An enlargement of the diameter of the right descending branch (RDB) of the pulmonary artery in chest radiographs may serve as a sign of pulmonary arterial hypertension. We tried at first to establish exactly the normal values for men and women of different age, analysing the radiographs of 112 healthy subjects. There is a relationship of RDB diameter to sex and age. We compared the RDB diameters in 95 men suffering from chronic bronchitis with the pulmonary arterial pressure, flow, and resistance, and with the right ventricular work: a highly significant relationship of RDB diameter to all but the blood flow values was found. Considering (in men over 40 years of age) a diameter of the RDB of 18 mm. or more as pathological, the reliability of the diagnosis of pulmonary hypertension in chronic bronchitis was 72-2% with readable films, or 64-2% when not reliably readable chest films were included. Nevertheless, a similar comparison in patients with mitral stenosis indicates that the radiographic picture of pulmonary hypertension differs according to the initial disease. Here we discuss the factors which may influence the RDB diameter.Compensated chronic cor pulmonale in chronic bronchitis and its complications frequently escape diagnosis unless an elevated pulmonary artery pressure is found by right heart catheterization.Physical signs of hypertrophy of the right ventricle are rare in the initial stages of cor pulmonale in chronic bronchitis associated with hypoventilation, and electrocardiographic signs are rarely found at this time.Radiological signs of pulmonary hypertension are more useful, as was proved by numerous authors who studied the radiological symptomatology of pulmonary hypertension (Assmann, 1920;Carmichael, Julian, Jones, and Wren, 1954; Dejdar, Widimsky, Valach, Fejfar, and Bergmann, 1959; Van Epps, 1958;Goodwin, Cleland, Hunter, Davies, and Steiner, 1955;Healey, Dow, Sosman, and Dexter, 1949;Milne, 1963;Schwedel, 1946;Steiner, 1957; Teichmann, Drib, Daum, and Ourednfk, 1961). The signs which may be related to pulmonary hypertension are enlargement of the right ventricle, enlargement of the main trunk of the pulmonary artery, enlargement of the hilar branches of the pulmonary artery, in particular of the right descending branch (described also as truncus intermedius or arteria intermedia), narrowing of branches of the peripheral arterial bed, and pulsation of the hilar arteries. We think that some of these signs are not frequent in pulmonary hypertension, or depend too much on the subjective evaluation of the physician, or appear only in heart failure (Teichmann and Drab, 1963).There is general agreement that the most useful radiographic sign is the width of the shadow of the descending branch of the right pulmonary artery (RDB).To elucidate the diagnostic importance of the RBD, we investigated the relation between its diameter and any pulmonary hypertension. We compared catheterization data with the width of the RDB and we tried to find out the difference, if any, between the radiographic appe...

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Our construction of the spinal cord stereotaxic apparatus is different from similar apparatus available. The base of the apparatus is attached directly to the arc of the vertebral body by means of a handle screw. The apparatus is light, easily demontable. Movement is possible in 3 perpendicular plains and carries one fine uni- or dipolar electrode. By means of this electrode the spinal cord potentials are recorded, the spinal cord structures can be stimulated and lesions are carried out by electrocoagulation. The target can be reached according to model maps of the spinal cord. The apparatus is used in order to influence the hyperspastic bladder and the spasticity of the lower limbs after interruption of the spinal cord. Results are encouraging us to use the stereotaxic method for the treatment of neurogenic bladder in the spinal cord segment S₂.

1. We have examined the effects of aminophylline on the respiration and pulmonary circulation of eleven patients with chronic bronchitis and six patients with peripheral bronchial carcinoma; the latter were free from bronchial obstruction at the time of study.2. Aminophylline caused an increase in total and alveolar ventilation and a decrease in arterial carbon dioxide tension. Lung diffusing capacity was unaltered in subjects with marked respiratory insufficiency but increased slightly in an additional group of less severely affected patients, and in the control subjects.3. Mean pulmonary arterial pressure decreased significantly in the patients with chronic bronchitis but not those with lung cancer. A positive correlation was observed between the level of pulmonary arterial pressure during the control period and the decrease after aminophylline. 4.For the group as a whole there was no significant change in cardiac output or arterial oxygen saturation or tension. However, in those subjects in whom the cardiac output was increased, the arterial blood oxygen was reduced despite an increase in alveolar ventilation. The data are interpreted as evidence for a disproportionate part of the increase in cardiac output being directed to poorly ventilated areas of the lung.Aminophylline is commonly used in the treatment of chronic obstructive bronchitis and its effects on respiration are well documented. However, there is as yet no good explanation for the occurrence of hypoxaemia in some patients but not in others. With a view to elucidating the mechanism we have investigated the effects of aminophylline on the respiration and pulmonary circulation of patients with chronic obstructive broncho-pulmonary disease and in control subjects.A total of seventeen subjects were examined in detail. Eleven of them suffered from chronic bronchitis with respiratory insufficiency. Additional subjects with bronchitis were used for 549 METHODS A N D SUBJECTS

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