strated the presence of Klebs-LofIler bacilli, virulent to nonprotected guinea pigs, in pure culture. Because of their experience with this case, the authors emphasize the need for early and adequate treatment with diphtheria antitoxin whenever cutaneous diphtheria is suspected. WENDKOS.
Bushong, Proved (Jan.),
Traumatic B. B.: and the Other 1947.
Rupture a Probable
of the Example
Aortic Valve: Report of This Condition.
of Two Cases, Ann. Int. Med.
One a 26:125
Two cases of musical diastolic murmurs, presumably due to traumatic rupture of the aortic valve, are reported. One was a SO-year-old man who had apparently been in good health until he developed chest pain and dyspnea while attempting to extricate himself,from a truckload of fence posts which had knocked him down. Sixty-nine days after this injury, he died of progressive cardiac failure. The autopsy revealed a transverse tear along the right anterior and posterior aortic valve leaflets which allowed the cusp margins to prolapse into the ventricle. Although no associated disease of the aortic valve or aorta was described, the weight of the heart was increased to 600 grams and hypertrophy and dilatation of both ventricles and auricles were present. The other case was that of an 11-year-old boy who was not suffering from symptoms of cardiac failure but was examined because of the sudden development of a buzzing sound in the chest No other murmurs were which presumably followed a blow to the chest during a boxing lesson. audible. Peripheral signs of aortic incompetency were well pronounced. No history of rheumatic fever could be obtained. The electrocardiogram was normal. A sound tracing showed the typical pattern of the “cooing-dove” murmur. WENDKOS. The Technique Robbins, L. L.: Infarct. Am. J. Roentgenol.
of the Roentgenologic 56:736, 1946.
The importance of early diagnosis of pulmonary infarct has become more evident with the institution of modern therapeutic methods for preventing and combating the sequelae of infarct-ion. Approximately 75 per cent of infarcts occur in the lower portion of the lung. The size of the infarct may vary from a small linear lesion lying against the pleura to a large lesion occupying the greater portion of a lobe. The shape of the infarct is dependent on its location, but it is always peripheral with its long axis parallel to the pleura. The shadow as a rule has a curved proximal margin. The infarct is at first indistinct hut gradually becomes more sharply defined. In a I,eri,od varying from days to a month it assumes a linear shape and may finally disappear except for a \ery fine linear scar. At least two views, a posterior-anterior and a lateral view of the chest, is the minimal number of films necessary to demonstrate adequately an infarct. If the condition of the patient permits, roentgenoscopy of the chest is very helpful. Adequate evaluation of the thoracic dynamics and optimum position for making films is possible following rocntgenoscopy. Spot films during fluoroscopy frequently will better demonstrate infarcts than a full 14x17 film. The author has found that the Merrill modification of the Fuch’s technique, using a high optimum kilovoltage and varying the milliampere seconds with the size of the patient, has resulted in a film of more uniform quality. A roentgen differential diagnosis is included in the paper. ZION. Lindgren, radiol.
E. : The Roentgen Diagnosis 27:585 (No. VI), 1946.
The author stresses the distinction, first made by Reid in 1925, between congenital artcriovenous aneurysm and acquired arteriovenous fistula. The congenital lesions have not been found to enlarge the heart, regardless of their proximity to it. Three cases of arteriovenous aneurysm of the pulmonic vessels are reported in addition to the two in the literature. The salient clinical characteristics were a systolic bruit over the aneurysm, heard through the chest wall; clubbed fingers; cyanosis of varying severity; normal heart size; and a characteristic roentgen picture of a nonpulsatile density, with vascular markings communicating with