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Biomedical subjects

I B Boruchow

Publications and source records attributed to I B Boruchow.

At least 19 recordsLinked to original sources
PubMed1996

Focal myocardial ischemic necroses associated with unstable angina pectoris.

OBJECTIVES: We sought to determine whether myocardial lesions develop in association with unstable angina pectoris. BACKGROUND: We observed a patient with unstable angina pectoris who developed foci of ischemic necroses in the distribution of a single coronary artery. The artery had an atherosclerotic plaque that had undergone ulceration of its fibrous cap. This case prompted us to study the occurrence of focal myocardial ischemic necroses in other patients with unstable angina pectoris. METHODS: Focal ischemic injuries of an age consistent with the duration of the episode of unstable angina pectoris were observed in 6 of 21 patients who died after hospital admission. The 21 patients had not undergone any invasive coronary procedures or thrombolysis, and the heart had been examined after postmortem arteriography and fixation in distension. RESULTS: Of the six patients with focal ischemic lesions, three had foci of contraction band necrosis and three had focal areas of ischemic necrosis in a state of early repair. Three had a recent myocardial infarct of an age less than the duration of unstable angina pectoris. In each of the six patients, the histologic age of the focal myocardial lesions correlated with the time frame of unstable angina. CONCLUSIONS: We conclude that the focal ischemic injuries observed in the myocardium were due to ischemic episodes that also produced the clinical manifestations of unstable angina pectoris.

Adult↗
PubMed1991

Delayed death from aortic root trauma.

A 40-year-old man suffered blunt chest trauma, had a myocardial infarct 58 days later, and died unexpectedly 19 days after that. Autopsy showed partial avulsion of a small branch of the right coronary artery with thrombus extending into the right coronary sinus of Valsalva occluding the right coronary artery and causing a myocardial infarct. Death was caused by a thromboembolus arising from the aortic root thrombus and occluding the left main coronary artery. The case is unusual in that the major consequences of the aortic root trauma were delayed, and death resulted from occlusion of both coronary arteries.

Adult↗
PubMed1977

Gastroduodenal perforation after open heart surgery.

During a thirty month period, 319 patients underwent open heart operations, and of these, three experienced a life-threatening explosive abdominal catastrophe. Aggressive radiographic maneuvers established the diagnosis of gastroduodenal perforation. Appropriate abdominal surgery with plication of the perforation and, whenever possible, the establishment of tube gastrostomy for decompression and a tube jejunostomy for feeding is desirable. All three patients required mechanical ventilatory support and tracheostomy prior to the abdominal catastrophe. Prophylactic antacids and sedation seem appropriate, particularly for selected patients (those with a prior peptic history and those with pulmonary dysfunction). Pulmonary toilet for those identified by preoperative pulmonary screening may circumvent the need for postoperative ventilatory support, which increases the risk of stress ulceration. Of the three patients described, all survived the gastrointestinal surgery but only one left the hospital. One died twenty days and another forty-eight days after the intestinal surgery, both of pneumonitis and septicemia.

Abscess↗
PubMed1977

Injury to ascending aorta by partial-occlusion clamp during aorta-coronary bypass.

Disease of the proximal ascending aortic wall from prolonged, poorly controlled hypertension predisposed to intimal injury after clamp compression. This creates a spectrum of problems: (1) intimal tear with late formation of a localized aneurysm, (2) delayed acute dissecting aneurysm, and (3) intraoperative acute dissecting aneurysm. Principles of management are discussed.

Aged↗
PubMed1971

Empyema.

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Adolescent↗