bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Acetylcholine on Hemodynamics and Blood Oxygen Saturation in Mitral Stenosis
Authors: STANFIELD C. ALPHEUS , FINLAYSON JAMES K. , LURIA MILTON N. , CONSTANTINE HERBERT , FLATLEY F. JOSEPH , Yu PAUL N. 
Published: June 2012

Acetylcholine was infused into the main pulmonary artery in a dose of 2 to 12 mg. per minute to 18 patients with mitral stenosis of rheumatic origin. The drug produced significant arterial oxygen desaturation in nine patients. This was associtaed with (a) a decrease in pulmonary resistance and pulmonary arterial pressure, (b) an increase in cardiac index and stroke index, and (c) an increase in "central" blood volume. The changes in the above parameters were minimal or in opposite direction in those patients who showed no significant desaturation.
The data did not lend support to the explanation that arterial desaturation during acetylcholine infusion was due to (a) decreased alveolar ventilaton, (b) focal bronchoconstriction, or (c) opening of pulmonary arteriovenous shunts bypassing the alveoli.
Evidence is presented to show that the most likely mechanism of the decline in arterial oxygen saturation during acetylcholine infusion was an increased pulmonary blood flow in pre-existing poorly ventilated regions of the lungs as a consequence of pulmonary arteriolar dilatation. These changes resulted in a significant lowering of the arterial blood oxygen tension and content, and a considerable widening of the alveolar-arterial oxygen gradient.
The Natural History of Isolated Ventricular Septal Defect
Authors: LUCAS RUSSELL V. , ADAMS PAUL , ANDERSON RAY C. , MEYNE NICOLAAS G. , LILLEHEI C. WALTON , VARCO RICHARD L. 
Published: June 2012

Forty patients with isolated ventricular septal defect were studied physiologically two or more times before they underwent surgical treatment. Utilizing baselines obtained by heart catheterizations of normal infants and children, we grouped patients with ventricular septal defect according to the magnitude of the total pulmonary resistance, pulmonary blood flow, and pulmonary arterial pressure, and according to changes in these values over time. The patients with small defects (less than 1 cm. per M.
2
of body surface area) were easily separable on the basis of physiologic findings. Patients with large ventricular septal defects (greater than 1 cm. per M.
2
of body surface area) exhibited one of three possible initial responses to the stress of high pulsatile pulmonary flow and increased pulmonary artery pressure: (1) normal regression of total pulmonary resistance; (2) delayed fall in total pulmonary resistance; (3) failure of the total pulmonary resistance to decrease with age.

These physiologic responses were thought to be related to normal maturation, delayed maturation, or failure of maturation of the pulmonary vascular bed. It was observed that a subsequent increase in total pulmonary resistance could be superimposed on any of the three initial responses at any time. Clinical evidence and catheterization data suggested that the relative size of the ventricular septal defect had decreased in five patients.
The variability of the physiologic courses, the importance of the pulmonary vascular bed in determining these responses, and our lack of understanding of the etiology of the pulmonary vascular changes were noted.
The indications for, and timing of surgical intervention in patients with isolated ventricular septal defects, are discussed in light of the above findings.
Clinical and Chemical Studies with
α
-Methyl-Dopa in Patients with Hypertension
Authors: GILLESPIE LOUIS , OATES JOHN A. , CROUT J. RICHARD , SJOERDSMA ALBERT 
Published: June 2012

A series of observations in 52 hypertensive patients is presented indicating that α-methyl-dopa is an effective antihypertensive agent.
The antihypertensive properties of the agent were discovered in the course of biochemical studies with the racemic compound the form used in initial therapeutic trials.

Studies on metabolism of
dl
-α-methyl-dopa indicate incomplete intestinal absorption and rapid excretion in the urine as unchanged drug and as α-methyl-dopamine. The former finding does not seem to be a significant deterrent to its use orally.

Comparisons of the
d
and
l
isomers of α-methyl-dopa in hypertensive patients showed that all the chemical and pharmacologic effects reside in the
l
-isomer (Aldomet). Thus, recent studies have been performed with Aldomet exclusively.

From observations to date the impression has been gained that Aldomet has several advantages over other antihypertensive agents; these include effectiveness against all degrees of hypertension, frequent lowering of recumbent as well as standing blood pressure, smoothness of effect, and tranquilizing effects. Questions of toxicity and tolerance are not yet completely answered.

Sympathetic blockade at a central or peripheral site is the probable basis of the drug's action. This effect may be unrelated to the biochemical property of inhibiting the decarboxylation of aromatic
l
-amino acids and is possibly due to depletion of tissue stores of norepinephrine by a mechanism not yet fully defined.
Restoration of Normal Intracardiac Pressures after Extensive Pericardiectomy for Constrictive Pericarditis
Authors: FITZPATRICK D. P. , WYSO E. M. , BOSHER L. H. , RICHARDSON D. W. 
Published: June 2012

In each of seven patients studied by cardiac catheterization more than 2 weeks after extensive pericardiectomy, performed because of constrictive pericarditis, normal right heart pressure-pulse contours were demonstrated.
The extensiveness of pericardial removal seems the most likely explanation for the normal catheterization findings, which contrast with demonstration by other workers of persistence for periods up to 2 years of the "W"-shaped atrial pressures and high end-diastolic ventricular pressures characteristic of pericardial constriction.
Clinical findings, abnormal right heart pressures, and surgical considerations are presented for a total of 11 patients with constrictive pericarditis who were subjected to pericardiectomy between 1955 and 1960.
Endocardial Cushion Defect with Pulmonic Stenosis
Authors: SCOTT LEWIS P. , HAUCK ANNA J. , NADAS ALEXANDER S. 
Published: June 2012

Five patients with endocardial cushion defect, pulmonic stenosis, and right-to-left shunt have been presented. Valvular pulmonic stenosis was present in all, with additional infundibular stenosis in two. Four patients had complete atrioventricular canal defects. In two children both great arteries arose from the right ventricle.
In the clinical differentiation of this entity from the common forms of cyanotic congenital heart disease, the electrocardiogram, characterized by left axis deviation and a counterclockwise inscription of the plane vector loop, is the most helpful tool.
The surgical problems presented may be formidable and even impossible to solve, if both great arteries emerge from the right ventricle.
Atrial Septal Defect
Authors: LEE YU-CHEN , SCHERLIS LEONARD 
Published: June 2012

The results of the electrocardiographic, vectorcardiographic, and hemodynamic studies of 70 patients with atrial septal defects are analyzed. Serial electrocardiograms and vectorcardiograms were obtained in 16 patients following surgery.
The incidence of the rSR' and rSr' patterns in the right precordial leads was 60 per cent.

To a limited extent, the configuration of the electrocardiogram is related to right ventricular pressure and PBF/SBF. However, no quantitative assessment could be made by determining the magnitude of R or R' in lead V
1
.

The vectorcardiogram is an important adjunct to the electrocardiogram in detecting right ventricular hypertrophy. As the right ventricular pressure increases, the QRS sÊ loop tends to shift more to the right and anteriorly.
Although it can be generally stated that the rSR' configuration in atrial septal defects is usually due to right ventricular hypertrophy, this configuration is also due to terminal conduction delay or terminal conduction delay associated with right ventricular hypertrophy in a significant number of instances.
The vectorcardiogram is useful in detecting terminal conduction delay in patients with rSR' in the right precordial leads. It was also of value in determining the presence of right ventricular hypertrophy in combination with terminal conduction delay.
The evidence of terminal conduction delay may disappear after successful repair of atrial septal defects.
Left axis deviation, superior displacement, and counterclockwise direction of inscription of the QRS sÊ loop in the frontal plane are valuable signs for differentiating ostium primum defects from ostium secundum defects. Each of the eight proved instances of ostium primum defects had these typical features.
Electrocardiographic Findings in 122,043 Individuals
Authors: HISS ROLAND G. , LAMB LAWRENCE E. 
Published: June 2012

Electrocardiograms on 122,043 apparently healthy male subjects aged 16 years to over 50 years have been studied. Of this group 5,773 subjects (4.72 per cent) had electrocardiographic abnormalities. The more common abnormalities were expressed in terms of rate per thousand subjects for each 5-year age group. This provides a means of relating incidence to age. Each abnormality and its clinical significance is discussed.
In 54,668 subjects incidental findings such as notched P waves, amplitude, and wave forms were tabulated.
Observations on Serum Cholesterol Levels in the Twin Population of Evans County, Georgia
Authors: MCDONOUGH JOHN R. , HAMES CURTIS G. , GREENBERG B. G. , GRIFFIN LOUIS H. , EDWARDS ANDREW J. 
Published: June 2012

Important factors affecting the variation in cholesterol were found to be the genotype of the individual, age, and type of residence. The effect of genotype is clearly shown in comparing MZ twins with their matched pairs. The difference between MZ twins and their matched pairs was large and statistically significant, while for DZ and UD twins the difference was so small it could easily have been due to chance. In interpreting the significance of the effect of type of residence, we are also comparing two age groups that are almost nonoverlapping, so that adjustment for age by covariance might be questionable, since it involves extrapolating beyond the limits of the data.
Thus, it seems that two important sources of variation of cholesterol have been isolated: type of residence or age which is confounded or entangled, and genotype.
Acyanotic Levocardia
Authors: ROSENBAUM HAROLD D. , PELLEGRINO EDMUND D. , TRECIOKAS LEO J. 
Published: June 2012

Three cases of acyanotic levocardia are reported. One case was associated with congenitally corrected transposition and arterial AV valve insufficiency. The precise nature of the heart disease in the second case has not been determined, and the last case was without known cardiac disease.
Attention is drawn to a serious lack of an accepted terminology in describing cases with spatial derangements of the heart or its chambers as well as incomplete data in published reports concerning the relative positions and internal anatomy of the chambers of the heart, its peripheral connections, and the disposition of the abdominal viscera.
It is probable many more individuals with levocardia without heart disease, or with acyanotic heart disease, exist than is suggested by the current medical literature.
Abdominal Aortic Aneurysms
Authors: SCHATZ IRWIN J. , FAIRBAIRN JOHN F. , JUERGENS JOHN L. 
Published: June 2012

Of 141 patients with abdominal aortic aneurysms diagnosed at the Mayo Clinic from 1950 through 1959 who were not operated on, follow-up information was obtained from 137 patients (97.1 per cent). Of those followed 1 year or more, 87.6 per cent survived 1 year or more; 52.5 per cent survived 3 years, and 36.4 per cent survived 5 years after diagnosis. These results indicate that the prognosis of abdominal aortic aneurysm in this selected group of patients was somewhat better than that previously reported.
The prognosis and survival of patients who had a history of associated cardiovascular disease at the time of diagnosis of aneurysm is distinctly less good than those of patients who had no such history. Of those with such a history, 75.0 per cent survived 1 year, 33.3 per cent survived 3 years, and 20.0 per cent survived 5 years. Of those without such a history 95.7 per cent survived 1 year, 63.2 per cent survived 3 years, and 50.0 per cent survived 5 years.
Patients with abdominal aortic aneurysms and associated cardiovascular diseases are more likely to die of cardiovascular complications other than ruptured aneurysms. Patients with abdominal aortic aneurysms who have no evidence of associated cardiovascular disease are more likely to die from a ruptured aneurysm than from anything else.
It would appear that small asymptomatic abdominal aortic aneurysms in patients with associated cardiovascular disease may be carefully observed until signs of expansion of the aneurysm or symptoms from the aneurysm appear.
Effects of Chlorothiazide on Systemic Hemodynamics in Essential Hypertension
Authors: VILLARREAL HERMAN , EXAIRE JOSÉ EMILIO , REVOLLO ANDRÉS , SONÍ JORGE 
Published: June 2012

Nineteen observations were made in 12 patients with early essential hypertension. The comparative effects upon mean arterial blood pressure, cardiac index, and total peripheral resistance of the acute and long-term administration of chlorothiazide were studied.
With acute administration of the drug, a 10 per cent drop in mean arterial blood pressure, a decrease of 18 per cent in cardiac index, and an increase of 7 per cent in peripheral resistance were observed.
With long-term administration, a decrease of 21 per cent in mean arterial blood pressure, an increase of 4 per cent in cardiac index, and a drop of 26 per cent in peripheral resistance were found.
The conclusion is drawn that reduction of mean arterial blood pressure with acute administration of chlorothiazide is due to decrease in cardiac output, whereas with long-term use it is due to reduction in total peripheral resistance.
Radioisotopic Renography
Authors: BURBANK MAHLON K. , HUNT JAMES C. , TAUXE W. NEWLON , MAHER FRANK T. 
Published: June 2012

Sodium ortho-iodohippurate (Hippuran) I
131
renography has been performed by a standardized technic in patients with renal artery stenosis, pyelonephritis, primary aldosteronism, pheochromocytoma, and renal tubular acidosis with nephrocalcinosis, as well as in patients in whom the hypertension was apparently not secondary. Fifty of 94 patients studied were found to have abnormal renograms.

In patients with renal artery stenosis, all of 37 patients studied had values on the renogram that were outside the range for normal subjects. Although the renographic findings were not considered diagnostic of renal artery stenosis, certain abnormalities of the renogram were commonly observed in the presence of such lesions. When a unilateral delay in the appearance of maximal radioactivity was associated with delayed disappearance ot the medium, renal artery stenosis was frequently observed. Less pronounced differences in the function of the two kidneys were observed in patients with bilateral renal artery stenosis. A state of antidiuresis was often found helpful in the detection of less severe differences in renal function.
In patients with predominantly unilateral pyelonephritis, the renographic abnormalities were qualitatively consistent with the degree of impairment of renal function. Bilateral abnormalities were observed in two patients who had bilateral parenchymal disease. The abnormalities on the renogram did not permit distinction between renovascular and renal parenchynal disease. Pyelonephritis associated with obstructive uropathy revealed findings highly suggestive of renal artery stenosis. Distinction from renovascular lesions could be determined with the aid of urographic studies.
Only three of 44 patients with essential hypertension had abnormal renograms. The renograms, normal and abnormal, revealed essentially equal function of the two kidneys. The patients with abnormal renograms were not found by other technics to have evidence of secondary hypertension.
The patients who were found to have pheochromocytoma and primary aldosteronism had normal isotope renograms. The patient with renal tubular acidosis and nephrocalcinosis had a bilaterally abnormal renogram and severe impairment of total renal function.
The presence of a normal isotope renogram, as performed in our laboratory, is considered strong evidence against the existence of a renal or renovascular cause for secondary hypertension.
Capillary Pattern in Familial Schizophrenics
Authors: MARICQ HILDEGARD RAND 
Published: June 2012

The nailfold capillary pattern was studied in 152 subjects: 60 normal, 50 familial, and 42 nonfamilial schizophrenic patients.
Significant correlation exists between family history and visibility of the subpapillary plexus in the nailfold.
The duration of illness is greater and there are more older patients in the familial group.
High plexus rating is not related to chronological age, sex, or duration of illness.
The incidence of above normal blood pressure is essentially the same in high plexus-low plexus groups.
It is concluded that there is a familial group of schizophrenic patients constitutionally different from the other schizophrenics; the combination of family history and plexus rating as criteria make it possible to select a homogeneous group of patients for further study in schizophrenia.
Aorto-Inferior Vena Caval Fistula of Neoplastic Origin Hemodynamic and Coronary Blood Flow Studies
Authors: CRAWFORD E. STANLEY , TURELL DAVID J. , ALEXANDER JAMES K. 
Published: June 2012

A case report of a 51-year-old man is presented, who spontaneously developed an aorto-vena caval fistula in the region of a mesenchymal tumor involving both the abdominal aorta and vena cava. The disease was manifested clinically by rapidly progressive and massive leg swelling, prominent abdominal and leg veins, a machinery murmur over the abdomen and in the flanks, and a pulsatile abdominal mass, with signs of cardiac enlargement and a high output state. The fistula was demonstrated preoperatively by translunmbar aortography and closed surgically by resection of the tumor en masse, with a part of the vena caval wall and the distal aorta and proximal common iliac arteries. Vascular continuity was restored by lateral suture of the vena cava and by insertion of a bifurcation graft bridging the defect in the aorta and iliac arteries. The patient has been relieved of all clinical manifestations of the fistula to date, 1 year after operation.
Preoperative hemodynamic studies revealed certain alterations characteristic of systemic arteriovenous fistula, including increased pulse pressure, high cardiac output and stroke volume, reduced systemic vascular resistance and arteriovenons oxygen difference, and increased plasnma and circulating blood volumes. Some degree of cardiac failure appeared to be present. Coronary arteriovenous oxygen difference was normal, indicating that the observed increase in coronary blood flow closely paralleled the augmented energy requirement of the heart as reflected by the ventricular oxygen uptake. Reversion to normal of the observed changes in systemic hemodynamics, coronary blood flow, and myocardial metabolism was demonstrated 2 weeks postoperatively.
A Simple Method for Intracardiac Acoustic Auscultation and Phonocardiography
Authors: FERUGLIO GEORGE A. 
Published: June 2012

Acoustic auscultation of the cavities of the heart was carried out in 62 patients with normal hearts and with congenital or acquired heart disease. The type of instrument used is a special cardiac catheter with closed distal tip and with side openings near the tip covered by a thin latex cuff. Intracardiac sound vibrations are collected by the latex membrane, which transmits them to the column of air in the catheter and thereby to the outside of the body.
The catheter can be connected either with the tubing of a binaural stethoscope, for acoustic intracardiac auscultation, or with a microphone. In the latter instance, with the help of a specially designed preamplifier, simultaneous intracardiac sounds and pulse curves can be recorded. This has a two-fold advantage: that of locating the site of recording (by the shape of the intracardiac pulse) and of correlating acoustic and mechanical intracardiac events of the cardiac cycle.
The advantages of acoustic intracardiac auscultation (an aid in avoiding artifacts and locating the best area of sound production) and the practicality, reliability, and low cost of the new technic of intracardiac phonocardiography are stressed.
Prognosis in Dissecting Aneurysm of the Aorta
Authors: KUIPERS FRED M. , SCHATZ IRWIN J. 
Published: June 2012

Of 26 patients with dissecting aneurysm of the aorta diagnosed at the Henry Ford Hospital from 1950 through 1962, 13 patients lived less than six weeks from the time of initial diagnosis. Of the other 13 patients, 2 had had successful operative repair of the aneurysm during the acute stage. The average survival of the remaining 11 patients was 26 months. Prognosis of this unselected group of patients was better than has been reported previously for this disease.
No significant correlation could be found between survival of the patient and the presence of past hypertension, associated recognized cardiovascular disease, or site of intimal rupture.
An Implantable, Synchronous Pacemaker for the Long-Term Correction of Complete Heart Block
Authors: NATHAN DAVID A. , CENTER SOL , WU CHANG-YOU , KELLER WALTER 
Published: June 2012

An implantable, synchronous cardiac pacemaker for long-term correction of complete heart block has been developed. It has been successfully used in dogs for periods up to eight months. The performance of the pacemaker during normal sinus rhythm and atrial arrhythmias is illustrated with electrocardiograms. After implantation of the pacemaker, the dogs have returned to completely normal activity and have tolerated all physical exercises well.
[see figure in the PDF file]
Peripheral Ramification of the Cardiac Conducting System
Authors: ESMOND WILLIAM G. , MOULTON G. ALLEN , COWLEY R. ADAMS , ATTAR SAFUH , BLAIR EMIL 
Published: June 2012

The study of the peripheral distribution of the right bundle branch in bovine, dog's, goat's, lamb's, and human hearts demonstrates an anatomical basis for the production of varying degrees of right bundle-branch block on operative incision of the anterior wall of the right ventricle.
The left branch of the cardiac conducting system, with its transventricular cavity conducting bundles to the papillary muscles and the ventricular wall in bovine, dog's, goat's, lamb's, and human hearts, offers an anatomical basis for varying degrees of disturbance in left ventricular conduction due to operative incision or instrumentation in the left ventricle. Comparative anatomical studies in man and animals show conducting fibers which traverse the ventricular cavities in structures previously termed pseudotendons or false chords.
In man, the existence of these transventricular cavity conducting bundles has not been emphasized, probably because of the traditional methods of opening the heart at autopsy.
The combined electrocardiographic and anatomical concepts provide a useful background for caution in open-heart operation, lest stretching during manipulative procedures or cutting these peripheral conducting bundles produces irrevocable conduction-damage.