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Biomedical subjects

J R Deshpande

Publications and source records attributed to J R Deshpande.

At least 19 recordsLinked to original sources
PubMed2001

Cardiac pathology of permanent pacemaker implementation.

The cardiac findings in five cases of permanent pacemaker implantation seen at autopsy in a three-year period is reported. Implantation was done for complete heart block in four patients and sick sinus syndrome in one. The periods of implantation ranged from seven days to four years. The common findings were right sided valvar and mural bland thrombus formation. Additional findings included superior vena caval thrombosis, endocardial 'tunnel' formation for the pacing wires, perforation of the tricuspid leaflet and a gross morphology similar to that seen in right sided endomyocardial fibrosis.

Autopsy↗
PubMed2000

Isolated right ventricular infarction.

Rare occurrence of isolated right ventricular infarction is reported in four patients, three of whom were elderly. The causes of infarction were due to pulmonary thromboembolism and dissection of non-dominant right coronary artery. None of the hearts had right ventricular hypertrophy and significant coronary atherosclerosis.

Adult↗
PubMed2000

Intrapericardial teratoma--a report of two cases.

Two rare cases of intra-pericardial teratoma in infants are reported. The presenting symptoms were either due to pericardial effusion and cardiac tamponade or due to compression of the tracheo-bronchial tree. The tumors were well encapsulated and were attached to the ascending aorta. Histologically, they were composed of derivatives of the three germ cell layers.

Fatal Outcome↗
PubMed1999

Neonatal candidial endocarditis--a rare manifestation of systemic candidiasis.

Infective candidial endocarditis in four premature neonates is reported. These occurred as a complication of systemic candidiasis. Vegetations were present on the right side of the heart in two cases and both sides in the other two. Diagnosis requires a high degree of clinical suspicion. Mortality rate is high despite appropriate therapy.

Candidiasis↗
PubMed1998

Emergent balloon mitral valvotomy in patients presenting with cardiac arrest, cardiogenic shock or refractory pulmonary edema.

OBJECTIVES: The present study was performed to determine the outcome of emergent balloon mitral valvotomy (BMV) in patients with cardiac arrest, pulmonary edema or cardiogenic shock. BACKGROUND: In India, many patients with mitral stenosis present in critical condition. They have high mortality despite surgical relief. The role of BMV in such patients is ill-defined. METHODS: Of 558 patients undergoing BMV between January 1993 and December 1994, 40 presented with cardiogenic shock, cardiac arrest or pulmonary edema refractory to medical treatment and underwent emergent BMV (group I). Elective BMV was performed in the remaining 518 patients (group II). RESULTS: Age ([mean +/- SD] 40 +/- 13 vs. 31 +/- 9 years, p < 0.05), incidence of atrial fibrillation (35% vs. 11%, p < 0.05), pulmonary artery systolic pressure (PAsP) (64 +/- 14 vs. 51 +/- 12 mm Hg, p < 0.001) and mitral valve (MV) score (7.4 +/- 1.2 vs. 6.4 +/- 1, p < 0.001) were higher and MV area lower (0.74 +/- 0.17 vs. 0.86 +/- 0.14 cm2, p < 0.001) in group I patients. After emergent BMV in group I, mitral regurgitation occurred in 15%, and the mortality rate was 35%. Stepwise logistic regression analysis identified MV score > or =8 (p = 0.008), PAsP > or =65 mm Hg (p = 0.023) and cardiac output < or =3.151 liters/min (p = 0.001) as significant predictors of a fatal outcome. Follow-up of 1 to 16 months (median 8) was available in 20 of 26 survivors in group I, of whom 15 were asymptomatic. The gain in MV area and the decrease in transmitral gradient and PAsP obtained immediately after BMV persisted during the follow-up period. CONCLUSIONS: Emergent BMV is feasible in critically ill patients. In-hospital survivors have excellent clinical and hemodynamic status at intermediate follow-up.

Catheterization↗
PubMed1997

Pulmonary carcinomatous arteriopathy--a rare cause of dyspnoea and pulmonary hypertension.

Pulmonary carcinomatous arteriopathy was seen at autopsy in three patients who presented with sub-acute cor pulmonale. All had adenocarcinomas of unknown origin. The arteries and arterioles showed fresh and organizing thrombi with narrowing or occlusion. Large muscular arteries also showed tumour cells within the thrombi. Lymphangitis carcinomatosis was also present to a variable extent.

Adenocarcinoma↗
PubMed1994

Primary malignant carcinoid of the esophagus.

Primary malignant esophageal carcinoid in a 55-year-old man with lung abscess is reported. The tumor was detected incidentally at autopsy and had metastasized to the posterior mediastinal lymph nodes.

Carcinoid Tumor↗
PubMed1992

Pulmonary arterial aneurysms.

Over a period of 12 years, two cases of pulmonary arterial aneurysms were encountered in our autopsy data of 13 cases of congenital heart defects with right-sided infective endocarditis. Pulmonary arterial aneurysms are rare lesions and may be categorized as central or peripheral. Although early reports implicated tuberculosis as a major aetiologic factor, pulmonary arterial aneurysms are generally associated with congenital heart disease.

Adult↗
PubMed1991

Atresia of the common pulmonary vein.

In our study of 1326 autopsied cases of congenital heart disease, we have encountered 3 cases of atresia of the common pulmonary vein. This is a rare condition of which, to the best part of our knowledge, only 19 cases have been reported so far. Interestingly, two of our cases were associated with isomerism of the right atrial appendages, and one also had a common arterial trunk. The association with isomerism of the right appendages, and with absence of the spleen, has been observed previously but no previous case of which we are aware has had a common arterial trunk. Atresia of the common pulmonary vein is part of the spectrum related to totally anomalous pulmonary venous connexion, a lesion known to be frequently associated with isomerism of the right atrial appendages. Atresia of the common pulmonary vein, however, has not commonly been found with isomerism of the right appendages.

Abnormalities, Multiple↗
PubMedDate not supplied

Pathology of the diffuse variant of supravalvar aortic stenosis.

Supravalvar aortic stenosis is a rare congenital heart anomaly, producing left ventricular outflow tract obstruction. Of the two anatomic variants that have been described, diffuse type is the rarest. We report five such cases in children between two months and nine years of age. None had features of Williams syndrome. The entire aorta was involved in three cases, with abdominal aortic coarctation in two cases. Stenosis was mainly due to involvement of the media, which showed smooth muscle hypertrophy, abnormal elastic fibers, and mild collagenization. Predominant intimal change was seen in one case. Pulmonary, coronary, arch, renal, and common iliac arteries were also involved.

Aorta, Abdominal↗
PubMedDate not supplied

Malignant hidradenoma: a rare sweat gland tumour.

Malignant hidradenoma is a rare sweat gland carcinoma, which can have an aggressive course with recurrence and/or metastasis. A case is reported, in an elderly male. The tumour had a histologic similarity to its benign counterpart, but exhibited additional features of infiltrative growth pattern and invasion of adjacent tissue.

Adenoma, Sweat Gland↗
PubMedDate not supplied

Ebstein's anomaly--an autopsy study of 28 cases.

Twenty eight autopsy specimens of Ebstein's anomaly were studied in order to evaluate the morphologic features of the abnormal tricuspid valve. All cases showed marked dilatation of the original tricuspid annulus, a normally positioned anterior leaflet and variable downward displacement of the posterior and septal leaflets. Sixteen cases showed a very large anterior leaflet. All three leaflets showed dysplastic features and a wide range of anatomic abnormalities in the valve and valve apparatus. A thin walled atrialised right ventricle was present in nine cases. Associated cardiac anomalies were seen in 21 cases, the commonest being an atrial septal defect (17 cases).

Adolescent↗