The APS Journal Legacy Content is the corpus of 100 years of historical scientific research from the American Physiological Society research journals. This package goes back to the first issue of each of the APS journals including the American Journal of Physiology, first published in 1898. The full text scanned images of the printed pages are easily searchable. Downloads quickly in PDF format.
(3). It generally has been agreed that energy metabolism in mild cases of diabetes is normal, and that in the more severe cases is found increased when determined on the basis of kilogram of body weight. The lack of a satisfactory standard of comparison between diabetic and nondiabetic subjects hampered much of the earlier work in this field and led to disagreement regarding interpretation of data. Benedict and Joslin (1, 2), using the Harris-Benedict prediction standard, reported increases in metabolic rate of diabetic subjects of between 15 and 20 per cent. Lusk (4) criticized these data and computed that the increase in metabolism did not exceed 5 per cent. With the general acceptance of the more valid Du Bois standard (5) comprehending body surface area, many of the earlier data ascribing an increase in metabolic rate to diabetes have been recalculated and shown to be erroneous. More recent publications likewise have been of conflicting nature reporting increases in metabolic rate as great as 40 per cent and decreases of 32 per cent in severe clinical diabetes mellitus (6-9).In the pancreatectomized dog, on the other hand, respiratory metabolism generally has been found to be increased (10-12). However, attempts at direct comparison between this type of acute canine diabetes and the disease as it occurs in humans is illogical in view of the typical alteration in fatty acid metabolism following pancreatectomy. We are not aware that oxidative metabolism has been measured previously in the alloxan diabetic animal which provides a metabolic defect more nearly identical with that occurring in human diabetes mellitus.That an increase in oxygen consumption in dia-1 Present address:
Twelve patients with aortic insufficiency (AI) were investigated by echocardiographic methods using reflected ultrasound. No patients with associated mitral valvular disease were included. Estimates of each patient's aortic valvular total flow (Q
At
) as computed from left ventricular cavity minor-axis dimension changes at end-diastole (D
d
) and end-systole (D
s
) were compared with their respective mitral valvular flows (Q
M
) as estimated from the opening velocity of the anterior mitral leaflet. The arithmetic difference of the two valvular flows permitted calculation of the aortic regurgitant flow (Q
Ar
) as Q
At
-Q
M
=Q
Ar
. In this series of patients Q
At
varied from 5.2 to 12.9 liters/min, Q
M
from 3.3 to 7.3 liters/min, Q
Ar
from 1.1 to 6.5 liters/min, ejection fraction (EF) from 0.37 to 0.60 and regurgitant fraction (Q
Ar
/Q
At
) from 0.15 to 0.58. A statistically significant difference of Q
At
and Q
M
was not evident in a series of 20 patients without AI.
Left ventricular performance in the patients with AI was estimated by echocardiographic methods by measuring the amplitude of systolic excursion of the left ventricular midwall (PWE), the mean velocity of posterior wall motion (mean PWV), and computation of the mean velocity of circumferential fiber shortening (V
CF
) for the left ventricular myocardium.
The data presented appear to provide a simple noninvasive method for serial observations of the hemodynamic consequences of AI and the eventual alteration of myocardial performance in such patients.
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