A case of dissecting aneurysm of the thoracic aorta is presented. Leakage from the aorta formed an extrapleural hematoma. This hematoma appeared as a round mass with a well-delineated border on chest x-ray examination. The value of this x-ray finding in the diagnosis of dissecting thoracic aorta is emphasized.
The Editorial Board is pleased to announce the appointment of Dr. John H. K. Vogel as Department Editor of our new section, “Cardiovascular Techniques.” Dr. Vogel is Associate Professor of Medicine and Director of the Cardiovascular Laboratory at the University of Colorado Medical School, Denver. He received his M.D. degree from the University of Washington and had residency training in internal medicine at Vanderbilt University Hospital, 1958-60. From 1960-63, he was a Fellow in cardiology at the University of Colorado Medical Center. Fellowship awards include a post-doctoral research fellowship, USPHS, 1960–63 and an advanced research fellowship, American Heart Association, 1963-65. He is chairman of the western section of the American Federation for Clinical Research.
A. Soffer, M.D.
Hemorrhage in the atrioventricular conduction system and myocardial necrosis commonly occur in the first week after valve replacement. Later, thrombosis on the prosthesis and infarcts in other organs become important but developing or persistent myocardial damage continuously menaces. Occlusion of small vessels, especially by embolism of foreign material, may contribute to the development of these lesions. Although the extracorporeal circulation, anticoagulation, cardiac pacing and steroid therapy generally applied to patients undergoing Starr-Edwards valve replacement either are necessary to the surgery or effectively overcome some potent dangers, these practices may disguise progression to more serious levels of some maladies induced by operation. Data accumulating from these autopsies and from clinical records include many and varied complications of surgery.
The Mono-Vacc tuberculin test was evaluated in a group of 1,423 individuals, the standard for comparison being simultaneously administered Mantoux (PPD, 5 TU). In approximately one-half of these individuals, it was compared with the tine tuberculin test as well. The Mono-Vacc test was found to be acceptable for screening patients for tuberculin sensitivity. It was easily applied, highly acceptable to patients, and produced readily measurable induration. False negative reactions occurred in 1.2 percent which is within the intratest variability of the Mantoux test and thus unlikely to be statistically significant. The primary limiting factor was an 8.4 percent incidence of false positive reactions. However, the ease with which this test is applied would appear to more than compensate for the time spent in retesting with the Mantoux those who prove to be false positives. The tine tuberculin test was found to give similar results, but was more difficult to read and was less acceptable to patients.
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