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Biomedical subjects

J Tiefenbrun

Publications and source records attributed to J Tiefenbrun.

13 recordsLinked to original sources
PubMed1993

Thrombosis of the descending thoracic aorta: a case report.

A 76-year-old woman with primary polycythemia vera had emboli to both superficial femoral arteries and to a branch of the superior mesenteric artery. Polycythemia vera is a neoplastic disease of bone marrow stem cells in which increased red cell production leads to hyperviscosity manifested by propensity to thromboembolic phenomena. These problems usually occur in smaller vessels, sparing large vessels that have high blood flow. The patient underwent an extensive investigation to determine the source of the emboli. Abdominal aortic angiograms and cardiac echogram failed to reveal the source. An esophageal echogram showed free-floating thrombus in the descending thoracic aorta, which was confirmed by magnetic resonance imaging. A thoracic aortic thrombectomy was performed. Embolic phenomena ceased and postoperative esophageal echogram confirmed a clear thoracic aorta. Although extremely rare in the descending thoracic aorta, thrombus formation may occur in association with polycythemia vera and should be sought when usual investigations fail to reveal the source.

Aged↗
PubMed1987

Jumping from the Brooklyn Bridge.

In an attempt to identify factors contributing to survival of free fall and impact, we evaluated the records of four patients who survived a jump from the Brooklyn Bridge into the East River in New York Harbor between 1977 and 1985. All four patients were male and ranged in age from 22 to 67 years. They had free falls of between 41.0 and 48.8 meters. All of the patients were brought to the hospital within 24 minutes of entering the water. Three of the four had emergency surgical treatment and the fourth patient had only minor injuries. All four patients survived the suicide attempts. The length of the hospital stay ranged from two to 26 days.

Adult↗
PubMed1975

The correlation of sequential changes in the distribution of pulmonary blood flow in hemorrhagic shock with the histopathologic anatomy.

Histopathologic changes were described and correlated with hemodynamic changes in a series of farm-reared dogs by a preparation and a protocol which were shown to simulate closely physiologic events in clinical hemorrhagic shock; neither anesthesia nor thoracotomy was used and flush solutions for catheters were strictly limited; a series of sham-treated controls was used for comparison. Five different isotopes were used to label microspheres to measure blood flow sequentially at the tissue level at various stages of the shock protocol. At death, multiple tissue sections were taken relative to six parallel segments of the lung arranged according to dependency so that correlations of structure and function might be related to the influence of gravity. The degrees of severity of atelectasis, hemorrhage, edema, congestion, inflammation, and hyperaeration were evaluated by rating scales. Tissues from the most dependent areas had a higher incidence and greater severity of histologic lesions. Tissues with mild histologic rating tended to have lower percentages of flow after hemorrhage, but normal or increased flow after reinfusion. The severely damaged tissue received greater than average flow throughout. Tissues with severe atelectasis paralleled the course of those with a high over-all severe pathologic rating. Tissues with severe inflammation had less blood flow in the control period, increased flow in Stages B1 and B2 and a subsequent return to control values. Those with severe edema had reduced flow in Stages B2 and B3, but high flows after reinfusion.

Animals↗
PubMedDate not supplied

Aorto-caval fistula: a clinical spectrum.

Ten cases of aortocaval fistula (ACF) associated with abdominal aortic aneurysm (AAA) were reviewed. In 5 cases the ACF became apparent after evacuation of the thrombus; only 5 patients presented with features of patent ACF. Four patients in addition presented with extra-caval rupture of the aneurysm. Based on these variables, a classification relating ACF and AAA was developed. In this series all patients were male with a mean aneurysm size of 8.5 cm. All patients required bifurcation grafts for reconstruction. A multifactorial etiology related to enlargement and rupture of all aneurysms seems to apply to ACF. Eight of 10 patients survived. Awareness of this entity and proper preparation allow for successful outcome in the treatment of this condition.

Aged↗