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Biomedical subjects

S John

Publications and source records attributed to S John.

At least 217 records · Page 12Linked to original sources
PubMed1979

Tetralogy of Fallot in adults. A report on 147 patients.

Presented here is the clinical and hemodynamic profile of 147 patients, above the age of 18 with tetralogy of Fallot. Cardiac catheterization and selective cineangiocardiography were performed in all. Infundibular pulmonary stenosis, a subaortic large infracristal ventricular septal defect, mitral-aortic fibrous continuity and equal pressures in both the ventricles and aorta were considered mandatory for the diagnosis of tetralogy of Fallot. Cardiac enlargement was seen in 25.8 per cent of the patients, and 15.6 per cent were in congestive cardiac failure; 9.5 per cent had systemic hypertension, and aortic regurgitation was present in 6.7 per cent. A reticular pattern in the lung fields due to bronchial collaterals was seen in 23.1 per cent. The incidence of right aortic arch (19.9 per cent), absent left pulmonary artery (2.8 per cent), absent right pulmonary artery (0.7 per cent) and dextrocardia (1.4 per cent) is brought out. The right atrial mean pressure was increased in 4.8 per cent and a prominent "a" wave greater than 10 mm Hg was present in 10.9 per cent. The right ventricular end-diastolic pressure was increased in 23.8 per cent and the left ventricular end-diastolic pressure in 25.9 per cent of the patients.

Adolescent↗
PubMed1979

Pulmonary hydatid cyst: a 25-year experience.

This study reviews our experience with 102 patients operated on for pulmonary hydatid cysts during a 25-year period. The sex incidence was approximately equal. All subjects except three were symptomatic. The diagnosis was made on the radiographic findings. Early surgery is advised for complicated cysts in view of their increased postoperative morbidity and mortality. Surgical treatment included Barrett's enucleation for uncomplicated cysts and resection for complicated ones.

Adolescent↗
PubMed1978

Restenosis of the mitral valve: surgical considerations and results of operation.

Our experience over an eight-year period with 63 consecutive patients with mitral restenosis who underwent operation forms the basis for this report. Striking clinical disability was a notable finding. A majority of the patients were less than 30 years old. Embolic phenomena were rare. Closed transventricular valvotomy offers excellent low-risk palliation and good long-term results. Follow-up showed excellent or good results in 90.5% of the patients and poor results in 9.5%. Hemodynamic study of 6 patients demonstrated a pronounced decrease in the pulmonary artery pressure. Open valvotomy was performed in 6 subjects. The presence of intracardiac calcification together with mild mitral incompetence in 2 patients made valve replacement mandatory. The problem of restenosis of the mitral valve is complex, and only after further long-term results are available will the superiority of any one method be demonstrated.

Adolescent↗
PubMed1978

Achalasia cardia: a review of 100 cases.

Achaiasia cardia is the commonest benign obstructive lesion of the oesophagus in India. We have reviewed 100 cases over a 20-year period. This is the largest series that has been reported from India. Some unusual features were observed. Males were more often affected than females in a ratio of 2.3:1. Children below the age of 10 years are not often affected, but we had 10 subjects in this age group. In our series dysphagia for solids has been the main presenting feature. Barium swallow X-ray studies of the oesophagus were diagnostic. The treatment of choice had been surgical, and a modified Heller's operation has been the chosen procedure. Our preference is for the thoracic approach. Postoperative complications were few. Long-term follow-up of 65 patients over a 19-year period revealed excellent results in 50 patients (76.9%), good results in 10 (15.4%), and fair and poor results in two (3.1%) and three (4.6%) patients respectively. The fair and poor results occurred in patients with recurrence of symptoms or stricture formation due to reflux oesophagitis. The excellent results even on long-term follow-up, we believe are due to the adequate myotomy that was performed.

Adolescent↗
PubMed1978

Severe pulmonary hypertension in advanced aortic valve disease.

Review of haemodynamic data of 151 cases with isolated aortic valve disease revealed severe pulmonary hypertension (pulmonary arterial systolic pressure of 60 mmHg or more) in 17 (11%). The left ventricular end-diastolic pressure was high in all but one case, suggesting that the severe pulmonary hypertension was a reflection of the late stages of aortic valve disease. The majority (64.7%) had a low cardiac index. Premature closure of the mitral valve was seen in 12 of the 17 patients. While the incidence of premature mitral closure was the same as in others with mild and moderate pulmonary hypertension, the average reversed ventriculoatrial gradient was higher in the latter groups.

Adolescent↗
PubMed1977

Rheumatic aortic stenosis in young patients presenting with combined aortic and mitral stenosis.

This report describes 30 patients under the age of 30 years with rheumatic aortic stenosis, presenting with combined aortic and mitral stenosis. Three patients had additional tricuspid stenosis. Twenty-eight patients gave a history of rheumatic polyarthritis. The diagnosis was confirmed by right and left heart catheterisation in all. The murmur of aortic stenosis was not initially present in 8 out of 10 patients in congestive heart failure. Aortic valve calcification was not seen. Cineangiography showed a tricuspid aortic valve in all, unlike congenital aortic stenosis. A unique feature of this group was the raised pulmonary vascular resistance in 87 per cent of the patients. The present study shows that patients in India developing aortic stenosis after rheumatic fever do so early in the natural history of the disease.

Adolescent↗
PubMed1976

Massive left atrial thrombus complicating mitral stenosis with atrial fibrillation: results of surgical treatment.

Thirty-five patients with massive atrial thrombus complicating mitral stenosis and atrial fibrillation were treated surgically. The mean age in this series is lower than that reported in the West. Furthermore, the incidence of preoperative embolic manifestations has been less frequent in our experience. We believe it is desirable to document the presence of a thrombus by selective left atrial cineangiography. Surgical treatment was accomplished with an acceptable mortality. The vital role played by the use of low-molecular-weight dextran and early anticoagulation in decreasing the incidence of postoperative cerebral embolism is emphasized. Follow-up data in the survivors has shown excellent functional status with no late embolic phenomena in any subject.

Adult↗
PubMed1976

[Intraocular pressure in snorkling and diving (author's transl)].

The reactions of the intraocular pressure (i.o.p) in snorkling and scuba diving were studies on 29 healthy subjects. A patient with chronic glaucoma simplex was examined in a pressure tank. The results confirm the author's opinion, that a well compensated chronic glaucoma simplex with intact discs and fields does not exclude fitness to dive. However, a diver with narrow angel glaucoma risks sudden rise in i.o.p. and acute glaucoma while ascending to the surface. Persons, who are examined for fitness to dive, should be seen by an ophthalmologist, if they have a glaucoma or if they are hypermetropic and over 40 years of age.

Adult↗