Search PubMed⌕ Search

Biomedical subjects

W J French

Publications and source records attributed to W J French.

70 records · Page 4Linked to original sources
PubMed1985

Cardiac tamponade as the initial presentation of malignancy.

Although neoplastic involvement of the pericardium frequently is present postmortem, cardiac manifestations before death are uncommon, and cardiac tamponade as the initial presentation of cancer is rare. In this study, a malignancy was first recognized in eight of 23 patients (35 percent) who presented with cardiac tamponade. Seven of these eight patients had lung and one patient thyroid carcinoma. The prognosis of these eight patients was poor with seven of eight patients dead within a mean of seven weeks (range 2.5 to 16). Overall, pericardial fluid cytology demonstrated a specific diagnosis of malignancy in 14 of 19 patients (74 percent). Earlier recognition of the possibility of malignancy may allow initiation of appropriate local or systemic treatment to lessen the probability of cardiac tamponade and improve survival. We recommend that all patients who present with tamponade have cytology performed on the pericardial fluid, even if malignancy is not suspected initially.

Adenocarcinoma↗
PubMed1984

Accurate internal correction for the magnification of cineangiocardiography in infants with congenital heart disease.

Correction for x-ray magnification at cineangiocardiography (cine) requires accurate localization of the level of the left ventricle (LV). This study compared LV volumes calculated using a standard external reference object (area grid) with volumes calculated using an intracardiac radiopaque catheter balloon in cine studies of casts (n = 26), normal lambs (n = 15), and infants with congenital heart disease (n = 11). Comparisons of LV volumes calculated using both correction methods with true cast displacement volumes were excellent (r = 0.99). Correlations of both methods were highly significant (p less than 0.001) in casts (r = 0.99), normal lambs (r = 0.97), and in infants (r = 0.83). The absolute percent difference (17.6 +/- 2.4 SE%) between LV volumes calculated by both methods was greatest in infants. Thus external localization of the LV may be more difficult in infants. The radiopaque balloon provides convenient accurate correction for cine x-ray magnification and calculation of LV volumes, particularly since flow-directed catheters are widely used for diagnostic cine ventriculography in infants.

Animals↗
PubMed1984

Slight rate acceleration in permanent rechargeable nickel-cadmium pacemakers: a possible marker of battery failure.

Thirty-seven rechargeable pacemakers were implanted in 33 patients between 1972 and 1976. Average follow-up has been 4.9 years. Six patients have had these pacers for an average of 7.8 years. Slight rate acceleration of 3 to 5 beats per minute was demonstrated in 46% of the units; rate acceleration to greater than 80 beats per minute was present in three pacemakers, two of which failed within three months. Although rechargeable pacemakers have performed well, frequent surveillance or replacement is warranted if the pacing rate increases to greater than 80 beats per minute.

Adolescent↗
PubMed1984

Favorable ten-year experience with valve procedures for active infective endocarditis.

We have reviewed our 1972 to 1982 experience with valve procedures for infective endocarditis in 52 consecutive patients to evaluate the results of an interdisciplinary policy of early operation for uncontrolled complications. There were 47 patients with native valve endocarditis and five with prosthetic valve endocarditis. Twenty-seven were drug addicts and 25 were not. Thirty-seven (71%) required operation during the active phase of the disease and 15 during the inactive phase. Ninety-three percent of the addicts, 41% of the nonaddicts, and all patients with prosthetic valve endocarditis were in the active group. The distribution of infected valves was as follows: aortic, 21 active and 10 inactive; mitral, six active and three inactive; aortic and mitral, five active and two inactive; aortic and tricuspid, one active and none inactive; and tricuspid, four active and none inactive. Streptococcus was the most common infecting organism in both groups--predominantly group D in addicts and non-D in nonaddicts. Staphylococcus, gram-negative rods, and fungi occurred only in the active group. Indications for operation were congestive heart failure alone (19 active and 15 inactive), congestive heart failure and refractory infection or major emboli (nine active and none inactive), and resistant or refractory infection alone or with emboli (nine active and none inactive). Periannular abscess or aneurysm formation was most frequent at the aortic valve site in patients with native valve endocarditis; it occurred in 13 of 25 patients (52%) in the active group and in one of 12 patients (8%) in the inactive group. Six patients with preoperative stroke syndromes underwent operation without neurological deterioration; two patients had rupture of cerebral mycotic aneurysms postoperatively. Hospital mortality was 8% (3/7) in the active group and 0% in the inactive group. The late actuarial survival rate was 64% at 5 years and 54% at 10 years. Seven of nine deaths in the addict group were related to continued drug use, with five deaths occurring in the first 18 months. These results support a policy of early operation for uncontrolled complications with attention to the particular problems of active endocarditis.

Actuarial Analysis↗
PubMed1983

Estimation of mixed venous oxygen saturation.

Pulmonary artery oxygen saturation (PA) was measured directly and estimated from venal cavae samples in 175 adults without intracardiac shunts to ascertain which of four formulas (MV1, MV2, MV3, or MV4) best estimated mixed venous oxygen saturation. Because the formula MV1, which favored IVC samples, most closely approximated pulmonary artery saturation, we recommend its use to estimate systemic flow in patients with left-to-right shunts. In addition, a difference between directly measured PA and calculated MV1 of 6% or greater indicates the presence of a left-to-right shunt in 97% of cases.

Adolescent↗
PubMed1983

Enzyme-linked immunosorbent assays for detection of xylem-limited bacteria: use of trinder reagent.

Quantitation and detection of xylem-limited bacteria with an enzyme-linked immunosorbent assay with a peroxidase conjugate is described. The use of the Trinder reagent (4-aminoantipyrine) allows the determination of extremely small quantities of peroxidase with no precipitate formation or inactivation of the enzyme by H(2)O(2). Comparison of the enzyme-linked immunosorbent assay method with microscopic and histochemical tests for the presence of the phony peach disease bacterium in 9-year-old "June Gold" peach trees gave comparable results. The peroxidase conjugate with the Trinder reagent is more sensitive than the alkaline phosphatase conjugate typically used for enzyme-linked immunosorbent assay quantitation.

Journal Article↗
PubMed1982

Ejection fraction derived using dye dilution and angiographic methods.

Ventriculographically derived ejection fraction (EF-V) is the most frequently used method to measure left ventricular (LV) function, However, significant error may result in the measurement of end-systolic volume (ESV), which is used to calculate EF-V. This error is ascribed to the variable, irregular, nonellipsoidal geometry of the end-systolic ventricular chamber. Since stroke volume (SV) is determined more accurately by dilution methods than by ventriculography, an improved measure of ESV can be calculated by subtracting green dye determined SV from the ventriculographic determined end-diastolic volume (EDV). The purpose of this study was to measure a correlated ejection fraction (EF-C) using EDV by ventriculography and SV derived using green dye. In eight anesthesized dogs cardiac outputs (COs) were calculated by green dye and left ventriculography. CO determined by ventriculography was greater than that measured by green dye (p less than 0.005). EF-V (55 +/- 15%) was always greater than EF-C (32 +/- 12%) (p less than 0.005). These studies (1) may partially explain the discrepancy in CO calculated from the use of dilution methods and ventriculography and (2) present a method to improve the calculation of LV ejection fraction.

Animals↗
PubMed1982

Postmyocardial infarction angina and coronary spasm.

Coronary spasm can cause chest pain, and may even culminate in a myocardial infarction, but it is not often considered a cause of chest pain in the early postinfarction period. Three patients who had chest pain early (1 day to 3 weeks) after myocardial infarction were shown to have coronary spasm with ergonovine maleate provocation. Two patients had spasm in the coronary artery associated with the acute infarction; the third had spasm in a remote vessel. Two required intracoronary nitroglycerin to establish patency in the affected vessel. It is concluded that coronary vasospasm can result in postinfarction angina.

Adult↗
PubMed1980

Main pulmonary artery distention: a potential mechanism for acute pulmonary hypertension in the human newborn infant.

Balloon-induced distention of the main pulmonary artery causes acute pulmonary hypertension and reflex pulmonary vasoconstriction in animals. Pulmonary artery pressure responses caused by MPA balloon inflation were measured in ten human newborn infants with cardiac failure (n = 5) or persistent fetal circulation (n = 5). During balloon inflation distal mean PAP increased significantly while cardiac rate remained unchanged. MPA distention caused greater increases of PAP in those infants with lower resting PAP. The greatest balloon-induced increases of PAP were observed in infants recovering from PFC. The existence of a pulmonary artery reflex and its possible role in the regulation of the human fetal and neonatal pulmonary circulation is discussed.

Cardiac Catheterization↗
PubMedDate not supplied

Use of transesophageal echocardiography during thrombolysis with tissue plasminogen activator of a thrombosed prosthetic mitral valve.

Inadequate anticoagulation in patients with mechanical prosthetic heart valves can result in a significant incidence of thromboembolic complications. An even more life-threatening complication is massive thrombosis of the valve itself. Thrombolytic therapy was given to a moribund 22-year-old woman with intractable heart failure caused by a thrombosed St. Jude prosthetic mitral valve (St. Jude Medical, Inc., St. Paul, Minn.). Although this form of therapy has been used before, this is the first report of a case in which transesophageal echocardiography was performed during thrombolytic therapy to continually record successful thrombolysis of the clotted prosthetic valve. Serial imaging during thrombolysis displayed progressive dissolution of the thrombus and progressive improvement in valve function. Transesophageal echocardiography is helpful in the diagnosis of prosthetic valve thrombosis and has the ability to monitor continually the effect of treatment with thrombolysis. Although thrombolytic therapy with recombinant tissue plasminogen activator is effective in treating prosthetic valve thrombosis, it carries a high risk for serious thromboembolic complications and thus should be reserved for critically ill patients who are too sick to undergo immediate surgery.

Adult↗
PubMedDate not supplied

Morphological changes in small vessels on endomyocardial biopsy.

Small vessel disease has been described in various cardiac conditions including diabetes mellitus, amyloidosis, and connective tissue disease. Less well understood is the incidence and morphological features of small vessel disease in patients with myocardial disease of unknown etiology. This study examines the incidence, clinical presentation, and pathological changes of small vessel disease in patients with normal epicardial coronary arteries undergoing endomyocardial biopsy. Biopsy specimens in 110 consecutive patients were analyzed by light and electron microscopy. Small vessel abnormalities were present in 16 patients (14.6 percent) of whom five patients had associated hypertension and 11 patients had idiopathic small vessel disease. There were six males and 10 females with a mean age of 53 (26 to 76) years. Clinical presentations were arrhythmias, heart failure, or chest pain. The left ventricular ejection fraction was reduced (less than 50 percent) in 12 of these 16 patients. The morphological features of small vessel disease included marked thickening of the arterial wall owing to subendothelial deposits of heterogeneous electron dense materials consisting of microfibrils, collagen and elastic fibers, cellular debris, and other amorphous substances. Subendothelial deposits comprised a mean 60 percent (40 to 76 percent) of the arterial wall thickness.

Adolescent↗