Showing papers in "Angiology in 1969"
289 citations
TL;DR: A new approach, the management of hypertension with Shavasan, where the vast majority of patients fall into the category of essential hypertension, and specific therapy is not available for these cases.
Abstract: Hypertension increases the morbidity and mortality in man. Extensive actuary data have shown that increase in mortality is directly proportional to the severity of blood pressure. In spite of diagnostic advances in recent years, the etiology of hypertension still remains relatively obscure. The vast majority of patients fall into the category of &dquo;essential hypertension&dquo; and specific therapy is not available for these cases. Drugs are therefore necessary for these patients. The antihypertensive drugs available so far are by no means ideal and have many disadvantages. Any new method for reducing blood pressure is, therefore, most welcome. Management of hypertension by measures other than drugs has been envisaged by Bilgutay et al.1 In this communication, we present a new approach, the management of hypertension with &dquo;shavasan,&dquo;
139 citations
TL;DR: The statistical analyses were performed in Northern Europe University Computing Center, Technical University of Denmark, Lyngby, Denmark.
Abstract: From the Connective Tissue Research Laboratories, University of Copenhagen, Department of Dermatology, Rigshospital, Copenhagen, and from Medical Department C, Gentofte Hospital, Hellerup, Copenhagen, Denmark. Supported by Grants from the Danish State Research Foundation and the Danish Heart Foundation. The statistical analyses were performed in Northern Europe University Computing Center, Technical University of Denmark, Lyngby, Denmark. ARTERIOSCLEROSIS IN RABBIT AORTA INDUCED BY
91 citations
59 citations
TL;DR: Although clinical diagnostic procedures, in particular the use of phlebography, have been of great importance for the elucidation of the frequency and extent of thromboembolic disease, autopsy studies are a necessary complement for detailed information in this respect.
Abstract: Although clinical diagnostic procedures, in particular the use of phlebography,7-14 have been of great importance for the elucidation of the frequency and extent of thromboembolic disease, autopsy studies are a necessary complement for detailed information in this respect. Such studies must include, besides a thorough investigation of the pulmonary arterial system with its smallest ramifications, a complete venous dissection of the lower extremities. However, extended dissections of this kind are cumbersome and time-consuming, and are associated with such great practical inconveniences that they have been performed thoroughly only by a few investigators. 4, 15 In order to facilitate the pathoanatomical exploration of the veins of the lower leg for broad postmortem studies of the frequency and significance of
33 citations
TL;DR: Electrical stimulation of the carotid sinus nerve (CSNS), sometimes called baropacing, has been proposed as a treatment of uncontrolled essential hypertension and relatively few studies on cardiac performance during CSNS have been reported.
Abstract: Electrical stimulation of the carotid sinus nerve (CSNS), sometimes called baropacing, has been proposed as a treatment of uncontrolled essential hypertension.l,2 2 Although the method has been applied clinically, relatively few studies on cardiac performance during CSNS have been reported. The role of the carotid sinus in the regulating of systemic blood pressure was first described by Hering in 1923.3 The carotid sinus &dquo;baroreceptors&dquo; are stretch receptors which are stimulated by an increase in mean arterial pres-
31 citations
TL;DR: The circulation to solid cancer tissue is of fundamental interest because the present blood-borne cancerocidal drugs and tumor antisera depend on contact of the agent with tumor cells.
Abstract: From the Department of Surgery, University of Texas Medical School at San Antonio, Texas, and the Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota. This work was supported in part by a research grant (T-156) from the American Cancer Society. The present blood-borne cancerocidal drugs and tumor antisera depend on contact of the agent with tumor cells. Therefore, knowledge of the circulation to solid cancer tissue is of fundamental interest.
31 citations
TL;DR: This study is one of a group, the overall purpose of which is to join the three-dimensional knowledge of living histology with that of microphysiology, pathologic physiology and histopathology by equations, making these largely separate disciplines into a single dimensional science.
Abstract: This study is one of a group, the overall purpose of which is to join the three-dimensional knowledge of living histology with that of microphysiology, pathologic physiology and histopathology by equations, making these largely separate disciplines into a single dimensional science (using the word &dquo;dimension&dquo; in the sense in which it is used by Bridgman2’-) . This will permit the use of mathematics to analyze certain biologic phenomena and to make
29 citations
29 citations
TL;DR: The cerebral form of thromboangiitis may be most suitable, because, in contrast to the limbs, the brain is best protected from influences of external pathogenetic factors such as cold and superimposed secondary phenomena like infection and gangrene unrelated to the primary disease.
Abstract: From the Max-Planck-Institut für Hirnforschung, Dept. of General Neurology and the Neurological Clinic of the Städtische Krankenanstalt, Köln-Merheim, Germany. We have chosen the provocative title of this paper because scientists of international standing as R. Adams, C. Miller Fisher and von Albertini deny the existence of such an entity of vascular disease as von WiniwarterBuerger’s thromboangiitis obliterans. Definitions of the pathology, etiology, pathogenetic factors and the clinical diagnosis would lead us to endless and fatiguing enumeration of details (see v. Winiwarter,l Burger von Hasselbach,3 Llavero,~ Meyer,~ Eicke,6 Spatz,’ and Lindenberg and Spatz.8 For discussion the cerebral form of thromboangiitis may be most suitable, because, in contrast to the limbs, the brain is best protected from influences of external pathogenetic factors such as cold and superimposed secondary phenomena like infection and gangrene unrelated to the primary disease (see original case of von Winiwarter1) . In many thousand autopsies, we only saw two instructive cases. Thromboangiitis, therefore, seems to be a very rare disease. Case 1. A 31-year-old man suddenly died from a massive hemorrhage of &dquo;atypical&dquo; site, i.e., in the frontal lobe. However, the large basal arteries of the brain did not show any pathologic manifestations. On the other hand, on the surface we found &dquo;whitish, bloodless, solid, shrunken&dquo; terminal arteries of the cortex (fig. 1). These findings being systematically observed all over the cerebral and cerebellar convexity (fig. 2), seem to be the first characteristic feature of this disease, particularly in the zone near the granular atrophy (fig. 3). However, single vessels of this type which are found distally
25 citations
TL;DR: An experimental model that results in a constant and extremely elevated incidence of easily observed large occlusive thromboses in rats, provided the animals are fed certain high-fat diets for 6 to 10 weeks is devised.
Abstract: A few years ago, Pickering’ noted, &dquo;The great weakness of the lipid hypothesis is that it does not account for the thrombus.&dquo; He did not consider as satisfying to a clinician that alterations in lipid metabolism could also predispose to thrombosis. Nevertheless, numerous studies have indicated a relationship between thrombosis and hyperlipemia,2-4 as well as the importance of lipids in blood clotting~ ; in addition, there is a strong possibility that the longchain saturated fatty acids of the dietary fat are responsible for thrombosis6 being by far the most effective fatty acids in aggregating blood platelets in vitro.7, 8 In recent experiments in rats, we devised an experimental model9 that results in a constant and extremely elevated incidence of easily observed large occlusive thromboses, provided the animals are fed certain high-fat diets for 6 to 10 weeks.l° Thrombosis is then initiated by the intravenous injection of a Gram-negative bacteria endotoxin, resulting in multiple, red hepatic infarcts, and a simple quantitative evaluation of the phenomenon can be
TL;DR: Cushny,l in 1897, while performing high-dose digitalis experiments on animals, is given credit for first describing the phenomenon, however, Knoll’s work in which he produced atrial standstill, giving helleborein to animals is mentioned.
Abstract: Cushny,l in 1897, while performing high-dose digitalis experiments on animals, is given credit for first describing the phenomenon. However, he also mentions Knoll’s work in which he produced atrial standstill, giving helleborein to animals. In 1908 Laslett2 also showed with experiments on animals that with increased vagal tone he could produce atrial standstill. Lewis et a1.,3 in 1913, produced this in cats in the preterminal stages of asphyxia. Boden and Neukirck,4 in 1921, using isolated perfused rabbit’s hearts and fetal hearts, gave quinidine and produced atrial standstill. They could reverse this with a perfusion of Tyrode’s solution. Haggard,5 the same year, with experiments using dogs, showed that he could produce atrial standstill
TL;DR: Monitoring of the central venous pressure has been widely accepted and applied clinically, primarily to the patient who has sustained major trauma or is undergoing certain operative procedures, in particular those dealing with the cardiovascular system.
Abstract: Monitoring of the central venous pressure has been widely accepted and applied clinically, primarily to the patient who has sustained major trauma or is undergoing certain operative procedures, in particular those dealing with the cardiovascular system. Plastic central venous catheters are placed either by the percutaneous technique or by surgical exposure of a peripheral vein. Except for the incidence of hemopneumothorax associated with percutaneous subclavian vein catheterization, both methods share similar complications, namely, thrombosis with or without embolism, infection, local hematoma, embolization of a catheter segment and perforation of the vein by the catheter tip. We have encountered three
TL;DR: This appears to be the first reported instance of abdominal aortic aneurysm associated with Osler’s disease, a rare malady characterized by its familial occurrence passed on as a mendelian dominant, the presence of typical telangiectases and by the tendency of the telANGiectatic areas to bleed.
Abstract: ease when, in 1901, he wrote his classic paper. lVeber4 elaborated upon the description and emphasized the clear-cut differences between hemorrhagic telangiectasia and hemophilia. He noted especially the absence of sex-linked transmission and the tendency for nosebleeds to occur before telangiectases were manifest. The disease is characterized by its familial occurrence passed on as a mendelian dominant, the presence of typical telangiectases and by the tendency of the telangiectatic areas to bleed. Pulmonary arteriovenous fistulae 5-8 gastrointestinal bleeding,9-13 hematuria 14 and hepatic telangiectasisls, 16 have been recognized for some years as possible accompaniments. Aneurysms of the splenicl7 and hepatic arteries have also been found in patients afflicted by this uncommon disease. More recently, aortic aneurysm has been mentioned in association with Osler’s disease. Thomasl° reported a patient who died from dissecting aneurysm of the aortic arch, and Muggia2° observed a patient with radiologic evidence of an aneurysm of the aortic arch. Necropsy in Thomas’ case revealed areas of cystic necrosis in the media of the aortic arch. Our contribution is to describe a patient with Osler’s disease who had multiple aneurysms of the large vessels. This appears to be the first reported instance of abdominal aortic aneurysm associated with this rare malady.
TL;DR: When proteolytic enzymes first became available as therapeutic agents, the most obvious field of application seemed to be thrombophlebitis, because the expectation was that these enzymes were fibrinolytic and therefore would lyse the thrombi.
Abstract: When proteolytic enzymes first became available as therapeutic agents, the most obvious field of application seemed to be thrombophlebitis. The expectation was that these enzymes were fibrinolytic and therefore would lyse the thrombi. Numerous clinical studies were published which indicated that intramuscularly administered trypsin and chymotrypsin had a favorable influence on the inflammatory process in thrombophlebitis.l3 Among these studies was a double-blind investigation by Kryle et a1.,4 showing excellent results in 28 of 39 thrombophlebitis patients treated with trypsin i.m. as compared to 5 of 43 patients given placebo. The general experience was that the proteolytic enzymes were more effective
TL;DR: The subclavian steal syndrome, at first angiographically observed by Cotorni7 in 160, and according to clinical experiments determined by Reivich et a1.2 in 1961, has expectedly gained practical importance in the past years and is to be understood as an occlusion or a stenosis.
Abstract: From the Medizinische Klinik und Poliklinik der Freien Universität Berlin in Klinikum Westend (Director: Prof. Dr. G. A. Neuhaus) and the I. Innere Abteilung des Städtischen Krankenhauses Berlin-Moabit, Berlin, Germany (Director: Prof. Dr. O. Bayer). Presented at the 10th Annual Meeting of the International College of Angiology, Geneva, July 24-27, 1968. 1. Scientific Session. The subclavian steal syndrome, at first angiographically observed by Cotorni7 in 160, and according to clinical experiments determined by Reivich et a1.2 in 1961, has expectedly gained practical importance in the past years. Up to now we have noticed some 203 publications and 386 cases described in the Anglo-American as well as German and French literature, of which information was given lately in a comprehensive summary.3 Up to now, the German literature has published some 27 compositions on subclavian steal syndrome and reported on 97 cases (table 1). In the Anglo-American literature, comparable summary reports were submitted by Patel and Toole, 29 Killen et al.,3° Santschi et a1.31 and Solnitzky.32 Recently, Labauge et al.33 also published results of an important case analysis. A subclavian steal syndrome is to be understood as an occlusion or a stenosis
TL;DR: Animal studies indicate the prevention and remission of experimental atheroma in rats and dogs and in rabbits under controlled conditions as well as successful veterinary use and it was felt that a controlled trial in human cerebral athersoma would be of benefit.
Abstract: From Powick Hospital, Worcester, England. &dquo;Strokes&dquo; due to cerebrovascular disease account for nearly one-fifth of all present deaths, compared with 9 per cent of all deaths in 1935,~ and the mortality and morbidity continue to rise. The etiology of atheroma is in dispute, but it has been suggested that ischemia of the middle zone of the arterial walls caused by intimal thickening leads to loss of oxidative enzymes, with consequent accumulation of cholesterol and other fats in the inner zone of the arterial ~=a11.2 Abnormally low values of various enzymes, principally dehydrogenases, have been found in atheromatous artery walls,3 whereas the activity of aldolase is apparently decreased in sclerotic parts of the aortic wall and increased in normal parts of the same aorta.4 Diminution of adenosine triphosphatase activity is said to precede the development of any observable anatomic change.5 There have therefore been several attempts to treat atheroma with various enzymes including j3glueuronidase,&dquo; cytochrome c7 and hepatic catalases as well as with such substances as nicotinic acid,9 metal ionsl° and estrogens, which may well act enzymatically.ll The subject is well reviewed by Kask.11 The enzyme preparation used here has been reported to be successful in atheroma by many authors, some listed here.~2-2o Although these trials were uncontrolled, large numbers (e.g., Forster21 had 2187) of patients were used and often objective criteria of improvement, e.g., skin reddening time, 22 the elasticity coefficient of vascular walls23 and pulse wave velocity.l2 Cerebral atheroma patients may do particularly well.19, 24, 25 Animal studies indicate the prevention and remission of experimental atheroma in rats and dogs26 and in rabbits27 under controlled conditions as well as successful veterinary use28 and we felt that a controlled trial in human cerebral atheroma would be of
TL;DR: A case of chronic poisoning by ergotamine tartrate is presented, interesting by the appearance of acute circulatory signs which occurred during suppression of the medication.
Abstract: Chronic ergotism appears both epidemically and sporadically with druginduced etiology. These two forms constitute poisoning by ergot alkaloids, which are derivatives of lysergic acid. We present here a case of chronic poisoning by ergotamine tartrate, interesting by the appearance of acute circulatory signs which occurred during suppression of the medication. These signs were confirmed by roentgenogram and necessitated surgical treatment.
TL;DR: The method described here is based on Von Kossa's reaction for calcium, one which is easily performed and permits gross demonstration of calcifications of the inner elastic membrane, M6nekeberg’s sclerosis and calcific deposits in the atherosclerotic plaques.
Abstract: The method described here is based on Von Kossa’s reaction for calcium, one which is easily performed and permits gross demonstration of calcifications of the inner elastic membrane, M6nekeberg’s sclerosis and calcific deposits in the atherosclerotic plaques. This technique also facilitates selection of representative specimens for further microscopic or microradiographic examination, especially if tangential sections are preferable.
TL;DR: With the advent of safe angiography and the adjuncts of subtraction and cineradiography, worthwhile advances in diagnostic accuracy have been made and it has become possible not only to determine the location of a lesion such as a plaque in the carotid bifurcation, but also to out-
Abstract: events which have certain features in common. In one of the institutions in which I received training, the word &dquo;stroke&dquo; was defined as &dquo;the term used when the lazy physician does not know his patient’s anatomical diagnosis, and is considerably less than enthusiastic about finding it out.&dquo; Not only does the expression fail to signify any one etiologic agent, or even any one group of etiologic agents, but in some instances the very use of the word &dquo;stroke&dquo; becomes an obstacle to further clinical investigation and in effect eliminates the possibility of therapy. Despite the acceptance of defeat that is implicit in this kind of rough categorization, there has been throughout the same two centuries a parallel effort to define the entities that cause the stroke syndromes, and to distinguish those that might be amenable to treatment from those that have been clearly not amenable to means of therapy available in the workers’ respective eras. As early as 1761, Morgagni classified strokes as hemorrhagic and nonhemorrhagic. It was long believed that nonhemorrhagic strokes resulted from ischemia due to arterial occlusion. During the last two decades, however, with the advent of safe angiography and the adjuncts of subtraction and cineradiography, worthwhile advances in diagnostic accuracy have been made. By the use of such aids, it has become possible not only to determine the location of a lesion such as a plaque in the carotid bifurcation, but also to out-
TL;DR: The tortuosity of varicose veins, especially their peculiar serpentine course, is investigated, prompted by Leopold and W olman’sl article entitled, River meanders, in which meanders are described as being formed by erosion and sedimentation of material from the river banks and a consequent reshaping of the river to a regular serpentine pattern.
Abstract: ence on venous tone, increased venous pressure and prolonged standing. The actual cause of the disorder, however, still baflles research. By definition a varix is a &dquo;dilated, elongated and tortuous vein.&dquo; An approach to the etiology of varices may include a study of these three morphologic criteria of the disease. This paper concerns the tortuosity of varicose veins, especially their peculiar serpentine course. The investigation was prompted by Leopold and W olman’sl article entitled, &dquo;River meanders,&dquo; in which meanders of a river are described as being formed by erosion and sedimentation of material from the river banks and a consequent reshaping of the river to a regular serpentine pattern. The underlying mechanism of this modification of the course of a river has been cleared up by Leopold and Langbein.2 2
TL;DR: From the Departments of Internal Medicine, Temple University Health Sciences Center, Philadelphia, and the Mercy Hospital, Wilkes-Barre, Pennsylvania: Statements regarding the Osler’s node as a pathognomonic sign of subacute bacterial endocarditis still abound in the medical literature.
Abstract: From the Departments of Internal Medicine, Temple University Health Sciences Center, Philadelphia, and the Mercy Hospital, Wilkes-Barre, Pennsylvania. Statements regarding the Osler’s node as a pathognomonic sign of subacute bacterial endocarditis still abound in the medical literature. Although it is true that the mucocutaneous lesions, such as Osler’s nodes, Janeway’s spots, conjunctival petechiae and splinter hemorrhages, are more frequently seen in patients with subacute bacterial endocarditis than with other conditions,
TL;DR: This work suggests that shock whether due to hemorrhage, cardiac damage or infection with gramnegative bacteria and their contained endotoxin, culminates in a final common pathway of baroreceptor-mediated, increased sympathetic nervous system activity with viscerocutaneous vasoconstriction, reduced tissue perfusion and death.
Abstract: From the Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota 55455. Supported by USPHS Grant HEO 2941, Minnesota Heart Association, Army Research and Development and Commonwealth Electric Fund. a Sterling-Winthrop Research Fellow. b Research Fellow in Surgery. c USPHS Postdoctoral Research Fellow. d Professor of Surgery. Recently, the &dquo;Unitarian Concept&dquo; of shock has met a serious challenge.1-3 This idea, developed primarily in the experimental laboratory, suggests that shock whether due to hemorrhage, cardiac damage or infection with gramnegative bacteria and their contained endotoxin, culminates in a final common pathway of baroreceptor-mediated, increased sympathetic nervous system activity with viscerocutaneous vasoconstriction, reduced tissue perfusion and death.4 Each of these forms of shock in the laboratory is associated with a reduced cardiac output and blood pressure and activation of baroreceptors. Under these conditions, sympathetic activity is increased producing vasoconstriction in the viscerocutaneous vascular beds, resulting in increased systemic and regional resistance and ending in stagnant anoxia. Consequently, most types of shock are considered to be a variant of this low-output, high-resist-
TL;DR: It would appear that abnormalities of the platelets and clotting mechanism contributed to the gangrene in the patient with severe Raynaud’s phenomena.
Abstract: some known condition such as a collagen disease. 1, 2 The patient in this report presented with severe Raynaud’s phenomena, complicated by gangrene of one digit and spasmodic pain in the hand and other fingers. Investigations for any of the usual underlying causes were negative, but it would appear that in this case abnormalities of the platelets and clotting mechanism contributed to the gangrene.