Biomedical subjects

J F Silverman

Publications and source records attributed to J F Silverman.

At least 181 records · Page 10Linked to original sources

PubMed1976

Complications of percutaneous transfemoral coronary arteriography.

Complications statistics in 1625 patients undergoing selective coronary angiography by Judkin's technique have been analysed for four major areas-death, myocardial infarction, cerebral vascular accidents, and femoral thrombosis. Over a six-year period, considerable decrease in the number of complications has occurred. Myocardial infarctions have decreased from 2.4% (1967-71) to 0.44% (1973), an improvement related to careful catheter flushing, guidewire insertion technique and careful pressure monitoring within the coronary arteries. Cerebral accidents have decreased from a maximum of 1.3% (1972) to none (1973). This is also related to catheter guidewire techniques, and to avoidance of entering the cerebral vessels inadvertently when crossing the aortic arch with the coronary catheter. Femoral artery thromboses have decreased from 2.7% (1967-71) to none (1973). This is due to monitoring the dorsalis pedis pulse when compressing the femoral artery and avoiding complete femoral arterial obstruction with the associated lack of flow ultimately leading to thrombosis. Death rate has remained essentially unchanged (0.3-0.6%).

Angiography↗

PubMed1976

Spontaneously and pharmacologically provoked coronary arterial spasm in Prinzmetal variant angina.

Eleven of 21 consecutive patients with Prinzmetal angina (PMA) exhibited no significant fixed stenoses of the coronary arteries. Spontaneous coronary arterial spasm was demonstrated in 3 patients. Ergonovine maleate produced near-total occlusion of a major vessel in 3 of 4 other patients with PMA, but did not provoke spasm in 10 without PMA. The current study documents spasm as the mechanism of myocardial ischemia in some patients with normal coronary arteries and provides initial and favorable diagnostic results with provocative pharmacoangiography in this entity.

Angina Pectoris↗

PubMed1976

An unusual form of the transposition complex. Uncorrected levo-transposition with horizontal ventricular septum: Report of two cases.

A distinctive angiographic appearance is described in two patients who had uncorrected levo-transposition of the great vessels. Although levo-transposition with inversion of the ventricles usually results in physiologically corrected transposition, in these patients the anatomy was arranged in such a way as to result in an uncorrected transposition. The following elements were responsible for this physiological condition: normal atrial situs, inverted ventricles with "criss-cross" atrioventricular flow, levo-transposed great arteries. In addition, the morphological right ventricle was hypoplastic, left sided and superior to the left ventricle and the ventricular septum was horizontal in position. The two ventricles were connected via a large ventricular septal defect. The importance of accurate, detailed, preoperative angiographic demonstration of the anatomic situation is stressed.

Adolescent↗

PubMed1976

Primary pulmonary neurilemoma. Report of a case with ultrastructural examination.

The electron microscopic features of a primary neurilemoma of the lung, a very rare neoplasm, were studied. Characteristic Schwann cells were present, with cytoplasm and elongated cytoplasmic processes coated with a basal lamina. The highly characteristic Luse bodies were also seen. We add electron microscopic corroboration to the previous tissue culture confirmation of this unusual benign pulmonary neoplasm.

Humans↗

PubMed1976

Rhabdomyoma of the heart: ultrastructural study of three cases.

The electron microscopic features of three primary cardiac rhabdomyomas were studied for the first time. Distinct striated muscle cells arranged in a disorderly fashion are described. The cases demonstrated a spectrum of possible myobibril differentiation with one case having only Z-bands and myosin filaments present while the other two had well formed thick and thin filaments with all of the bands present including Z, I, A, H, and M. Glycogen bodies, numerous mitochondria with tubular cristae, lipid deposits, and peculiar striated structures resembling zebra bodies were also seen. Desmonsomal attachments suggestive of Purkinje-type fibers were seen in all of the cases and were the only types seen in cases 2 and 3. In addition, intercalated discs characteristic of myocardial fibers were noted in case 1. This finding still leaves the exact histogenesis of the lesion uncertain although origin from two types of fibers is possible.

Heart Neoplasms↗

PubMed1975

An ultrastructural study of mixed hepatoblastoma with osteoid elements.

A case of mixed hepatoblastoma with osteoid elements was studied by light and electron microscopy. The ultrastructure of the epithelial elements showed a lack of differentiation and simple cytoplasmic organelles. However, an occasional cytoplasmic crystalloid structure were seen. The ultrastructure of the osteoid foci showed fibroblast-like cells capable of collagen formation, clearly distinguishable from the epithelial elements. These cells had neoplastic characteristics of nuclear pleomorphism and high nucleo-cytoplasmic ratio. These findings support the belief that hepatoblastoma arises from a multipotential blastema capable of both epithelial and mesenchymal differentiation, with the osteoid elements being an intrinsic neoplastic component of the tumor.

Carcinoma, Hepatocellular↗

PubMed1975

Coronary bypass surgery for unstable angina pectoris. Clinical follow-up and results of postoperative treadmill electrocardiograms.

The first 81 patients who underwent coronary artery bypass surgery at Stanford University Hospital for unstable angina pectoris have been followed up for an average of 18 months. The over-all surgical mortality was 8.6 per cent (seven patients). There have been no operative deaths in last 32 patients, which may be due to over 75 per cent of these patients being stabilized on intensive medical therapy from 24 to 72 hours before study or surgery. There was a 16 per cent (13 patients) perioperative and 15 per cent (12 patients) late incidence of myocardial infarction. Of 74 patients who survived the initial operation 2 died 2 and 3 months postoperatively. Good or complete relief from pain was obtained in 94 per cent (70 patients) of the survivors. Of 57 longterm survivors tested, 49 per cent (28 patients) had a definite ischemic response to treadmill exercise testing. This may reflect the severe nature of the occlusive coronary disease or mechanisms other than increased coronary flow being responsible for the relief of pain. Although coronary bypass surgery appears to be effective in relieving the pain of patients with unstable angina pectoris, the 18 month average follow-up indicates that the incidence of myocardial infarction in surgically treated patients is comparable to that in medically treated patients.

Adult↗

PubMed1974