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Biomedical subjects

D S Reid

Publications and source records attributed to D S Reid.

71 records · Page 4Linked to original sources

Ejection phase indices of left ventricular performance in infants, children, and adults.

A validatory study of quantitative single plane left ventricular cineangiography is presented, using human left ventricular casts ranging in size from 1.6 to 135 ml. Good correlation was found between actual and calculated volumes (r=0.967). 62 patient studies were carried out and the value of the usually calculated indices of left ventricular performance were compared to one another. Ejection fraction and mean rate of circumferential fibre shortening (mean Vcf) were found to be the best discriminators of abnormal left ventricular function, and, on the basis of the presented data, it is suggested that mean Vcf is the more sensitive index of left ventricular performance.

Adolescent↗

Studies in a newborn infant with supraventricular tachycardia and Wolff-Parkinson-White syndrome.

A neonatal patient with Wolff-Parkinson-White type A and supraventricular tachycardia is described. Demonstration of the mechanism of the tachycardia and its termination were achieved using intracardiac electrography and cardiac pacing. Quantitative left ventricular angiography and echocardiography showed impaired left ventricular function following the arrhythmia. Serial echocardiograms demonstrated the subsequent return to normal left ventricular performance.

Angiocardiography↗

Bidirectional tachycardia in a child. A study using His bundle electrography.

This is a report of a case of bidirectional tachycardia in a 6-year-old girl with no evidence of any structural abnormality of the heart. The patient had never received digitalis. The arrhythmia appeared to be precipitated by effort and emotional stress, and could be induced by increasing the heart rate by atrial pacing or isoprenaline administration. His bundle electrography showed that the arrhythmia was ventricular in origin. This emphasizes the importance of recording an effort electrocardiogram in all children with unexplained syncopal episodes, even when the resting electrocardiogram is normal.

Bundle of His↗

Localized left ventricular myocardial defect leading to fatal cerebral embolism.

The case of a previously health 17-year-old youth who presented a fatal cerebral infarct is described. A localized defect in the anterior left ventricular myocardium with overlying thrombus, and left ventricular hypertrophy were found at necropsy. An old infarct was found in the left kidney. There were no signs of ischaemic or inflammatory heart disease. The possible origins of the lesion are discussed.

Adolescent↗

A simple, clinical assay to evaluate the acrosin activity of human spermatozoa.

Acrosin, a sperm-specific acrosomal proteinase, has an essential role in the fertilization process. Low levels of acrosin appear to be associated with subfertility and infertility, and the acrosin activity of spermatozoa may potentially be a useful indicator of semen quality. The standard acrosin tests employed by research laboratories are too complicated and/or time consuming for clinical use; therefore, a simple assay has been developed to assess total acrosin activity (acrosin and activatable proacrosin). To perform the test, liquefied semen is centrifuged over Ficoll, the washed sperm pellet is suspended in a detergent (Triton X-100)-substrate (N-alpha-benzoyl-DL-arginine p-nitroanilide) buffer, pH. 8.0, and the amidase activity is determined spectrophotometrically after a 3-hour incubation period. Amidase activity can be inhibited with benzamidine, indicating that the activity is primarily or entirely due to acrosin. The absence of detergent in the incubation medium results in greatly reduced activity. The assay is repeatable, linear with increasing sperm concentration, sensitive to a lower limit of 2 x 10(6) spermatozoa, and the results correspond to those obtained with a standard acrosin extraction and assay technique. Storage of ejaculates at 3 to 6 C or at 22 to 24 C for 24 hours does not affect the acrosin activity significantly but much higher temperatures can cause a loss of activity. Freezing ejaculates results in a large decrease in sperm acrosin activity. Leukocytes show minimal activity in the assay. Sperm populations prepared by a swim-up procedure average approximately a 2-fold higher acrosin activity than the original ejaculates. Preliminary experiments indicate that the average sperm acrosin activity of ejaculates whose spermatozoa successfully fertilize human eggs in vitro is significantly higher than those that do not fertilize eggs.

Acrosin↗

A comparison of amiodarone and digoxin in the treatment of atrial fibrillation complicating suspected acute myocardial infarction.

Thirty-four patients with atrial fibrillation complicating suspected acute myocardial infarction were randomised to treatment with intravenous amiodarone (n = 18) or intravenous digoxin (n = 16). After 24 h, similar proportions of patients in each group had reverted to sinus rhythm. However, there was a tendency towards earlier reversion with amiodarone. At 4 h, 72% of the amiodarone group had reverted to sinus rhythm, compared with 31% of the digoxin group (p less than 0.1). This tendency was more marked in patients with definite infarction (at 4 h, amiodarone 75% reversion, digoxin 10% reversion). Neither drug had a significant effect on blood pressure. Atrial fibrillation may cause serious haemodynamic deterioration in acute myocardial infarction. In comparison with digoxin, amiodarone offers more rapid control of the ventricular response rate and may, in addition, restore sinus rhythm more rapidly.

Aged↗

Pericardial effusion--an uncommon complication of Salmonella enteritis.

A 62-year-old lady who was receiving corticosteroids for rheumatoid arthritis was admitted suffering from dehydration due to salmonella enteritis. Despite rehydration and appropriate chemotherapy she remained unwell and developed hypotension and elevation of her jugular venous pressure. Echocardiography and subsequent aspiration demonstrated a purulent pericardial effusion from which S typhimurium was cultured. Following aspiration and a change of antibiotic therapy, her condition improved dramatically.

Enteritis↗