bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a Phenolic Ether, Su-13437, on Serum Cholesterol, Triglyceride, and Transaminase Levels of Human Subjects
Authors: DUNCAN CHARLES H. , BEST MAURICE M. 
Published: June 2012

The hypolipidemic activity of the phenolic ether, 2-methyl-2-[p-(1,2,3,4-tetrahydro-1-naphthyl)-phenoxy]-propionic acid (Su-13437, Ciba) has been studied in 10 hypercholesterolemic patients. The patients were studied at 3-week intervals during 30 weeks of placebo administration and a 30-week period of treatment with Su-13437, 400 mg daily.
Individual mean serum total cholesterol during administration of placebo ranged from 255 to 609 mg/100 ml and during treatment from 187 to 493, the mean reduction being 22%. Five of the subjects were also hypertriglyceridemic, with individual mean levels of triglycerides during placebo periods ranging from 159 to 1247 mg/100 ml. During treatment with Su-13437 mean triglyceride levels of these five patients ranged from 81 to 314 mg/100 ml, a mean reduction of 51%.
The drug was well tolerated and its only effect on the hematologic and biochemical tests for possible toxicity was an increase in SGOT and SGPT levels in two patients, the levels being maximal between the sixth and ninth weeks of drug administration and returning later toward pretreatment values despite continuation of Su-13437.
Vectorcardiographic Differentiation Between Right Ventricular Hypertrophy and Posterobasal Myocardial Infarction
Authors: MATHUR VIRENDRA S. , LEVINE HAROLD D. 
Published: June 2012

Vectorcardiograms were recorded by the Frank lead system in 203 cases of right ventricular hypertrophy (RVH) and 85 cases of posterobasal myocardial infarction (PBMI). Of the RVH cases, 33 were confirmed by autopsy and 135 by cardiac catheterization or surgery. Of the cases of PBMI, 12 were confirmed by autopsy and 48 had definite clinical episodes associated with enzymatic or serial electrocardiographic changes or both.
Of several measurements made, the following proved most helpful: (1) location of mean frontal plane QRS axis between 75° and 220° in 64% of the cases of RVH and between 350° and 74° in 78% of the cases of PBMI; (2) location of mean horizontal plane QRS axis between 350° and 90° in 85% of the cases of PBMI but in only 11% of the cases of RVH; (3) location of the 0.04-sec instantaneous vector in the horizontal plane between 350° and 60° in 76% of the cases of PBMI but in only 22% of the cases of RVH; (4) magnitude of terminal rightward voltage of less than 1.0 mv in 88% of the cases of PBMI and equal to or greater than 1.0 mv in 80% of the cases of RVH; and (5) clockwise inscription of the horizontal plane loop favored RVH, but counterclockwise rotation in the horizontal plane was not helpful. Synthesis of criteria 2 and 4 provided the best combination for the separation of RVH from PBMI. If both these criteria were fulfilled, a correct diagnosis could be made with 95% certainty.
Hemodynamic Responses to Tilt and Beta-Adrenergic Blockade in Young Patients with Borderline Hypertension
Authors: SANNERSTEDT RUNE , JULIUS STEVO , CONWAY JAMES 
Published: June 2012

Seventeen young patients with borderline hypertension (one female) and 18 normotensive paid volunteers (two females) were studied at rest and in the tilted position after 10 min of 45° head-up tilt. Cardiac output, heart rate, and intra-arterial pressure were recorded. The measurements at rest and during the tilt were repeated after betaadrenergic blockade with propranolol.
By comparison with the normotensives, cardiac output and heart rate in those with borderline hypertension were elevated initially, after 50 min of rest, and during tilt. The change of the cardiac output and heart rate to tilt was of the same magnitude in patients and control subjects. Consequently, regulation of the rate and flow in borderline hypertensives appears to be normal but starts from a higher base line level.
After blockade with propranolol, cardiac output in patients with borderline hypertension was still slightly elevated, but the difference from controls was not significant. The heart rate, however, remained significantly elevated at rest and during tilt. Elevation of the heart rate in borderline hypertensives is not mediated through the beta-adrenergic system and may result from decreased parasympathetic inhibition or from different intrinsic myocardial pacing.
Echocardiographic Features of Atrial Septal Defect
Authors: DIAMOND MORTON A. , DILLON JAMES C. , HAINE CHARLES L. , CHANG SONIA , FEIGENBAUM HARVEY 
Published: June 2012

Echocardiographic studies were performed on 39 adult patients with atrial septal defects. Findings were compared with those from normal subjects, patients with other congenital left-to-right shunts (ventricular septal defect and patent ductus arteriosus), patients with uncomplicated right ventricular pressure overload (pulmonic stenosis and pulmonary hypertension), and patients with pulmonary hypertension complicated by tricuspid regurgitation. Two echocardiographic features were assessed: 1) a right ventricular dimension, or RVD Index, representing the distance between the right ventricular epicardial echoes and echoes from the right side of the interventricular septum divided by the patient's body surface area, and 2) motion of the interventricular septum.
The increased RVD Index and abnormal septal motion observed in the patients with atrial septal defects provided an ultrasound complex that could clearly separate these patients from normal individuals, those with ventricular septal defect and patent ductus arteriosus, and those with uncomplicated right ventricular pressure overload. However, patients with tricuspid regurgitation could not be differentiated from the group with atrial septal defects, indicating that this echocardiographic complex reflected a volume overload of the right ventricle.
Spontaneous Closure of Physiologically Advantageous Ventricular Septal Defects
Authors: RAO P. SYAMASUNDAR , SISSMAN NORMAN J. 
Published: June 2012

The clinical and pathological features of two cases in which physiologically advantageous ventricular septal defects closed spontaneously are presented. The first patient, with tricuspid atresia, Type I(c), developed symptoms and signs of increasing systemic hypoxemia, decreasing pulmonary blood flow, and a systolic murmur of decreasing intensity. His ventricular septal defect, previously demonstrated angiocardiographically, could not be found at autopsy; it is presumed to have closed by fusion of its muscular rims with subsequent covering by endocardial proliferation. The second patient, with a double-outlet right ventricle, demonstrated progressive left ventricular enlargement and congestive failure despite increasing pulmonary vascular resistance. Postmortem examination showed that this defect was sealed by adherence of the septal leaflet of the tricuspid valve to the edges of the defect. Appreciation of the true nature of the changing anatomical situation would have resulted in more rational effective therapeutic approaches.
The cases presented and review of pertinent literature contribute to more complete understanding of circumstances surrounding the spontaneous closure of ventricular septal defects.
Electrical Stimulation of the Heart in Patients with Wolff-Parkinson-White Syndrome, Type A
Authors: WELLENS HEIN J. J. , SCHUILENBERG REINIER M. , DURRER DIRK 
Published: June 2012

The initiation and termination of tachycardias were studied in five patients with Wolff-Parkinson-White syndrome, type A. In all patients, electrical stimulation was performed from the right side of the heart. In three patients the effect of induced left-sided premature beats was studied as well. In contrast to patients with Wolff-Parkinson-White syndrome, type B, there was difficulty in initiation and termination of tachycardias with premature beats applied to the right atrium or ventricle. This could easily be accomplished with left-sided premature stimuli. In two patients the simultaneous recording of right and left atrial activation during a tachycardia, showing atrioventricular conduction by way of the A-V nodal-His pathway and ventriculoatrial conduction via the anomalous connection, revealed that left atrial activation occurred far in advance of right atrial activation. During regular driving of the right and the left atrium at identical rates the most pronounced pre-excitation pattern was seen after left atrial stimulation.
Our results are in agreement with a circus movement or reciprocal mechanism by way of the A-V nodal-His pathway and the anomalous A-V connection as a causal mechanism for tachycardias in Wolff-Parkinson-White syndrome, type A. In contrast to the usual finding of atrioventricular conduction during the tachycardia via the A-V nodal—His pathway and ventriculoatrial conduction by way of the anomalous connection, one patient showed tachyeardias running in the opposite direction. A location of the anomalous pathway on the left side of the heart is supported by our findings.
Long-term Results of Aortopulmonary Anastomosis for Tetralogy of Fallot
Authors: COLE ROGER B. , MUSTER ALEXANDER J. , FIXLER DAVID E. , PAUL MILTON H. 
Published: June 2012

A review of 340 patients with tetralogy of Fallot undergoing aortopulmonary anastomosis of the Potts-Smith type (descending aorta to pulmonary artery) has been made for assessment of the complications and long-term results (1946-1969) of this procedure. There were 30 operative deaths (9%) and 52 late medical deaths (20%) The symptomatic improvement has remained impressive in the survivors even up to 20 years after shunt surgery, with 85% of the patients having a functional classification of I or II.
The major late complications have been related to anastomotic channels which were made or eventually became too large, resulting in congestive heart failure (20 late medical deaths) or in pulmonary hypertension with pulmonary vascular obstructive disease. These complications are not unique to the Potts operation, and may be anticipated in patients with excessively large ascending aorta to right pulmonary artery anastomoses. Careful patient follow-up is indicated and, in the event of congestive heart failure or evidence for pulmonary hypertension, an aggressive approach with either shunt take down and intracardiac repair or shunt revision should be considered.
Morphology of the Human Tricuspid Valve
Authors: SILVER M. D. , LAM J. H. C. , RANGANATHAN N. , WIGLE E. D. 
Published: June 2012

The morphology of 50 normal tricuspid valves was studied. The surface of the leaflets was divided into three zones: (1) the rough zone, into which most of the chordae tendineae are inserted, (2) the basal zone, and (3) the clear zone, which lies between the rough and basal zones.
Five types of chordae were distinguished by their morphology and mode of insertion: fan-shaped, rough zone, basal, free edge, and deep chordae. The last two types are unique to the tricuspid valve.
If fan-shaped chordae, used to define the commissures between the leaflets, are absent, other landmarks may be used for commissural definition. Once defined, all tissue between the commissures was regarded as part of the anterior, posterior, or septal leaflet. The recognition that the free edges of the anterior and septal leaflets contain notches, that rough zone chordae insert into them, and that the posterior leaflet has scallops further aids identification of a leaflet's components. Thus, structures formerly regarded as accessory leaflets were incorporated into one of the three leaflets.
Significance of the Diagnostic Q Wave of Myocardial Infarction
Authors: HORAN LEO G. , FLOWERS NANCY C. , JOHNSON JENNIFER C. 
Published: June 2012

Correlation between the QRS complex and postmortem ventricular anatomy was made in 1184 instances of normal conduction:
(1) Mechanical reliance on the sheer presence or absence of a Q wave greater than 0.03 sec in duration led to "correct" diagnosis of infarction or not in 79% of the series.

(2)With normal conduction, abnormal Q waves
isolated
to either the anteroseptal (V
l
-V
4
) or inferior (II, III,
a
V
F
) electrocardiographic zones were frequently false (46%). However, abnormal Q waves restricted to the lateral zone (V
5
-V
6
) or in a combination of more than one electrocardiographic zone, were rarely false predictors of the presence of infarction (4%).

(3) Classical localization of infarction with normal conduction was statistically relatively reliable as compared with bundle-branch block. The increased frequency of the anatomic pattern of lateral basal infarction in association with normal QRS complexes (but known infarction) suggests relative "electrical silence" of the laterobasal left ventricle in abnormal Q-wave genesis.
(4) Lesions confined to a given anatomic location in the left ventricle tended to place particular emphasis and limits on the spectrum of electrocardiographic expression but did not yield a uniform single pattern of Q-wave distribution.
Ascending Aorta-Right Pulmonary Artery Shunt in Infants and Older Patients with Certain Types of Cyanotic Congenital Heart Disease
Authors: BERNHARD WILLIAM F. , JONES JIMMY E. , FRIEDBERG DAVID Z. , LITWIN S. BERT 
Published: June 2012

A side-to-side anastomosis between the ascending aorta and the right pulmonary artery was created in 80 infants (less than 1 year of age) and in 61 older children with a variety of cyanotic cardiac abnormalities in which there is pulmonary stenosis or atresia. Seventy-one per cent of the infant group and 90% of patients over 1 year of age were long-term survivors (up to 6 years).
Tetralogy of Fallot was the most commonly encountered anomaly in all 141 patients (66%); transposition of the great vessels and pulmonary stenosis occurred in 18%; and tricuspid atresia with pulmonary stenosis in 10%.
The presence of an excessively large shunt anastomosis (55% of deaths) and additional (unrecognized) other anomalies (26%) were major causes of postoperative deaths.
In patients in whom a systemic-pulmonary artery anastomosis is required, this operation is the procedure of choice in infants under 1 year of age. It is also of value in older patients if a Blalock-Taussig shunt cannot be performed.
Mitral Insufficiency Resulting from "Overshooting" of Leaflets
Authors: EDWARDS JESSE E. 
Published: June 2012

Mitral insufficiency may result from abnormal degrees of upward extension of valvular tissue, a condition which may be termed "overshooting."
This condition may result either from rupture of elements in the papillary musclechordal mechanism or from inadequate support of leaflets without rupture. The latter may occur in myocardial infarction or in instances of intrinsic weakness of connective tissues of leaflets and/or chordae tendineae.
Abnormalities of Left Ventricular Contraction Induced by Beta Adrenergic Blockade
Authors: HELFANT RICHARD H. , HERMAN MICHAEL V. , GORLIN RICHARD 
Published: June 2012

To understand better the hemodynamic effects caused by propranolol, its effect on the geometry of left ventricular contraction was studied in ten subjects, four with angiographic evidence of coronary artery disease and six without demonstrable heart disease. Heart rate was controlled in four subjects with right atrial pacing. After 5 mg of intravenous propranolol, there were decreases in heart rate and cardiac index in most subjects with a variable effect on left ventricular end-diastolic pressure.
Left ventricular end-diastolic volume increased in the majority of instances with a reduction in both volume ejected and per cent circumferential fiber shortening of the left ventricle. Furthermore, after propranolol the left ventricle assumed a more elongated shape. Propranolol either induced or exaggerated asynergy in five subjects, three of whom had coronary heart disease. These changes provide a morphologic basis for some of the cardiac hemodynamic effects of propranolol.
Localization and Sequence of Development of Atherosclerotic Lesions in the Carotid and Vertebral Arteries
Authors: SOLBERG LARS A. , EGGEN DOUGLAS A. 
Published: June 2012

The distribution of fatty streaks, fibrous plaques, complicated lesions, and calcified lesions were determined for each of five segments in the common carotid arteries, each of five segments of internal carotid arteries, and for each of seven segments of vertebral arteries in specimens from 961 autopsied cases in Oslo, Norway, and Guatemala. The pattern of distribution of the lesions along the length of the arteries is characteristic for the different arteries. This pattern seems to be independent of sex, age group, type of lesions, and geographic location.
Fatty streaks and fibrous plaques have the same pattern of distribution within each artery at all ages. This close topographic association is consistent with the hypothesis that fibrous plaques are derived from fatty streaks. The early atherosclerotic lesions are located at the same sites where stenotic and occlusive lesions have been reported. Thus, it is likely that the early atherosclerotic lesions and the stenotic or occlusive lesions are pathogenetically closely associated with each other.
Balloon Closure of Ventricular Septal Defect
Authors: MILLS NOEL L. , VARGISH THOMAS , KLEINMAN LEONARD H. , BLOOMFIELD DENNIS A. , REED GEORGE E. 
Published: June 2012

A prototype double-lumen cardiac catheter with an inflatable disc balloon for interim closure of left-to-right shunts through the ventricular septum is described. Five clinical fatalities following ventricular septal rupture in the early postmyocardial infarction period were seen at New York University Medical Center from October, 1968 to March, 1970.
Ventricular septal defects were made in nine acute dog experiments. Shunt sizes ranged from 2.2:1 to 4.8:1. Absence of shunting after balloon occlusion was confirmed by oxygen saturations, phonocardiography, and the hydrogen electrode method. Left ventricular angiography confirmed cardiac catheter positions.
The feasibility of ventricular shunt occlusion in patients who are deteriorating from early postinfarction septal rupture is discussed.
Humoral Antibody in Canine Cardiac Allograft Rejection
Authors: GOLDMAN BERNARD S. , SHUMAK KENNETH H. , CARTIER JEAN , SILVER MALCOLM D. , BIGELOW WILFRED G. , CROOKSTON JOHN H. 
Published: June 2012

The antibodies formed in response to cardiac allografts were studied in four groups of dogs receiving one of the following: (1) no immunosuppressive treatment; (2) azathioprine and prednisone; (3) acetylsalicylic acid; (4) antilymphocyte serum.
Only azathioprine-prednisone treatment was effective in reducing antibody formation, although the histological changes of rejection were modified in each of groups 2, 3, and 4. Hearts transplanted in the presence of "donor-specific" lymphocytotoxic antibodies were not hyperacutely rejected, despite the fixation of antibodies to the sarcolemma within minutes or a few hours of transplantation.
Rehabilitation Following Cardiac Surgery
Authors: FINCHUM R. NEWELL 
Published: June 2012

Of 120 vocational rehabilitation clients having cardiac surgery between July, 1966 and December, 1968, seven were lost to follow-up, and the operative and late mortality totaled 14%. Ninety-six patients were seen for voluntary outpatient evaluation with a mean postoperative evaluation time of 22 months. Two-thirds of the patients had acquired heart disease and were in functional class III or IV preoperatively. After surgery 76 were in functional class I or II with 20 in functional class III. The electrocardiogram and radiographic heart size had returned toward normal in over 50%, and 76% of those having preoperative exercise tests demonstrated improved exercise capacity postoperatively.
The rehabilitation effort was successful in 83% of those surviving surgery and 77% of the entire series. Medical and surgical physical factors were found to be more important than psychosocial factors in determining the vocational outcome after surgery. The duration of unemployment was the most important preoperative variable in predicting the rehabilitation result. The importance of medical follow-up after cardiac surgery is emphasized by the detection of a significant number of residual medical problems.
Intracardiac Surgery in Neonates and Infants Using Deep Hypothermia with Surface Cooling and Limited Cardiopulmonary Bypass
Authors: BARRATT-BOYES BRIAN G. , SIMPSON M. , NEUTZE JOHN M. 
Published: June 2012

In an attempt to achieve safe intracardiac surgery in severely ill babies with congenital heart defects, a technique of deep hypothermia with surface cooling and limited bypass has been used. Under halothane anesthesia, these infants were cooled to a nasopharyngeal temperature of 26 C on a circulating water blanket and the temperature was lowered further to 22 C by a short period of total body perfusion. After a period of circulatory arrest which averaged 48 minutes at 22 C, during which the intracardiac repair was carried out, rewarming to 32 C was achieved by 20 minutes of total body perfusion and final rewarming to 36 C by surface means.
Thirty-three of 37 infants under 10 kg in weight, with correctable lesions, survived this procedure, including 25 aged 8 days to 12 months. Conditions corrected were transposition (13), tetralogy of Fallot (9), total anomalous pulmonary venous connection (6), ventricular septal defect (6), and atrioventricular canal (3). The technique gave ideal operating conditions and is believed to have wide application in the neonatal and infant group.
Obstruction of Tricuspid Ball-Valve Prostheses
Authors: VANDER VEER JOSEPH B. , RHYNEER GEORGE S. , HODAM ROBERT P. , KLOSTER FRANK E. 
Published: June 2012

Obstruction of Starr-Edwards tricuspid prostheses occurred in seven patients from 2 to 52 months after surgery. Four patients were taking anticoagulants. Three patients presented with acute right-heart failure, three were asymptomatic, and one died suddenly. Of the six who were examined, all had high-pitched tricuspid diastolic murmurs and elevated jugular venous pressure, five had hepatomegaly, and three had peripheral edema. Cardiac catheterization in four patients revealed elevated right atrial pressure in all and large transvalvular pressure gradients in three. Angiography showed impaired flow across the valve in all cases. In six cases, impingement of a prosthesis strut on the ventricular myocardium was the underlying mechanism of obstruction. Two patients died without reoperation. Four of the remaining five patients survived reoperation and were improved.
Tricuspid ball-valve obstruction is a potentially lethal complication that may develop with minimal symptoms. A characteristic diastolic murmur and elevated systemic venous pressure have uniformly been present. Confirmatory hemodynamic studies should be followed by early reoperation.
Appraisal of Surgical Atrial Septectomy for Transposition of the Great Arteries
Authors: LITWIN S. BERT , PLAUTH WILLIAM H. , JONES JIMMY E. , BERNHARD WILLIAM F. 
Published: June 2012

The results of surgical atrial septectomy alone, septectomy with pulmonary artery banding, and septectomy with shunting procedures in 105 patients are reported. There were 82 survivors with eight deaths directly related to surgery, seven related to specific preoperative complications, and eight resulting from associated cardiac malformations. Excellent improvement in arterial oxygen saturation was achieved and maintained over an extended period of time in the majority of survivors.
Although balloon septostomy has proved to be a helpful palliative maneuver in patients with TGA, 34 children who had this procedure later required surgical septectomy.
A late fall in arterial oxygen saturation was often indicative of diminishing pulmonary blood flow on the basis of increasing pulmonary stenosis or pulmonary vascular obstructive disease.