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Biomedical subjects

S Stern

Publications and source records attributed to S Stern.

At least 199 records · Page 11Linked to original sources
PubMed1979

Development of carcinoma of the breast at the site of an implanted pacemaker in two patients.

We report here on two female patients who had permanent pacemakers implanted in their chests and who developed carcinoma of the breast subsequently. An association is suspected between the breast cancer and the pacemaker, which is implanted in an area which borders with the mammary gland or is even right within it. This suspicion led us lately to change in female patients the site of the subcutaneous pocket for the implantation of the pacemaker to a position higher in the chest than before. Moreover, we advocate frequent breast examinations in all female patients with implanted pacemakers.

Adenocarcinoma↗
PubMed1979

Doctor, will you please testify!

A special problem exists for the plaintiff's lawyer in most malpractice cases--obtaining expert medical witnesses. The authors explain how this can be done and offer a detailed outline for bringing the process to a successful conclusion. In addition, the article gives prospective defendants and their counsel insight into what can be expected when a case comes to trial.

Expert Testimony↗
PubMed1978

Myocardial infarction with patent coronary arteries.

A 62-year-old patient suffered an acute anterior wall infarction as documented by clinical, electrocardiographic and enzymatic evidence. His ECG returned to a near normal pattern on the 5th day. The next day the patient died suddenly. Post mortem examination revealed a transmural anterior infarction with a mural thrombus, and a fresh thrombus in the left renal artery, but the coronary arteries were patient with only slight arteriosclerotic changes. We assume that a coronary thrombus might have been the cause of the infarction, with subsequent lysis. Such early lysis (6 days after the infarction) has not yet been demonstrated in earlier reports.

Acute Disease↗
PubMed1978

Ambulatory ECG monitoring and bicycle ergometry: correlation with findings on coronary arteriography.

Ambulatory ECG monitoring during everyday activities (AEM) and a multistage submaximal bicycle ergometric test (BET) was performed on a series of 48 patients suffering from precordial symptoms or pain. The results of these tests were compared with the results of coronary arteriography. In 20 subjects with a negative AEM and BET the coronary arteriography was normal in 18, moderately pathological (30-60% narrowing) in 1, and severely pathological (greater than 60% narrowing) in another. In 23 subjects in whom both AEM and BET disclosed ST-T alterations, 20 had severely pathological and 1 moderately pathological coronary arteriograms; normal coronary arteries were found in only 2 subjects. Only 5 of the total of 48 patients of the series showed a discrepancy between the results of AEM and BET. The findings on coronary arteriography confirmed that patients with a normal AEM and BET have a very high probability of having normal coronary arteries, while if both tests are positive the patient will most likely have advanced coronary pathology. When the two tests were concordant, the number of false positive and false negative results were slightly less than if ergometry was performed alone. Although AEM does not provide the quantitative aspect of effort testing, it does have the advantage of avoiding the risk of unusual physical effort for the patient.

Activities of Daily Living↗
PubMed1977

The role of adrenergic receptor blockade in serotonin-induced changes in the pulmonary circulation.

1. In dogs i.v. injection of serotonin caused a rise in pulmonary artery pressure and pulmonary arteriocapillary resistance that persisted even after alpha- and beta-adrenergic receptor blockade; pulmonary venous resistance also increased, but this was abolished by pretreatment with either propranolol or phenoxybenzamine. 2. The injection of serotonin into the ascending aorta produced an immediate rise in systemic, pulmonary arterial and pulmonary venous pressures and pulmonary venous resistance. After phenoxybenzmine, the rise in systemic and pulmonary arterial pressures remained unchanged, but previously observed increases in pulmonary venous pressure and resistance were blocked. In contrast, propranolol failed to abolish the rise in pulmonary venous resistance after serotonin injection into the ascending aorta. 3. These results confirm the observation that the vasoconstrictor effect attributed to intravenously injected serotonin on the arterial side of the pulmonary circulation is independent of the known sympathetic pathways. The data suggest that the pulmonary venoconstriction induced by intravenous serotonin is of reflex origin, abolished by alpha and beta receptor blockade, whereas the efferent arm of the reflex pulmonary venoconstriction following injection of serotonin into the ascending aorta is mediated via alpha-adrenergic receptors.

Animals↗
PubMed1977

Complete heart block following therapeutic irradiation of the left side of the chest.

Two female patients had received therapeutic irradiation of the left side of the chest for adenocarcinoma of the left breast and 18 and 23 years later, respectively, developed atrioventricular block. Both patients had early and late cutaneous reactions, as well as fibrosis of the left lung, lymphedema of the left arm, and pathologic rib fractures but had no signs of recurrence of the carcinoma. One patient developed signs of congestive heart failure while the electrocardiogram revealed second and third degree atrioventricular block; subsequent pacemaker implantation relieved the congestive heart failure. In the second patient, fatigue was the only symptom leading to the diagnosis of transient second and third degree atrioventricular block; this symptom subsided after pacemaker implantation. Based on reports of radiation-induced cardiac damage, it is assumed that the heart block in these two patients might have been due to postirradiation fibrosis of the atrioventricular node, either direct or mediated by fibro-occlusive changes in the coronary vessels.

Adenocarcinoma↗
PubMed1977

Positive radionuclide myocardial infarction pattern after ventricular fibrillation and direct current countershock.

A patient is presented in whom direct current counter-shock was applied for primary ventricular fibrillation. He recovered uneventfully and no evidence was found of a myocardial infarction; however, a positive 99m technetium stannous diphosphate scan obtained four days after the defibrillation showed positive findings. This positive scintigram was most probably due to myocardial or skeletal muscular damage consequent to counter-schock, but myocardial necrosis induced by ventricular fibrillation may be another cause. This case demonstrates again that a transmural or subendocardial infarction is not the only circumstance under which an abnormal scintigram can be obtained.

Electric Countershock↗
PubMed1976

Costosternal syndrome: its frequency and importance in differential diagnosis of coronary heart disease.

In a series of 320 consecutive patients referred because of precordial pain, the costosternal syndrome was found to be the underlying cause in 21, while in nine others, this syndrome was found to be coexisting with coronary heart disease. In our opinion, because of the current readiness to diagnose coronary artery disease, local causes for chest pain often are overlooked. The frequency of this syndrome is relatively high, both as a sole cause of chest pain and combined with coronary artery disease. Local injection of steroids was followed by improvement in the majority of our patients.

Adolescent↗
PubMed1976

Acute coronary occlusion following blunt injury to the chest in the absence of coronary atherosclerosis.

A 35-year-old man suffered transmural diaphragmatic wall infarction immediately after receiving a nonpenetrating trauma to his chest. During subsequent months crippling angina pectoris developed and coronary arteriography was performed. A complete obstruction of the left circumflex coronary artery was demonstrated 2 cm. distal to its origin. In contrast to most cases previously published, in this case no signs of atherosclerosis were observed in the other coronary arteries. It must be assumed, therefore, that blunt trauma can induce complete coronary occlusion with infarction, even in subjects with normal coronary arteries.

Acute Disease↗