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Biomedical subjects

A M Lansing

Publications and source records attributed to A M Lansing.

At least 37 records · Page 2Linked to original sources
PubMed1991

Acute mycotic aneurysm of the ascending aorta following aortocoronary bypass: successful repair.

Acute mycotic aneurysms of the ascending aorta following aortocoronary bypass are exceedingly rare. To our knowledge, there have been few reports of successful management. The central location of this lesion places it apart from acute or chronic mycotic aneurysms in general and enhances its lethality. The availability of ascending and arch aortography, computerized chest tomography and the techniques of peripheral cardiopulmonary bypass, deep hypothermia and reversible circulatory arrest for prolonged periods of time permit successful management. The purpose of this report is to (1) illustrate such a problem; (2) describe its successful management; (3) review the etiology of mycotic aneurysms, historically and contemporarily; and (4) to differentiate early, acute mycotic aneurysms of the ascending aorta following aortocoronary bypass (usually lethal) from similar late chronic processes (readily reparable).

Acute Disease↗
PubMed1990

Regional cholesterol screening: problems and potentials.

Mass cholesterol level screening was carried out in 3,288 individuals. Over a wide range of ages, moderate or high risk values were found in 16%. Follow-up of those with abnormal cholesterol levels revealed that a low percentage visited their family physicians. Moreover, successful responses to treatment were identified in a very small number. The cost of lowering an elevated serum cholesterol level identified in this manner was approximately $800. Problems and potentials of this approach are discussed. Interest in serum cholesterol level control and understanding of its importance have greatly increased. Patients and physicians have become more well informed as a result of the Lipid Research Clinics-Coronary Primary Prevention Trial (LRC-CPPT) and recent guidelines proposed by the National Heart Lung and Blood Institute (NHLBI). As a result of these reports, it is now recognized that lowering an elevated cholesterol by 1% causes a 2% reduction in mortality from coronary artery occlusive disease. Moreover, it is now conceded that normal levels are much less than had been thought previously and it is recommended that all adults receive treatment to maintain a serum cholesterol less than 200 mg/dl. We were recently invited to present an exhibit in the high technology area of the Kentucky State Fair. This provided an opportunity to develop and test the mass screening process, collect data, and to evaluate the cost-effectiveness of such screening processes.

Adolescent↗
PubMed1987

Malignant clinical behavior of cardiac myxomas and "myxoid imitators".

The clinical experience with cardiac myxomas and "myxoid imitators" at the Humana Heart Institute International is reviewed and contrasted with a comprehensive review of the world literature. Twenty-two patients with primary cardiac tumors have been treated at our institution. Three (13.6%) of them had myxoid imitators, and 19 had classic myxomas. One of the 19 patients with a classic myxoma had recurrence on two occasions (recurrence rate, 5.3%). The cases of 57 patients from the world literature are reviewed. Recurrence and/or metastases (including formation of mycotic aneurysm) occurred in approximately 50% of these patients. The overall mortality in these patients was 47%. This review provides documentation of the malignant clinical behavior of cardiac myxomas and myxoid imitators. Neither local recurrence nor regrowth of the tumor in a new location, whether intracardiac or extracardiac, can be predicted from the microscopic appearance of the primary tumor. Resection of the myxoma with a wide margin is the recommended surgical procedure but does not ensure a cure. Therefore, long-term follow-up is mandatory.

Fibroma↗
PubMed1987

Infective endocarditis: diagnosis, treatment, and mortality, as related to surgical timing and infectious organism.

To evaluate the timing of surgical treatment in infective endocarditis and to determine the relationship between the risk of mortality and the species of infectious organism, we reviewed a consecutive series of 65 cases involving patients with infective endocarditis who had been treated over a 17-year period. The patients included 41 males and 24 females, who ranged in age from 6 to 85 years (mean, 39.3 years). Forty-five had native valve endocarditis, 14 had prosthetic valve endocarditis, and six had endocarditis associated with congenital heart defects. Fifty-two patients underwent valve replacement, which was associated with an overall operative mortality of 19%. Those who underwent valve replacement during the early active stage (first 3 weeks) of infection had a higher mortality rate than those who had surgery either during the late active stage (second 3 weeks) of infection or after 6 weeks of antibiotic therapy. S. aureus and Pseudomonas organisms were responsible for the most deaths. On the basis of this study, we recommend that, when cardiovascular function permits, patients who are hemodynamically stable and free of emboli should receive 4 to 6 weeks of antibiotic therapy before undergoing surgical treatment. In contrast, patients with high-risk organisms are more likely to survive if subjected to early surgical intervention.

Journal Article↗
PubMed1985

Heparin-induced thrombocytopenia and recurrent thromboembolism in siblings.

Two brothers with heparin-induced thrombocytopenia and multiple arterial and venous thromboembolism affecting peripheral vessels are described. Heparin-dependent antiplatelet antibody was detected using platelet aggregometry in both patients. Although these observations may be coincidental, the possibility of familial occurrence of this adverse reaction to heparin cannot be excluded with certainty.

Disease Susceptibility↗
PubMed1983

Left atrial-left ventricular bypass for congenital mitral stenosis.

The case of a patient with congenital mitral stenosis successfully treated by insertion of a left atrial-left ventricular valved conduit is presented. After insertion of the conduit, pulmonary artery pressure was normal, persistent pulmonary edema and ascites disappeared, and the child's rate of growth and level of activities returned to normal.

Child↗