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Copyright of Langenbecks Archiv fuer Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Langenbecks Archiv fuer Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Studies the causes and prevalence of left ventricular hypertrophy in patients with clinical diagnosis of chronic bronchitis and emphysema associated with severe hypoxemia and hypercarbia. Etiological factors that have been postulated for the occurrence of hypertrophy of the left ventricle; Criteria used to determine the causes and prevalence of the disease; Possible causes of left ventricular hypertrophy.

The effect of tolazoline on forefoot blood flow in patients with obliterative atherosclerosis has been compared after intra-arterial and intravenous injection. The forefoot blood flow increased considerably after injection in most of the patients. The flow increase was practically identical whether tolazoline was injected intra-arterially or intravenously, and was most marked in patients with moderate peripheral arterial insufficiency. The flow increase was accompanied by a significant augmentation of the systemic blood pressure. In the majority of the patients tolazoline also caused considerable reduction of the peripheral resistance of the foot both after intra-arterial and intravenous administration. The increase was, however, least—or was lacking—in patients with severe skin ischaemia. The collateral pressure gradient did not decrease after the injection of tolazoline. It is concluded that tolazoline may be a valuable drug in selected patients, although the effect is most uncertain in patients with the most urgent need for augmented flow. Intravenous administration of tolazoline should be preferred. [ABSTRACT FROM AUTHOR]

In summary, a prognostic and therapeutic evaluation of 227 patients first seen from 1967 to the end of 1969 with a follow-up of 4–7 years was made. The results are indeed depressing. In spite of close follow-up and systematic treatment with modern antihypertensive agents, the mortality of patients having hypertension with superimposed arteriosclerosis was 27% (15 to 56) for males as contrasted to 3% (2 of 75) for females. Since the last casual blood pressure in both living and deceased patients of the mixed group were similar, the level of blood pressure following treatment could not be incriminated for the deceased patients. An exaggerated systolic and pulse pressure cold pressor response emerged as an important indicator of presence of arteriosclerosis alone. When hypertension and arteriosclerosis coexisted there was also exaggeration in diastolic cold pressor response. A further exaggeration in systolic and diastolic cold pressor response was seen in the deceased as compared to living male patients, a finding which appears to have grave prognostic significance for coronary heart disease and stroke. Thus a marked exaggeration in both systolic and diastolic cold pressor response in males might prove to be the single most important predictor of premature death from atherosclerotic vascular disease. A further analysis of the deceased male patients having hypertension and superimposed arteriosclerosis, indicates that treatment of hypertension may prevent death from stroke but not from coronary heart disease. Two-thirds of the deaths occur suddenly and only one-third of the deceased patients reach the hospital before dying. In view of these distressing findings a plea for early detection and treatment of hypertension, prior to the development of superimposed arteriosclerotic changes, particularly in males, is made. [ABSTRACT FROM AUTHOR]

Focuses on the panel discussion regarding human arterial atherosclerosis. Indication of endothelial cell damage; Investigation on the reactions of the components of the vessel wall in intima; Selection of the different types of damaging agents.

The selective coronary arteriography has proved of immense help in the delineation of patterns of coronary arterial disease in living man. This report describes three patients who were referred for coronary arteriography because of disabling angina and with the clinical impression of arterioscterotic heart disease. On selective cineangiography the coronary arteries were found to be patent. Coincidentally, coronary arteriovenous fistula was found in these patients. Ligation of the fistula in two patients who underwent surgery resulted in complete relief of chest pain. Surgical correction has not been accomplished in the third patient as of yet. The mechanism of `coronary steal syndrome is briefly discussed. [ABSTRACT FROM AUTHOR]

Studies on electromyographic changes in the lower limbs have been published in connection with obliterative arterial changes, because the blood supply of the sciatic nerve and its branches has its origin in the common iliac artery. Previous studies have dealt with maximal motor conduction and no differences have been shown in the conduction velocity of the femoral nerve between ischaemics and controls. The authors examined 18 patients with intermittent claudication due to obliterative arteriosclerosis, and 18 age-matched controls. On five of the patients either a thrombendarterectomy or a by-pass reconstruction was performed; these patients were examined again postoperatively. The maximal motor conduction velocities (MCV) of the deep peroneal and the posterior tibial nerve were measured as well as the conduction velocity of the slower fibers (CVSF) of the former. As a group the claudication patients differed from normal age-matched controls in regard to the CVSF of the lateral popliteal nerve and in regard to the total sum of conduction velocities of the nerves in lower extremities. When individual patients were surveyed, it was noted that 6 out of 18 had slight damage in at least two peripheral nerves, and only five of them had all their conduction velocities within the range of normal controls. Operative correction of the arterial circulatory deficit improved nervous function as indicated by the improvement of conduction velocities. The site of obstruction did not exhibit a statistically significant correlation to conduction velocities. Our findings, especially the slowing of the CVSF of the deep peroneal nerve, would suggest partial demyelination of a motor nerve in these patients. [ABSTRACT FROM AUTHOR]

Multitechnical non-invasive procedures were used to assess the arteriolar effects of cinnarizine and its difluoroderivative, flunarizine, in 20 normal volunteers and in 43 elderly patients with occlusive disease of the extremities due to arteriosclerosis, 22 of whom had intermittent claudication. The trial involved six separate studies of which three were double-blind cross-over, one was a 6-month open study followed by a 6-month double-blind study and two were open studies. Significant drug-related effects were obtained by venous occlusion plethysmometry, differentiated pulse plethysmometry, oscillometry, claudicometer, postexercise arm-ankle pressure gradients and exercise tolerance measurements, but not by light plethysmometry and skin temperature measurements. The results indicated that cinnarizine and flunarizine improved vascular distension and blood How in normal volunteers, as well as in patients with occlusive disease of the extremities due to arteriosclerosis. The patients also showed increased postexercise arm-ankle pressure gradients, improved arterial pulsations and better exercise performance and tolerance. The drugs were devoid of effects on sympathetic reflexes, resting blood pressure and pulse rate; they were devoid of side-effects and were well tolerated also by patients treated with antihypertensives and cardiac glycosides. Flunarizine was at least as effective as its parent compound at two to three times lower dose levels. [ABSTRACT FROM AUTHOR]

Male and female virgin rats, with no arteriosclerosis and male anti female breeder rats with pre-existing arteriosclerosis were given chronic injections of a contraceptive drug, Enovid, for 4, 8, and 12 weeks. All of the treated animals exhibited a marked loss in body weight, adrenal glandular hypertrophy and hemorrhage concomitant with severe thymus gland involution, degranulation of pituitary gonadotrophic cells, and testicular and ovarian atrophy. Serum enzymes, e.g., CPK, SGOT, SGPT & LDH, were first greatly elevated and thon their level receded. The Enovid-treated animals developed a fatty liver, hypertriglyceridemia, elevated free fatty acids and hypercholesterolemia. Although the drug-treated animals were acutely diabetic, all of them eventually manifested hypoglycemia despite beta cell degranulation. Serum corticosterone levels were subnormal suggestive of adrenal ‘exhaustion.’ The outstanding finding was the appearance of microscopic arterial lesions in the previously non-arteriosclerotic male and female virgin rats. There was no exacerbation of the arterial lesions in breeder rats with pre-existing arteriosclerosis. Lesions were found in the aorta, and its side branches consisting of intimal mucopolysaccharide, collagen, elastolytic changes and calcification. It is believed that the contraceptive drug upset hypothalamic and gonadal hormone homeostasis which led to endogenous hormonal-metabolic alterations favoring the pathogenesis of cardiovascular disease in both male and female rats. [ABSTRACT FROM AUTHOR]

Eighty patients with aorto-iliac / femoro-popliteal atherosclerosis were collected to examine in detail their plasma cholesteryl ester fatty acid compositions and to compare them with the incidence of ischaemic heart disease through a 4-year follow-up. Various other biochemical and rheological parameters were also measured to see if these might explain any association between the abnormal fatty acid pattern and ischaemic heart disease. The abnormal fatty acid pattern was specifically and generally similar to that found in essential fatty acid (EFA) deficient animals and children as shown by the increase of the specific trienoic acid (C.20: 3ω9) by reduced linoleic acid concentrations, and by an increase of C.18 and C.16 monoenoic acids (oleic and palmitoleic), but not of their corresponding saturated forms, stearic and palmitic. The results suggest that the abnormal fatty acid composition resulted from an increased synthesis of monoenoic acids and monounsaturase activity, coupled with a relative inadequacy of linoleic acid. The patients with a reduced concentration of linoleic acid (<35%) subsequently had a higher incidence of myocardial infarction. No significant correlations were found between the fatty acid concentration and various other biochemical or rheological parameters except marginally between linoleic acid and platelet adhesiveness. Only the linoleic acid concentration distinguished between the patients with and without myocardial infarction. A marked inverse correlation was found, however, between the monoenoic and linoleic acid concentration, without parallel changes in other fatty acids. It seems that as in animals, a balance exists between EFA and monoenoic pathways which are known to compete for the same desaturase systems and acyl sites. It appears that human EFA requirements and effects need to be considered not only by their intake and metabolism, but also through individual factors which vary the monoenoic concentrations and monounsaturase activity. Since these factors include several currently associated with human atherosclerosis the question arises of whether the EFA-monoenoic balance is one link between them and the pathology of the arterial occlusions and myocardial infarction. [ABSTRACT FROM PUBLISHER]

Arteriosclerotic vascular disease begins in childhood. This most common and serious disorder must be of concern to all those caring for the health of children. Consideration should be given to the possibilities of altering the basic American diet to one lower in saturated fats and cholesterol. [ABSTRACT FROM AUTHOR]

Copyright of Archiv für Psychiatrie und Nervenkrankheiten is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Forty patients who came to necropsy over a period of five years due to myocardial damage sustained during cardiac valve replacements were studied. The clinical presentation of myocardial damage was assessed in relation to the preoperative cardiac status. The cause and nature of myocardial damage were assessed at necropsy. Evidence of clinical, electrocardiographic and aortographic coronary atheroma was correlated with distribution at necropsy, and the value of selective coronary angiography in perfusing the coronary arteries during cardiopulmonary bypass is stressed. The causes of myocardial damage could be classified as () thrombo-embolic, () iatrogenic damage to the coronary arteries, and () poor or absent coronary perfusion during cardiopulmonary bypass. A case is made for the importance of coronary perfusion during cardiopulmonary bypass. [ABSTRACT FROM PUBLISHER]

This publication reports the findings of an epidemiological analysis of arteriosclerotic heart disease mortality data of rural Ohio. Incidence rates of death by this type of heart disease were obtained from the Division of Vital Statistics of the Ohio Department of Health. Data descriptive of several demographic, occupational, sociological, and economic community characteristics were obtained from other, secondary sources. The purpose of the analysis was to delineate variables that are associated with the incidence rates of death by arteriosclerotic diseases of the heart and to study the nature and degree of that association. Certain hypotheses relating emotional and occupational stress to mortality by these heart diseases are presented on the basis of the study findings. The study was supported in part by a grant from the Central Ohio Heart Association. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift Für Die Gesamte Experimentelle Medizin Einschließlich Experimentelle Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Klinische Wochenschrift is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses the study of the occurrence of homovanillic acid (HVA) in the human brain, with regard to senile dementia. Senile dementia is a disease with a disturbance in the monoamine metabolism, which is reflected in a reduction of HVA in the neostriatum. The study was conducted to a control group and three dementia groups on the concentration of HVA in the caudate nucleus, the putamen, and the globus pallidus. Findings show that in a presumed senile dementia group there is a significantly lower concentration of HVA compared with the other groups. In addition, the relation between HVA concentration and degree of dementia in the senile dementia group is statistically significant.

The article focuses on a controlled investigation of plasma lipids in manic-depressives. The relation of plasma cholesterol to atherosclerosis-thrombosis has been widely discussed and generally accepted. With the purpose of examining whether manic-depressives differ from other persons as to plasma lipid level we have determined fasting values of plasma triglycerides in 26 manic-depressives and 26 patients with other psychiatric diagnoses. They have found out that the plasma triglyceride level was higher in the manic-depressive men than in their controls, the difference being statistically significant.

The article cites a controlled clinical trial of Cosaldon in patients with arteriosclerotic dementia. The study involved 20 patients who were divided into two groups, the placebo group and the drug group, and they were assessed using vocabulary, memory, and numerical ability tests. It found that no member of the experimental group showed any improvement on psychological testing and there were no reported side-effects to the drug. The study indicated that the diagnostic criteria did not include explicit statements about the neurological status of the patients. It revealed that the cerebral arteries are among the least reactive in the human body. The criteria for defining arteriosclerotic dementia is also discussed and a brief review of some of the literature on Cosaldon is also included.

1. Fourteen cases of massive hemorrhage due to diverticula of the colon are reported. 2. Rectal bleeding is a frequent presenting symptom in patients with diverticula of the colon. The percentage of gross rectal bleeding over a 3% year period was found to be 28 per cent. Massive hemorrhage occurred in 10 per cent of the cases. 3. Massive rectal hemorrhage looms as an increasingly important problem in an aging population. Recognition of its association with colonic diverticula is necessary for proper treatment, which is primarily medical although surgical exploration may be indicated for recurrent massive hemorrhage. 4. The presence of an elevation of temperature should make one suspect a medical or surgical complication. 5. Arteriosclerosis and hypertension are common incidental findings in patients with hemorrhage due to diverticula, and their role in the etiology of the bleeding may be an important one. [ABSTRACT FROM AUTHOR]

In treating occlusive arterial disease of the limbs one must nevertheless consider the whole patient. We have tubular vision when we limit ourselves to a particular drug or surgical measure. At best we still are a long way from the ideal method of management, which is prevention. This may have to wait for the day when we learn to control genetic development and breed individuals resistant to arteriosclerosis. It is ridiculous to emphasize low fat diets and to feed cholesterol-lowering drugs to adults. The atherosclerosis and the ulcerative lesions are not reversible. The same is probably true of anticoagulants since thrombosis is only a part of the occlusive process. In the over-all management of the patient with peripheral vascular disease it is wise to let the body develop its own resources, its collateral circulation to combat the depletion of a vascular bed. It needs no verbal orders or supervision from the outside to do this, but it may be aided by the physician who prescribes exercise judiciously, who sees that foot care is not a sheet of instructions but a way of life, who combats bacterial infection vigorously with the appropriate antibiotic, and who prescribes medications for the symptomatic relief of pain, discomfort and anxiety. Until specific proof is presented to the contrary, it seems wise to use vasodilator drugs. When this regime fails, as it will in a small number, then and only then in such an emergent situation, do we feel that arterial grafting has its place. Success at this point gives a little extra time in controlling a disease which progresses relentlessly. [ABSTRACT FROM AUTHOR]

The authors present their experiences in the application of the Lown-Cardioverter in surgical conditions. This instrument is used for the. termination of ectopic arrhythmias, such as atrial fibrillation or ventricular tachycardia. By delivering a synchronized direct current counter-shock, a complete depolarization of the heart is accomplished and sinus rhythm restored, The procedure was used as an adjuvant to surgical therapy in mitral stenosis with atrial fibrillation, postcommissurotomy, tachyarrhythmia, arteriosclerotic heart disease with repeated embolizations, and ventricular tachycardia occurring during open heart surgery. The results were satisfactory and no complications occurred. [ABSTRACT FROM AUTHOR]

Because of seemed logical to expect a difference between the fibrinolytic activity in the blood of patients suffering from complications of atherosclerosis and of subjects having no evidence of the disease, two such groups have been studied. Plasminogen, plasminogen activator and inhibitor activity were assayed by techniques measuring proteolytic activity of plasma. No differences between the two groups could be demonstrated. [ABSTRACT FROM AUTHOR]

This article focuses on a study of bifurcations of the abdominal aorta and common carotid arteries. During the past decade, great interest has developed in the definite treatment of occluded primary arterial trunks. Because of the interest in definitive treatment, a correlated anatomic study was undertaken to note the incidence of athennatosis, arteriosclerosis and occlusion of the bifurcations of the abdominal aorta and of the carotid arteries in the same host. The dissections included the abdominal aorta and its bifurcation; if the common iliac at its bifurcation was not destroyed this anatomic site was also utilized; and, finally, the common carotid artery and its bifurcation was used. When the anatomic dissection interfered with a proper interpretation, the material was discarded. These arterial bifurcations were then cut in the midcoronal plane and a gross anatomic study was made. At each dissection, photographs were taken of all of the representative material. The material was finally collated for graphic and tabular analysis.

The clinical, radiologic and pathologic features of an arteriosclerotic celiac axis aneurysm with fatal rupture into the right pleural cavity of an 81-year-old woman are described. The clinical symptomatology, common to such rare aneurystns, is stressed. A brief review of the recent literature pertaining to celiac artery aneurysms is also included. [ABSTRACT FROM AUTHOR]

Known defects in enzyme activities in arteriosclerosis are reviewed, with emphasis on the arterial wall as a metabolically active organ. The author is of the opinion that such defects are real, as verified by the multiple investigative reports, and that it is likely that at least some of them are primary' and of greater importance in the etiology of arteriosclerosis than variations in the quantity or quality of substrate offered to the enzymes in the form of food. The major part of arteriosclerosis research appears to have taken the opposite stand so far, but this stand seems to simply ignore the inevitable dependence of all substrates on enzyme activities for their metabolism, and that the interconversion of the different classes of food into each other in the organism makes the withholding of one class from the diet unlikely of definitive success in dealing with the perennial and extensive problem of arteriosclerosis. The author also describes his own observations in four arteriosclerotic persons who received a relatively long-term treatment by a combination of metabolic (oxidative) enzymes. [ABSTRACT FROM AUTHOR]

Reports on the successful resection and end-to- end anastomosis of an aneurysm of the common carotid and in another case of anastomosing the internal carotid to the common carotid arteries. Variability of the brain to withstand cerebral anoxia without the protection afforded by hypothermia or a temporary bypass shunt; Unpredictability of cerebral anoxia is enhanced in an elderly artierosclerotic patient.

In a group of 100 patients, of whom 60 had diabetes, arteriosclerosis, hypertension or a combination thereof, we were able to get weight reduction, using a combination of amphetamines, including amphetamine saccharate, and diet. In those diabeties who had an adequate weight reduction, we noted an increase in carbohydrate tolerance. Similarly, hypertensives responded with lowering of the blood pressure and many arterioselerotics with coronary insufficiency demonstrated marked improvement. With a daily divided dosage of 30 mg of this amphetamine compound, we were able to obtain appetite depression without nervous restlessness or insomnia in 26 of 30 patients wins previously had been unable to use other amphetamines in any dosage sufficient to maintain the anorexic effect. It is important to note that all patients had appetite depression while on this drug, but only those with apparent adequate motivation were successful because of adherence to a proper dietary intake. This demonstrate again that the obese patient eats not because of hunger or physical demand but rather because of a psychologic need and urge which is rarely affected by medication alone. No attempt was made to determine what proportion of our group was successful in weight reduction because of the marked variance in the rate of weight reduction between the group and in the individual himself. It is our experience that a successful reduction is one that either accomplishes a return to optimal weight and maintains it so or one that, regardless of rate of reduction, maintains a constant and progressive loss over prolonged and continuing periods of time. This latter state of affairs implies 2 desirable effects—arrival at the optimal weight level in some and, in others, the continued but discouragingly slow loss of weight. Therefore, in a study such as this with its limited periods of observation, one cannot divide the results up into successful or unsuccessful groups since most lost weight in some period of time, only to falter with gain of weight in some or failure to lose in others. Reinstitution of weight loss with a return of interest or motivation was frequently observed. Cooperative patients lost weight progressively but starts and stops were the general rule. In the cooperative patient, the new anoretic amphetamine compound was beneficial in producing the desirable weight loss with minimal side effects, even in patients with cardiovascular and other chronic diseases where the use of amphetamines with stimulating side effects is undesirable but where weight loss may be life saving and appetite curbing most helpful. [ABSTRACT FROM AUTHOR]

Focuses on the capability of sublingual heparin in restoring the distribution of lipoprotein in the body in the treatment of atherosclerosis. Cause of atherosclerosis; Importance of the clearing factor of the heparin in its capacity in treating atherosclerosis; Developments in the heparin therapy.

Focuses on the result of the angiographic observations on arteriosclerotic venopathy of the inferior vena cava. Changes occurring in the inferior vena cava; Clinical features of arteriosclerotic venopathy; Efficacy of arteriographic and venographic examinations in classifying vascular disorders.

In patients suffering from arteriosclerosis and its complications, special patterns of the small vessels in the conjunction and nailbed are described and illustrated. These patterns may serve as signs aiding in the diagnosis of arteriosclerosis. The patterns in conjunctiva or nailbed were found in over 80 per cent of patients with clinical arteriosclerosis and in 36 per cent of persons over the age of 56 without clinical arteriosclerosis. In younger patients the pattern was seen in arteriosclerosis and in hypertension. In arteriosclerosis the arterioles and arteriolar limbs of the capillaries were moderately narrowed. In the conjunctiva the ratio of arteriole to venule diameter became 1:3 and may reach 1:6 or more. Severe capillary narrowing is uncommon in arteriosclerosis. In hypertension severe capillary narrowing (diameter less than 3.5 μ) is common. Blood pressure in terminal digital vessels in arteriosclerosis is normal. In severe hypertension it is very high. [ABSTRACT FROM AUTHOR]

The article focuses on the arteriosclerosis of the lower extremities. The management of arteriosclerosis of the lower extremities has undergone a radical change during the last 10 years. The article collects a series of patients suffering from intermittent claudication due to arterisclerosis but without gangrene or pregangrenous changes and follows them indefinitely. It classifies arteriosclerosis of the lower extremities into following categories: diffuse arteriosclerosis; secondary aortic; secondary femoral thrombosis; secondary popliteal thrombosis. The task of assessing the mortality and success rates of arterial reconstruction in order to get an over-all picture of the results is no easy one.

This paper reviews and evaluates medical literature reports and hospital records in an attempt to elucidate the apparent relationship between the activity of the suprarenal cortex, particularly 17-ketosteroids, and arteriosclerosis. The .suggestion obtained is that a shortage of 17-ketosteroids, especially dehydroepiandrosterone, seems to accompany, and possibly have causal significance in, cases of arteriosclerotic disease. Persons with an overabundance of 17-ketosteroids, and perhaps more specifically of dehydroepiandrosterone, may be relatively protected. Preliminary results of a treatment with dehydroepiandrosterone are presented in an addendum. [ABSTRACT FROM AUTHOR]

Aortic atheromatosis is not uncommon as a primary cause of Leriche's or Martorell's syndrome, syndrome, sometimes there is such severity that the arteries of all four extremities and the head are completely occluded at or near their origin. Nine cases of this syndrome are reviewed with comments on the mechanisms of the obstruction. [ABSTRACT FROM AUTHOR]

Examines a clinical approach to the management of intermittent claudication or angina cruris. Consideration of plethysmographic studies in judging the effect of vasodilating drugs on the peripheral circulation; Importance of supplementing vasodilators with tranquilizers; Description of the efficacy of a vasodilating drug, Cartrax.

Examines the pathological anatomy of atherosclerosis and its relation to peripheral artery grafting. Rare occurrence of atherosclerosis to affect the smaller vessels; Identification of the most common site of obstruction in the thigh; Diffusion of intimal disease throughout the length of the superficial femoral artery and the proximal part of the popliteal artery.

Provides information about intermittent claudication. Cause and pathogenesis; Signs and symptoms; Diagnosis and treatment;

Focuses on the surgical treatment of occlusive peripheral atherosclerosis. History of vascular surgery; Basic concepts of the atherosclerotic occlusion of the abdominal aorta and its branches; Clinical aspects of chromic arterial occlusion due to atherosclerosis.

Focuses on the problem of peripheral atherosclerosis in a chronic illness population. Evaluation of the peripheral circulation; Analysis of the peripheral vascular impairment diabetes mellitus; Assessment of the factors that affect the problem of peripheral atherosclerosis.

This is a survey of 200 consecutive male patients attending a clinic suffering from intermittent claudication. The following points are discussed: 1. Etiology, especially in relation to type of work and tobacco and alcohol consumption. 2. Methods of investigation. 3. Technique and equipment required for intra-arterial therapy. 4. Results of this type of treatment. 5. Selection of patients for intra-arterial therapy. [ABSTRACT FROM AUTHOR]

An unusual case of associated cardiovascular disease is presented. A 64-yearold diabetic, arterioselerotic and hypertensive patient had an episode of pulmonary edema with vascular collapse followed by bilateral gangrene of the lower limbs. A second episode caused death. Autopsy revealed: (1) rheumatic heart disease with tight mitral stenosis; (2) coronary heart disease with an old and a recent infarct; (3) left atrial thrombosis resulting in multiple embolisms (one old—cerebral; one recent—of the iliac arteries); (4) arteriosclerosis obliterans. Mitral stenosis was silent, as proved by auscultation and phonocardiography. Electrocardiography failed to undisputedly reveal the infarcts (one was old, the other, terminal). Surgery showed that the gangrene was not due to embolism (a saddle- or double-embolus took place only in the terminal stage). [ABSTRACT FROM AUTHOR]

1. A survey of 2300 case records was made, showing the incidence of the various disorders which one may expect to find in the average course of practice, in clinics or in hospitals. Among the arterial disorders, the most commonly met conditions are arteriosclerosis obliterans, diabetic atheromatosis, and thrombosis of the arteries due to various causes. It may be noted that thromboangiitis obliterans, although frequently mentioned among the vascular disorders, is not as common as might be expected. We have not fully computed the number of our cases where the abdominal aorta shows some pathologic changes. This is not uncommon, and will be discussed in another presentation. Arteriospasm was commonly found among our patients with circulatory disturbances. Among the venous disorders, thrombophlebitis is a condition which is commonly found and the incidence seems to be increasing. 2. The method of evaluating the effects of treatment and the rules that were formulated to score the results of therapy into three groups (good results, moderate improvement and failures) were discussed. 3. The methods of treatment were briefly outlined, as were the various procedures used in the arterial cases and in the thrombophlebitis group. 4. The results of treatment showed that of the 1000 cases that were treated, the arterial group showed 381 good results (54.9 per cent); 259 were cases of moderate improvement (37.4 per cent); and 53 failures (7.7 per cent). Of the venous series, 254 cases showed good results (76.1 per cent), 73 (21.8 per cent) showed a moderate improvement, and 7 (2.1 per cent) were failures. Of the lymphatic series, 2 of the 9 cases showed good results, 4 were moderately improved, and 3 were unimproved. 5. Attention may be focused chiefly on the occlusive vascular group, because it is, particularly, for this type of patient that surgery is being advocated. In view of our very satisfactory results in improving these cases and preventing the development of gangrene, the question is raised whether surgery for these patients is justifiable at the present time. 6. Under medical treatment, patients have been carried along for 5 to 10 years or even longer, with comfort and were able to continue their activities. The incidence of gangrene in patients with thrombosis, excluding thromboangiitis obliterans and diabetes, is minimal. 7. Furthermore, it is quite possible that in the near future, further advances in biochemistry and the study of hormones may eventually not only contain the progressiveness of thrombosis, but may be helpful in inducing a regression of this pathologic condition. [ABSTRACT FROM AUTHOR]