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Venous pressure and circulation time during acute progressive anoxia in man
Dill,
L. V., and Isenhour, With Renal Hypertension.
C. E.: Occurrence of Mberoma Arch. Path. 33: 65.5, 1942.
in $be Aorta
in Rabbits
-4theromatous plaques were found in the aortas of rabita with persistent hypertension, produced by aortie constriction proximal to the origin of the renal arteries. The plaque formation seemed to be proportional to the elevation and duration of the hypertension. It was also seen more frequently in animals in which frequent preg nancies had occurred. KERSHBAUM. Peery,
T. M.:
Incomplete
Rupture
of the
Aorta.
Arch.
IlIt.
Med.
70:
689,
19-i".
Small tears in the intima and media of the aorta are not uncommon findings at autopsy in cases of hypertension. These tears are thought to be an early stage of dissecting aneurysm, the stage before actual dissection has occnrred. Most of the tears encountered have been transverse and across one of the commissures of the aortic valve. Tears in this area may result in slipping downward of the commissures so that the three valve cusps do not approximate, resulting in the clinical manifestations of aortic insufficiency. In some casee t,he tears heal at this stage, resulting in crippling of the aortic valve and death from congestive heart failure. In other cases dissection may occur days or months later, through the base of the old tear, and obliterate the evidence of a stage of incomplete rupture. In several instances reeonstruction of the past history of a case of dissecting aneurysm has revealed two stages. The original period of substernal pain and sudden dyspnea or choking probably corresponds to the stage of actnal dissection. If t.he tear occurs higher in the aorta, so that there is no effect upon the eommissuree, there may be no aortic insufficiency, and clinical manifestations may be slight. Occ.asionally a rough, rasping systolic murmur is noted over the sortie area. In cases in which dissection is preceded by incomplete rupture, the actual dissection is usual!y short, with termination by hemopericardium and cardiac tamponade. Of the eleven cases reported, five have shown incomplete aortic tears as purely incidental autopsy findings; two have died of congestive heart failure due to aortic insufficiency; and four have later developed dissecting aneurysm which resulted in death.
Bergman, A., and Neuman, Medicina, Buenos Aires
J.: Thromboarteriosclerosis 3: 87, 1942.
The clinical diagnosis of thromboarteriosclerosis finding of an arterial thrombus or embolus. and
The thromboses of the lead to the amputation
deep veins of a limb.
can
and
Venous
does not presuppose
Thrombosis.
the anatomical
aggravate
the
clinical
picture
of ischemia AUTHORS.
Ershler, Time
I., Kossmann, During Acute
C. E., and Progressive
In nineteen young, healthy, rebreathing, had the following
White, Anoxia
male effects
Venons M. S.: in Man. Am.
subjects, :
acute
Pressure J. Physiol.
progressive
and Circulation 138: 593, 1943.
anoxia,
induced
by
In four subjects it progressively The venous pressure showed a variable response. In seven subjects, who fainted during the rebreathing, the venous presdecreased. suggesting failure of the right ventricle. sure rose precipitously just before syncope, Iu all cases the venous pressure was restored promptly to normal by permitting the subject to breathe room air.
SELECTED
571
dBSTRlCTS
The circulation time from the right arm to the tongue was decreased in all This decrease was statistically significant. The rate of circulation was subjects. normal or slightIy slower in some cases as soon as the oxygen saturation of the blood was restored to the control level. AUTHORS.
Treatment of Leg Ulcers With Blood and Concentrated M.: J. M. SC. 205: 489, 1943.
Naide,
Plasma.
Am.
A simple method has been described for the treatment of i’schemie and varicose leg ulcers with patient’s own blood and with concentrated plasma. Nine of fifteen ulcers, refractory to other treatment, were healed, two were improved, and four failed to heal. This treatment results in rapid relief of pain and subsidence of the local inflammatory reaction. AUTHOR. Weston,
R. E., Janota,
concentration
M.,
Zevinson,
S. O., and
and Shock Following
Necheles,
Severe Hemorrhage.
H.: Am.
Studies on HemoJ. Physiol. 138:
450, 1943. Typical shock has been reproduced by graded hemorrhage in eleven nondehydrated, and in fifteen dehydrated, unauesthetized, normal dogs. In two of the nondehydrated (18 per cent), and in eight of the dehydrated animals Plasma volume and plasma protein (53 per cent), hemoeoneentration occurred. determinations, before and after hemorrhage, revealed that the animals which hemoconcentrated actualIy lost additional plasma &id and protein as shock developed. Pathologic changes consisting of gastrointestinal engorgement and hemorrhage, pulmonary congestion and engorgement, and occasional changes in other viscera were observed in a number of animals. The hemodiluting, nondehydrated animaIs tolerated an average tota bIood loss of 49 per cent as compared to an average total blood loss of 43 per cent tolerated by the other animals. The changes in plasma protein concentration after hemorrhage indicated that the hemoconcentrating dehydrated animals hemodiluted during and after hemorrhage to a lesser degree than the other three groups. This relative inability to hemodilute could explain their inability to tolerate as much bleeding before going into shock, and could lessen the masking by earlier hemodilution of the subsequent hemoconcentration as shock develops. It is suggested that the confficting reports as to the occurrence of hemoconeentra tion after hemorrhage may be related to the state of hydration of the animals studied. It is concluded that there are no definite grounds for dift’erentiating between hemorrhagic shock and shock from other causes. AUTHORS. Fox,
T. T., Travell,
Syndrome 71:
J., and
Molofsky,
of Short PR Interval
L.: Action of Digitalis on Conduction in the and Prolonged QRS Complex. Arch. Int. Med.
206, 1943.
A case is reported in which the electrocardiographic picture of short P-R interval in association with prolongation of the QRX complex was exhibited. Observations were made over a period of nearly two years. The effect of changes in vagal activity produced in various ways was studied. The effect of atropine sulfate on this syndrome was always to shorten the QRS time. This indicates that there was a vagal component in the mechanism of the syndrome.
L. V., and Isenhour, With Renal Hypertension.
C. E.: Occurrence of Mberoma Arch. Path. 33: 65.5, 1942.
in $be Aorta
in Rabbits
-4theromatous plaques were found in the aortas of rabita with persistent hypertension, produced by aortie constriction proximal to the origin of the renal arteries. The plaque formation seemed to be proportional to the elevation and duration of the hypertension. It was also seen more frequently in animals in which frequent preg nancies had occurred. KERSHBAUM. Peery,
T. M.:
Incomplete
Rupture
of the
Aorta.
Arch.
IlIt.
Med.
70:
689,
19-i".
Small tears in the intima and media of the aorta are not uncommon findings at autopsy in cases of hypertension. These tears are thought to be an early stage of dissecting aneurysm, the stage before actual dissection has occnrred. Most of the tears encountered have been transverse and across one of the commissures of the aortic valve. Tears in this area may result in slipping downward of the commissures so that the three valve cusps do not approximate, resulting in the clinical manifestations of aortic insufficiency. In some casee t,he tears heal at this stage, resulting in crippling of the aortic valve and death from congestive heart failure. In other cases dissection may occur days or months later, through the base of the old tear, and obliterate the evidence of a stage of incomplete rupture. In several instances reeonstruction of the past history of a case of dissecting aneurysm has revealed two stages. The original period of substernal pain and sudden dyspnea or choking probably corresponds to the stage of actnal dissection. If t.he tear occurs higher in the aorta, so that there is no effect upon the eommissuree, there may be no aortic insufficiency, and clinical manifestations may be slight. Occ.asionally a rough, rasping systolic murmur is noted over the sortie area. In cases in which dissection is preceded by incomplete rupture, the actual dissection is usual!y short, with termination by hemopericardium and cardiac tamponade. Of the eleven cases reported, five have shown incomplete aortic tears as purely incidental autopsy findings; two have died of congestive heart failure due to aortic insufficiency; and four have later developed dissecting aneurysm which resulted in death.
Bergman, A., and Neuman, Medicina, Buenos Aires
J.: Thromboarteriosclerosis 3: 87, 1942.
The clinical diagnosis of thromboarteriosclerosis finding of an arterial thrombus or embolus. and
The thromboses of the lead to the amputation
deep veins of a limb.
can
and
Venous
does not presuppose
Thrombosis.
the anatomical
aggravate
the
clinical
picture
of ischemia AUTHORS.
Ershler, Time
I., Kossmann, During Acute
C. E., and Progressive
In nineteen young, healthy, rebreathing, had the following
White, Anoxia
male effects
Venons M. S.: in Man. Am.
subjects, :
acute
Pressure J. Physiol.
progressive
and Circulation 138: 593, 1943.
anoxia,
induced
by
In four subjects it progressively The venous pressure showed a variable response. In seven subjects, who fainted during the rebreathing, the venous presdecreased. suggesting failure of the right ventricle. sure rose precipitously just before syncope, Iu all cases the venous pressure was restored promptly to normal by permitting the subject to breathe room air.
SELECTED
571
dBSTRlCTS
The circulation time from the right arm to the tongue was decreased in all This decrease was statistically significant. The rate of circulation was subjects. normal or slightIy slower in some cases as soon as the oxygen saturation of the blood was restored to the control level. AUTHORS.
Treatment of Leg Ulcers With Blood and Concentrated M.: J. M. SC. 205: 489, 1943.
Naide,
Plasma.
Am.
A simple method has been described for the treatment of i’schemie and varicose leg ulcers with patient’s own blood and with concentrated plasma. Nine of fifteen ulcers, refractory to other treatment, were healed, two were improved, and four failed to heal. This treatment results in rapid relief of pain and subsidence of the local inflammatory reaction. AUTHOR. Weston,
R. E., Janota,
concentration
M.,
Zevinson,
S. O., and
and Shock Following
Necheles,
Severe Hemorrhage.
H.: Am.
Studies on HemoJ. Physiol. 138:
450, 1943. Typical shock has been reproduced by graded hemorrhage in eleven nondehydrated, and in fifteen dehydrated, unauesthetized, normal dogs. In two of the nondehydrated (18 per cent), and in eight of the dehydrated animals Plasma volume and plasma protein (53 per cent), hemoeoneentration occurred. determinations, before and after hemorrhage, revealed that the animals which hemoconcentrated actualIy lost additional plasma &id and protein as shock developed. Pathologic changes consisting of gastrointestinal engorgement and hemorrhage, pulmonary congestion and engorgement, and occasional changes in other viscera were observed in a number of animals. The hemodiluting, nondehydrated animaIs tolerated an average tota bIood loss of 49 per cent as compared to an average total blood loss of 43 per cent tolerated by the other animals. The changes in plasma protein concentration after hemorrhage indicated that the hemoconcentrating dehydrated animals hemodiluted during and after hemorrhage to a lesser degree than the other three groups. This relative inability to hemodilute could explain their inability to tolerate as much bleeding before going into shock, and could lessen the masking by earlier hemodilution of the subsequent hemoconcentration as shock develops. It is suggested that the confficting reports as to the occurrence of hemoconeentra tion after hemorrhage may be related to the state of hydration of the animals studied. It is concluded that there are no definite grounds for dift’erentiating between hemorrhagic shock and shock from other causes. AUTHORS. Fox,
T. T., Travell,
Syndrome 71:
J., and
Molofsky,
of Short PR Interval
L.: Action of Digitalis on Conduction in the and Prolonged QRS Complex. Arch. Int. Med.
206, 1943.
A case is reported in which the electrocardiographic picture of short P-R interval in association with prolongation of the QRX complex was exhibited. Observations were made over a period of nearly two years. The effect of changes in vagal activity produced in various ways was studied. The effect of atropine sulfate on this syndrome was always to shorten the QRS time. This indicates that there was a vagal component in the mechanism of the syndrome.