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Biomedical subjects

S Grajek

Publications and source records attributed to S Grajek.

At least 19 recordsLinked to original sources
PubMed1992

[Unusually large thrombus in the left cardiac ventricle in a patient with a history of anterior wall infarction].

The giant size thrombus like a swallow's nest in the left cardiac ventricle in the patient with a history of anterior infarction was reported. In the autopsy a significant narrowing of the left coronary artery and two critical narrowings of the anterior interventricular artery were revealed. The relation between the localization of the pathological changes in the coronary arteries and the thrombi occurring during cardiac infarction was discussed.

Aged↗
PubMed1992

Online bibliographic information: integration into an emerging IAIMS environment.

The Medical Library at Yale University has developed an online free-text database containing Current Contents citations. The database was designed to be integrated into an emerging campus-wide information environment. To this end Current Contents at Yale was designed with a user interface familiar to the Yale community, an alerting service based on electronic mail, and search expansion using the National Library of Medicine's Meta-1 metathesaurus.

Consumer Behavior↗
PubMed1992

[Hypertrophy or hyperplasia of myocytes in heart hypertrophy?].

One of the most controversial problem in cardiac muscle pathology is the existence of myocyte hyperplasia. The term hypertrophy indicates an increase in size of the individual muscle cells without changing their total number, whereas in hyperplasia there occurs proliferation of the myocyte. This fundamental question of the character of cardiac growth remains unresolved in spite of the wide attention it has received. Contemporary views concerning the cardiac muscle hyperplasia are presented. From clinical point of view the problem is significant for two reasons. The loss of the ability of muscle cells to proliferate is responsible for the irreversible myocardial destruction after injury. From another point of view, if the increase of the heart muscle is maintained, although a complete remission of cardiac hypertrophy becomes impossible. In 103 hearts with various forms of cardiac muscle hypertrophy the following parameters were estimated: diameter, length, volume, density and number of myocytes, as well as the density of nuclei of myocytes. The values of all histometric parameters correlated well with the LV weight up to 350 g. In heavier hearts these parameters were approximately at the same magnitude. The number of myocytes was significantly higher in hearts with LV weight above 250 g than in hearts below 250 g: 5.53 x 10(9) vs 4.31 x 10(9), p < 0.001. The influence of coronary artery diameters, degree of atherosclerosis, weight and percent of fibrous tissue and age on LV weight were evaluated as well. From these parameters only coronary artery diameters significantly influenced on LV weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiomegaly↗
PubMed1991

[The mitral valve in mitral valve defect. Histological and clinical correlations].

The purpose of this study was to investigate the correlation between the histologic changes in the excised mitral valves and the clinical findings in patients with mitral stenosis (with or without regurgitation). The Study group consists of 26 men and 23 women ranged in age from 24 to 56 years. The mitral valves were removed in a uniform manner by one surgeon during mitral valve replacement. The controls were 13 mitral valves removed at necropsy from patients who died of extracardiac causes. Excised valves were fixed in 5% solution of formaline. The extent of calcification was determined by radiographs. Tissue from the center of the anterior and posterior leaflet were selected as the samples. The blocks were paraffin embedded and processed in the conventional manner. For histological examination 11.5 um thick sections were stained with haematoxylin and eosin, Alcian blue, Van Gieson and Von Koss stain. Then the sections were examined under light microscope. We estimated the degree of fibrotic disorganization of architecture, vascularization, acid mucopolysaccharide content, number of fibroblasts, and the presence of calcific deposits and lymphoid infiltrates. The control valves had normal architecture with thick "fibrosa". In all stenotic mitral valves we found complete or partial disorganization of architecture. The most common change was hyalinization present in 94% valves, vascularization in 84% and calcification present in 66% of valves. In 33% of stenotic valves were present infiltrations by lymphocytes. We found a significant correlation (p less than 0.05) between the presence of lymphoid infiltrates and the duration of disease prior to surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Heart amyloidosis with enormous cardiomegaly ("the king of hearts")].

A case is presented of a 74 years old man with systemic hypertension, congestive heart failure and history of heart infarction in the past. The physical findings revealed: blood pressure - 130/80 mmHg, arrhythmia and symptoms of congestion in systemic and pulmonary circulation. Ecg tracing showed multifocal atrial rhythm about 90 bpm., very low QRS voltage and lack of R waves in precordial V1-V4. On autopsy an enormous enlargement of the whole heart (1005 g) was found. Microscopical investigation revealed abundant amyloid deposits in the muscle of atria, ventricles and sinus node, disseminated atheromatous changes in the coronary system with no critical narrowing (more than 75% of lumen area). No sings of healed infarct were find. This is the first published case of so called "the king of hearts" due to amyloidosis.

Aged↗
PubMed1991

[Coronary lumen diameter and cardiac mass in various forms of cardiac hypertrophy].

Morphometric evaluation of the epicardial arteries is described in detail in 103 patients with various forms of cardiac hypertrophy. Coronary lumen diameter increases with aging regardless of the cardiac mass. Such an increase is observed in some particular types of cardiac hypertrophy and presumably is caused by the changes of intramuscular vessels and diminished perfusion. In patients with so called myocardial atherosclerosis correlation between coronary lumen diameter age and cardiac mass is opposite. In some forms of cardiac hypertrophy the increment of coronary lumen diameter is accompanied by the increase of the cross sectional area of the artery. In this pattern the increase of lumen diameter is not due to passive vessel dilatation because significant thickening of its wall can be seen. Age appeared to be the most important factor influencing the coronary lumen diameter within the whole population, although this correlation can hardly be seen in patients with "myocardial arteriosclerosis".

Aging↗
PubMed1991

[Diagnostic effectiveness of Rtg-TV, echocardiography and computerized tomography in mitral valve calcinosis].

The aim of the study was a comparative evaluation of the three diagnostic procedures: fluoroscopy (Rtg-TV), echocardiography (ECHO) and computer assisted tomography (CT) in detection of mitral valve calcifications. These methods were applied to the 46 patients with mitral valve disease (24 males and 22 females which age was 24-56 years). The results were compared with radiograms of isolated valves after surgery. We found that the most efficient diagnostic method is CT which provided following results: sensitivity--100%, specificity-- 89% efficiency--95%, false positives and false negatives rates 11% and 0% respectively. The same diagnostic indices in the other methods were: ECHO--92%, 77%, 85%, 22%, 7%; Rtg-TV--50%, 100%, 75%, 0%, 50%. The last method can not be used as a routine examination in detecting of the mitral valve calcifications because of its low sensitivity+ and high grade of false-negatives rate.

Adult↗
PubMed1991

[Unusually large vegetation on the mitral valve in a patient with bacterial endocarditis].

We present a case history of 29-year old female with infective endocarditis, who was admitted 15 months after neurosurgical treatment of disruption of cerebral aneurysm. The diagnosis of organic heart disease had been established in her childhood. 6 months after discharge from neurosurgery she developed marked dyspnoea on exertion and became febrile (up to 39.0 C). The presumptive diagnosis of infective endocarditis was established 6 months later, when she developed the symptoms and signs of severe anaemia with ESR 170 mm/hr although blood cultures were negative. The patient underwent treatment with Penicillin and Debecillin. On admission to our Institute echocardiography showed a very large, mobile vegetation in the left ventricle, connected to the anterior leaflet of mitral valve. Decision of mitral valve replacement was made, but rupture of the next cerebral aneurysm was the reason of unexpected, sudden death of the patient. The postmortem examination revealed 7 x 4 cm large vegetation, with the mass of 7.0 g. Histologically the vegetation consisted of mass of fibrin strands, platelets and blood cell with inflammatory cells. On its base the signs of the process of organization were marked. This vegetation was the largest one that we found in literature on this subject.

Adult↗
PubMed1991

[Intensity of tone and opening snap, and morphology of the bicuspid valve in patients with mitral valve disease].

The purpose of this study was to investigate the correlation between mitral valve morphology and amplitude of the first heart sound and the opening snap. The material consisted of 21 women and 19 men with mitral valve disease. They ranged in age from 24 to 56 years. 36 patients had pure or dominant mitral stenosis and 4 patients had combined mitral valve disease with dominant regurgitation. Phonocardiograms were recorded in all patients before mitral valve replacement. We analyzed the presence and the amplitude of opening snap and the amplitude of the first heart sound at the apex. The amplitude of the opening snap was expressed in mm and as a ratio to the maximal vibration of the second sound in the same cycle. The amplitude of the first sound was expressed in mm and as a ratio of the maximal vibration of the first sound to the maximal vibration of the first sound to the maximal vibration of the second sound in the same cycle. All amplitude measurements were made in 10 consecutive cardiac cycles and were then averaged. Then we studied all mitral valves removed in a uniform manner by one surgeon. Excised valves were fixed in 5% solution of formaline. The extent of calcification was determined by radiographs (fig. 1). The mitral valve area and calcification area were estimated by planimetry of radiographs. Then we analyzed the localization of calcification and we calculated the ratio of calcification area to valve area. Valves were divided into three groups according to the degree of the fusion of subvalvular structures ("a funnel") (fig. 2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Comparative evaluation of coronary arteriosclerosis in arterial hypertension and ischemic heart disease. Morphometric analysis of 4062 coronary artery specimens].

We performed a postmortem study on 61 hearts from patients who died of acute ischemic heart disease (IA). Chronic ischemic heart disease (IB) and from hypertensive patients who died of heart infarction (IIA) and other hypertensive complications (IIB). Control group consisted of 16 pts. who died of non cardiac diseases. 4062 coronary artery specimens were estimated. Irrespective of the clinical course of ischemic heart disease the mean percent of coronary artery stenosis was similar in both ischemic groups and significantly higher than in control group. In hypertensive pts. who died of heart infarction it was also significantly higher and similar to ischemic pts. We found the highest percent of segments with critical stenosis in the left anterior descending coronary artery in group IA, IB, IIA. It was also significantly higher in the left main coronary artery in the group of ischemic pts. (IA, IB).

Adult↗
PubMed1991

[Ramus limbi dextri or "moderator band" artery].

A patient who died of acute left ventricular failure in the course of myocardial infarct is described. At autopsy anterior myocardial infarct was confirmed. Postmortem coronarography revealed almost complete occlusion of the left main coronary artery and a very well developed collateral circulation. Part of the collateral circulation was the moderator band artery (visualized during coronarography).

Acute Disease↗
PubMed1990

[Unusual location of mural thrombi in the right atrium caused by pathological changes in the sinoatrial node].

We present a post-mortem examination of two hearts in which we found organized mural thrombi attached to the right atrial endocardium in the recess called antrum atrii dextri. This region is a place where the sinus node is situated very close to the endocardium of right atrium. Any pathological process involving the node (inflammation, degeneration) may reach this part of endocardium by continuity, this in turn creates convenient conditions for mural thrombi formation. The first case--a 52-year old man who died of severe congestive heart failure caused by rheumatic disease with mitral and aortic stenosis. Atrial fibrillation had developed several years before his death. Apart from typical changes of mitral and aortic valves a post-mortem examination revealed an organized, globular thrombus in antrum atrii dextri. In the microscopical findings of the sino-atrial region the fatty degeneration of the sinus node with multiple mononuclear cell infiltration was the most striking feature. The sinus node artery was narrowed due to fibro-muscular dysplasia of its wall. The second case--a 74-years old man who suffered from arterial hypertension and chronic pyelonephritis with a history of heart infarct in the past. The ECG recording showed multifocal atrial rythm with variable P wave morphology and P-Q distance. At necropsy the whole heart was significantly enlarged with no scars or any other signs of healed infarct. The microscopical findings revealed the heart muscle to be infiltrated by amyloid deposits particularly apparent in the sinus node. Similar thrombus of 1.5 cm in diameter was found in antrum of the right atrium.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Myocardial infarction in patients with arterial hypertension. Changes in the creatine kinase MB isoenzyme activity in relation to myocardial hypertrophy].

The aim of the study was to investigate the relationship of arterial hypertension coexisting with myocardial hypertrophy to the infarct size evaluated by serial CK-MB measurements. The group of 98 patients (72 males and 26 females) with the first Q-wave infarction was selected from 137 patients admitted to I Clinic of Cardiology of Poznan Medical School with acute myocardial infarction (AMIO). Age of the patients ranged from 35 to 82, mean 60 years. Time from the onset of symptoms to admission to the hospital varied from 1 to 8 hours, mean 4. Enzymatic tests were performed on admission, every 4 hours during the first 24 hours, every 6 hours during the second and the third day and every 8 hours during the 4th and the 5th day. Anterior infarction was diagnosed in 46 patients and inferior infarction in 52 patients. The type of CK-MB curve, maximal CK-MB activity and the mass of necrotic tissue was evaluated for every patient using Sobel formula modified by Norris. Total mass of the left ventricle was calculated from echocardiographic measurements (2-D and M-mode) and the ratio of LV mass per square meter of the body surface was was calculated according to Horton's formula. The subgroup of 44 patients (25 males and 19 females) with the history of hypertension was selected. Ophthalmic examination revealed angiopathic changes of I and II grade K-W. This group, as compared to remaining patients with AMI was characterised by higher left-ventricular mass (198.0 +/- 28.6 vs 151.0 +/- 16.9 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Myocardial structure in various forms of hypertrophy. I. Myocyte hypertrophy or hyperplasia? Pathophysiological aspects and the methods of study].

One of most controversial problems in cardiac muscle pathology is the existence of myocyte hyperplasia. The term hypertrophy indicates an increase in size of the individual muscle cells without changing their total number, whereas in hyperplasia proliferation of the myocyte occurs. This fundamental question of the character of cardiac growth remains unresolved in spite of the wide attention in has received. Contemporary views concerning the cardiac muscle hyperplasia are presented. From clinical point of view the problem is significant for two reasons. The loss of the ability of muscle cells to proliferate is responsible for the irreversible myocardial destruction after injury. From another point of view, if the increase of the heart muscle is maintained, although a complete remission of cardiac hypertrophy becomes impossible. In the light of these controversies we undertook the attempt to solve this complicated problem. Morphometric evaluation of the cardiac myocyte is described in detail.

Anthropometry↗
PubMed1990

[Myocardial structure in various forms of hypertrophy. II. Myocyte hypertrophy or hyperplasia? Results of the study].

In 103 hearts with various forms of cardiac muscle hypertrophy the following parameters were estimated: diameter, length, volume, density and number of myocytes, as well as the density of nuclei of myocytes. The values of all histometric parameters correlated well with the LV weight up to 350 g. In heavier hearts these parameters were approximately at the same magnitude. The number of myocytes was significantly higher in hearts with LV weight above 250 g than in hearts below 250 g: 5.53 x 10(9) vs 4.31 x 10(9), p less than 0.001. The influence of coronary artery diameters, degree of atherosclerosis, weight and percent of fibrous tissue and age on LV weight were evaluated as well. Only coronary artery diameters significantly influenced on LV weight. On the basis of linear discriminant function, three classes of hearts were separated: 1) LV weight 250 g - absence of hyperplasia, only hypertrophy 2) LV weight 251-350 g - hypertrophy + signs of hyperplasia 3) LV weight 350 g - marked signs of hyperplasia Among 18 patients with the LV weight above 350 g (all patients with congestive heart failure), 11 suffered from valvular disease, 3 were postinfarction patients, 2 suffered from primary hypertension and 2 from primary congestive cardiomyopathy. It indicates that, irrespective to the etiologic factor, hyperplasia is a simple result of the cardiac muscle mass increase.

Adult↗