Oxygen utilization and lactic acid production in the extremities during rest and exercise

Webs, Soma, aad Ellis, Laurence duction

in

the

Extremities

Dllring

B.:

Oxygen Utiiization and I;actic .A&.& %‘ruExercise. dreh. Int. Med. 55: 665,.

Re#st and

1935. Tbo utilization lower extremities disessa with and

of lactic a161 in of oxygen and the production were compared in riotmal subjce,ts and in patients without congestive failure.

the upper an., having heart

The average oxygen utilization during rest was esselktially the same in the arm and in the leg. In heart disease without congestive failure, the utilization of oxygen during rest was normal in magnitude, but with congestive failure there was a tendency toward an increased periphera! utilixation. ThiE is evidence that in congestive failure the blood flow through the extremities is frequently re:luced. Edema of the leg was not found to bo associated with a relatively or absoIut,ely increased local blood flow. In the standing posture, the oxygen utiliznt,ion of the extremities increased both in subjects with normal and in those with diseased cardiovascular sgstc?ms, as a result,, in part at least, of decreased blood flow. Immediately after exercise t,he oxygen utilization it returned t.o the level during rest within ten minutes. 3sease the oxygen content of the femoral venous blood was as low as 1.1 volumes per cent.

increased markedly, hut In a patient with hcar~~ immediately after tvxwisa

The average resting level of the lactic acid in the t:xtremitios was :,etwPen 1;: and 14 mg. for all groups. Prnmediatcly after the patients ceased walkingP The lactic acid content of the femoral venous blood; draining the active rnnscle snore than doubled; it then fell rapidly during the next ten minutes hut dir1 not reach the level observed during rest within twenty minutes. The lactic acid content of the venous blood of the inactive arm rose slightly immediately after the exercise, but in ten minutes was similar to that of t,hP leg, as a result of the With the increasing severity of eireniatory mixing effcet of the circulation. failure, thera was a tendency for t,he femoral lactic apid tu rise to a higher l~~vei ihan normal immediately after exercke and to fall more slowly. With the exception of one ease of congenital intraventricula,r septa! tiefeet, the etiology of the heart disease played no ralc in the nature of the peripbernl circuiatory response. Certain patients showecl marlsed cardiac [disability, i.e., orthopnea, dynpnes., artJ low vital capacity of the lungs, and yet they had normal venous pressure, no edema, or hepatic enlargement and normal oxygen utilization and lac.tie acitl lY%plSC. The disability in these patients cannot be explained on the b&s af the behavior of the peripheral circulation. When disturbances in the laetje acid production and peripheral circulation occur, they are the resuit and not ihe ~s,use of heart failure. Wikxm,

May

of Upper bemolysin

-Fever in

CL,

Wheeler,

George W., and Leask, Marguerite

M.:

Respiratory Infections to Rheumatic Fever in C&l&en. Titre’s in Respiratory Infecti.ons and Their Bignifica~nce Children. J. Clin. Investigation 14: 333, 1935.

The ~~a~i~~ 11. Anti-

in ‘Rheuma~,bc

There is presented a correlation of the clinical courbc with the bacteri&gical alid immunological observations in eighty rheumatic subjects observed OYBP :r. I)erioli of twelve to eighteen months. The antistroptolysin titer for rheumatic suljjects tlu~ing apparent health ga.v,: a hasal average of 135 units with a range of 25 to 715 units. There was no significant difference in the range of antistreptolysin titer observed for sull,jects iuring apparent health and during respiratory a,nii rheumatic infection, il. CORI-