bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypertension and Ischemic Heart Disease in Hiroshima, Japan
Authors: SWITZER SAM 
Published: June 2012

A random sampling of Hiroshima residents, comprising 1,051 males and 1,872 females, has been studied with respect to the interrelations of hypertension, ischemic heart disease, blood lipid levels, and ionizing irradiation experienced during the atom bombing of 1945. No significant effect of ionizing irradiation upon the cardiovascular system has been detected.
No major difference in age-sex specific mean blood pressures between Hiroshima residents and a suitable white American comparison group was found. Dissimilarities noted with other groups compared are considered due to the sum of sampling bias, varying technics, and coincidental environmental factors rather than a true racial difference. Blood pressure levels, stable from puberty through young adulthood, begin to rise early in middle age and continue to rise into old age. As a result, hypertension as clinically defined (140/90), is common in middle-aged and elderly Japanese. In 94.4 per cent of instances, or more, a demonstrable etiology for hypertension could not be found; these are considered to represent essential hypertension.
An accelerated course with fulminating vascular deterioration was suspected in only 1 per cent of the hypertensive subjects. As a result, advanced retinopathy and renal failure were rarely seen. Electrocardiographic evidence of left ventricular hypertrophy occurred in 7.2 per cent of the hypertensive Japanese in this study, and was readily correlated with the ambient systolic blood pressure. Evidence of ischemic heart disease and congestive failure is rare and distinctly less common than in American males unselected as to blood pressure levels. In contrast, mortality statistics indicate cerebrovascular disease to be at least as common in Japan as in the U. S.
Japanese exhibit low serum cholesterol concentrations by Western standards and elevated levels are predominantly limited to the obese. Both factors appear of importance in the occasional hypertensive Japanese with ischemic heart disease. The therapeutic implication of this observation is briefly discussed.
Coronary Heart Disease among Minnesota Business and Professional Men Followed Fifteen Years
Authors: KEYS ANCEL , TAYLOR HENRY LONGSTREET , BLACKBURN HENRY , BROZEK JOSEF , ANDERSON JOSEPH T. , SIMONSON ERNST 
Published: June 2012

Relative weight, body fatness (skinfold thickness), blood pressure, and serum cholesterol are reported from 281 Minnesota business and professional men, initially clinically healthy and aged 45 to 55, who were followed by annual examinations since the winter of 1947-48. In 15 elapsed years, coronary heart disease developed definitely in 32 men and possibly in 16 other men.

The incidence of coronary heart disease tended to be higher among men above the median at first examination in relative weight, body fatness, systolic and diastolic blood pressure, and serum cholesterol concentration but these segregations were not statistically significant except with serum cholesterol, which was associated with
p
< 0.001. The data for the last pre-disease year on the men who developed coronary heart disease showed a significant relationship between incidence and systolic blood pressure as well as for cholesterol. Average data over all pre-disease years showed significantly reduced risk among the men in the bottom quartile for diastolic as well as for systolic blood pressure, while the cholesterol level was significantly prognostic over the entire range of that variable. The few men who developed coronary heart disease with low cholesterol values tended to be in the top 20 per cent of the distribution of blood pressure or relative weight or both.

Relative weight showed a high but still imperfect correlation with body fatness. Arterial blood pressure tended to be elevated in extremely obese or grossly overweight men. Serum cholesterol was not significantly related to any of the other variables.
Men who developed coronary heart disease tended to have low values for cholesterol in the alpha-lipoprotein fraction in the serum but the ratio of cholesterol in the alpha- to the beta-lipoprotein fraction of the serum was no more prognostic than total cholesterol alone.
Comparison with similar follow-up data from Framingham, Massachusetts, Albany, New York, and Chicago, show a high degree of concordance. In all series relative weight had least significance and the incidence of coronary heart disease rose continuously with the serum cholesterol level. With men classified according to pre-disease cholesterol level, about 80 per cent of the total variance in relative subsequent risk is accounted for by regression of risk on the cholesterol value raised to any power from 2 to 3 and the correlation between observed and predicted relative risk is of the order of r = 0.9.
The Electrocardiogram in Some Indian Population Groups
Authors: SRIKANTIA S. G. , PADMAVATI S. , GOPALAN C. 
Published: June 2012

Of 941 subjects studied, there were 16 cases of myocardial infarction of which one was a silent infarct. Of these, nine were in the low-income group and seven in the high-income group. All the cases were among the civilian population.
About 11 of the subjects had high voltage in the chest leads without any evidence of hypertension or other heart disease. These were equally distributed at all ages in the different income groups, civil and military.
There was no significant difference in the incidence of ST-segment depression in the various groups. On the other hand, T-wave changes in standard leads, I, II and left chest leads was higher in the high-income groups at all ages than in the low-income groups and the increase was significant after the age of 50 years.
ST and T-wave changes following exercise were slightly higher in the high-income groups than in the low-income groups among the civilian subjects.
The incidence of Grusin's abnormality was higher in the low-income group, both civil and military, than in the high-income groups. The incidence of ischemic heart disease (and of electrocardiographic abnormalities generally) was very low in this study as compared to studies elsewhere.
Radioelectrocardiography during Exercise in Patients with the Anginal Syndrome Use of Multiple Leads
Authors: BELLET SAMUEL , MULLER OTTO F. , LAVAN DONALD W. , NICHOLS GEORGE J. , HERRING ALLEN B. 
Published: June 2012

The electrocardiographic alterations during the period of and immediately following exercise were studied by means of radioelectrocardiography, in 90 patients with angina pectoris. Three leads (II, V
4
, and V
6
) were utilized.

The criteria for abnormality were based on the findings of 229 "normal" subjects between the ages of 17 and 39 and 300 "normal" subjects between the ages of 40 and 60.
Sixty-eight of the 90 patients (76 per cent) with angina pectoris showed electrocardiographic abnormalities during and after the period of exercise. An additional seven patients (8 per cent) manifested alterations that were considered to be "probably abnormal." The incidence of false-negative tests was 10 per cent, those patients being excluded in whom the test had to be stopped early because of fatigue, leg pain, or other complaints.
The findings indicate that the recording of the electrocardiogram during exercise adds considerably to the value of the test. In some patients (12 per cent), the electrocardiogram was positive only during the period of exercise, and in 30 per cent the abnormal findings were obtained chiefly during this period.
The Master two-step test involves various technical and subjective difficulties such as interpretation of the alterations, wandering of the baseline, and lack of cooperation from the patient. In a certain percentage of patients with clinical angina pectoris false-negative tests are obtained. Also positive tests in subjects without definite anginal symptoms are not rare, but not enough long-term follow-up studies have been performed to delineate the significance of these findings.
In spite of some limitations, the exercise electrocardiogram, especially that taken during as well as after exercise, is an important adjunct in the diagnosis of angina pectoris.
Kidney Function after Renal Revascularization for Hypertension
Authors: SIMON NORMAN M. , DEL GRECO FRANCESCO 
Published: June 2012

Kidney function was evaluated in 53 patients with renal arterial hypertension before and after renal revascularization and was correlated with changes in blood pressure. Data were derived from an analysis of personal observations and of findings reported by others.
Revascularization produced a significant decrease in blood urea nitrogen and serum creatinine in 13 azotemic patients. It did not significantly affect glomerular filtration rate when normal in 20 patients, but caused a rise in renal blood flow in three patients. Improvement in renal function was more closely correlated with preoperative functional status than with cure of hypertension.
Glomerular filtration rate and renal blood flow increased significantly in the revascularized kidney, but decreased in the contralateral kidney. Urine flow and sodium concentration in the revascularized kidney rose to levels equal to, or greater than, those in the contralateral kidney. The preoperative disparity in urine osmolality between kidneys was narrowed, whereas the concentration of nonresorbable urine solute became equal to, or lower than, that of its mate postoperatively. In most cases, the Howard test reverted to negative. The tubular rejection fraction ratio of sodium became normal or suggested contralateral renal arterial disease. The only functional differences between patients whose hypertension was cured and those whose blood pressure failed to respond to revascularization related to glomerular filtration rate and the Howard test.
Impairment of function of the contralateral uninvolved kidney was rarely observed after surgery. The revascularized kidney frequently exhibited excessive natriuresis and diuresis, independent of changes in systemic blood pressure or glomerular filtration rate.
Compensatory Adjustments in the Structure of Coronary Arteries of the Heart with Stenotic Atherosclerosis
Authors: ANITSCHKOW N. N. , WOLKOFF K. G. , KIKAION E. E. , POZHARISSKI K. M. 
Published: June 2012

Adjustments within the coronary arterial system that compensate for stenotic atherosclerosis include hypertrophy of larger coronary arterial branches unaffected by atherosclerosis that undertake supply of blood to an anemic myocardial area; development of collateral circulation; extension of the "paravasal" bed; formation of short anastomoses; and wide recanalization of thrombi.
A combination of special technics devised for this investigation included fixation of coronary arteries with formol under pressure approximating the level of diastolic blood pressure, followed by their injection with an opaque mixture or colored gelatin; angiographic examination and dissection; and microscopic examination of numerous cross sections prepared from the whole length of major trunks and their branches. The size of atherosclerotic plaques and degree of luminal narrowing were then determined planimetrically, as a percentage of the original lumen.
These studies yielded objective evidence for assessing the influence exerted by varying degrees of luminal narrowing on blood supply to myocardium as well as on development of intercoronary anastomoses, and their compensatory significance. The principal conditions bringing about insufficiency of compensatory adjustments have also been considered: progression of coronary atherosclerosis involving arterial anastomoses in the process; successive deposition of lipids over the walls of wide channels through organized thrombi, resulting in their occlusion due to secondary thrombosis; and individually inadequate development of compensatory adjustments.
Acid-Base Management for Open-Heart Surgery
Authors: MORRIS LUCIEN E. , EDMARK K. WILLIAM , JONES THOMAS W. , LOGAN GORDON A. , SAUVAGE LESTER R. , THOMAS GEORGE I. 
Published: June 2012

An important part of managing patients during open-heart surgery is continuous monitoring of the acid-base status prior to, during, and following cardiopulmonary bypass. The use of a thermostatically controlled triple electrode system whereby arterial pH, pCO
2
, and pO
2
can be measured and base excess or base deficit quantitated by special application of the Astrup-Andersen nomogram is enthusiastically endorsed.

In the opinion of the authors, respiratory alkalosis is to be avoided throughout the entire operation and postoperatively, as this appears to result in a base deficit, which is subsequently revealed as a metabolic acidosis. Particular consideration is given to the bypass phase when hypothermia is employed, since "optimal" pH appears to vary with temperature.
Continued maintenance of good acid-base status with buffers is advocated. It is considered that buffer administration should be on a "titration" principle with frequent arterial blood gas analyses.
Possible reasons are presented for the improved postoperative morbidity when optimal acid-base status is maintained throughout the operation and postoperatively.
The Determination of Coronary Flow Equivalent with Coincidence Counting Technic
Authors: BING RICHARD J. , BENNISH ARVIN , BLUEMCHEN GERHARD , COHEN ALBERTO , GALLAGHER JAMES P. , ZALESKI EDWARD J. 
Published: June 2012

The coincidence counting technic was used to measure the clearance equivalent of rubidium-84 as a function of coronary flow by the human heart in vivo. This technic makes possible a distinction of radioactivity of the heart muscle from the surrounding tissue, eliminates lead collimation, and is more sensitive than the singles technic.
In experiments on isolated dog heart it was found that changes in rate of perfusion of the coronary arteries failed to influence the myocardial extraction ratio of rubidium-84. Alterations in heart rate were also without effect.
Nitroglycerin increased the clearance equivalent of rubidium-84 in patients without coronary heart disease. In patients with coronary artery disease the drug led to fall in clearance equivalent.
The method has been helpful in distinguishing between normal individuals and those with coronary artery disease.
Hemodynamics of Large and Small Vessels in Peripheral Vascular Disease
Authors: CONRAD MARGARET C. , GREEN HAROLD D. 
Published: June 2012

To evaluate the hemodynamics of large and small vessels in patients with complete arterial occlusion and patients with vasospasm, digital flow, digital pulse contour, small-vessel resistance, flow-to-pulse ratio, large-vessel pressure drop, pulse velocity, and distensibility were compared to values found in normal subjects.
[see figure in the PDF file]
In the normal subject following orally administered alcohol, small-vessel resistance decreased but large-artery pressure drop, pulse velocity, and distensibility of the capacity vessels were not altered significantly.
In arterial occlusive disease, small-vessel resistance was essentially normal in the absence of small-vessel occlusion; a high large-artery pressure drop, rounded pulse contour, and decreased pulse amplitude were observed. These are interpreted as being due to the damping effect of the narrowed, elongated collateral flow pathway that develops around the site of the occlusion. Pulse velocity also was decreased whereas flow-to-pulse ratio was increased in patients with occlusive disease. Large-vessel hemodynamics were unchanged after alcohol, suggesting lack of effect of the dilator on the collateral vessels.
In vasospasm there was evidence of increased large-artery and small-vessel resistance and decreased distensibility of the capacity vessels, all of which returned toward but not completely to normal following alcohol.
Digital pulse amplitude was found not to correlate well with flow, particularly in patients with arterial occlusive disease.
Hemodynamic Events during the Development of Cyanosis and Heart Failure in a Patient with Large Ventricular Septal Defect
Authors: BLISS HARRY A. , MOFFAT JEAN E. 
Published: June 2012

A patient with large ventricular septal defect experienced cardiac failure in childhood but improved and participated vigorously in competitive athletics during adolescence. Subsequently exertional dyspnea gradually developed, followed by increasing cyanosis and cardiac failure.
Repeated cardiac catheterizations during the latter period showed that cardiac output into both the pulmonary and the systemic circuits gradually fell to very low levels while vascular resistance rose progressively. The ratios of flows, pressures, and resistances in the two circuits did not change. Left-to-right shunting always predominated. Right atrial pressure rose but pulmonary artery "wedge" pressure remained unaltered.
Progressive reduction in output from both sides of the heart explained the appearance of reduced arterial oxygen saturation, increased cyanosis, and the manifestations of cardiac failure.
Endocardial Fibroelastosis
Authors: MOLLER JAMES H. , LUCAS RUSSELL V. , ADAMS PAUL , ANDERSON RAY C. , JORGENS JOSEPH , EDWARDS JESSE E. 
Published: June 2012

A clinical and pathologic study of 47 cases with endocardial fibroelastosis is presented. These cases have been classified according to the associated cardiac anomaly and the anatomic condition of the left ventricle. In so doing, a better understanding is had of the role the cardiac anomaly associated with endocardial fibroelastosis plays in the production of cardiac signs and symptoms.
In each of the specimens available for review, a change of the mitral valve was present that rendered it insufficient. Those cases grouped as primary endocardial fibro-elastosis had this as the only abnormality present, other than the endocardial fibroelastosis. Many of the clinical and laboratory findings in this group could be explained on the basis of mitral insufficiency, and one cannot necessarily assign the cardiac signs and symptoms to the endocardial process itself. In those cases with associated cardiac anomalies the hemodynamic consequences appear to be a summation of the combined effects of the mitral insufficiency, endocardial fibroelastosis, and the associated cardiac anomaly.
In this review, we were unable to distinguish, by either gross or microscopic methods, between primary and secondary endocardial fibroelastosis. Since use of these terms suggests etiologic relations, it is preferable to classify cases of endocardial fibroelastosis on the basis of the structural abnormalities present.
Constrictive Pericarditis Complicating Disseminated Lupus Erythematosus
Authors: YURCHAK PETER M. , LEVINE SAMUEL A. , GORLIN RICHARD 
Published: June 2012

A case of constrictive pericarditis complicating disseminated lupus erythematosus is reported in a 58-year-old man. Hemodynamic studies documented the diagnosis and also confirmed the clinical suspicion of coexistent atrial septal defect. Measurement of left ventricular volume by a thermodilution technic augmented information available from routine studies. Pericardiectomy and closure of the atrial septal defect relieved the mechanical lesion.
The case is also unique in its documentation of the coexistence of three different forms of heart disease—congenital atrial septal defect, pericardial constriction from lupus erythematosus, and rheumatic valvular disease.
Interventricular Septal Defect
Authors: WALKER WELDON J. , GARCIA-GONZALEZ EFRAIN , HALL ROBERT J. , CZARNECKI STEPHEN W. , FRANKLIN ROBERT B. , DAS SUNIL K. , CHEITLIN MELVIN D. 
Published: June 2012

Four hundred fifteen patients with interventricular septal defect, proved at cardiac catheterization, have been followed for 1,407 patient years. As a group, they demonstrated marked growth failure in early childhood, which was more striking for weight than height. Ninety patients had serial hemodynamic studies without intervening cardiovascular surgery. Eight demonstrated spontaneous functional closure of their defect; only one progressed to the Eisenmenger syndrome. No patient with initially normal pressure developed pulmonary hypertension. Patients with initial pulmonary hypertension more commonly demonstrated regression than progression of the hypertension. Six patients developed bacterial endocarditis; all recovered. There was a frequent association (11 per cent) between interventricular septal defect and right ventricular outflow obstruction. Some patients developed increasing right ventricular outflow obstruction during the study. Eighteen patients with predominant right-to-left shunt were studied. Seventeen were cyanotic at the time of the initial study. The incidence of cyanosis was equal in the two sexes but females developed it later in life than males.
Twenty-nine patients have died. Twenty-two deaths resulted from operative procedures; seven from the natural course of the disease. The principal factors associated with operative mortality was the presence of pulmonary hypertension and surgical repair before age 5. There were no operative deaths in patients with pulmonary artery systolic pressure below 65 mm. Hg. One patient died of progressive pulmonary hypertension 6 years after successful surgical closure of his defect.
There is a great need for more information concerning the natural course of this disease in all age groups, both in the unoperated patient and in patients whose defects have been surgically closed.
A New Technic for the Detection of Left-to-Right Cardiac Shunts by Use of an Esophageal Geiger-Müller Tube
Authors: IRA GORDON H. , ORGAIN EDWARD S. 
Published: June 2012

A new technic is described for the detection of left-to-right shunts. A miniature Geiger-Müller tube is placed in the esophagus behind the left atrium and positioned by the electrocardiogram. In this position the G-M tube measures radioactivity from the left atrium. Curves are then recorded simultaneously from the precordium, lung, and left atrium. Methods of injection, monitoring, and recording are presented that provide greater diagnostic accuracy over those external detector technics currently in use.
Of 23 patients studied, 11 presented left-to-right shunts. Eight of these 11 patients were submitted to surgery; all were studied preoperatively and seven were studied postoperatively. Seven of the 11 shunts were detected by both precordial and esophageal technics. Four of the 11 shunts were missed by conventional precordial technics but were correctly diagnosed preoperatively by the esophageal detector. In addition, one shunt, which remained open postoperatively, was demonstrated clearly by the esophageal technic but was not indicated by the precordial curves. In no instance was the precordial curve positive for left-to-right shunt when the esophageal curve was negative.
Although the accuracy of any radioisotope detection technic with external counting may not approach that of direct cardiac catheterization, this method, because of its relative simplicity and accuracy, is useful in the demonstration of left-to-right shunts both preoperatively and postoperatively.