bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Frequency of Aschoff Bodies in Atrial Appendages of Patients with Mitral Stenosis
Authors: RUEBNER B. H. , BOITNOTT J. K. 
Published: June 2012

Three hundred and sixteen biopsies of atrial appendages obtained at mitral valvotomy were studied histologically. They were divided into those with Aschoff bodies (41 per cent), those with nonspecific granulomas (23 per cent), and those without either lesion. These findings were compared with those of previous investigators.
A study of 24 hearts with mitral stenosis and survey of the literature showed that Aschoff bodies in the left atrial appendage are usually accompanied by similar lesions in the rest of the heart.
The average age of patients with Aschoff bodies in their atrial biopsy was 4 years less than that of those with "nonspecific granulomas" and more than 7 years less than that of patients without inflammatory foci in the endocardium. The etiology of "nonspecific granulomas" is discussed.
Aschoff bodies were rare in patients with organized atrial thrombi, most of whom were fibrillating. Statistical analysis showed that thrombosis rather than fibrillation was the principal factor associated with a lowered incidence of Aschoff bodies. It was concluded that mechanical factors may determine the localization of rheumatic lesions in the heart.
Elevated sedimentation rates were recorded as often in patients with negative biopsies as in those with Aschoff bodies.
The percentage of positive biopsies fell from 66 per cent in patients aged 15 to 20 years to 14 per cent in patients aged over 55 years. The age incidence of Aschoff bodies has been compared with that of acute rheumatic fever, which is rare after the age of 15 years. It is concluded that in patients with mitral stenosis, histologic activity may continue for 20 years or more in the absence of clinical signs and symptoms.
The proportion of positive biopsies was lowest in June and maximal in September. This seasonal change suggests that the histologic process is only intermittently active. The seasonal variation in the percentage of Aschoff bodies is discussed in relation to the seasonal incidence of acute rheumatic fever.
Our results appear to establish the concept of a "subclinical" rheumatic process which has been postulated by many previous investigators.
Sodium from Drinking Water as an Unsuspected Cause of Cardiac Decompensation
Authors: ELLIOTT GEORGE B. , ALEXANDER ELIZABETH A. 
Published: June 2012

A survey of 300 samples of drinking water from Southern Alberta analyzed for sodium content showed that a considerable proportion of well waters contain very high sodium levels, ranging up to 420 mg. per cent (4,200 ppm.).
Two instances of recurrent episodes of heart failure at home, which ceased after substitution of a low- for unsuspected high-sodium water supplies, are described.
The sodium is present in soils derived from underlying marine deposits of seas that covered the whole of the North American plains in ancient times. It is not readily recognizable by taste, especially as sulfate, and may cause darkening of soil so that its presence remains quite unsuspected.
Tasteless sodium in water forms a source of perplexing decompensation in otherwise well-controlled heart disease. The features of the terrain that lead to high sodium content in water supplies are described to alert physicians to similar possibilities in their own regions.
Isolated Incompetence of the Pulmonic Valve
Authors: PRICE BEN O. 
Published: June 2012

Two cases of isolated incompetence of the pulmonic valve diagnosed during life are reported and a review of the literature is presented.
The diagnosis should be suspected in patients with a basal diastolic murmur and right ventricular enlargement who have no evidence of other cardiac valvular disease.
The characteristic murmur associated with isolated incompetence of the pulmonic valve appears to be related to filling of the dilated right ventricle.
The diagnosis can be confirmed clinically by right heart catheterization.
The lesion is not benign in the human being, and right ventricular failure may be precipitated when complicating diseases are present.
Vascular Malformation Overlying the Pulmonary Artery Simulating a Patent Ductus Arteriosus
Authors: ERNST CALVIN B. , KLASSEN KARL P. , RYAN JOSEPH M. 
Published: June 2012

An arteriovenous fistula with aneurysmal dilatation involving branches of both coronary vessels and the pulmonary artery is discussed.
The malformation was limited to the main pulmonary artery and presented a small left-to-right shunt without symptoms.
Ligation of the supplying vessels resulted in the disappearance of a murmur typical of a patent ductus arteriosus.
Prognosis of Men Returning to Work after First Myocardial Infarction
Authors: DIMOND GEORGE E. 
Published: June 2012

The 5-year prognosis of 202 railway operating employees returning to full-time work after their initial myocardial infarction and the 10-year survival rates of 97 of these men have been described. The 5-year survival rate was 83 per cent and the 10-year survival rate was 57 per cent.
Twenty-five per cent of these men died or were totally disabled at the end of 5 years and 50 per cent at the end of 10 years. The cause of death or disability following the initial infarction was largely due to recurrent myocardial infarction.
The prognosis for men returning to fulltime activity after the first myocardial infarction is better than that reported for those surviving without consideration for their functional recovery. This better prognosis is not due to freedom from second infarctions but to a decreased incidence of myocardial failure and the ability better to survive and tolerate a second infarction.
Relationship between Arterial Pressure and Exertional Angina Pectoris in Hypertensive Patients
Authors: GEORGOPOULOS A. J. , SONES F. M. , PAGE IRVINE H. 
Published: June 2012

Seven hypertensive patients, five with coronary arterial disease and two with normal coronary arteries, with exertional angina pectoris and left ventricular hypertrophy were subjected to exercise in the sitting and supine position.
The five patients with coronary arterial disease developed, during exercise in both positions, striking arterial pressure elevation followed by angina pectoris and electrocardiographic changes. When the pressor response to exercise was eliminated by intravenous sodium nitroprusside, these were prevented.
In the two patients with normal coronary arteries who had orthostatic and exertional hypotension secondary to antihypertensive treatment, exercise in the sitting position caused intense hypotension followed by angina pectoris and electrocardiographic changes. In contrast, exercise in the supine position, which caused only minimal pressure changes, was not followed by angina pectoris.
It is concluded that in hypertensive patients with coronary arterial disease, further elevation of arterial pressure during exercise is an important factor in precipitating angina pectoris by increasing cardiac work. In hypertensive patients with normal coronary arteries and exertional hypotension secondary to antihypertensive treatment, marked lowering of arterial pressure during exercise is a factor of importance in producing angina pectoris, probably by reduction of perfusion pressure and coronary flow relative to the hypertrophied left ventricle.
A New Technic for Complete Correction of Transposition of the Great Vessels
Authors: IDRISS F. S. , GOLDSTEIN I. R. , GRANA L. , FRENCH D. , POTTS W. J. 
Published: June 2012

A procedure for complete anatomic correction of transposition of the great vessels is described. The technic is based on the concept of isolating an aortic segment containing both coronary ostia and turning the segment over to fit the outflow stump of the left ventricle. Experimental work and two clinical trials are presented and discussed.
We believe that this operation provides an anatomic and physiologic correction of the great vessels and coronary arteries in transposition. In spite of two clinical failures, we think this operation is worthy of further trials.
Comparative Effects of Thyroxin Analogues as Hypocholesteremic Agents
Authors: BEST MAURICE M. , DUNCAN CHARLES H. 
Published: June 2012

L-thyroxin and four thyroxin analogues were administered to a group of hypercholesteremic euthyroid patients, the majority with arteriosclerotic heart disease, and the effects on serum total cholesterol compared. L-thyroxin and each of the analogues studied, tetraiodothyroformic acid, dimethyldiiodothyroformic acid, D-thyroxin and D-triiodothyronine, were given to four to nine patients for periods up to 10 months.
At the doses employed each of the analogues resulted in a reduction in the mean level of serum cholesterol without obvious evidence of hypermetabolism or aggravation of angina pectoris or congestive heart failure. The reduced level of serum cholesterol was sustained throughout the period of hormone administration, and upon the substitution of a placebo returned to the pretreatment range.
L-thyroxin, at the dose employed, also effected a modest sustained reduction in serum cholesterol but both patients with angina included in this group experienced an increase in severity of symptoms.
Except for four patients who developed acneiform dermatitis, salivary gland swelling, or gastrointestinal symptoms during the administration of the formic acid analogues, no toxic or undesirable effects were observed from any of the analogues.
To evaluate better the general metabolic effects of the analogues each was administered to three or more of a group of seven myxedematous patients for periods of 6 to 12 months. Given in sufficient amount all were observed to increase basal metabolic rate and to maintain a clinically euthyroid state.
From these observations, it is concluded that the D-isomers of thyroxin and triiodothyronine, while not without general metabolic effects, are tolerated by the majority of euthyroid patients with coronary atherosclerosis in amounts sufficient to maintain a reduced serum cholesterol level.
The Electrocardiogram, Vectorcardiogram, and Ventricular Gradient in the Tetralogy of Fallot
Authors: DEPASQUALE N. P. , BURCH G. E. 
Published: June 2012

The electrocardiogram, ventricular gradient, and spatial vectorcardiogram were studied in 140 patients with proved tetralogy of Fallot. The patients were separated into three groups according to hemodynamic data.

The salient features of the electrocardiogram in patients of group I consisted of diminutive R waves in leads I and V
6
, a deep Q wave and high R wave in lead III, a prominent R wave in lead V
1
, which was not wide, and the absence of Q waves in leads I, V
1
, and V
6
.

The electrocardiogram in patients of group II was similar to that of the patients of group I except for the appearance of more signs of left ventricular electric activity and less clock-wise rotation of the heart.
The electrocardiogram of the patients of group III was similar to that previously described for ventricular septal defect.

Â
QRS
, Â
T
, Ĝ, and sVCG reflected the same general trend as the electrocardiograms.

The electrophysiologic data presented support clinical observations indicating that the tetralogy of Fallot includes patients with a wide range of hemodynamic differences.
Study of the Mechanism of Hyperlipemia
Authors: KUO PETER T. , WHEREAT ARTHUR F. , BASSETT DAVID R. , STAPLE EZRA 
Published: June 2012

The fatty acid patterns of the serum chylomicrons of 10 normal and 10 hyperlipemic subjects were determined by gas-liquid chromatography, before and after feedings of cream, corn oil, and coconut oil. Their depot fat composition was analyzed. Changes in the composition of the fasting serum chylomicrons of these hyperlipemic patients after they were stabilized on low fat, and rice and fruit diets were also studied.
Upon a full American diet, after 12 hours of fasting, the fatty acid pattern of the very light serum chylomicrons of the hyperlipemic patients was found to reflect that of the ingested fats, consisting chiefly of a mixture of saturated animal fats. The effect of food fats was less evident in the heavier serum chylomicrons and very low density lipoprotein fraction of these patients, where the pattern of endogenously synthesized fat predominated.
A low-fat diet in eight of these patients caused a significant lowering of the serum chylomicron (triglyceride) concentration and a shift of chromatographic pattern of the very light serum chylomicrons toward that of the non-hyperlipemic subjects. It is apparent that the clearing of the exogenous fats from the serum permits the endogenous lipids to dominate the picture.
A low caloric rice and fruit diet appeared to arouse a temporary acceleration in the mobilization of fat from the body depot in two patients. In these patients, the fatty acid composition of serum chylomicrons, the very low density lipoproteins, and the depot fat were found to be similar to one another.
Dietary fat contributed directly to alimentary lipemia of the normal and diseased subjects. At or near the peak of alimentary lipemia, the composition of the very light serum chylomicrons of all subjects was found to be practically identical with the ingested fat. Alimentary lipemia of hyperlipemic patients was intensified and prolonged.
A relative increase in oleic acid, together with an elevated oleic/stearic ratio has been reported in the serum chylomicrons of patients with coronary artery disease. The same findings occurred in our patients, when there was an increase (relative or absolute) in the very light serum chylomicrons, due either to excessive dietary fat intake or to increased mobilization of fat from the depot.
The Reopened Ventricular Septal Defect
Authors: MARCH HAROLD W. , GERBODE FRANK , HULTGREN HERBERT N. 
Published: June 2012

The persistence of a left-to-right shunt due to the unsuccessful repair of a ventricular septal defect associated with infundibular stenosis has been described.
A characteristic clinical picture has been reported. The main features include congestive heart failure, tricuspid insufficiency, and increased pulmonary blood flow.
The severity of the symptoms appears to be due to the persistence of a left-to-right shunt at a time when the myocardium has been affected adversely by such operative insults as potassium arrest and ventriculotomy.
The particular difficulties attending the repair of a ventricular septal defect with infundibular stenosis include the proximity of the defect to the hypertrophied muscle mass, the soft muscular margin of such a defect, and the tension on the suture line. Ivalon and Teflon prostheses have been disappointing in their failure to maintain the integrity of the repair.
All of the patients were reoperated upon. Five survived and their defects are now closed. The second repairs were abetted by the development of a fibrous scar around the margin of the defect. The five survivors are in good health and there is no evidence of a remaining shunt.
As a consequence of these experiences, surgical technics were modified. The defects are now closed by direct suture with interrupted silk, followed by the application of a crimped Dacron patch over the repair. The results have been encouraging and since the new technic has been adopted, there have been virtually no recurrences.
Complete Atrioventricular Block due to Cardiac Metastasis of Bronchogenic Carcinoma
Authors: BUCKBERG GERALD D. , FOWLER NOBLE O. 
Published: June 2012

A partial review of the literature indicates that the heart is not infrequently involved in patients who have malignant disease. The most common tumors metastasizing to the heart are bronchogenic carcinoma, breast carcinoma, malignant melanoma, and the group of hematopoietic malignant tumors. The clinical triad of myocardial insufficiency, cardiac arrhythmia, and pericardial effusion involving a previously normal heart should alert one to this possibility, especially in a patient with known malignant tumor.
Complete atrioventricular block is a rather uncommon manifestation of metastatic cardiac tumor. A case is reported in which complete heart block appeared as the sole clinical manifestation of metastatic involvement of the heart by bronehogenic carcinoma. Necropsy revealed cardiac involvement by tumor to be virtually limited to the interventricular septum.
Effect of Antibiotics on the Serum Cholesterol Concentration of Patients with Atherosclerosis
Authors: STEINER ALFRED , HOWARD ELLIOTT , AKGUN SUAT 
Published: June 2012

Oral neomycin, at the dose level of 0.5 to 2 Gm. daily, produced a significant fall in the level of serum cholesterol in all of 29 periods in 20 patients studied. The effect reached a maximum in approximately 2 weeks and persisted for the duration of the experiments up to 9 months. After the medication was discontinued, the serum cholesterol levels returned to control values within 2 weeks. No significant toxic reaction to oral neomycin was discernible. Neomycin by injection in excess of the amount calculated to be absorbed from the gastrointestinal tract failed to lower the serum cholesterol level. The mechanism of action of neomycin was not determined, but it is thought to be a local effect in the gastrointestinal tract or its contents.
Oral aureomycin and oral kanamycin had a similar but less marked and less consistent effect on the level of serum cholesterol in a number of patients. In a limited number of patients, oral achromycin, bacitracin, chloromycetin, streptomycin, and mycostatin did not have a significant effect on the serum cholesterol level; likewise, intramuscular penicillin and streptomycin failed to alter the serum cholesterol level.
The prior lowering of the serum cholesterol concentration by a low-fat diet did not prevent a further decrease in the serum cholesterol by oral neomycin.
Myocardial Metabolism in Progressive Muscular Dystrophy
Authors: SUNDERMEYER J. F. , GUDBJARNASON S. , WENDT V. E. , DEN BAKKER P. B. , BING R. J. 
Published: June 2012

Myocardial metabolism was studied in 11 patients with progressive muscular dystrophy. Coronary blood flow was measured in four, the cardiac output in six patients. The blood concentrations of oxygen, glucose, inorganic phosphate, pyruvate, and lactate, and the serum activities of malic dehydrogenase and aldolase were determined in simultaneously drawn coronary sinus and arterial blood samples.
The cardiac outputs were elevated in all patients. Myocardial extractions of pyruvate and lactate were negative in two patients. Inorganic phosphate concentrations in blood were elevated. Malic dehydrogenase and aldolase were released by the heart in several patients. Differences in oxidation-reduction potential between arterial and coronary venous blood were positive, suggesting glycolysis in the heart muscle. This was accompanied by increased myocardial extraction of glucose. Apparently aerobic glycolysis occurred, since sufficient oxygen was present to account for all glucose extracted.
Stimulation of glycolysis by inorganic phosphate was suggested by the relationship between the elevated inorganic phosphate concentration in blood and the myocardial glucose extraction. This suggests the possibility of uncoupling of oxidative phosphorlyation in the myocardium.
Direct Communication of a Pulmonary Artery with the Left Atrium
Authors: LUCAS RUSSELL V. , LUND GEORGE W. , EDWARDS JESSE E. 
Published: June 2012

Direct communication of a pulmonary artery with the left atrium is described and considered a variant of pulmonary arteriovenous fistula.
A 3-year-old girl presented with clinical evidence of a lesion of the central nervous system. The history revealed that she had been cyanotic and had had clubbing of the digits and polycythemia. A rounded mass was noted in the region of the right pulmonary hilus in the posteroanterior thoracic roentgenogram. A pulmonary arteriovenous fistula was suspected, but the patient succumbed with a cerebral abscess before definitive diagnostic studies and therapy were undertaken.
Anatomic examination revealed an unusual variant of pulmonary arteriovenous fistula, namely, direct communication of the right lower pulmonary artery with the left atrium and absence of the middle and lower lobes of the right lung.
It is important that pulmonary arteriovenous fistulas be suspected clinically, since definitive diagnosis and therapy are now possible. While the hemodynamic effects of this type of lesion are usually not severe, untreated patients suffer a high morbidity and mortality through systemic arterial oxygen desaturation, paradoxic embolization, cerebral abscess, and rupture of the fistula.
Some Contributions to the Pharmacology of Synthetic Angiotensin
Authors: GROSS F. , BOCK K. D. 
Published: June 2012

The examination of synthetic valyl-5-angiotensin II-amide in the conscious dog revealed the following:
1. Both the arterial and the central venous pressure responses exhibit tachyplylaxis when high doses of angiotensin II are administered, althoug not when medium or low doses are given. Cross-tachyphylaxis can be demonstrated between renin and angiotensin II but not between either of these and norepinephrine. These results suggest that tachyphylaxis to renin is due to tachyphylaxis to angiotensin.
2. Angiotensin II and norepinephrine provoke a dose-dependent increase in central venous pressure. The threshold dose is about 10 times higher than that necessary for the effect on arterial pressure. In doses eliciting the same increase of arterial blood pressure, norepinephrine is about twice as active on the venous pressure as angiotensin II.
3. Anesthesia and atropinization both reduce or abolish the effect of angiotensin II as well as that of norepinephrine on the venous pressure, indicating the reflex nature of the underlying mechanism.
4. In endotoxin hypotension, the pressor response to angiotensin II and to norepinephrine is diminished, and the venous pressure response becomes gradually depressed until it is completely abolished.
5. During hemorrhagic hypotension, the response to angiotensin II may be retained or even enhanced and is less likely to have an adverse effect on the myocardium than norepinephrine.