PubMed Health⌕ Search

Biomedical subjects

N Stolf

Publications and source records attributed to N Stolf.

15 recordsLinked to original sources
PubMed1992

[Acute aortic dissections. Hospital outcome of 186 cases].

PURPOSE: To determine in hospital outcome acute aortic dissection patients. METHODS: We revised 186 consecutive cases (up to 14 days of dissection), in a period of 6 years. The patients were divided according to Daily's classification (types A and B). RESULTS: Type A--127 cases: a) 75 were surgically treated (37 died); b) 2 were medically treated (both died); c) 39 died before the definitive treatment could be initiated; d) 11 died misdiagnosed or undiagnosed. The total mortality was 70.0%. Type B--59 cases: a) 11 complicated cases were surgically treated (6 died); b) 40 were medically treated (8 died); c) 7 died before the definitive treatment could be initiated; d) one died misdiagnosed. The total mortality was 37.25%. In summary, 41.4% of the patients survived. 28.4% died despite the definitive treatment, 24.7% died before the definitive treatment could be initiated and 6.4% died without the correct diagnosis. CONCLUSION: The acute aortic dissection is a dramatic situation, mainly type A. In this type of dissection many patients (41%) died misdiagnosed, undiagnosed or without enough time to surgical therapy. So, an earlier diagnosis and treatment are imperative.

Acute Disease↗
PubMed1991

Decrease in sulphated glycosaminoglycans in aortic dissection--possible role in the pathogenesis.

STUDY OBJECTIVE: The aim was to investigate alterations in sulphated glycosaminoglycans in aortic dissection. DESIGN: Aortic fragments were taken from 10 patients within the first 3 d after onset of symptoms of aortic dissection and from nine age matched patients with no aortic disease. Sulphated glycosaminoglycans were analysed and quantified by agarose gel electrophoresis and densitometry after degradation with specific enzymes. MEASUREMENTS AND MAIN RESULTS: The amount of chondroitin sulphate was similar (7.14 v 7.60 mg.g-1 of dry tissue, n = 10, p greater than 0.5) in patients with dissection and in the control group. Total sulphated glycosaminoglycan content was decreased (11.51 v 14.26 mg.g-1 of dry tissue, n = 10, p less than 0.001). This difference was due to heparan sulphate (1.79 v 2.48 mg.g-1 of dry tissue, n = 10, p less than 0.05) and mainly to dermatan sulphate (2.58 v 4.18 mg.g-1 of dry tissue, n = 10, p less than 0.001). The ratio of 6-/4-sulphated disaccharides after chondroitinase ABC digestion was increased in the affected group. No correlation between these biochemical results and a histological evaluation of mucoid content was found. On the other hand, a significant increase in chondroitin sulphate could be observed related to aging. CONCLUSIONS: The diminution in sulphated glycosaminoglycans and its possible relationship with fat, collagen, and other extracellular matrix molecules could lead to a weakness in the aortic wall related to the dissection.

Adult↗
PubMed1991

[Coronary angioplasty in a 12-year-old child].

Coronary artery disease is seldom reported in patients under 20 years of age. We present here the case of a 12 years old male, with systemic high blood pressure who had 2 episodes of typical chest pain. He underwent a submaximal exercise treadmill test which was negative. He then underwent cinecoronarography that revealed a 78% (measured by the caliper) obstruction in the proximal segment of the circumflex coronary artery with 3 mm of extension. The left coronary artery and the left ventricle were normal. The patient was subjected to a percutaneous transluminal coronary angioplasty, which was successful and left a 12% (measured by caliper) residual stenosis. The late angiographic restudy (5 months after the procedure) showed the maintenance of the immediate success of the procedure.

Angioplasty, Balloon, Coronary↗
PubMed1990

[Severe pulmonary embolism in a single lung].

A 68 years old white man complaining of hemoptysis in the last 2 months was admitted for evaluation. He was a heavy smoker and thorax radiography as week as CT Scan showed a 5 cm mass in the right pulmonary hilum. Endoscopy with biopsy demonstrated an adenocarcinoma of middle lobe. He was operated on and a tumor was found in the middle lobe with invasion of the other two lobes and pericardium. A right pneumectomy was performed. In the 10th postoperative day the patient sustained a pulmonary thromboembolism. A pulmonary scintigraphy showed hypoperfusion of large areas of left lung. He was medically treated and had a good response. The patient was discharged in the 22nd postoperative day. Pulmonary thromboembolism in bowen more severe in patients with single lung, nevertheless the recovery of this patients was good with early diagnosis and treatment.

Adenocarcinoma↗
PubMed1990

[Surgical treatment of right ventricular fibroma in infants. Report of 2 cases].

Two patients under 8 months of age, with right ventricular fibroma, presented with clinical manifestations of pulmonary stenosis. The diagnosis was established in one by echocardiography and in the other by echocardiography. CT scan and angiocardiographic study. The patients were operated and the tumors were successfully resected.

Angiocardiography↗
PubMed1990

[Pericardial disease erroneously diagnosed as endomyocardial fibrosis. Report of 2 cases].

Two patients who were sent to operation with diagnosis of endomyocardial fibrosis (EMF) turned out to have pericardial disease. EMF had been suspected on the basis of clinical history, electrocardiographic, radiologic and echocardiographic data. The hemodynamic studies were "typical", and included apex amputation, flat ventricular surface and mitral and tricuspid insufficiencies. Thus, ventriculography should not be considered specific, but rather suggestive of endomyocardial fibrosis.

Adult↗
PubMed1989

[Comparison of histologic changes in Chagas' cardiomyopathy and dilated cardiomyopathy].

In this study the histopathologic features of Chagas' disease and idiopathic dilated cardiomyopathy were compared in 38 patients with congestive heart failure, classes II or III. Biopsy specimens were obtained with the Stanford model needle for right ventricle. Twenty-two patients presented non-chagasic dilated cardiomyopathy, and 16 were carriers of Chagas' disease. Twenty-three were male and 15 were female; their ages varied 18 and 49 years (mean 35.5). Fibrosis was slightly more frequently and intense in Chagas' disease than in dilated cardiomyopathy. Myocarditis aspect also was more frequent in Chagas' disease than in dilated cardiomyopathy (62.4% vs. 50%), with all cases showing a chronic form; acute myocarditis was observed only in dilated myocardiopathy. These differences, however, did not reach statistical significance. In conclusion, the presence of fibrosis, hypertrophy and moderate to severe degrees of chronic inflammatory infiltrate are suggestive of but not pathognomonic of Chagas' disease. On the other hand, dilated myocardiopathies are more frequently associated with less fibrosis or hypertrophy and the presence of mild degree of inflammatory infiltrate. The arrangement of this inflammatory infiltrate tends to be diffuse in dilated cardiomyopathy and in chagasic myocarditis it is multifocal, very similar to the histopathological aspect found in myocardial rejections episodes of transplanted hearts.

Adolescent↗
PubMed1989

[Combined surgical treatment of endocarditis of the right atrium by Aspergillus sp and pulmonary fungus ball. Report of a case].

Endocarditis due to Aspergillus is rare and associated with a high mortality. The authors report the case of a 23 year-old patient with Klippel-Trenaunay syndrome who was admitted with dyspnea and loss of weight. The physical examination showed split second sound and presystolic accentuation. In the chest x ray there were cavities in the upper lobe of the right lung and pleural thickening. The echocardiogram and the hemodynamic evaluation demonstrated an image suggesting a right atrial tumor. The patient was operated on under cardiopulmonary bypass, a vegetation in the valve of the inferior vena cava was resected and a lesion of the right lung was also resected. The histologic study showed that the lesions was caused by Aspergillus. The patient had had an uneventful recovery, was discharged on the 13th postoperative day and is well 65 months after the operation.

Adult↗
PubMed1989

[Histopathologic aspects of hyperacute graft rejection in human cardiac transplantation. A case report].

The first case of a hyperacute rejection of a human cardiac allograft in Brazil is reported. The histopathological aspects of hyperacute cardiac rejection in its earlier moments are described when degenerative and necrotic features of the cardiac fibers are not totally developed. The authors believe that neutrophilic exudation and lesion of the vessel wall are good signs for a correct diagnosis of hyperacute rejection. Furthermore, they observed that the process is diffuse enough to justify the indication of endomyocardial biopsy when there are reasons to suspect this diagnosis. Presence of IgM and complement (C3) are also useful.

Adult↗
PubMedDate not supplied

Acute myocardial infarction with diffuse endarteritis, contraction bands, and distal thrombosis of the coronary arteries in a heart transplant patient.

The case history of a heart transplant patient who died of an acute myocardial infarction 6 months after the procedure is described. The finding of contraction bands and thrombosis associated with endarteritis suggests that coronary vasospasm may have contributed to the acute myocardial infarction during an episode of vascular rejection.

Adult↗
PubMedDate not supplied

Usefulness of T-cell phenotype characterization in endomyocardial biopsy fragments from human cardiac allografts.

The mean numbers of cytotoxic/suppressor (CD8+) and helper/inducer (CD4+) T cells were determined in 111 successive endomyocardial biopsy fragments from eight cardiac allograft patients in an attempt to define their significance in the rejection process. Endomyocardial fragments from autopsy or donor hearts without myocarditis were evaluated as controls. The mean numbers of CD8+ and CD4+ T cells in the control group were 0.8 and 0.5 cells/field at x400 magnification, respectively. The mean numbers of CD8+ T cells per field in the cardiac allograft biopsies were 2.4, no rejection group; 5.4 mild rejection group; 11.1, moderate rejection group; and 4.9, resolving rejection group. The mean numbers of CD4+ T cells per field for the same groups were slightly lower than those of the CD8+ T cells. The number of CD8+ T cells per field reliably indicated the severity of rejection. Patients with normal numbers of CD8+ T cells and no evidence of rejection had better long-term outcomes (two or fewer moderate rejection episodes) than those with higher numbers. Analysis of the data suggests that the presence of two or fewer CD8+ T cells/field may be considered normal in the myocardial interstitium. The diagnosis of no evidence of rejection should be coupled to the presence of a normal number of CD8+ T cells. High numbers (greater than 10) of CD8+ T cells, even in absence of myocytolysis, should be treated more assertively, including the use of high doses of prednisone, because all our cases with high numbers showed a worse histologic picture at the subsequent biopsy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗