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Biomedical subjects

C E Essed

Publications and source records attributed to C E Essed.

At least 55 records · Page 3Linked to original sources
PubMed1985

Tandem coarctation of the thoracic aorta with hypoplasia of the abdominal aorta.

After resection of the coarctation in a 3-year-old child with end-to-end anastomosis, a second membrane was found 1.5 cm lower. After a successful reoperation with an aortoplasty using Gore-Tex weak femoral pulses persisted. At catheterization, an area of irregular narrowing of the abdominal aorta just distal to the superior mesenteric artery was found with hypoplasia of the iliac and femoral arteries. In addition, this child had a two-sided cheilo-gnatho-palatoschisis, vesicoureteral reflux and absence of gall bladder and hepato-duodenal ligament. It is worthwhile considering that a second or third aortic abnormality can be hidden by a coarctation of the aorta.

Aorta, Abdominal↗
PubMed1984

"Offsetting" of the septal tricuspid leaflet in normal hearts and in hearts with Ebstein's anomaly. Anatomic and echographic correlation.

Apical displacement of the septal tricuspid valve leaflet is considered the most reliable criterion to diagnose Ebstein's anomaly. This feature is best assessed using 2-dimensional echocardiography. However, the anatomy in Ebstein's anomaly is highly variable; therefore, the problem arises as to how to distinguish between the abnormal displacement in borderline cases of Ebstein's disease and the lowered septal offsetting of the tricuspid valve in normal persons. To solve this problem the minimal and maximal differences in offsetting of the tricuspid and mitral valves have been studied, both anatomically and echocardiographically, in fetuses, infants, children and adults. In fetuses in the first trimester of pregnancy it was impossible to measure a difference in offsetting of the 2 atrioventricular valves. Thereafter, a gradual increase occurred with age. In normal hearts the most significant separation was usually recorded in anteriorly angulated 4-chamber views, whereas in hearts with Ebstein's anomaly maximal separation appeared to posteriorly angulated views. The anatomic and echographic measurements showed a constant relation. When the minimal distances in offsetting were measured, an overlap was found between cases with and those without Ebstein's anomaly. The maximal values, however, clearly discriminated between the 2 conditions. The critical difference in children was 15 mm, and in adults the discriminating value was 20 mm.

Adolescent↗
PubMed1984

Primary restrictive foramen ovale.

A newborn infant with primary restrictive foramen ovale, tubular hypoplasia of the aortic arch, and some other developmental defects is described. This combination resulted in fetal hydrops, as was shown by ultrasonography. The child died 24 h after birth due to low output syndrome and extensive bronchopneumonia. The pathogenesis of this clinical entity is discussed.

Aorta, Thoracic↗
PubMed1984

Inflammatory pleuropulmonary fibrosis in essential fatty acid deficient rats and the lack of response to methysergide.

In view of the association between essential fatty acid (EFA) deficiency and human cystic fibrosis, we have investigated the possible occurrence of pulmonary disease in rats fed an EFA deficient (EFAD) diet for 40 weeks. In contrast to a few slight spontaneous lesions consisting of pleural membrane hyperplasia, which were found in the lungs of control rats, a much greater incidence of fibrotic lesions was observed in the lungs of EFAD rats. These pleuropulmonary fibroses extended from the hyperplastic pleural membrane into the alveoli and were characterized by collagen deposition and marked macrophage infiltration to the extent that, in some cases, the alveolar septa were completely obstructed by inflammatory exudate. These findings lend indirect support to the contention that EFA deficiency plays a role in the aetiology of cystic fibrosis, at least with regard to pulmonary lesions. Administration of methysergide (10 mg/kg/day, p.o.) for a total of 11 weeks, did not alter the incidence of fibrosis in the lungs of EFAD rats, despite the finding that a man who had developed pleuropulmonary fibrosis as a result of chronic methysergide treatment exhibited a relative serum EFA deficiency. While a relative EFA deficiency may be a predisposing factor for the induction of fibrosis by chronic methysergide treatment, our data are not sufficient to make a decision upon this hypothesis.

Adult↗
PubMed1984

Left atrial isomerism associated with asplenia: prenatal echocardiographic detection of complex congenital cardiac malformations.

Complex congenital heart disease with suspected isomerism of the atria was diagnosed in two fetuses of 20 and 29 weeks' gestation using two-dimensional and M-mode scanning techniques. The first pregnancy was terminated at 21 weeks' gestation and stillbirth occurred at 31 weeks' gestation in the second pregnancy. At postmortem examination, a thoracoabdominal discordancy was found; the spleen was absent and the arrangement of the abdominal vessels was as anticipated for asplenia, but the thoracic situs revealed a bilateral right-sided arrangement with left isomerism of the atria. The heart, otherwise, showed complex abnormalities as anticipated for asplenia.

Abnormalities, Multiple↗
PubMed1984

Ventricular free wall rupture: sudden, subacute, slow, sealed and stabilized varieties.

Six cases of acute myocardial infarction with blood in the pericardial sac are described. In one case rapid death followed myocardial rupture leaving no time for the possibility of intervention. Of two other cases acute symptoms developing after myocardial rupture, one was operated on promptly and the other, whose condition improved on pericardiocentesis, after a delay of a few hours. Both are now long term survivors A fourth patient probably had two episodes of rupture which apparently sealed off. He underwent cardiac catheterization, but no epicardial leak was found. Subsequently at operation a sealed myocardial rupture was detected and sutured over. The fifth patient suffered a silent myocardial rupture. A false aneurysm was diagnosed four months later and he withstood successful surgery. In the sixth patient, the course was similar to that of case 1, namely rapid death with a clinical picture suggestive of tamponade. Postmortem examination showed a covert rupture with some evidence of attempts to plug the opening. The purpose of this report is to emphasize the varying course which myocardial rupture can take.

Acute Disease↗
PubMed1984

Fluorocarbons and the microcirculation.

A short discussion of oxygen transport and delivery by fluorocarbon containing blood substitutes is presented. Those physical properties of the preparations that would tend to cause improvement in oxygenation in areas of damaged or impeded microcirculation are also discussed. A number of studies carried out at the Erasmus University, Rotterdam have demonstrated certain important characteristics of fluorocarbons with respect to tissue oxygenation. In the first instance, it has been demonstrated that extracorporal perfusion with Fluosol-DA 20% can maintain oxygenation and viability of isolated extremities for periods of up to 48 hours. Secondly it has been shown that the preparation can indeed penetrate compromised capillary beds, its low viscosity enabling it to travel along collateral perfusion pathways and to provide oxygenation of areas of ischaemic hypoxia. The low particle of the emulsion may, in combination with the low viscosity of the product, contribute to the re-establishment of perfusion in areas of circulatory arrest. The clinical implications of the above findings are numerous and wide spread. The importance of Fluosol in maintaining and improving micro-circulatory oxygenation should not be underestimated.

Animals↗
PubMed1983

Prenatal ultrasound diagnosis of congenital heart disease associated with intrauterine growth retardation. A report of 2 cases.

Two fetuses with extreme growth retardation (IUGR) of 31 and 34 weeks gestation were studied using a combination of two dimensional echocardiography (2DE), pulse wave Doppler (PWD) and differential measurement of the instantaneous vessel diameter techniques. The first fetus was diagnosed as having univentricular heart or possible double outlet right ventricle (DORV). Descending aorta blood flow was reduced as was indexing for weight. The second fetus was diagnosed as having univentricular heart with periodic bigeminal and trigeminal rhythm. Descending aorta blood flow was measured on two occasions and was reduced both times. Indexing for weight was within normal limits the first time and showed gross reduction on the second occasion prior to fetal demise. Fetal death occurred in both cases at 34 weeks gestation. Cardiovascular evaluation in fetuses with IUGR is useful as the detection of severe congenital cardiac abnormalities may substantially alter the management of these pregnancies, in particular caesarean section may be avoided when the prognosis for the fetus is considered hopeless.

Adult↗
PubMed1983

Right to left shunt, with severe hypoxemia, at the atrial level in a patient with hemodynamically important right ventricular infarction.

This report describes a patient with a massive right ventricular infarction, complicated by severe hypoxemia. Contrast echocardiography demonstrated a right to left shunt through a previously asymptomatic atrial septal defect. This phenomenon should be considered as a possible cause of hypoxemia in the presence of right ventricular infarction.

Echocardiography↗
PubMed1983

Transluminal coronary angioplasty and early restenosis. Fibrocellular occlusion after wall laceration.

Transluminal coronary angioplasty was performed in a 51 year old man with a localised narrowing of the proximal segment of the left anterior descending coronary artery. Initial inflations with a small size balloon catheter were unsuccessful. A second attempt, during the same procedure, using a larger calibre catheter relieved the obstruction but produced a dissection. Angina pectoris reappeared approximately three months later. Another attempt to relieve the obstruction by angioplasty, five months after the initial procedure, induced ST segment elevation before angioplasty, followed by ventricular fibrillation and death. The necropsy showed a split in the pre-existent sclerotic plaque and a dissecting aneurysm of the media. A proliferation of fibrocellular tissue filled the false channel and almost totally occluded the pre-existent arterial lumen. The observation suggests that wall laceration with exposure of smooth muscle cells to blood may have initiated the excessive fibrocellular tissue response. This event may be the underlying pathogenetic mechanism for the occurrence of early restenosis after transluminal coronary angioplasty.

Angioplasty, Balloon↗
PubMed1982

Persistent right sinus venosus valve.

A 13-year-old girl presented with clinical features of pulmonary stenosis and regurgitation. Haemodynamic studies suggested the presence of a right ventricular tumour. M-mode and two dimensional echocardiograms indicated one or probably two soft thin walled structures originating from the right atrium. At operation a persistent right sinus venosus valve was removed. One earlier case report described the M-mode echocardiographic features of this condition in a neonate who died shortly after operation. This report illustrates that a large persistent right sinus venosus valve may present clinically years after birth. Echocardiography played an important role in making the diagnosis.

Adolescent↗
PubMed1980

Atrioventricular conduction system in univentricular heart of right ventricular type with right-sided rudimentary chamber.

The conduction tissue in a univentricular heart of the right ventricular type with a right-sided rudimentary chamber was studied. Both an anterior and conventional node were found, the anterior node being positioned in the atrial septum very close to the conventional node. Between the two nodes, a sling of conduction tissue passed through the annulus fibrosus but was not related to the trabecular septum. A non-branching bundle descended on to a free-running trabecula in the main ventricular chamber, the trabecular septum itself being devoid of conduction tissue. We believe it is likely that this trabecula represents the trabecula septomarginalis of the normal right ventricle. It has recently been suggested that during development the primordium of the trabecula septomarginalis is the structure which carries the conduction tissue from the atrioventricular node (whatever its position) to the trabecular septum. The present findings seem to support this.

Atrioventricular Node↗