Dogs were submitted to one of three hemorrhagic shock procedures: normovolemic shock, oligemic hypotension or posthemorrhagic hypotension. 13 animals fulfilled well-defined criteria of irreversible hemorrhagic shock, based on mortality, take-up volume and metabolic changes. Lung function was measured at regular intervals. Lungs were fixed by infusion fixation. The macroscopical aspect of the lungs was not different from that of six control dogs which were anesthetized for the same period. Minor microscopical changes were found, but the only histological parameter which was significantly different from the controls was accumulation of granulocytes. Gas exchange remained normal, ventilation was increased with an enlarged dead space and veno-arterial shunting was reduced. Pulmonary vascular resistance was not different from the control group.

Valve replacement was performed during a 7-year period in 27 patients with acute or subacute infective endocarditis. Twenty-three patients had single valve affection--16 aortic and 7 mitral--and 4 patients had affection of both the aortic and mitral valves. Eight of the patients with aortic valve lesion had congenital aortic valve stenosis and 2 of the mitral patients had mitral prolapse. Two patients were operated upon only on the echocardiographic finding of valvular vegetations. The rest of the patients were operated because of cardiac insufficiency, intractable infection or peripheral embolization. Five patients died and 22 patients (82%) were discharged. One of these patients died in the follow-up period. The remaining 21 patients all belong to class I or II (NYHA) postoperatively. There were no cases of reinfection. Emphasis is placed on the use of echocardiography in detecting valvular vegetations, and the need to take the proper surgical action as a result of this finding, even in asymptomatic patients.

Among 40 dogs submitted to 1 of 3 experimental shock procedures: hemorrhagic shock, soft tissue trauma or regional ischemia, 24 dogs fulfilled the criteria of irreversible shock, based on survival or characteristic hemodynamic and metabolic changes. The 24 dogs were studied by measurements of lung function and hemodynamics. During the shock period no impairment of lung function was observed. The pulmonary shunting ratio fell and pulmonary vascular resistance increased. The macroscopical aspect of the lungs did not differ from that of 10 control dogs. The microscopical examination of the lungs, performed after infusion fixation, revealed only a higher granulocyte infiltration in traumatic shock and more severe congestion in hemorrhagic shock.

No abstract

F m i i the Departriieiit of Gynnrcolugy and Obstetrics (Head: K . J . AIIiii~-Mplli~r). Drpurtiitrii: of sirrgery (Heads: 0. Noririg a~i d H . Pauhy), and Departitwit 01 Pathology (Hrcitls: L . Klinkor and P. Poll) of the Cerltral Ilospitul. Nykpbing Falster, the Departniiwt oJ Surgery (Heads: 1. G leiierr rind S . Lyriclriip) of the Maribo Hospital, am/ the Departiiieiit o/ Siirgery (Hrcrcls: D . Pryt: uird 1. I4'iclaridt) of the Nokskov Hospitul, Divinicrrk Abstract. A series of 230 patients was studied with a view 805, 1958.