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Biomedical subjects

J E Edwards

Publications and source records attributed to J E Edwards.

At least 253 records · Page 14Linked to original sources
PubMed1980

Combined effect of amphotericin B and rifampin on Candida species.

Synergism with the combination of rifampin and amphotericin B in vitro has been demonstrated with a limited number of Candida strains. To extend these studies (particularly at clinically achievable levels of rifampin), we evaluated the in vitro combined activity of serial twofold dilutions of amphotericin B (0.1 to 6.0 microgram/ml) against 11 concentrations of rifampin (0.2 to 200 microgram/ml) for 40 strains of Candida: 20 Candida albicans, 7 Candida parapsilosis, 8 Candida tropicalis, 2 Candida stellatoidea, 2 Candida guilliermondii, and 1 Candida krusei by using a modified checkerboard microtitration technique. An additive or synergistic effect was seen for 45% of strains with 6.25 microgram of rifampin per ml added to amphotericin B. Whereas the minimal inhibitory concentration to amphotericin B alone was 0.4 microgram/ml or less for 50% of the strains, the percentage increased to 90 with the addition of 6.25 microgram of rifampin per ml. A similar effect was seen with killing: 25% of the strains were killed by 0.4 microgram or less of amphotericin B alone per ml, and 75% of the strains were killed with the addition of 6.25 microgram of rifampin per ml. In vivo studies are needed for confirmation of the usefulness of combined amphotericin B and rifampin therapy.

Amphotericin B↗
PubMed1980

Effect of immunosuppression on the development of experimental hematogenous Candida endophthalmitis.

The induction of neutropenia and immunosuppression by the administration of nitrogen mustard (HN2) decreased the frequency and altered the morphology of clinically detectable hematogenous Candida endophthalmitis in the rabbit model of disseminated candidiasis. Whereas 95% of eyes in rabbits infected with Candida albicans without pretreatment with HN2 developed typical lesions of hematogenous Candida endophthalmitis, only 6.2% of eyes in rabbits that had been given 3.0 mg of HN2 per kg developed clinically detectable endophthalmitis. Lesions that developed in the severely immunocompromised and neutropenic rabbits were small and atypical in appearance. From these data, we conclude that ophthalmoscopic examination may not be a sensitive diagnostic modality for disseminated candidiasis in severely immunocompromised, neutropenic patients.

Agranulocytosis↗
PubMed1980

An unusual aberrant left subclavian artery.

In a child with tetraology of Fallot, pulmonary atresia, and right aortic arch, the left subclavian artery arose from an unusually low position, and was initially misinterpreted as a systemic pulmonary collateral. This anomaly probably resulted from a "lag" in embryological migration of the left subclavian artery onto the aortic arch.

Abnormalities, Multiple↗
PubMed1980

Angiographic findings in recanalization of coronary arterial thrombi.

Four patients with atherosclerotic disease were found to have a recanalized coronary arterial thrombus on angiography. The functional significance of this finding varied. In 2 cases, flow (judged by collaterals) was insignificant in spite of the recanalization. In the other 2, collateral supply had been shown to be absent during the initial stage of thrombosis. In one case, recanalization was confirmed pathologically.

Adult↗
PubMed1980

The mechanism of balloon angioplasty.

A new theory of the mechanism of percutaneous arterial angioplasty is advanced. For this study, abdominal aortas and coronary, renal, superior mesenteric, and iliac arteries were obtained from cadavers. In addition, the iliac arteries of dogs were dilated and studied. No evidence of significant compression or redistribution of plaques could be found, supporting the theory that atheromatous material is incompressible. Cracking of the intima and separation of it from the media were histologically demonstrated following angioplasty. It is proposed that the stretched media distends following dilatation, carrying with the intima and atheromatous material. Once the media is freed from the encasing effect of the intima, it adapts to the circulatory needs of the body. Beyond a certain point, the arterial widening becomes permanent, due to an overstretching of the muscle fibers, which is demonstrated by a corkscrew deformity of the muscle cell nuclei.

Aged↗
PubMed1980

Experimental intraabdominal candidiasis: macroscopic, microscopic and cultural natural history.

We have developed a rabbit model for intraabdominal candidiasis by the intraperitoneal injection of Candida albicans. The most reliable early predictor of induction of disease was positive paracentesis cultures for C. albicans during the 1st week post-inoculation (p.i.). Cultures of mesenteric and renal abscess were mean log 6.20 and 3.18 colony-forming units (CFU) per gram tissue, respectively, 1 week p.i., and remained positive for the 21-day i.p. period. Incidence of hematogenous dissemination, judged by chorioretinal cultures, was 69%. Histopathology of involved organs demonstrated suppurative abscesses at 1 week p.i.; lesions became more granulomatous at 2 and 3 weeks p.i.

Abdomen↗
PubMed1980

Acquired aortic stenosis in systemic lupus erythematosus.

Two patients with systemic lupus erythematosus had aortic valvular stenosis resulting from massive thrombotic deposits on the valve. This condition has not been described previously, but a similar process has been reported to have caused mitral stenosis in a patient.

Adult↗
PubMed1980

Coronary arterial dominance associated with congenital bicuspid aortic valve.

Gross examination was done of 186 hearts, principally from adults, for the nature of the aortic valve and the source of the posterior descending coronary artery (origin from the right coronary artery indicated as right dominance, origin from the left circumflex artery as left dominance). Exclusive of cases with coarctation of the aorta, the overall incidence of left coronary dominance in cases with congenital bicuspid aortic valves was 24.4%, while in cases with tricuspid aortic valves the incidence was 9.5%. There appears to be a greater tendency for left coronary arterial dominance in coarctation of the aorta than in the general population regardless of the type of the aortic valve.

Adolescent↗
PubMed1980

Accessory flaplike tissue causing ventricular outflow obstruction.

In three cases, two in children and one in a young adult, ventricular outflow obstruction was caused by a valvelike flap of accessory endocardial tissue. The angiocardiographic feature was that of a narrow radiolucent, crescent-shaped or linear filling defect corresponding to the site of obstruction. Resection of the accessory tissue was performed in each case at the time of correction of associated conditions. In one case (a woman 20 years of age) the obstructing membrane was in the outflow tract of the right ventricle, and a ventricular septal defect was associated. In each of the other two cases the outflow tract of the left ventricle was the site of obstruction. In one (a 14-month-old boy), an ostium primum type of atrial septal defect and cleft mitral valve were associated; in the remaining case (a 7-year-old boy) complete transposition and ventricular septal defect were also present. In the latter case a Mustard procedure was performed and was followed by death. Successful results were obtained in the first two patients.

Adult↗
PubMed1979

Experimental hematogenous Candida endophthalmitis: diagnostic approaches.

Anterior chamber aspiration and vitreous aspiration were evaluated as diagnostic procedures for establishing a specific microbiological diagnosis in the rabbit model of hematogenous Candida endophthalmitis. Vitreous aspiration was the most successful procedure, confirming the diagnosis of hematogenous Candida endophthalmitis in 62% of eyes with documented intraocular infection. When animals with only the most severe clinical endophthalmitis were considered, vitreous aspiration confirmed the diagnosis in 89% of eyes evaluated. Vitreous aspiration correlated well with the extent of clinical endophthalmitis, as well as with postmortem, whole-vitreous cultures. Gram staining of the aspirate was additive to culture results in confirming the diagnosis. Anterior chamber aspiration was positive in only 1 of 58 eyes evaluated (1.7%). Additionally, muscle biospy was evaluated in this study as a tool for establishing a microbiological diagnosis in the rabbit model of disseminated candidiasis. Only 2 of 131 biospy specimens contained detectable Candida. Although vitreous aspiration may be associated with ocular complications, in certain clinical settings this procedure may be valuable in establishing the definitive microbiological diagnosis of hematogenous Candida endophthalmitis.

Animals↗
PubMed1979

Prevalence and characteristics of disporportionate ventricular septal thickening in infants with congenital heart disease.

Necropsy studies were performed in 125 infants, 2 years old or less, with a variety of congenital heart malformations. Disproportionate ventricular septal thickening (septal-to-left ventricular free wall thickness ratio greater than or equal to 1.3) was present in 31 (25%) of the 125 patients. In the majority of patients, an abnormal septal-to-free wall ratio did not appear to be a manifestation of genetically transmitted hypertrophic cardiomyopathy, since: 1) marked disorganization of septal myocardium (involving greater than or equal to 5% of the tissue section) was present in only five of the 31 patients with disproportionate septal thickening; and 2) echocardiographic studies in first degree relatives of four other patients with disproportionate septal thickening and normal septal architecture did not show asymmetric septal hypertrophy. The relatively high prevalence of septal-to-free wall ratios of 1.3 or greater in this population of infants with congenital heart disease appeared to be due in part to minor differerences in ventricular wall thicknesses (in patients with relatively thin absolute wall thicknesses) which may produce particularly large deviations from unity in septal-to-free wall ratio. Hence, 1) nongenetically transmitted disproportionate septal thickening is relatively common in infants with congenital heart diseases studied at necropsy: and 2) a septal-to-free wall ratio of greater than or equal to 1.3 cannot be used as the sole criterion for identifying associated hypertrophic cardiomyopathy in infants with other congenital heart diseases, particularly if marked absolute septal thickening is absent.

Cardiomegaly↗
PubMed1979

Increased mitral-aortic separation in discrete subaortic stenosis.

We recently speculated that mitral-aortic separation (MAS) might be increased in discrete subaortic stenosis (DSS). We have examined this hypothesis in 22 heart specimens in which the subaortic obstruction originated on the muscular ventricular septum below the right aortic sinus, either as a discrete band, an accumulation of several bands or a diffuse ridge, and extended posteriorly into the MAS or anterior leaflet of the mitral valve or both, with a variable relationship to the aortic cusps and sinuses. No specimen had ventricular septal defect, supravalvular aortic stenosis or other features of Shone syndrome. The mean MAS was nearly twice that of 80 normal specimens (4.9 vs 2.5 mm), the range of MAS was increased from normal (0.11 vs 0.7 mm) and the mean diameter of the aortic annulus was decreased compared with the normal specimens, data that will be of interest to echo- and angiocardiographers in the clinical description of DSS, and to the surgeon who must resect these lesions.

Adult↗