Biomedical subjects
Publications and source records attributed to J Hager.
A congenital arteriovenous fistula involving the inferior epigastric arteries and the umbilical vein, simulating a congestive heart failure, occurred in a newborn infant. The embryology of this condition is explained. The involved vessels were ligated and excised. The diagnostic and surgical problems of this rare type of fistula are discussed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
At the present time mechanical assisted circulation is indicated in patients with cardiac failure after open heart operations. The results after clinical implantation of the left ventricular assist devices are not encouraging. However, most of these patients suffer from irreversible cardiac failure and no restitution is to be expected. In patients with postoperative cardiac failure, a distinction must be made between isolated left heart failure and total heart failure. In patients with total heart failure - for example with diffuse, marked coronary sclerosis - both left and right ventricle failure exists. In these patients, no left ventricular assist device per se can bring the desired effect, since due to the right heart failure syndrome, the left system does not work adequately. With the biventricular bypass it is possible to maintain complete circulation in cases of cardiac insufficiency. The cannulation concept is biventricular transatrial to the aorta or to the pulmonary artery. The technique is simple and can be carried out very quickly. In cases of clinical emergency this device can be recommended due to the satisfactory haemodynamic effects achieved and the small degree of traumatic haemolysis. It represents an easy and quick implantable system for total functional heart replacement.
Hydrothorax and retroperitoneal extravasation are rare complications with parenteral nutrition. We demonstrate here a case of perforation of the iliac vein with retroperitoneal extravasation, which led to laparotomy because of signs of peritonitis. Catherization of peripheral and central veins and the complications arising are discussed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The results of the first clinical trials of left ventricular assist devices are not encouraging. The only indication at present is in patients with cardiac failure after cardiac operations. The acute type of ellipsoid heart described in this paper-displays a canulation technique where the inflow canula inserted in the left ventricular cavity via the left atrium and the outflow canula is directly connected to the aortic canula of the cardiopulmonary bypass. The haemodynamic response shows the efficacy of this system. The circulation can be maintained in severe cardiac failure, as well as in ventricular fibrillation and cardiac arrest. On the basis of data obtained in experiments on 7 female calves this system is considered worthy of clinical trial.
Explore the source record for details and available documents.
Two cases of oncocytic papillary carcinoma of the thyroid gland are reported, which occurred in two sisters during pregnancy. In both cases the follow-up is without complications (after strumectomy and postoperative radiation) and therefore it is in strong contrast to the aggressive biological behaviour during pregnancy. The oncocytic papillary carcinoma is a rare disease in the endemic-goitre area without iodine prophylaxis. Electron microscopic findings confirm the histological diagnosis and outline the oncocytic cell against light-microscopically similar cells.
Three cardiac Myxomas were studied by light-, immuno-fluorescence and electron microscopy. Acid mucopolysaccharides of the tumour were isolated chromatographically. The surfaces of the "myxomas" were papillary in two cases and smooth in one. The smooth surfaced tumour recurred six months after primary resection; histological specimens were more cellular than those of the papillary tumors and showed nuclear polymorphism and mitoses. The cells of two papillary tumours were identified as endocardial by electron microscopy, however, the cells of the smooth surfaced tumour were typical myofibroblasts. In both types of "myxomas" the cells were rich on cytoplasmic filament that contained acto-myosin. Biochemical investigation failed to reveal any difference between the acid mucopolysaccharide pattern of the two tumour types; isolated mucopolysaccharides being typical for embryonal mesenchymal tissue. The authors agree with Albertini (1963), that "cardiac myxoma" is a misnomer for two different typical endocardial tumours: a true endothelioma and a "special fibroma" (myofibroma or myofibrosarcoma).
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We suggest to differentiate between the real spontaneous perforation of the gallbladder and the inflammatory rupture and contrast both with the traumatic form. In one case treated by us we suceeded in finding the cause of the perforation to be an antatomical deficiency. Sterile cholascos should be distinguished from severe bile peritonitis.
The investigation of 20 clinical patients and the autopsy material of 15 cases showed that neuromas of the cystic duct stump following cholecystectomy represent a regular pathomorphologic condition and have no correlation with any postoperative symptoms. Identical morphologic alterations can also be found on arterial stumps after resection of abdominal organs. Therefore, we suggest eliminating the cystic duct neuroma from the list of possible causes of symptoms after cholecystectomy.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.