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The electrocardiographic effects of 25 chemically produced myocardial lesions in dogs were studied. Eleven of these were restricted to the subepicardial half of the left ventricular wall, 2 were located in the posterior basal portion of the left ventricle, and 12 were located in the right ventricular wall. Eight of the 11 subepicardial left ventricular lesions altered only mid-temporal and terminal portions of the QRS complex. The other 3 lesions were all located near the interventricular septum and altered early as well as later portions of the QRS. The 2 lesions of the posterior basal left ventricular wall altered only mid-temporal and terminal portions of the QRS complex. Right ventricular lesions in the right lateral wall near the base and those near the interventricular septum altered early as well as late portions of the QRS complex. Other right ventricular lesions altered only mid-temporal and terminal portions of the QRS. The significance of these findings may be summarized as follows: (1) Lesions in a variety of locations cannot be recognized by electrocardiographic standards which require abnormalities of the initial portion of the QRS complex. (2) Recognition of the relatively small and variable electrocardiographic effects of subepicardial, posterior basal, and right ventricular lesions may require modification of current clinical electrocardiographic techniques and standards for the diagnosis of myocardial infarction (3) The finding that most subepicardial lesions did not alter initial portions of the QRS is not consistent with reported evidence that activation of only subepicardial portions of the heart contributes to the form of QRS deflections.

Two cases of Tracheal tumor are presented.47 year old male, complaining of intermittent dyspnea getting worse past 6 months, was admitted for removal of the tumor from tracheal wall.Under local anesthesia, patient was placed in supine position, and the Tracheotomy was carried out on 3rd through 6th tracheal Ring.The tumor which was well pedunculated was removed from posterior wall of trachea, and electrocautery was applied at steeled area.Tumor was proved to be adenoid cystic carcinoma histologically. The incision was well closed in usual maneuver.54 year old male was admitted to the Department of Chest Surgery on emergency base of acute dyspnea.Patient had had intermittent dyspnea past 1 year.Patient was prepared in same manner as former patient was done. The tumor, arising from right lateral wall, was removed without any disturbance of Respiration in quick procedure.Recurrence was noted 3 months after operation, and the patient is ready for resection of trachea.Literatures were reviewed together and the management of rescue of airway problems was discussed.

Case 33: Impermeable Deep Stricture. —A man, 38 years of age, was referred to me by Dr. M. W. Thompson, of Chicago. Had a history of successive attacks of gonorrhea extending over a period of years. Symptoms of urinary obstruction had existed for some four or five years, and had increased until the stricture had become surgically impermeable. I performed perineal section without a guide, found the urethra extremely hard and nodular from the perineo-scrotal junction well down into the membranous portion. The stricture practically involved the entire extent of the latter. Considering the rather complicated state of affairs the bladder was reached with considerable rapidity, the operation requiring about eight minutes after the opening of the urethra. A small fibrous tumor was found in the right lateral wall of the urethra in the midst of the stricture tissue. This was about the size of a fat pea and was