Loyola University ChicagoLoyola eCommons

Master's Theses Theses and Dissertations

1968

Myocardial Water and Electrolyte Changes inVentricular Fibrillation with Cardiac MassageFollowed by Electrical DefibrillationAlan D. KaplanLoyola University Chicago

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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.Copyright © 1968 Alan D. Kaplan

Recommended CitationKaplan, Alan D., "Myocardial Water and Electrolyte Changes in Ventricular Fibrillation with Cardiac Massage Followed by ElectricalDefibrillation" (1968). Master's Theses. Paper 2269.http://ecommons.luc.edu/luc_theses/2269

lfYOCAIDIAL atilt AJI) ltUcnoL'fft ~s U VDTIICVtAI

'laULU'HOIiI WIft CdDUC MASUCI ~ .t ItICft.ICAL DIFlUJUAtlOl

A 'fUel. SOait." t. t'be Faculty .f the OI'&4\141t. khool .f

Loyola Val .... ".1-ty 11l '.l't1al rulfi.l1Mat of the

ltaqut .... ata tor the Deane of

Meater of ktaH

1 wtab to -PT ••• ., ... 1. .laee" Iratt.tude to Dr II V'lMot V.

Omt.... ., .tYi_I". fOI" u. 1IIiDY hoen of hlp aU dl.MU.loa ¥btela 84e

thLa .'vel1' peuible. 11. ft1!1OOU' ...... t ... fiDthut ... "1'. 1Ht1'UllllOtal ,in

he1,1o& _ chl'oul" the _1'8 ,1"01>1 ... e1c 61''' •• f the pnJ.et. Sp1Ic1al ... -

tScm aut .. .... of DI'. .1ce .. C. ......11. Ctlal...... lktpal'mMt of Ph,..101-

011. fol' lu,id,q .. to puck',.,. til the, __ lM4 lfa41eal I)ootO"-"8t._

.f Scl __ ,.......... u4 for 1\1. thouab.f1ll aD4 c._cnet1_ ... itlei_ of n. thuie. I.OIlilU .1 .. like '0 chatt. DI'. ~a I.. To1,)b. fot' b18 p.tlntc.tpacion

_ tke t .... t. c .... tc .. a4 It ... '-l,f.l 8.,_el..._ 'a ,rep.I't., eM flul

tbuls.

'lull,. t _l .. to &Xpno ., ap,rees.a,ioo for the fluaet.l •• ,,­

POI"' Ir ..... '" tM »!vus.. of ea..,.l *4Scalk1eacM ot tbo Ra'loul

la.titut.. of Bea1th.

1

IIOGlAPll

Al_ D. I.&pl_ .. ))on Oft Ma, 31. 1'43, iu ctd .• a.o. 1111 .. 1a •

.. va arad .... eM , ... '1'._ aaoo! ta ltS1 _4 f~_ Iv ... tem

Towuhtp .1&h khool I.e 1961. He atte.4a4 ~1a UftlYfttalty in Chte .. o,

Illt801a. fol' thr .. JU .. 8 of at .. ,. 18 the It.U of , .. __ Ucal uta ..

a.1eDc •••

I!f.r'. l.aplM._ aoupted u a MelleAl a,u4eAr at ~1a trnJ.'ftI1'81ty.

Itl'ltell School .1 ... 1c1M., 1t1 .. ,t .. ar. 196',. bu."t •• eM .... 1' of that

,. .. 1" he eate... tMI.ttoul Io.e-tltut.. of 'I_leb eoeD~ Medical Studgt­

Mut ... of h1 ..... heal'- b the Depal'tMat of Ph,,.101ol1. Ufl4er tn. "per­

ri.loa of Dr. 'traceot ,. Gl .. taao.

111 .,1'11, 1961. he '1' .... 84 • papeJ' em electl'ol,tU 1a cb,. UBi.

ayoCI&I'41_ foll.,. ... l.ctl'lal '.""1'1118t1_. at cae ~tud_t AtM.riCi •

.... '"1 Aa800tat1oe - ht,"n1t,. .f .,... ..... I'U 'Oha. 10. Gel.eeeon, 'faa."

ii

1. A.D .. lapl_ UlCl , .... Clu1.." .,."aNtal Ilecttl'Olyte <:haaS •• hlel'll

... IuY10a ' .. '¥'cu1ar'~rllla'loa aa4 '.llowt.. tl.ctc1c&l

hf1kll.1.atlon. t .... Report. of 1101.7 aM HMle1M, 1-..1' ~

1H1.

iii

Chapter

1.

11.

III.

IV.

v.

'UlLE 01 COlCTINTS

IHTRODUCTI0N •••••• e~ •••••••••••••••••••••••• ~ ••••••••••••••••

A. J.

A. B. c.

V.ntricular fibr1llatlon •• ~ •••••••••••••••••••••••••••• Defibrillat1 .......................................... .

.. •• theata ... Sura.ry ••••••••••••••••••••••••••••••••• Cheatcal. d.t.~t1oa.e ••••••••••••••••••••••••••• e ••• Mathaat:1ca1 ana1,.t. of d.t •••••••••••••••••••••••••••

A. 'rotal. U ..... coaeea.tratiou of potaeal_. lI04.i .. , and

P·ae

1

2 S

8 10 12

chlo~1de............................................... 14 B. Pl .... coacentr.tloD of potustwa. sodium. and

c. I).

I.

chlorid •••••••••••• e •••••••••••••••••••••••••••••••••••

Total tl •••• and eompart ... t.l wat.r ••••••••••••••••••• Dertv.d CODceatratl0.a of lat.retitt.l and iatrae.llalar .l.ctrolytes •• e ••••••••••••••••••••••••••

Ca~4tod,.a.1e ••••••••••••••••••••••••••• ~ ••••••••••••••

DlSCUSSlOl ••••••••••••• & ••• e •••••• o ••••••••••••• ~ ••••••••••••

S'UtllAllt(\ •• ~ •••• I.> ...................................... ft.~ ••••••

16 18

20 22

28

33

IIBLIOOlAPBY ••••••••••••••••••••••••••••••••••••• e .••••. e............. 35

iv

TD1 ..

1.

II.

III.

D.

LIlT or TAlUS

,., ... ,_ c..c_trati .. in ,law. ... Car4tac •• 01. Dvt1a& Control (CTOUp 1) 1/ rtbrillaU." (Croup II)" r.llotriq 11ut .. "..1 Def1bd.llattoa (GI'OUP 111) ......................... 24

SocI1_ CoDCatl'atWu ,. '1 ..... ad Cant .. Muel. Durlaa CHtco1 (Gr", 1). 'thrill.tift (Croup II), 'o11nfal 11 .. , ... 1 .. 1 hfUt .. 1Uat:1oa (01'.., 11I) •••••••••••••• 2S

Ql ... U. Cftceatratlo .. :111 '1 ... aa4 caNUel .. c1. Burl .. tea'rol (Orou, Il, "'1'111&tioa (Group 11), '.11oriq 11.certea! .. '11.,:111&.:1_ (GntJp IIl) .................... 26

Wacel' Cntea, .f 114_ aad Cal'dlac ."1. 'Dur11l& CoIltrol (Croup t). ltbrUlatioll (Oro.p II). 'ell"iIll 11_trl .. l Daflbl'tUat1eD (01'.., 111) •••••••••••••••••••••••• 27

v

1.

,.

LIlT or PICURIS

Total Ti.... Ilactrolyee Ccmeeaeuti01l. of Canina "00&r4i .. Durimc Control, Ventricular ribrillation

Page

aad '.llowtaa Electrical D.fibrillatlon •••••••••••••••••••• lS

Pla ... Ilacer.lyee Coaceatl'atleas in eoacrol »OSe, fibrillated Do.. and In Doa. 'ollowina Electrical Defibr111.tioa •••••••••••••••• e •••••••••• ~ ••••••••••••••••• 17

".t.l T1tIaue au Coapartantal. Watar tn Coatrol Doge, fibrillated Doa. aDd Doa. 'ollowtna Electrical Deft~il1atioa ••• o ••••••••••••••••••••••••••••••••••••••••• 19

4. lntr.cellular Blectrolyte Coneentratione of Canina Myocardlua Dart .. Control. V_tl'icular flbrillatloa aDd Pol1owlRI Electrical Deflbrll1atioa •••••••••••••••••••• 21

5. Cal'dlo4yaaale "cordiass of • Dol Durina Control, Veatr1culaz 11Dr1llatiou aod rollowiDa Ilectrical D.f1brillation ••••••••••••••••••••••••••••••••••••••••••••• 2'

vi

.CIW1'D I

CUatoa11, it H ... ..,.. ,Ntpa,'.t. it-1aI .. , .. IGUlal' flbl'U­

lattea •• .., an "--Met_el, ."h .. illa, •• a1eotdeaU.,.. • ...... e1,. ft'ftI't

h ,"o anb,Ual& vip", a f. __ I.e fol1aw:tq •• r"d.llg..... !h •

• ,.rial pnMDte4 ta Ph ..... u i. lat .... to 4 ..... ,t.cl .. '0 t1I& _ ...

..,10 ........ of el .. , ... 1"'8 ad ..... "dolf ... of the 'haft ,,, .... ,.rt ..

..... t.ah17 folJ.ow111a eM conMI1_ of waU1wlu '''rilla'loa ." 4lec­

.neal ............. k. lion ..-Uiu11,. tbe , ..... ,q.tloa w. &004.'"

1) To .... adM if "U'ftl'1 of • ,..,. .. t.l Up.larut .. _mat to

th • .,....,_ hHlu ltI .. d, .... U .•• f .,. ....... 1 .lect'l'OI,.. •• aM

_to ...... t.

2) to SMrHc .... t ... ,..."1111, tut .1 .. , .. 1.&1 .. ftltrtUactoa

.., t. l'Htf .................. 1'41. __ 18 81actnlytea vlttet. ..... .

,tie It.ean '0 ...... n ...... U .• t.e te n-'O"f.l1atS..

s) t ... &lut. die .ff .. , •• f ""lac ......... 1I)'OO41'4t.l

.1uCl'olfC_ 'u'CiaI ..... tl'tcula ,s..I'111at .....

1

CHAPTER II

REVIEW OF THE LITERATURE

A. VENTRICULAR. FIBRILLATION. The electrical induction of a car­

diac arrhythmia that leads to the demise of the animal within three to five

minutes was first noted by Ludwig and Boffa in 1849. Twenty-five years later,

Vulpian gave this arrhythmia the name of "Movement Fibrillaire". Although

this phenomena was frequently reported in laboratory animals, little defini­

tive work was done in the area until 1940, when Wiggers described the fibril­

lation threshold, and the course of fibrillation in the canine heart (10).

Wiggers described ventricular fibrillation as an incoordinate type of muscu­

lar contraction that despite a high metabolic rate rendered the heart incap­

able of doing work. 'I'hrough the use of cinematographic and electrocardio­

graphic techniques he observed that the incoordinated beat first involves

comparatively large sections of myocardium, which progressively multiply and

decrease in size. Four general stages were described:

First, the "undulatory stage", lasting 1 to 2 seconds where there

are 3 to 6 undulating contractions, having the characteristics of premature

systoles. According to Wiggers, only the first beat is actually a premature

2

/

!'ll ....... abael •• ,. IS 10 60 ........ t.a t .... tl\e t!t __

... 1ftt .. ~_. '" It SAt .. " .. 1.11. ... '" _ ... f~t ..... of. _ .....

, ... ,t_ .1ob .... , ......... 11_ ..... 1 ... f tH 'ftIatd.cl •• "

!he ,b'M It ...... '"i&MtM .. "t,,-.lou 1 .......... Uj_~ ..

It __ tl'_ .1 IMnutas f ....... '.'l_ ., ·Ue watd.M1_ ........ I'U\I1tu,

In. IIIIiIlld aM ... 11 .... ..., .... '1" _., ... tq .rue", hr1 .. tilt. ,....

'M .1KtriUl Mt.'U., .......... eM .1acl ...... S'O ........ ut .. u s..-....... 'he flul ...... "at .. " IDI't11at .... • ~_.t .... l'U .. t ..... u1t ,.,.

lbe lau_u • ...sa ludt .. h • .., ..... S ... , --.tJ':utU .. fone,. .lev

.. _.lea aM -.t..u, naltlUl "'1Mb witll • .,1 .... ,.tl._ .f _11'''-tiUt, U9 •• ""

."8 .... '1,.. _ ... : ,,_ ..... 41 .. , .. t_H ...,,,..... 'M

e1MtHl1h ... utakU ........ '" .,... •• 1 ......... 'JI'VV'at-ee .......

• ..cl'lcu1u ""'rilla.,_ ........ anu.., .... Nthe' ...... ''''' .tw.ltu. Ilaa. , ........... i •• l (It.) ..... tllat t" f&ft11atlq hurt 1 .. .

,. .... 1_ vb11. It t ...... Md .... (21)" a.el. at .t 'e 1t54 41" •• Mel

.... 1R ........... althR.1l ... 1 ....... nl' ........ vi .... .,..r.U.a1 ..,._

., •• t. UU. ht:. ..... ,. of ' ..... tipton ....... SacH ...... lact1e .. 14

vtt.tl .......... aU.luat1_ O'f ,,.,..Ita ... IlGC ... '11 It., .. .t ........ f.

t ........... _ the ... ,_ .f • ""le...,U ... \OI .f dJ ........ 1'Na11a ... , ••••

.... ... ft1, • ...u tlla 1_01 .... .....,t.1'11.U ......... ..,. co ........... 1 •

••••• '" .. ,.tat" .... tkat ..... ,., .t,~t""'1..t. taci ...... b1e

4

tor the oxidative decarboxylation of pyruvate (12,28).

Gregg also studied tbe effects of ventricular fibrillation on myo­

cardial AT? production. Be noted a decrease in the coronary sinus level of

ATP. On. the other hand f when he perfused the heart and thus maintained myo­

cardial oxygenation, he was able to prevent the loss of potassium, increased

production of lactic acid, decreased utilization of glucose, pyruvate and

ATl. Be found this would hold true, even if fibrillation and perfUSion were

maintained for periods up to forty minutes. In hearts that were not perfused

for thirty minutes, he found that reinstitution of coronary artery perfusion

resulted in restoration of rapid fibri11atory movements, although he did not

report successful defibrillation in these preparations (11). This apparent

improvement in the type of fibrillation (from stage IV to stage II fibrilla­

tion as described by Wiggers), was suggested to be due to re-synthesis of high

energy phosphate. Senning (1952) and Jwoene11e (1945) in a clinical report

along these saae lines wrote thatventrlcu1ar fibrillation was not damaging to

the heart per se, provided there was adequate myocardial oxygenation (18,32).

Bing, et a1 in 1959, considered ventricular fibrillation as it effected the

transmembrane electrical potentials. Tbeyfound that during early fibrilla­

tion of the ventricles, electrical activity was only slightly irregular with

little change in amplitude. As the period of fibrillation was lengthened, an

increasing degree of irregularity was present with the occurrence of action

potentials of small amplitude (15,16,17).

While those investigators considered so far utilized electrical

stimulation to initiate ventricular fibrillation, numeroua other studies

were conducted in altering the ion concentration of myocardial muscle as the

, _'i.10lte a._t.. It 1. irlt.l' •• 'lq. to cmud.4et' this .,.,roach a •• ".t~1cm-

1 .... 'lHUlat1_ , ... c.od '" 81utrl •• 1 ....... ,.an to 1" ••• 1,& lDaf>Hrattl.e

.f eke ... '-14 c •• U,tuuta (5). It t •• _r.11, _-.,ted tbat t .......

a .eb 'I'ute.r COBfM'IRt"attoo .f potau1_ witbto e1M "ntM .,uJel$! 0.11 U.

ttil .... ~ MCad ... e t'be Ml1. t~d,. hl.ol Cbe buta .f ..... ,.ta.W 4U' .....

dietina Mba eke ..... nae. hn (1"1) ............ eM ."., • • , _-

cr..-taa potu ........ 14e ,lw...n. h .-wla'e4 ,a.-t 4Mt'eu1 .. ,.. ... la

utl'u.Ualull, '0 ."......'.1,. 1/4 Ite .. au1 • .-.tra,u., .... 14 leN to

.. Itl'uk4ewa.f eM tuallltSq , .. __ «1M .f tl:te "'1''' to _1I\ta18 • 4"' ....

... • f ,..._ta .. Nth _U_ ., t •• __ ..... ftfttU""'" Sa ....... .t.al'

flttl"lUatiA. .. ......... " _tue ... tl'iftla liltd.lleU._ will u' ..... ...

...... Uat. ........ ,. t •• .,... ... '" the f •• 01. • o __ ttut 4"1' .... 1D

.. W_. 1t .u.1. , .......... _~ 'Ut •• tl'tal_ '1lJrtl1.' .... M, k

•• la,N '0 eM C .... /l+ ¥atlo ... au. ........... 1,. ... eh. ,.....,_ 4..., .() ..

ll1fHlt'. aid ..,. •• (1''') f'nt i"' ........ en ......,t .... , ._ aMla fWP ia •• ,1'...- by 1_ atNMllulAal' , ....... (14). au. (1'57)

,.M'" ftC CMt .de","", dlu .....t .. deJw .. eM .... fn. t"M k9"'. It

., al .... _ ... tat ,.e.1M .. 1M ., ....... t_. 1.",.. the 'tOle of 4MI'ftftH

atl'.11tll.u. po, ...... to eM • __ u of .... "'lala 'Sbdllacs.oa _ytaft1 ••

tu .. tin .. daa "'tl' •• l1ulAr 80418. ,.., (3).

I. RnIlU.LA.'l'IGlS.. 'lllcUlf3J, ..... ,,,tala. fthilla.S. ...

... w.nd .. , ...... S.U,_ ..... , wvW .1aMt .,ba, ._.,..Ioa .....,., a

eM ...... f the patS_c. Ie 1M' y.M1' .... et .1 (42) ..... lopbt tM

"_ of ,....' ...... '&11.:1. (1900) ...... '1'4t_ lHt ..... watl".1 ..

on14 ....... h11,. M 4.,tbd,11atetl ad • "I'~f. .. t" Hart Mat .... tol'.4

6

tbnvllt &M 8,,11c8tl_ of .. 6(')-o,c1. al'a"aU .• , ."r-•• t .ock of 1 .., ....

tor 0.1-' •• 00D4 ••

lG 1934 f."l'ia clucl1.\)H I.be HM ,woe«ut._ t •• l ...... cbut •• iaa1a,

_tas blPer c.urna'. (9).

Sta , •• ,.. la'a .. CA1'1 wt .... n publ:1..H4 ........ 1 ",,81'8 oa the .. claM •

• f e1Mcrlul daf1~n..ll.ttoa (3:9,42,43). Se poia&04 out that 1f a "I'~ ., t1_ a1., ... bet'NeD tbe cue, ofttln .. tUatloa ao.4 tlte: attap' to elHtd.ca11,

.ftbd.ll.ate the "an. the ",'fleulty ___ t ..... 18 ree ... .., of eM han

w.u .. to Jac.apHit)" of t1\o 1I7ocar41_ to .... _ 'riaent.- b.aUBI u4 aot tbe

, •• luJ,.tqu .f 4dtlitctU.acloa", 'fbi. 1M to tb • .tieCOftI', ,liat ..... ' •• 1 ..

__ eM a.,. .,. ... ,t_. _t .a '-..1'''''81' ... youeM the g •• of c4ur.suc .... -

.... to .u..taia .,.. __ U."l'J to tha bu .. t aM ~rtpta.q.

With 1' .... 4 to aetul '.,ibd,l1.,1cm. Wl0tre. fow_ that .... lal.­

f1bI'111.U .. v •• _1'8 .,tle .. 1 .... CUD 8 .:lAt1& .bock. i •• ,lal,,*, caat

tbl'M '0 ..... J.rl-' .hoop 1 .. to,...... •• , .. MqiAI of _11al' f1"d.ll.U"s

.. a .. Jato lut ... a ..... wbteb " ... o.oDt .... tlDa out .f ,a ... witb ... hotlle ...

ftea ... ttaal sbock eteppecl .11 .lectl'iul activn,. ~ 811cw4 tba pace­

.aka .. to t_ttlate .. coor4inate. beat (42).

J'u1"thl' .'tit ..... by Yal"beu,b (1944) CD allematt ... "enu

41net eUl'nat cOImt4trabocu, .u bet ... 1960 aM 1965 tl .... l'09. ,..,.1". "1.'. ,.ttl.l.,*, em thll ,by.tea1 ....... l"Hultt., 11'_ At and lX abMk.. Ie '_1'&1 ..

the cnt_tloa of 411 tu •• _thon •• tbat .lectl'1cal 4ef1brUlat1011 could

h. Mh:1fted with .ltu .. A.C 01' DC eo1.'l'o.,.. kt tut tiw latte .. :eaUd 1... of

& U •••• buh (19.22,24,16.45) ..

7

the .. jo~ .1t.~.tl0G8 Got" .ft.~ 4.ltoT1114t1.. ~1 T_rao.. ..~ fowe~.

(1964) uwl'ftl;lIi Sehll Clut_1e Claol.eeU.(f T'I'._.1".". e18 •• tiou ed t~·w •••

:18"1'111 .. (31).. Altltou~b t:~u, aNt ~"' _*boI for 'lltefthrUbtltm b curl'­

cuU,. with .t!! id.ctd,ctal d1.dlal'l'*' iQ tb. lIut. ~{llQl '.Ubdllat!01l ._ .t.. 1~~tHatly IJU.-,t4l4.

\ilta,.hI (1940) ,"11f.'" .,.e.aeeluD •. dt. ~ ........ 1' .f ffbrUl.tu~

... bu1't ....... to lb. e.~l •• "" Cut 'IK\J' " $lOot lII041fy tb •• ta, ••• f

eM ftbrtl1ftto!'1 ,hIIt"_. b .. , eat they 1ItIQ.ly h •• 'eft it ~ the 404 ......... It "!v.,. .. ".t01.. nt. uytItoU ..... ult. '1' __ ... ,fA 4., ..... 1" of ft_~tf..c'm. of th.

heart.

Calet_ ... <"",*,,,1, .,1.,. f •. n ... ;. .. ' •. ftltdltnt .. ftt'b po" .....

et_ ...... act..,t , ........ , ... t. CM Hal't .. W11 •• _ "tft'" .. t that ft.

uJ.c'- ft_ .... 1';:: 'Mct ... l,. ... u I ... ne • ..., , ....... ., •• te ddl.s.. ,.,

ca .. t .. h1,.~.&1~ (41). ' ... a. (41) .............. ft .t"8C' t.e 1J.ou .-.1 ... 1 ., .1_-tl1.4a1 46f.tJaz-lllat:t_. _I: it w. 1.1t ... ., ... t l.rW_t" ..... tb.u '1' •••• ,,_

., .. to. •• 'PP •• tq tflM .... _ nm-etul" vi.h _&t'-I' typ .f ... ,tt.d,lla" .•

(4S).

10 1"'. IMhl'.'.,.,U.Qf#4 • ,.,.1' .. tt ... ·ftM' •• f uIU.>t'tll.ts..

_ .1e.' .. fl17t. l4Ml1«a 1. CM .,...a •• u.... h Mbi.,," 't"l'ilHtl_ rit.i Acft1-

tiM aM •• 0 .•• 1U.4"_ wit •• .1_11& ... " .. ",t ... llk6 e~. Hl.,iHt •••

........ 1 ....... 1: 1.,ra4eUula .. ,.., .. _,_ C&"ftM.lM ."It_lut.l,. lSU4uiq tUl-

tUl&t.lft, Gl4follovu. 4.I""d.l1.':hm ,0, ... 1_ .. tb4m ~"hItM te ..... 1

l.".la.. latt'oulll11u' "'1_ .. _ t ... to •• v .... "fJ .1");.t1,, '\i.-tnt ft'b-

1'1.114&10. IdIUl Ib_ fGll _1''' .. 1, 4.rial .efttor111.U .. ,. .. 41d Mt .~ .. ne It

_""Utc_, .t'.HI1.ft ,. vat.1' ooDt.at •• d . ." th _1:1" "ntuuitll'. (13).

It.. MIft'BISlA.AJttj SVlCIU\Y.. Tverlty-fl". _1. IIOna;rtll dog.. _,.1\111&

.Pftl"oxiMtel, 14 'I wel'e "tHind tft uta atUlll,w All of tbu •• ,\tN1. had

,... atab!lt... .. to 4ie, 884 h,iratlcn for a ,..104 of GO. week priGI' to

dt.il'.... n. .... W~. '1d. ... lato Eline COUP. con51.tl"&l of Croup I, I

cftt'l'ol 40,8, Ol"GUf II •• as. with vwCd.cular f1)1"111&t1., tm4 Grou, Ill,

t .0,8 with .ue .... f.l 4et1'rtllatloa. the followtDa .urgie.l ,roca4u~ •

• era ,edol'!H4'l _ 611 .iu18. 'I'M tl'edwi ._ UWlWlate4 fl'UCll • rd41iu

HC). lacs..t«t • .aftd tbe 1.ft ~ oal'OtU al'tG" wa_ laolata" (26).. A .0. t\

uatted Stat.. Catheter an4 tcat~t. X-I'., catheter va. i ... rted tD this

..... 1 a4 paN. tlu"fmlh ebe aortic .. 1ft lato tbe left ••• td.c:lft for .elli­

tottAl l.ft 1Atl'aveetr1cula'l' ,H""Ul'e. Tbe l.ft ft«M'u a"'t8l'1 ft8 bolated

..... _thetenllM 1dth a 1"'1tlch 1'1 190 %ntr __ Uc poly.th,l ••• CAtheter for

"1004 1'>9 ••• 1'4 I'MOl'C.u"",~ A aatbeht' "8 alao lil.e. 1" tM npt fOllOI'.1

ve1. to .. ta"ectloa .f b~1:b (04t_ salt).. A. 1.ft 1.t.l'al thora.t..,. to­

.. Ivins 1'1'_ 2throuah 1 va. 'eYfo~ and the rib. retl'ecte4. The pe~1c.~·

cU,.,. w •• tDd ... 4 _4 ., ,erica"ta! cl'Mle ._ COtU'tntetH to 11ft .....

-8-

9

The left intraventricular catheter and the blood pressure catheter

were connected to Sanborn No. 267AC pressure transd'l.u:ers. The standard

bipolar 11mb leads for electrocardiographic monitoring 'were also connected (8).

A Sanborn No. 4560 polygraph was used for continuous I'ecordins~ while visual

moni.toring was accomplished. on a Sonborn No. 760 oscilloscope. Following

the above procedure, Heparin (5 mg/Kg) was administered and the animal was

allowed to stabilize for twenty m:lnutes. As the proc;edures followed from

th1.s point on were somewhat different, they are described separately below.

Group I -- a 10ec sample of homogeneous ',venous blood was taken,·

from the right ventricle by direct puncture. Approximately two grams of

cardiac muscle were excised from the lateral border of the left ventricle.

The surface blood was rinsed away with Uiple distilled water and the tissue

was blotted and trimmed of fate The sample was then divided, half being fro-

zen in liquid N for electrolyte analysis and the remainder was dried and 2

extracted with ether for water and fat content.

Group 11 -- twenty minutes following the administration of Heparin,

the heart was fibrillated with a 4-volt, 80-cycle per second sine wave pulse,

applied to the apex of the heart for 2-3 secondse Fibrillation was allowed

to proceed for a total period of 30 seconds, during which time cardiac

massage was performed to maintain coronary and systemic circulat:lon. After

an initial 25 seconds of fibrillation and massage a blood sample was taken

from the right ventricle and during the ~emaining 5 seconds of fibrillation

a sample of cardiae muscle was taken from the left ventricle.

Group III -- the same procedure was followed as in Group II, exc.ept

10

Oat blood ... Is.. ... ...,1 .. ·...,.. ••• tat_ .f.el' 30 ...... of fOd.llaU,on.

X....... .1., .. S .. 1 •• fS\trilla,t. .. w ••• , .... with ... cliek DC/I" 4.fl.-

l»dUat., •• ...u.a .. "'pt .f 19 wt ........... (22). hUowSaa tlla .... tonti ..

of ... _an hac ......... if .... .,. cbe eJAcCl"OUftUpaa tbe '.,......t1_ .... • 11 .... te newe" tft 9' ...... , ... at ebb ,fae blood .. e: ...... ...,1 ••

•• C1II84CAL ~... s.apt..f ,Ia ...... 1.' ........ ted ...

.,0Cft'41_ 4w1 • .unl, '''rillACi •• ad .. f' ... 11lat ..... we ... ...,.,... til

aU .... In k+ ......... Cl-. ft •• 0. .. Iaalf of eu.. Me ,1aoe4ta l~

IIa WIt "'jH'M to .. , ........ of ..... ad fa. _t_c. !be , ...... ...,le .. caRMI, '., ........ ,Me ...... UM ,_

tIIfte ..... t ...... hte ...... n ... j .................... lata .... S 111 .f O.S •

"J. TIM .......... tlIMt 'NUfe ..... to • _crt,... , ....... a '1Ml

.Utatl_ .1 Is 15 ............ aftar tbn. 1'tB ... et •• tf. .... d ..... "'til

0.5 • 1DIOtJ. 1tN .'1e1:e4 .................... e ........ tri.,.... fft 10 .... .

a. 1200 I fer ......... t , .. leDattw. Alt .... of the ......... , ....

..... ...... fO'&" eM .......... , ...... tf.cIM of ..... , 1+ aM Cl- .. ~ .. Sa

llae f.U,owl ....... .

Ct-

1 a1 •• ,.nateat ti-t ...... 4' .. .,., I. .1ol'U ••• cena1u'''''

k+

1 til "' ........ +2.1 a1 of JO .... , lOO at. uu,_ aelfa.e dtl",_ '0 2' a1 will tr~la .utU.l ....... fol' .,.t ... t_ 4et.uuct ..

3 .1 ....... , .. , + 2.' 111 .1 JO .... , 1&0 a1 I1tb!a .ul­,.,. 411", .. &0 2' .1 wleh td.,l. 4f..­tUIM wa'el' f.~ Md'_ •• 'eratu'l_

11

Wi_ aRd pMu81_ de.e,.M«1 •• we ... tu4. (if1 • , ...... aM

lut~'. (1104*1 U) fl._ pt.ot .. ,er, -:taa Lithia .. _ 1ateraal ata4a" ~

1M ... of ,t.. t.uenual a' __ ' ... mt. ttl .... ,.1' .,"'U1", ...... _b

tu ....... the pnc1aioa .f thl ____ ,.. Litht. Sa fa~ •• _ Ie

al_,. ,.'eU 0. ......... &1' • .,._ 1ft .....,. .. 1." .• ""'taa au1,.... !1M

1..tPt "'puC I .... tbe , .... fllM of aM .... _t ........ _, ... ., two .,tt-

.. 1 .,at- .!ale., .. ". OM .,.,_ M ,....,.... vida aUD'. fl1 .... ad

the oCUli' ftth ., ..... 1' ............. MCU._ 'tl'e .. 4"."_1 .. tbe lea Miq

.b4tad... 1M tw ........ all.we4 to ,taU eta ..... ..,...'0 HWHI' la,w

, .. , .. .u. (tk Lt+ .. U ... the ...... &+ oal1). tM .'puc .f tM 1.1+ .. 11

ia .tt ... J ....... aIM, lbe ...... f tM .... (1.+) cell -iDa ,be .&1 ....... 1'

... .u ,.tat. ..e_. t'lau. OJ , ............. Il .. tutt. 1a tlaa 'ata .....

• ,.,.., ,hor.oce11 ... ,ut ~I' c,,- tut ............... ntsn.f .... 1:+,

01' 1.1+ 1ft .u flaM td.U .f' ... Nth ,.bOU • ....n,.. .lace .... ,-...tor

~e1 ............... eM •• ,,18 .f 0. ........... ,_ .. ch_ lbe .ueet cell .. ,.t. Pu. fl.* .. tl. ..... to .. 1........ ftl. INtn ... t .......... nao~llit7

•• 1.01 .... ". u..1' ..... tM"." 0 c. 100 .......... ' .. leat. ,. .. lOG .. • f

•• 1 ....... .

Chlor1.t ... .....-uf14 ....... U ...... c.t1cMt elMtrlcaJ. .it .... e

...... _ the .. tMcl of Caft' (1951) ... *t.cb .'1 .... , ..... 11. ..... t" t .....

..u ...... 1 ........ at a __ r ............. "ta" .... orUe lea ... &be

.. 1tatt... 'An. cel:'P"J. ... "'til ••• I'$.u .f ............. 1aks, the e1-

c.e.rrati, .. t ••••• , ...,la ... M M'aad1aa4 (4).

11"11'01,'8 .. 1,818 of '1 .... ...,1.. for ...... 1.+ ... C1 ........ lao

UI'I"" "' .. ia41catM .. th4t'o1lovl .. , .. as

0.1 .1 p~ ti-t ... ," 41~.ctly t.l' ehloft~. ..tGrm1ua­tloa

1+

1 1111. pl .... + 2.S -1 of 30 del/lOO III 11"'1-. ._11_,. dl1~t.d to 2S 81 Vitti ,w1ft. .'at11144 ntey: for pot ... l_ 4.­tenia.U,_

12

/).1 .1 ~b._ <+ 2.5 .. 1 fl.! SO _14/100 wl l1chlua eul­f.t. diluted to 2S .1 witb tI'1,1e 41.,111.4 water lot: .041_ 4 ... :.n11\4t1_

., •• J.DI cU foUovial ,I'OC"... no __ 0I\fl taelf of tM ,r-n1cHaal, .... c:d,b • ..t

..,1e vu ,l.&u4 10 • clMa 4ry .atpiaa tlc't1 .... r k.uv4 "take. 'lb.

".1ptll,betU. aM ...,1 ..... " t.1Ma .... 1P-.:l. the NapltJ .N tUft dl'!e4 to

COIUI'._ ~t at 100° C fol' .8 boaI'll M£4 wue·J' «_tat wu equated to til.

wi&ht IN. Nt"... tM wet. _act 41'f .. 4 •• pl... 'eneuu.. £at-I'I'.. 4t'Y ve1,,-,

....... u. '" "",",ht. tbe ell"" • ..,14 .1;.:1' .. 1. atl'I.ct10Q, v1tk

dHtk,l athft 4"OI"1q to eha _PH .t l.ow1ry ao4 B •• tillia (194223).

C. MA'rBDfAT1CA1. .Ml.ALl'Sll o:r nA.tA. ta orcl.r that tlle re .. 1e. of

CM ,rob1_. .. "tol. .,.t .... e hu. ".,. 1'~uJ.I''' wb,i_ exclodd "'.tel'. f&1 t

au eoll ___ tnh .f tM luau. Sial.. canta ... ecl>l!l 1. pneUcAl17

.... ,. of eollAt •• Mel .iaM Hart ... cl. wu l"dO'ftcl acutel,. 11M thel'o'ore ac

0,pol't_it1 '.'1' iMru.. q coUaa- coat_t te Geftr (u 1. Che Cbl'Old,ca11,

10jued beart) t tM "collapD.-fl' •• " fMtor w •• eot lu.lu4e4 •• part of the

13

el ... 1, .ppl'ft1aa,,,ctie coae.n.tt:aU.OR .t pee ... '_ 10 1at~,t:8ttt1aj. _t~1:

(lloHne • .., ,.,. ..... , 19'130). ~ .OUlney of the chlor1de .;PM. otthe

hun 4ud.q UlJ ... 11latloa with caNtac ... q. qfl1 fl.t ibI'Ul&1tiflA _~ duon ....

trated oa .. 40a 10 wl. ch1ol'~ 1 .... 18 ift tbe .I't_I'18.1 circulation. and

cenu.,. .,_ 111004 _n ~ .ad 'MD4 Mt to ...... tpUiuatly.

Jiutrtktl_ .f 1 .. rithia tbe ut"Malitia" "'a.8. 1 ••• "-

"'Tl_. A Doaua '.ct.'&' ....... 81_t lou of 0.98 I. tu .,.utUwa 11M

_" _ tile .... 1. of tbe f1HlDaa .t Drla'ker e, .l (1940) kMd ... tn:otel.

coaceatl'atloa of 41 ta cardtac i,.,h ('.%$).

hOil tbe ,.. .. 1 ... 11 eutec.t .... ..,t!... tblt followtq ... l&tioa­

ehl,. an .... I'ally acce,t" 'M' ..... 41H __ 14t (I,U,1'.!.)

(~ll • (&>, X 0.98

[J&)J • (BG)p DO .. 9.

(ella • (el), X 0."

(120). • 1000 (C1)t - (11, ~O)'f ~ .... , •• r

lel) - (ll & 1

(1120) .. (alo)., - (1120)1

(t) I or (Na) 1 • (l)1" ('~)E J. (H20):& ._ ..... ". ~. p ~w,.,"" __ .. ...._

1000

(1.)1 01.* 1.11 .~~~~!! __ ~!!?L_ (H10~~

(1)

(2)

(3)

(4)

U)

(ii)

(1)

CHAPTER III

EXPERIMENTAL RESULTS

A. TOTAL TISSUE CONCENTRATION OF POTASSIUM, SODIUM AND

CHLOKIDE.

Calculations of intrecellular and extracellular volumes in­

volv~d the assumption ~hat extracellular K+ closely approxima­

ted the cOIlcentration of Cl- in the intracellular compartment.

As such, these quantities differ by approximately 10% from

results reported by Lowry and Hastings (1942). These authors

calculated intracellular and extracellular water on the basis

of CI- being restricted purely to the extracellular compartment.

The myocardial concen:~atioa of clcc:~olytc3 in the con-

trol dogs are in agreement with those reported by other in­

vestigators using fat-free d~y myoc~~diu~ 8S th~ reference 25 ?

base (Manery, 1954 ; Benson et aI, 1956-; Colman and Glaviano,

1954 5 ).

Figure 1 compares the change~ observed during control, at

the end of 30 seconds of ventricul~r ~~~ril1gt!n~ 8~~ q~ necon­

ds after defibrillation. During ventricular fibrillation the

level of cardiac muscle ~+ w~s ohae~ve~ to dro, ~~OM ~~ ~verage

centrol le~el of 3Q.04 ~.42 mEq/lOn gm. FFDT to an average

level of 33.42 ! 1.98 ~Eq/100 Rro FFDT. This was a change of

14.4%

-14-

'FIGURE 1

Total Tissue Electrolyte Concentratioas of Canine Myocardium During

40

30 ~ a &I. &I.

E bl 20 8 ... '" cr

~ 10

Control, Ventricular Fibrillation and Following

Electrical Defibrillation

o Control ~ Fibrillation 8 Defibri lIation

CIT

16

u.4 .... a:tluU1c.a1:lt to 4& , < 0.02. It.Ht)' •• cncle .fta .. electrical uatll:n .. U ....

laclOl\ pot.atu. va. olut."" to tt .. to 36.43 ~ 1.08 a'1l4/10a PI J"FM Which

1 •• t111 ,d.ptftcut1y lcrvtel' tbaa _.tI'01 (P<O.O,).. 'lb. tabul .. tetd re •• lte

&... ~ .. _ted 1a t'.hl. 1..,

Cantac .... 1. sAd!_ vas ob •• " .. to rUe /1\11'1 ... U .. bl'UlaUon

fl'Oll U ...... coatl'81 .f 17.48 * 1 .. 06 ~/I00 III "If,l ,. ell .... of ""rmd.­

_tel, 101. Xa the poet detlb'flUatol'1 pflr1", &od1_ WII. aot o'b.ened to

.. etura t~ .. ..al. but coatleue4 to 1'1 •• to 20.'1 * 2.10 "~/lOO 1ft FPDf,

• 201 i.ere .... "1' ... t~l. r.~lated I'eaulta .pp_al' 1a Tabl. II.

Tabulated .... It. for total t1.sue culorl •• ar8 liven t. t.~l.

IlI.fr_ the Cata t Gh1od .•• wa .......... to d." .lilliel" frotl ...... c_tro1

Inel of 12.69 * 0 .. 6' a&q./l00 sa. J71J.t to 14.02 * 0.16 aa ... /1OOp. nDT .fter

30 .. c0a4. of Yentrtcular flbI'111etl00. r.l1owi.. electtl •• 1 'efl~r111.tioct

elM C1"" total U ..... 1 .... 1 4.c ...... to 13." * ti.SS dq./1OO ... 11'ft.

Altbouab it .,pu ... that the chao ... ok,," •• 1IiIkt he pt.eN co the pro-

c .. " be' ... atad1M.. staU .• ttcal .lpttl .......... aot _c.t.u4 _tth tbt.

ue_, Nt'neIt eM _Cl'Ol, 'tbt:illaCioo aM 4.f1_t11at1_ ... ...,.. of ntM.la.

a. PLA8IfA COIIICUftA1'lOl. or PO'USS1VH, JODIlfM .. CIU..OlIDI ..

PJ.uaa 1ft 1 ••• 1e a" llYn 1r4 ltaura I, aa4 ... .,1' .... , .al.,.,o .f ao.osaou

.........1004 ,I' .... t 10 the riat:a' v_tricle. SbM tbe .1oed frOil the COl'O-

ury at.. 1'.,.1' .... ,. oal, a 8IM.ll cOIltrtbut1oa to the total yol-.. ,re •• ut

ta lb. rtant ... ,.101., the cha.... Obaer¥ed in the 1"1sbt ... t.tcul.r plaaaa

loa MDCtmt •• t:S.M are _I _pat84 , ••• 1'1 w1th tb. oha .... UIY" 1a total

ayM.ari1al elMtl"olrt.... 'l'oc ... t_ toa " .. fOU'li'Ht to ••• raso 3.61 tOO.11 dill.

/L pla ... water 4 ....... coatro!.. .tel' 30 .-.eGAd. 01 Ilbrl1latt_ .. He ...... to

/

flaM 11 .. ,1'011'. eou.ftCI'At:S.- ... Coae ... l lop. ftbrt.1lat- PoS­

aM Sa »ea- '011-" 11Mel'lUl »efDTUlatioa

4

....

""" =-2 III E

DControl ~ Fibri Ilation 8 Defibrillation

.... ~ :80 E

18

2.93 t 0.2' 1IIq.1L va 00 •• ",", vb11e 'O_coMa altar olectric.1 d.Ubd.l·"

laU .• ,hotOMt .. l. a .. l".I. ~ a rta. to 3.'8 t 0 .. 40 .r.q.1L pumu vat.r~

'1 .... 8041 .. r ..... fro. &R ."I'al. e .. trol of 14$.1' t 3."

a1q.ll.. '1 .... wata' to 13t.3fi t 1 .. 11 lIIct.lL followf.. flbrlUatioth ni.

leftl W.8 o~ ......... Ie d.8" U ttl. poet ..... flbl'1l1.tloa per i 0 dlO • 1St_ ef

117.4' * 1.11 dq.1L 'e U1.19 t 2.0' .. ":'.tt/t 4uI'iaa ftbrtllatlcm aM th ....

fall to ...... 01 I1S.S4 * 2 .. 4' dq .. /t90 •• cOl2.1da .tterd.f1'bl'illat:1olll.

',.tlatteal 8841,.1. of the data OM .11 tbr •• '1 .... loa. (K+,

It.+ 8M C1-) f.U" to 4-.Ml'ate 8taClat1cal1" 8i.a1flcat cbu, •• betve_

fibrtllatlem aM d..,tbd.l1atioft ('P 'R1 •• 0 •. 10- 0 .. 90) .. 'tabulated data .appUT

1a cahl.. 1, 11 .ad 111.

e.fOTAl. tUIUIAD COhfAl'nlllftn VA'fD 01' 'fBI JtrOCAlDIUM ..

'aw.. 101' total tl ..... vatel' au tM cU.vi.,toa 1vto atl'. aM lutrace11"lu

ntH "I'M el ... l,. riCh ChoN "'.,01'1" b" oC.h.el'l.ft"'"tt,atol'. ( ..... 'Aer'. 195422' i

ilOlUJ.Oa at &1, 1",2, Colaa acI Clayuao. 1964'). Tb:roopour. the lIIIlq)ed.Mnt31

'1'004 ........ ip.lf1c .. ~ ch.ns- VU olt .. nM ('>0.40 - o.SO) 1a 4ftY of the

cOIipenaeet. O'laur. J). Coatl'Ol ", ... 1. -.vera," "'.16 't ,.,4, 275 .. '1 t 4." .... ".S5 '* S.6' pl100... rnrr for total U.ene wat_, Ht .... «11ul .. " water

au4 dtl'ac.ellu1&r ..,at_ ... a,ecti ... 1,. luru., 'I.-.l'tl1atioa total th •• vater,

... 371.61 * 4.6' s-I1OO sa rrDt vbtl. 1nt:racel1u1a:r water v •• 272.S4 % 4.29

,..1100 p. ftM.E'xtJ'aceUv1a.,. ."'fA,eel ta tM .• atate vate .. 106 .. 06 * '.18

.... llOC.... FI'D'f. 'ellow!q 4.f1l1r111atl_ wtel' dlat'flbuU.ft va ••• follow8;

flWU 3

'foul y ..... eM ~t.l Watal' 10 Coat"l Dote. 'tbrillated

1)0&8 .. 1oI. hUow£DI 11ec11'1ca1 ..,1\ .... 11.t"

400

... 0300 II. II.

E bIl

g200 .... ~ bIl

1 00

DControl

~ Fibri Ilation ta Defi bri II atlon

0~-L~~~ __ ~~~1----L~~~-----lota I Extrace Ilular Intracellular

20

to,.l '1 .... ')12.0.7 t t .. i4 .. ",/lOO ... rrrn. in',.cellulal' W.,.' 212.21 • 6.06

,..11. sa. Jnn MIl ah_l1t&1_ .... 109.80 s '.01 .... /l~ Sli. ."".. ..

t.o1nJlaM4 ...... "... .. ,. 'abl. lYe

a. "1ft&) COICU'fU."lOD Of IBftII1TrIAl. AlDlltfUtlLL.ut..d

Wt:J'lO'LTlU. .As .... dH4 _ttlt... (, ... 1" t tk ... 4t.tl"lkll_ tft ttt.

1ateftU.U.e1 pbaM .f tbo dCI".elW." ....... ftan.t ... '.taatad .,U:. 4

.............. '_101'. .. .'pU'", ._ .... VU uctUt 4ud ... _, ., tbe ,ro-

....... 1)Ji. 'If" .,.. ... _, __ the •• ftl ........ 4.1'1."" dlr •• tl, fl'w

liM ,laeM c •• u .. "'I'., .... _loh .1 .. • 1. Mt ._ow a stpt.fi .. , ch.It,_ 1a

ele.c!'ol" ...

laCI" ... llular .1 •• 11".1,... .0 .. '" la «he .... 't~i.. .. t~.

t.e.l t1 ... ftl.... ' ............ elatu l'he thai" .un __ ,. t"tl'Hel1alAI'

., •••. .tIa+ ."...... , •• tl& .......... iud.a •• ,_ld. tatru_UsU't 1'.. 4 .. 1' .....

tcea ..... ~1 of 140.51 * 1.61 .a.JIa lat •••• llular 120 to 121.49 * 7.04

aIt/lctatl'.ceUola .. 1,0. ..SpUI.a, cit..- (PcO.G2). ,.11Otrtq: elactl'kal

4.'lbrtU.ct_ the ..... t .. ,. of th18 :t_ vith .. tM _11 nhrud ,e

1'2 .. " • 2.U ..,111 blt • ...u.:t_ .,0. It. 'Q1. eiplft __ U,. '_low t1&.t .,

ecmt1rOl (feG.O.).

IM'_ ........... d ... laU.ellul.wI" -Lat til. fl.d.11 ....

tftJ' ,.nM. tno • M9tI'Ol ., 7 _.S * 0."1 ..,.1Ie u.t .... U.u1a1' 8aO to

10.196 * 1." ... Ila lat .. -..llul ... 1t20. '011 ....... el_,.tul 4.f1 ..... 111 ... ,,_

'" ..... 'r ............. to ........... Hb1«Ylq • 1 .... 1 ., 1'.12' t ~L04

a1ft1lc laC"4CfI11w . ., lafJ 90 ....... ,Nt .fQrUlact_. tab ft. (I • .,.

of ."nxi_hl1 "I ..... COd ... 1 ad W_ -ia'Alft.uat t •• '410 .. 0'_

nGUU It /

lathclJ.llulAr 11Mtl'Olyt_ e __ dentS_ of CalM "'".'ftU,., Durtas

C.tnl.. "_trtnl... P1bd.Uatloa ... :roll.owf.a& &luufe&1 Dett"d.l1attoe

150

~

0100 .N z ....... bI)

:.: ~50 III E

o·~ __ ~ __ ~~-----K· I

21

15

10

5

DControl

r!jFi brill ation

§ Defibri II ation

Na. I

22'

I. CAIOIOD'fbHlCS. ......1" __ ,. of carcU .•• factin reCtO"'" ..

the 1.', hu __ tS'S • .t ... pceu...... ' .. "al ... lood pr ••• up ... the .1.ectl'O-

can.acr:. " ... lac. ... ct to ...... t the _ •• nuco. aa4 ,rosr ... 100 of ... -

td.nlar U ..... 1Ua' ..... IN ....... e' .f hurt ....... aM tM 1' .. 'or&tlon of

ur41u f.ett_ '.1~ el .. cr1u1 .etthrf.l1atiea cna-.5). 10 .. 'o, ........ the ,.tat ...... "t&rUlaltoa" the .,,1eal

.t .. lroc.ri1o .................. d.uod.1Ht4 ~ Viap... (1960' ... MtN. 'DI ... .

... a , ..... tw. Ma' .. f.U ...... tt, a a1'l lUll of cufl, ... "",. which ... 1 ...

lato • '1 •• ra ,.ttlltn. (40). Ale. it WII. obMn-N tb.t with tbe oo •• t of

"hillat1_ 1. ella .lMtftCAl'CJlos"a,lktc tnc ... , tH kit ........... crt_1ft

, .......... '.-cal .1004 pre ...... t..u",c~, I.U. '-1'1:"1' a10at _ ttaat

rHO .. 4 eM .ta ....... of .,., ... einvla"_ v .. Heat ......... by the

el ... , .. I.', .... 1' ... CI', ....... , ......... 'M f..n1 '1'" , ........ . tit. ai441e ......... na ...... to ,,,,.rSod ~tel.l., fo11owlq

8leotl',"l •• flbrlllats... "'-ID, fttch & d ..... f.-Tal .. 1..., p ...........

saa .. eut .. l.ft iatr .... ut.ulal' , ...... ,. vera .... .,...M. The Mct. nocml , ..... ala.e .thl' .' •• rillacua ...... le •

• ..... 1& ... 1a ........ :lep ...... ...u..t .. da. la e_ lefe .... I' .... tri-

nlal' , ....... ad ' .... 1 Itl .... ''1'''''' •.

FIGURE 5

Cardiodynamic Recordings of a Dog During Control, Ventricular

Fibrillation And Following Electrical Defibrillation

~;oH3' 100

50

a

75~ 50 25

a

150~ 100 50 a

75§ 50 2

Defibrillation

:~~~~~N~~~

~~~ 25 a

1 min. post-defibrillation

Bp - remoral Blood Pressure LVP • Left Intraventricular Pressure

BeG - Electrocardiogram

24

TABLE I

POTASSIUM CONCENTRATIONS IN PI..ASMA AND CARDIAC MUSCLE DURING CONTROL (GROUP I),

FIBRILLATION (GROUP II), FOLLOWING ELECTRICAL DEFIBRILLATIOl~ (GROUP III)

Exp. No.

301 38.039 302 40.136 303 39.723 304 37.185 305 40.687 306 38.756 307 38.238 308 39.593

Group I

141.84 2.5406 2.5925 138.64 3.3574 3.4260 148.98 4.1999 4.2851 139.89 3.8623 3.9412 144.25 4.0353 4.1177 134.64 3.6894 3.7647 140.87 3.4025 3.4720 134.97 3.6750 3.7500

Group II Exp. + + No. {K)T ,[K JI

201 202 203 204 205 206 207 208

36.679 33.394 22.271 28.145 34.198 36.552 39.545 36.544

125.75 115.08

81.43 110.98 127.51 132.52 147.02 136.61

3.6605 3.5051 1.6496 2.1181 3.0558 3.2185 2.7195 3.0264

3.7353 3.5767 1.6833 2.1614 3.1182 3.2842 2.7750 3.0882

Mean 39.044 140.51 3.5953 3.6687 33.416 121.49 2.8691 2.9277

S.E. 0.420 1.61 0.1811 0.1855

Exp. No. 161 102 103 104 105 106 107 108 109

Grnup III (K+) T {tef'h

38.852 139.52 31.751 132.84 37.048. 139.63 34.329 138.61 34.745 136.56 30.444 117.56 41.463 138.40 34.637 119.87 38.651 130.35

1.984

""4. 305~ 3.4843 3.6206 3.9471 3.5933 0.5717 4.7133 3.2665 4.0833

7.044 0.2422 0.2471

4.3935 3.5555 3.6945 4.0277 3.6667 0.5834 4.8095 3.3332 4.1667

Mean 36.431 132.59 3.5095 3.5811 S.E. 1.083 2.83 0.3963 0.4044

(K+)T .. mEq. Potassium/l00gm fat-free dry muscle

~l! .. mEq. Potassium/Kg cell water

~} E .. mEq. Potassium/Kg interstitial water

clC+rp .. mEq. Potassium/L plasma

25

Ult.z II

80DltlN ·COIICI'.I'BAuOtS. D Pl...lIM'A AD CADUC lW.CLE DilJU:JC COJIf1tOl.· (CIOlJP t). rDJlD.U.no1t (caouP 11). ros..tOVtIO ILIC'ralCAL DUtlllnu.TIOJ (QlOUP Ill)

lOt 1'.2" 7.683 122.01 124 .. 50 201 U.036 9 .. 9" 139.92 147 .. 18 J02 1'.114 6.6. 141.25 1St.!' %02 2S.2JIU .. ~84 152.'6 1",,81 m - -- 144 .. 99 141.'5 203 14~50' U4 .. 44 1.16,,17 304 1 •• 4. 6.207 1".1' 1".25 204 11.'" 1~,,24 136.48 30' 11.519 7.61' 1".'4 1'6.&8 105 18.194 .$ .. 674 112 .. 94 176.47 306 15. toe 7.4. 143.32 146.24 206 20.101 14 .. 254 11'." 118.02 307 17.013 9.'" 149.10 152.15 207 11 .. 6" 7.6" 1'2.38 11,.49 $01 1'.811 9.5" 146.7' 14'.72 208 19.667 ,.~:t 144.63 147.5' Hun 11.418 7.a" 14'.23 141.19 1'.111 10.19' 140.87 13' .. 30 a.l. 0.621. O~'31 3." 3.63 1 .. 056 1.'92 6." 1.11

kotIp ttt bp.

('Ia+ 11.+ ..+ J •• + 110. f - 1 ,.

.. _ ..... -u'~ __ .~ "'lI .' •• , ...-~"'< Iff , ... ,,_ "!Ol"\'l\~ .... ~_ ~~~~~' ",~,.j.'"

101 10.270 - 147.00 150.00 102 22 .. 9Z2 6.340 151." 160.80 10' 15 .. "1 '.512 1"." 160.80 104 27.204 1'."9 150 .. 03 153 .. " 105 23 .. 0'2 U .. H6 15-6.08 1)'.26 106 13.)1' 'M. -.... 107 27.756 15.7'1 166 .. 06 1".45 lOS 25.613 21.6" 119.40 111.84 109 22."9 12.841 145 .. 31 141.11 Mea 20.969 1'.123 149.'1 1'2.9·4

8.1 .. 2.019 2.040 4.9' 5.0'

( •• +i'l' (111 1l1q-. IMt,..Jl00p fttt-t .... d~ .. elA .. of t (111 ..... Sodt_1&a •• 11 fttel'

.... I. • .... lod1ua/1a hlt-ereU.t1al vater

hi p (111 Idq. 8o.iaa/l.,lana

26 TABLE III

CBLOJlIDI COICIlITllATIOBS IN PLASMA AID CARDIAC MUSCLE DUllING CONTI.OL (GROUP I),

nBlULUTIOR (Cl.0UP II), J'OLLOWING ELECTItICAL DErIBJlILLATION (GJlOUP III)

Group I Group II Ixp. . Exp. )to. (Cl-)T ECl-}1 [Cl-]lp No. (C1-'T [Cl-) ~'cl-1' . E P

301 13.941 122.51 120.06 201 12.343 119.46 117.07 302 14.054 122;18 119.74 202 14.954 123.63 121.16 303 16.173 120.18 117.78 203 15.631 127.52 124.97 304 12.761 118.54 116.17 204 18.281 134.61 131.92 305 11.787 114.87 112.57 205 12.219 121.59 119.16 306 10.984 124.94 122.44 206 13.441 120.33 117.92 307 10.115 118.45 116.01 207 12. 95ft 130.32 127.72 308 11.712 117.46 115.11 208 12.326 116.79 114.45

Mean 12.690 119.89 117.49 14.019 124.28 121.79

S.B. 0.6926 1.13 1.11 0.756 2.13 2.09

Group III Exp.

(Cl-)T rC1-ht tCl-}p 10 • • 1'.218 12'.31 126.12" 102 13.852 111.29 109.06 103 10.674 113.72 111.45 104 16 .. 705 111.29 109.06 lOS 13.583 114.21 111.93 106 13.426 121.50 119.07 107 15.373 125.85 123.33 108 13.162 110.57 10S.36 109 13.964 123.38 120.91

Mean 13.884 117.90 115.54

S.I. 0.545 2.48

(Cl~T • mEq. Chloride/100.. fat-free dry mus~le

{C1i 1E • mEq. Chloride/Kg interstitial water

{Cl+J p • 1IBq. Sodium/L plana

27

WLI I'f

una conur or f1.t.IMA .. CMbUC !lUICLI DUIDC COJftOt (now 1)_

nlltlJ ..... 10l (GIOUr U). rot.LOWIIC at.ICtUCAL DUDJtlJJ..AnOl (GIOUJ' III)

..,1 OI'OUP II lap. -. Io. (11,0)'1 0ItJ>1 CIJO'. 110. (BJf),. (BJO>t; (Il20). J01

....... " , "4.51 "266.24 . iOi:1T ~ .. "iii'. fo" '111 .. "-'" .. "r'-~m

302 "4. OJ 116.89 107.14 202 ,"." 281 • ." 112.13 30' JU •• 26'.10 U,.,. 20' '".18 271.11 119.07 J04 S67.1S 26'.07 '9.080 2G4 38Z." 251.10 131.16 30' 371.» 27'.46 '2.'9' 20' 364.03 2,6." 87.041 306 "5.16 2a,.O 7'.47' 206 379. SIt 273.01 1M." S07 )41.12 2".'" 77."1 207 "2.94 2'7.17 ".767 '01 S81.50 2tO.a, 90.609 20e ,.,." 2".27 ICC." ... '73.11 27S.61 97.'50 "1.61 272.'4 106.068

'.1. 5.34 4.5' ' •• 34 4." 4.2' ' .. 184

Onup tIl ..,. 10. (8,O)T (·2°)1 OlJO),

, ." Ill.. 'dI ... p" • W., I ,. l1li ~ .. , i/ii -.-: ..............

101 '71.14 27'.2t 102.&' 102 3M.U 211.16 11$.8' 10' 146.85 I6J.l' 12.86' 104 387." 246.16 141.37 lOS 162.52 151." lU.11 I" '6'.73 81.44 109.2' 187 486.19 291.11 IU.OI 10. "'.49 2".90 110." lot SH.4' 29'.01 103.41 .... 312..01 271.21 109.101

1.1. 6.64 6." '.061

(ISO), • ....... 11 • .. t ..... , ... 417 ... 1e

(120), • ........... 11.lal' "".1' /100 .. tu 'reo • ..,. .ac1.

(1.8). • .. _ •• att.ia1 ..... 1100 .. fat-'I''' '" _cta

CUAftU tv

hI ••• att..,U .. , ,. _ .... the Rn* ct •• ttoru. pa-op .... 1. tk.

ll1t,,04utl_, 1t 111 .. 0 .... '17 '0 enat. a 1.tIdfled ...... f 'M altcraU,._

which OOCQ.l' 4uI'iDI ftI1tl'1cv1M' ttbdUat1oe. a.callJ.aa tke ob.U'Yattna of

WJ.apr8 (1140) _ the PC'OIl'u.tn .f Itbd,luCia 1. the cum1 •• h •• rt. he

1'.,.fl:M tha' canlM MCl¥tty 81ell a.t.pt remt 1 ........ t. pft'ful_

<oan .. Cioa) of ct. • .,.._"tw 18 l .. t witba the ft.aC two '0 tD:'-_ .~ •

• f fl .... Ulad.ora. (40) <II rue ta ... Co tbe D1'Mb, of .t.1t ...... oOGer.atle

of the _tire ... tUIU, .... f th. IlMn lato "'" RIlll ....... CnflnaU ...

• f the Nl'l, lou of ,.f.ioa ..... eb ....... :la the up,.r tl'a .. of n .. "I'. S.

whe •• laft iaU ..... l'lcuiu aD4 ' ..... 1 "1004 'h ....... r. DOted to "'U.u

w:Lthta two ....... f'81' the ... , of ftbrillatlOD.

I'ollov .... eM 1 ... of 1ooa1 tUeue .., ... , .... u.l'aocnr8 •

ponM .f , ......... ,,,. tat1t1". 1a eGGtI'Mt"'. ..U.l tlwl tad.t'ridul un.1t. 00

lola ...... .,. _tlft. W1IP'" (1940) atat.. tut ttl1 ...... to tM --.1c

... 1t1_ .f tIM Hal't (40). Ona .... 'Uta, who at.ucU,e4 tbe ~ effl ••• f

28

29

atleM tna e_ fllt~tl1." .. Ileeft (Cttapter 1) 1,*,.1'1 .. ctle •• eNUtMI ult1l.-

.. dea of ".,... •• as .b.l' .. t.n.,~ ef ,lIMa .... ,.... .f aanla (11,21).

hull,., ..... ,.. ... t .. out tha, fttll ........ ttutae 0.,... .. t108 t_l'e1 •

.... " ....... ., tlut ..............,1Me .,.at-. w.tct1l lata to ...... ,...,latloc

•• " ....... (21). II til ..... U ... of PJ'ftftc. ... ~1,. lon"" .. ...

...u nedc .......... ta the prodMtioft of hilh eMl'11 c ....... a ... .

m. • .......... na ............ t1al fu1 t.., 1M .ch_'_ of elMtI'01".

t~ .. poI't 1 ...... ta the cad ... ..u. it wwl. h a,ee.a4 tbat .1t .... tlou

.f e •• le .... !". eaacatntl __ latdMd .. 81t_ d .. of eM -'rue

,., ,Me. ,.,.. wU.l .. .,t.l, .... It • ...• I'Ddeed. .. .. I, Sa the • .,. .. of ID-

.S11atieD ..... a-. .... 81eetnl,t. a'IId'_ (l'M)U. 11_ (1",)28 ..

.. ,laa (..,..11.aUi1) NfUl ..... eM .an lone pe'''.'_ ......... a04:l ••

e." ... ..., ~ i.e alee .....n .. 1e , .... ,ta. flHs.a .. ,.... ... , .. 1.

Qaa, ... Ill. ,M ....... Hnc 30 ...... ct' .... tI'Seu1a1' 'U."UJAttoa "'t1\

,"'total t ..... aM ... t., ..... Uu1et' ancatntt .. a .t r:" aft ftl1atat1aU,.

......... .... ....... 1M a1H "nul. 1"181111 ..... te of tecal ct .......

tat.~ .. 11v1a1' ... ...

,.. ef' •• t ·0' Wa a1t •• ,108 Ia electn1,.. 'alae ........ the

...... _II '- '0 1 ..... the tI' .......... pot_tla.1 (llteftt e4lutt.oa

... It SatJt!1 ... I).'l !tat. tUt'H ••• th. naceptllttl1ty '0 '_I'ate eetoplc , -en-; foed.. tIa4t .,..lic uten .f the .,.ca .1 •• ' "'crl ... vUl 1M tatft"RI"e4 1ft

OM of tv. ..,... If _t .... t_. ,.te ...... will e_t1aue to alt *11e ._.1_ vU1 "'14 up _cata the a.l1. atil the __ -raM •• a ..... ..,18c.l,. , ....

po1ad.'" tMt .... ,.1.1'1 •• t1n ta .... 1. co •• etll'. tlda....,.. aftl' •• ,... te

30

tM end of "sasen fourt.h at.,. .f fibrillae!_.. Oft th other haa4 t tb. c)'CU.c

,l'Oca" .. y k f.aten't&pt" .,. "fAl'lllattea Md· tupetle"t M, te.OftI'.

It ., ....... tbat .lectl'l .. 1 Wiltt"!11.,' .. would 1ItHtt llkel, til-

tenupt the ., .... 4ucl"tbe4 ."GIft .t eta. poia' .·f ... ~.tin of 'lb. ec:t.,f.c.

foci b, the ........ *17 cuI'I' .. 'a. ., add ... tea 48.,.14rt ... t1_ of the eattl'. lMart

at .. e tiM, 411 c1l'_ ..... t. al'. Mlt.Mlled U:d thit ,ac ... t." ,. allowed:

to .he"ate the MXt ...... 1aatM but.

hw .twitoa _ ,1'01-. .. pu1 .... f YftC'I'ic.tllal' ftbd.UAtl __ lIb

"I'oury JMtrt_tea (11, 18,12,"" 1t .,,.an iht the alt.l'a'ti.oaa lis ...... tac

(nett_ oa17 "'ac_ t. the .'&Ift ., ...... t_ .afect cUracteria. by

et..... ewrr .. ta. 10 alt ... &cIOD tR .... bolt.. occurs. th.- Vbcu electrical

4ef:l~I'Ul.t"" itaattapt_ m Ihde bHl't •• tM aMitt .. ! pl'ola of ••

41HIl'el,'4 , •• 1att.ca MY at .. , ..... t.

ft_ ca .... tu ...... 11 ... to _tatat •• ,.C(ull"'1al ...,,1O .. tl_

1M cMq.. ......lt1.. fl'Oll ft'bdl1aU.0II lis e01lMtW1'le,.e "twa tb. • ... 1'. elac-

trel,t. ta'bal ... _ ... ;Ca thea ........ c .8ft aM tho .'1101" «baa-..... ft'M la

tbe ,.t .... Mart.. ... 01_11"1 •• 1 .. fUt'l'lUati_ u attapte' ft ••• hlavd

1. ,ht. tn- of prep • .,..tt_. t+ 1. t •• '"""to 1'1 .. t""1'd~l to 'kth

tile total tl ............. t. eel .. th 1.'1' ... 1.1.1&1' ...,.I't.nt.. IOtU .....

the otlaft ......... t ...... n t ...... lta ' ....... 1 ... 111 • ., lewl iI' 'ht coatlaue.lt

to I'f.... At 90 MCoade ,... .. '11t .. 1114'''' _ 1mn:'a ... f 661 .... 1' .. ,"1 t.

o,""e4.

1Mb ... ,,.. (.196') ..... 4 .... tl'.' .. that _ .. A"_11,,. wu .... to

.. "14ft ..,l •. ,natt_. eha tatno.l1em eM'_ .......... 11. thl. 1, .... to

..... 1.'1. tNt .. 411ff.na'tal dfeet I. , ........ ft tlMa ,.,. l'ap1at1es

... ,_ ... pot.a.'_ ._ e1e.tr1Ml •• '1\)I.'11lal1. , • ..,1.,.4 •. the .041_

,., ... It __ ... to 'e .... , ..,a4eat (dU1trepl\eaol etud' •• ), wh11 ••

coula1.e atu, lYe_ " ... ...,10." ia tbe ea •• of the potulI1_ ,., .. 6,1

Til ... v.akaove effect of tM etr.,.. electrlcal eli.curse NY well be rlll.t.ed

to • 4ienaptlO1l .f the .041_ tru.,ol't sy.t_ ..

The .ffecta of tb1e alt.... 10D1c atate of the cardiae c.ll 1D the

early poa, .aft'1'111.to~ p.riod ara alaost ideatical with thoe. obaeTVe4 10

tbe late .ta._ .f ....u ftbr11laU.DIl. '!'be low 'Iltl'acellular ,ot .... 1 __ ct

hi.Jl iatl'acel1111ar sHiue would. re.utt in a lowerfAa .f the •• 1'.-1'... poteat­

tal 1e.. h1P01'Olariutioa. .otaa the oell .,,1'8 ... cepeihla te produetin of

• aplke .,.tutUl. "'eft .bno_ ............

b aU phu ... f the ..,.t1.aeatal'l'ocu" .. a, wa.ar .utl.'lbad ...

at_lee nn ,el'foftlll4. I'na the f1MblS tot tMra wen ua1p1ficat

ah..... eltbe 18 toeal tlMU. water or ta coapal'tlleatal nter. 1t ou be

......... tut the '..., .... '1 ... irrYol ...... b tbe atady WI'& 1\Ot 18 failure. 44

Ibu 1t ... , 'be coael.... that ella .... u.el"Md m .beat .. l .... bellOClyaaaic

f1suShp "81>I' ... t ohaaa.. ... to f1bl':1.11atlO11 u4 .lactd.eal defibrillation ..

Cl1a:l.eaU,. tM.. atu4, ia4katee tbat ~h.. pat teat who 1. 'DOt

uacle'l',o1aa eonu'1'7 l*'I'f.t_. ._tber 1n .. ,".ery. "o.pital bed 01' ... raRc,.

noa, aa4 _0 u."" III_tri.ally •• f1"'1'111&t_ for conecttem of .. 1\'1'1 ...

.,..t4.f1)l'1.l1atuy p.1'104. As the .,,1dece pl'e •• tM potau to tb. electr­

olyte tau .. e .. a po •• lb18 _jor cOlltl'lhueftt to the a .... la of ref 1bI'111.-

tl_ ..... 1 •• 'I' .. t:1_ of .... t. wh1ch vnld. 1'8,1,.1, cotHct thi. electrolyte

1 .... 1 .... vouU 1M vOl.'th11e. Altbeuah aoct1 .. a .. 4 calcl_ 10ae IIMt probably

32

u. hWol ... 1D thu , .. obl_. 1M low lat~a •• ll,ul.r pot ... i_ ...... t. It •• lf

to the ..... U .• ".1IIM eta •• ,ol.rtat.1 .. luU." haYe alna4y Me 4eM1l.trat-

e. to rapt4ly .1 ... ,. latracel1u1aY poe ... ,.-. 21.27

htual .. .,s..u.f total ,itt .... pia .... Iatel'aetu.a1 aM ,.,1' .... cellular ... &.. pet ... l_. ck1ori4e .... _Cal' wen pel'foCM4 .. a_tnt ....

sa ..... 'rinlu 11bril1&e1. ... f.U_iAa .1ocl'tcal att"l'tllactoa. "ftaa

'.11wf.aa aSplflcM.t ...... wn , __ ,

.) DMl'MM8 latotal U ........ t ... 1 __ n oh •• "'" "U'I'iaa

"feIltI'S_lU' 'anllAtt ... atMt, ........ f,.1' .1ectl'icd 4et'.l'tl1att_

tilt ... 1-.141 .............. to ......... t .... ,owar4 raorae1 b., Wft .cU1

.t.ptfiAatl,. •• 1 .. aenal.

t:.) l1.acleM 111 ceul t1 ...... htr.ceU.talar ao4t_ wn

... """ _ .. 18, ..... t .. teal ... Itk1.11.t1ea. ltat' ........ feu .t •• ut .. 1

•• flbl'tllactoa 1....,.. .f .................. to 1'1 ... .

• ) Vatft e_t_t of 1.ft .... ' .. 'cal ... _eel. 1' ... 1AU OeM'''''. Itatt.tAul .......... aoe obMl'ft4 I.a .'.1' .t ....... i_ het .... 'lu14

...,.:rbft •••

33

34

fte: 4"HUe U ~ atl'ueUular petaHl_, .... 1 .... U.OD

., t.t .... l1d ...... t_ 4Htaa .... ,I't-ul' "''''tlilacs..., U1M .,... 4H to

fall.ft ., t.M ....... rltSUl4tol'J .,.u ••. ""&1'1 to IMd. U ........ i."

a.. 'albn of ... 1wl CO ...... '4MfU\IIt _t61 leftl. follftial

.1_c., ... al ".ftlntS-ll.as ... u feU to, " .. ela .... '0 .......... ffMt 'Of til.

,.o,,'ul elect.rical .. ,.l_ta"" CUUMl' _ t'he •• 41_ ,., .. Ita ,..1 •• ..... , .,.,_. a. ....... &lea."l .. Ia .,..arital a1M, ... l,t •• I.. t •• "1'11

pM, .. ·Uf1,.l\1'111.1.17 ,. ... 1 ........ .".,.1.ac1uttn .. thtt _itl'aM, _lebo

en. 'MOlt"" .tunud ... c.,U,l,111t, of , ...... n tJO n-f1brUlaU.cm ..

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35

36

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37

27. Pallares. Sodi. The polarizing treatment of acute myocardial infarc-tiont possibility of ita use in other cardiovascularcouditiollS. Dit. C}las!;,!> !1: 424, 1963.

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30. I.obert80n, WiUi_ Van It) and Peyser.... Chang .. in vater and eleet--rolyt .. of cardiac muscle followinl .p:tnephrine. a .. 1.. • .!l PhUio1.,.!§§!. 277, 1951.

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38. Wat_be. Yaahio, L. S. Dreitus.and V. P. Satiuky. Mechani81ll8 of ventricular fibrillation. Mechtn1,...!!!! Thera!,. !!t. Cardia!!, ArrJ!Itgtas, New Yorlu G1.'1me" Stratton, ed. by L. Dreifus and

39. Wearia, lene aa4 earl Wiaaers. 'actors determining the production of "1entrieular fibrillation by direct cunents. Am. l. $)f FPIs1C!1. 131s 104, 1940.

40.. Wt •• "tI, Carl J" The Mcluad.n ad 'lUI'''' of ... trl.nlal' fibrilla-ct... AI.. 1.1.:1... .12: 3ft, 1940.

41.. Wllpr8, Cal'1 J.. ItwU ... of ftD'Cl'lculal' ftltt:Uuttoa u_4 '" alec-tr10 aI\ock (lUi... b, c+ aM NYlva1 vith calcA.>. M.I, .. l ... l' 3S1, I' ••

42. W1_t'8, carl J. 'tU phy.loloaSC M.ele I. cANtac " .... tt-aU._ troll vellcrtcutal' I,brtUatl ___ tbed for M'l'tal tk'lk111at1oa. e. I .. It..,, 12t 413.

43. Vl ... r., Cerl J ........ v.pu. Quat It aU ................ t of tt.. '''''1'111.,1_ tllr ... l •• f the ..... U .• .,.lrUl .. rith ... T-... ts.._ .. tM .ff •• ts of ,l'ocalM. •• l... f.t~ •• mt 296, 1140

44. Y~o.t I. A., J. o. Dayle, I. Cae 1 ... _4 M. 'h'.,.. ... • ehaa-u. ., .,...cdial ..... ta clop w1th ~e ..... 11 .. Mart fall.a. lR. 1., • .2l.I!\DW •• 112' 60', 1960.

4'. l'aI'lIouah. I.A CGIIPAl'taft of eM effec'. of ..... c. aQCl D. C .. cOUIlte .. shMk _ ftatw:t.culAl' f.c'1oft iat ... J' .... OIdaed ..... Ia. l .. ~ •• M,I 504. 1964.

APPltOVAL SHIET

The tb •• is submitted by Alan D. Kaplan hat been read and approved

by three ..-bars of the facult, of the Graduate School

The ftnal copies have been exami.ed by the direetor of the th •• is

and the 8{anatur. which appears below verifies the fact tbat any necessary

chanaea have been incorporated. ad that the theais is now liven final

approval with reference to coaee.t, fon and .. chanical aecuracy ..

The the.ia 18 therefore accepted 1n partial fulf11laent of the

requ1reaenta for the Degree of Kaster of Science.

~~~<F Date Signature of Advisor