Harvey White

Randomized, Placebo-Controlled Trial of Platelet Glycoprotein IIb/IIIa Blockade With Primary Angioplasty for Acute Myocardial Infarction

Background—The benefit of catheter-based reperfusion for acute myocardial infarction (MI) is limited by a 5% to 15% incidence of in-hospital major ischemic events, usually caused by infarct artery reocclusion, and a 20% to 40% need for repeat percutaneous or surgical revascularization. Platelets play a key role in the process of early infarct artery reocclusion, but inhibition of aggregation via the glycoprotein IIb/IIIa receptor has not been prospectively evaluated in the setting of acute MI. Methods and Results—Patients with acute MI of <12 hours’ duration were randomized, on a double-blind basis, to placebo or abciximab if they were deemed candidates for primary PTCA. The primary efficacy end point was death, reinfarction, or any (urgent or elective) target vessel revascularization (TVR) at 6 months by intention-to-treat (ITT) analysis. Other key prespecified end points were early (7 and 30 days) death, reinfarction, or urgent TVR. The baseline clinical and angiographic variables of the 483 (242 placeb...

Bronchial Obstruction Due to Pulmonary Artery Anomalies I. Vascular Sling

A left pulmonary artery, coursing anomalously above the right bronchus and behind the trachea en route to the left lung, can produce disabling respiratory symptoms. Three cases observed by the authors are presented in detail and 5 similar cases, previously reported, are reviewed. The clinical features are those of tracheobronchial obstruction, occurring early in life, associated with endoscopic evidence of extrinsic pressure on the right bronchus and posterior wall of the trachea. The importance of the clinical recognition of this anomaly is stressed, since it appears to be amenable to surgical correction.

Bronchial Obstruction Due to Pulmonary Artery Anomalies: II. Pulmonary Artery Aneurysm

In a previous publication attention was drawn to the occurrence of pulmonary artery anomalies as conditions causing tracheobronchial obstruction. In the present report 2 infants are presented in whom a large aneurysm of the pulmonary artery pressed upon the walls of the left bronchus, producing severe respiratory symptoms.

Bleomycin-induced pulmonary fibrosis mimicking recurrent metastatic disease in a patient with testicular carcinoma: case report of the CT scan appearance.

Pulmonary fibrosis is a well‐recognized complication of bleomycin therapy. Detection of bleomycin‐induced pulmonary fibrosis by computed axial tomographic scanning (CT) has not been reported. We report on a patient in whom the development of lesions on chest CT scan following cessation of chemotherapy (including bleomycin) was interpreted as representing recurrent metastatic disease. At bilateral thoracotomy, only pulmonary fibrosis was found. In this patient, the CT scan appearance of bleomycin‐induced pulmonary fibrosis mimicked recurrent disease.

The thymic mass as a mediastinal dilemma

Five patients with normal thymus glands whose radiographs were mimicking mediastinal masses are presented; one in an infant with a compressed right upper lobe bronchus and two in adolescents with normal large lobes of the thymus. There were also two patients with regrowth of the thymus, one after severe infection and one after irradiation for secondary malignancies. We discuss the use of various techniques utilised to confirm the diagnosis and avert surgical procedures.

Congenital tracheoesophageal fistula in the neck without atresia

Summary A rare type of tracheoesophageal fistula in the neck is reported. Surgical repair could not be done in this case because of the general debility of the patient.