bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Flexible Vascular Adhesive for Use in Cardiovascular Surgery
Authors: BERNHARD WILLIAM F. , CUMMIN ALFRED S. , HARRIS PAUL D. , KENT EDWARD W. 
Published: June 2012

1. Preliminary studies of polyurethane resins of the reactive prepolymer type indicate that they may be of considerable value in experimental and clinical cardiovascular surgery as adhesive agents.
2. These resins combine hardness, elastomeric (rubber-like) properties, and chemical inertness which persist unchanged for periods of at least six months.
3. The position and quantity of isocyanate groups in the prepolymer molecule, together with the molecular weights of the prepolymer and polyol, determine the physical properties of the final polymer obtained.
4. Exceptional adhesion between the polymer and blood vessel wall is a result of the reaction between available hydrogen atoms in the substrate tissue and the isocyanate groups in the prepolymer.
Studies of Myocardial Actomyosin and Myosin After Shock, Acute Hemorrhage, Acute Hypoxia, and Cardiopulmonary Bypass
Authors: CHO YOUNG W. , GALLETTI PIERRE M. , NELSON LEONARD 
Published: June 2012

Decreases in cardiac efficiency have been observed in experimental endotoxic shock, acute hemorrhage, and cardiopulmonary bypass. Diminished coronary blood flow, tissue anoxia, or metabolic alteration may affect the contractile protein which, in turn, causes cardiac inefficiency. To test this hypothesis, cardiac actomyosin and myosin were extracted with Guba-Straub solution, and intrinsic viscosity, ATP (adenosinetriphosphate) activity, ATP sensitivity, the rate of ATP hydrolysis, and myosin-ATPase activity were determined. Under these experimental conditions, both myosin and actin were altered.
In order to exclude the possible effect of hypoxia of the arterial blood upon the cardiac contractile system, acute hypoxia was produced in dogs and the physicochemical properties of actomyosin and myosin were studied. During acute hypoxia, the myosin-ATPase was affected, but actin appeared to remain unaltered.
These changes of actomyosin and myosin may cause insufficient energy utilization by the contractile system and thereby affect the cardiac efficiency.
The Transseptal Conduction Time in the Human Heart
Authors: KATZ ARNOLD M. , PICK ALFRED 
Published: June 2012

Four unusual cases of bundle-branch block with a parasystolic rhythm originating in the blocked ventricle are described. Varying interference of natural and parasystolic impulses permits calculation of the transseptal conduction time in man by two independent methods. The physiologic basis of each method is discussed and its validity confirmed by application to data from animal experiments available in the literature. The normal transseptal conduction time in the human heart is estimated to be 0.06 to 0.07 second in both directions. This is about twice as long as in the dog. Under pathologic conditions, it may lengthen to at least 0.115 second.
A functionally "complete" bundle-branch block can result from a delay in impulse transmission down one of the bundle branches greater than the transseptal conduction time, and need not be due to total anatomic interruption of one bundle branch.
Complete Transposition of the Great Vessels
Authors: ELLIOTT LARRY P. , ANDERSON RAY C. , TUNA NAIP , ADAMS PAUL , NEUFELD HENRY N. 
Published: June 2012

A correlative study of necropsy findings and electrocardiography in 54 cases of complete transposition of the great vessels was made to determine whether or not specific electrical patterns could predict the status of the ventricular septum. It became apparent that published criteria for distinguishing between patients with a ventricular septal defect and those with an intact ventricular septum were not uniformly reliable.
Rather than the location of a communication, the important factor in differentiation depended upon the size of the opening, be it between the ventricles or through a patent ductus arteriosus.
Cases were divided into two groups: In group I were those with a small communication, and in group II were those with a large communication between the greater and lesser circulations. The group with small communication showed a narrow or obliterated ductus arteriosus and an intact ventricular septum, or a small ventricular septal defect. In group II there was either a wide patent ductus arteriosus with an intact ventricular septum or a large ventricular septal defect.
In group I the electrocardiogram predominantly showed isolated right ventricular hypertrophy, whereas, in group II, biventricular hypertrophy was the usual finding.
Among the five patients in whom the mean manifest electrical axis was deviated to the left, two showed obstructive malformations of the aortic arch, and two left ventricular-right atrial communication. The fifth case was simply one of a large communication without complicating anomalies.
The Role of Catecholamines in the Free Fatty Acid Response to Cigarette Smoking
Authors: KERSHBAUM ALFRED , KHORSANDIAN ROSTAM , CAPLAN RAYMOND F. , BELLET SAMUEL , FEINBERG LEONARD J. 
Published: June 2012

The role of the adrenal glands and the sympathetic nervous system in the free fatty acid (FFA) rise after smoking was investigated.
In 11 subjects who smoked three cigarettes per hour for a 3-hour period, urinary free catecholamine excretion increased 2.5 µg./hr. (21 per cent) and total catecholamine excretion increased 3.1 µg./hr. (16 per cent). FFA elevations occurred in all subjects during the smoking period.
In three subjects, repeated control determinations of their FFA response to smoking were made and a rise was observed in each instance. Sympathetic ganglionic blockade was then induced with methaphan camphorsulfonate and the smoking tests were repeated. No rise in FFA after smoking occurred following blockade.
Eight patients, who had previously undergone bilateral adrenalectomy for the treatment of hypertension, were studied for their FFA response to smoking. In six subjects there was no significant elevation. In two subjects there was a minimal effect.
These findings indicate that for cigarette smoking to cause an increase in serum free fatty acids both the adrenal glands and the sympathetic nervous system must be functioning, probably to produce an effective level of circulating catecholamines.
Intrapericardial Aortico-Pulmonary Artery Shunt
Authors: REDO S. FRANK , ECKER ROGER R. 
Published: June 2012

An operative procedure for the creation of an aorticopulmonary artery anastomosis with use of a Teflon prosthesis was developed.
After laboratory trial in animals, the operation was performed in six patients varying in age from 2 months to 14 years. In all but one instance the shunt remained patent. The longest observation in dogs is 1½ years. In this animal the shunt has remained open and there has been no evidence of pulmonary or cardiac embarrassment.
One child, 5 years of age, has lived 10 months after the operation. He has had marked improvement in his cyanosis and clubbing, his hematocrit value remains less than 50 per cent, and he is generally well.
The operation should carry no more risk than a Blalock-Taussig or Potts procedure and is thought to be another, perhaps better, method for increasing pulmonary blood flow in cyanotic infants and children.
The Clinical Usefulness of Hydrogen Gas as an Indicator of Left-to-Right Shunts
Authors: HUGENHOLTZ PAUL G. , SCHWARK THOMAS , MONROE R. GRIER , GAMBLE WALTER J. , HAUCK ANNA J. , NADAS ALEXANDER S. 
Published: June 2012

In 60 patients with congenital heart disease 210 observations with hydrogen gas as an indicator for left-to-right shunts were recorded at cardiac catheterization. All but nine had other definite evidence of the presence or absence of left-to-right shunting. In these nine, 21 early hydrogen arrival times formed the only conclusive evidence of left-to-right shunting.
Although hydrogen and oxygen may form a highly explosive mixture, pure hydrogen used with proper precautions is a safe, reliable, and extremely simple indicator, eminently suited as a rapid screening procedure or as a supplementary tool in cases in which left-to-right shunts are difficult to prove.
Spatial Magnitude, Orientation, and Velocity of the Normal and Abnormal QRS Complex
Authors: YANO KATSUHIKO , PIPBERGER HUBERT V. 
Published: June 2012

Curves of spatial magnitude, orientation, and velocity of the QRS complex were obtained by digital computation from 252 normal and 328 abnormal orthogonal electrocardiograms (Frank system). An attempt was made to evaluate the diagnostic usefulness of this type of spatial data display. Because of interindividual variability in QRS duration it was not possible to compare accurately individual records with normal standards. Normalization in time was, therefore, necessary by dividing each QRS complex in time in 10 equal parts. Mean curves were computed for the normal control group and eight pathologic entities. Although differences in configuration between the various groups became evident, a large overlap between the various ranges prevented an efficient classification for diagnostic purposes.
A point-by-point separation between normal ranges and individual curves showed high recognition rates for abnormalities without specific diagnostic classification. The highest information content appeared to be present in curves of spatial orientation.
Since time-normalization and numerical statistical analysis of multiple points are not feasible with presently available analog computers, the question is raised whether digital computation is not more efficient in diagnostic classification of electrocardiograms.
Comparison of the Hemodynamic Effects of Mercurial Diuretics and Digitalis in Congestive Heart Failure
Authors: RADER BERTHA , SMITH WARREN W. , BERGER ADOLPH R. , EICHNA LUDWIG W. 
Published: June 2012

The non-xanthine-containing mercurial diuretic mercaptomerin (Thiomerin), a noncardiotonic agent, was given repeatedly to 14 patients with congestive heart failure until all edema fluid had been eliminated. There resulted relief of subjective symptoms and removal of the characteristic physical signs of circulatory congestion to the point where subjects were considered in "cardiac compensation"; reduction of the elevated intracardiac pressures, in the right atrium, right ventricle, and pulmonary artery; variable changes in cardiac function (cardiac output) and cardiocirculatory (arterial-mixed venous oxygen difference) function, with improvement toward normal in half of the patients and no change in the other half.
In subjects in whom full mercurial diuresis alone improved the cardiac and cardiocirculatory functions, subsequent digitalization produced no further improvement in these functions. These patients were in a first or second episode of cardiac decompensation.
In subjects in whom full diuresis alone did not alter the cardiac and cardiocirculatory dynamics, subsequent digitalization produced an increase in cardiac output and a decrease in A-V oxygen difference toward normal values. These subjects usually had had one or several previous episodes of congestive failure.
When there was persistent chronic congestive heart failure, neither mercurial diuretic nor digitalis therapy altered the low cardiac output or the high A-V oxygen difference. Removal of the edema and vascular congestion by diuresis alone nevertheless produced subjective improvement.
In those patients in whom an increase in cardiac output occurred as the mercurial diuretic eliminated edema and lowered the elevated intracardiac pressures, the response may be considered consistent with Starling's law of the heart in man in congestive heart failure.
The data clearly make the point that it is the circulatory congestion that produces the symptoms and the physical signs traditionally considered characteristic of congestive heart failure. Removal of the circulatory congestion, however accomplished, relieves the symptoms and physical signs of congestive heart failure, regardless of whether or not cardiac function is improved toward the normal.
Circulatory congestion does not necessarily indicate, nor correlate with, the status of cardiac function.
Physiologic Studies of Pulmonary Edema at High Altitude
Authors: HULTGREN HERBERT N. , LOPEZ CESAR E. , LUNDBERG EINAR , MILLER HARRY 
Published: June 2012

Cardiac catheterization studies have been performed in four patients during acute pulmonary edema at an elevation of 12,300 feet in the central Peruvian Andes.
Pulmonary hypertension, low cardiac output, arterial unsaturation, and low normal pulmonary artery wedge pressures were observed. Oxygen breathing was accompanied by a prompt, marked fall in pulmonary artery pressure and a slight rise in wedge pressure, indicating the presence of anoxic pulmonary arteriolar constriction.
In one patient, pulmonary artery wedge pressures were not elevated during added hypoxia nor during exercise. The blood pressure response to the Valsalva maneuver was normal.
Similar studies were carried out in four subjects after recovery from pulmonary edema. One 9-year-old boy had persisting pulmonary hypertension. None had evidence of underlying cardiac disease. An abnormal rise in pulmonary artery pressure during induced hypoxia was observed in three of four patients.
It is concluded that pulmonary edema at high altitude is a unique form of pulmonary edema produced by hypoxia under certain conditions of exposure at high altitude. Severe pulmonary hypertension due to anoxic pulmonary arteriolar constriction is present. There is no evidence that pulmonary venous constriction and cardiac failure are causative mechanisms.
Intracardiac Oximetry in Congenital Heart Disease
Authors: ENSON YALE , JAMESON A. GREGORY , COURNAND ANDRÉ 
Published: June 2012

A fiberoptic reflection oximeter has been adapted to the diagnostic study of patients suspected of having congenital heart disease. The results of 10 successive catheterizations with use of this technic are reported and compared with the results obtained in the same subjects with a standard sampling technic.
A large number of determinations was possible without blood loss. The results were immediately available for use in directing the manipulation of the catheter. Freedom from the distortions attendant upon catheter sampling permitted precise observation of the nature of flow across a ventricular septal defect and of the relationship between blood oxygen saturation in the main pulmonary artery and the pulmonary arterial wedge position.
Congenital Stenosis of the Pulmonary Artery Branches
Authors: BAUM DAVID , KHOURY GEORGE H. , ONGLEY PATRICK A. , SWAN H. J. C. , KINCAID OWINGS W. 
Published: June 2012

Eighteen cases of stenosis of the branches of the pulmonary artery, seen at the Mayo Clinic, have been reviewed and subdivided into two main types: Type I, stenosis of the main branches of the pulmonary artery, 11 cases, and type II, stenosis of multiple peripheral branches of the pulmonary arteries, seven cases. Of special interest were two cases in which thrombosis occurred as a complication and one case in which surgical relief of multiple areas of stenosis in the peripheral branches of the pulmonary arteries was accomplished.
Unexplained pulmonary hypertension necessitates further investigation, which includes cardiac catheterization for measurement of intracardiac pressure and frequently selective angiocardiography.
Main branch or peripheral pulmonary artery stenosis should be suspected when a continuous murmur is heard or when poststenotic dilatations of the pulmonary artery branches or areas of decreased pulmonary vasculature can be perceived in the roentgenogram. Angiocardiography is the only technic that permits detailed anatomic evaluation of the entire pulmonary vasculature, especially in the cases associated with severe infundibular or valvular pulmonic stenosis.
Stenosis of the branches of the pulmonary artery must be taken into account, when surgical repair of associated cardiovascular defects is considered. These lesions also might complicate anastomotic procedures involving the pulmonary artery in cyanotic patients.
Atrial Fibrillation in Flying Personnel
Authors: LAMB LAWRENCE E. , POLLARD LAWRENCE W. 
Published: June 2012

Sixty cases of atrial fibrillation from the USAF flying population are reported. Follow-up information in 59 subjects averaged 41.2 months.
Only three cases of persistent atrial fibrillation were detected and two of these had normal sinus rhythm prior to the onset of atrial fibrillation.
There were 21 cases of recurrent paroxysmal atrial fibrillation and 36 cases of isolated acute atrial fibrillation associated with a variety of precipitating factors. Thyrotoxicosis was notable by its absence in any of these cases of atrial fibrillation.
Symptomatology either related to the primary disorder precipitating atrial fibrillation or secondary to the arrhythmia itself was frequently observed.
The hemodynamic effects of atrial fibrillation on cardiac output, and cerebral artery spasm with diminished cerebral blood flow are important aeromedical considerations.
Localization of the Aortic Valve by Intracavitary Electrocardiography
Authors: UNDERHILL WILLIAM L. , HELLERSTEIN HERMAN K. , TREDWAY JOHN B. , D'ANGELO GEORGE J. 
Published: June 2012

The intracavitary electrocardiogram was studied in the aortic outflow tract during left heart catheterization to determine its usefulness in accurately locating the aortic valve.
Twenty-eight of 31 cases studied showed a significant electrocardiographic change at the valve which was not observed elsewhere. Changes noted included decrease in QRS voltage, qualitative QRS change, and P-wave change.
The routine use of the intracardiac electrocardiogram in conjunction with other technics is advocated.
Idiopathic Hypertrophic Subaortic Stenosis: III. Intraoperative Studies of the Mechanism of Obstruction and Its Hemodynamic Consequences
Authors: PIERCE GEORGE E. , MORROW ANDREW G. , BRAUNWALD EUGENE , Seipp Harry W. , Cobb David E. , Montgomery Maxine P. 
Published: June 2012

Pressures in the left ventricle and central aorta were recorded together with instantaneous aortic blood flow at the time of operation in 9 patients. Four patients had IHSS, 4 had valvular or discrete subvalvular aortic stenosis, and 1 was considered to have a normal aortic valve and left ventricular outflow tract. In each of the 4 patients with IHSS, the pattern of aortic blood flow was distinctly abnormal when significant obstruction was present and nearly 80% of total flow took place in the first half of systole. In contrast, [see figure in the PDF file] the distribution of flow was symmetrical in all patients with discrete aortic stenosis.
When flow and the pressure gradient were related at brief intervals during systole, and the orifice size calculated, it was found that the orifice was always greatest at the onset of contraction, diminished rapidly in size, and often became totally obliterated toward the end of the ejection period in patients with IHSS. The size of the orifice remained constant during systole in the patients with discrete obstruction. The abnormalities of instantaneous aortic blood flow, and the rate of systolic narrowing of the subvalvular orifice were exaggerated following premature ventricular contractions, after the administration of pharmacologic agents with positive inotropic effects (isoproterenol and calcium chloride), and after reduction of the circulating blood volume. With valvular and discrete subaortic stenosis, however, these interventions did not change the symmetrical pattern of blood flow and the orifice area was constant. Augmentation of the circulating blood volume or partial occlusion of the ascending aorta decreased the severity of outflow obstruction in every patient with IHSS and converted the abnormal flow pattern to one characteristic of discrete stenosis.
These studies provide the first evidence of the instantaneous changes which occur within the outflow tract of the left ventricle in patients with IHSS, and provide information concerning the various mechanisms by which the intensity of obstruction may be modified.
Anomalous Origin of the Left Coronary Artery from the Pulmonary Trunk with Special Reference to the Occurrence of Mitral Insufficiency
Authors: NOREN GEORGE R. , RAGHIB GUNAY , MOLLER JAMES H. , AMPLATZ KURT , ADAMS PAUL , EDWARDS JESSE E. 
Published: June 2012

Nine cases of anomalous origin of the left coronary artery from the pulmonary trunk, involving patients ranging in age from 2 months to 7 years, have been reviewed. In six patients, mitral insufficiency was a prominent feature and, in three of these patients, mitral insufficiency presented the major problem, clinically.
Of the five patients who died, necropsy was done in four. In each, healed infarction of the posterior papillary muscles of the left ventricle was demonstrated and, in two, the anterior papillary muscles were also involved.
The clinical picture was that of an acyanotic patient with nonspecific respiratory complaints and retardation of growth. In five patients, there were symptoms (although a presenting complaint in only one) which are considered classic for this anomaly. These symptoms included episodes of pallor, dyspnea, and perspiration. Eight patients experienced cardiac failure in infancy and response to digitalis was effective in each.
In this study, endocardial fibroelastosis, without associated cardiac malformations other than mitral insufficiency, presented difficulty in the differential diagnosis. The vectorcardiogram in the horizontal plane was most helpful in the diagnosis of anomalous origin of the left coronary from the pulmonary trunk. The QRS sÊ loop in the horizontal plane in this anomaly was oriented posteriorly to the left and its direction was clockwise, in contrast to the counterclockwise direction of the loop in endocardial fibroelastosis.
Selective ascending aortography or selective right coronary arteriography established the diagnosis in seven cases.
Effects of Norepinephrine on the Coronary Circulation in Man
Authors: YURCHAK PETER M. , ROLETT ELLIS L. , COHEN LAWRENCE S. , GORLIN RICHARD 
Published: June 2012

The effect of norepinephrine infusion on the coronary circulation has been studied in 21 subjects. In doses ranging from 2 to 17 µg. base per minute norepinephrine caused a pari passu rise in perfusing pressure and coronary flow of 16 per cent above the control state. Despite an increase in cardiac oxygen consumption, coronary vascular resistance was unchanged, suggesting no vasodilatation in the coronary bed. On the contrary, oxygen extraction across the heart increased, implying that oxygen needs were inadequately met by rise in flow. An increase in vascular tone induced by norepinephrine is inferred from the unchanged coronary resistance at a higher perfusion pressure.
Responses of the normal and failing left ventricle groups were qualitatively the same as for the group as a whole. The failure group showed greater tendency to meet oxygen needs by increased extraction than did the normal hearts.
Although these observations are not strictly applicable to the role and effects of norepinephrine in states of clinical shock, nonetheless it seems likely that norepinephrine induces a suboptimal rise in coronary flow that may set the stage for ultimate myocardial ischemia, particularly when coronary perfusion pressure is inadequate.