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Withdrawal of 2 previously published reports
LETTERS*
WITHDRAWAL
OF
PUBLISHED
2 PREVIOUSLY REPORTS
During 1981 I became aware of irregularities in data collected in my laboratory, as described in Section II of the Report of an Ad Hoc Advisory Committee to the Dean of the Harvard Medical School (Harvard University Gazette, January 29, 1982, Volume 77, page 1; and Nature, December 24, 1981, Volume 294, page 684). This problem and further investigation have brought into question the validity of the data in the 2 reports listed below: 1. Darsee JR, Kloner RA. Dependency of location of salvageable myocardium on type of intervention. Am J Cardiol 1981;48:702-710.
Enclosed is a brochure on proper trademark usage distributed by the United States Trademark Association. It is not our intent to presume to instruct the Journal and its editors on proper trademark usage, but instead to lend some authenticity to the need for proper use of our trademark by members of the public such as yourselves. Rule 6 in the brochure refers to the need and desirability of using a trademark to refer to the finished product and not to some other material or procedure. Thus, “Swan-Ganz catheter” or “Swan-Ganz thermodilution catheter” is a correct usage; “Swan-Ganz catheterization” or “Swan-Ganz balloon” is not. Your cooperation in using our Swan-Ganz mark in t,he recommended manner will be appreciated. Trademark Counsel, American Hospital Supply Corporation, One American Plaza, Evanston, Illinois 6020 1
Robert E. Hartenberger,
2. Darsee JR, Kloner RA. The no reflow phenomenon: a time-limiting factor for reperfusion after coronary occlusion? Am J Cardiol 1980;46:800-806.
Because of the circumstances referred to above, it is my opinion that these reports should be retracted. However, additional experiments have been carried out in my laboratory t(J examine the validity of the conclusions in these reports. These have validated the conclusions in the first report that drugs may result in both a lateral and subepicardial zone of salvage. These findings have been published. The observation that reperfusion results mainly in subepicardial salvage and the major concept in the second report that zones of microvascular damage occur within zones of myocardial cells which are already irreversibly damaged has also been confirmed, and the results have been submitted for publication. Robert A. Kloner, MD, PhD, Department of Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts 02 115
PROPER IDENTIFICATION OF TRADEMARKED PRODUCTS I call your attention to an article in your March issue (Fuchs RM, Heuser RR, Yin FCP, Brinker JA. Limitations of pulmonary wedge V waves in diagnosing mitral regurgitation. Am J Cardiol 1982;49:849-854), in which the term “Swan-Ganz catheterization” is used to refer to a catheterization presumably performed using a flow-directed thermodilution catheter. Swan-Ganz is a registered trademark of American Hospital Supply Corporation, U.S. Trademark Registration No. 929,651. The term “Swan-Ganz” is registered for use with catheters. To use it, as the article does, to describe a surgical procedure is a misuse which, if repeated continually, would weaken and diminish our exclusive rights to use the SwanGanz trademark to identify our products. We recognize that the article in question was submitted to you in approximately its present form and that the authors of the article and not your editors chose the term. It is nevertheless our hope that, by acquainting you with our concerns, we can enlist your cooperation for the future in using our Swan-Ganz trademark properly. l
Letters
COnCerning
a PartiCUlar
ceived within 2 months of the
article’s
in the Journal publication
article
must
be re_
THE MORPHOLOGIC METHOD APPLIED TO THE PROBLEM OF “SINGLE” RIGHT VENTRICLE Although Shinebourne et al.’ claim to present 18 cases of single right ventricle (“univentricular heart of right ventricular type”), in fact they presented none. In addition to a large morphologically right ventricle, all of their cases also had a small morphologically left ventricle (LV). In single right ventricle, the left ventricle is absent (by definition), not just small.Zx:3 Although the authors’ presented no case of single right ventricle, which is a rare malformation,Zl:3 they did make a good presentation of double inlet right ventricle, common inlet right ventricle, and mitral atresia in biventricular hearts with a large right ventricle and a small left ventricle. The basic problem with the paper by Shinebourne et al.’ is that these authors essentially accepted the classic definition of single ventricleZ,:3-that single ventricle is present when both atrioventricular (A-V) valves or a common A-V valve opens entirely or predominantly into 1 ventricular chamber. Unfortunately, this old definition leaves much to be desired. Briefly: 1. It is wrong in principle because it embodies an error in logic. This old definition attempts to define 1 variable (the anatomic status of the ventricles) primarily in terms of another variable (the anatomic status of the A-V valves). Instead, each variable should be defined primarily in terms of its own characteristics. For example, the anatomic status of the ventricles should be defined in terms of the morphologic characteristics of the ventricular portion of the heart, not in terms of any other variable, such as the A-V valves or the semilunar valves. 2. This old definition violates the morphologic method of diagnosing and naming the cardiac chambers in congenital heart disease. This method, which was introduced by Lev4 in 1954 and has subsequently proved essential to the understanding of complex congenital heart disease,“~~3~~may be stated as follows: (A) Cardiac chambers are diagnosed and named by means of their gross myocardial morphologic characteristics. (B) Cardiac chambers are not diagnosed and named by means of their vessels or valves of entry or exit, nor in terms of relative positions (such as right- or left-sided), nor in terms of the type or types of blood conveyed (such as arterial or venous), because all of these considerations are variables in congenital heart disease.
October 1982
The American Journal of CARDIOLOGY
Volume 50
929
WITHDRAWAL
OF
PUBLISHED
2 PREVIOUSLY REPORTS
During 1981 I became aware of irregularities in data collected in my laboratory, as described in Section II of the Report of an Ad Hoc Advisory Committee to the Dean of the Harvard Medical School (Harvard University Gazette, January 29, 1982, Volume 77, page 1; and Nature, December 24, 1981, Volume 294, page 684). This problem and further investigation have brought into question the validity of the data in the 2 reports listed below: 1. Darsee JR, Kloner RA. Dependency of location of salvageable myocardium on type of intervention. Am J Cardiol 1981;48:702-710.
Enclosed is a brochure on proper trademark usage distributed by the United States Trademark Association. It is not our intent to presume to instruct the Journal and its editors on proper trademark usage, but instead to lend some authenticity to the need for proper use of our trademark by members of the public such as yourselves. Rule 6 in the brochure refers to the need and desirability of using a trademark to refer to the finished product and not to some other material or procedure. Thus, “Swan-Ganz catheter” or “Swan-Ganz thermodilution catheter” is a correct usage; “Swan-Ganz catheterization” or “Swan-Ganz balloon” is not. Your cooperation in using our Swan-Ganz mark in t,he recommended manner will be appreciated. Trademark Counsel, American Hospital Supply Corporation, One American Plaza, Evanston, Illinois 6020 1
Robert E. Hartenberger,
2. Darsee JR, Kloner RA. The no reflow phenomenon: a time-limiting factor for reperfusion after coronary occlusion? Am J Cardiol 1980;46:800-806.
Because of the circumstances referred to above, it is my opinion that these reports should be retracted. However, additional experiments have been carried out in my laboratory t(J examine the validity of the conclusions in these reports. These have validated the conclusions in the first report that drugs may result in both a lateral and subepicardial zone of salvage. These findings have been published. The observation that reperfusion results mainly in subepicardial salvage and the major concept in the second report that zones of microvascular damage occur within zones of myocardial cells which are already irreversibly damaged has also been confirmed, and the results have been submitted for publication. Robert A. Kloner, MD, PhD, Department of Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts 02 115
PROPER IDENTIFICATION OF TRADEMARKED PRODUCTS I call your attention to an article in your March issue (Fuchs RM, Heuser RR, Yin FCP, Brinker JA. Limitations of pulmonary wedge V waves in diagnosing mitral regurgitation. Am J Cardiol 1982;49:849-854), in which the term “Swan-Ganz catheterization” is used to refer to a catheterization presumably performed using a flow-directed thermodilution catheter. Swan-Ganz is a registered trademark of American Hospital Supply Corporation, U.S. Trademark Registration No. 929,651. The term “Swan-Ganz” is registered for use with catheters. To use it, as the article does, to describe a surgical procedure is a misuse which, if repeated continually, would weaken and diminish our exclusive rights to use the SwanGanz trademark to identify our products. We recognize that the article in question was submitted to you in approximately its present form and that the authors of the article and not your editors chose the term. It is nevertheless our hope that, by acquainting you with our concerns, we can enlist your cooperation for the future in using our Swan-Ganz trademark properly. l
Letters
COnCerning
a PartiCUlar
ceived within 2 months of the
article’s
in the Journal publication
article
must
be re_
THE MORPHOLOGIC METHOD APPLIED TO THE PROBLEM OF “SINGLE” RIGHT VENTRICLE Although Shinebourne et al.’ claim to present 18 cases of single right ventricle (“univentricular heart of right ventricular type”), in fact they presented none. In addition to a large morphologically right ventricle, all of their cases also had a small morphologically left ventricle (LV). In single right ventricle, the left ventricle is absent (by definition), not just small.Zx:3 Although the authors’ presented no case of single right ventricle, which is a rare malformation,Zl:3 they did make a good presentation of double inlet right ventricle, common inlet right ventricle, and mitral atresia in biventricular hearts with a large right ventricle and a small left ventricle. The basic problem with the paper by Shinebourne et al.’ is that these authors essentially accepted the classic definition of single ventricleZ,:3-that single ventricle is present when both atrioventricular (A-V) valves or a common A-V valve opens entirely or predominantly into 1 ventricular chamber. Unfortunately, this old definition leaves much to be desired. Briefly: 1. It is wrong in principle because it embodies an error in logic. This old definition attempts to define 1 variable (the anatomic status of the ventricles) primarily in terms of another variable (the anatomic status of the A-V valves). Instead, each variable should be defined primarily in terms of its own characteristics. For example, the anatomic status of the ventricles should be defined in terms of the morphologic characteristics of the ventricular portion of the heart, not in terms of any other variable, such as the A-V valves or the semilunar valves. 2. This old definition violates the morphologic method of diagnosing and naming the cardiac chambers in congenital heart disease. This method, which was introduced by Lev4 in 1954 and has subsequently proved essential to the understanding of complex congenital heart disease,“~~3~~may be stated as follows: (A) Cardiac chambers are diagnosed and named by means of their gross myocardial morphologic characteristics. (B) Cardiac chambers are not diagnosed and named by means of their vessels or valves of entry or exit, nor in terms of relative positions (such as right- or left-sided), nor in terms of the type or types of blood conveyed (such as arterial or venous), because all of these considerations are variables in congenital heart disease.
October 1982
The American Journal of CARDIOLOGY
Volume 50
929