and the reduction of the human ventricular gradient are discussed.
The Modern Treatment of Coronary Thrombosis with Myocardial Infarction
Authors: WRIGHT IRVING S.
Published: June 2012

Coronary thrombosis with myocardial infarction is an extremely serious disease to the individual and to the nation. It kills at least 200,000 persons a year and cripples unknown numbers. The modern treatment is herein outlined. Established therapy is reviewed and evaluated. The use and technics for the control of anticoagulant therapy are discussed.
Iproniazid in Angina Pectoris
Authors: SHOSHKES MILTON , ROTHFELD EDWIN L. , BECKER MARVIN C. , FINKELSTEIN AARON , SMITH CALVIN C. , WACHTEL FRED W.
Published: June 2012

There has been considerable recent interest in the treatment of angina pectoris with iproniazid. In this paper the results of a careful double-blind study of its effect are evaluated.
Familial Patterns in Hypertension and Coronary Heart Disease
Authors: THOMAS CAROLINE BEDELL
Published: June 2012

The family histories of Johns Hopkins medical students were studied in detail and independent evaluations were made of the prevalences of hypertension and of Coronary heart disease among the students' parents and grandparents. The hereditary factors in hypertension and coronary heart disease were studied and some interesting patterns of differences in sex inheritance became apparent that need further investigation.
Surgical Treatment of Atherosclerotic Occlusive Lesions in Patients with Cerebral Arterial Insufficiency
Authors: CRAWFORD E. STANLEY , DE BAKEY MICHAEL E. , FIELDS WILLIAM S. , COOLEY DENTON A. , MORRIS GEORGE C.
Published: June 2012

Cerebral vascular disease, according to the results of arteriography, may be caused by extracranial arterial lesions in one third of the cases. Observations in 174 cases are described. The results of surgical treatment in 63 patients are presented and evaluated on the basis of restoration of circulation, clinical improvement, and survival. The implications regarding diagnosis and indications and contraindications for surgery are discussed.
Functional Aortic Stenosis
Authors: MORROW ANDREW G. , BRAUNWALD EUGENE
Published: June 2012

When the clinical findings of aortic stenosis are present and a pressure gradient is demonstrated between the left ventricle and aorta, a discrete site of obstruction, generally amenable to surgical correction, has been assumed. The fallacy of this widely held concept is emphasized by the operative and hemodynamic findings in 3 patients described.
Right Bundle-Branch Block
Authors: DICKENS JANET , MARANHAO VLADIR , GOLDBERG HARRY
Published: June 2012

Confusion still exists regarding the differentiation between right bundle-branch block and right ventricular hypertrophy. Study of patients after open-heart surgery was helpful in this problem because postoperative changes in electrocardiograms and vectorcardiograms were clearly due to traumatic disturbance of the right bundle branch and not to right ventricular hypertrophy.
Formation of the "P-R Segment"
Authors: CACERES CESAR A. , KELSER GEORGE A. , MIZE W. RAYMOND
Published: June 2012

Variance of opinion among authors regarding the cause and duration of each succeeding portion of the P-R interval points out that knowledge regarding the physiologic basis for these waves is incomplete. Data regarding the P-R segment are scant in electrocardiographic literature. The necessity for precision in measurement and the need for better visualization of electrocardiographic waves to enhance their diagnostic value are illustrated by study of the generally ignored region between the P and QRS.
Plasma Norepinephrine Response to Tilting in Essential Hypertension
Authors: HICKLER ROGER B. , HAMLIN JAMES T. , WELLS ROE E.
Published: June 2012

A significant increase in the plasma concentration of norepinephrine on tilting 19 normal subjects from the horizontal to 60° upright is described. Evidence that this represents an increased neuroadrenergic activity to maintain cerebral circulation despite the peripheral pooling of blood has previously been reported. When 9 subjects with severe essential hypertension were similarly tilted, the rise in plasma norepinephrine concentration was insignificant. This may indicate a diminished neuroadrenergic activity in essential hypertension due to compensatory reflexes from the baroreceptor regions.
Phonocardiographic Features of Atrial Septal Defect
Authors: EISENBERG ROBERT , HULTGREN HERBERT N.
Published: June 2012

The heart sounds of 20 patients with uncomplicated atrial septal defect have been analyzed, and the deviations from a normal control group were noted. Following complete closure of the defect 11 patients have been restudied, and the changes produced in the heart sounds by closure of the defect are discussed. By comparison of pre-operative and postoperative heart sounds and electrocardiograms it has been possible to ascribe some abnormalities of the heart sounds to the presence of the left-to-right shunt, and some to the presence of delayed electrical depolarization of the right ventricle.
Renal Excretion of Sodium in Arterial Hypertension
Authors: HANENSON IRWIN B. , TAUSSKY HERTHA H. , POLASKY NATHAN , RANSOHOFF WILLIAM , MILLER BENJAMIN F.
Published: June 2012

Patients with arterial hypertension excrete a sodium load more rapidly than do individuals with normal blood pressure. The relationship of this abnormal sodium excretory response to blood pressure and such extrarenal factors as the central nervous system, dietary salt intake, body fluid volume and sodium content, and the adrenal glands has been studied. On the basis of this and other evidence, it is suggested that the exaggerated natriuresis is the result of a renal tubular defect which occurs after the development of hypertension.
Autopsy Studies in Atherosclerosis
Authors: ROBERTS JAMES C. , MOSES CAMPBELL , WILKINS ROBERT H.
Published: June 2012

Gross lesions of atheroselerosis in many arterial sites were graded in 500 consecutive autopsies in a general hospital. The grading system used took into account both the total area of intimal involvement and the severity of individual lesions. The first report analyzes the distribution and severity of atherosclerosis in the 347 men and women of the study group who died
without
morphologic evidence of atherosclerotic catastrophe in the heart, aorta, or brain. The second report describes the atherosclerotic lesions in patients who died
with
evidence of atherosclerotic catastrophe. The third report carries out a similar investigation in those subjects who presented evidence of obesity, hypertension, nephrosclerosis, and rheumatic heart disease.
Successful Surgical Repair of Aortic Insufficiency Due to Valvular Fenestration
Authors: BAILEY C. P. , BREST ALBERT N. , DONTAS NICOLAS , URICCHIO J. F.
Published: June 2012

A case of dynamic aortic insufficiency due to valvular fenestration is described. The defect was successfully repaired with an Ivalon patch to close the fenestration plus the surgical creation of a bicuspid aortic valve.
Diagnosis of Diffuse Myocardial Fibrosis
Authors: BURWELL C. SIDNEY , ROBIN EUGENE D.
Published: June 2012

Diffuse myocardial fibrosis is a disease of diverse etiology; the commonest cause is coronary artery disease. Physiologically, it produces a restriction of diastolic filling and thus resembles constrictive pericarditis and endocardial fibroelastosis. Clinically, it resembles constrictive pericarditis so closely that in many patients the differential diagnosis between these 2 disorders can be resolved only by thoracotomy and direct observation of the pericardium.
Pulmonary Resistance in Acquired Heart Disease
Authors: CHARMS BERNARD L. , BROFMAN BERNARD L. , KOHN PAUL M.
Published: June 2012

Disproportionately high pulmonary artery pressures and pulmonary vascular resistance in acquired heart disease, particularly mitral stenosis, have been repeatedly observed. Seventeen patients with pulmonary hypertension secondary to elevated left atrial pressure have been studied by the method of temporary unilateral pulmonary artery occlusion: Resistances calculated before and after occlusion showed no change in most cases. The data show that despite very high initial resistance, increase in flow in the lung can occur with rapid reduction in resistance. It is suggested that "tone" of the pulmonary vasculature is operative even at very high pressure levels.
Serum-Induced Thrombosis
Authors: WESSLER STANFORD , REINER LEOPOLD , FREIMAN DAVID G. , REIMER STANLEY M. , LERTZMAN MORLEY
Published: June 2012

A simple, reproducible, physiologic technic is delineated for the production and study of thromboembolism. The method is based on the observation that the infusion of serum, in striking contrast to plasma, induces massive thrombosis in vascular segments containing stagnant blood far removed from the site of infusion. Data are presented on the nature of the thrombosis-inducing activity of canine and human serum, on the effect of serum infusions on recipient animals, and on the morphology of the induced thrombus. The adaptability of this method to the study of a variety of thromboembolic phenomena in man is described.
A Simplified Indicator-Dilution Technic for the Localization of Left-to-Right Circulatory Shunts
Authors: BRAUNWALD EUGENE , PFAFF WILLIAM W. , LONG ROBERT T. L. , MORROW ANDREW G.
Published: June 2012

Indicator-dilution curves recorded from a systemic artery after injection in the right heart may show the presence of a left-to-right shunt but will not localize it. Injections into the left side of the heart with arterial sampling or into the pulmonary artery with right heart sampling provide accurate and sensitive methods for localization but the technics are inconvenient and sometimes impossible to apply. A simplified indicator method for the localization of left-to-right circulatory shunts is described.
Multiple and Infraductal Coarctations of the Aorta
Authors: ZAROFF LAWRENCE I. , KREEL ISADORE , SOBEL HAROLD J. , BARONOFSKY IVAN D.
Published: June 2012

Reports of multiple and infraductal coarctations are appearing more frequently in the literature as interest in the treatment of cardiovascular disease grows.

A case with 4 distinct coarctations is presented.
Supravalvular Aortic Stenosis
Authors: MORROW ANDREW G. , WALDHAUSEN JOHN A. , PETERS ROBERT L. , BLOODWELL ROBERT D. , BRAUNWALD EUGENE
Published: June 2012

In 3 patients obstruction to left ventricular outflow was shown to be due to a localized narrowing of the aortic root at the point of insertion of the aortic leaflets. The site of obstruction was localized by left heart catheterization and selective angiography. The pathologic findings in 2 patients are described and the problem of the surgical management of this unusual form of aortic stenosis is discussed.
Lipoproteins, Cholesterol and Serum Proteins as Predictors of Myocardial Infarction
Authors: PAGE IRVINE H. , LEWIS LENA A.
Published: June 2012

The normal variability of lipoprotein and cholesterol levels was established for 6 women over a period of 5 months for comparison with levels in people who develop myocardial infarction. We have studied 107 normal men for 7 years. Among these 11 developed infarction and 6 angina pectoris. Little change in lipid levels was associated with these events. Electrophoretic patterns early after infarction showed certain relatively characteristic changes, especially increase in α-2 and β globulins and fibrinogen. Low-density lipoprotein also increased. While α-2 globulin was usually greatest in patients with the most extensive myocardial damage, there was little over-all correlation between lipoprotein pattern and severity of infarction. The "coronary profile" can be more sharply delineated by repeated lipid measurements because as a group those with atherosclerosis and infarction exhibit slightly elevated values.
Relationship Between Plasma and Extracellular Fluid Volume Depletion and the Antihypertensive Effect of Chlorothiazide
Authors: WILSON ILSE M. , FREIS EDWARD D. , Taylor Mary J.
Published: June 2012

The importance of plasma and extracellular fluid volumes in the mechanism of the antihypertensive effect of chlorothiazide is disputed. The present investigation indicates that the lowering of blood pressure is accompanied by reductions in plasma and extracellular fluid volumes and in body weight. Furthermore, re-expansion of plasma volume with salt-free dextran reverses the antihypertensive effect. However, since gradual reaccumulation of extracellular fluid occurs during 1 year of continuous treatment, the
late
antihypertensive effects of chlorothiazide cannot be explained by the volume-depletion mechanism.
Evaluation of Chlorothiazide Alone in the Treatment of Moderately Severe and Severe Hypertension
Authors: FINNERTY FRANK A. , BUCHHOLZ JOACHIM H. , TUCKMAN JOHN , HAJJAR GEORGE T. , MASSARO GLORIA DECARLO
Published: June 2012

The effectiveness of alternate 6-month courses of chlorothiazide alone with standard antihypertensive therapy is compared in 11 patients with severe hypertension and 30 patients with moderately severe hypertension. These results are then compared with those of a 6-month combined treatment period when the patients received both chlorothiazide and standard antihypertensive therapy.
A Hydrostatic Pressure Stocking for the Treatment of Ulcers due to Chronic Venous Insufficiency
Authors: WOOD J. EDWIN
Published: June 2012

Chronic venous insufficiency may be complicated by ulceration of the skin of the involved extremity. The ulcers appear to be caused by the prolonged elevation of venous pressure in the leg and the resultant edema. A device is described that counterbalances exactly the elevated pressure in the veins of the leg, regardless of the position of the patient. This hydrostatic pressure stocking prevents formation of edema without interfering with the flow of blood through the tissues. The use of this device in the treatment of ulcers due to chronic venous insufficiency is also described.
Effect of Intravenous Heparin on Human Blood Viscosity
Authors: GOUSIOS ARISTIDES , SHEARN MARTIN A.
Published: June 2012

In view of conflicting reports, the effect of intravenously administered heparin on the viscosity of the blood of normal subjects was evaluated. A simple, in vivo technic based on Poiseuille's law was used in 18 subjects.
Electrocardiographic Studies in Pulmonary Disease
Authors: SPODICK DAVID H.
Published: June 2012

Electrocardiograms of 79 consecutively admitted patients with diffuse lung diseases were analyzed. The frontal plane P-wave axis and the P-wave configuration in limb and precordial leads emerged as the common denominator for the large majority of the group. Other abnormalities were common but not so characteristic.
Value of Continuous Photoelectric Recording of Dye Curves in the Estimation of Cardiac Output
Authors: RICHARDSON D. W. , WYSO E. M. , HECHT A. M. , FITZPATRICK D. P.
Published: June 2012

In order to test photoelectric recording of dye curves, simultaneous determinations of cardiac output were made in 48 patients with heart disease with the Fick and dye-dilution technics. The dye curves were recorded with a Colson densitometer following either intrathoracic or antecubital injection of dye. Both Evans blue and indocyanine green dyes were employed. Satisfactory agreement was noted between Fick and dye estimates, demonstrating empirically the usefulness of the continuous recording technic.
Atherosclerosis in the Bantu
Authors: STRONG JACK P. , WAINWRIGHT JOHN , MCGILL HENRY C.
Published: June 2012

The aortic lesions of atherosclerosis in Bantu, aged 1 to 40 years, have been studied in 241 autopsied cases from Durban, South Africa. The findings are compared with those from a similar study of white and Negro cases in New Orleans, La. The relationship of incidence and quantitative extent of aortic fatty streaks and fibrous plaques to race, environment, blood lipid levels, coagulation factors, and clinical manifestations of atherosclerosis is discussed.
Selection for Surgery of Patients with Ventricular Septal Defect and Pulmonary Hypertension
Authors: DUSHANE JAMES W. , KIRKLIN JOHN W.
Published: June 2012

Estimation of pulmonary blood flow relative to systemic blood flow is a critical point in selecting patients with ventricular septal defect and severe pulmonary hypertension for operation. A detailed medical history, physical examination, thoracic roentgenograms, careful interpretation of electrocardiograms, cardiac catheterization, and biopsy of the lung provide approaches to the problem. In borderline cases, decision still may be extremely difficult. The authors usually favor operation, however, with recognition that this decision may be in error. Obviously proper evaluation for operation cannot assure uniformly good results. Method of conduct of operation, perfusion, and postoperative care determine the results.
Secondary R Waves in Right Precordial Leads in Normal Persons and in Patients with Cardiac Disease
Authors: TAPIA FERNANDO A. , PROUDFIT WILLIAM L.
Published: June 2012

Secondary R waves in leads V
1
or V
3R
are definitely abnormal if the primiary R wave is high for the age group even though the R' is small; if the secondary R wave is more than 6 mm.; or if the R'/S ratio exceeds 1. Other patterns may be found both in patients with heart disease and in normal subjects. In the abnormal cases, the QRS changes persist in leads taken below but in line with V
1
and V
3R
; but in normal cases, the secondary R waves usually disappear in the lower leads.
A Study of Renal Function in Orthostatic Hypotension
Authors: BRODWALL ERLING KRUGE
Published: June 2012

Renal function studies have been carried out in both the recumbent and in the oblique position in 2 cases of orthostatic hypotension. In both cases a definite fall in plasma flow and glomerular filtration rate took place, but this occurred only after registration of a considerable fall in blood pressure.

The filtration fraction remains unchanged after the fall in blood pressure. The extraction ratio remains unchanged after a considerable fall in blood pressure.

The data may indicate that the renal function becomes normal if blood pressure is kept on a low level over a fairly long period. However, further observations are required before any definite conclusion may be drawn.
Configuration of Elastic Tissue of Pulmonary Trunk in Idiopathic Pulmonary Hypertension
Authors: HEATH DONALD , EDWARDS JESSE E.
Published: June 2012

A study was made of the configuration of the elastic tissue of the pulmonary trunk in 6 cases of idiopathic pulmonary hypertension. The ages of the patients ranged from 12 to 54 years. The pattern was that of the adult pulmonary type in the 5 female patients, whereas it more closely resembled the fetal, aorta-like type in the single male patient. These data are interpreted as indicating that idiopathic pulmonary hypertension is acquired in most cases but that it may be present from birth in a minority of instances.
Coronary Embolism Following Repair of a Ventricular Septal Defect
Authors: WINTERS WILLIAM L. , LAUTSCH ELIZABETH V. , SOLOFF LOUIS A.
Published: June 2012

A unique cause of coronary embolism is described: open-heart surgery for correction of a ventricular septal defect.
Goitre Plongeant
Authors: PERKINS HENRY T. , MCINTOSH HENRY D. , BOINEAU JOHN P.
Published: June 2012

The diagnosis of an intrathoracic goiter can, on occasion, be difficult to confirm. The Valsalva maneuver was found useful in making this diagnosis in 2 patients whose case histories are reported. Such goiters are termed plunging goiters. The phenomenon is discussed and the use of the Valsalva maneuver in demonstrating such lesions is emphasized.
SYMPOSIUM ON CONGESTIVE HEART FAILURE
Authors: KATZ L. N. , FEINBERG H. , SHAFFER A. B.
Published: June 2012

The 3 articles in this issue on congestive heart failure comprise the first of 10 contributions on this subject. The remaining 7 articles will be published in the February and March issues.—EDITOR.
The Use of L-Lysine Monohydrochloride in Combination with Mercurial Diuretics in the Treatment of Refractory Fluid Retention
Authors: RUBIN ALBERT L. , SPRITZ NORTON , MEAD ALLEN W. , HERRMANN RICHARD A. , BRAVEMAN WARREN S. , LUCKEY E. HUGH
Published: June 2012

Administration of large doses of L-lysine monohydrochloride at meal times has proved to be an efficient method, free of significant side effects, for the production of a hyperchloremic acidosis to restore responsiveness to mercurial diuretics in cardiac and cirrhotic patients with refractory fluid retention. Results obtained in a group of 14 patients are presented and advantages of L-lysine monohydrochloride over previously available acidifying chloride salts are discussed.
Differentiation of Interatrial Communications by Clinical Methods
Authors: DUSHANE JAMES W. , WEIDMAN WILLIAM H. , BRANDENBURG ROBERT O. , KIRKLIN JOHN W.
Published: June 2012

Of 128 children with anatomically confirmed interatrial communications 74 had ostium secundum, 37 had ostium primum defects, 5 had common atrium, and 12 had total anomalous pulmonary venous connection.

Analysis of the medical history, physical examination, roentgenogram, and electrocardiogram resulted in accurate diagnosis in most instances. In 6 of the 128 patients the proper diagnosis was not made: 3 infants with total anomalous pulmonary venous connection died within a few hours after admission to the hospital and did not have proper diagnostic evaluation; the condition of 3 other patients with ostium secundum defects was misdiagnosed as ostium primum defect before surgical treatment.

In patients with ostium secundum and ostium primum defects the symptoms, signs, roentgenologic data, and findings at cardiac catheterization are similar, but differences in respect to the electrocardiograms are striking when the latter are subjected to vectorial analysis. The QRS loop is clockwise in the presence of ostium secundum defect and counterclockwise when ostium primum defect is at hand.

Clinical and roentgenologic manifestations also are noted among patients with common atrium and total anomalous pulmonary venous connection, and the findings at cardiac catheterization likewise may be similar, but the electrocardiographic differences are significant. The QRS loop is counterclockwise in patients with common atrium and clockwise in patients with total anomalous pulmonary venous connection.
Gonadal Dysgenesis with Cor Pulmonale
Authors: DAVIDSON LINDSAY , HEATH DONALD
Published: June 2012

The clinical and pathologic features of a 37-year-old patient with Turner's syndrome are described. Dyspnea developed in the third decade and respiratory signs and symptoms finally dominated the clinical picture, so that the case appeared terminally as one of anoxic cor pumonale. The heart failure is considered to be related to the kyphoscoliosis present as one of the skeletal deformities of the syndrome.
Open Operation in the Treatment of Calcific Aortic Stenosis
Authors: KIRKLIN JOHN W. , MANKIN HAROLD T.
Published: June 2012

Calcareous disease of the aortic valve, diagnosed by fairly uniform signs and measurements, has been treated in 14 cases at the Mayo Clinic by an open surgical technic with utilization of extracorporeal circulation. One patient died during the operation and another died after leaving the hospital. Among 7 cases followed 6 to 9 months after operation, definite symptomatic improvement has been shown in 6.

This disease is very dangerous, but a small improvement in the size of the valvular orifice can bring important benefits. The open operation is advantageous in avoidance of creating or aggravating insufficiency while relieving stenosis.

Presently this operation is advised for patients whose disability is significant or progressing. Severe coexisting coronary artery disease is a contraindication; but associated aortic valvular insufficiency, advanced degrees of disability, and left ventricular failure are not.
Volume Receptors
Authors: WELT LOUIS G.
Published: June 2012

This paper reviews the complicated interplay which may be involved in the retention of water and salt by the kidney. For the sake of brevity, it does not treat either the mechanisms which regulate the intake of water or the disposition of fluid throughout the body. The neurohumoral pathways by which a change in intravascular volume can effect a retention of water by the kidney receives particular attention. The difficulties in dissociating intrarenal from extrarenal determinants of salt and water excretion are considered in detail.
Adrenocorticotropic Action of Antidiuretic Hormone
Authors: HILTON JAMES G.
Published: June 2012

By means of direct arterial perfusion of the adrenal glands of the hypophysectomized dog, it has been shown that synthetic lysine, arginine and acetyl arginine vasopressins stimulate the adrenal cortex directly to secrete hydrocortisone. Pressor activity and cortisol-stimulating activity were demonstrated to be independent of each other. Similar polypeptides, such as oxytocin, insulin, glucagon, and pressor amines, such as epinephrine and norepinephrine, did not show any cortisol-stimulating activity. ACTH was found consistently to increase the rate of secretion of aldosterone when perfused through the glands of hypophysectomized animals. The probable role of arginine vasopressin as an important factor in the stress reaction is considered along with its postulated ability to activate adrenal phosphorylase.
Clinical and Cardiodynamic Effects of Adrenocortical
Authors: GREENE MURRAY A. , GORDON ARTHUR , BOLTAX ADOLPH J.
Published: June 2012

This study is concerned with the effects of adrenocortical steroids in patients with congestive heart failure.

Nine adults with heart failure were studied during a steady clinical state (5 to 7 days), during administration for 13 to 16 days of prednisome (6 patients) or triamcinolone (3 patients) and in some subjects following steroid withdrawal. Daily determinations of fluid balances were made. Standard right heart catheterizations and measurements of blood volumes were performed prior to and at the termination of therapy.

Three types of responses to steroids occurred. In 5 patients increases in subjective and objective manifestations of heart failure and increased fluid retention occurred. Four of them developed precarious clinical conditions during steroid therapy, requiring mercurial diuretics, but with poor results. In general, cardiodynamic status at the termination of steroid therapy correlated well with clinical status. In 3 patients the clinical status did not change. Some depression in urinary sodium and chloride excretions were noted during therapy. Cardiodynamics were unaltered, except for an unexplained decrease in right ventricular end-diastolic pressure in 1 patient. In 1 patient clinical and cardiodynamic state improved, despite positive fluid balance. This was the only subject with primary lung disease (emphysema) and cor pulmonale.

These studies suggest that corticosteroids are generally detrimental in uncomplicated congestive heart failure. Greater deterioration appeared in subjects having the more severe degrees of decompensation, suggesting that exogenous fluid-retaining influences were added to endogenous fluid-retaining forces, resulting in further accumulation of fluid in a circulatory system already burdened by hypervolemia.
Changes in the Character and Location of Arterial Lesions in Mammals and Birds in the Philadelphia Zoological Garden
Authors: RATCLIFFE H. L. , YERASIMIDES T. G. , ELLIOTT G. A.
Published: June 2012

Improved nutrition for mammals and birds at the Philadelphia Zoological Garden has been followed by continued increases in the frequency of arteriosclerosis and by changes in the character and location of the lesions. During the first decade after diets were improved the large atheromata of the proximal aorta and brachiocephalic arteries of birds were replaced by smaller, more compact lesions, usually of the abdominal aorta. At the same time many species of mammals developed atheromata of the aorta, whereas earlier these lesions had been found chiefly in baboons and monkeys (Cercopithecidae).

During the second decade of adequate nutrition, and especially since 1950, arteriosclerosis of the coronary arteries has become relatively common in both mammals and birds. Usually this lesion has developed in the distal, intramural segments of the coronary arteries, as intimal thickening and occlusion. Most frequently it has been associated with myocardial fibrosis, but it also has led to myocardial infarction and sudden death in both mammals and birds. Present evidence suggests that this lesion reflects a response of adequately nourished animals to population densities.
Some Properties of Ionic and Nonionic Semipermeable Membranes
Authors: MAURO ALEXANDER
Published: June 2012

Some fundamental properties of barriers are reviewed. The barrier of biologic significance is the plasma membrane. The role of the barrier in the transport of solvent and neutral solute species is discussed; 2 fundamental transport processes, namely, diffusion and mass flow are emphasized. The latter is shown to arise as the barrier offers increasing impedance to the movement of a given solute species; the barrier is then referred to as a semipermeable membrane, and the transport of the solvent as osmosis. The osmotic movement, undoubtedly one of the most important transport mechanisms in physiologic systems, is shown to arise from a gradient of hydrostatic pressure in the barrier. The need for the consideration of profiles of thermodynamic quantities is stressed. Finally, the third thermodynamic quantity, electrical potential, is introduced when ionic species are considered in the analysis of the "fixed charge" membrane.
Osmotic Concentration and Dilution in the Mammalian Nephron
Authors: GOTTSCHALK CARL WILLIAM
Published: June 2012

The micropuncture evidence relating to the location and the mechanism for concentration and dilution of the urine is reviewed. As required by the countercurrent hypothesis for urine concentration, these data demonstrate that in the presence of antidiuretic hormone, the tubular urine is first concentrated in the descending limb of the loop of Henle and then diluted in the ascending limb of the loop before its final concentration in the collecting ducts. The loop of Henle is believed to function as a countercurrent multiplier system, and the vasa recta as countercurrent diffusion exchangers. Additional data are required during water diuresis before the course of events in this condition is established.
Mucopolysaccharides and Sodium Metabolism
Authors: FARBER SAUL J.
Published: June 2012

This paper deals with the possible relationship between a native, negatively charged polyelectrolyte, chondroitin sulfate, and sodium metabolism. The physical chemical property of decreased activity of the cations Na, K and Ca in chondroitin sulfate is described. The data of experiments indicating an alteration in the mucoprotein metabolism of the cartilage of the rabbit's ear in response to the depletion of salt are presented.
The Salt-Secreting Gland of Marine Birds
Authors: SCHMIDT-NIELSEN KNUT
Published: June 2012

Marine birds possess salt-secreting nasal glands which produce hypertonic solutions of sodium chloride in response to osmotic loads such as ingestion of sea water. The concentration of the secreted fluid is always high, several times as high as the maximum urine concentration in birds. The presence of this gland must be considered a necessary adaptation to marine life in animals whose kidney cannot excrete high salt concentrations. The structure and blood supply to the gland indicate a countercurrent flow, but at the moment it is not possible to explain the high concentrations of the secreted fluid as the result of a countercurrent multiplier system. The gland is under parasympathetic nerve control; its secretory function is blocked by anesthesia and certain drugs, including carbonic anhydrase inhibitors.
Electrolyte Excretion in Bile
Authors: WHEELER HENRY O. , RAMOS OSWALDO L. , WHITLOCK ROBERT T.
Published: June 2012

The high concentration of certain test substances in both urine and bile suggests that similarities exist between the biliary and renal tubular functions. Evidence from dogs with permanent duodenal fistulas indicates that the rate of elaboration of bile depends primarily on the rate of secretion of bile salts. The variations in flow and composition of hepatic bile seem to result from the addition of a fluid which is similar in some respects to pancreatic juice.
Differential Diagnosis of the Taussig-Bing Heart from Complete Transposition of the Great Vessels with a Posteriorly Overriding Pulmonary Artery
Authors: BEUREN ALOIS
Published: June 2012

The Taussig-Bing transposition bears the name of the authors who described for the first time the clinical, physiologic, and anatomic findings. It has been recognized that the malformation is physiologically not so distinct as it is anatomically and that a transposition with the same physiologic pattern but different anatomy has been observed. Several case reports have appeared in the literature in which no clear differentiation was made in regard to the second type of transposition with overriding pulmonary artery. In the latter instance there is a complete transposition of both great vessels with a posteriorly placed overriding pulmonary artery in contrast to the original Taussig-Bing heart in which the 2 vessels are side by side, the pulmonary artery being in its normal place.

Following the original case report, 14 cases were seen in this clinic in which the diagnosis was established either by catheterization, angiocardiography, or autopsy. In 4 other cases, the diagnosis of a transposition with a posterior overriding pulmonary artery was made. Criteria for the differential diagnosis of these 2 lesions are pointed out. The differentiation of these 2 transpositions is of particular importance for possible surgical correction.
Prognostic Significance of Raynaud's Phenomenon and Other Clinical Characteristics of Systemic Scleroderma
Authors: FARMER RICHARD G. , GIFFORD RAY W. , HINES EDGAR A.
Published: June 2012

Two hundred seventy-one patients with unequivocal systemic scleroderma for whom the diagnosis was first established at the Mayo Clinic between January 1, 1945, and December 31, 1952, have been studied. Follow-up information was obtained 5 to 13 years after the diagnosis at the clinic concerning 236 of these patients, 115 of whom were dead. The cases were analyzed in an effort to determine what factors had a bearing on prognosis. The following seemed to bear little relation to the ultimate prognosis: sex, mode of onset, Raynaud's phenomenon, involvement of lungs and periodontal membrane, calcinosis cutis, and trophic changes. The following were considered poor prognostic omens: cardiac or renal involvement, significant elevation of the erythrocyte sedimentation rate, and anemia.

The prognosis in systemic scleroderma was found to be worse than previous reports had indicated. This study yielded no basis for the subdivision of systemic scleroderma into acrosclerosis and generalized progressive scleroderma.
A Case of Kinking of the Aortic Arch
Authors: ŠARIĆ S. , VULETIĆ V. , GVOZDANOVIĆ V. , MARK B.
Published: June 2012

A case of uncommon aortic anomaly has been described. The clinical signs as well as the differential diagnosis are stressed.
The Electrocardiogram in Population Studies
Authors: BLACKBURN HENRY , KEYS ANCEL , SIMONSON ERNST , RAUTAHARJU PENTTI , PUNSAR SVEN
Published: June 2012

Information now available about the prevalence and incidence of coronary heart disease is seriously deficient because of the lack of standardized and objective methods of collection, tabulation, interpretation, and reporting of survey data. Chief reliance in the
objective
diagnosis of coronary heart disease rests on the electrocardiogram, a crucial tool in population studies. A classification system for the electrocardiogram in epidemiologic studies has been developed, tested, and herein presented. It is adapted to the usual clinical reading technics of the electrocardiographer. It embodies criteria widely employed and of diagnostic and prognostic import, but
no
stipulations about interpretation are made. The system permits more valid comparisons of data on heart disease between populations. It is susceptible to modern methods of data processing.
Vitamin E
Authors: HARMAN DENHAM
Published: June 2012

Vitamin E had no significant effect on serum levels of cholesterol or lipoproteins when taken orally by normal working individuals at the level of 300 or 600 mg. per day for a period of 4 weeks.
Electrocardiogram in Asthmatic Children
Authors: MIYAMOTO TERUMASA , KASS IRVING , HOFFMAN MURRAY S.
Published: June 2012

Electrocardiograms of 137 asthmatic children, 5 to 16 years in age, were compared with findings in normal children.

The following deviations from normal were found: lower voltage and longer duration of P waves in all leads; lower voltage of R waves in all precordial leads and almost all limb and unipolar leads; deeper S waves over left precordial leads; slight delay of intrinsicoid deflection in right precordial leads, but no difference in left precordial leads; somewhat increased duration of QRS complexes; increased heart rate in the older age groups, but no differences in P-R and Q-T intervals; predominantly vertical electrocardiographic position of the heart.

These observations provide further electro-cardiographic evidence that asthmatic children, compared with normal children of the same age range, show a tendency toward right ventricular hypertrophy and hyperinflated lungs.
Tricuspid Stenosis with Pulmonary Atresia
Authors: PAUL MILTON H. , LEV MAURICE
Published: June 2012

An opportunity was presented during cardiac catheterization to study the hemodynamic function of the obstructed right ventricular chamber in a heart with tricuspid stenosis, pulmonary atresia, and an intact ventricular septum.

Cineangiocardiograms demonstrated that the anatomically stenotic tricuspid orifice was also a regurgitant orifice and it is postulated that the bidirectional flow of blood associated with the tricuspid regurgitation prevents the obstructed ventricle from becoming obliterated by stasis-thrombosis.
Intermittent Disappearance of the Murmur of Patent Ductus Arteriosus
Authors: SHAPIRO WILLIAM , SAID SAMI I. , NOVA PHILLIP L.
Published: June 2012

Transient spontaneous disappearance of the machinery murmur in an otherwise typical case of patent ductus arteriosus unassociated with pulmonary hypertension is described.

Observations of blood pressure changes, physiologic dead space variations in the upright and horizontal postures, and the anatomy of the ductus arteriosus suggested that shunt flow was absent or markedly reduced during the periods in which the murmur was inaudible.
Liver Function in Patients with Elevated Serum Cholesterol or Low-Density Lipoproteins
Authors: ENGELBERG H.
Published: June 2012

Liver function tests were performed in 42 individuals with increased levels of serum cholesterol and low-density lipoproteins. The tests were normal in 39 patients; the sulfobromophthalein excretion was impaired in 3. These results indicate that disturbances in liver function are not usually involved in elevations of serum triglycerides. Other clinical evidence is discussed which suggests that the heparin lipoprotein-lipase lipolytic mechanism, but not the liver or reticuloendothelial system, occupies the initial role in the removal of alimentary fat from the bloodstream in man.
Atherosclerosis and Related Factors in Immigrants to Israel
Authors: TOOR M. , KATCHALSKY A. , AGMON J. , ALLALOUF D.
Published: June 2012

Clinical experience in Israel, supported by statistical surveys, showed a low incidence of atherosclerosis among immigrants from eastern countries as compared to immigrants from western countries. In particular, the incidence of atherosclerosis among immigrants from Yemen was found to be strikingly low.

An investigation of the socioeconomic condition, diet, and nutritional status of 2,200 immigrants from western and eastern countries belonging to different social groups was carried out. Determinations of serum total lipids, total cholesterol, alpha and beta cholesterol, phospholipids, lipoproteins, proteins, and protein fractions were performed.

Significantly the lowest serum cholesterol and beta cholesterol values were found among the "recent" Yemenites (after 5 years in Israel), the poorest economically, and with an imbalanced caloric intake of the lowest fat content. Higher cholesterol and beta cholesterol values were found among "early" (after 20 years in Israel) Yemenites, Iraqi, and European manual workers with no significant differences among them, whereas in Europeans of higher economic level these values were even higher.

Review of 5,000 hospitalized cases of myocardial infarction showed a very low incidence for Yemenites, higher for immigrants from other eastern countries, and considerably higher for European immigrants.

A statistical survey of the entire population for the years 1953 to 1957 showed that the mortality rate from atherosclerosis was extremely low for "recent" Yemenites, considerably higher for "early" Yemenites, and still higher for European immigrants.

These results suggest the influence of socioeconomic conditions, diet, and total caloric balance on serum cholesterol values and atherosclerosis morbidity and mortality. They support the assumption that atherosclerosis is a disease of lipid metabolism influenced by phenotypic factors and therefore can be prevented.
Blood Pressure in Bushmen of the Kalahari Desert
Authors: KAMINER BENJAMIN , LUTZ W. P. W.
Published: June 2012

The blood pressure was studied in 42 males and 36 females in 2 groups of nomadic Bushmen, living near Ghanzi in the Kalahari Desert, as well as in a third group of 21 Bushmen prisoners and farm laborers from the same region. The pressures were also "corrected" for arm girth.

The average systolic pressures were 108.4 mm. Hg (S.D. 11.4) for men and 112.8 mm. Hg (S.D. 14.6) for women. The average diastolic pressures were 66.2 mm. Hg (S.D. 6.9) and 69.6 mm. Hg (S.D. 8.0) for men and women, respectively. These pressures with stated exception, are considered to be lower than for most populations.

In the women, the systolic and diastolic pressures were higher than those in the men.

The blood pressure showed no tendency to rise with age, an observation in contrast to that found in most other populations. It was suggested that an increase of the blood pressure with age may be an indication of the existence of essential hypertension within that population.

The blood pressures of Bushmen prisoners and farm laborers were higher than those in nomadic Bushmen.

Further investigation is needed of the genetic and environmental factors affecting the blood pressure in the nomadic Bushmen.
Cardiac Enlargement in Chronic Severe Anemia
Authors: SANGHVI L. M. , MISRA S. N. , BANERJEE K.
Published: June 2012

One hundred and fifty patients with chronic severe anemia were studied to determine the nature of cardiac enlargement and its relation to various factors.

Enlargement was present in 120 patients. It showed no consistent relation to the hemoglobin level on admission. A significant increase in the cardiac size and incidence of failure was observed with increased severity of anemia, and in female as compared to male patients. The incidence of enlargement showed no relation to the age and sex of the patient and the duration or the etiologic factor of anemia.

With correction of the anemia, enlargement disappeared rapidly in 92 patients, indicating that it was due to dilatation alone. Some enlargement persisted in 28 patients, and it is believed to be associated with cardiac hypertrophy.

Pericardial effusion due to heart failure in 2 patients contributed to a small extent to the enlargement of the cardiac shadow.
Metastatic Cancer to the Heart
Authors: HANFLING STANLEY M.
Published: June 2012

A review of the literature of metastatic cancer to the heart is presented, and a new classification offered.

Autopsy data of The New York Hospital have been analyzed. In the 7-year period, 1947 to 1953, in 694 deaths from cancer, an over-all incidence of 18.3 per cent (127 cases) of metastases to the heart was observed. In a group of 169 cases of lymphoma, leukemia, and myeloma, there was an incidence of 36 per cent (61 cases) of metastases to the heart. In the remaining 525 cases, there was an incidence of 12.6 per cent (66 cases) of metastases to the heart. In 61 of these, gross lesions were present, an incidence of 11.6 per cent (61 cases) of gross metastases to the heart. These figures are comparable to those reported in other series.