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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dynamic cardiomyoplasty has been used to correct cardiac defects, augment contraction of weakened myocardium, and support circulation of end-stage heart disease patients by using their own skeletal muscle after electric conditioning. Five patients, each with a history of myocardial infarction and diffused coronary artery disease, underwent the application of the left latissimus dorsi muscle over the anterolateral wall or around the ventricles. In all patients the left latissimus dorsi muscle was dissected free from all insertions with careful preservation of the thoracodorsal nerve and vessels. The freed muscle flap was internalized into the thoracic cavity with the humeral tendinous end of the muscle sutured to the periosteum of the second or third rib after subperiosteum resection of a portion of the rib. The muscle flap was used in three of the five patients for ventricular wall repair after aneurysmectomy. In the other two patients the muscle was applied over the ventricles for functional augmentation. The skeletal muscle was electrically conditioned to contain mainly fatigue-resistant muscle fibers and was stimulated to contract synchronously with the heart. All patients survived the operation, with immediate improvement of ventricular function for those who had had aneurysmectomy. A significant increase in ejection fraction was observed in three of the five patients when the pacemaker was turned on. One patient died of sudden ventricular arrhythmia 2 months after the operation. The last patient is doing well at 6 weeks after operation. The first patient has been followed up for more than 3 years and continues to do well.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dynamic cardiomyoplasty in patients. 235 78

Prostaglandin E1 (PGE1) causes skeletal hypertrophy, a phenomenon noted when it is administered for several weeks to maintain ductus arteriosus patency in neonates with congenital heart disease. This effect, a dose-dependent and reversible hyperostosis, was described radiologically as bone within bone, but skeletal histopathology was not studied. We compared postmortem gross, radiological, and histological bone findings for untreated controls and term gestation infants after 4, 27, and 56 days of continuous 0.1-0.2 microgram/kg/min PGE1. Bone was not significantly different from controls after 4 days of PGE1. Radiographs were negative after 27 days, but femoral cortex showed early periosteal osteoblast proliferation. At 56 days of PGE1, there was severe, radiologically apparent neocortex formation in tubular, rib, and scapular bones. Corresponding sections of femoral shaft revealed distinctive histopathology with thickened periosteum and fibrocartilage-like tissue covering an exuberant neocortex of closely aligned, gracile, woven bone trabeculae. Paratrabecular stroma contained ectatic capillaries orthogonally oriented to the periosteum, suggesting that a vascular reaction to PGE1 is important in the observed effect. The native cortex was partially resorbed; because it is stress shielded by the neocortex and no inflammation was present, this was interpreted as a secondary effect. We conclude that PGE1-associated paracortical bone hypertrophy is distinct from inflammatory processes and that its early stages may not be apparent radiologically. Moreover, the time course of PGE1-induced osteoblast proliferation and mineralization suggests that experimental use for 4-8 weeks may benefit conditions such as ununited fractures.
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PMID:Prostaglandin E1-induced hyperostosis: clinicopathologic correlations and possible pathogenetic mechanisms. 902 48

Current advances in the study of hypertrophic osteoarthropathy are discussed. An update of the classification of hypertrophic osteoarthropathy is given in which the POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome is included among the associated diseases. Cyanotic heart disease is the internal illness most closely linked to hypertrophic osteoarthropathy. The bony alterations at the distal phalanxes and on the periosteum of the tubular bones leave a characteristic and indelible mark that can be diagnosed centuries after the death of the individual. Current thinking suggests that localized activation of endothelial cells by an abnormal platelet population, with the ensuing release of fibroblast growth factors, plays a central role in the pathogenesis of the acropachy. Antiphospholipid syndrome may be a feature of cardiogenic hypertrophic osteoarthropathy. Unraveling the mechanisms of hypertrophic osteoarthropathy may help in understanding the pathogenesis of the associated diseases.
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PMID:Hypertrophic osteoarthropathy. 911 Jan 40

Prostaglandin E1 (PGE1) is the drug of choice for providing ductal patency in cyanotic congenital heart disease (CCHD) for a short period of time until essential surgical management. Occasionally, prolonged use of PGE1 is required when the surgical procedure is delayed due to certain clinical conditions. Prolonged use of PGE1 may lead to bone and tissue changes such as pretibial and soft tissue swelling of the extremities and reversible cortical proliferation of the bones. Venous stasis as an additional risk factor can result in generalized periosteal reaction that initially can cause the separation of the periosteum from the cortex. We report an infant with CCHD who developed severe tissue swelling and generalized periosteal reaction due to coexistence of prolonged use of PGE1 and venous stasis. To the best of our knowledge, this is the first case report with both of these risk factors.
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PMID:Generalized periosteal reaction and tissue swelling secondary to prolonged prostaglandin E1 infusion and venous stasis: a case report. 2438 39