Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This retrospective review of nine infants treated for vaginal tumors between 1964 and 1986 identifies the spectrum of lesions and examines the trend toward more conservative surgical therapy. Our patients' ages ranged from 1 to 30 months. Symptoms of vaginal bleeding or protruding tissue prompted examination under general anesthesia in all cases. Two children had benign protruding polypoid masses treated by simple excision. Seven had malignant tumors, two with endodermal sinus lesions and five with embryonal rhabdomyosarcoma. Early in this series, surgical therapy for embryonal rhabdomyosarcoma consisted of either anterior or complete pelvic exenteration, with adjuvant chemotherapy given in two of the three patients. One patient was operated on prior to the development of effective chemotherapy, and died of recurrent tumor 14 months after surgery. A second patient died from cardiac failure secondary to adriamycin toxicity 6 years after initial therapy. A third patient underwent total pelvic exenteration followed by successful reanastomosis of the colon to the anal verge. This patient, a female, is the oldest survivor and is free of disease 14 years after therapy. The most recent therapeutic approach used in two patients with embryonal rhabdomyosarcoma consisted of local tumor excision followed by postoperative chemotherapy. Both patients are alive and disease-free 9 and 11 years after therapy. Two patients with endodermal sinus tumor were treated with chemotherapy after simple excisional biopsy. They were then followed with serial vaginal biopsies at 3-month intervals. One required a partial vaginectomy for local recurrence 21 months after initial presentation. Both patients are alive and disease-free 18 months and 4 years after surgery.
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PMID:Vaginal neoplasms in infancy: the combined role of chemotherapy and conservative surgical resection. 318 98

Previous investigations have shown that antibodies in sera from patients with halothane hepatitis recognize neoantigens, expressed in livers of halothane-exposed rabbits and rats, which consist of a halothane metabolite bound covalently to specific microsomal proteins. These studies have suggested that the patients' antibodies may play a role in the pathogenesis of the hepatitis. In the present investigation, human liver biopsy samples were analyzed using an immunoblotting method to seek evidence for expression of halothane-induced neoantigens in humans. Sera from four patients with halothane hepatitis, which recognized halothane-induced rabbit liver neoantigens of 100, 76 and 57 kD, reacted strongly with antigens of very similar molecular weights that were expressed in livers from two patients who had died of cardiac failure following recent anesthesia with halothane. The antigens were not expressed in normal human liver or in livers from three patients who died of cardiac failure following anesthesia with agents other than halothane. The human antigens were not recognized by antibodies present in various control sera. Recognition of the 100- and 76-kD human antigens by the patients' antibodies was greatly reduced by absorption of sera with liver microsomes from halothane-exposed rabbits, but not by absorption of sera with control rabbit microsomes. These results indicate that humans exposed to halothane express liver neoantigens which are analogous to the halothane metabolite-protein neoantigens characterized previously in halothane-exposed animals.
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PMID:Evidence for expression in human liver of halothane-induced neoantigens recognized by antibodies in sera from patients with halothane hepatitis. 319 77

The authors report that total cardiopulmonary bypass (CPBP) for severe heart failure can be safely maintained for several days through peripheral cannulation alone. In two healthy sheep under general anesthesia, the authors cannulated the right external jugular vein and the right subclavian artery. A special spring was attached to a 7F Swan-Ganz catheter and positioned at the level of the pulmonary artery (PA) valve, rendering it partially incompetent. The extracorporeal circuit included a venous reservoir, a roller pump, a membrane lung, and a blood pulsator set at 25 beats/min. Ventricular fibrillation was induced with 110 VAC. Extracorporeal blood flow was raised to 100-120 ml/kg min. Mechanical pulmonary ventilation was changed to 5% CO2 in room air. During bypass, the wedge pressure (WP) averaged 9-13 mmHg, PA pressure 7-13 mmHg, and central venous pressure 1-9 mmHg. After 38 and 48 hr respectively the hearts were defibrillated with DC shock. There was total heart failure with no ejection from right or left. We continued with TCPBP. The right heart recovered after 1 and 3 hr respectively. After 7 and 5 hr, respectively, there was some aortic ejection. By 11 and 4 hr, respectively, the sheep were off bypass and on room air, with return to baseline cardiac function. Throughout the recovery the WP averaged 4-8 mmHg. At autopsy, all hearts were soft and normal in appearance. Histologic examination of the lungs and the heart was unremarkable. The authors conclude that the PA spring readily decompressed the LV. Ventilating lungs with 5% CO2 in air during CPBP sustained excellent lung function.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term closed chest partial and total cardiopulmonary bypass by peripheral cannulation for severe right and/or left ventricular failure, including ventricular fibrillation. The use of a percutaneous spring in the pulmonary artery position to decompress the left heart. 319 50

Approximately 32% of the rats used as animal models showed an elevated heart weight/body weight ratio (0.432[SEM 0.022] g.100 g-1 compared to 0.293[0.009] g.100 g-1 for sham-operated rats), a hydrothorax, pulmonary and liver congestion, and specific histological changes 82-93 weeks after surgically induced aortic constriction. The histological changes were comparable to those observed in hearts of people suffering from long term hypertension. Cardiac failure was also confirmed by depressed contractility as measured by maximum and minimum dP/dt (first derivative of left ventricular pressure), which were 4604(346) and 3627(526) mm Hg.sec-1, respectively, compared with 9165(745) and 5835(268) mm Hg.sec-1 respectively in rats that did not develop left ventricular hypertrophy and failure (CLIP rats). Systolic and left ventricular blood pressures measured under anaesthesia were also decreased: 71.6(5.0) and 88.1(6.3) mm Hg respectively in rats with congestive heart failure, compared with 83.6(2.4) and 109.5(3.6) mm Hg in CLIP rats. Except for a prolonged mean PQ interval associated with a lower heart rate and for a slightly shorter QRS interval in the conscious state, the electrocardiograms of rats with congestive heart failure did not show any major abnormalities specific to ventricular hypertrophy and/or failure. This model could be useful for studying the pathology and adaptative mechanisms in compensated pressure overload induced congestive heart failure as well as in studies comparing pathological changes and means of treatment of congestive heart failure with different aetiologies encountered in the human population.
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PMID:A pressure overload model of congestive heart failure in rats. 259 Sep 29

In a prospective randomized multi-centre study, the mortality following internal fixation surgery for fracture of the upper femur was investigated in 538 elderly patients allocated to receive subarachnoid blockade or general (narcotic-relaxant) anaesthesia. The 28-day mortality was 6.6% with subarachnoid, and 5.9% with general, anaesthesia. The difference was not significant (95% confidence limits: -3.5 to +4.8). At 1 year following surgery, the mortality was 20.4%. Increasing age, ischaemic heart disease, cardiac failure, preoperative arrhythmias and poor ASA status were all associated with increases in early and long term mortality. A delay to surgery of more than 24 h from admission was also associated with an increased 28-day mortality. Senile dementia and admission other than from the patient's own home, were factors associated with a poorer long term outcome. From the point of view of mortality, subarachnoid anaesthesia did not appear to confer any advantages over general anaesthesia in non-prosthetic surgery for hip fracture in the elderly.
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PMID:Prospective, multi-centre trial of mortality following general or spinal anaesthesia for hip fracture surgery in the elderly. 331 Nov

An 11-year-old girl was anesthetized with hyper-baric solution of lidocaine as spinal anesthesia for an appendectomy in a surgical clinic. Respiratory arrest which occurred soon after the injection, was not discovered for a period of time. Since spontaneous respiration recovered within 2 h of intensive resuscitation, the patient was transferred to a community hospital for intensive care. Ten hours after the spinal anesthesia, she died of cardiac failure. The concentration of lidocaine in the brain was 5-10 times more than that in other tissues. The relationship between the possibility of malpractice of spinal anesthesia and tissue distribution of the drug was discussed. In addition to lidocaine, a toxic amount of disopyramide, an antiarrhythmic drug, was detected in the body. The distribution of disopyramide was also estimated, and the pharmacokinetics of disopyramide in plasma and tissues were studied experimentally in rats.
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PMID:Distribution of lidocaine and disopyramide in human blood and tissue, a case report of death caused by spinal anesthesia. 335 Apr 55

The haemodynamic changes following anaesthesia for hip surgery in 16 very old ASA II or III patients (mean age 85.8 +/- 5 years) were studied. Patients were randomly assigned to two groups: group I 1 mg X kg-1 propofol, group II 1.5 mg X kg-1 ketamine. After injection, the patients were left spontaneously breathing oxygen, and were assisted when apneic. Haemodynamic measures with a Swan-Ganz catheter and thermodilution cardiac output calculator were made before and 1, 3, 5, 10 and 15 min after anaesthetic induction. The two groups were similar in age, weight and mean arterial pressure, but statistically different for some haemodynamic parameters (Ppa, Ppw, CI). In group I, arterial pressure fell significantly (-17%) in the first minute and continued to fall (-15%) until the 15th min. Heart rate remained unchanged: right atrial and pulmonary pressures were not changed; cardiac index fell slightly and MVO2 estimated by the triple product fell (-27%) as soon as propofol was infused. There was no clinical sign of cardiac failure. In group II, arterial pressure increased significantly, and heart rate decreased; pulmonary capillary wedge pressure increased (+93% after the 3rd min) and cardiac index was unchanged. The ventricular function curve was shifted to the right, suggesting a decrease in inotropism. Systemic vascular resistances were steady. MVO2 increased twofold, mainly due to the rise in pulmonary capillary wedge pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Propofol or ketamine in anesthesia of the very old patient. Study of the hemodynamic effects during induction]. 349 92

Interaction between kininase II and anaesthesia is not well described. Twenty two patients treated by kininase II for congestive heart failure are studied during anaesthesia for cardiovascular surgery. A first group of seventeen homogeneous hemodynamic data are reported. High cardiac index contrasts with severe clinical cardiac failure. A second group of inhomogeneous patients are separately described. Vasoconstrictor can be codified in the situation of low systemic resistance with high cardiac index. Preoperative treatment can be continued, under requirement of hemodynamic monitoring.
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PMID:[Is it necessary to discontinue captopril before heart surgery?]. 355 42

The cardiotonic effect of the secretion of the toads Bufo viridis Laur. skin glands and discharged bufadienolidines has been studied in the experiments on dogs under anaesthesia. It has been shown that the toad poison and bufadienolidines administered intravenously produce a marked cardiotonic and vasotonic effect, increasing the intraventricular and aortal pressure, the rate of pressure growth in the ventricles and the contraction index of the myocardium. The cardiotonic effect of poisons has also been noted in the model study of cardiac insufficiency caused by the bandaging of the coronary artery, it has greater effect than that of the cardiac glycoside corglycon.
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PMID:[Effect of the venom of the toad Bufo viridis Laur. on cardiac hemodynamics in dogs]. 370 29

The examination of 46 patients with pheochromocytoma has shown all the patients to have cardiac insufficiency before operation. This finding shows the necessity of preoperative preparation of the myocardium. The standard administration of beta-adrenoblocking agents without controlling the parameters of central hemodynamics can cause insufficiency of the minute volume of blood circulation. The authors failed to reveal advantages of any kind of general anesthesia. They consider that all the efforts in the course of anesthesiologic measures should be directed to the correction of hemodynamics.
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PMID:[Various features of anesthesiologic provisions for surgery of pheochromocytoma]. 372 84


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