摘要:

Electrocardiograms were recorded from 2,449 men and 2,689 women past 16 years of age, 85 per cent of the adult population of Tecumseh, Michigan. The tracings were classified according to the system of Blackburn and associates and the various categories are tabulated and discussed.Abnormal Q waves and certain “nonspecific” changes such as left axis deviation, high-amplitude R waves, ST-segment depression, T-wave inversion, first-degree atrioventricular block, complete intraventricular block, and arrhythmias increased in frequency with age. Hypertension and hyperglycemia occurred with significant frequency among persons with some of these changes. It seems likely that such “nonspecific” electrocardiographic abnormalities are frequently signs of coronary or hypertensive heart disease.The mean amplitudes of QRS complexes of men less than 50 years of age were greater than those of women. Such sex differences should be taken into account in the interpretation of clinical electrocardiograms.Further examinations and surveillance of the participants of this study are expected to clarify the significance of the electrocardiographic features discussed and the relationships between such features and other physiologic variables.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

In a search for atheromata, multiple sections of thoracic ducts from 119 autopsied individuals, varying in age from newborns to 91 years, were studied histologically with various stains, including fat stains on frozen sections of 84 different ducts.No atheromata were found. Changes in the wall of the duct apparently related to aging included increasing density, minimal intimal fibrosis, degenerative changes in the internal elastic plate, and the appearance of occasional microscopic fibrous polypoid projections into the lumen.Although fat was demonstrated with ease in the wall of the duct and did not appear to be related to the intimal fibrosis, it appeared to be passing through the wall of the vessel without exciting either inflammatory reaction or fibrosis.The findings in the thoracic duct were evaluated with respect to the conventionally accepted definitions of atherosclerosis and phlebosclerosis. It was concluded that the sclerotic changes found in the thoracic duct are more like phlebosclerosis and unlike atherosclerosis in that they bear no relationship to lipid infiltration and reaction thereto. The term “lymphatic sclerosis” was suggested for the condition.The common presence of lipid in the wall of the thoracic duct without reaction and without true atheroma formation indicates that factors beyond mere lipid infiltration of vascular walls must play an important role in the pathogenesis of atherosclerosis.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

Eight cases of termination of the left superior vena cava in the left atrium are reviewed pathologically and clinically.In three of the five patients who died, pathologic examination revealed three anomalies which, together, are considered to form a developmental complex. The anomalies are (1) termination of the left superior vena cava in the left atrium, (2) absence of the coronary sinus, and (3) an atrial septal defect lying in the postero-inferior angle of the atrial septum. In the two remaining fatal cases, the aforementioned anomalies were associated with persistent common atrioventricular canal. In this situation, the atrial septal defect of the latter malformation was confluent with the atrial septal defect of the anomalous complex described.The coexistence of three anomalies-the left superior vena cava terminating in the left atrium, absent coronary sinus, and atrial septal defect-is considered to result from a single developmental abnormality. This takes the form of failure of complete formation of the left atriovenous fold, that fold which normally develops along the left side of the junction of the sinus venosus and the atrial portion of the heart.Clinically, features of increased pulmonary blood flow, coupled with duskiness of the skin, were the significant abnormalities.When cardiac catheterization was attempted through a right-sided vein, the data revealed a left-to-right shunt at atrial level, while levels of arterial oxygen desaturation were present.Except in cases with coexistent ventricular septal defect, pulmonary hypertension was absent.In each of the four patients in whom cardiac catheterization was performed through a left antecubital vein, the catheter was advanced into the left superior vena cava, left atrium, and left ventricle. This was substantiated by angiocardiography in three of the four patients. In our experience, angiocardiography was the most reliable procedure to substantiate the termination of the left superior vena cava in the left atrium.The present study suggests that, in the absence of pulmonary hypertension, a left-to-right transatrial shunt associated with systemic arterial oxygen desaturation may indicate the presence of a persistent left superior vena cava terminating in the left atrium. Moreover, an atrial septal defect identified surgically as lying in the postero-inferior angle of the atrial septum should suggest that an additional anomaly may be present in the form of termination of the left superior vena cava in the left atrium.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

An investigation of 1,275 autopsy protocols and available clinical records of white, male, chronic schizophrenic patients, 40 years or older, with an average length of hospitalization of over 20 years, showed that (a) the prevalence of coronary heart disease as a cause of death was as high in this group of schizophrenic subjects (31 per cent) as in the comparable section of the general population; (b) the fatality rate (66 per cent) of coronary heart disease, (c) the incidence of sudden death (64 per cent of all deaths from coronary heart disease), (d) the incidence of myocardial rupture (21.7 per cent of all fresh myocardial infarctions) and (e) the incidence of painless heart attacks were higher in schizophrenic patients (60 per cent) than in the general population; (f) myocardial aneurysm was found less commonly in schizophrenic patients (2 per cent of all patients who either died of coronary heart disease or other causes but showed old infarct or old occlusion), and (g) there was an almost complete absence of anginal syndrome preceding or following myocardial infarction.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID