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Biomedical subjects

S John

Publications and source records attributed to S John.

At least 199 records · Page 11Linked to original sources
PubMed1984

The effect of neuroleptic treatment and of high dosage diazepam therapy on beta-endorphin immunoreactivity in plasma of schizophrenic patients.

In 14 schizophrenic patients, treated with neuroleptic drugs, and in 7 patients, treated with high-dosage diazepam, beta-endorphin-like immunoreactivity in plasma has been measured by use of a highly sensitive and relatively specific radioimmunoassay. Neuroleptic treatment induced a significant increase of beta-endorphin-like immunoreactivity (beta-ELI). The pharmacological and clinical implications of this finding are discussed. High-dosage diazepam treatment induces a slight reduction of plasma beta-ELI, a finding which is attributed to antistress effect of diazepam.

Adolescent↗
PubMed1983

Pulmonary hypertension in isolated secundum atrial septal defect: high frequency in young patients.

Out of 709 consecutive patients with isolated secundum atrial septal defect, the pulmonary artery systolic pressure was greater than 50 mm Hg in 118 patients (17%). Pulmonary hypertension was present in 13% of patients under 10 years and in 14% aged 11 to 20 years. The Eisenmenger reaction was present in 9% of the 709 patients. The frequency of the Eisenmenger reaction was high in young patients and was not significantly different in patients in the first and second decades as compared to older patients. None of our patients with pulmonary hypertension resided at high altitude. The high frequency of pulmonary hypertension in our young patients cannot be satisfactorily explained. Autopsy studies suggest that in some, pulmonary hypertension is due to the persistence of the fetal pulmonary vascular pattern.

Adolescent↗
PubMed1983

Heroin addiction: beta-endorphin immunoreactivity in plasma increases during withdrawal.

Seven patients with heroin addiction were hospitalized and immediately withdrawn from opiates. Abstinence symptomatology was evaluated quantitatively by use of the Himmelsbach Score. Maximal intensity of withdrawal symptomatology was reached within 2 days. beta-Endorphin immunoreactivity in plasma was measured by use of a very sensitive radioimmunoassay with a low cross-reactivity (28%) against beta-LPH. A statistically significant increase of mean plasma beta-endorphin-like immunoreactivity during withdrawal could be demonstrated.

Adult↗
PubMed1983

Results of surgical treatment of ventricular septal defects with pulmonary hypertension.

Two hundred and twenty-five consecutive patients with interventricular septal defect and associated pulmonary hypertension have undergone corrective surgery at the Christian Medical College Hospital. The mean preoperative systolic pulmonary artery pressure was 70.5 (range 31-136) mm Hg and the calculated pulmonary vascular resistance ranged from 300 to 1680 dyn/s cm-5. A paracoronary right ventriculotomy was the approach of choice. Profound hypothermia and circulatory arrest were not used, even in 12 patients weighing under 10 kg. Among the older children and young adolescents there were 27 who had a calculated pulmonary vascular resistance of over 800 dyn/s cm-1 and their mortality was 22%, which is good when compared with that of other series. It is evident that both the early and the late death rate after surgery increase with the age of the patient, especially in those with associated pulmonary hypertension. In 69 patients studied after repair recatheterisation showed no residual defect by oximetry. The fall in the pulmonary artery pressures after surgery has been striking in most patients. The late death rate was 2.5%. The surviving patients are leading normal, active lives.

Adolescent↗
PubMed1983

Closed mitral valvotomy: early results and long-term follow-up of 3724 consecutive patients.

Between 1956 and 1980 closed mitral valvotomies were performed in 3724 consecutive patients (male:female ratio 1.1:1) with mitral stenoses. Their ages ranged from 6 to 69 years, with a mean (SD) of 27.3 (9.3). Mitral stenosis in the younger age group is a unique condition and a great majority of these patients rapidly develop significant pulmonary hypertension and congestive cardiac failure. In this study a large number of subjects belonged to functional class IV (41.5%). Hospital mortality was 1.5% over the last 5 years. After valvotomy, 11 patients (0.3%) developed severe mitral regurgitation that made valve replacement necessary in the immediate postoperative period. Early postoperative embolism occurred in 0.4% of those who were in atrial fibrillation and had preoperative anticoagulation whereas it occurred in 0.95% of those in sinus rhythm who had no anticoagulation. Late postoperative embolism occurred at a rate of 0.3 to 1.6 per 1000 patients per year over a 20 year period. Rheumatic reactivity occurred at a rate of 1.3 to 2.2 per 1000 patients per year during the same period. Rate of occurrence of restenosis varied from 4.2 to 11.4 per 1000 patients per year between the fifth and fifteenth year of follow-up. Closed transventricular revalvotomy for restenosis was accomplished in 130 subjects with a 6.7% mortality. Excellent symptomatic improvement was evident in 86% of long-term survivors at the end of 15 years. Actuarial survival was 95%, 93.1%, 89.5%, and 84.2% at 6, 12, 18, and 24 years, respectively, after closed mitral valvotomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1983

[Spontaneous bilio-digestive fistula after intraoperative choledochus ligation].

Intraoperative lesions of the extrahepatic bile ducts during cholecystectomy do occur; the incidence is about 0.2 to 0.8%. Lesions of the hepatic duct and the choledochus duct followed by stenosis (usually of the cystic duct confluent) do occur most frequently. Intraoperative ligation of the hepatic duct or the choledochus duct are the most severe sequelae of biliary surgery; the leading symptom is progressive postoperative obstructive jaundice. A bilio-digestive fistula may be formed spontaneously and may masquerade this complication leading to relapsing cholangitis. Pathogenesis, clinical symptoms and therapy of bilio-digestive fistula are discussed, after an own case report is given.

Aged↗
PubMed1983

Mitral valve replacement in the young patient with rheumatic heart disease. Early and late results in 118 subjects.

During a 14 year period, 118 young patients between 9 and 20 years of age underwent mitral valve replacement. In view of the acknowledged advantage of durability and minimal thrombogenicity, we chose the Starr-Edwards valve prosthesis in the large majority of our subjects. Other prostheses have also been used. Hospital mortality has been only 3% in the past 5 years. Frail, severely incapacitated children and adolescents have had an impressive spurt in growth and weight and have returned to normal activities. Nine of the patients have had a normal pregnancy and have borne children. The remarkable clinical improvement has been corroborated by hemodynamic benefit. Follow-up over a period 1 to 15 years (mean 5.09 +/- 3.3) showed a very low incidence of embolic phenomena. In Third World countries, rheumatic heart disease continues to be a daunting challenge with pronounced disability resulting in death. Mitral valve replacement in the young subject with significant rheumatic valve disease should not be delayed until severe pulmonary vascular changes and myocardial damage pose a major deterrent.

Adolescent↗
PubMed1981

Surgical treatment of congenital coronary artery fistula.

Six patients with congenital coronary artery fistula underwent successful corrective surgery. Precise diagnosis was established either by retrograde aortography or more recently by selective arteriography. The left coronary artery was involved in four and the right in two cases. The fistula communicated with the right ventricle in three and the right atrium in three subjects. The operative approach is dictated by the site of entry of the vessel into the cardiac chamber. The use of cardiopulmonary bypass for intracardiac repair allows accurate closure of the fistula thereby reducing the chances of recurrence. A follow-up of one to seven years showed that all patients are asymptomatic and leading normal lives.

Adolescent↗
PubMed1981

The adult ductus: review of surgical experience with 131 patients.

Results in patients over 14 years of age who have undergone surgical closure of a patent ductus arteriosus during the period 1967 through 1979 have been reviewed. There were 131 subjects (average age 22 years) with a slight male predominance, which is at variance with other reports. Sixty-two subjects underwent hemodynamic evaluation and of these, 30 had pulmonary artery pressures ranging from 50 to 150 mm Hg. Division and suture of the ductus with aortic cross-clamping under normothermic conditions was performed in 61 subjects. This approach was particularly indicated in cases in which the ductus was unusually short in relation to its diameter as well as in many with atheromatous changes at the aortic end. In 65 subjects, the conventional division and suture with ductus clamps was employed. Total cardiopulmonary bypass with transaortic patch closure of the ductus was carried out in three instances. There were five early deaths which were principally associated with severe pulmonary hypertension. During a follow-up period extending from 1 to 11 years, three subjects died, but the remainder are well and active. Recatheterization data in nine patients with severe pulmonary hypertension showed gratifying results.

Adolescent↗
PubMed1980

The use of an omental pedicle flap in the closure of bronchopleural fistulae.

Two recurrent bronchopleural fistulae in patients in whom previous intercostal myoplasty had failed were successfully closed by an omental pedicle flap and a bucket-handle flap slide over the omentum. The original procedure in both was left lower lobectomy. The advantages of the procedure are its simplicity, the absence of cosmetic defect, and its suitability for left lower or lingular bronchopleural fistulae when other procedures have failed.

Adult↗
PubMed1980

Experience with the surgical treatment of coarctation of the aorta in India.

Between 1961 and 1977, 51 patients underwent operations for coarctation of the aorta. The average age of presentation of these cases was higher than in other series. Only three were asymptomatic, a finding which is not seen in reports from the West. Operative procedures included resection and graft interposition, resection and end-to-end anastomosis, and bypass grafting. However, the technique of patch angioplasty, routinely performed in the last three years of this review, seemed by far the most satisfactory procedure. The overall operative mortality was 9.8%. Hypertension did not regress in some cases in spite of a successful operation. Recoarctation was not seen in this series. Associated defects influenced results adversely. The overall results of operation for coarctation of the aorta have been very satisfactory and comparable with those in other recorded series.

Abnormalities, Multiple↗
PubMed1980

Endomyocardial fibrosis from a surgical standpoint.

Successful surgical correction was accomplished in a 12-year-old boy with proved endomyocardial fibrosis. Pathological features and the role of surgical therapy in the management of this lesion are discussed. This report presents one of the youngest patients who has undergone endocardiectomy and valve replacement for right-sided endomyocardial fibrosis.

Child↗