An unusual cause of progressive heart failure.
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Amyloid↗
Biomedical subjects
A K Abdulla
Publications and source records attributed to A K Abdulla.
Hepatocyte degeneration as predictive of early graft function in liver transplantation.
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Endoplasmic Reticulum↗
Effect of prostacyclin PGI2 on cardiopulmonary bypass-induced lung injury.
Lung injury produced by cardiopulmonary bypass (CPB) is clinically characterized as postperfusion pulmonary dysfunction syndrome. The roles of humoral factors, altered perfusion modes and the occurrence of diffuse microembolism have been subjects of a number of studies. This paper presents the effectiveness of a platelet inhibiting drug, PGI2 in preventing occlusive microaggregates in the pulmonary circulation. In a series of experimental dog studies using a PGI2 dosage protocol of 10 ng/kg/minute for 30 minutes prior to the onset of CPB followed by 20 mg/kg/minute during CPB, the following effects have been observed: 1) Preservation of platelet numbers during CPB (p < 0.01 versus controls; n = 16). 2) Significant reduction in platelet aggregation during CPB (p < 0.01; n = 16). 3) Insignificant hypotensive effect at normal levels of peripheral vascular resistance (n = 16). 4) Occlusive fibrin, leucocytes and small platelet-based microaggregates obstructing pulmonary arterioles in six of the seven control dogs but in none of the dogs receiving PGI2 infusion. 5) No evidence of perivascular or intra-alveolar oedema, interstitial inflammatory cell infiltrates or haemorrhage was seen in either group of dogs. The controversy existing in relation to the possible therapeutic role of PGI2 and, in particular, its ability to prevent occlusive microaggregates in the arterioles and capillaries of vital organs should encourage further clinical studies of PGI2 and its derivatives during cardiac surgery.
Animals↗
Coronary embolism by metastatic choriocarcinoma of the uterus: an unusual cause of ischemic heart disease.
Although gestational choriocarcinoma is a rapidly invasive malignancy, metastatic invasion of this tumor to the heart is rare. We report an unusual case of coronary embolism, which was caused by malignant trophoblasts from choriocarcinoma in a 26-year-old woman. The woman presented with classic symptoms of ischemic heart disease after having successfully undergone chemotherapeutic treatment for choriocarcinoma several months earlier. Thus, she was thought to have coronary heart disease or to have developed cardiotoxicity from antineoplastic drugs. This is the first report of this type of metastatic localization and tumor involvement in the heart and underscores the need for suspecting isolated metastases in uncommon sites in patients with choriocarcinoma.
Adult↗
Echocardiography and pathology of left ventricular "false tendons".
The anatomic incidence of left ventricular false tendons has been determined in 100 hearts obtained from consecutive autopsies on patients who had a wide variety of cardiac conditions. In this series, an anomalous band was found in 34 cases. A retrospective two-dimensional (2D) echocardiographic study was able to identify false tendons in only 18 percent of cases with anatomic evidence of them, indicating 2 mm as the limit of resolution of 2D echocardiography even with appropriate projections. Finally, the histologic examination has shown false tendons to contain conduction tissue and thus it is assumed to be intracavitary radiations of the bundle of His. This last consideration introduces new physical and electrophysiologic implications.
Adolescent↗
Assessment of neuron in congenital heart disease with heart failure.
Pathological studies in five hearts from patients with congenital heart diseases have demonstrated that the number of neurons is similar to that found in normal controls. The number of neurons has been counted in a strip of right atrial wall between the venae cavae. The hearts were selected from a wide spectrum of the population, the youngest being 5-months old and the oldest 35 years old (mean age: 12 years); all were in failure. The neuronal counts are comparable to those found in a normal population of mean age 40 years.
Adult↗
Fatal measles myocarditis.
A case of fulminant measles myocarditis is reported. Diagnosis has been obtained at autopsy, due to absence of skin rash, by identification of measles giant cells in the myocardium and by positive reaction of myocardial tissue to measles-specific immunoperoxidase. Unusual outcome is interpreted as due to defective cell-bound immunity and extentive involvement of myocardial microcirculation.
Acute Disease↗
Congenital lymphangiectasia of interventricular septum.
A case of congenital lymphangiectasia of ventricular septum obstructing outflow tract is reported. It mimicks hypertrophic cardiomyopathy or a primary tumor of the heart. Surgical operation has been successful and the expected prognosis is good.
Heart Septal Defects, Ventricular↗
Chemical shift magnetic resonance imaging of human atheroma.
Fifteen necropsy specimens of human descending aorta and from eight patients with atheromatous vascular disease were studied by magnetic resonance imaging at 0.5 T. Images were acquired in coronal and transverse planes to localised protruding lesions and then chemical shift imaging was performed by techniques described by Dixon and by Hinks. These techniques produce images in which signal strength is proportional to lipid content. The signal was expressed as a percentage of that from extravascular fat. The total lipid content and its distribution within the plaques were noted. After imaging, the postmortem specimens were examined histologically and the lipid content of the plaque was assessed on a semiquantitative scale. The distribution of lipid within the plaque and between intima and media was also noted. The findings of chemical shift imaging agreed well with histological examination both for total lipid content and for distribution within each plaque. Chemical shift imaging also provided an assessment of the lipid content of the plaques measured in living patients, but validation was more difficult. The usefulness of the technique in routine clinical practice remains to be established.
Aorta, Abdominal↗
Persisting hypereosinophilia and myocardial activity in the fibrotic stage of endomyocardial disease.
An unusual case of endomyocardial fibrosis is reported complicating an idiopathic hypereosinophilic syndrome. Persisting hypereosinophilia, degranulated eosinophils in the blood, and myocardial activity have been found accompanying the fibrotic phase of endomyocardial disease. This occurrence supports the unitarian theory on tropical and temperate endomyocardial disease and suggests in such a condition the use of steroids or cytotoxic drugs in addition to surgery.
Endocardium↗
Viability and morphology of aortic and pulmonary homografts. A comparative study.
In view of possible clinical use of the pulmonary homograft for right ventricular outflow tract reconstruction a comparative study with the aortic counterpart was performed. Samples of aortic and pulmonary walls from 10 cadaveric hearts were assessed for viability and morphologic characteristics before and after storage in nutrient-antibiotic solution. The viability, as evaluated by an autoradiographic technique, was similar in both aortic and pulmonary specimens at the time of dissection, after 2 weeks, and after 4 weeks of storage. The histologic examination showed no changes in the structure of the media in all samples up to 4 weeks of storage. The total calcium content per gram of tissue in the pulmonary media was on an average less than half of that in the aortic counterpart. We conclude that the pulmonary homograft is preserved the same as the aortic homograft and, accordingly, it becomes available for clinical application. Moreover, a lesser content of elastic tissue and a lower amount of total calcium may, in all likelihood, make the pulmonary wall less prone to calcification.
Adolescent↗
Lymphoepithelial carcinoma of salivary glands.
BACKGROUND: Malignant lymphoepithelial lesions (MLEL) or lymphoepithelial carcinoma or undifferentiated carcinoma with lymphoid stroma, is a rare but unique malignancy of the major salivary glands. There is an exceptionally high incidence in Eskimos and native Greenlanders, but it has never been reported in the Arab population. We report the first case from Saudi Arabia in the native Arabs. These are unencapsulated tumors with a strong tendency to metastasize to the regional lymph nodes. METHODS: We reviewed English and Arabic literature and found the total number of reported cases of MLEL to be 103 with predominant involvement of the parotid gland. Parotidectomy followed by neck dissection and radiotherapy was performed, with a survey of the nasopharynx and EB virus titer. RESULTS: The patient underwent radical neck dissection followed by radiation after developing the neck metastasize. Three years to date he remains in remission with no distant or regional metastases. CONCLUSION: Malignant lymphoepithelial lesions of the salivary gland are unencapsulated tumors with poorly differentiated epithelial cells scattered throughout fibrolymphocytic stroma. They have a strong tendency to metastasize to the regional lymph nodes with predominant involvement of the parotid gland. They are commonly associated with Epstein-Barr virus infection. The majority of them are radiosensitive. Combination therapy with surgery and radiation is desirable to control the disease. We recommend complete surgical excision with neck dissection followed by postoperative radiotherapy to the local site as well as to the neck as treatment of choice.
Arabs↗