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Biomedical subjects

L J Freant

Publications and source records attributed to L J Freant.

9 recordsLinked to original sources
PubMed1993

Gross and semiquantitative histologic findings in mononuclear cell myocarditis causing sudden death, and implications for endomyocardial biopsy.

The distribution of gross myocardial lesions and the relative density of the inflammatory cells in various myocardial locations (subepicardial and subendocardial halves of the left ventricular free wall, right ventricular and left ventricular halves of the ventricular septum, and the right ventricular free wall) were studied in 14 patients (11 male [79%], 8 black [57%], aged 7 months to 65 years [median 16 years]) who died suddenly of acute mononuclear-cell myocarditis. Grossly visible myocardial lesions were present in 8 patients, and preferentially involved the subepicardial regions of the left ventricular free wall. The highest mean number of mononuclear cells were seen in the subepicardial regions of the left ventricular free wall (193 cells per high-power field) and the lowest in the right ventricular one half of the ventricular septum (92 cells per high-power field, p < 0.001). Thus the predominant location of the gross myocardial lesions in acute mononuclear-cell myocarditis is the subepicardial region of the left ventricular free wall. A relatively low density of mononuclear cells are found in the right ventricular half of the ventricular septum, the main location of endomyocardial biopsies.

Adolescent↗
PubMed1979

Congenital lobar emphysema.

Congenital lobar emphysema is a rare disorder thay may present outside the newborn period. It is generally best treated surgically by excision of the affected lobe. We describe a 6 1/2-week-old infant in whom the initial auscultatory and roentgenographic findings were confusing and of no help in making the diagnosis. The etiology of congenital lobar emphysema remains unclear.

Diseases in Twins↗
PubMedDate not supplied

Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature.

The majority of cardiac involvement in rheumatoid arthritis (RA) is an incidental finding at postmortem, as less than 3% of patients with RA have clinical cardiac signs or symptoms. Most cardiac involvement in RA involves the pericardium and has been known since Charcot first described an RA patient with pericarditis in 1881. Cardiac involvement takes two different forms: non-specific inflammatory changes and specific granuloma formation. Specific rheumatoid nodules in the heart are an infrequent complication of RA. This is the first case report of a surgically excised heart valve with rheumatoid nodules. A 74-year-old RA patient with a high seropositive rheumatoid factor presented with severe aortic regurgitation and underwent a valve replacement. The native aortic valve showed significant stenosis with multiple, classic rheumatoid nodules.

Aged↗
PubMedDate not supplied

Gastrointestinal pathology in sickle cell disease.

The literature was reviewed to investigate the existence of unique gastrointestinal (GI) pathological lesions in sickle-cell disease (SCD). Chole- and choledocholithiasis have long been recognized, but bilirubin gallstones can occur in any chronic hemolytic anemia. Acute pancreatitis has been reported as a possible ischemic consequence of sickling. It is unclear if the hepatic lesions of SCD differ from those of any chronically transfused population. Hepatic failure has been associated with massive sickling and hyperviscous bile ("sludge") has been linked to SCD. Elevated 5'-nucleotidase in the presence of elevated aminotransferase may suggest both hepatic and biliary tree involvement in a subgroup of patients with SCD. Low levels of the hepatically produced coagulation inhibitors, Protein S and Protein C, have been identified in SCD, but their precise relation to thrombosis in this instance remains unclear. Finally, a syndrome of intracanalicular cholestasis, sinusoidal dilation. Kupffer cell hyperplasia, and erythrophagocytosis has been linked to SCD. It has been suggested that the use of exchange transfusion prior to liver biopsy in this group of pediatric SCD patients may mask the pathophysiological role of sickled red blood cells in hepatic dysfunction. With the exception of some of the situations cited, it is concluded that most GI lesions in SCD are common to a heavily transfused population with chronic hemolytic anemia.

Anemia, Sickle Cell↗