Life In Jeopardy Research Articles

The induction of arrhythmias by sympathetic activity before and after occlusion of a coronary artery in the canine heart

Summary Stimulation of the left ansa subclavia before and after occlusion of the anterior descending artery of the dog's heart has produced significantly greater ventricular arrhythmia responses in the post-occlusion trials than in trials before occlusion. Data are presented from two series of acute experiments, Series 1 and Series 2 which include findings from 11 and 16 dogs, respectively. The experiments of the two series differed in types of electrical stimuli used and in elapsed time between occlusion of the artery and the first post-occlusion stimulation. All stimulations were applied when sinus rhythm was complete and no premature beats had occurred within a specified preceding duration. The arrhythmia responses in Series 1 were more intense (except that ventricular fibrillations were equal) and more prolonged than in Series 2. Reasons are discussed but not yet clear. The increased ventricular arrhythmia response persists strongly 5 days after occlusion. Propranolol, 0.5 mg/kg, blocked the arrhythmia response to sympathetic nerve stimulation completely during a period of 45–60 min after injection, but no blockade was apparent after 80 min. Possible mechanisms of origin of the induced arrhythmias were considered and evidence presented to indicate that individually generated discharges in ectopic pacemakers produced the arrhythmia in parts of the records and that reentry was the mechanism in other parts, particularly during approach to onset of ventricular fibrillation. The demonstration that brief periods of stimulation of sympathetic nerve strands to dog's hearts after coronary occlusion can produce ventricular arrhythmias of all degrees of severity including ventricular fibrillation suggests that emotional excitation of a myocardial infarction patient may induce similar ventricular arrhythmias and thereby place life in jeopardy.

The Russian Road to Berlin, 1944–45

OF the numerous volumes of memoirs written by men who commanded the Red Army in the Second World War, only General Alexander Gorbatov's Wars and Years, first serialised in Novy Mir in 1964, is likely to find a permanent place in Russian literature on the strength of its literary merits. For Gorbatov's descriptions of his peasant childhood and his experiences in Stalin's prisons and labour camps have the powerful simplicity of Gorky's, or even Dostoyevsky's, writings. Of the other volumes of memoirs by military commanders, Marshal Vasily Chuikov's are no doubt the most readable-a quality they owe to the personality of their author, and, quite likely, to the fact that he himself wrote them. It was not until Khrushchev's speech to the Twentieth Congress of the Soviet Communist Party in 1956, in which he debunked Stalin's military genius, that Soviet military leaders began to write and publish their mlemoirs. The reason why they had not written 'them earlier is quite simple: they knew that the very fact of being known to have written about one's part in the war while Stalin was alive was to put one's life in jeopardy. They knew, or suspected, that the reason why Nikolai Alexeyevich Voznesensky, head of the State Planning Commission before the war and deputy chairman of the State Committee of Defence during the war, was liquidated in 1949 as part of the 'Leningrad Affair' was closely linked with the publication in 1947 of his work The Wartime Economy of the Soviet Union duuring the Fatherland War. Although the book had been read and revised by Stalin before publication, Voznesensky's doxology in his honour had not satisfied the Soviet dictator, who knew better than anybody else that it was chiefly due to Voznesensky that the Soviet war industries had been rebuilt and expanded in the eastern regions of the country to provide the Red Army with most of the weapons it needed to defeat Germany. And so when Beriya reported to Stalin that Voznesensky, who at the time was a Deputy Prime Minister and head of the State Planning Commission, had completed an 800-page work entitled The Political Economy of Communism, the Georgian gave the order which resulted in Voznesensky's arrest on March 5, 1949, his anonymous death and the destruction of the completed manuscript.'

Advances in treatment of acute and chronic renal insufficiency.

Renal insufficiency is defined for this discussion as a defect in excretory function that interferes with well-being or even places life in jeopardy. The acute insufficiencies result from more or less selective toxic or ischemic damage to tubule cells, they are usually associated with oliguria or anuria, and their course is toward recovery by cell regeneration; hence, the aim of treatment is to maintain the patient until this predictable repair has been adequately effected. In contrast, in chronic renal insufficiency, blocks and masses of nephrons have usually been destroyed beyond repair. Many patients with chronic renal insufficiency can be maintained in comfortable and useful life in spite of severe defects in renal function, but treatment is essentially palliative and the ultimate prognosis commonly grave. The causes, lesions, courses, and therapeutic aims are different in acute and chronic renal insufficiency. In both, however, the basic principles of treatment are the same.