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Biomedical subjects

I H Gessner

Publications and source records attributed to I H Gessner.

At least 37 records · Page 2Linked to original sources

The significance of the left atrial appendage in rheumatic heart disease.

The possible diagnostic value of an enlarged left atrial appendage (LAA) on the posterior-anterior or right anterior oblique chest film as a means of implicating a rheumatic etiology for mitral valve disease in children was investigated. Chest films were examined without prior knowledge of clinical or laboratory data, and the results were later correlated with this information in 113 children and adolescents. The clinical and laboratory data included application of the modified Jones criteria for the diagnosis of acute rheumatic fever, streptococcal antibody titers and clinical and cardiac catheterization findings. In children with mitral valve disease, our data suggest that as enlarged LAA, especially in the presence of pulmonary venous obstruction, is characteristic of rheumatic heart disease. This finding appears to be particularly useful, in conjunction with streptococcal antibody studies, in distinguishing rheumatic from nonrheumatic patients with mitral insufficiency.

Cardiomegaly↗

Persistence of fetal cardiopulmonary circulation: one manifestation of transient tachypnea of the newborn.

Five cyanotic newborn infants underwent cardiac catheterization between 8 and 36 hours of age with a tentative diagnosis of cyanotic congenital heart disease. All had normal cardiovascular anatomy. Cyanosis was the result of persistence of fetal cardiopulmonary circulation with right-to-left shunting across the ductus arteriosus. In all infants, cyanosis resolved spontaneously and the infants survived without sequelae. Admission chest roentgenograms of all infants showed marked hyperinflation of the lungs. Except for severe hypoxemia, the clinical presentation, chest films, and course of illness of these infants were consistent with transient tachypnea of the newborn. It is proposed that an increase in pulmonary vascular resistance, due to hyperinflation of the lungs, was the mechanism which reopened the fetal cardiopulmonary circulatory channels and produced hypoxemia, and that these infants suffered from a rare manifestation of a usually benign newborn respiratory condition. Further, given these pathophysiologic mechanisms, the use of continuous transpulmonary pressure gradients in the management of such infants would be contraindicated.

Blood Circulation↗

A simplified method for quantitating left-to-right shunts from arterial dilution curves.

This report presents a new, simple and reliable method of quantitating left-to-right shunts from arterial dilution surves. When indicatior (e,g., indocyanine green) is injected centrally (right venticle or pulmonary artery) and blood is withdrawn rapidly from either the aorta or other central systemic artery, in the presence of a left-to-right shunt to recorded indicator-dilution curve usually shows two discrete peaks: p-1 of the magnitude of the shunt expressed as percent of pulmonary blood flow, Experimental and clinical data demonstrate that this method is accurate in quantitating shunts from such curves.

Adolescent↗