Reuven Terdiman

Hemodynamic correlates of the normal aortic valve echogram. A study of sound, flow, and motion.

SUMMARY The aortic valve echogram was recorded in open chest dogs simultaneously with aortic flow, acceleration of flow, aortic and left ventricular pressures, and intracardiac phonocardiograms.Comparison of echographic with hemodynamic data showed the following: The aortic valve started its opening with the onset of flow, at the same point that left ventricular pressure exceeded aortic pressure. Complete valve opening preceded peak aortic flow by an average of 43 msec and the cusps started to move toward closure while flow was still accelerating. Final closure of the valve was achieved at the time of zero flow and preceded the aortic second sound by 4–10 msec. The echographically determined “valve orifice area” correlated well with aortic stroke volume (r = 0.94). The intensity of the aortic first sound was related to peak acceleration of aortic flow. The intensity of the second sound was not related to the amplitude of cusp motion but correlated well with the aortic pressure at the time of closure and with peak flow deceleration.

Selective screening for colorectal tumors in the Tel-Aviv area: Relevance of epidemiology and family history

A selective screening program for the early detection of colorectal tumors was carried out in the Tel‐Aviv area. The criteria for inclusion were based, in part, on relevant epidemiologic data which showed that European‐ and American‐born immigrants were at the highest risk for developing this cancer, followed by Israeli‐born Jews. The Tel‐Aviv area, because of its large elderly population of European origin, has a high incidence of colorectal cancer. Families of patients with colon cancer are known to have an increased risk for developing colon tumors. These relatives were actively searched for, and were, along with the control group, examined by Hemoccult testing and flexible sigmoidoscopy. The colon tumor (cancer or adenomatous polyps) rate was 6.3% in the group with a family history of colon cancer, as contrasted to 3.8% in a similar control group without this history. This increased yield, greater than usually found in an unselected population, emphasizes the economic value of selective screening utilizing relevant epidemiologic data and the family history.