Search PubMed⌕ Search

Biomedical subjects

G Cherian

Publications and source records attributed to G Cherian.

At least 109 records · Page 6Linked to original sources

Restenosis of the mitral valve: surgical considerations and results of operation.

Our experience over an eight-year period with 63 consecutive patients with mitral restenosis who underwent operation forms the basis for this report. Striking clinical disability was a notable finding. A majority of the patients were less than 30 years old. Embolic phenomena were rare. Closed transventricular valvotomy offers excellent low-risk palliation and good long-term results. Follow-up showed excellent or good results in 90.5% of the patients and poor results in 9.5%. Hemodynamic study of 6 patients demonstrated a pronounced decrease in the pulmonary artery pressure. Open valvotomy was performed in 6 subjects. The presence of intracardiac calcification together with mild mitral incompetence in 2 patients made valve replacement mandatory. The problem of restenosis of the mitral valve is complex, and only after further long-term results are available will the superiority of any one method be demonstrated.

Adolescent↗

Severe pulmonary hypertension in advanced aortic valve disease.

Review of haemodynamic data of 151 cases with isolated aortic valve disease revealed severe pulmonary hypertension (pulmonary arterial systolic pressure of 60 mmHg or more) in 17 (11%). The left ventricular end-diastolic pressure was high in all but one case, suggesting that the severe pulmonary hypertension was a reflection of the late stages of aortic valve disease. The majority (64.7%) had a low cardiac index. Premature closure of the mitral valve was seen in 12 of the 17 patients. While the incidence of premature mitral closure was the same as in others with mild and moderate pulmonary hypertension, the average reversed ventriculoatrial gradient was higher in the latter groups.

Adolescent↗

Increased dietary cadmium absorption in mice and human subjects with iron deficiency.

In mice fed a low iron diet, the addition of low levels of cadmium chloride (10 micrometer) to the drinking water impaired growth and accentuated the development of anemia. Cadmium had no effect on mice given a similar diet supplemented with iron. Iron deficiency increased the concentration of cadmium in the duodenal mucosa, the transfer of cadmium to the body from the intestinal tract, and the deposition of absorbed cadmium in the kidneys. In human subjects, the average absorption of 25 microgram of cadmium, labeled with 115mCd, from a test meal was 8.9 +/- 2.0% (mean +/- SE) in 10 people with low body iron stores (serum ferritin less than 20 ng per ml) and 2.3 +/- 0.3% in 12 subjects with normal iron stores (serum ferritin greater than 23 ng per ml). The biological half-time of the radiocadmium in 3 of the subjects ranged from 90 to 202 days. Thus, the intestinal adaptive response to iron deficiency in both experimental animals and human subjects leads to the increased absorption of cadmium, a potentially toxic element.

Anemia, Hypochromic↗

Rheumatic aortic stenosis in young patients presenting with combined aortic and mitral stenosis.

This report describes 30 patients under the age of 30 years with rheumatic aortic stenosis, presenting with combined aortic and mitral stenosis. Three patients had additional tricuspid stenosis. Twenty-eight patients gave a history of rheumatic polyarthritis. The diagnosis was confirmed by right and left heart catheterisation in all. The murmur of aortic stenosis was not initially present in 8 out of 10 patients in congestive heart failure. Aortic valve calcification was not seen. Cineangiography showed a tricuspid aortic valve in all, unlike congenital aortic stenosis. A unique feature of this group was the raised pulmonary vascular resistance in 87 per cent of the patients. The present study shows that patients in India developing aortic stenosis after rheumatic fever do so early in the natural history of the disease.

Adolescent↗

Left ventricular endomyocardial fibrosis in India.

Clinical, radiological, electrocardiographic, haemodynamic, and cineangiographic features of left ventricular endomyocardial fibrosis are described in 8 patients seen during the 10-year period 1965-1975. Exertional dyspnoea was the commonest presenting symptom. Mild to moderate cardiomegaly was often present. The apex beat was never forcible. A loud third heart sound over the apex and an apical early systolic murmur with late systolic decresendo were characteristic of this desease. Chest X-rays films showed left atrial enlargement and pulmonary venous congestion. A pronounced rise in left ventricular end-diastolic pressure, severe pulmonary hypertension, and low cardiac index were seen in 6. Ventriculography showed an irregular, poorly contracting left ventricle with areas of dyskinesis and large end-systolic volume. Mitral regurgitation, when present, was not severe.

Adolescent↗