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The operation
.h. Heart J. January, 1960
teht is ~lwre wnsitive than the other. However, they consider this test to be more dangerouh kc-.luse the rewnling electrocardiographic alterations sometimes require strenuous exertion for their appearance, with the possible onset of arrhl-thmias, prolonged coronary insufficiency, or heart fArIre. The linal conclusion indicates preference for the hypoxia test, which, howe\.rr, should he performed in a laboratoq The second essay, elItitled “‘l‘he Humoral S>-ndrome of Ylyocardial Infarct,” is by L)r. AndreclA, Ik. Rlaggi, Ik. Marchetti, and Dr. Ragaini. It deals with the blood changes of enzymes, ure.1, chr)lcstcrol and sugar, hematocrit, Icukocyte and differential counts, proteins, ESR, Crextile protein and electrolytes, and the urinar) wcretion of corticosteroids. The personal obscr\xtion~ of 20 cases n-ere started on the same day of the attack and continued until the tnentl--fifth day. ‘I‘he following phases were recognized: (a) lst-2nd day: increase of enzymes and blood sugar; (b) 3rd.5th day: increase of lactodehydrogenasc; (c) 5th-10th day: increase in ay?globulins and sedimentation rate; (d) lOth-25th day: increase of /3-globulins while the other data gradually return to normal values. The steroid secretion failed to re\-eal any increase of activit!, of the adrenal cortex. The eurZy cha?zges were interpreted as being due to both a central mechanism (zupar, leukoc->,tes, feverj al~tl the beginning of necrosis (enzymes, glycoproteins, olg-globulins, C-reactive protein). The Intc clznngcs were due to reaction of the connective tissue, not limited to the site of infawtion. Changes of the nonprotein nitrogen were considered to be due to hcmodyIlamic alterations. ‘fhe moditications of the blood bvcre considered as a reliable guide for the sturl~~ of the ex-olution of the infarct. The third essay, entitled “Quinidine in Atrial Fibrillation,” is by Dr. Noseda, Ik. I’ace, l)r. Fauda, and Ik. Klein. There is a detailed discus&n of those cases which can be benefited b> treatment tvith quinidine. The authors do not ad&c doses greater than 3 Gm. daily.. The possible association of quinidine \vith digitalis or the antihistaminics is discussed. Benadryl is considered useful in the maintenance of the sinus rhythm, after the use of quinidine. Cases with a large left atrium and long-lasting fibrillation may be benefited by preliminary treatment with antiroagulants. This would reduce the incidence of thromboembolic phenomena. .A prolongation of the Q-T inter\-al ~1.3~ found rather frequently during therapy. This volume, whirh has a foreword by Prof. \We, is of delinite interest to cardiologists and internists and rontnills a c-omplete bibliography.
I’HYSI~~LOGY OF CAK~IAC CORPOKE.ZI, COOI.ING.
Sr-RGERY:
HYPOTHERMIA,
~~TKACORPOKKAL
CIRCULATION,
AND
Ex~r~a-
Ry Frank Gollan, M.D., &sistant Director of Professional Services for Research, \‘eterans Administration Hospital, Nashville, Term., and Research Associate, I)epartment of Surgery, Vanderbilt University nledical School, Nashville, Tenn. Springfield, 111., 1959, Chxles C Thomas, Publisher, 96 pages, 18 figures. Price $4.50.
This book presents cssa)-s on certain physiologic observations related to hypothermia and estracorporeal kculation, but its title is misleading, because many aspects of the physiology of cartliac surgery are not included in the book. It is difficult to understand what audience the author had in mind when writing the book. Experienced workers in the field of extracorporeal circulation are reasonably familiar with most of the physiologic studies presented, and the uninitiated reader would be dismayed by the emphasis on minutiae and the lack of an over-all appraisal of hypothermia and extracorporeal circulation in the treatment of heart disease. This book is not recommended to readers of the .‘l,~euican IIeert Jozwnd.
‘fii~i
01~1~anos.
pages.
Price
By 1,eonard U.95.
Engel.
New-
York,
1958,
McGraw-Hill
Book
Company,
Inc.,
277
This book is an attempt to acquaint the lay reader with the substance of a heart operation and the important historical de\~elopments that made it possible. After one has read it, there is little doubt that the author has succeeded in an admirable fashion. The patient, the operating room, the surgeons, and the operation itself are described so vividl!., yet without melodrama,
teht is ~lwre wnsitive than the other. However, they consider this test to be more dangerouh kc-.luse the rewnling electrocardiographic alterations sometimes require strenuous exertion for their appearance, with the possible onset of arrhl-thmias, prolonged coronary insufficiency, or heart fArIre. The linal conclusion indicates preference for the hypoxia test, which, howe\.rr, should he performed in a laboratoq The second essay, elItitled “‘l‘he Humoral S>-ndrome of Ylyocardial Infarct,” is by L)r. AndreclA, Ik. Rlaggi, Ik. Marchetti, and Dr. Ragaini. It deals with the blood changes of enzymes, ure.1, chr)lcstcrol and sugar, hematocrit, Icukocyte and differential counts, proteins, ESR, Crextile protein and electrolytes, and the urinar) wcretion of corticosteroids. The personal obscr\xtion~ of 20 cases n-ere started on the same day of the attack and continued until the tnentl--fifth day. ‘I‘he following phases were recognized: (a) lst-2nd day: increase of enzymes and blood sugar; (b) 3rd.5th day: increase of lactodehydrogenasc; (c) 5th-10th day: increase in ay?globulins and sedimentation rate; (d) lOth-25th day: increase of /3-globulins while the other data gradually return to normal values. The steroid secretion failed to re\-eal any increase of activit!, of the adrenal cortex. The eurZy cha?zges were interpreted as being due to both a central mechanism (zupar, leukoc->,tes, feverj al~tl the beginning of necrosis (enzymes, glycoproteins, olg-globulins, C-reactive protein). The Intc clznngcs were due to reaction of the connective tissue, not limited to the site of infawtion. Changes of the nonprotein nitrogen were considered to be due to hcmodyIlamic alterations. ‘fhe moditications of the blood bvcre considered as a reliable guide for the sturl~~ of the ex-olution of the infarct. The third essay, entitled “Quinidine in Atrial Fibrillation,” is by Dr. Noseda, Ik. I’ace, l)r. Fauda, and Ik. Klein. There is a detailed discus&n of those cases which can be benefited b> treatment tvith quinidine. The authors do not ad&c doses greater than 3 Gm. daily.. The possible association of quinidine \vith digitalis or the antihistaminics is discussed. Benadryl is considered useful in the maintenance of the sinus rhythm, after the use of quinidine. Cases with a large left atrium and long-lasting fibrillation may be benefited by preliminary treatment with antiroagulants. This would reduce the incidence of thromboembolic phenomena. .A prolongation of the Q-T inter\-al ~1.3~ found rather frequently during therapy. This volume, whirh has a foreword by Prof. \We, is of delinite interest to cardiologists and internists and rontnills a c-omplete bibliography.
I’HYSI~~LOGY OF CAK~IAC CORPOKE.ZI, COOI.ING.
Sr-RGERY:
HYPOTHERMIA,
~~TKACORPOKKAL
CIRCULATION,
AND
Ex~r~a-
Ry Frank Gollan, M.D., &sistant Director of Professional Services for Research, \‘eterans Administration Hospital, Nashville, Term., and Research Associate, I)epartment of Surgery, Vanderbilt University nledical School, Nashville, Tenn. Springfield, 111., 1959, Chxles C Thomas, Publisher, 96 pages, 18 figures. Price $4.50.
This book presents cssa)-s on certain physiologic observations related to hypothermia and estracorporeal kculation, but its title is misleading, because many aspects of the physiology of cartliac surgery are not included in the book. It is difficult to understand what audience the author had in mind when writing the book. Experienced workers in the field of extracorporeal circulation are reasonably familiar with most of the physiologic studies presented, and the uninitiated reader would be dismayed by the emphasis on minutiae and the lack of an over-all appraisal of hypothermia and extracorporeal circulation in the treatment of heart disease. This book is not recommended to readers of the .‘l,~euican IIeert Jozwnd.
‘fii~i
01~1~anos.
pages.
Price
By 1,eonard U.95.
Engel.
New-
York,
1958,
McGraw-Hill
Book
Company,
Inc.,
277
This book is an attempt to acquaint the lay reader with the substance of a heart operation and the important historical de\~elopments that made it possible. After one has read it, there is little doubt that the author has succeeded in an admirable fashion. The patient, the operating room, the surgeons, and the operation itself are described so vividl!., yet without melodrama,