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Biomedical subjects

C B Fraser

Publications and source records attributed to C B Fraser.

14 recordsLinked to original sources
PubMed1985

Coarctation and coarctation syndrome. A 5-year review.

The management of and results of treatment in 57 children with coarctation of the aorta are presented. In this series, 75% of the patients presented in the 1st year of life and 51% presented as neonates. Among the 50 patients who underwent surgery the total surgical mortality rate was 14%. The higher mortality in young infants is closely related to associated cardiac anomalies. We suggest that neonates with coarctation presenting with heart failure should be operated on early, as this significantly reduces the mortality.

Age Factors↗
PubMed1984

Critical congenital heart disease.

We have reviewed the outcome in 94 infants who underwent diagnostic cardiac catheterization in the 1st month of life during the period 1976-1980. Eighty-three were shown to have congenital heart disease, and in nearly 50% further active intervention was attempted. Mortality directly related to catheterization was only 1%, although hospital mortality after surgery was 44%, and overall mortality was 53%. The prevalence of cardiac abnormalities encountered has remained unchanged over the past 10 years, but there has been a gradual improvement in prognosis. Factors contributing to this are discussed.

Cardiac Catheterization↗
PubMed1984

Treatment choice in acute rheumatic carditis.

A trial was conducted using sequential analysis by pairs to compare the efficacy of corticosteroids and salicylates in the treatment of acute rheumatic carditis. The results show a significantly favourable effect of steroid treatment both in clinical response and in reduction of the erythrocyte sedimentation rate. In addition, patients receiving steroids usually had a shorter hospital stay. The use of steroids in acute rheumatic fever with carditis is recommended.

Acute Disease↗
PubMed1983

Anomalous left coronary artery from the pulmonary artery - a therapeutic dilemma.

An anomalous left coronary artery from the pulmonary artery was diagnosed clinically in 12 patients (and confirmed angiographically in 11 and at autopsy in 1). A classic history of 'infantile angina' was obtained in only 1 patient, while the typical electrocardiographic findings of anterolateral ischaemia or infarction were present in 11 patients (92%). The majority had evidence of left ventricular dysfunction and mitral regurgitation. Three patients underwent surgical reimplantation of the anomalous left coronary artery into the ascending aorta. Two survive, but with persistent electrocardiographic changes and cardiomegaly. Nine patients, of whom 4 survive, were managed medically. Five of the 6 deaths occurred within 1 month of diagnosis. A conservative approach to surgical intervention is recommended, as surgery is unlikely to alter the ultimate prognosis.

Angiography↗
PubMed1983

The use of radionuclides in the investigation of conjoined twins.

Three sets of thoraco-omphalopagous conjoined twins were investigated. The clinical findings indicated a complex shared heart in two sets, and separate cardiovascular systems in the other. These assessments were confirmed by dynamic imaging after bolus injection of Tc-99m(Sn)colloid or Tc-99m millimicrospheres. Static images were then used to establish the configurations of the shared livers. The results of these studies were in keeping with the angiographic and autopsy findings in the two sets with complex cardiac anomalies and with the surgical findings during successful separation of the third set.

Heart Defects, Congenital↗
PubMed1982

The prolonged QT syndrome in childhood. Case reports.

Syncopal episodes in 5 children have been shown to be caused by the prolonged QT syndrome. The clinical features, pathogenesis and treatment of this syndrome are discussed, and the poor prognosis without treatment is stressed. The prolonged QT syndrome should be considered and an ECG performed in all cases of recurrent unexplained syncope in the paediatric age group.

Adolescent↗
PubMed1982

Phagocytosis of particulate nickel compounds by rat peritoneal macrophages in vitro.

Phagocytic indices of 17 nickel compounds were measured in vitro in monolayer cultures of rat peritoneal macrophages. The macrophages were exposed for 1 h at 37 degrees C to particles (1.5 micrometer median diameter) of the nickel compounds, at concentrations of 10 microgram/ml of medium (2 microgram/cm2 of monolayer). Phagocytic induces (i.e., the percentages of macrophages with one or more engulfed particles) ranged from 69% (NiO) to 3% (amorphous NiS). In order to decreasing phagocytic indices, the 17 nickel compounds were ranked as follows: NiO greater than Ni4FeS4 greater than NiTiO3 greater than NiSe greater than alpha Ni3S2 greater than Ni greater than Ni5As2 greater than NiS2 greater than NiFe alloy greater than NiSb greater than Ni11As8 greater Ni3-Se2 greater than beta NiS greater than NiTe greater than NiAs greater than NiAsS greater than amorphous NiS. Rank-correlation (P less than 0.03) was observed between the phagocytic indices of the nickel compounds and their dissolution half-times in rat serum. Nickel subsulfide, alpha Ni3S2, was a notable exception to the general concordance between phagocytic indices and dissolution half-times: alpha Ni3S2 was avidly phagocytized by macrophages, yet it had one or the shortest dissolution half-times. Preliminary results of carcinogenesis tests of 14 of the nickel compounds do not indicate significant rank-correlation between the phagocytic indices of the nickel compounds and the sarcoma incidences at 1 yr after i.m. administration of the compounds to rats.

Animals↗
PubMed1982

Mitral valve replacement in children.

Mitral valve replacement (MVR) is associated with higher mortality and morbidity rates in children than in adults, and the use of heterograft valves has been encouraged. The results of MVR in 56 consecutive patients, aged 2 to 12 years, presenting between January, 1972, and January 1979, were reviewed to test these beliefs. The etiology of mitral valve disease was rheumatic in 46, congenital in eight, and acute bacterial endocarditis in two. All children were seriously disabled (NYHA Classes III and IV). Cardiac catheterization in 36 patients revealed mixed valve disease in 26, pure mitral regurgitation in seven, and pure mitral stenosis in three. Seventeen Starr-Edwards (SE), five Lillehei (L), Björk-Shiley (BS), eight Hancock (H), and 25 Carpentier-Edwards (CE) mitral prosthesis were inserted. Operative mortality was 2% (1 BS) and late mortality was 10% (three SE, one L, two CE). Serious late complications occurred in 30% of survivors, including 11 instances of calcific valve stenosis (five H, six CE), one case of valve thrombosis (1 L), and two embolic episodes (1 SER, 1 H). Survival curves were similar for patients with heterograft and mechanical valves (92% and 77% at 5 years). Event-free curves showed heterograft valves to have a far higher complication rate than mechanical valves (10% complication free at 4 years compared to 84% free at 5 years). Early operative results in children are excellent, and the overall mortality (10%) compares favorably with figures for MVR in adults. However the long-term durability and choice of prostheses remain problematical, since less than 10% of heterograft valves survive beyond 5 years.

Acute Disease↗
PubMed1976

Transcutaneous aortovelography: reproducibility in adults and children.

Transcutaneous aortovelography (TAV), a new ultrasonic technique for measuring instantaneous mainstream blood velocity in the aorta, is described. The technique uses the Doppler shift principle. The highest local blood velocity within the aortic arch can be recorded from a transducer placed in the suprasternal notch. Inspection of the systolic complexes recorded allows measurement of peak velocity, systolic complex area (proportional to ejected stroke volume), mean (time averaged) blood velocity and initial systolic acceleration. Formal analysis of variance was performed on measurements made by the five observers on 11 healthy adults and by 2 observers on 10 healthy children. Coefficients of variation of from 4 to 8% were found of all variables other than acceleration where the variation was up to 16%. Peak velocities in adults ranged from 97 to 130 cm/sec and were higher in children.

Adult↗
PubMed1975

Assessment of Doppler ultrasound to measure systolic and diastolic blood pressures in infants and young children.

A recently developed instrument uses the Doppler shift technique to detect vessel wall movement, and it has been suggested that in conjunction with a conventional sphygmomanometer systolic and diastolic blood pressures can be measured. A controlled study was carried out in 20 children recovering from cardiac surgery where direct intra-arterial measurements (one observer) were compared with independent measurements using the Doppler instrument (2 observers). Systolic pressures measured directly and by Doppler technique correlated well and there was no significant difference between intra-arterial and indirect measurements whether the latter were taken by doctors or by nurses. In contrast, direct and indirect diastolic pressure measurements correlated poorly and were significantly overestimated with a mean difference of 6-25 mmHg (range +25 to -10) for doctors, and 4-25 mmHg (range +20 to -10) for nurses. Thus, the instrument adequately measured systolic blood pressure, but in our hands did not give precise measurements for diastolic blood pressure.

Blood Pressure Determination↗
PubMedDate not supplied

Effects of nickel chloride and diethyldithiocarbamate on metallothionein in rat liver and kidney.

Effects of NiCl2 and sodium diethyldithiocarbamate (DDC) upon metallothionein (MT) concentrations were studied in liver and kidney of male Fischer rats. After injection of NiCl2 (0.75 mmol per kg, sc), hepatic MT concentration increased 2.6-fold at 6.5 hr and 8.2-fold at 17 hr; renal MT concentration increased 1.4-fold at 6.5 hr and 2.3-fold at 17 hr. Dose-related increases of MT concentrations were observed in liver and kidney of rats killed 17 hr after injection of NiCl2 (0.25 to 0.75 mmol per kg, sc). Repeated administration of NiCl2 (0.1 mmol per kg, ip) on four successive days, with sacrifice three days after the last treatment, increased MT concentrations 1.4-fold in liver and kidney, whereas CdCl2-treatment at the same dosage schedule increased MT concentration 16-fold in liver and 3.3-fold in kidney. NiCl2-Induction of MT in liver and kidney was not prevented by actinomycin D (1 mg per kg, ip), but was inhibited by cycloheximide (2 mg per kg, ip). Sodium diethyldithiocarbamate given alone (1.33 mmol per kg, im) 17 hr before death, increased MT concentration 7.6-fold in liver but did not affect MT concentration in kidney; administration of DDC prior to injection of NiCl2 did not inhibit NiCl2-induction of MT.

Animals↗