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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nosocomial infection of the lower respiratory tract is a frequent and serious complication after major operations. A 32% incidence of lower respiratory tract infections was found after brain-tumor surgery in 289 patients, with a 21% incidence of pneumonia. In 186 of these patients (Group A), five factors were identified which were associated with an increased risk of postoperative lower respiratory tract infection. These were: age, tumor type, cardiac insufficiency, preoperative disturbances of consciousness, and preoperative corticosteroid treatment. Based on these factors, a risk score was developed which correlated well with the incidence of infection in this group of patients. In a second group of patients (Group B), the derived risk score was applied and was found to possess a high degree of validity. As long as patients were intubated postoperatively, their freedom from infection decreased exponentially, with a half-life of 3.5 days.
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PMID:Prognostic factors for lower respiratory tract infections after brain-tumor surgery. 271 13

A case is presented where endocardial fibrosis with pulmonary stenosis, incompetence of the tricuspid valve, and severe right-sided heart failure, proved to be the only signs of a carcinoid tumor in the left ovary.
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PMID:[Right-sided cardiac failure as the primary symptom of carcinoid]. 273 97

An 80-year-old man who initially presented with a left hemiparesis rapidly developed right-sided heart failure and died. Although an echocardiogram suggested the presence of a tumor, the diagnosis of a primary cardiac lymphoma was made only at autopsy. The tumor involved a leaflet of the tricuspid valve, a finding not previously reported in the literature. In 1977, the Armed Forces Institute of Pathology defined a primary malignant lymphoma of the heart as that involving only the heart and pericardium. Many reports of primary cardiac malignant lymphomas have been published, however, most of which mention the presence of metastases. We have reviewed the world literature to determine the number of actual cases of primary malignant lymphoma of the heart. Only 15 reported cases, including the current case, were found to meet the current criteria.
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PMID:Primary cardiac lymphoma. 273 97

A 61-year-old man was admitted to our hospital with complaints of cough and left back and chest pain. He had suffered from left tuberculous pleurisy at the age of 20 years. Chest X-ray film and CT revealed atelectasis of the left lung, a left hilar mass and an irregular left atrial wall. Depressed P-Ta segment in the inferior limb and anterior chest leads and an abnormal P wave were found on ECG. Transbronchial lung biopsy showed squamous cell carcinoma. After radiation therapy, the patient complained of chest oppression. ECG revealed a normalized P-Ta segment deviation, markedly elevated ST segment in the inferior limb and lateral chest leads and a depressed ST segment in the anterior chest leads. These findings persisted until his death. An obscure appearance of the pericardium and an echogenic intramyocardial mass in the posteroinferior and lateral wall were evident by echocardiography. The patient died due to heart failure. Postmortem needle biopsy showed scattered intramyocardial tumor cell nests with keratinization. CPK, GOT and LDH were within normal limits throughout the course, but CPK-MB was slightly increased. Cardiac metastasis with an ECG appearance similar to that of acute myocardial infarction has been rarely reported. Our present case showed peculiar feature including 1) ECG findings similar to atrial and ventricular myocardial infarction, and 2) an echogenic intramyocardial mass and an ill-defined pericardium on echocardiography. These findings suggested direct invasion of squamous cell carcinoma of the lung to the ventricular myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Report of a case of lung cancer with metastasis to the myocardium which showed electrocardiographic findings similar to acute myocardial infarction and intramyocardial mass on echocardiography]. 274 Jun 46

Iron, iron-binding capacity, lactoferrin and total protein were determined in the plasma and pleural fluid of 30 patients with cardiac failure (n = 10), infectious/inflammatory disease (n = 9) and metastatic carcinoma (n = 11). In 16 patients pleural transferrin and ferritin was also measured. Plasma iron and total iron-binding capacity were reduced in inflammatory and neoplastic disease, whereas hyposideremia with normal iron-binding capacity was seen in patients with heart failure. Plasma lactoferrin was reduced in metastatic carcinoma. Exudates (protein greater than or equal to 30 g/l; infectious/inflammatory: 9/9, carcinomatous: 10/11) had significantly higher iron, lactoferrin, transferrin and ferritin concentrations than transudates (protein less than 30 g/l; heart failure: 10/10, carcinomatous: 1/11). Statistically, infectious/inflammatory exudates could be distinguished from neoplastic exudates by a higher median iron concentration (non-parametric Wilcoxon-Mann-Whitney test). Overlap of the respective ranges, however, did not allow a clear-cut differential diagnosis in individual cases. Pleural lactoferrin concentrations, on the other hand, correlated with the pleural granulocyte count and nonspecifically reflect the degree of granulocytic inflammation. Positive pleural/plasma correlations of protein and of iron concentrations were found in exudates only. Within exudates and transudates, on the other hand, total protein correlated with transferrin but not with iron concentrations. Therefore, and because of the substantially higher pleural/plasma ratio for iron than for transferrin concentrations, a quantitatively important, non-transferrin bound iron pool in pleural fluids, most probably ferritin, must be assumed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Iron and iron-binding proteins in the differential diagnosis of pleural effusion]. 276 88

A sixty-one year-old man with squamous cell carcinoma of the left upper lobe had an aberrant systemic artery to the left basal segments without pulmonary sequestration. Physical examination revealed neither cardiac murmur nor any sign of heart failure, which was at variance with reported cases in the literature. Chest X-ray film showed no abnormal density suggesting sequestrated lung. Bronchogram disclosed obstruction of the left upper lobar bronchus by the tumor and normal segmental bronchi of the lower lobe. Left pulmonary angiogram showed normal arterial distribution of the left upper lobe and the superior segment of the lower lobe, but the basal segmental arteries were not visualized. The aberrant pulmonary artery arising from the descending aorta was visualized by computed tomography. Following dissection of the abnormal vessel pneumonectomy was performed. Pathological examination of the left basal segments revealed prominent atheromatous changes in the aberrant systemic intrapulmonary artery and irreversible obstructive lesions in its tributaries. These arterial lesions in this patient would have precluded plastic operations such as transfer of the origin of the aberrant vessel to the left pulmonary artery even if other circumstances had been favorable for preservation of the left lower lobe.
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PMID:[Systemic origin of the sole artery to the basal segments of the left lung without pulmonary sequestration]. 276 27

An inappropriate antidiuretic hormone secretion (SIADH) has been recognized as the cause of hypotonic hyponatremia, and the occurrence of this syndrome, accompanied by an ADH-producing adenocarcinoma in the nasal cavity, is reported. In February, 1987, a 50-year-old male, showing sights of delirium, disorientation, and irritability was admitted to the hospital. The patient was observed to be healthy, except for a neck lymphnode metastasis that was present up to the time of his hospitalization. The hyponatremia was incidentally found, although dehydration or intravascular volume depletion were not noted. These neuropsychiatric symptoms were considered to be associated with hyponatremia due to SIADH. He had had a partial maxillectomy, a neck dissection, and irradiation to the nose and nasal cavity 32 months earlier, and then underwent a surgical resection of the neck metastasis; he had a total of 10 other operations before the onset of the symptoms. Upon initial inspection, since neither an intracranial invasion nor a brain metastasis was found, we diagnosed that his symptoms were due to an autonomic disturbance caused by surgical and mental "stress". When he died of cardiac failure due to a mediastinal invasion 8 months after the onset of SIADH, tumor tissues was extirpated in an autopsy and was then cultured. In this manner, it was proved that the tumor cells had been producing ADH. This procedure clarified that the syndrome had resulted from an ADH-producing tumor of the nasal cavity.
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PMID:[A case of adenocarcinoma of the nasal cavity associated with syndrome of inappropriate secretion of antidiuretic hormone(SIADH)]. 277 60

We experienced four operative cases of lung carcinoma with intra-atrial extension via the pulmonary vein. In two cases, after assessment of the cardiac involvement, we performed extensive surgery under cardiopulmonary bypass. Their postoperative courses were uneventful, and their performance status was improved. However, seven months later one patient died of widespread metastases, while the other is alive but has recurrence. The other two patients underwent ordinary lobectomy because there were no abnormal findings in the hilar examination. However, the lumen of the resected pulmonary vein was filled with tumor tissue. One patient had massive embolism and died on the second postoperative day. The last case had residual tumor dislodging from the left atrium to the aorta. Though he was discharged without any complication, he developed multiple brain metastases 4 months after operation. We conclude that extensive surgery using cardiopulmonary bypass for lung cancer patients with such intracardiac involvement is effective for improvement of PS and reduces the risk of sudden death due to cardiac failure or emboli. Accurate diagnosis of intracardiac extension in these unusual cases is important.
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PMID:[Four operative cases of lung carcinoma with intra-atrial extension via the pulmonary vein]. 285 68

We report a case of a 14 month old infant with severe stenosis of the pulmonary valve in whom the angiographic image suggested the presence of a right ventricular (RV) tumor mass. The patient was admitted because of clinical manifestations of heart failure. Right heart catheterization demonstrated a transvalvular pulmonary gradient and filling defects in the infundibulum compatible with an intracavitary mass. Two dimensional and Doppler echocardiography confirmed pulmonary stenosis and showed that the mass corresponded to hypertrophy of the anterior RV wall. The combination of two dimensional and Doppler echocardiography are the indicated techniques in differential diagnosis of RV tumor masses and RV hypertrophy secondary to severe pulmonary valve stenosis.
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PMID:[Left ventricular hypertrophy simulating an intracavitary tumor. Echocardiographic diagnosis]. 296 51

A case of primary liver carcinoma with intracavitary cardiac extension is presented. A 36-year-old female was admitted to our surgical clinic with dyspnea and generalized edema. Echocardiography and superior vena cavography demonstrated a large filling defect in the right atrium. After a diagnosis of acute cardiac failure due to an intracardiac tumor, the patient was operated upon immediately. A right atriotomy exposed a large yellow mass within the right atrium, which was not adherent to the atrial wall. The mass was in continuity with similar material in the inferior vena cava and right hepatic vein. With a suspicion of hepatic malignancy, the atrial tumor was removed, and debulking of the mass in the inferior vena cava and right hepatic vein was performed. A postoperative histological examination of the tumor showed hepatocellular carcinoma. Her postoperative course was uneventful, and she was discharged from the hospital. Intracardiac extension of hepatoma is rarely encountered. In this clinical setting, long-term survival cannot be anticipated from any surgery, but palliative clearing of the atrium and inferior vena cava may be of value in preventing cardiac arrest causing sudden death.
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PMID:Surgery of hepatoma with intracavitary cardiac extension. 301 31


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