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Biomedical subjects

J T Lie

Publications and source records attributed to J T Lie.

At least 253 records · Page 14Linked to original sources
PubMed1977

The columnar-cell-lined (Barrett's) esophagus: a premalignant condition?

A 65-year-old man developed adenocarcinoma arising in Barrett's epithelium of the esophagus. He died three months after unsuccessful surgery to remove the tumor. The columnar-cell-lined esophagus may represent a premalignant condition, and it is suggested that patients with this condition undergo regular follow-up examination.

Adenocarcinoma↗
PubMed1977

Anomalous origin of a single coronary artery from the innominate artery.

This is the third reported case of the origin of a single coronary artery arising from the innominate artery (brachiocephalic trunk). Associated cardiovascular malformations were truncus arteriosus and a single ventricle. The term infant died 12 hours after birth. Heart failure, evidenced by severe pulmonary and hepatic congestion found at necropsy, was probably the immediate cause of death. The origin of a single coronary artery from sites other than the aortic or pulmonary sinuses is extremely rare and is always associated with other severe cardiac malformations. Truncus arteriosus and cor bioculare or trioculare are the usual associated abnormalities.

Brachiocephalic Trunk↗
PubMed1977

Patterns of patency of 596 vein grafts up to seven years after aorta-coronary bypass.

The long-term behavior of vein grafts and their effect on the native circulation were studied by examining 596 vein grafts in 343 patients at a mean follow-up of 15.4 months, range zero to 84 months. Serial studies were performed on 27 patients with 38 grafts. The over-all graft patency rate was 84 per cent, and the rate after more than 5 years was 89 per cent. The patency rate in asymptomatic patients was 91 per cent compared with 81 per cent in the remainder. The patency of grafts attached distal to total occlusions was 82 per cent (78/82). The angle of origin of the grafts from the aorta did not appear to influence patency or the severity of intimal proliferative changes. In 76 patients with 126 grafts, pre- and postoperative cineangiograms were compared, and changes in the graft and underlying coronary artery classified as Groups 1 to to 6: Group 1, patent graft, bidirectional flow in the grafted vessel, proximal lesion unchanged; Group 2, patent graft, bidirectional flow, proximal lesion progressed to occlusion locally; Group 3; patent graft, distal flow only, occlusion of lesion and segment between graft and lesion; Group 4, graft occluded, native artery unaltered; Group 5, graft occluded, native artery now occluded at lesion and region of anastomosis; Group 6, new distal lesion. Results were as follows; Group 1, 58 per cent; Group 2, 21.2 per cent; Group 3, 5 per cent, Group 4, 12.5 per cent; Group 5, 2.5 per cent; and Group 6, 0.8 per cent. Native coronary arteries undergoing closure (Group 2) had lesions 95 per cent or greater in 93 per cent of patients. The rate of closure of ungrafted lesions was 2 per cent. We believe these results encourage the continued used of vein bypass grafts.

Coronary Artery Bypass↗
PubMed1977

Nonbacterial thrombotic endocarditis (NBTE) and disseminated intravascular coagulation (DIC): autopsy study of 36 patients.

A pathogenetic relationship between nonbacterial thrombotic endocarditis (NBTE) and disseminated intravascular coagulation (DIC) was sought by reviewing autopsies from a recent 12-year period. Of 4,783 autopsies, 36 patients were found to have NBTE. The histopathologic diagnosis of DIC in patients with NBTE was dependent on the observation of thrombi in vasa recta and central glomerular capillaries of the kidneys and in sinusoids, arterioles, capillaries, venules, and medium-sized veins of the major viscera. Morphologic evidence of DIC was found in 18 (50%) of the 36 patients with NBTE. In addition, venous and arterial thromboses were found in 13 patients (36%) and pulmonary thromboembolism in 17 (47%). These findings support the view that NBTE and DIC may be pathogenetically related and result from a hypercoagulable state.

Adult↗
PubMed1977

Cardiac lymphatic obstruction: ultrastructure of acute-phase myocardial injury in dogs.

Cardiac lymphatics exist as a network of intercommunicating channels in the myocardium and heart valves, and chronic obstruction of these vessels may result in endomyocardial fibrosis and mucoid degeneration of heart valves. The acute effects of experimental cardiac lymphatic obstruction were studied in the dog. Subendocardial edema and hemorrhage occurred within 150 minutes of the ligation of cardiac lymphatics. Ischemia-type myocardial injury was also observed. Attional changes detectable ultrastructurally included lymphangiectasia, myofibrillar degeneration, disruption of Z-band and intercalated disks, and various mitochondrial derangements. The spottiness of the changes was attributable to the known anatomic variability of lymphatic distribution in the heart. The findings reinforce the belief that greater attention should be focused on the role of cardiac lymphatics in the pathogenesis of a multitude of myocardial and vavular heart diseases.

Animals↗
PubMed1977

A criss-cross heart. Detailed anatomic description and discussion of morphogenesis.

Hearts with criss-cross atrioventricular connections are rare. Reports in the literature describe great anatomic variations with regard to the atrioventricular connections, spatial relationships of the ventricles, and connections and spatial relationships of the great arteries. In the example described in this report, the basic anatomic picture was that of transposition of the great arteries, but the criss-cross atrioventricular valves had resulted in atrioventricular discordance; hemodynamically, therefore, the situation resembled congenitally corrected transposition. One hypothesis for this anatomic configuration is that pronounced counterclockwise rotation (as viewed from below) brought the ventricular septum into a frontal plane and altered the respective positions of the pulmonary and aortic valves from those usually seen in congenitally corrected transposition and thereby resulted in crossed atrioventricular connections. An alternative hypothesis is that in this case one of the atrioventricular valves (the anteriorly positioned valve) may represent an anomalous communication that developed early in embryogenesis and connected the left atrial appendage to the right ventricular infundibulum.

Child↗
PubMed1977

Congenital papillary tumor of the tricuspid valve. An unusual cause of right ventricular outflow obstruction in a neonate with trisomy E.

A trisomy E neonate had congenital cardiac anomalies that included a ventricular septal defect, a bicuspid aortic valve, and a congenital papillary tumor of the tricuspid valve. The large papillary tumor was responsible for severe intermittent pulmonary outflow obstruction. The cause and pathogenesis of these rare papillary tumors are unknown, but they are probably related to the more sessile varieties of congenital valvular dysplasia. The life-threatening obstruction to blood flow caused by the congenital valvular tumor probably can be alleviated by simple surgical resection. This type of tumor should be considered in the differential diagnosis of atypical forms of outflow tract obstruction.

Abnormalities, Multiple↗
PubMed1976

Growth of cultured calf aortic smooth muscle cells on cardiovascular prosthetic materials.

The growth of cultured calf aortic smooth muscle cells on cardiovascular biomaterials was investigated, using native and oxidized polyacrylonitrile (orlon) fabrics, dacron velour, and Parylene-C coated polypropylene microfabric as substrates. By light microscopic evaluation, surface cell coverage was most complete on microfabric, followed by native orlon, dacron velour, and oxidized orlon. Native orlon supported the greatest total cell growth, as determined by chemically extractable protein, followed by oxidized orlon, dacron velour, and the microfabric. The observed differences appear to be related to the pore size and fiber thickness of the different substrates.

Acrylates↗
PubMed1976

Vein graft patency and intimal proliferation after aortocoronary bypass: early and long-term angiopathologic correlations.

To determine the clinical significance of intimal proliferation as a cause of aortocoronary bypass vein graft obstruction, 492 vein grafts from 281 patients were studied 0 to 75 months postoperatively. All grafts had been inserted between 1968 and 1975 by one surgeon using one technique. The graft patency rate was 92 percent (55 to 60) in the first month; 91 percent (49 of 54) at 1 to 3 months; 84 percent (37 to 44) at 4 to 6 months; 77 percent (33 of 43) at 7 to 12 months; 81 percent (113 of 140) at 13 to 24 months; 82 percent (59 of 72) at 25 to 36 months; and 84 percent (66 of 79) at 37 to 75 months. Vein graft samples were obtained from 41 patients: In 27 patients with 51 grafts (early group), they were obtained 0 to 30 days (mean 14 days) postoperatively; in 14 patients with 27 grafts (late group) they were obtained 7 to 75 months (mean 34 months) postoperatively. Intimal proliferation was graded 1 to 4 corresponding to an intima/media thickness ratio of 1,2,3 or 4, respectively. In the early group, all 51 vein grafts howed grade 1 to 2 intimal proliferation; 5 of these grafts were occluded, all as a result of recent thrombosis. In the late group, 17 of the 27 grafts were studied histologically. All patent vein grafts showed grade 2 to 3 intimal prolferation. Four vein grafts were occluded but only one as a result of grade 4 intimal proliferation. In 14 patients in the late group, angiograms performed shortly before vein graft samples were obtained revealed 14 patent and 4 occluded vein grafts. Ten of the 14 patent vein grafts showed grade 2 to 3 intimal proliferation but were of uniformly good caliber angiographically (graft/artery ratio more than 1.5).

Adult↗
PubMed1976

Pancarditis in Whipple's disease: electronmicroscopic demonstration of intracardiac bacillary bodies.

The advent of electron microscopy has repeatedly confirmed Whipple's original postulate that bacterial infestation might be the cause of intestinal lipodystrophy (Whipple's disease). We have recently studied two patients, a 67-year-old man and a 38-year-old woman, who died of untreated Whipple's disease, and both were found to have clinically unrecognized pancarditis. Histologically, PAS-positive histiocytes in foci of chronic inflammation were demonstrable in several organs, including the heart. Electron microscopy of autopsy tissues showed numerous intracellular and extracellular rod-shaped bacillary bodies and serpiginous membranes. The bacillary bodies, some sectioned transversely and others longitudinally, were about 0.2 mum wide and 2 mum long; each had a double-layered cell wall. These bacillary bodies have not been previously identified in the heart, and may be casually related to cardiac lesions occurring in many untreated cases of Whipple's disease.

Adult↗
PubMed1976

Clinically unsuspected disseminated intravascular coagulation (DIC): an autopsy survey.

In a review of 768 consecutive autopsies, 21 (2.7%) clinically unsuspected cases of disseminated intravascular coagulation (DIC) syndrome were diagnosed by histologic examination. DIC was diagnosed by the presence of fibrin thrombi in arterioles, capillaries, venules, and medium-sized veins. Fibrin thrombi were found, in the descending order of frequency, in the brain, heart, lungs, kidneys, adrenals, spleen and liver. Most patients had multiple visceral involvement, with three showing fibrin thrombi in as many as ten organs. The density of fibrin thrombi was greatest in the spleen, followed by kidneys, liver, lungs, adrenals, brain, and heart. A review of clinical data showed that infections were the most common underlying conditions in 13 cases, including nine with positive bacterial cultures from blood or cerebrospinal fluid, or both. The results suggest that, despite increasing clinical recognition of DIC, a great number of patients remain unsuspected of having the DIC syndrome prior to postmortem examination.

Adolescent↗
PubMed1976

Histopathology of the conduction system in the sudden infant death syndrome.

The cause of the sudden infant death syndrome (SIDS, crib death, or cot death) is unknown. Current hypotheses include lability of heart rate and/or rhythm as a pathogenetic factor. The conduction system of 50 infants coming to autopsy were examined by serial sections; the infants were from newborn to two years of age. Twenty-six were SIDS deaths and 24 were explained deaths (ED). The frequency of histologic abnormalities of the specialized tissue was almost identical in both groups of infants. Hemorrhage in or around different parts of the conduction system was present in 27% SIDS and 29% ED. There was no evidence of cell death or degeneration of conduction fibers, nor obstructive lesions of the atrioventricular (A-V) arteries. Apparent moulding of A-V node and His bundle was a universal finding in both SIDS and ED, and consisted of irregular interdigitation of A-V node and His bundle fibers with the myxoid central fibrous body (CFB). Isolated bundles of conduction fibers residing in CFB and membranous ventricular septum were seen in two SIDS, but no direct contact between these fibers and the working myocardium could be identified in serial sections in either case. Without corroborating antemortem electrophysiologic data, the functional significance of morphologic findings in the conduction system of SIDS must remain conjectural.

Atrioventricular Node↗
PubMed1976

Epicardial tumor-like angiofibromatous proliferative lesion. An unusual complication of coronary bypass surgery.

The first report of an unusual complication of coronary bypass surgery for myocardial revascularization is presented. In a dog used for experimental studies of internal mammary artery (IMA)-coronary bypass and killed three months later, the postmortem examination of the heart showed a tumor-like epicardial angiofibromatous nodule at the site of the IMA-left anterior descending (LAD) coronary artery anastomosis. The lesion, consisting of plexiform vascular channels in a fibrocollagenous stroma, measured 2 by 1.5 by 1 cm. This was the only lesion found in the animal. It was speculated that the lesion might have arisen from a hematoma developing at the site of arterial anastomosis.

Animals↗