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Biomedical subjects

M Dick

Publications and source records attributed to M Dick.

At least 145 records · Page 8Linked to original sources
PubMed1981

Clean Air and Noise Abatement Branch, Public Health Department, Western Australia.

Whole blood lead levels, free erythrocyte protoporphyrin (FEP) concentrations, and hair lead levels were measured in 181 schoolchildren resident in and around the town of Northampton, Western Australia, where tailings from a lead mine have been used extensively for ground surfacing and other purposes. Mean blood lead levels were 0.68 mumol/L (14.0 micrograms/100 mL) in boys and 0.5 mumol/L (10.4 micrograms/100 mL) in girls, the highest being 2.27 mumol/L (47 micrograms/100 mL). Nine children (5%) had blood lead levels above 1.21 mumol/L (25 micrograms/100 mL) and four had levels above 1.21 mumol/L (25 micrograms/100 mL) and four had levels above 1.45 mumol/L (30 micrograms/100 mL). Four of these children had FEP levels above 2.0 mumol/L. There was a statistically significant difference between the mean blood lead levels of children resident in the town (man blood lead level, 0.63 mumol/L (13.1 micrograms/100 mL)) compared with those resident out of the town 0.55 mumol/L (11.3 micrograms/100 mL). The presence of lead tailings in the town may account for the small difference.

Adolescent↗
PubMed1981

Ventricular tachycardia in children.

Thirty-eight patients aged 1 to 20 years (mean 11.2) were evaluated because of recurrent ventricular tachycardia. The follow-up period ranged from 0.5 to 12 years (mean 6). The patients were separated into two groups according to the presence or absence of known structural heart disease. Seventeen of the 21 patients with known heart disease were symptomatic (cardiac arrest in 5, syncope in 5, dizziness in 7) compared with only 6 of the 17 patients without heart disease (syncope in 3 and dizziness in 3) (p less than 0.01). All symptomatic patients had ventricular tachycardia with rates of more than 150 beats/min, whereas all but one of the asymptomatic patients had rates of less than 150 beats/min (p less than 0.01). Graded treadmill exercise testing was performed in 21 of the 38 patients. Exercise increased the degree of ventricular arrhythmia in 8 of the 11 symptomatic patients but decreased or abolished the arrhythmia in 9 of the 10 asymptomatic patients (p less than 0.01). Antiarrhythmic therapy was used in 28 of the 38 patients. Effectiveness of therapy was assessed with both 24 hour Holter monitoring and graded treadmill exercise testing. Therapy effectively abolished ventricular tachycardia and greatly decreased the number of premature ventricular complexes in the symptomatic patients but was less effective in the asymptomatic patients. Thus, this study suggests that the presence of underlying heart disease, the rate of ventricular tachycardia and the results of graded treadmill exercise tests are important in predicting the prognosis of children with ventricular tachycardia.

Adolescent↗
PubMed1981

Electrophysiologic delineation of the intraventricular His bundle in two patients with endocardial cushion type of ventricular septal defect.

Two patients who had an endocardial cushion type of ventricular septal defect underwent electrophysiologic studies for detection of specialized conduction tissue during operative repair. In one patient, with an inferior leftward frontal plane QRS axis on the ECG, we recorded an intraventricular His bundle electrograms from both the anterosuperior and posteroinferior margins of the defect, suggesting dual atrioventricular conduction tracts (branching intraventricular His bundle). These anatomic and electrophysiologic findings may account for the more normally oriented QRS frontal plane axis on the surface ECG of both of these patients and support the hypothesis that the changes observed on the ECGs of patients with the various forms of endocardial cushion defect can be explained by alterations in the anatomic configuration of the specialized atrioventricular conduction tissue.

Bundle of His↗
PubMed1981

Quantitative morphometric analysis of the pulmonary arteries in two patients with D-transposition of the great arteries and persistence of the fetal circulation.

Quantitative morphometric studies were performed on the pulmonary arteries of two newborns who died at 1 and 3 days of age with both transposition of the great arteries and persistence of the fetal circulation. Similar studies were performed on two normal control subjects (age 2 and 6 days), one newborn infant (age 1 day) with secondary persistence of the fetal circulation, and one newborn infant (age 2 days) with isolated D-transposition of the great arteries, as compared to those without it. When wall thickness was related to external diameter of the vessel, the greatest difference in thickness was observed in the smallest vessels (less than 150 mu in diameter). Extension of smooth muscle peripherally and to the smallest vessels (less than 50 mu) was similarly most marked in those infants with persistence of the fetal circulation may coexist but at the same time be unrelated in a single patient. Furthermore when such coexistence is unrecognized, pharmacologic manipulation of the ductus arteriosus may be hazardous.

Female↗
PubMed1980

Distribution and inheritance of low serum thyroxine-binding globulin levels in Australian Aborigines: a new genetic variation.

Evidence is presented that low serum thyroxine-binding globulin (TBG) levels in Aborigines are widely distributed throughout Australia, and that these are inherited rather than acquired. Levels of TBG in children, and lack of any correlation of low TBG levels with alcohol consumption or liver dysfunction, suggest that the low levels are not acquired in adult life. Genetic studies in eight families indicate (with one exception) an autosomal dominant pattern of inheritance with direct male-to-male transmission. These findings are in marked contrast to the much rarer X-linked pattern of inheritance of low TBG levels in Caucasians. This type of prevalent and inherited low level of TBG in serum appears so far to be unique to the Aboriginal race. The synthesis (or degradation) of TBG may be controlled by an autosomal gene in Aborigines.

Adolescent↗
PubMed1980

Prevalent low serum thyroxine-binding globulin level in Western Australian aborigines: its effect on thyroid function tests.

The first major variation from the normal human levels of thyroxine-binding globulin (TBG) in a racial group is reported in full-blood Aborigines of Western Australia. This finding has not only biochemical and anthropological interest, but also medical significance in that many common laboratory tests of thyroid function in this group are very liable to misinterpretation because of low TBG levels. In Aborigines in the Halls Creek area of Western Australia, 40% have TBG levels below the lower reference limit for Caucasians, and 18% have levels between half and one-third of the lower limit. Such subjects have low thyroxine levels by Caucasian standards, and frequently the results of triiodothyronine uptake (T3U) tests lend support to the false suggestion of hypothyroidism. Caucasian reference ranges are not valid in this large proportion of the Aboriginal population. It is not yet clear whether the low TBG levels are a normal feature in this racial population, or whether there is some other cause. The subjects of the study were not acutely ill and Aborigines with low TBG are well distributed throughout the State.

Australia↗
PubMed1979

Intraoperative recording of specialized atrioventricular conduction tissue electrograms in 47 patients.

Intraoperative mapping of the specialized atrioventricular conduction system was performed in 47 patients during cardiac surgery. Specialized conduction tissue electrograms were identified in 37, and atrioventricular conduction preserved in 92%. Specialized conduction tissue was identified in 27 patients with atrioventricular canal defect: complete heart block was avoided in 25. Conduction tissue was located in six of 12 patients with complex transpositions; atrioventricular conduction was preserved in all six. Other lesions in which the technique was useful were Ebstein's anomaly and single atrium. Limitations to the technique are 1) deep hypothermia and circulatory arrest; 2) interruption in atrioventricular conduction during mapping; 3) inadequate exposure and access to probable sites of conduction tissue; 4) variation of size and spatial relations of individual malformations; and 5) limited time for identification of unusually located conduction tissue. Indications for use of this technique include patients with both forms of atrioventricular canal, complex transpositions, atrioventricular discordance, single ventricle and single atrium.

Adolescent↗
PubMed1978

His bundle electrogram after intracardiac repair of tetralogy of Fallot. Analysis of data in 59 patients.

His bundle electrograms were recorded in 59 patients after intracardiac repair of tetralogy of Fallot and were correlated with the postoperative electrocardiogram. Except for five patients with first degree atrioventricular block postoperatively all patients in Group A (those with either a normal electrocardiogram or solitary right bundle branch block) had a normal A-H interval (77.7 +/- 21.6 msec) (mean +/- standard deviation); all had a normal H-V interval (39.5 +/- 7.2 msec). Patients in Group B (bifascicular block) tended to have a normal A-H interval (97.2 +/- 26.2 msec) with a prolonged H-V interval (48.8 +/- 10.7 msec). Patients in Group C (trifascicular block) had prolongation of both the A-H (160.0 +/- 32.4 msec) and the H-V interval (58.8 +/- 10.6 msec) by comparison with control values. Patients in Group D (transient complete heart block) had a normal A-H interval (79.5 +/- 28.2 msec) but a prolonged H-V interval (57.8 +/- 16.4 msec), similar to that in Group C. A good hemodynamic result was associated with a normal H-V interval; a prolonged interval accompanied a poor result.

Adolescent↗
PubMed1978

Early and late results with the Mustard operation in infancy.

Eighty-one patients, ranging in age from 36 hours to 24 months and in weight from 2.5 to 12 kg had a Mustard operation for D-transposition of the great arteries (D-TGA) (20 with complex D-TGA) using either deep hypothermic circulatory arrest (68 patients) or conventional cardiopulmonary bypass (13 patients). A Dacron patch was used for the intraatrial baffle and pericardium for augmentation of the pulmonary atrium. Ten patients died following operation. Thirty-two patients had cardiac catheterization 1 year after operation. Of 24 patients with D-TGA and intact ventricular septum, 23 had normal pulmonary artery pressures. In 20 patients left ventricular outflow tract gradients decreased from a mean of 32 mm Hg to a mean of 18 mm Hg after operation. Five patients who had D-TGA and ventricular septal defect and systemic pressures in the left ventricle before operation, had a notable decrease in left ventricular pressures after the procedure. Seven patients required reoperation for baffle obstruction. Mortality following Mustard repair was primarily related to the complexity of the lesion, maturity of the infant, and degree of pulmonary vascular changes. Caval obstruction was related to the configuration of the baffle used in the early part of this series.

Blood Pressure↗
PubMed1978

An improved screening method for 3-methoxy-4-hydroxy mandelic acid excretion in urine.

A screening method is described for urinary 3-methoxy-4-hydroxy mandelic acid using an initial ion exchange procedure, vanillin formation and extraction into toluene. The technique, is simple, rapid and specific, with a reference value up to 35 mumol (7.0 mg)/day established on 92 normal human subjects. Over 200 patients' urines were analysed by the method of which 18 gave values above the reference range. The majority of these increased excretions are attributed to the metabolic effects of drugs, one patient suffered from phaeochromocytoma and only 2 results remaining unexplained.

Chromatography, Ion Exchange↗
PubMed1977

Electrophysiologic delineation of the specialized atrioventricular conduction system in two patients with corrected transposition of the great arteries in situs inversus (I,D,D).

Electrophysiologic delineation of the atrioventricular conduction system at surgery is described in two patients with corrected transpostion of the great arteries in situs inversus. Intra-atrial electrograms were recorded in one patient from sites immediately adjacent to the coronary sinus located in the left-sided right atrium. The intraventricular portion of the atrioventricular conduction system was identified in both patients along the posterior and inferior margin of the ventricular septal defect, in contrast to the superior and anterior location found in corrected transposition of the great arteries in situs solitus. In contrast to the superior and anterior location found in corrected transposition of the great arteries in situs solitus. The course of the conduction system in the hearts of these two patients and a possible relationship to the cardiac loop and dual origin of the atrioventricular node is discussed. These cases illustrate the usefulness of segmental diagnosis of congenital heart disease and of electrophysiologic identification of the specialized atrioventricular conduction system at surgery.

Adolescent↗