Harold Stern

EXPERIMENTAL CARDIAC HYPERTROPHY: CONCENTRATIONS OF RNA IN THE VENTRICLES.

Banding of the aorta or pulmonary artery in puppies produces a selectively increased concentration of RNA in the ventricle with the increased hemodynamic load as compared to the opposite side or to normal hearts. The increase in concentration of RNA following distortion of the myocardial cell may represent a fundamental response of growth and the system described mayserve as a useful model for its study.

The roentgen aspects of intramural dissection of the esophagus. The mucosal stripe sign.

INTRAMURAL DISSECTION of the esophagus is an unusual type of rupture involving the mucosal layers of this viscus. The purpose of this report is to delineate the radiographic appearance of this entity following contrast studies and to emphasize the importance of differentiating it from the more ominous extraluminal perforation. The radiographic changes produced by intramural dissection of the esophagus may show a striking similarity to the typical roentgen findings in dissecting aneurysm of the aorta. In our case, true and false esophageal lumina were demonstrated, separated by a mucosal stripe resembling the appearance of the intima in aortic dissection. This finding differs from that seen in extraluminal rupture of the esophagus, which usually occurs as a longitudinal slit in the left posterolateral wall of the lower esophagus within 5 to 6 cm of the cardia. Radiographic signs of extraluminal extravasation of contrast media are virtually diagnostic of this potentially lethal condition when associated wit...

The Role of Pulmonary Angiography in Pulmonary Embolism: A Comprehensive Review of the Roentgen Findings

This paper was presented at the 12th Annual Meeting of the American College of Angiology, New Orleans, Louisiana April 21-23, 1966. We are indebted to James O. Hoppe, Ph.D., Section Head, Department of Pharmacology of the Stering-Winthrop Research Institute for his aid in the study of the contrast media utilized in these procedures. There is substantial evidence that pulmonary embolic disease represents a major cause of death. It has been indicated that pulmonary thromboembolism may be the sole cause of death of 47,000 persons annually in the United States and a contributing factor in three times as many more deaths (2, 5). Studies have been made of pulmonary thromboembolism employing the measurement of blood enzymes, pulmonary scanning after injection of radioactive macroalbumin, and clot detection after tagging with radioactive fibrin or plasminogen (22, 29). There has been critical appraisal of the current medical and surgical therapy now being utilized (27). Observations have also been made of the pharmacological and mechanical effects resulting in bronchoconstriction and vascular constriction associated with acute pulmonary embolism. It is acknowledged that a better understanding of pulmonary embolism in all of its aspects may lead to an early precise diagnosis with institution of proper therapy. A high suspicion and the recognition of the manifestations of the disease in chest roentgenograms are essential. Moreover, it is important to stress that an aggressive approach must be urged with utilization of pulmonary angiography as a necessity for accurate diagnosis and as a guide to proper therapy (1, 32). The papers on pulmonary embolism by Westermark (31), Hanelin (14) and Eyler, Torrance (28), and others have been mainly concerned with the evaluation of the plain chest roentgenograms (9). Fleischner (10) has described these radiologic findings utilizing the terms oligemia to designate diminished blood flow and ~leonemia to designate increased blood flow to the lung. These terms have been utilized subsequently by Chrispin (4) and other authors (20, 23, 25) to describe the roentgen findings associated with pulmonary embolism.

Carcinoid and Adenoid Cystic Carcinoma of the Bronchus

Abstract A careful study of the pharmacology of individual carcinoid tumors may increase our knowledge of such tumors. It may also be rewarding in other fields because of the biological interaction of kinins, serotonin, histamine, prostaglandins, and other agents. The poor correlation of signs and symptoms of the carcinoid syndrome with chemical assay may be due to lack of knowledge. The carcinoid syndrome must be considered a spectrum [130], and its diagnostic criteria should be liberalized. It is important to recognize the frequent association of carcinoid with other endocrine disorders, which in some instances may be best treated by removal of the carcinoid. History and gross appearance seem more reliable prognostic indicators than histological evaluation. Metastases may be consistent with long survival but on occasion indicate a rapid lethal course. The relation of carcinoid to oat cell carcinoma is pertinent. Cytology may be positive. All modalities of therapy, including operation, must be individualized. The smallest adequate cancer operation is the procedure of choice. More knowledge of the role of radiation therapy is needed.

Application of induced pulmonary arterial collateral circulation as collateral supply to the heart.

Summary When adhesions are created between the heart and a lung the pulmonary artery of which has been ligated, abundant large connections develop between the coronary arteries and vastly expanded bronchial arteries. The efficiency of these connecting vessels as collateral blood supply to the heart is under investigation.

Intrathoracic goitre: A cause of the superior vena cava syndrome

Benign lesions of the mediastinum rarely produce obstruction of the innominate vessels. Two patients with intrathoracic goitre are described who presented with the superior vena cava syndrome. Venography in each case demonstrated the extent of obstruction and degree of collateral circulation. Early recognition of the association of intrathoracic goitre and superior vena caval obstruction may lead to clinical improvement with surgical treatment.

Pulmonary Embolism and Intracardiac Shunt: A Unique Indication for Operation

Pulmonary embolism with right-to-left intracardiac shunt presents a special problem for the clinician. A review of the literature and 4 personal cases, all diagnosed antemortem, are presented. On the basis of this information certain conclusions are drawn, and we suggest the problem to be a unique indication for the consideration of surgical intervention.

New clamp for intraoperative chest tube placement.

We describe an instrument designed specifically to avoid the pitfalls of intraoperative chest tube placement.