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The effect of cardiac arrhythmias on the circulation of the vital organs
711
Abstracts prrssurc is cardiac because P-286 properties.
in origin.
This is of special
has been shown
to have
interest
RESTENOSIS
Harvard EXPERIENCES IN
;M.D., F..4.C.C.
CINEFLUOROGRAPHY.
St. Mary’s
Hospital,
Robert S. Green, Cincinnati,
Ohio.
Cinefluorography represents a relatively new field of medical investigation that will become increasingly important. This presentation outlines the problems that have occurred during four years’ experience with the development of this technic. Our cinefluorographic apparatus allows us to obtain from 33/4 to 30, 35 mm. motion pictures per second of an 8 by 8 to 14.5 by 14.5 inch fluoroscopic screen area with relatively low patient radiation. The discussion covers technical aspects of producing films, patient and personnel radiation, as well as film In relation to the latter we have developed analysis. a 35 mm. analyzer that enables us to study films frame by frame, forward or backwards, or at any motion speed up to 24 frames per second. Films are shown without flicker at frame speeds as low as 6 per second. Films are available for analysis within one hour of any procedure. A comparison of this method of cinefluorography with image intensification is included in the discussion.
Robert S. Green, M.D., F.A.C.C., Fernando L. Mender, M.D., Erna L. Borousch, M.D., Paul G. Geiss, M.D., Muzafer Aytur, M.D. and Gerhardt G. Hilt, M.D. St. Mary’s Hospital, CinCINEANGIOCARDIOGRAPHY.
cinnati,
Ohio.
This presentation details the technics and results with various types of cineangiocardiograms, i.e., single and double venous, selective, left ventricular and retrograde brachial. Emphasis is placed on the value of the relatively simple technic of retrograde brachial cineaortography in the diagnosis of patent ductus arteriosus. Excellent opacification of the pulmonary arteries from the dye-filled aorta plus early filling of the left auricle has been demonstrated in five infants from seventeen days to nine months of age in whom precise evaluation was mandatory because of impending failure. Similar results have been obtained on older children and adults. All cases have been verified by surgery.
CINEFLUOROGRAMS
OF
THE
BARIUM
SWALLOW
AND
OF
Robert S. Green, M.D., F.A.C.C., Fernando L. Mender, M.D., Erna L. Borousch, M.D., Paul G. Geiss, M.D., Murafer Aytur, M.D. and Gerhardt G. Hilt, M.D. St. Mary’s Hospital, Cincinnati, Ohio. HILAR
ACTIVITY.
The presentation includes full chest motion picture films of normal and abnormal barium swallows and of varying degrees of hilar activity. These results are correlated with findings from other procedures such as cardiac catheterization. The average skin radiation for each patient sequence was 1.5 r. This contrasts favorably with the 10 r figure reported with one minute of routine chest fluorThe value of motion picture records for group oscopy. analysis, teaching and subsequent comparative studies is discussed. MAY
1960
AND
REOPERATION
FOR
MITRAL
STENOSIS.
Dwight E. Harken, M.D., F.A.C.C., Harmon Black, M.D., Warren J. Taylor, M.D. and Laurence B. El1i.s1~\4.D.
antiarrhythmic
Medical
School, Boston, Mass.
Deterioration after valvuloplasty has been analyzed in previous communications, but no detailed follow-up has as yet been available to correlate the reasons for initial failure with the quality of results obatined by the various types of reoperation. The technics of reintervention include right- and leftsided simple direct transauricular pursestring entry, operating tunnel and open operations. Experience in over 150 cases is reviewed. More than half of these patients were originally operated on by us. The others were operated on elsewhere. Reasons for recurrence, indications for reintrrvention, the type of reintervention and the results of this surgery constitute the basis of this presentation.
THE EFFECT OF CARDIAC TION
OF
THE
VITAL
ARRHYTHMIAS ORGANS.
Herbert Gold, M.D., F.A.C.C. F.A.C.C. Cedars of Lebanon
ON
THE
CIRCULA-
Damd Iming, 2\4.D., and Eliot Corday. M.D., Hospital,
Los
Angeles,
Calif. The blood flow of the cerebral, coronary, hepatic, renal and gastrointestinal organs was measured with the electromagnetic flowmeter during naturally occurring and artificially produced cardiac arrhythmias. It was demonstrated that the rapid cardiac arrhythmias which caused a drop in systemic blood pressure caused a marked reduction in all the vital organs. However, the vasomotor reaction of each vital organ was different.
THE
CHOLESTEROL
LOGUES DISEASE.
IN
LOWERING
THYROID
SENSITIVE
EFFECT
OF
PATIENTS
HenryL. Jaje, M.D.,EliotCordoy,
THl’ROID WITH
ANAHEART
M.D., F.A.C.C.
and Herbert Gold, M.D., F.A.C.C. University of Southern California and University of California. Los .4ngeles, Calif. Patients with hypercholesterolemia have bern treated with a thyroid analogue (tetraiodothyfromic acid). It was demonstrated that the blood cholesterol could be lowered significantly. The patients selected for this study were mainly those with severe coronary artery disease who had been previously made hypometabolic with radioactive iodine. The patients had been fire of angina1 pain for a period of at least two years following radioiodine therapy. The blood cholesterol level of all these patients was markedly elevated. Most of the patients were sensitive to thyroid and previously could not tolerate doses larger than ‘/lo to ‘/4 grain of thyroid per day because it would induce angina1 attacks. Placebo medication was first administered to this group of patients, and the control blood cholesterol and electrolyte studies were determined at regular intervals of two weeks. The thyroid analogues were then given to these patients and subsequent serial blood studies demonstrated that the blood cholesterol level could be lowered as much as 280 mg. per cent. The average reduction was 112 mg. per cent over a six-week period. As a rule, the metabolism was not elevated by the thyroid analogue. Most of the patients could tolerate the thyroid analogue in sufficient dosage to significantly reduce blood cholesterol.
Abstracts prrssurc is cardiac because P-286 properties.
in origin.
This is of special
has been shown
to have
interest
RESTENOSIS
Harvard EXPERIENCES IN
;M.D., F..4.C.C.
CINEFLUOROGRAPHY.
St. Mary’s
Hospital,
Robert S. Green, Cincinnati,
Ohio.
Cinefluorography represents a relatively new field of medical investigation that will become increasingly important. This presentation outlines the problems that have occurred during four years’ experience with the development of this technic. Our cinefluorographic apparatus allows us to obtain from 33/4 to 30, 35 mm. motion pictures per second of an 8 by 8 to 14.5 by 14.5 inch fluoroscopic screen area with relatively low patient radiation. The discussion covers technical aspects of producing films, patient and personnel radiation, as well as film In relation to the latter we have developed analysis. a 35 mm. analyzer that enables us to study films frame by frame, forward or backwards, or at any motion speed up to 24 frames per second. Films are shown without flicker at frame speeds as low as 6 per second. Films are available for analysis within one hour of any procedure. A comparison of this method of cinefluorography with image intensification is included in the discussion.
Robert S. Green, M.D., F.A.C.C., Fernando L. Mender, M.D., Erna L. Borousch, M.D., Paul G. Geiss, M.D., Muzafer Aytur, M.D. and Gerhardt G. Hilt, M.D. St. Mary’s Hospital, CinCINEANGIOCARDIOGRAPHY.
cinnati,
Ohio.
This presentation details the technics and results with various types of cineangiocardiograms, i.e., single and double venous, selective, left ventricular and retrograde brachial. Emphasis is placed on the value of the relatively simple technic of retrograde brachial cineaortography in the diagnosis of patent ductus arteriosus. Excellent opacification of the pulmonary arteries from the dye-filled aorta plus early filling of the left auricle has been demonstrated in five infants from seventeen days to nine months of age in whom precise evaluation was mandatory because of impending failure. Similar results have been obtained on older children and adults. All cases have been verified by surgery.
CINEFLUOROGRAMS
OF
THE
BARIUM
SWALLOW
AND
OF
Robert S. Green, M.D., F.A.C.C., Fernando L. Mender, M.D., Erna L. Borousch, M.D., Paul G. Geiss, M.D., Murafer Aytur, M.D. and Gerhardt G. Hilt, M.D. St. Mary’s Hospital, Cincinnati, Ohio. HILAR
ACTIVITY.
The presentation includes full chest motion picture films of normal and abnormal barium swallows and of varying degrees of hilar activity. These results are correlated with findings from other procedures such as cardiac catheterization. The average skin radiation for each patient sequence was 1.5 r. This contrasts favorably with the 10 r figure reported with one minute of routine chest fluorThe value of motion picture records for group oscopy. analysis, teaching and subsequent comparative studies is discussed. MAY
1960
AND
REOPERATION
FOR
MITRAL
STENOSIS.
Dwight E. Harken, M.D., F.A.C.C., Harmon Black, M.D., Warren J. Taylor, M.D. and Laurence B. El1i.s1~\4.D.
antiarrhythmic
Medical
School, Boston, Mass.
Deterioration after valvuloplasty has been analyzed in previous communications, but no detailed follow-up has as yet been available to correlate the reasons for initial failure with the quality of results obatined by the various types of reoperation. The technics of reintervention include right- and leftsided simple direct transauricular pursestring entry, operating tunnel and open operations. Experience in over 150 cases is reviewed. More than half of these patients were originally operated on by us. The others were operated on elsewhere. Reasons for recurrence, indications for reintrrvention, the type of reintervention and the results of this surgery constitute the basis of this presentation.
THE EFFECT OF CARDIAC TION
OF
THE
VITAL
ARRHYTHMIAS ORGANS.
Herbert Gold, M.D., F.A.C.C. F.A.C.C. Cedars of Lebanon
ON
THE
CIRCULA-
Damd Iming, 2\4.D., and Eliot Corday. M.D., Hospital,
Los
Angeles,
Calif. The blood flow of the cerebral, coronary, hepatic, renal and gastrointestinal organs was measured with the electromagnetic flowmeter during naturally occurring and artificially produced cardiac arrhythmias. It was demonstrated that the rapid cardiac arrhythmias which caused a drop in systemic blood pressure caused a marked reduction in all the vital organs. However, the vasomotor reaction of each vital organ was different.
THE
CHOLESTEROL
LOGUES DISEASE.
IN
LOWERING
THYROID
SENSITIVE
EFFECT
OF
PATIENTS
HenryL. Jaje, M.D.,EliotCordoy,
THl’ROID WITH
ANAHEART
M.D., F.A.C.C.
and Herbert Gold, M.D., F.A.C.C. University of Southern California and University of California. Los .4ngeles, Calif. Patients with hypercholesterolemia have bern treated with a thyroid analogue (tetraiodothyfromic acid). It was demonstrated that the blood cholesterol could be lowered significantly. The patients selected for this study were mainly those with severe coronary artery disease who had been previously made hypometabolic with radioactive iodine. The patients had been fire of angina1 pain for a period of at least two years following radioiodine therapy. The blood cholesterol level of all these patients was markedly elevated. Most of the patients were sensitive to thyroid and previously could not tolerate doses larger than ‘/lo to ‘/4 grain of thyroid per day because it would induce angina1 attacks. Placebo medication was first administered to this group of patients, and the control blood cholesterol and electrolyte studies were determined at regular intervals of two weeks. The thyroid analogues were then given to these patients and subsequent serial blood studies demonstrated that the blood cholesterol level could be lowered as much as 280 mg. per cent. The average reduction was 112 mg. per cent over a six-week period. As a rule, the metabolism was not elevated by the thyroid analogue. Most of the patients could tolerate the thyroid analogue in sufficient dosage to significantly reduce blood cholesterol.