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Primary Resistance of Tubercle Bacilli to Viomycin, Ethionamide and Cycloserine
198
ROSENTHAL AND DOYLE
6 MARlTT, J. M.: "Pulmonary Compliance in Congestive Heart Failure," Reponed at the 33rd Scientific Sessions, American Heart Association, October, 1960. 7 HAYWARD, G. W. AND KNOTT, J. M.: "The Effect of Exercise on Lung Distensibility and Respiratory Work in Mitral Stenosis," Brit. Heart ]., 17: 303, 1955. 8 MARSHALL, R., MCILROY, B. M. AND CHRISTIE, R. V.: "The Work of Breathing in Mitral Stenosis," Clin. Sci., 13: 137, 1954. 9 SAXTON, G. A., JR., RABINOWITZ, M., DEXTER, L. ASD HAYNES, F.: "The Relationship of Pulmonary Compliance to Pulmonary Vascular Pressures in Patients with Heart Disease." ]. Clin. Invest., 35:611, 1956. 10 McILROY, M. B., MARSHALL, R. AND CHRISTIE, R. V.: "The Work of Breathing in Nonnal Subjects," Clin. Sci., 13:127,1954. 11 DOYLE, J. T., FORMEL, P. F., HILLEBOE, H. E. ASD HESLIN, A. S.: "The Early Diagnosis of Ischemic Heart Disease," New Engl. J. Med., 261: 1096, 1959. 12 MEAD, J., McILROY, M. B., SELVERSTONE, N. J. AND KRIETE, B. C.: "Measurement of Intraesophageal Pressure," ]. App. Physiol., 7: 491. 1955. 13 RAHN, H., OTIS, A. B., CHADWICK, L. E. AND FESN, W.O.: "The Pressure Volume Diagram of the Thorax and Lung," Am. J. App. Physiol., 146: 161, 1946. 14 CHERNIAK, R. M., FARHI, L. E., ARMSTRONG, B. W. AND PROCTOR, D. F. "A Comparison of Esophageal and Intrapleural Pressures in Man," ]. App. Physiol., 8:203, 1955. 15 RODBARD, S., CIESIELSKI, J. AND OLIN, C.: "Quantitative Clinical Measure of Cardiovascular Dysfunction Based on Undulations in
Blood Pressure," Fed. Proc., 15: 155, 1956.
Disease! of the Che!t
16 OTIS, A. B., McKERROW, C. B.. BARRETT. R. A., MEAD, J., McILROY, M. B., SELVERSTOI"E, N. J. AND RADFORD, E. P.: "Mechanical Factors in Distribution of Pulmonary Ventilation," ]. App. Ph).siol., 8: 427, 1956. 17 JUDSON, W., HOLLASDER, W., HATCHER, J. ASD HALPERS, M.: "The Effects of Exercise on Cardiovascular and Renal Function in Cardiac Patients with and without Heart Failure." ]. Clin. Invest., 34: 1546, 1955. 18 BECKER, D. L., BURCHELL, H. B. AND EDWARDS, J. E.: "Pathology of the Pulmonary Vascular Tree." Circulation, 3: 230, 1951. 19 Bmml;RAsT, S., HICKAM, J. B. AND ISLEY, J.: "Pulmonary and Circulatory Effects of Acute Pulmonary Vascular Engorgement in Nonnal Subjects," J. Clin. Invest., 36:59. 1957. 20 SHARP, J. T.: "The Effect of Body Position Change on Lung Compliance in Nonnal Subjects and in Patient with Congest i ve Heart Failure." J. Clin. Inl'est., 38:659. 1959. ~I BoRST, H. G., BERGLUSD, E .. WHITTENBERGER, J. L., MEAD, j., McGREGOR, M. AND COLLIER, C.: "The Effect of Pulmonary Vascular Pressure on the Mechanical Properties of the Lungs of Anesthetised Dogs," ]. Clin. Inc'est., 36: 1708, 1957. 22 MULLER, O. AND RORVIK, K.: "Haemodynamic Consequences of Coronary Heart Disease," Brit. Heart ]., 20: 302, 1958. 23 DOYLE, j. T., HESLIN, A. S., HILLEBOE, H. E., FORMEL, P. F. AND KORNS, R. F.: "III. A Prospective Study of Degenerative Cardiovascular Disease in Albany: Report of Three Yean' Experience. I. Ischemic Hean Disease," Am. J. Pub. Health, 47:4, 1957. 1957. For reprints, please write Dr. Rosenthal, Albany Medical College, Albany, N. Y.
COR TRIATRIATUM The occurrence of severe pulmonary venous obstruction due to the congenital anomaly known as cor trlatrlatum In a 19-year-old furniture mover Is described. Relentless and massive hemoptysis led to pulmonary edema, and an attempt at surgical correction under unfavorable condItions was not successful. Seven other cases of cor triatriatum In adults are reviewed. The hemodynamic abnormalities closely resemble mitral stenosis. except that pressures In the true left atrium were normal In the presence of elevated pulmonary capUlary pressures. The avallablllty of ftow across the obstructing membrane during systole. as well as diastole. Is probably the major element In the surprisIngly good tolerance of severe degrees of anatomic obstruction
for long periods of time. Slow Increase In the degree of obstruction could also be a factor. The clinical picture In these patients closely resembles mitral stenosis. Hemoptysis appeared to be more frequent In cor trlatrlatum. Features suggestive of the correct diagnosis would Include the absence of an opening snap. the absence of a typical murmur of mitral stenosis. regular rhythm. and lesser evidence of left atrial enlargement In the presence of obvious pulmonary hypertension. Five of these patients have undergone successful correction of their disease by operation. MCGuIIlF., L. B., NOLAN. T. B., REEVE. R. AND DAM·
MANN. ). F., )a.: "Cor Triatriatum u a Problem of Adult Heart Disease," eire.IA/io". ~I :26~. 196~.
PRIMARY RESISTANCE OF TUBERCLE BACILLI TO VIOMYCIN, ETHIONAMIDE AND CYCLOSERINE Sensitivity tests to the second line drugs were done In 390 tuberculous patients who had never been treated with these drugs. The material was divided Into three groups: Group I IRcluded 283 patients not treated previously with kanamycin or viomycin: four of these patients had bacllll resistant to viomycin «1.4 per cent). In Group II. Including 215 patients not treated previously with cycloserine. one had ml-
croorganlsms resistant to cycloserine, I.e., 0.47 per cent. Group III Included 219 patients never treated with either ethionamide or thlosemlcarbazones: In 15 cases (6.8 per cent). bacterial resistance to ethionamide was found. KOWALCZYK, H., RADECKI, A. AND LUKIANSItJ, M.: "Pri· mary R~i!tance of Tubercle Bacilli to Viomycin. Ethionamide and Cycloserine." Gr.:lieA. H:~I, 196~.
ROSENTHAL AND DOYLE
6 MARlTT, J. M.: "Pulmonary Compliance in Congestive Heart Failure," Reponed at the 33rd Scientific Sessions, American Heart Association, October, 1960. 7 HAYWARD, G. W. AND KNOTT, J. M.: "The Effect of Exercise on Lung Distensibility and Respiratory Work in Mitral Stenosis," Brit. Heart ]., 17: 303, 1955. 8 MARSHALL, R., MCILROY, B. M. AND CHRISTIE, R. V.: "The Work of Breathing in Mitral Stenosis," Clin. Sci., 13: 137, 1954. 9 SAXTON, G. A., JR., RABINOWITZ, M., DEXTER, L. ASD HAYNES, F.: "The Relationship of Pulmonary Compliance to Pulmonary Vascular Pressures in Patients with Heart Disease." ]. Clin. Invest., 35:611, 1956. 10 McILROY, M. B., MARSHALL, R. AND CHRISTIE, R. V.: "The Work of Breathing in Nonnal Subjects," Clin. Sci., 13:127,1954. 11 DOYLE, J. T., FORMEL, P. F., HILLEBOE, H. E. ASD HESLIN, A. S.: "The Early Diagnosis of Ischemic Heart Disease," New Engl. J. Med., 261: 1096, 1959. 12 MEAD, J., McILROY, M. B., SELVERSTONE, N. J. AND KRIETE, B. C.: "Measurement of Intraesophageal Pressure," ]. App. Physiol., 7: 491. 1955. 13 RAHN, H., OTIS, A. B., CHADWICK, L. E. AND FESN, W.O.: "The Pressure Volume Diagram of the Thorax and Lung," Am. J. App. Physiol., 146: 161, 1946. 14 CHERNIAK, R. M., FARHI, L. E., ARMSTRONG, B. W. AND PROCTOR, D. F. "A Comparison of Esophageal and Intrapleural Pressures in Man," ]. App. Physiol., 8:203, 1955. 15 RODBARD, S., CIESIELSKI, J. AND OLIN, C.: "Quantitative Clinical Measure of Cardiovascular Dysfunction Based on Undulations in
Blood Pressure," Fed. Proc., 15: 155, 1956.
Disease! of the Che!t
16 OTIS, A. B., McKERROW, C. B.. BARRETT. R. A., MEAD, J., McILROY, M. B., SELVERSTOI"E, N. J. AND RADFORD, E. P.: "Mechanical Factors in Distribution of Pulmonary Ventilation," ]. App. Ph).siol., 8: 427, 1956. 17 JUDSON, W., HOLLASDER, W., HATCHER, J. ASD HALPERS, M.: "The Effects of Exercise on Cardiovascular and Renal Function in Cardiac Patients with and without Heart Failure." ]. Clin. Invest., 34: 1546, 1955. 18 BECKER, D. L., BURCHELL, H. B. AND EDWARDS, J. E.: "Pathology of the Pulmonary Vascular Tree." Circulation, 3: 230, 1951. 19 Bmml;RAsT, S., HICKAM, J. B. AND ISLEY, J.: "Pulmonary and Circulatory Effects of Acute Pulmonary Vascular Engorgement in Nonnal Subjects," J. Clin. Invest., 36:59. 1957. 20 SHARP, J. T.: "The Effect of Body Position Change on Lung Compliance in Nonnal Subjects and in Patient with Congest i ve Heart Failure." J. Clin. Inl'est., 38:659. 1959. ~I BoRST, H. G., BERGLUSD, E .. WHITTENBERGER, J. L., MEAD, j., McGREGOR, M. AND COLLIER, C.: "The Effect of Pulmonary Vascular Pressure on the Mechanical Properties of the Lungs of Anesthetised Dogs," ]. Clin. Inc'est., 36: 1708, 1957. 22 MULLER, O. AND RORVIK, K.: "Haemodynamic Consequences of Coronary Heart Disease," Brit. Heart ]., 20: 302, 1958. 23 DOYLE, j. T., HESLIN, A. S., HILLEBOE, H. E., FORMEL, P. F. AND KORNS, R. F.: "III. A Prospective Study of Degenerative Cardiovascular Disease in Albany: Report of Three Yean' Experience. I. Ischemic Hean Disease," Am. J. Pub. Health, 47:4, 1957. 1957. For reprints, please write Dr. Rosenthal, Albany Medical College, Albany, N. Y.
COR TRIATRIATUM The occurrence of severe pulmonary venous obstruction due to the congenital anomaly known as cor trlatrlatum In a 19-year-old furniture mover Is described. Relentless and massive hemoptysis led to pulmonary edema, and an attempt at surgical correction under unfavorable condItions was not successful. Seven other cases of cor triatriatum In adults are reviewed. The hemodynamic abnormalities closely resemble mitral stenosis. except that pressures In the true left atrium were normal In the presence of elevated pulmonary capUlary pressures. The avallablllty of ftow across the obstructing membrane during systole. as well as diastole. Is probably the major element In the surprisIngly good tolerance of severe degrees of anatomic obstruction
for long periods of time. Slow Increase In the degree of obstruction could also be a factor. The clinical picture In these patients closely resembles mitral stenosis. Hemoptysis appeared to be more frequent In cor trlatrlatum. Features suggestive of the correct diagnosis would Include the absence of an opening snap. the absence of a typical murmur of mitral stenosis. regular rhythm. and lesser evidence of left atrial enlargement In the presence of obvious pulmonary hypertension. Five of these patients have undergone successful correction of their disease by operation. MCGuIIlF., L. B., NOLAN. T. B., REEVE. R. AND DAM·
MANN. ). F., )a.: "Cor Triatriatum u a Problem of Adult Heart Disease," eire.IA/io". ~I :26~. 196~.
PRIMARY RESISTANCE OF TUBERCLE BACILLI TO VIOMYCIN, ETHIONAMIDE AND CYCLOSERINE Sensitivity tests to the second line drugs were done In 390 tuberculous patients who had never been treated with these drugs. The material was divided Into three groups: Group I IRcluded 283 patients not treated previously with kanamycin or viomycin: four of these patients had bacllll resistant to viomycin «1.4 per cent). In Group II. Including 215 patients not treated previously with cycloserine. one had ml-
croorganlsms resistant to cycloserine, I.e., 0.47 per cent. Group III Included 219 patients never treated with either ethionamide or thlosemlcarbazones: In 15 cases (6.8 per cent). bacterial resistance to ethionamide was found. KOWALCZYK, H., RADECKI, A. AND LUKIANSItJ, M.: "Pri· mary R~i!tance of Tubercle Bacilli to Viomycin. Ethionamide and Cycloserine." Gr.:lieA. H:~I, 196~.