ISSN:0009-7322    

出版商:OVID    

年代:1961

数据来源: OVID

摘要:

Serial determinations of the urinary excretion of aldosterone have been made in hypertensive patients. Although the majority of patients with benign essential hypertension excrete amounts of aldosterone within the normal range, the mean excretion of 26 patients was significantly higher than that observed in normotensive individuals. When renal complications were present, the mean excretion was still further increased and in patients with malignant hypertension all the values were above the normal range.The mean excretion of the tetrahydro metabolite of aldosterone was also found to be higher in patients with essential hypertension.These patients have a normal response to adrenocorticotrophic hormone stimulation, urinary and plasma corticosteroids, as well as urinary aldosterone, showing comparable increases.The aldosterone content of adrenal glands obtained post mortem from two patients with malignant hypertension was within the range observed by other investigators in primary aldosteronism.

ISSN:0009-7322    

出版商:OVID    

年代:1961

数据来源: OVID

摘要:

The hemodynamic findings in 31 patients with mitral valvular disease were correlated with the signs obtained by chest tomography. The normal and pathologic findings are described. The advantages of the tomographic technic for the study of the pulmonary vasculature are pointed out.The progression of mitral valve narrowing was considered to be best related to the integrated picture of "impaired venous drainage." On this basis, three stages were defined.The over-all response of the pulmonary circulation to the severity of the disease can be judged by the pattern of blood vessels filling throughout the lung.It is concluded that for the evaluation of mitral valvular disease routine tomographic technic can indicate many of the essential hemodynamic findings with less hazard than either angiography or cardiac catheterization.

ISSN:0009-7322    

出版商:OVID    

年代:1961

数据来源: OVID

摘要:

In the presence of valvular aortic stenosis or of discrete subvalvular stenosis, the narrowed orifice is constant and its size is not altered by changes in the force of ventricular contraction. In hypertrophic subaortic stenosis the orifice narrows during systolic contraction of the hypertrophied muscle in the left ventricular outflow tract and the orifice size therefore is a function of the force of left ventricular contraction. In 75 patients, proved to have the discrete, "fixed" type of aortic or subaortic stenosis the beats following the compensatory pause after a premature contraction were always characterized by higher left ventricular systolic pressures and larger systemic arterial pulse pressures than the normal beats, i.e., arterial pulse pressure varied directly with left ventricular systolic pressure and with the duration of diastole. In 12 patients proved to have hypertrophic subaortic stenosis, the beats following premature contractions always exhibitedlowerarterial pulse pressures than did the normal beats, i.e., arterial pulse pressure variedinverselywith left ventricular systolic pressure and with the duration of diastole. The distinction between these two types of obstruction to left ventricular outflow may be established with confidence by this analysis of the effects of premature ventricular contractions on either the simultaneously recorded left ventricular and arterial pressure pulses, or on the arterial pressure pulses alone. The recognition of hypertrophic subaortic stenosis is essential in formulating a rational plan of treatment for all patients with obstruction to left ventricular outflow, and the hemodynamic technic described affords a simple but reliable diagnostic approach.

ISSN:0009-7322    

出版商:OVID    

年代:1961

数据来源: OVID

摘要:

Ballistocardiographic study in 10 cases of chronic severe anemia, with use of Dock's direct body ballistocardiograph, has been reported. The tracings were studied before and after treatment of anemia.All cases showed abnormal ballistocardiograms. The abnormalities presented no specific pattern. Prior to treatment, in the majority of cases, the waves were smaller than normal. With few exceptions, the tracings tended to regain their normal size on correction of anemia. No tracings showed fused HJ complexes, tall H waves, notched J waves, M patterns, or high-amplitude curves either before or after treatment.The present study shows that the state of severe anemia of chronic duration, impairs the mechanical force of cardiac contractions, and, on improvement of anemia, the functional state of the heart improves. Thus, it reflects the usefulness of this new tool in assessing the functional status of the heart in patients with chronically severe anemia.

ISSN:0009-7322    

出版商:OVID    

年代:1961

数据来源: OVID

摘要:

Clearance experiments have been performed in 24 subjects with different levels of glomerular filtration, suffering from renal disease without edema, in order to compare the diuretic, saluretic, and kaliuretic responses to a single intravenous injection of meralluride, chlorothiazide, or both together. The inulin clearances of these patients ranged from 5.9 to 135 ml. per minute. The effects of the drugs were studied under constant loading with saline over 3 hours after injection.Our results indicate that over a wide range (15 to 20 ml. per minute up to normal values) a permanent reduction of the glomerular filtration rate has little influence on the diuretic and saluretic effects of meralluride or chlorothiazide. Below 15 to 20 ml. per minute a further reduction results in a sharp decrease in the diuretic and saluretic actions. This can be best explained by assuming that the diuretic agents block an increasing fraction or the tubular reabsorption of water, sodium, and chloride related to the decrease in glomerular filtration rate. This fraction, however, seems to be limited to 30 to 40 per cent of the filtered load. Some dispersion in the glomerulo-tubular activity may account for the splay of the experimental curves.The kaliuretic effect of chlorothiazide is proportional to the glomerular filtration rate. This effect can be blocked by meralluride.At high levels of glomerular filtration the diuretic and saluretic actions of meralluride and chlorothiazide are additive. At lower levels of filtration, such a summation effect is not demonstrable. Apparently, both drugs given together cannot block the reabsorption of more than 30 to 40 per cent of the filtered load.A single injection of chlorothiazide does not lower the arterial blood pressure of hypertensive subjects, loaded with saline, but produces a slight decrease in the glomerular filtration rate, averaging 7 per cent.

ISSN:0009-7322    

出版商:OVID    

年代:1961

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1961

数据来源: OVID

摘要:

The beta/alpha lipoprotein ratio and other serum lipid components have been studied in a population of full-blooded Navajo Indians. The findings offer a basis for assessing the low degree of atherogenesis and are consistent with evidence for the low incidence of coronary heart disease in this ethnic group.

ISSN:0009-7322    

出版商:OVID    

年代:1961

数据来源: OVID

摘要:

One hundred and nineteen cases of ventricular septal defect in infancy and childhood have been reviewed, with special reference to the electrocardiogram. The changes in the electrocardiogram were related to the hemodynamics found at cardiac catheterization, and particularly the pulmonary to systemic blood flow ratios, pulmonary artery pressures, and oximetry. They were also studied in relation to the groups of cases that obviously had a low pulmonary vascular resistance with or without diastolic loading of the left ventricle. Survival of a patient following closure of the defect with a drop in pulmonary artery pressure was also taken as a sign that the pulmonary vascular resistance was not excessive. The patients with clinical and hemodynamic evidence of a high pulmonary vascular resistance were also evaluated in relation to the electrocardiogram.The information obtained from the electrocardiogram may be graded according to degree of severity: (a) normal electrocardiogram, (b) left ventricular loading, (c) combined loading, (d) isolated right ventricular loading. These groups may be further graded depending on the diminishing number of signs listed below.1-7A detailed review of these four groups in relation to the following criteria may allow one to identify a low or only moderately raised pulmonary vascular resistance, or one that is sufficiently moderate to permit successful corrective surgery in the pediatric age group: 1. An R in V6over 20 mm. 2. A Q in V6of 4 mm. or over. 3. An S in V1over 25 mm. 4. A Q in V6of 2 mm. or more when associated with evidence of right ventricular loading. 5. An axis of less than 90°. 6. Counterclockwise vector. 7. Broad notched P waves in standard leads I or II, with late inversion in V1.As a rule, several of these criteria occur together, but even if only one of them is present, one may conclude that the pulmonary vascular resistance is not excessive. Further support to this conclusion is evident if any of the above 7 items are accompanied by one or more of the following: (x) a pulmonary blood flow that is twice systemic, (y) an absence of reversal of flow through the defect either at rest or with exercise, (z) an age under 7 years.Among the 119 infants and children with ventricular septal defect, over 90 per cent appeared to have a sufficiently low pulmonary vascular resistance to be operable provided the surgical technic is adequate and provided complete heart block does not occur.Age appears to be an important factor in assessing the likelihood of success at surgery. Only an exceptional case shows hemodynamic findings indicating inoperability before the age of 7 years.During the first year of life many cases of ventricular septal defect have signs of left ventricular loading appear or increase, suggesting a favorable trend in the pulmonary vascular resistance. Until surgical technic makes operation more readily feasible in infancy, the optimum age of correction would appear to be between 2 and 7 years.

ISSN:0009-7322    

出版商:OVID    

年代:1961

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1961

数据来源: OVID