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Biomedical subjects

J Goldstein

Publications and source records attributed to J Goldstein.

440 records · Page 25Linked to original sources
PubMedDate not supplied

Composite graft replacement of the aortic root and ascending aorta for annuloaortic ectasia.

Eighteen patients with annuloaortic ectasia were surgically treated during a six year period. Cystic media-necrosis was present in 17 patients, five of them presented with Marfan syndrome. All patients received a composite graft with reversed mitral Björk-Shiley or St-Jude prosthesis and reimplantation of the coronary ostia or venous bypass grafts. Combined profound selective hypothermia and hyperkalemic cardioplegia was the preferred myocardial protection technique. There was one early postoperative and two late deaths. The fifteen survivors, with a follow-up between 6 and 72 months did not present conduit related complications and clinical results are excellent; all patients are NYHA class I (11) or II (4).

Adult↗
PubMedDate not supplied

Electromechanical dissociation after ventricular fibrillation: prevention with calcium-entry blockers.

Calcium-entry blockers were administered in an attempt to protect myocardium during cardiac arrest due to ventricular fibrillation in mechanically ventilated dogs. An intravenous injection of verapamil, nifedipine, or lidoflazine was administered prior to successively prolonged episodes of ventricular fibrillation, during which no thoracic compression was performed. It is of interest that ventricular defibrillation was more easily obtained after treatment with the three drugs. As previously observed in this model, nine control dogs developed electromechanical dissociation (EMD) after 120 seconds of ventricular fibrillation. In contrast, six of the 11 dogs treated with 0.3 mg/kg of verapamil recovered mechanical systole after 120 seconds of ventricular fibrillation (p less than 0.05). Nifedipine administration also postponed the onset of EMD in three of four dogs. However, lidoflazine postponed the onset of EMD in only one of the eight dogs. The later onset of EMD after administration of verapamil or nifedipine in this model was attributed to myocardial protection by calcium-entry blockers during ventricular fibrillation. Decreased energy utilization during cardiac arrest was considered to be the principal protective mechanism. These observations indicate calcium-entry blockers, and especially verapamil and nifedipine, can be valuable drugs during cardiac resuscitation for ventricular fibrillation.

Animals↗
PubMedDate not supplied

A method of repair for Achilles tendon ruptures without cast immobilization. Preliminary report.

A new technique for the repair of Achilles tendon ruptures has been developed with a Dacron vascular graft used as a tension suture material. The suture is passed through the calcaneal tuberosity and, with two loops applying tension to the tendon at the level of the musculotendinous junction, brings the tendon ends together by creating a solid structure. Post-operative immobilization and its possible adverse sequelae are eliminated by this procedure. The technique was first tested on five dogs with severed Achilles tendons of both hind legs. One side in each animal was repaired with this suture technique; the second leg was left as an untreated control. All the animals recovered from surgery and walked almost normally on the sutured leg within less than three weeks. The dogs did not walk on the unsutured legs. In a second procedure, the control leg was repaired by the same reparative procedure. Equally good results were obtained. The technique was then used on five patients with recent and neglected Achilles tendon ruptures or lacerations. In all instances excellent surgical results were obtained and leg immobilization was virtually eliminated. Physical therapy was begun in the immediate postoperative period. The rehabilitation period was significantly reduced.

Achilles Tendon↗
PubMedDate not supplied

Cystosarcoma phyllodes.

A series of 27 cystosarcoma phyllodes diagnosed in 23 patients is presented. Treatment consisted of wide local excision with a rim of normal tissue for the histologically benign-appearing tumors, and simple mastectomy for the histologically malignant-appearing tumors. Of the three tumors with a malignant appearance, one metastasized distantly and the patient died; the other two patients were apparently cured. Of the 24 benign-appearing tumors, 3 recurred locally and were cured by reexcision. None behaved in a malignant fashion. There was one case of bilateral cystosarcoma phyllodes, and one tumor was associated with carcinoma of the breast. The local recurrence rate of 11% (3 out of 27) and mortality rate of 4% (1 out of 23) appears to justify this therapeutic approach. The precise indications for mastectomy in this disease are still unclear.

Adolescent↗
PubMedDate not supplied

[Malignant spinal hemangiopericytoma, with benign radiological appearance].

A spinal intra-dural and extra-medullary tumour is described, presenting both clinically and radiologically as a benign process. However, the pathological examination, helped by electron microscopy, concluded in favour of a malignant hemangiopericytoma. The clinical cause, after surgery and radiotherapy, confirmed this latter diagnosis.

Adult↗
PubMedDate not supplied

Primary Schwannoma of the thyroid gland.

A primary Schwannoma of the thyroid gland caused severe dyspnea due to tracheal compression and deviation. The thyroid gland is a very rare site of origin for this tumor, and to the best of our knowledge this report represents the first documented case of a Schwannoma with such symptomatology.

Dyspnea↗