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Biomedical subjects

J I Brenner

Publications and source records attributed to J I Brenner.

At least 55 records · Page 3Linked to original sources
PubMed1983

Rare type of intrapulmonary drainage of one lung by the other with total anomalous pulmonary venous return.

A rare form of obstructed total anomalous pulmonary venous drainage is presented. A neonate with asplenia, pulmonary atresia and complex congenital heart disease also had drainage of the left lung forming a venous confluence that proceeded in an intrapulmonary fashion through the right lung. A hypoplastic pulmonary venous channel then emerged from the right upper lobe leading to the superior vena cava. Pulmonary venous obstruction was suspected on initial plain chest X-ray examination and on angiography, which revealed the pulmonary artery to be larger than anticipated. Administration of prostaglandin E1 may allow augmentation of pulmonary blood flow and angiographic definition of this association in infants with asplenia complex.

Abnormalities, Multiple↗
PubMed1983

Myocarditis as a complication of infantile Chlamydia trachomatis pneumonitis.

The case is presented of an infant with chlamydia pneumonitis who developed clinical and electrocardiographic signs of myocarditis. No significant antiviral antibodies developed. Elevated antichlamydial IgG titers were demonstrated during the initial phase. These declined during convalescence. This report provides further evidence associating C. trachomatis with infectious myocarditis.

Chlamydia Infections↗
PubMed1983

Structural failure of a Starr-Edwards aortic track valve.

Structural failure of a Model 2400 Starr-Edwards aortic track valve occurred suddenly, 4 years after implantation. At operation, the valve cage was removed from the descending aorta. Examination of the excised prosthesis disclosed minimal cloth wear and no evidence of infective growth; however, three struts were fractured above their insertion into the valve ring. To our knowledge, this type of valve malfunction has not been previously noted.

Journal Article↗
PubMed1983

Echocardiographic characteristics of premature infants with patient ductus arteriosus.

As part of a multicenter collaborative study, M-mode echocardiograms were obtained shortly after birth on 3,559 premature infants with birth weight less than or equal to 1,750 g. Of these infants, 1,496 did not develop a cardiac murmur or other signs of a "hemodynamically significant" patent ductus arteriosus (PDA). Echocardiographic parameters from this "normal" group were compared with results obtained from 415 infants in whom PDA was diagnosed on the basis of clinical findings alone, irrespective of the echocardiogram (PDA group). The best discrimination between the two groups, when considering a single parameter, was provided by a left atrial to aortic root ratio (LA/AO) of 1.40, a left ventricular to aortic root ratio (LV/AO) of 2.10, or a left ventricular systolic time interval ratio (LPEP/LVET) of 0.27. Multivariate analysis demonstrated that better separation between the two groups occurred when the left atrial to aortic root ratio and the left ventricular systolic time interval ratio were considered jointly. Because of a large degree of overlap of all echocardiographic variables between the normal group and the group with PDA, the echocardiogram alone was not a good indicator of PDA. However, when used in conjunction with a priori estimates of the probability of PDA (based, for example, on birth weight and degree of respiratory disease), use of echocardiographic data was found to improve the detection of hemodynamically significant patent ductus arteriosus in premature infants.

Age Factors↗
PubMed1983

Medical cure of apparent brain abscesses.

Two children with apparent brain abscesses were cured with antibiotic therapy. Review of the literature reveals clinical and experimental evidence that both cerebritis and an encapsulated abscess may appear as an enhancing ring lesion on cranial computed tomography. Patients reported to have had brain abscesses cured without surgery actually may have had cerebritis. There are only preliminary hints as to how to differentiate patients with cerebritis from those with an abscess. More experience is necessary to develop criteria to determine which patients may be appropriately treated with antibiotic therapy alone.

Anti-Bacterial Agents↗
PubMed1982

Evaluation of left ventricular performance in infants and children using radionuclide angiography.

Eight quantitative first-pass (FP) radionuclide angiograms were performed in six children with left ventricular (LV) dysfunction without associated LV outflow obstruction and one infant with obstructive cardiomyopathy (CM) to define regional and global LV function. All patients (3 months to 15 years) had clinical findings of congestive heart failure. Echocardiographic evaluation was performed within 24 hours of the FP study. LV ejection fraction (LVEF), regional ejection fraction index (REFI), LV wall motion perimeters, transit time, and curve analysis were evaluated. Ejection fraction by FP-RNA was compared to echo in all patients. FP-RNA derived end-diastolic and end-systolic LV perimeters were compared to corresponding contrast angiographic definition of LV wall boundaries. FP-LVEF ranged from 23-44% in 6 patients with non-obstructive CM and was 79% in 1 patient with obstructive CM. REFI revealed diffuse hypokinesis in 6 patients with nonobstructive CM, with additional apical akinesis in 1 patient. The infant with obstructive CM had hyperdynamic wall motion. These data compared favorably with echo EF and angiographic assessment of LVEF and wall motion.

Adolescent↗
PubMed1982

Use of computed axial tomography to diagnose vascular ring in an infant.

Computed axial tomography was performed in an infant with severe respiratory distress. A right aortic arch and paratracheal density was visualized, suggesting a vascular ring. Angiography confirmed a right aortic arch, mirror-image branching, and a left patent ductus arteriosus.

Journal Article↗
PubMed1980

Prediction of left ventricular pressure in infants with aortic stenosis.

Peak systolic left ventricular pressure was predicted in five infants with aortic stenosis by use of a wall stress constant, K. K was determined in 10 normal infants according to the formula K = P . Ds/Ws, where P = arterial pressure by Doppler, DS = end-systolic LV dimension, and WS = end-systolic wall thickness. Left ventricular peak systolic pressure was estimated in five infants using the formula P = K. Ws/Ds. Excellent correlation was obtained between measured left ventricular pressure and left ventricular-aortic pressure difference at cardiac catheterisation and echo estimates. Echocardiographic assessment of the severity of aortic stenosis may be applied to infants with good results.

Aortic Valve Stenosis↗
PubMed1978

Application of an improved intracardiac fibreoptic system.

An improved fibreoptic in vivo haemoreflection system has been used in over 200 patients. Continuous recording of oxygen saturation while moving the catheter permits measurement of simultaneous pressure and oxygen saturation at almost an unlimited number of sites through the right heart. The oxygen saturation can be continuously monitored and the response is sufficiently fast to permit investigation of changes in oxygen saturation during portions of the cardiac cycle. Dye dilution curves have been recorded from over 200 patients. The only blood withdrawn for the dye dilution curve was the 3 ml needed for checking the calibration of the instrument. We have found that the calibration is extremely stable. In some instances where it has been deemed impractical to obtain blood for calibration, the calibration factor for each catheter may be used. In any case, the calibration check is performed at the end of the study and does not present problems of sterility. The calibration factor may yield a correction factor which then applies uniformly to all the cardiac output values obtained during the study.

Calibration↗
PubMed1978

Effect of phasic respiration on left ventricular dimension and performance in a normal population. An echocardiographic study.

Echocardiographic examination of the left ventricle (LV) in 30 normal subjects, 5 to 47 years of age, was performed in order to analyze the effects of phasic respiration on LV dimensions and derived LV function. Peak expiratory and peak inspiratory LV diastolic and systolic dimensions were measured and extrapolated to volume estimates using a standard formula. Although there was wide variation in the individual measurements, and particularly in systolic dimension, the mean peak inspiratory diastolic dimension, derived diastolic volume, and stroke volume all decreased significantly (P less than 0.001); a smaller decrease in ejection fraction was seen (P less than 0.02), while the changes in mean end-systolic dimension and end-systolic volume were not significant. While these observed changes may reflect a true physiologic variation, an artifactual component cannot be excluded. Regardless of their physiologic significance, however, these data show that the effect of phasic respiration is a factor to be considered in correlative echocardiographic studies of LV function in both normal and, possibly, pathologic cardiovascular conditions.

Adolescent↗
PubMed1978

Absent tricuspid valve with aortic atresia in mixed levocardia (atria situs solitus, L-loop). A hitherto undescribed entity.

Clinical, angiographic and pathologic features are described in a 36-hour-old male infant with mixed (discordant) levocardia, aortic valve atresia, absent tricuspid (left atrioventricular) valve and resultant massive cardiomegaly. This is the first reported case of this type of complex in a heart with discordant chambers. A possible embryologic explanation is offered for the concomitant presence of semilunar valve atresia and absence of the tricuspid valve.

Aortic Valve↗
PubMed1977

Single coronary artery with a fistula to the main pulmonary artery in a patient with tetralogy of Fallot.

The presence of a single coronary artery arising in the anterior cusp and terminating in a large fistula to the main pulmonary artery was noted during the preoperative evaluation of a patient with tetralogy of Fallot. Recognition of this rare association dictated the use of a valved conduit to avoid injury to the left anterior descending coronary as it crossed the right ventricular outflow tract and permitted abolition of intracardiac shunting by ligation of the fistula. It is postulated that the increasing arterial saturation noted in this patient prior to intracardiac repair may have been related in part to progressive augmentation in flow through the coronary fistula to the main pulmonary artery.

Adult↗