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Biomedical subjects

E W Spooner

Publications and source records attributed to E W Spooner.

8 recordsLinked to original sources

Evaluation of a temporal increase in ventricular septal defects: estimated prevalence and severity in northeastern New York, 1970-1983.

A marked increase or "epidemic" in ventricular septal defects (VSD) in recent years has been reported by the Center for Disease Control. Many pediatric cardiologists believe that this increase is simply a reflection of more intensive diagnosis and evaluation of infants throughout the country. Yet to our knowledge there has been no objective evidence for this explanation. We evaluated this possibility by considering records on live births occurring in 1970-1983 in the counties surrounding Albany, New York. In that period a single group of pediatric cardiologists has been evaluating all infants with suspected or confirmed cardiac defects in this area. We limited this analysis to ventricular septal defects unassociated with any cardiac syndrome complex. Thus, VSDs occurring as part of cyanotic heart disease or other complex cardiac "syndromes" were excluded. Consistent with the reported national trend, the estimated prevalence rate of ventricular septal defects diagnosed under 1 year of age in this period has increased from 1.0 per 1,000 live births in 1970 to 4.0 per 1,000 in 1983.(ABSTRACT TRUNCATED AT 250 WORDS)

Demography

Cardiac rhabdomyoma in the neonate: surgical management.

Rhabdomyoma is the most common cardiac neoplasm in neonates. Tuberous sclerosis is found in half of the patients with rhabdomyomas. We maintain a surgical policy of accepting for operation only neonates in whom it has been demonstrated that the primary cause for hemodynamic compromise is obstructing, intracavitary neoplasms. Only the intracavitary portions of the rhabdomyoma are excised; no effort is made to completely remove all intramural tumors. Rhabdomyomas demonstrate benign pathological characteristics and may regress. Neonates with rhabdomyomas but no hemodynamic impairment, or those in whom only intramural masses can be demonstrated, are not considered surgical candidates. Tuberous sclerosis by itself should not be judged a contraindication to operation. The results of our surgical policy regarding rhabdomyomas in neonates are reported in two case presentations.

Cardiac Catheterization

Estimation of pulmonary/systemic resistance ratios from echocardiographic systolic time intervals in young patients with congenital or acquired heard disease.

Previous work has shown the positive correlation of echocardiographic right ventricular preejection period/right ventricular ejection time ratio (RPEP/RVET) with pulmonary vascular resistance and pulmonary arterial diastolic pressure obtained at cardiac catheterization. However, the correlation was insufficient to predict pulmonary arterial diastolic pressure or vascular resistance from a given RPEP/RVET ratio. In this study the RPEP/RVET ratio was compared with left ventricular preejection period/ejection time ratio (LVEP/LVET) in 25 patients undergoing cardiac catheterization, and a strong correlation was found between the ratio (RPEP/RVET)/(LPEP/LVET) = R/L and the ratio of pulmonary arteriolar resistance/systemic arteriolar resistance (PAR/RS), especially when R/L was correlated with log10 PAR/RS (r = 0.902). A very high correlation (r = 0.960) was found between R/L and log10 PAR/RS when the group was restricted to patients with a ventricular septal defect or a complete endocardial cushion defect. Regression equations for prediction of PAR/RS have been derived for the various groups.

Adolescent

Diagnosis of pericardial effusion in children: a new radiographic sign.

A band of increased density paralleling the left lower border of the cardio-pericardial silhouette is seen on anteroposterior chest films in some children with pericardial effusions. To analyze the incidence and accuracy of this sign, films of children with pericardial effusions and controls were compared. Among 17 children with proved pericardial effusion, bands of density within the cardio-pericardial silhouette were seen in six films, while positive epicardial fat pad signs were seen on four. When three radiologists without experience in use of the sign evaluated radiographs of the six patients with the sign and six controls without pericardial effusion, the sign was detected in most instances in the children with effusions (specificity and sensitivity, 83%). In vitro studies of unpreserved hearts in baths of solutions of varying osmolarity failed to show detectable differences in density between myocardium and any of the solutions. We conclude that the new sign may be produced by epicardial fat adjacent to pericardial fluid.

Humans