A case report of a retroesophageal right subclavian artery causing dysphagia in an adult is presented. The necessity of reestablishing a pulsatile flow in the right subclavian artery to prevent the subclavian steal syndrome is emphasized.
Unifocal ventricular rhythms with rates between 60 and 100 per minute were classified as slow ventricular tachycardias when occurring in patients with acute myocardial infarction. Analysis of selected electrocardiograms showed that the paroxysms were usually automatic, nonparasystolic and intermittent However, in one case, the arrhythmia resulted from the exit block of a faster, parasystolic, ventricular tachycardia. The first ectopic beat in each series appeared either as an escape or as a late extrasystole. Variations in rate attributed to a disturbance of automaticity and/or conductivity were frequently observed. The erratic and unpredictable behavior of this arrhythmia probably reflected the unstable condition of the injured cells during the early stages of myocardial infarction.
The effects of nine weeks of physical training on certain ventilatory variables and the pulmonary diffusing capacity for carbon monoxide were studied in ten university distance runners. A nonexercising control group of five medical students was also investigated. Daily calisthenics and long-distance running as well as frequent participation in competitive meets had no measurable effect on minute volume of ventilation, oxygen uptake, carbon dioxide elimination or diffusing capacity. The lack of training effect of diffusing capacity measured at a single submaximal work load confirms the results of other recent longitudinal studies. Brief review is made of previous investigations into the relationship of diffusing capacity, participation in athletics and physical training. It is pointed out that diffusing capacity is closely correlated with dimensional and functional factors of the oxygen transport system, and that training augmentation of these parameters serves primarily to extend an athlete's maximal work and endurance capabilities. The suggestion is therefore made that training effects on pulmonary diffusing capacity should be studied during maximal work loading.
To achieve total cardiac revascularization, to supply extracoronary oxygenated blood to atria, pacing and conducting systems, the right and left ventricles is best accomplished by revascularizing the intramyocardial arteriolar networks, and joining them together by collaterals. Operations capable of total cardiac revascularization are: 1) single internal mammary artery implant into a tri-arteriolar zone in left ventricular wall; 2) single implant into anterior wall of right ventricle; 3) combining single or double implants with epicardiectomy and free omental graft. Locations of tri-arteriolar zones in human hearts are outlined. Anastomoses between anterior descending and circumflex arterioles and mammary arteries implanted into bi-arteriolar zones are shown experimentally. Experience with patients who had left internal mammary arteries implanted into tri-arteriolar zones alone or combined with epicardiectomy and free omental graft, is outlined. Patients in chronic left ventricular failure with less than 50 percent of viable ventricular muscle have successfully undergone operation.
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