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An unusual case of ventricular tachycardia
834
AMERICAN
type; it gives a halo of marginal opacity reabsorption of air. Chronic, progressive lowed by sclerosis. Various roentgenologic considerations
Taquini, H. C., Yodice, Normal Heart and 14:117 (May-June),
HEART
JOURNAL
caused by circulatory stasis which later is followed by atelectasis is accompanied by infIammation and is fol-
A., and Taqulni, the Heart With 1947.
in the
diagnosis
A. C.: Effects Experimental
of these
of Gall Infarction.
conditions
Bladder Rev.
are
given. LUISADA.
Distention on the Argent. de cardiol.
The effects of acute distention of the normal gall bladder were investigated both in conscious and anesthetized dogs with normal hearts and after coronary occlusion. No changes were detected in the electrocardiogram. The authors conclude that stimulation of a healthy gall bladder does not initiate abnormal reflexes in the heart. LUISADA. Mantovani, Auricle.
A., and Lorenzoni, Folia Cardiologica
B. : On the Oscillographic 651 (June 30), 1947.
Index
in Dilatation
of the
Left
The authors studied the amplitude of the oscillographic index in the four limbs of fifty-nine patients with lesions of the mitral valve. The Pachon oscillometer showed that cases with left auricuIar entargement present a smaller pulse in the brachial and femoral arteries of the left side. This sign, which is also present in tumors of the posterior mediastinum, is explained as the result of irritation of the sympathetic plexus of the mediastinum by the large left auricle, with resulting vasoconstriction of the vessels on the left side of the body. LUISADA. Hopps, H. C., and Lewis, J. H.: Studies on Capillary mia. Am. J. Path. 23:829 (Sept.), 1947.
Permeability
as Affected
by Anoxe-
These workers studied the effect of “anoxic” anoxemia on the permeability of capillary endothelium in guinea pigs. To study this subject, they utilized a well-known phenomenon in immunology, namely, the “minimum latent period of passive anaphylaxis,” which is the length of time, in hours, that must elapse before an animal becomes susceptible to anaphylactic shock. They reasoned that if anoxic anoxia increases capillary permeability to antibody globulin, the minimum latent period of passive anaphylaxis will be shortened. Guinea pigs sensitized to a specific antiserum (anticrystalline egg albumin-rabbit serum) were subjected to atmospheric pressure similar to that at 30,000 ft. altitude. At this pressure, oxygen concentration is only 6.4 per cent. It was demonstrated that sensitized animals did not develop anaphylactic shock more quickly than control animals. The authors then showed that a smaller protein molecule, serum albumin, did not pass through capillary endothelium more quickly under the same altered atmospheric pressure. This was proved by the rate of disappearance of a dye from the blood of those animals that received injections of serum albumin combined with Evans blue. The capillary permeability was unchanged in animals under low oxygen tension. The authors conclude that anoxic anoxia does not alter the permeability of capillary endothelium to protein molecules; that anoxic anoxia thus differs from the local action (for example, on an isolated limb) of stagnation anoxia; and that the classic experiments of Landis on the effect of anoxia on capillary permeability probably deal with effects of increased carbon dioxide rather than decreased oxygen tension. GOULEY. Beers, Ann.
S. D., Int.
and Med.
de la Chapelle, 27:441 (Sept.),
C. E.: 1947.
An
Unusual
Case
of Ventricular
Tachycardia.
A 57-year-old white man was admitted to the hospital with the chief complaint of palpitation of ten hours’ duration. There was a history of attacks of palpitation for some twenty years. An electrocardiogram taken about three weeks before the present episode of tachycardia showed a pattern compatible with the Wolff-Parkinson-White syndrome. An electrocardiogram made on
SELECTED the day 160 per nesium following cardia, initiated definite
835
ABSTRACTS
of his hospital admission showed the presence of a ventricular tachycardia with a rate of minute. Various drugs, which included quinidine sulfate, potassium chloride, and magsulfate, were used in an attempt to abolish the paroxysm. There was no immediate success the exhibition of these drugs. Finally, after twelve days of almost continuous tachya normal sinus rhythm returned. The possibility that the ventricular tachycardia was by an acute myocardial infarction is raised by the authors, even though there were no electrocardiographic changes to substantiate such a diagnosis.
WENDKOS. O’Neill, J. F.: The Effects on Venous Endothelium the Vessels in Vein Walls and the Possible 270 (Sept.), 1947.
of Alterations in Blood Relation to Thrombosis.
Flow Ann.
Through Surg. 126:
The author investigated experimentally in dogs the role that alterations in the endothelial coat of veins played in the production of venous thrombosis. First, he devised a technique for studying the normal architecture of the vasa venarum, utilizing staining with benzedine, which, by selectively staining red blood cells, can outline the vessels in which they are contained. Subsequently the specimens were cleared with oil of wintergreen. When the preparations were examined with a hand lens or a microscope, it was found that the vasa venarum varied in diameter from those of true capillary size with diameters of 10 to 20 /J to those of arteriole or venule proportions with diameters of 60 to 75~. They were seen in the adventitia but not in the media or intima. No conclusions could be drawn from this observation as to the depth to which the vessels extended, since the findings could have been due to a lack of penetration of the dye beyond the adventitia. The arteriolar vasa venarum were seen entering the venous adventitial coat and then dividing and subdividing to form a rich capillary network which then entered venules. These eventually emerged from the adventitia of the vein wall as venae comites serving the entering arterioles and emptied into veins which ran in the loose perivenous connective tissue. No signs were noted of venous capillaries in the vasa venarum of a vein wall draining directly into the parent lumen. The effects of destroying the blood supply to a vein and of partial obstruction were studied with regard to changes in the endothelium and the production of clot formation. Staining with It was found that when the venous endothelium was silver nitrate was utilized in this problem. deprived of the blood supply in the vein wall, endothelial damage was produced. Partial obstruction without altering the blood supply was a slightly more frequent cause of intravenous clotting, although it did not produce destruction of endothelium as readily as did a loss of blood supply. The author suggested that both factors might operate in the production of “spontaneous” intravenous clotting.
ABRAMSON. Wise,
A. W., and Miller, W. A.: Subacute Bacterial Endocarditis Due to B. Tularense, Treated by Streptomycin. Illinois M. J. 92:182 (Sept.), 1947. The authors present the case of a Sl-year-old man admitted to the hospital with a spiking type of temperature ranging between 101” and 103°F. daily. There was a history of a heart lesion since early childhood, probably since birth, which was considered to be a combined pulmonary stenosis and patent intraventricular septal defect. In view of the heart lesion, and definite and .pecific evidence of emholic phenomena and rhe febrile course over a period of three to four weeka, n diagnosis of subacute bacteria1 endocardiris was made, in spite of negative blood cultures. Penicillin was given in doses of 800,000 units daily and continued for twelve days with no reduction in the fever. At this time a definite maculopapular rash broke out over both lower extremities, and a history of a tick bite before entry to the hospital was elicited. Agglutination test for tularemia was positive for B. tuhrense in dilutions as low as 1 to 3,200. It was then felt that tularemia was the He was started on streptomycin and was given 800,basis of the subacute bacterial endocarditis. 000 units daily at four-hour intervals by the intramuscular route. After a course of 6, 000,000 units in eight days, his temperature dropped to normal and he felt much improved. He was dismissed from the hospital two weeks later with an apparent arrest of the infection.
BELLET.
AMERICAN
type; it gives a halo of marginal opacity reabsorption of air. Chronic, progressive lowed by sclerosis. Various roentgenologic considerations
Taquini, H. C., Yodice, Normal Heart and 14:117 (May-June),
HEART
JOURNAL
caused by circulatory stasis which later is followed by atelectasis is accompanied by infIammation and is fol-
A., and Taqulni, the Heart With 1947.
in the
diagnosis
A. C.: Effects Experimental
of these
of Gall Infarction.
conditions
Bladder Rev.
are
given. LUISADA.
Distention on the Argent. de cardiol.
The effects of acute distention of the normal gall bladder were investigated both in conscious and anesthetized dogs with normal hearts and after coronary occlusion. No changes were detected in the electrocardiogram. The authors conclude that stimulation of a healthy gall bladder does not initiate abnormal reflexes in the heart. LUISADA. Mantovani, Auricle.
A., and Lorenzoni, Folia Cardiologica
B. : On the Oscillographic 651 (June 30), 1947.
Index
in Dilatation
of the
Left
The authors studied the amplitude of the oscillographic index in the four limbs of fifty-nine patients with lesions of the mitral valve. The Pachon oscillometer showed that cases with left auricuIar entargement present a smaller pulse in the brachial and femoral arteries of the left side. This sign, which is also present in tumors of the posterior mediastinum, is explained as the result of irritation of the sympathetic plexus of the mediastinum by the large left auricle, with resulting vasoconstriction of the vessels on the left side of the body. LUISADA. Hopps, H. C., and Lewis, J. H.: Studies on Capillary mia. Am. J. Path. 23:829 (Sept.), 1947.
Permeability
as Affected
by Anoxe-
These workers studied the effect of “anoxic” anoxemia on the permeability of capillary endothelium in guinea pigs. To study this subject, they utilized a well-known phenomenon in immunology, namely, the “minimum latent period of passive anaphylaxis,” which is the length of time, in hours, that must elapse before an animal becomes susceptible to anaphylactic shock. They reasoned that if anoxic anoxia increases capillary permeability to antibody globulin, the minimum latent period of passive anaphylaxis will be shortened. Guinea pigs sensitized to a specific antiserum (anticrystalline egg albumin-rabbit serum) were subjected to atmospheric pressure similar to that at 30,000 ft. altitude. At this pressure, oxygen concentration is only 6.4 per cent. It was demonstrated that sensitized animals did not develop anaphylactic shock more quickly than control animals. The authors then showed that a smaller protein molecule, serum albumin, did not pass through capillary endothelium more quickly under the same altered atmospheric pressure. This was proved by the rate of disappearance of a dye from the blood of those animals that received injections of serum albumin combined with Evans blue. The capillary permeability was unchanged in animals under low oxygen tension. The authors conclude that anoxic anoxia does not alter the permeability of capillary endothelium to protein molecules; that anoxic anoxia thus differs from the local action (for example, on an isolated limb) of stagnation anoxia; and that the classic experiments of Landis on the effect of anoxia on capillary permeability probably deal with effects of increased carbon dioxide rather than decreased oxygen tension. GOULEY. Beers, Ann.
S. D., Int.
and Med.
de la Chapelle, 27:441 (Sept.),
C. E.: 1947.
An
Unusual
Case
of Ventricular
Tachycardia.
A 57-year-old white man was admitted to the hospital with the chief complaint of palpitation of ten hours’ duration. There was a history of attacks of palpitation for some twenty years. An electrocardiogram taken about three weeks before the present episode of tachycardia showed a pattern compatible with the Wolff-Parkinson-White syndrome. An electrocardiogram made on
SELECTED the day 160 per nesium following cardia, initiated definite
835
ABSTRACTS
of his hospital admission showed the presence of a ventricular tachycardia with a rate of minute. Various drugs, which included quinidine sulfate, potassium chloride, and magsulfate, were used in an attempt to abolish the paroxysm. There was no immediate success the exhibition of these drugs. Finally, after twelve days of almost continuous tachya normal sinus rhythm returned. The possibility that the ventricular tachycardia was by an acute myocardial infarction is raised by the authors, even though there were no electrocardiographic changes to substantiate such a diagnosis.
WENDKOS. O’Neill, J. F.: The Effects on Venous Endothelium the Vessels in Vein Walls and the Possible 270 (Sept.), 1947.
of Alterations in Blood Relation to Thrombosis.
Flow Ann.
Through Surg. 126:
The author investigated experimentally in dogs the role that alterations in the endothelial coat of veins played in the production of venous thrombosis. First, he devised a technique for studying the normal architecture of the vasa venarum, utilizing staining with benzedine, which, by selectively staining red blood cells, can outline the vessels in which they are contained. Subsequently the specimens were cleared with oil of wintergreen. When the preparations were examined with a hand lens or a microscope, it was found that the vasa venarum varied in diameter from those of true capillary size with diameters of 10 to 20 /J to those of arteriole or venule proportions with diameters of 60 to 75~. They were seen in the adventitia but not in the media or intima. No conclusions could be drawn from this observation as to the depth to which the vessels extended, since the findings could have been due to a lack of penetration of the dye beyond the adventitia. The arteriolar vasa venarum were seen entering the venous adventitial coat and then dividing and subdividing to form a rich capillary network which then entered venules. These eventually emerged from the adventitia of the vein wall as venae comites serving the entering arterioles and emptied into veins which ran in the loose perivenous connective tissue. No signs were noted of venous capillaries in the vasa venarum of a vein wall draining directly into the parent lumen. The effects of destroying the blood supply to a vein and of partial obstruction were studied with regard to changes in the endothelium and the production of clot formation. Staining with It was found that when the venous endothelium was silver nitrate was utilized in this problem. deprived of the blood supply in the vein wall, endothelial damage was produced. Partial obstruction without altering the blood supply was a slightly more frequent cause of intravenous clotting, although it did not produce destruction of endothelium as readily as did a loss of blood supply. The author suggested that both factors might operate in the production of “spontaneous” intravenous clotting.
ABRAMSON. Wise,
A. W., and Miller, W. A.: Subacute Bacterial Endocarditis Due to B. Tularense, Treated by Streptomycin. Illinois M. J. 92:182 (Sept.), 1947. The authors present the case of a Sl-year-old man admitted to the hospital with a spiking type of temperature ranging between 101” and 103°F. daily. There was a history of a heart lesion since early childhood, probably since birth, which was considered to be a combined pulmonary stenosis and patent intraventricular septal defect. In view of the heart lesion, and definite and .pecific evidence of emholic phenomena and rhe febrile course over a period of three to four weeka, n diagnosis of subacute bacteria1 endocardiris was made, in spite of negative blood cultures. Penicillin was given in doses of 800,000 units daily and continued for twelve days with no reduction in the fever. At this time a definite maculopapular rash broke out over both lower extremities, and a history of a tick bite before entry to the hospital was elicited. Agglutination test for tularemia was positive for B. tuhrense in dilutions as low as 1 to 3,200. It was then felt that tularemia was the He was started on streptomycin and was given 800,basis of the subacute bacterial endocarditis. 000 units daily at four-hour intervals by the intramuscular route. After a course of 6, 000,000 units in eight days, his temperature dropped to normal and he felt much improved. He was dismissed from the hospital two weeks later with an apparent arrest of the infection.
BELLET.