bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of the Kidney and the Renin-Angiotensin System in the Response of Aldosterone Secretion to Hemorrhage
Authors: MULROW PATRICK J. , GANONG WILLIAM F. 
Published: June 2012

In summary, these data show that in hypophysectomized dogs:
1. Hemorrhage stimulates mainly aldosterone secretion.
2. Nephrectomy prevents stimulation of aldosterone secretion by hemorrhage.
3. Nephrectomy lowers basal secretion of aldosterone.
4. Crude saline extracts of dog kidneys, semipurified renin extracts of dog kidneys, and synthetic angiotensin can stimulate aldosterone secretion.
These findings suggest that in hypophysectomized dogs, the kidney, via the renin-angiotensin system, is an important mechanism by which hemorrhage stimulates aldosterone secretion.
Anomalous Muscle Bundle of the Right Ventricle
Authors: LUCAS RUSSELL V. , VARCO RICHARD L. , LILLEHEI C. WALTON , ADAMS PAUL , ANDERSON RAY C. , EDWARDS JESSE E. 
Published: June 2012

Seven examples of anomalous muscle bundles of the right ventricle have been presented. In one patient having an associated ventricular septal defect, spaces between the anomalous muscle were confused surgically with the ventricular septal defect.
In the remaining six cases, the anomalous muscle bundle caused obstruction within the right ventricular cavity. Five of these patients had associated ventricular septal defect, with a clinical picture resembling that of the cyanotic or acyanotic tetralogy of Fallot. The cases served to demonstrate that the surgeon who exposes the right ventricle to relieve an obstructive lesion in the right ventricular infundibulum or in the pulmonary valve, may find no such lesions in these locations but instead may be dealing with an obstruction more proximal than these areas. Relief of the obstruction within the right ventricle may be attained by resecting the anomalous muscle mass.
In one patient having intact ventricular septum and pulmonary valvular stenosis, an anomalous muscle bundle within the right ventricle which lay proximal to the infundibulum was responsible for persistent right ventricular obstruction after pulmonary valvotomy.
Anomalous muscle bundles in the right ventricle may be suspected when, in the angiocardiogram, they cause filling defects within the right ventricle.
Cardiac Myxomas with Systemic Embolization
Authors: SILVERMAN JAY , OLWIN JOHN S. , GRAETTINGER JOHN S. 
Published: June 2012

A case of left atrial myxohemangioendothelioma, diagnosed ante mortem by removing a tumor embolus to the bifurcation of the aorta, is reported. The patient had been misdiagnosed as having had rheumatic heart disease with paroxysmal atrial fibrillation and embolization to the right middle cerebral artery. In retrospect, because of the characteristics of the second heart sound and absence of an opening snap, a rheumatic etiology should have been questioned.
The literature regarding embolization of atrial myxomas has been reviewed.
Resection of Myocardial Aneurysms after Infarction during Temporary Cardiopulmonary Bypass
Authors: LILLEHEI C. WALTON , LEVY MORRIS J. , DEWALL RICHARD A. , WARDEN HERBERT E. 
Published: June 2012

The report consists of five patients with chronic postinfarct left ventricular aneurysms. The age distribution was between 47 and 63 years. The time lapse between the initial infarct and the appearance of the left ventricular aneurysm was 2 weeks to 2 years. The time interval between the initial infarct and surgery was 5 months to 6 years. Less than adequate bedrest following the infarct, multiple infarcts, and systemic hypertension were other factors present in this group. Right heart catheterization was performed in two patients and showed reduced cardiac output and elevated pulmonary pressures in one. The electrocardiograms were consistent with extensive old myocardial infarction and ventricular aneurysm. The diagnosis was suggested by electrocardiograms and roentgenography, supported by kymography, and confirmed by angiography.
The world literature on surgically treated patients with ventricular aneurysms is briefly reviewed with emphasis on the varied surgical approaches to the problem in the past. The method of complete excision with ventriculoplasty during cardiopulmonary bypass was used in all our patients during the past 4 years. The anatomic distribution of the ventricular aneurysm as well as the histopathology of the resected specimen is described.
All patients survived the operation, and were observed from 6 months to 40 months after operation. There have been no late deaths to date, and all patients have been rehabilitated. Postoperative catheterization studies have confirmed the clinical improvements observed.
More attention should be given to this relatively common complication after infarct because excision under temporary heart-lung bypass is a safe and feasible approach.
A Longitudinal Study of Blood Pressure
Authors: HARLAN WILLIAM R. , OSBORNE ROBERT K. , GRAYBIEL ASHTON 
Published: June 2012

A longitudinal study of blood pressure in a homogeneous group of young men followed over an 18-year period has been presented. Seven hundred and eighty-five (96 per cent) of the surviving members have been re-evaluated, and the mean age at the time of re-examination was 42 years.
Frequency distribution curves of blood pressure yielded a unimodal distribution and indicated that blood pressure is a graded continuous variable. There was no evidence of natural bimodal distribution to suggest emergence of a qualitatively different population. Each individual tended to maintain his relative position within the distribution curve over the period of study, but this was modified by genetic and environmental factors.
Significant correlations were found between the variables of weight and somatotype. A significantly greater increase in blood pressure was noted in association with increasing weight. Subjects with a predominance of ectomorphic characteristics had a smaller increment of blood pressure over the period of study. Endomorphic subjects had a greater increment of blood pressure. The changes in blood pressure related to somatotype were modified by weight, but not dependent upon an increase in weight.
A family history of vascular disease was associated with a significantly greater increase in blood pressure. The greater increment in blood pressure associated with a positive family history was not dependent upon weight gain for its influence. There was no evidence that a positive family history separated a portion of the population ranked according to blood pressure.
Analysis of the upper and lower segments of the distribution curves, revealed significant differences between the characteristics of each group. These differences followed the same pattern as the entire group but were quantitatively different.
These results are discussed with regard to the concept that hypertension represents a quantitative difference in blood pressure resulting from a multiplicity of factors, both genetic and environmental.
Alternation of the Heart
Authors: LITTMANN DAVID 
Published: June 2012

Alteration of the heart occurs whenever any of its tissues, contractile or conductive, fail to function during alternate beats. This results in a diversity of 2:1 conduction blocks with electrical alternation and myocardial blocks that produce alternation of the pulse. In a general way, the more distal blocks, involving bundle branches, arborization, and myocardium are the more ominous, implying serious underlying heart disease. They can occur normally, however, at rapid heart rates.
Another type of alternation involving atrial as well as ventricular waves is sometimes seen in serious pericardial disease with effusion. It is believed to be due to an unusual rotary oscillation of the heart released from its normal inhibitory mediastinal restraints by the surrounding effusion. This is an anatomic rather than a cellular form of alternation and can exhibit other mechanical disorders such as alternating friction sounds.
Intracardiac Rupture of Hydatid Cysts of the Heart
Authors: DI BELLO RAÚL , MENÉNDEZ HÉCTOR. 
Published: June 2012

Intracardiac rupture of hydatid cysts of the heart is very frequent (38.66 per cent) and often causes sudden death (29 per cent). Cysts of the right ventricle rupture into the heart cavities far more often than do those of the left ventricle. Frequently, the cyst undergoes multiple intracardiac or pericardio-intracardiac ruptures.
The consequences of the intracardiac rupture depend above all upon the contents of the cyst. If it contains liquid and microscopic elements, no mechanical disorders occur, but it may give rise to metastatic visceral echinococcosis. If it contains vesicles, or is degenerated, it may give rise to large emboli.
Relationship of Hypoxia to Arrhythmia and Cardiac Conduction Hemorrhage
Authors: CLARK RICHARD E. , CHRISTLIEB IGNACIO , SANMARCO MIGUEL , DIAZ-PEREZ RODRIGO , DAMMANN J. FRANCIS , Zipser Martin E. 
Published: June 2012

The relationship between hypoxia, arrhythmia, and hemorrhage of the conducting system was studied in the experimental laboratory by rendering several different groups of rats and dogs hypoxic, and by the histological examination of the area of the atrioventricular node and bundle of His in sections obtained from the hearts of these animals. Sixty-one per cent of rats aged two weeks or older developed arrhythmias and had hemorrhage. None of 10 baby rats presented changes when submitted to the same type of experiment. Hemorrhage was present in only 40 per cent of asphyxiated dogs and in 40 per cent of the dogs that were made hypoxic during cardiopulmonary bypass; 75 per cent of dogs which underwent total mitral valvular replacement and expired in acute pulmonary edema 3 to 10 days postoperatively presented a similar type of lesion. In most cases, the administration of oxygen sufficed to reverse the electrocardiographic changes back to normal.
Hypoxia is suggested as the primary cause for these changes, on the basis of previous clinical and experimental work and the information collected from these experiments. The importance of a possible species difference was suggested when attempts were made to correlate the results in rats, dogs, and humans.
Hypotensive and Renal Effects of Diazoxide, a Sodium-Retaining Benzothiadiazine Compound
Authors: BARTORELLI C. , GARGANO N. , LEONETTI G. , ZANCHETTI A. 
Published: June 2012

Diazoxide, a new compound of the benzo-thiadiazine group, has been shown to decrease both systolic and diastolic arterial pressure in mild or moderate hypertensive patients, even though it lacks the saluretic properties characteristic of the other known compounds of the group.
Instead of promoting sodium excretion, diazoxide appears to be a powerful sodium- and chloride-retaining agent, its prolonged use leading to important increases in plasma volume and body weight, and probably to some redistribution between extracellular and intracellular fluid. Glomerular filtration rate and renal plasma flow are often increased during treatment with the drug.
Although diazoxide was in several respects a useful hypotensive agent, at least in hypertensive patients without heart failure, it may share with other benzothiadiazine compounds some pancreatic toxicity, a side effect that should be carefully considered during benzothiadiazine treatment.
Results of Surgical Treatment of Incipient Stroke
Authors: WHISNANT JACK P. , SIEKERT ROBERT G. , BERNATZ PHILIP E. , ELLIS F. HENRY 
Published: June 2012

Recently we have studied the role of surgical treatment of patients having occlusive cerebrovascular disease, particularly incipient stroke (or focal intermittent cerebrovascular insufficiency). This report concerns 35 pa-patients with incipient stroke in whom circulation was restored to normal by operation on an artery in an attempt to prevent transient ischemic episodes and cerebral infarction.
Since all of the patients were neurologically normal at the time of the surgical procedure, we were concerned primarily with the risk of [see tablein the PDF file] the procedure, particularly in terms of cerebral infarction. The operative mortality rate was 8.5 per cent (three patients). Six patients (17 per cent) sustained cerebral infarcts. Four of these had mild neurologic deficits, usually consisting of clumsiness and mildly reduced discriminatory sensation in one hand; one had a severe neurologic deficit, and one died. Evidence shows that at least some of these infarcts resulted from emboli arising from the operative site at the time of or shortly after the operation.
The results of long-term follow-up revealed that 66 per cent of the surgically treated patients were normal compared to 25 per cent of a contrast group; and 17 per cent of the treated patients had suffered cerebral infarcts compared to 40 per cent of the contrast group. The long-term results are thus similar to the immediate postoperative results. These findings simply indicate that an operated patient's prognosis was good over the long term if the cerebral ischemic episodes were relieved and if he sustained no complications from the surgical procedure.
Subclavian Steal
Authors: WILLIAMS CARL L. , SCOTT STEWART M. , TAKARO TIMOTHY 
Published: June 2012

Five patients with subclavian artery stenosis, reversed vertebral artery blood flow, and basilar arterial insufficiency have been described. Four patients were successfully treated by arterial reconstruction.
Serial angiography demonstrated in each case a stenosis of the subclavian artery proximal to the origin of the vertebral artery, with delayed retrograde flow through this vertebral artery to the subclavian artery distally.
Coronary Radiography and Endarterectomy
Authors: NILES NELSON R. , DOTTER CHARLES T. 
Published: June 2012

Postmortem angiography, kerosene perfusion, latex mass-injection radiographic studies and the conventional methods of anatomic pathology have been used in a study of coronary artery disease in 189 hearts, 88 of which had myocardial infarction associated with coronary arteriosclerosis. Analysis was directed to ascertain whether sclerotic lesions appeared to be amenable to surgical removal and whether such removal is likely to result in an increased flow of blood to the myocardium. Affirmative conclusions to these questions were reinforced by 42 postmortem coronary resections done in 31 cases. Fluidtight closures permitted follow-up perfusion studies in 25 successful resections done for the relief of coronary luminal narrowing, and in 16 of these significant increase in the perfusion rate resulted. Twelve of these 25 were endarterectomies, and increased perfusion rates were achieved in 10 of them. From the logical standpoint, direct relief such as appears mechanically feasible through surgical endarterectomy offers an attractive therapeutic approach to myocardial ischemia from coronary arteriosclerosis. The presence of multiple main-vessel lesions and of distal small-branch disease does not preclude significant improvement; these are not contraindications to such surgery.
In view of the frequency and mortality of coronary arteriosclerosis and because of the inadequacies of other methods of therapy in use today, the clinical trial of a direct attack upon the occluding lesion appears to be warranted. Current clinical failures provide opportunities while external artificial circulation and other methods for left ventricular assistance or bypass pumping provide means for gaining surgical experience and offering at least a slim chance to patients whose lives would otherwise be lost. Radiographic studies of the coronary system will be essential to any surgical attack likely to succeed.
Persistent Truncus Arteriosus
Authors: TANDON RAJENDRA , HAUCK ANNA J. , NADAS ALEXANDER S. 
Published: June 2012

The clinical, hemodynamic, and autopsy data on 19 patients with a diagnosis of persistent truncus arteriosus have been presented.
A proposed clinical classification, dividing the patients into types I and II only, with exclusion of type IV, provides a uniform clinical profile. The patients, as a rule, are small infants with a large left-to-right shunt, minimal cyanosis, wide pulse pressure, left or combined ventricular hypertrophy, and congestive heart failure, and resemble patients with a ventricular septal defect or patent ductus arteriosus.
At cardiac catheterization distinct but slight differences in pressures or saturations between pulmonary arteries and "ascending aorta" do not exclude the diagnosis of persistent truncus arteriosus.
The prognosis is uniformly poor. Most infants die in congestive heart failure within the first 6 months of life, others develop pulmonary vascular obstructive disease in later years.
Transient Bundle-Branch Block
Authors: BAUER G. E. 
Published: June 2012

Fourteen patients with transient bundle-branch block have been personally studied. All but one suffered from ischemic heart disease commonly accompanied by hypertension. The conduction defect was observed to appear during acute infarction, attacks of prolonged chest pain, and episodes of left ventricular failure. Not infrequently, however, the appearance and disappearance of bundle-branch block was unaccompanied by any recognizable change in the patient's physical condition.
Bundle-branch block may revert to normal intraventricular conduction after many years. In one patient bundle-branch block disappeared on three separate occasions after having been present for over 12 months. Another patient is described in whom normal conduction returned after left bundle-branch block had been established for a record duration of 6 years.
The etiology, prognosis, and pathogenesis of transient bundle-branch block have been discussed and the practical importance of this conduction defect in the electrocardiographic diagnosis of myocardial infarction is mentioned.
Idiopathic Hypertrophic Subaortic Stenosis: II. Operative Treatment and the Results of Pre- and Postoperative Hemodynamic Evaluations
Authors: MORROW ANDREW G. , LAMBREW COSTAS T. , BRAUNWALD EUGENE 
Published: June 2012

In 10 of 64 patients with IHSS, operations designed to relieve obstruction were performed. The pertinent preoperative clinical and hemodynamic findings in these patients, the operative methods employed, and the results of operation are presented in the present report.

Eight of the patients were males, 2 were females, and at the time of operation their ages ranged from 10 to 54 years. All of the patients were symptomatic and all but 2 were in functional classes III and IV. In each patient left heart catheterization proved the presence of left ventricular outflow obstruction and the peak systolic gradients between the left ventricle and a systemic artery ranged from 68 to 175 mm. Hg (average 110 mm. Hg). The effective orifice areas ranged from 0.44 to 0.99 cm.
2
(average 0.61 cm.
2
). Pulmonary hypertension was present in 2 patients.

In 5 patients simple left ventriculomyotomy was performed, and in the other 5 ventriculomyotomy was combined with resection of a portion of the hypertrophied interventricular septum. One patient, in whom operative pressure measurements indicated satisfactory relief of obstruction, died suddenly on the eighth postoperative day, apparently from arrhythmia. Complete heart block was produced in 2 patients, and these patients have implanted pacemakers. Seven of the 9 surviving patients have been followed for periods of 7 to 51 months, and each has had striking symptomatic improvement. Left heart catheterizations have been carried out postoperatively on one or more occasions in all 7 patients. In 6 no intraventricular pressure gradient was present at rest or during exercise, while in the remaining patient a peak gradient of 24 mm. Hg was evident.
The pertinent clinical findings in these 10 patients, the operative methods utilized, and the results of their pre- and postoperative hemodynamic assessments are presented in detail. Consideration is also given to present concepts in the selection of patients for operation, and in the choice of operative techniques.
Serum Lipids and Conjunctival Circulation after Fat Ingestion in Men Exhibiting Type-A Behavior Pattern
Authors: FRIEDMAN MEYER , ROSENMAN RAY H. , BYERS SANFORD , Carroll Vernice , Hayashi Warren , King Marshon , Omoto Clarence , Tam Ashley 
Published: June 2012

A group of 12 subjects exhibiting a behavior pattern A, associated with a high incidence of clinical coronary artery disease, and a second group of subjects exhibiting a converse type of behavior pattern B, were fed a standard fat meal, before and after which studies were made of serum lipid and cholesterol changes. In addition, studies were made of their bulbar conjunctival vasculature.
It was found that the average fasting serum triglyceride, cholesterol, and phospholipid values of the "A" subjects were significantly greater than those of the "B" subjects. Following the meal, the average serum triglyceride rose much higher and remained relatively much higher and longer in subjects with pattern A than in those with pattern B. The serum free fatty acid content was essentially the same in both groups, both before and after the meal. The observed differences in serum triglyceride behavior did not appear to be due to differences in the circulating phase of the heparininduced lipoprotein-lipase system.
Following the meal, marked sludging and capillary ischemia were found in the conjunctival tissue of 10 or 12 subjects with pattern A and in only three of the 12 subjects with pattern B.
Pathology of the Pulmonary Vascular Tree
Authors: EDWARDS JESSE E. , CHAMBERLIN WILLIAM B. 
Published: June 2012

The pulmonary vessels in 2 cases of cor triloculare with subaortic stenosis are compared. Each showed medial hypertrophy of the muscular arteries of the lungs. In 1 case concerning an 8 year old boy this class of vessels showed, in addition, severe intimal fibrosis. The arterioles were normal.
It is emphasized that the changes in the pulmonary arteries are similar to those seen in the Eisenmenger complex, in coarctation of the aorta proximal to a patent ductus arteriosus and in the normal fetus. These conditions, though anatomically different from each other and from cor triloculare with subaortic stenosis, are functionally alike in that there is in each a common ventricular ejectile force for the pulmonary and the systemic circulations in the absence of stenosis in the major arterial pathways to the lungs.
It is suggested that in cor triloculare biatriatum with subaortic stenosis, the structure of the pulmonary muscular arteries is, and that their function seems, similar to that of the fetus. The changes in the case of the malformation may be considered a carry-over from fetal life.
Congenital Communications of the Right Pulmonary Veins with the Azygos Vein
Authors: ANDERSON HOWARD N. , GUNTHEROTH WARREN G. , WINTERSCHEID LOREN C. , MERENDINO K. ALVIN 
Published: June 2012

A case of total pulmonary venous drainage of the right lung into the azygos vein, surgically corrected, has been reported.
There have been 10 previous cases of varying degrees of partial right, total right, to total (bilateral) pulmonary venous drainage into the azygos vein. The authors' case is the third to be diagnosed during life and apparently the first case to be successfully corrected. With one exception, all previously reported cases have occurred in females.
A review of previous cases and surgical considerations in the authors' case have been presented.