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Biomedical subjects

J E Edwards

Publications and source records attributed to J E Edwards.

At least 235 records · Page 13Linked to original sources
PubMed1982

Comparative ocular pathogenicity of Cryptococcus neoformans, Candida glabrata, and Aspergillus fumigatus in the rabbit.

In a previous study, 88% of rabbits with disseminated infection caused by Candida albicans developed ophthalmoscopically visible, hematogenous endophthalmitis (chorioretinitis) over a 2 week period. To determine the incidence of this ocular complication in disseminated infection caused by Cryptococcus neoformans, Candida glabrata, and Aspergillus fumigatus compared with that caused by C. albicans, the first three species of fungi were injected intravenously (between 10(5) and 10(9) organisms per animal) into 36 New Zealand white rabbits. No chorioretinal lesions were seen by indirect ophthalmoscopy over a 2 week period. C. glabrata and A. fumigatus were not cultured from chorioretinas despite positive cultures from brains and kidneys at 1 and 2 weeks. In contrast, C. neoformans was cultured from 12 of 18 chorioretinas. (mean Log10 3.45 colony forming units/gm of tissue) as well as from the brains and kidneys. The less intense inflammatory cell response to C. neoformans compared with that 10 C. albicans seen on histopathologic examination most likely explains the nondetectability of the cryptococcal chorioretinitis by indirect ophthalmoscopy. These data suggest that C. glabrata. A. fumigatus, and possibly C. neoformans have less ocular pathogenicity than C. albicans in rabbits and correlate with the small number of documented human cases of ophthalmoscopically visible hematogenous endophthalmitis caused by fungi other than C. albicans.

Animals↗
PubMed1981

Signs of membranous subaortic stenosis appearing after correction of persistent common atrioventricular canal.

Two cases are presented of persistent common atrioventricular (A-V) canal with interventricular communication in which associated membranous subaortic stenosis became apparent only after correction of the basic malformation and replacement of the mitral valve. The features of the membranous subaortic stenosis present only after operation were a left ventricular outflow pressure gradient and angiocardiographic demonstration of the membrane. In one case, additional echocardiograms demonstrated systolic flutter of the aortic cusps after the first operation (no echocardiograms were taken preoperatively). The flutter disappeared after a second operation in which the subaortic membranous tissue was resected. The appearance of hemodynamic signs of subaortic stenosis after the corrective operation for the persistent common A-V canal is explained by the fact that preoperatively the interventricular communication allowed decompression of the left ventricle so as to preclude a left ventricular outflow gradient. It is presumed that the use of additional angiocardiographic projections might have demonstrated the anatomic state preoperatively.

Adolescent↗
PubMed1981

Hematogenous candida endophthalmitis in patients receiving parenteral hyperalimentation fluids.

To determine the incidence of hematogenous candida endophthalmitis in seriously ill patients given parenteral hyperalimentation fluids, 131 hyperalimented postoperative patients were prospectively evaluated. All patients were screened weekly for the development of chorioretinal lesions, blood cultures positive for Candida albicans, and signs and symptoms of candida infection. Thirteen (9.9%) of 131 patients developed chorioretinal lesions compatible with hematogenous candida endophthalmitis. Seven of the 13 patients with eye lesions had blood cultures positive for yeast, whereas only two of 118 without eye lesions had blood cultures positive for yeast (P less than 0.0005). Thus, the occurrence of eye lesions consistent with hematogenous candida endophthalmitis correlated with positive blood cultures for yeast and strongly suggested invasive candidiasis.

Amphotericin B↗
PubMed1981

Experimental intraabdominal candidiasis in rabbits: therapy with low-total-dose intravenous amphotericin B.

By using a recently developed rabbit model, we examined the efficacy of relatively low-total-dose intravenous amphotericin B (Am-B; 7 to 14 mg/kg) in the treatment of intraabdominal candidiasis due to Candida albicans. Forty-eight percent of the rabbits developed evidence of hematogenously disseminated infection (Candida endophthalmitis) before therapy. By day 7 of therapy, there was a significant decrease in the mean log10 colony-forming units per gram of peritoneal abscess in comparison with both pretherapy cultures and concomitantly sacrificed controls (no Am-B treatment; P less than 0.25). By day 11 of therapy, peritoneal abscesses were sterilized by Am-B, whereas control rabbit cultures remained positive. In contrast, low-dose Am-B therapy produced no significant decrease in colony-forming units per gram of renal or chorioretinal abscess in rabbits which developed hematogenously disseminated candidiasis. Serum Am-B levels approached or exceeded the minimal fungistatic concentrations for this C. albicans strain in most animals tested. Low-dose Am-B was effective in eradicating intraabdominal candidiasis, but was not curative when extraperitoneal dissemination occurred.

Abdomen↗
PubMed1981

Congenital aneurysm of left atrial appendage.

Congenital aneurysm of the left atrial appendage is a rare anomaly, usually presenting in adult life. The case reported is that of a 55-year-old man who died of cerebral embolism originating from a thrombus in a congenital aneurysm of the left atrial appendage. The cardiac silhouette 11 years previously had suggested a cardiac tumour or a pericardial cyst. As judged frm 14 published cases, the major manifestations of these aneurysms are an abnormal cardiac silhouette in the x-ray, supraventricular tachycardia, and systemic embolism. Angiocardiography appears to be the method of choice in establishing the diagnosis. Resection of th aneurysm is the recommended form of treatment.

Adult↗
PubMed1981

Aortic origin of conus coronary artery. Evidence of postnatal coronary development.

The conus coronary artery has been reported to arise independently from the aorta in approximately 45 per cent of hearts. In this study, 305 necropsy specimens were examined to determine the origin of the conus coronary artery and variations in patterns of origin with respect to age. Three patterns were recognised: 1, in which the conus artery arose from the aorta independently of the right coronary artery; 2, in which the conus artery and the right coronary arose from a common ostium; and 3, in which only the right coronary artery took origin from the right aortic sinus. The relative incidence of the three patterns varied with age. Pattern 1 was recognised in 14 to 24 per cent of specimens from patients under the age of 2 years, whereas in older patients, it occurred in 41 to 63 per cent. These data suggest that aortic origin of the conus arterial ostium may appear in some individuals between 2 and 4 years of age, and they support the concept that some coronary arterial patterns are not fully established at the time of birth.

Adolescent↗
PubMed1981

The three types of criss-cross heart: a simple rotational anomaly.

Criss-cross heart is an angiographically confusing malformation where apparent crossing but not mixing of contrast medium is seen at atrioventricular level. The malformation can be understood by a clockwise or counter-clockwise ventricular rotation. In the normal heart or one with complete transposition ventricular rotation is clockwise. With corrected transposition rotation occurs in a counter-clockwise fashion. One case of criss-cross heart with associated corrected transposition and two criss-cross hearts occurring with complete transposition are reported.

Heart↗
PubMed1981

Isolation of a subclavian artery.

Eight patients with isolation of a subclavian artery are described. Isolation of subclavian artery is defined as a loss of continuity between the subclavian artery and aorta but with persistent connection to the homolateral pulmonary artery through a ductus arteriosus. The connecting ductus arteriosus may or may not be patent. As the pulmonary vascular resistance is usually lower than the systemic resistance, the isolated subclavian artery is perfused by subclavian steal, and if the connecting ductus arteriosus is patent, flow occurs from the subclavian artery into the pulmonary artery. In this material and in all reported cases, isolation of subclavian artery has always been associated with other anomalies of the aortic arch, such as right aortic arch or bilateral ductus. Its frequent association with intracardiac defects, usually the tetralogy of Fallot, makes its recognition clinically important. Thoracic aortography with delayed filming is the only procedure that allows consistent diagnosis of this rare anomaly during life.

Child, Preschool↗
PubMed1981

Cryptococcal intracerebral mass lesions: the role of computed tomography and nonsurgical management.

Cephalic computed tomography (CT) is a sensitive technique for defining certain intracerebral diseases. Four patients with cryptococcosis were evaluated with cephalic computed tomography over 3 years. All had focal, intracerebral "contrast-enhanced" lesions consistent with cryptococcal mass lesions, confirmed histopathologically in two. An analysis of 55 cases of cryptococcal intracerebral mass lesions from the literature showed that 18% of patients with these lesions associated with cryptococcal meningitis did not have specific symptoms or signs of focal intracerebral disease or increased intracranial pressure. We therefore recommend that patients with cryptococcal meningitis, regardless of localizing symptoms or signs, be considered for cephalic CT evaluation to ascertain the presence of mass lesions. Three patients in this report were treated with systemic antifungal medication without surgery. Decreased size or disappearance of these lesions was seen on sequential CT scan in all patients. We conclude that selected patients with cryptococcal intracerebral mass lesions may be managed successfully with systemic antifungal therapy alone.

Adolescent↗
PubMed1981

Separation of neointima from Dacron graft causing obstruction. Case following Fontan procedure for tricuspid atresia.

A nine-year-old patient with tricuspid atresia and normally related great vessels underwent a Fontan procedure, in which a porcine valved Dacron conduit was interposed between the right atrium and pulmonary trunk. After death, 6 months postoperatively, pathological examination revealed a thick layer of neointima (peel) lining the conduit. The peel was thicker in the segment of the conduit proximal to the valve, where it measured up to 4.5 mm in thickness. Proximal to the valve, the peel had separated from the wall of the graft and a hematoma had developed between the separated peel and graft. The result was reduction in the caliber of the conduit to about half the original. The patient's final illness was complicated, being associated with acute pancreatitis. Reduction in the caliber of the graft may have contributed to the death.

Acute Disease↗
PubMed1981

Mural thrombosis of the left atrium following replacement of the mitral valve.

The nature and incidence of postoperative mural thrombosis of the septal and/or posterior walls of the left atrium were studied in autopsy specimens of hearts from patients in whom the mitral valve had been replaced by a prosthesis 1 day or longer before death. The cases were divided into length of postoperative period as follows; Group I, 1 to 60 days, 57 cases; Group II, 61 days or longer, 36 cases. In Group I mural thrombus of the septal and/or posterior walls of the left atrium was found in 35 of 57 patients (61%). Thrombi against the septal wall tended to be broad and flat. Thrombi involving the posterior wall tended to be multifocal. In Group II, lesions interpreted as old thrombi of the atrial septum were found in 23 of 36 subjects (64%). Grossly, the old lesions were represented by gray nodularity. Histologically such lesions were consistent with organized thrombi. Superimposed recent thrombosis occurred in some cases. Systemic embolism occurred in each group. In the cases in which left-sided thrombi were restricted to the septal and/or posterior walls of the left atrium, systemic embolism was observed in 10 of 23 cases in Group I (43%) and in two of seven cases in Group II (29%). Obstruction of the mitral prosthesis by bulky mural thrombosis originating at the septal wall of the left atrium was observed in one case. The study suggests that the process of postoperative mural thrombosis of the septal and posterior walls of the left atrium may result from trauma to these structures during the operative procedure.

Adolescent↗
PubMed1980

Cardiomyopathies characterized by evidence of resistance to left ventricular inflow.

Restrictive cardiomyopathy characterized by evidence of left ventricular inflow obstruction was studied in four cases--one child and three adults. In three of the cases, including the child, there was pathologic evidence of hypertrophic cardiomyopathy with asymmetric septal hypertrophy. In the fourth case, no cardiac disease was identified as the anatomic basis for the inflow restriction. This latter case broadens the concept of restrictive cardiomyopathies.

Adult↗
PubMed1980

Atrial standstill, myocarditis and destruction of cardiac conduction system: clinicopathologic correlation in a dog.

A case of permanent atrial standstill is described in a 10-month-old dog with ascites as a presenting complaint. The patient had absence of P waves in all leads in numerous ECG's and had a regular idioventricular rhythm. Pathologically, the patient had multiple areas of atrial and ventricular myocardial necrosis and fibrosis, with chronic active myocarditis and obliteration of the SA and AV node and AV bundle.

Animals↗
PubMed1980

Atypical d-transposition of the great arteries: anterior pulmonary trunk.

Clinical, angiocardiographic and necropsy data in a case of atypical d-transposition of the great arteries with an anterior pulmonary trunk are described. The unusual arrangement of the great arteries and the presence of bilateral coni were demonstrated with angiocardiography and confirmed on pathologic study.

Cardiac Catheterization↗