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Biomedical subjects

J E Edwards

Publications and source records attributed to J E Edwards.

At least 307 records · Page 17Linked to original sources
PubMed1976

Candida meningitis. Report of seven cases and review of the english literature.

Seven patients with Candida meningitis are reported. These 7, plus 21 previously cited cases, were reviewed. This infection arose by two distinct mechanisms: hematogenous dissemination and direct inoculation. Recent antibiotic therapy, corticosteroid administration and severe underlying diseases were important predisposing factors. Fever, meningismus, elevated CSF pressures and localizing neurologic signs were commonly noted. Organisms were seen on gram-stain of CSF in only 43% of cases. Mortality rate in patients receiving inadequate or no antifungal therapy was high (greater than 90%), while those patients given appropriate antifungal drugs, especially intravenous amphotericin B, had a significantly lower mortality rate (38%). Several factors associated with poor prognosis were delineated in this study: diagnostic interval after symptomatic onset longer than two weeks, CSF glucose levels below 35 mg/100 ml and presence of intracranial hypertension and focal neurologic deficits.

Amphotericin B↗
PubMed1976

Dissecting aneurysm of aorta complicating aortic valvular stenosis.

Six cases of classical dissecting aneurysm of the aorta complicating aortic valvular disease in which aortic stenosis was dominant are described. In three of the cases the aortic complication occurred after the natural aortic valve had been replaced by a prosthetic valve. The longest postoperative period was four months. The factor common to all reported cases in our series was cystic medial necrosis of the aorta. The authors agree with the concept of McKusick and associates that aortic dissecting aneurysm complicating aortic valvular disease is an association other than chance and is related to cystic medial necrosis of the aorta. The latter, in turn, is a consequence of the altered hemodynamics of aortic valvular disease, particularly stenosis.

Aged↗
PubMed1976

Clinical conference: Rupture of right ventricle complicating closed chest cardiac massage.

Two cases of rupture of the right ventricle following closed chest cardiac massage are presented. This is believed to result from trapping of blood in the right ventricle at levels of systemic arterial pressure. In one case there was massive pulmonary embolism which interfered with egress of blood from the right ventricle. In the other case, application of pressure during a closed chest resuscitative attempt might have closed the right ventricular outflow tract.

Aged↗
PubMed1976

Uremic pericarditis as a cause of cardiac tamponade.

Uremic pericarditis may complicate either acute or, more commonly, chronic renal failure. When dialysis is not employed, uremic pericarditis is usually a preterminal event and is characterized by a serofibrinous exudation of an amount inadequate to cause cardiac tamponade. Nevertheless, cardiac tamponade may uncommonly be observed in nondialyzed patients. Cardiac tamponade, which may be life-threatening, is more common in dialyzed than in nondialyzed patients with chronic renal failure. The primary causes of cardiac tamponade in uremic pericarditis in order of decreasing frequency are (1) pericardial effusion, usually of the serosanguineous type, (2) massive hemorrhage into the pericardial sac and (3) collagenization of pericardial exudate. From pathologic evidence, the following forms of therapy appear appropriate to manage uremic pericarditis that has reached the stage of causing cardiac tamponade. For effusion, pericardiocentesis or parietal pericardiectomy are logical procedures. Massive hemorrhage into the pericardial sac is usually attended by clotting and requires pericardiotomy and evacuation of clot. Collagenization of exudate yields an encasing, fibrous shell over the heart and requires decortication, as is practised in classical constrictive pericarditis.

Acute Kidney Injury↗
PubMed1976

Anatomic causes of pulmonary stenosis in complete transposition.

Among 166 specimens with classical complete transposition, pulmonary or subpulmonary stenosis was present in 22 cases. The bases for obstruction were pulmonary valvular stenosis (one case), membranous subpulmonary stenosis (nine cases), anomalous attachment of the mitral valve to the ventricular septum (five cases) and combinations of causes (seven cases). Conditions contributing to combinations of causes included the above, in addition to accessory mitral or pulmonary valvular tissue and herniation of a tricuspid valvular pouch through a related ventricular septal defect. In addition to the 166 cases mentioned, our collection contained six cases of atypical complete transposition characterized by a conus being present in the each ventricel. In three of these six, subpulmonary stenosis was present and caused by a narrow inlet to the left ventricular conus.

Adolescent↗
PubMed1976

Coronary atherosclerosis in subjects with mitral stenosis.

The coronary arteries were examined in 60 specimens from patients with mitral stenosis. In three, localized obstruction was nonatherosclerotic in nature (in one, arterial dysplasia; in two, embolic). In 18 of the remaining 57 cases (31.5%), significantly obstructive atherosclerosis in one or more segments of the coronary arterial system was found. This represented 46% of the males and 27% of the females. The incidence of involvement of three or more arteries by significantly obstructive atherosclerosis was 39%, while in a cited series of subjects with angina pectoris three or more vessels were involved in 79% of the cases. It may be concluded that, on the average, the distribution of lesions in patients with mitral stenosis and significant coronary atherosclerosis is less wide than in subjects with clinical coronary disease.

Age Factors↗
PubMed1976

De subitaneis mortibus. XX. Cardiac electrical instability in the presence of a left superior vena cava.

Abnormalities of cardiac rhythm have been reported by others in patients with a persistent left superior vena cava. We present the histological findings from postmortem examination of the cardiac conduction system of two such patients. The first patient was a schoolboy who died suddenly and unexpectedly. His sinus node was abnormally small, his A-V node contained numerous venous lacunae and was stretched out beneath the enlarged coronary sinus, both A-V node and His bundle were dispersed in the central fibrous body in a fetal pattern, and isolated fragments of A-V nodal tissue were connected to the myocardium at the crest of the interventricular septum. The second patient complained of palpitations many months prior to surgical correction of an interventricular septal defect; his postoperative course included multiple arrhythmias and he died suddenly on the 16th postoperative day. Although his sinus node was histologically normal, the nutrient artery contained a polypoid fibromuscular mass virtually occluding its lumen; his A-V node and His bundle were also dispersed in the central fibrous body in the fetal pattern, and the A-V node contained numerous venous lacunae as well as being histologically disorganized in its cytological pattern. These anatomical findings may indicate a basis for various forms of cardiac electrical instability, and deserve consideration in the future evaluation of any patient found to have a persistent left superior vene cava, but particularly if there is clinical evidence suggesting an arrhythmia or conduction disturbance.

Adolescent↗
PubMed1976

Bilateral ductal origin of the pulmonary arteries. Systemic-pulmonary arterial anastomosis as first stage in planned total correction.

Absence of continuity between the heart and the pulmonary arteries has the potential for total correction. When the pulmonary arteries are narrow, a palliative first stage systemic-pulmonary arterial anastomosis serves to enlarge the pulmonary arteries so that, with time, they become of adequate caliber for total correction. In a case with bilateral ductal origin of pulmonary arteries, palliative anastomosis between the aorta and right pulmonary artery was performed as the first stage in a program planned for ultimate total correction.

Aorta↗
PubMed1976

Stenotic semilunar valve in persistent truncus arteriosus.

The clinical, hemodynamic, and pathologic findings in two newborn infants with persistent truncus arteriosus and stenosis of the truncal valve are described. In one case the anatomic features of the basic condition were classic, with a dysplastic semilunar valve which was mainly stenotic and also incompetent, while in the other the truncus arteriosus arose exclusively from the right ventricle and was almost exclusively stenotic. A ventricular septal defect was the only outlet for the left ventricle. In this case, mitral stenosis was also present and associated with a left-to-right shunt at the atrial level.

Aortic Valve Stenosis↗
PubMed1976

Anomalous double blood supply to the lung.

We report an unusual case in which an apparently normal upper lobe of the right lung was supplied by major systemic arterial and pulmonary arterial vessels. The anomalous artery arose from the descending aorta. Following interruption of this vessel, the machinery-like murmur previously present disappeared.

Child, Preschool↗
PubMed1976

Lesions of conduction tissue complicating aortic valvular replacement.

A pathologic study of the cardiac conduction system was performed in 57 patients who died within 30 days after aortic valvular replacement. Histologically, there were old and recent lesions present in 34 (60 percent) and 43 (75 percent) of the patients, respectively. Old lesions did not show meaningful correlation with preoperative electrocardiograms. Although nontraumatic recent lesions were rarely the cause of postoperative abnormal cardiac conduction, traumatic lesions were frequently associated with loss of sinus mechanism. The main cause of trauma to the major cardiac conduction tissue was injury by sutures. The short membranous septum predisposed to injury, while the configuration of the left ventricular outflow tract was not a significant factor in injury. Traumatic lesions of the cardiac conduction tissue were more common in subjects with bicuspid than tricuspid aortic valves.

Adolescent↗
PubMed1976

Relationship between right ventricular muscle bundles and pulmonary valve. Significance in pulmonary atresia with intact ventricular septum.

The normal pulmonary valvular cusps and related sinuses lie superimposed upon specific muscle bundles of the right ventricular infundibulum. Most prominent of such muscle bundles are those related to the right and left (posterior) pulmonary valvular cusps and sinuses. Least prominent is the muscle bundle related to the anterior pulmonary cusp and sinus. In pulmonary valvular atresia with intact septum the normal relationships are accentuated by right ventricular hypertrophy. A transpulmonary valvotomy done either through the region of the right or left (posterior) cusp tends to extend through subjacent muscle. The opening made through the region of the anterior cusp is more apt to lead directly into the right ventricular cavity.

Cardiomegaly↗