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The aim of this paper is to present an evidence that ABO blood-groups play a key role in the rheology of blood in cardiovascular diseases, that they might influence the pathways of aetiology of those diseases, especially in relation to the microcirculation, tissue perfusion and thrombus formation, and that there exists a possibility that ABO blood-group specific drugs might be more effective in counteracting a development and progress of these diseases than drugs which do not take any account of inherent differences between patients of different ABO blood groups. [ABSTRACT FROM AUTHOR]

The association of abnormalities of the lymphoreticular system with abnormalities of the cardiovascular system has long been recognized; for example, individuals with absence of the spleen have a high incidence of congenital heart disease. In 1959, Lobdell described a child with absence of the thymus, anomalies of the aortic arch, no parathyroids and clinical hypoparathyroidism. In 1960, a second similar case was reported from the Children's Medical Center in Boston. In 1965, DiGeorge recognized that such patients had normal immunoglobulin production but did not develop delayed hypersensitivity or reject a homograft. At least 20 additional cases of 'third and fourth pharyngeal pouch syndrome' have been placed in the literature in the past few years. This paper reports two additional cases with absence of the thymus and parathyroids, and emphasizes the association of these anomalies with vascular anomalies of the great vessels.

In this paper a survey is given on the group of risk in patients with diseases of the circulatory system under the stress of anaesthesia with special regard to arterial hypertension, chronic ischaemic heart disease, disturbances of cardiac rhythm and global heart insufficiency besides the generally acknowledged therapeutic principles for cardiological patients of risk. On the conditions of a surgical intervention the author adopts a definite attitude to the partly still contrary problems of the preoperative antihypertensive treatment and to the prophylactic therapy with glycosides. The most important diagnostic and therapeutic facts concerning the necessary interdisciplinary cooperation between internist, anaesthesist and operator in preparation and performance of an operative intervention in patients with circulatory diseases are described.

The projecting of an anamnestic questionnaire concerning angiocardiopathies for purposes of screening for the 8 most important groups of angiocardiopathies was performed in two simultaneous stages--model experiments and population experiment. In the model stage, which is the topic of this paper, apart from investigations of reproducibility and controls of voluntary falsifications of answers above all an examination concerning the significance of the data was carried out. The methods used for this--analysis of the complaints of typical groups of patients (analysis of discriminancy) and analysis of experiences of recognized experts of angiocardiopathies (scale graduation of symptoms)--were discussed and first results described.

It has been established that sustained emotional arousal can accompany the psychosocial stimulation induced by the social interaction of members of a social group as they compete for desiderata, such as food and water. This paper reviews the evidence that this arousal of neuronendocrine response patterns can, in turn, lead to disease states and to a fatal outcome. Various experimental observations in pigs, monkeys, baboons, tree shrews, and rodents demonstrate both acute and chronic disturbances of cardiovascular function. These conditions can lead to sudden death or to sustained high blood pressure with arteriosclerotic lesions in the heart and blood vessels. It is shown that when social pressure that has been maintained for a sufficiently long period is relieved, the organism does not revert to normal.

No large series of patients with cardiovascular disease has yet been reported from Ethiopia, where only limited means for investigation are at present available. The authors therefore studied the types of heart disease detected by mass miniature radiography in a largely self-selected population at the Addis Ababa Tuberculosis Centre, and examined the value of this method of cardiac case-finding. Rheumatic heart disease occurred in 34.8% of patients, but syphilitic aortitis, hypertension, "cardiomyopathy" and tuberculous pericarditis were also common. Endomyocardial fibrosis was not seen; this may be a further significant fact in the search for its cause. Mass miniature radiography is valuable for detecting symptomatic patients with the cardiovascular diseases mentioned above. The technique described in this paper could be used in other developing countries as it uses a single method of screening for 2 groups of diseases.

Focuses on the observation of the efficacy and toxicity of Norpace therapy among patients with cardiovascular related diseases. Determination of the drug levels following the administration of antiarrhythmic agent; Implications of antiarrhythmic agents for patients with 1st degree block; Treatment of acute myocardial infarction in coronary care units.

The article seeks to examine a number of problems in the treatment of depressive states by means of a blind trial to compare the effectiveness of amitriptyline and imipramine. Taking in conjunction with the findings reported in earlier papers, the results convincingly suggest that antidepressant drugs should be used before a decision to give electroconvulsive therapy is made except in deluded depressives. It was also shown that amitriptyline is the best available antidepressant agent. Moreover, imipramine is contra-indicated in patients with cardiovascular degeneration as is amitriptyline in patients with glaucoma. Both drugs should be administered with caution in patients over 70 years old.

Two patients with systemic arterial hypertension due to ischemia of a solitary functioning kidney were presented. Both patients had stricture of the left renal artery. Additionally, one had the right kidney artery completely occluded and the other underwent a right nephrectomy five years previously. It was the authors' observation that in the presence of stenosis of one of the renal arteries the elimination of the function of the other kidney severely aggravates the clinical picture, and that such patients are especially apt to develop hypertension of extremely serious character. After reconstructive vascular surgery, the blood pressure of both patients returned to normal and they had complete relief from their symptoms. [ABSTRACT FROM AUTHOR]

Unselected patients from an obstetrical department were re-examined 2 to 31 years after they had suffered from deep thrombosis of the lower limbs which was probably not confined to the lower leg in any case. The thrombosis had been treated by strict immobilization. Re-examination of 89 extremities with a follow-up period exceeding 5 years showed that 89 per cent had developed serious sequelae. The latter consisted in heaviness and fatigue in 87 per cent, edema in 78 percent, present or past ulcer of the leg in 27 per cent, and 45 per cent had to wear a bandage all the time. In 30 instances a symptom free period occurred, usually within one year of the acute thrombosis. In twenty of these cases, however, the symptoms returned later, so that only 10 limbs in all (=11 per cent) had no subjective symptoms at the time of the follow-up. With regard to some of the symptoms and signs (such as varicose veins), the study showed an incidence increasing steadily in the course of time; but on the whole the re-examination showed that the sequelae appear to reach their maximum within the first 5 years or so and that after that time the state appears to remain fairly stationary. Thus, 67 per cent of all ulcers had appeared within 6 years of the thrombosis. The incidence of pains, however, decreased as the years went by. [ABSTRACT FROM AUTHOR]

Presents abstracts of scientific papers presented at the 43rd Annual Session of the American College of Physicians in Philadelphia, Pennsylvania held April 9-13, 1962. 'Gross Left Atrial Enlargement Without Pressure Elevation in Severe Mitral Regurgitation,' by W.C. Awe, and E. Braunwald; 'Cerebral Manifestations of the Cardiac Arrhythmias: A Clinical and Experimental Study,' by E. Corday and D.W. Irving.

Studies the division of deep venous thrombosis into localized thrombosis and the classical entities of Phlegmasia alba dolens and Phlegmasia Cerulea Dolens. Characterization of Phlegmasia Cerulea Dolens by a sudden onset and rapid progression of edema discoloration; Maximum intensity of cyanosis in the distal part of the limb; Occurrence of spasms in the vessels.

Focuses on vascular reconstruction in far-advanced and poor risk situations. Distal abdominal aortic and iliac disease; Aortoiliac endarterectomy; Dacron bypassing procedure.

Presents treatment options for severe post-thrombotic conditions. Characteristics of the chronic post-thrombotic syndrome; Surgical and conservative methods of dealing with the condition; Evaluation of different therapeutic methods based on the observation of cases; Methods of conservative treatment; Standards of assessment.

Comments on the papers prepared for the Inter-Society Commission for Heart Disease Resources, published by the U.S. Government Printing Office, which provide guidelines for the prevention and care of cardiovascular diseases. Features of the publication; Recommendations of the papers; Persons concerned with health planning who should be required to read the papers.

A list of articles related to public health published in several journals are presented including "Integration of Medical Research and Health Policies," by S. P. Strickland, and "Strokes and Hypertension," by A. B. Carter.

The article provides information on degenerative heart disease that can be prevented by physical activity. Oxygen supply and demand affect the oxygen economy of the heart. Systematic physical training can prevent detriments of habitual physical inactivity to the metabolism of the heart muscle. Results of studies on the relationship between the incidence of ischemic heart disease and lack of physical exercise show the influence of social factors involving exercise, habits and dietary customs.

, , 343-348. Abnormally prolonged peripheral vasoconstriction has been detected prospectively by means of a toe temperature nomogram in 15 (11·5%) out of 131 patients following cardiopulmonary bypass. This state has been associated with a 53% incidence of hospital death, a detectable pathological cause in all cases, and in seven of the 15 cases it was the first or only evidence of a circulatory disorder. It is apparent that toe temperature monitoring after open-heart surgery gives early warning of a wide variety of potentially serious pathological processes, permitting effective treatment of the underlying cause before irreversible changes occur. It has become an indispensable part of routine postoperative care in our unit and is regarded as the simplest and most effective method of monitoring the circulation currently available. [ABSTRACT FROM PUBLISHER]

This article distinguishes between effects of feedback from the cardiovascular system and from other autonomic system and suggested that heart rate (HR) acceleration should be associated with stimulus "rejection" and HR deceleration with "attention" or stimulus "acceptance." The present study quantified certain attributes of the sound of the high speed dental engine and tested the effects of this sound on HR and measures of hostility, depression, and anxiety. Thirty-eight females enrolled at the University of Bridgeport were assigned to one of four groups predetermined by a questionnaire investigating their past experience and familiarity with the dental engine. Heart rate and measures of hostility, depression, and anxiety varied directly with the subjects' familiarity and subjective experience with the acoustic stimuli. Heart rate was found to be more accelerated in subjects who had less experience with and who rated the acoustic stimulus as more unpleasant. Similarly such subjects demonstrated higher scores on anxiety, depression, and hostility scales. [ABSTRACT FROM AUTHOR]

A prospective epidemiological study on a large population of elderly persons was carried out to investigate the incidence of cerebrovascular attack (stroke) and its relationship to other variables, particularly preexisting cardiovascular disease. [ABSTRACT FROM AUTHOR]

Emergency vascular conditions commonly seen by all of us are those of vascular trauma of various types, intra-arterial embolic occlusion, the intra-arterial thrombosis (with or without concomitant venous thrombosis), the venous thrombosis not responding to anticoagulation with early pulmonary embolization, and finally, the condition of phlegmasia cerula dolens. In all these cases it is essential to achieve an early diagnosis and to institute corrective and reconstructive treatment as rapidly as possible. Subsequent postoperative complications such as edema and fascial compression must be treated swiftly. Postoperative observation in the critical care unit by trained personnel is essential. [ABSTRACT FROM AUTHOR]

1. Neurohumoral mechanisms operating via the catecholamines are discussed in their relationship to such hypertensive diseases as pheochromocytoma and labile and established essential hypertension. 2. In pheochromocytoma, diagnosis depends almost entirely on identification of increased amounts of catecholamine metabolites in the urine. Because of the danger, manipulative or invasive procedures both for diagnosis and during surgery should be kept at a minimum. 3. In established essential hypertension, reactivity to norepinephrine and plasma norepinephrine are increased, whereas norepinephrine uptake and apparent secretion rate are decreased. 4. In labile essential hypertension, reactivity to epinephrine and probably plasma epinephrine are increased and uptake of epinephrine decreased. 5. Labile hypertension with all its characteristics may or may not coexist with established essential hypertension with all its features. 6. The sympathetic nervous system is also involved in other types of hypertensive disease. Many patients with renovascular hypertension as well as with primary and secondary hyperaldosteronism also have essential hypertension. Angiotensin IL affects the sympathetic nervous system and the juxtaglomerular apparatus appears to be beta adrenergic receptor activated, at least in part. [ABSTRACT FROM AUTHOR]

A case of political artery thrombosis secondary to Behçet's syndrome is reported and attention is drawn to its presentation, diagnosis and treatment. A brief review of the syndrome is also included. [ABSTRACT FROM AUTHOR]

1) In 37 lower extremities of 34 patients and in 14 extremities of 10 control subjects, calf blood flow was measured at rest and after ischaemic exercise by strain-gauge plethysmography. The pathological extremities were also studied by angiography and divided into four groups as follows: (1) atherosclerosis of patent arteries without occlusions. (2) proximal occlusions (femoral and/or popliteal only) (3) distal occlusions (calf arteries only), and (4) combined occlusions. 2) Rest flow in the patients was slightly but insignificantly lower than flow in the controls. Maximal flow, however, was definitely lower in the pathological group (P < 0.005). There was a linear correlation between rest and maximal flow in patients with proximal occlusions. 3) Maximal calf flow was significantly decreased in atherosclerosis of patent arteries without occlusions and in all types of occlusions. Moreover, atherosclerosis of patent arterial segments further decreased maximal blood flow in the presence of occlusions. 4) Maximal calf flow could neither he correlated with total length of occlusions in the affected extremity nor with maximal foot flow after body heating. 5) It is concluded that measurement of maximal calf blood flow is a useful procedure serving to recognize unapparent lesions and to test the progress of the disease as well as the effect of treatment in follow-up studies. [ABSTRACT FROM AUTHOR]

Autonomic response patterns of 20 male non-readers, ranging in age from 7 years 11 months to 11 years 4 months, were compared with those of 20 matched controls. Analyses were made of the onset orienting response, the offset orienting response and anticipatory response as measured for heart rate, finger pulse and electrodermal pheonomena (skin potential and skin resistance). Nonreaders had lower mean skin conductance levels across trials, greater amplitude of skin resistance response to a novel stimulus (75 decibel tone), fewer electrodermal offset responses, fewer negative and diphasic skin potential responses, fewer electrodermal and heart rate anticipatory responses, slower motor reaction times, and a higher degree of sinus arrhythmia. AII these differences between the groups were statistically significant. Habituation of the electrodermal, finger pulse, and heart rate onset responses did not differ, and no difference was found between groups as to the magnitude or shape of the heart rate onset response. Both groups showed decreasing skin conductance levels with increasing heart rate levels over trials. Data suggest nonreaders were physiologically less mature, unable to maintain a constant attentional level, and slower in "simple" learning than their matched controls. [ABSTRACT FROM AUTHOR]

The article provides information on the documents and publications of the United Nations and Specialized agencies used in the journal. For the population, health and food articles, the authors used the following "Epidemiological and Vital Statistics Report" from World Health Organization, "Promotion of Medical Practitioners' Interest in Preventive Medicine" and "Rehabilitation of Patients with Cardiovascular Diseases." References for social structures and economics include "United Nations Special Fund: The Implementation of the Programmes Approved by the Governing Council at its 2nd Through 10th Sessions," Investment Laws and Regulations in Africa" and "Women Workers in a Changing World."

The course of cryptogenic fibrosing alveolitis (CFA) in 96 patients is described. The mean survival from the onset of the first symptom until death was 47·4 months in all the 59 fatal cases, 49·6 months in those dying from CFA only, and 48·4 months in those dying from CFA in whom the course of the illness was not influenced by corticosteroids. There was a wide variation in the natural course of the disorder, varying from death within a year of the onset of symptoms in five patients to prolonged survival with slow or arrested progress in four patients not treated with corticosteroids. Most patients died from CFA but five developed bronchial carcinoma and two died after lung biopsy. The main factor influencing the prognosis was the effectiveness of corticosteroid drugs. Only 16% of the treated patients had a worthwhile (grade 2) response to these drugs and the five-year survival of this group was 67%. In those patients in whom the course of the illness was uninfluenced by corticosteroids the five-year survival rate was only 20%. The histological appearances on lung biopsy gave a rough guide to the likely effect of corticosteroid therapy. Other factors influencing the prognosis were the degree of dyspnoea on presentation, the vital capacity, and the presence of arterial hypoxaemia. Patients who had had symptoms for more than four years before the first hospital attendance had a relatively good prognosis. By contrast, neither the extent of radiographic abnormality nor the presence of circulating rheumatoid and antinuclear factors influenced subsequent survival. [ABSTRACT FROM PUBLISHER]

Presents the text of a speech given by Herman F. De Feo, Associate Clinical Professor, Stritch School of Medicine, the 27th Annual Convention of the American College of Gastroenterology held in Chicago, Illinois in October 1962. Cardiovascular situations producing abdominal or gastrointestinal manifestations; Discussion on cardiovascular problems, such as coronary occlusion; Relationship between the cardiopulmonary-gastrointestinal symptoms.

Stokes­Adams seizure associated with complete heart block that is intractable to medical therapy can best be treated by the implantation of a permanent pacemaker. It has been demonstrated that the preliminary insertion of an intracardiac dipolar catheter electrode is an invaluable adjunct to the technical regimen. The intracardiac dipole is safe and simple to insert. It permits the immediate complete control of any existing critical clinical situation. After insertion and pacing, patients can he ambulated. During the period of time that then elapses Therefore definitive surgery is performed congestive failure and azotemia are relieved, and the patient brought to optimum condition for operation. The subsequent anesthesia and thoracotomy necessary for the implantation of the permanent unit are rendered relatively safe. [ABSTRACT FROM AUTHOR]

Discusses the methods for inducing experimental thrombosis. Analysis on the etiology of thrombosis; Classical triad of the causative factors of thrombosis; Ability of perivascular application of fixing agents to reduce or eliminate cellular and metabolic activities of the disease.

In a group of 100 patients, of whom 60 had diabetes, arteriosclerosis, hypertension or a combination thereof, we were able to get weight reduction, using a combination of amphetamines, including amphetamine saccharate, and diet. In those diabeties who had an adequate weight reduction, we noted an increase in carbohydrate tolerance. Similarly, hypertensives responded with lowering of the blood pressure and many arterioselerotics with coronary insufficiency demonstrated marked improvement. With a daily divided dosage of 30 mg of this amphetamine compound, we were able to obtain appetite depression without nervous restlessness or insomnia in 26 of 30 patients wins previously had been unable to use other amphetamines in any dosage sufficient to maintain the anorexic effect. It is important to note that all patients had appetite depression while on this drug, but only those with apparent adequate motivation were successful because of adherence to a proper dietary intake. This demonstrate again that the obese patient eats not because of hunger or physical demand but rather because of a psychologic need and urge which is rarely affected by medication alone. No attempt was made to determine what proportion of our group was successful in weight reduction because of the marked variance in the rate of weight reduction between the group and in the individual himself. It is our experience that a successful reduction is one that either accomplishes a return to optimal weight and maintains it so or one that, regardless of rate of reduction, maintains a constant and progressive loss over prolonged and continuing periods of time. This latter state of affairs implies 2 desirable effects—arrival at the optimal weight level in some and, in others, the continued but discouragingly slow loss of weight. Therefore, in a study such as this with its limited periods of observation, one cannot divide the results up into successful or unsuccessful groups since most lost weight in some period of time, only to falter with gain of weight in some or failure to lose in others. Reinstitution of weight loss with a return of interest or motivation was frequently observed. Cooperative patients lost weight progressively but starts and stops were the general rule. In the cooperative patient, the new anoretic amphetamine compound was beneficial in producing the desirable weight loss with minimal side effects, even in patients with cardiovascular and other chronic diseases where the use of amphetamines with stimulating side effects is undesirable but where weight loss may be life saving and appetite curbing most helpful. [ABSTRACT FROM AUTHOR]

Sixty-eight subjects with coronary insufficiency, 23 postcoronary patients and 45 with developing arteriosclerotic heart disease, were placed on a program consisting of three elements: emergency medication (nitroglycerin), a long-acting protective agent (trolnitrate phosphate), and reassurance by the physician. Fifty-nine (87 per cent) reported no anginal episodes or a marked decrease in the number and severity of attacks. Fifty-seven (84 per cent) were able to continue their ‘normal’ lives with virtually no restrictions or only partial restrictions. Trolnitrate phosphate appears to be an excellent antianginal agent for prophylactic use, especially in the geriatric patient. A well rounded program such as described above is recommended for the treatment of coronary insufficiency. [ABSTRACT FROM AUTHOR]

1. The collateral arterial circulation in the body is extensive and capable of providing adequate passageways for the arterial flow especially when the major vessels are occluded. 2. A reduction of the normal arterial inflow as from an occlusion and muscle activity distally are both necessary for the maximum lasting enlargement of the collateral circulation to the area. 3. The collateral vessels enlarge with time and need. 4. Collateral vessels resist dilation when damaged, as from arteriosclerosis or loss of elastic fibers; or when spastic, as in vasomotor disturbances. 5. In peripheral arterial occlusive disease, muscle activity is best provided by graduated walking exercises. 6. It is possible to enlarge the collateral arterial circulation to the point where it is permanently adequate for normal activity and stress. [ABSTRACT FROM AUTHOR]

Experiments on rats were performed to examine the effect of sodium deficiency upon various experimental cardiac lesions, which differ widely from each other in both their causative agents and their histologic characteristics. It was found that sodium deficiency significantly protected the heart against the production of necrosis, inflammation and/or calcification by dihydrotachysterol (DHT), plasmocid and papain. In fluorocortisol conditioned, sodium deficient animals the cardiac necrosis eliciting effect of neuromuscular effort was also markedly inhibited. A reduction of the severity and incidence of the ‘spotty myolysis’ normally due to the administration of noradrenaline and vasopressin was suggestive, but not statistically significant. On the other hand, combined administration of DHT + calcium acetate produced fatal, acute suppurative myocarditis of an equal degree in the (control and sodium deficient rats. Thus, the protective effect of sodium deficiency against the calcifying and necrotizing actions of DHT was completely abolished by the concurrent administration of calcium acetate. The importance of sodium in the pathogenosis of cardiac necroses and the possible role of electrolyte-steroid interactions in calcifying and necrotizing cardiac diseases are briefly discussed on the basis of those and previous observations. [ABSTRACT FROM AUTHOR]

Hemodynamic arteriopathy is the segmentary lesion of an artery resulting from its abnormal contact with a hard tissue. The constantly repeated trauma due to the systolic expansion gradually modifies the wall of the artery, which thickens, and the lumen decreases and finally becomes obliterated by thrombosis. Hemodynamic arteriopathy has been induced experimentally in dogs. At present, there seem to be four localisations of this process: femoral hemodynamic arteriopathy, starting in Hunter's canal; subclavian hemodynamic arteriopathy due to faulty crutches; axillary hemodynamic arteriopathy due to faulty crutches; and hemodynamic arteriopathy due to an abnormal bony callus. The pathology, etiology, symptoms and arteriograms of the disease have been studied. In the treatment of the disorder, best results have been obtained with grafts. [ABSTRACT FROM AUTHOR]

Discusses some aspects of cardiovascular regulation in humans. Medical view that illness results from the interaction of plural noxious agents in the environment and multiple defenses of the host; Essential features of hypertension and migraine syndrome; List of possible relationship between psychologic stress and high blood pressure; Remarkable coincidence of blushing and blood pressure elevations.

Examines the association between thrombophlebitis and carcinoma. Possibility of an underlying neoplastic lesion to appear from thrombophlebitis; Interval between the initial vascular process and the recognition of the carcinoma; Mechanism of the cause of venous thrombosis in carcinoma.

Anxiety may play a significant role in the production and accentuation of symptoms with organic background in cardiovascular disease. Alleviation of some of the emotional components may be followed by substantial relief of symptoms. The observations made in this study indicate that the regular administration of meprobamate may be effective in this respect and it has been strik- ingly demonstrated, especially in coronary insufficiency and paroxysmal tachycardia. By overcoming anxiety, attacks have been lessened in frequency and intensity and in some instances completely eliminated after meprobamate administration. In the conduct of therapy of cardiovascular disorders in which emotional factors may be very prominent it is recommended that this form of treatment be employed unless contraindication exists. To be sure there may be considerable overlapping in categorizing the cases noted above: patients with essential hypertension may show evidences of coronary disease, or may be subject to crises characterized by paroxysms of tachycardia. In all of these disorders the emo- tional overlay may be of primary importance. Hence, the use of a drug to counteract this is proper therapy. It is important to point out that tranquilizer drug is only an addition to the therapeutic armamentarium. Psychotherapy as employed by the clinician may be essential, and dietary restriction, weight control, vasodilators and circulatory stimulants and anticoagulants when indicated must be used. In a small group of patients it has been found that the addition of meprobamate to Pertrate (penta-erythritol-penta-nitrate) appears to be more effective than Pertrate alone in the control of coronary insufficiency and angina pectoris. The effective- ness of meprobamate in the control of symptoms in mildly disturbed patients with cerebral arteriosclerosis has been satisfactory. Patients of this group, excitable, negativistic and unruly have become obedient, quiet and cooperative, following the regular administration of meprobamate. Extensive studies were made to detect evidences of toxicity. Weekly laboratory examinations including hemograms and evaluation of urinary and liver function yielded no instance of significant alteration. These older patients frequently exhibit subclinical hepatic and renal pathology and are therefore more apt to reveal evidences of toxicity from the drug used. Hence it is especially significant that none was detected in this study. Estimations of prothrombin time by the Link-Shapiro modification of the Quick single-stage technique were made weekly and were all in the normal range. Skin rash was not a problem in this study. It is interesting to note that in two of eight patients with arteriosclerotic endarteritis, claudication was improved strikingly after the use of meprobamate plus dexedrine sulfate at low dosage level. This is being pursued in a continued study. In patients with chronic congestive failure, the addition of meprobamate to the usual supportive therapy has been found helpful in quieting the patient, lessening the anxiety and improving sleep. In vasospastic disorders such as Raynaud's disease meprobamate was without significant effect. The problem of sluggishness or drowsiness after meprobamate arose in some persons taking doses of 400 mg each. Attempts to counteract this by adding 0.5 mg dexedrine sulfate to 400 mg Miltown was not strikingly successful because in some it was followed by sleeplessness at night; hence, the addition of dexedrine was abandoned as a regular procedure. However, with the exception of the elderly patients, it was usually found that meprobamate was equally effective at dosage levels of 200 mg and that the occurrence of drowsiness after this smaller dose was not a problem. For the most part, 200 mg doses are now being used in place of 400 mg in the regular administration of the drug, particularly in patients in whom drowsiness must be avoided. [ABSTRACT FROM AUTHOR]

On the basis of reported follow-up studies on the value of various methods of treatment, the degrees of severity of sequelae of thrombosis of the lower limb are compared. Active movements and ambulation seem to followed by sequelae of the same degree of severity as those resulting from treatment with anticoagulants and active movement. The history of active-movement therapy is briefly reviewed. [ABSTRACT FROM AUTHOR]

A case of thromboangiitis obliterans in a 43-year-old woman is described. Despite prolonged and intensive medication, the peripheral arterial insufficiency led to grave nutritional disturbances in the foot, including necrosis of the toes. Amputation above or possibly below the knee joint was considered. Arteriography revealed a 10-cm arterial obstruction in the femoral popliteal artery. Local re section and reconstruction of the arterial pathway with a venous graft led to rapid regression of the severe signs of ischemia and healing of the ulcers. The formerly incapacitated woman was in very found condition 3½ years after the operation, able-bodied and with only slight symptoms. In order not to overlook the possibility of this type of surgical therapy, it is important that a careful analysis of the arterial network be made in cases of peripheral arterial insufficiency. The result in this case demonstrates the importance of reconstruction of the main artery even in the presence of areas of occlusion in medium-sized and small distal arteries. [ABSTRACT FROM AUTHOR]

Presents a study on the association between pulmonary capillary pressure (PCP) and left auricular (LA) and pulmonary artery pressure in patients with mitral stenosis. Characteristics of tracings obtained under the conditions; Usefulness of mean PCP as an index of mean LA pressures; Variations in the pressures in the pulmonary artery.

The effect of rapid warming on thighs of dogs exposed to a range of temperature from 0° to -20°C. was studied. The foot and lower leg was protected from cold injury to avoid secondary complicating factors, such as infection and thrombosis. The chilling of both thighs in the dog involved a considerable mass of tissue and, in the lower range of temperatures employed, reduced the body core temperature to a considerable degree. This effect, in combination with other factors, produced a fairly high mortality. Thermocouples were used to record superficial and deep temperatures of the tissue of the thigh exposed to cold. It was noted that the extent and depth of injury were greatest in those animals in whom the temperature of the chilled tissues was lower, especially if the lower temperature was maintained for long periods of time. However, there were marked variations in amount of necrosis of skin among different dogs. Necrosis of skin occurred without actual freezing, but required prolonged exposure to cold. In the dog, permanent injury to muscles, determined by histological examination after autopsy, was observed only when there was necrosis of the overlying skin. The reduced temperature of the tissues and probable consequent decreased blood supply during exposure to cold was one of the main factors in determining the final extent of injury. Immediate rapid warming in a bath at 42° to 40°C. markedly reduced the extent of skin necrosis when a large mass of tissue was exposed to cold. [ABSTRACT FROM AUTHOR]

A technique is described, which permits the experimental creation of venous thromboses in the hind legs of rabbits and guinea-pigs. Because of their resemblance to clinical conditions the so created thromboses can be recommended for studies of thromboembolic disease. [ABSTRACT FROM AUTHOR]