Occupational disease surveillance at DOH.
Explore the source record for details and available documents.
Humans↗
Biomedical subjects
E O Smith
Publications and source records attributed to E O Smith.
Differentiating anomalous left main coronary artery originating from the pulmonary artery in infants from myocarditis and dilated cardiomyopathy by electrocardiogram.
Anomalous left main coronary artery (ALMCA) originating from the pulmonary artery is an important cause of morbidity from heart failure and mortality in infants. Discriminating ALMCA from myocarditis or other forms of dilated cardiomyopathy (DC) in infants is critical for proper early management of this treatable disease. This study was performed to characterize electrocardiographic (ECG) patterns in infants with ALMCA, and to identify features that would allow differentiation of these infants from those with myocarditis/DC. Presenting electrocardiograms from 28 patients with ALMCA < 2 years of age were analyzed for 103 variables, and compared with electrocardiograms from 28 aged-matched infants with myocarditis/DC using the t test, Fisher's exact test, and discriminant analysis using stepwise logistic regression techniques. ECG findings characteristic of infants with ALMCA were confirmed, including deep (> or = 3 mm) and wide (> or = 30 ms) Q waves and a QR pattern in at least 1 of the following leads: I, aVL, V5 to V7. Also, the complete absence of Q waves from leads II, III, and aVF in all infants with ALMCA was noted. These and other ECG patterns were more common in infants with ALMCA than in those with myocarditis/DC (p < 0.05), but were also noted in some patients with myocarditis/DC. Stepwise logistic regression analysis identified 3 ECG variables that best discriminated ALMCA from myocarditis/DC, including Q wave width (w) in lead I, and Q-wave depth (d) and ST-segment amplitude (s) in lead aVL.(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiomyopathy, Dilated↗
Decreased single-photon emission computed tomographic [123I]beta-CIT striatal uptake correlates with symptom severity in Parkinson's disease.
Previous studies have utilized single-photon emission computed tomography (SPECT) to demonstrate decreased [123I]beta-CIT striatal uptake in idiopathic Parkinson disease (PD) patients. The present study extends this work by examining SPECT outcome measures in a larger group of PD patients with varying disease severity. Twenty-eight L-dopa-responsive PD patients (Hoehn-Yahr stages 1-4) and 27 healthy controls had SPECT scans at 18 to 24 hours after injection of [123I]beta-CIT. Specific to nondisplaceable striatal uptake ratios (designated V3") were correlated with Hoehn-Yahr stage and Unified Parkinson's Disease Rating Scale (UPDRS) subscores. Linear discriminant function analyses utilizing striatal uptakes, putamen-to-caudate ratios, and ipsilateral-contralateral asymmetry indices were performed. Decreased striatal tracer uptake (V3") was correlated with total UPDRS score for both contralateral and ipsilateral striatum. Putamen uptake was relatively more reduced than caudate with mean putamen:caudate ratios of 0.50 +/- 0.17 and 0.82 +/- 0.09 for PD patients and controls, respectively. Ipsilateral:contralateral asymmetry was significantly greater in PD patients than controls. Discriminant function analysis utilizing V3" for ipsilateral and contralateral caudate and putamen correctly classified all 55 cases. These data demonstrate marked differences in [123I]beta-CIT SPECT measures in healthy controls and PD patients. The significant correlation of SPECT measures with motor severity suggests [123I]beta-CIT may be a useful marker of disease severity in PD.
Adult↗
Quantitation of echocardiographic predictors of outcome in infants with isolated ventricular septal defect.
Clinical and morphometric features such as ventricular septal defect (VSD) size and location may determine outcome in infants with an isolated VSD. However, no currently available data allow quantitative estimation of the probability of spontaneous closure or surgery in individual patients. To identify independent predictors of outcome and to quantitate the probability of spontaneous closure and surgery in patients with isolated VSD, we studied 156 consecutive infants who had a diagnosis of an isolated VSD between January 1, 1988, and December 31, 1990, and who were subsequently monitored for 28.5 +/- 15 months. Of the 149 patients with membranous (n = 100) and muscular (n = 49) defects who were studied, 46 (31%) patients had spontaneous closure, and an additional 37 (25%) patients underwent surgical repair. Univariate analysis identified defect cross-sectional area indexed to body surface area, location in the muscular septum, presence of Down syndrome, and in membranous defects the presence of aneurysmal tissue as potential predictors of spontaneous closure or surgery. Multiple logistic regression analysis with these candidate variables identified indexed defect cross-sectional area as an independent predictor of spontaneous closure and surgery (p < 0.001). An inverse nonlinear relationship was seen between indexed VSD area and the probability of spontaneous closure (probability = (1 + e[-1.74 + 4.57CSA])-1 and a positive nonlinear relationship between indexed VSD area and the probability of surgery (probability = (1 + e[3.39 - 2.31CSA])-1). Muscular defects were more likely to close spontaneously than membranous defects (odds ratio 2.6, 95% CL = 1.01 - 6.8, p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)
Down Syndrome↗
Energy requirements from infancy to adulthood.
To investigate how age and body composition affect energy requirements, the sedentary daily expenditure (SDE) and basal metabolic rate (BMR) of 101 infants, 82 girls, and 27 adults were measured. Energy expenditure was scaled for differences in body size to test the effects of age and body fatness. A power function was superior to linear models. For all subjects, WT0.63 (where WT is weight) or FFM0.63 (where FFM is fat-free mass) explained 94% of the variability in BMR, and WT0.70 or FFM0.70 explained 97% of the variability in SDE. The effects of height and fat mass (kg or % body wt) on BMR and SDE scaled for weight or fat-free mass were age dependent. Best-fitted exponents relating BMR or SDE to body size differed between children (0.40-0.52) and infants (1.04-1.30) (P = 0.001). Human energy requirements from infancy to adulthood appear to be a power, not a linear, function of body weight and composition.
Adolescent↗
Influence of early feeding mode on body composition of infants.
To determine the effect of infant feeding mode on body composition, a cross-sectional study was designed in which 10 breast-fed and 10 formula-fed infants were studied at 1 month of age, and another 10 breast-fed and 10 formula-fed infants at 4 months of age. Anthropometric measurements included body weights, lengths, selected diameters, circumferences and skinfold thicknesses. Total body water (TBWO) was measured by 18O dilution. A dose equivalent to 300 mg 18O/kg body weight was administered orally to the infants. Fat-free mass (FFMO) was calculated from TBWO using reference hydration constants of 0.805 and 0.798 at 1 and 4 months, respectively. Body fatO was taken as the difference between weight and FFMO. Total-body electrical conductivity (TOBEC) measurements were used to estimate FFMT and FATT. ANOVA was used to analyze the anthropometric and body composition data using feeding mode and age as grouping factors. Anthropometric measurements did not differ by feeding mode. TBW (kg) and FFM (kg) and body fat (kg) derived from 18O dilution or TOBEC did not differ by feeding mode. TBWO,T (%wt), FFMO,T (%wt), and body fatO,T (%wt) derived from 18O dilution and TOBEC differed significantly between the breast-fed and formula-fed infants at 4 months of age (p < 0.05). Expressed as a percentage of body weight, TBWO and FFMO,T were higher and body fatO,T was lower among the 4-month formula-fed infants.
Adipose Tissue↗
Difference images calculated from ictal and interictal technetium-99m-HMPAO SPECT scans of epilepsy.
UNLABELLED: Image processing techniques were applied to SPECT brain images to aid in the localization of epileptic foci. METHODS: Ictal and interictal cerebral perfusion SPECT images were acquired from 12 epilepsy patients (6 temporal, 6 extratemporal) after injection of 20 mCi 99mTc-HMPAO. Each ictal scan was registered to the same patient's interictal scan. Normalization of the three-dimensional data was applied to account for global percent brain uptake and total injected activity. After registration, normalization and subtraction of the SPECT images and functional difference images were computed. Difference images were calculated, which give a quantitative measure of perfusion alterations during ictus. The resulting difference images were also registered with each patient's MRI scan which permits localization of perfusion changes onto anatomical structures. RESULTS: Areas in the brain where significant perfusion increases occur correlate with areas confirmed to be seizure foci. Four of the six patients with known temporal lobe seizure foci exhibited significant perfusion increases on the difference images. These areas demonstrate a percent increase of perfusion larger than 40%. For the extratemporal seizure patients, four of the four confirmed seizure sites were diagnosed with difference images. Results on the remaining two patients were inconclusive. CONCLUSION: When compared to side-by-side visual interpretation of the ictal and interictal SPECT images, registration of SPECT and MR images together with calculated difference maps greatly enhances the ability to localize epileptic seizure foci. This offers the potential to locate epileptic seizure foci using a noninvasive, inexpensive imaging procedure and data processing algorithm.
Adolescent↗
Computerized three-dimensional segmented human anatomy.
Manual segmentation of 129 x-ray CT transverse slices of a living male human has been done and a computerized 3-dimensional volume array modeling all major internal structures of the body has been created. Each voxel of the volume contains a index number designating it as belonging to a given organ or internal structure. The original x-ray CT images were reconstructed in a 512 x 512 matrix with a resolution of 1 mm in the x,y plane. The z-axis resolution is 1 cm from neck to midthigh and 0.5 cm from neck to crown of the head. This volume array represents a high resolution model of the human anatomy and can serve as a voxel-based anthropomorphic phantom suitable for many computer-based modeling and simulation calculations.
Computer Simulation↗
The epidemiology of Helicobacter pylori in Peruvian children between 6 and 30 months of age.
OBJECTIVES: Cross-sectional studies of children in developing countries show a high prevalence of Helicobacter pylori infection at 6 months of age, but a decrease in the prevalence of infection between 1 and 5 yr of age. The decrease suggests a loss or clearance of infection, an uncommon finding in adults. Our objective in this study was to determine the longitudinal persistence of H. pylori infection in young children. METHODS: We tested an initial cohort of 105 6-month-old infants at 6-month intervals with the 13C-urea breath test; 56 subjects were successfully studied for 2 yr or until 30 months of age. RESULTS: Overall prevalence decreased from 71.4% to 47.9% when children were between 6 and 18 months of age, and we found a significant gender difference (males 63.6-55.0%, females 80.0-38.7%, p = 0.03). Of the 56 subjects, six had negative breath tests at all 6-month intervals, 10 were consistently positive, and 36 subjects had one or more negative tests after a positive test. The overall probability of acquiring H. pylori in a given 6-month period ranged between 0.28 and 0.38; the probability of clearing the infection was between 0.22 and 0.45. During the first 18 months after birth, male infants were more likely to acquire H. pylori and less likely to clear the infection than female infants. CONCLUSION: We conclude that H. pylori colonization in infants may be a reversible process.
Breath Tests↗
Human biodistribution and dosimetry of the SPECT benzodiazepine receptor radioligand iodine-123-iomazenil.
UNLABELLED: SPECT imaging of the brain with [123I]iomazenil has shown avid uptake of the radioligand in a distribution consistent with benzodiazepine receptor binding. The purposes of this study were to measure the whole-body distribution of activity following i.v. administration of [123I]iomazenil and to evaluate the resulting organ radiation burdens. METHODS: Serial total body scans were obtained in healthy volunteers after thyroid blockade and demonstrated avid brain uptake of radioligand. RESULTS: Abdominal imaging showed significant activity retention within the urinary and gastrointestinal tracts consistent with excretion via these routes. Absorbed dose to the urinary bladder was calculated to be 0.19 mGy/MBq, to the lower large intestine 0.079 mGy/MBq, to the upper large intestine 0.066 mGy/MBq, and to the thyroid 0.063 mGy/MBq. CONCLUSION: Thyroid uptake may in part have represented binding to benzodiazepine receptors, since radioligand binding to tissue homogenates prepared from human thyroid showed the presence of benzodiazepine binding sites.
Adult↗
Whole-body biodistribution, radiation absorbed dose and brain SPECT imaging with iodine-123-beta-CIT in healthy human subjects.
UNLABELLED: SPECT imaging with 123I-labeled methyl 3 beta-(4-iodophenyl)tropane-2 beta-carboxylate ([123I]beta-CIT) in nonhuman primates has shown brain striatal activity, which primarily reflects binding to the dopamine transporter. The biodistribution and calculated radiation-absorbed doses of [123I]beta-CIT administered to eight healthy subjects were measured with attention to the accurate determination of organ time-activity data. METHODS: Whole-body transmission images were obtained with a scanning line source for attenuation correction of the emission images. Following administration of 92.5 +/- 22.2 MBq (2.5 +/- 0.6 mCi) of [123I]beta-CIT, subjects were imaged with a whole-body imager every 30 min for 3 hr, every 60 min for the next 3 hr and at 12, 24 and 48 hr postinjection. Regional body conjugate counts were converted to microcuries of activity, with a calibration factor determined in a separate experiment using a distributed source of 123I. RESULTS: The peak brain uptake represented 14% of the injected dose, with 2% of the activity approximately overlying the striatal region. Highest radiation-absorbed doses were to the lung (0.1 mGy/MBq, 0.38 rads/mCi), liver (0.087 mGy/MBq, 0.32 rads/mCi) and lower large intestine (0.053 mGy/MBq, 0.20 rads/mCi). CONCLUSIONS: Iodine-123-beta-CIT is a promising SPECT agent for imaging of the dopamine transporter in humans with favorable dosimetry and high brain uptake.
Adult↗
Structural organization of the bovine gene for the heart/muscle isoform of cytochrome c oxidase subunit VIa.
The bovine gene for the nuclear-encoded heart/muscle isoform of cytochrome c oxidase subunit VIa (COX6A1) was isolated from a library of bovine genomic DNA in lambda EMBL3 and sequenced. The gene spans 760 bp and comprises three exons and two small introns. Exon 1 encodes a 193 bp 5' untranslated region, a 12 amino acid presequence, and the first 12 amino acids of the mature COX VIa protein. Exon 2 encodes amino acids 13 to 58, and exon 3 amino acids 59 to 85 plus the 35 bp 3' untranslated region. Exons 2 and 3 are separated by a small intron of only 96 bp. All exon-intron boundaries matched the consensus splice junction sequences. COX6A1 transcripts are present in RNA from bovine heart but not brain. Primer extension and ribonuclease protection assays were used to map the 5' ends of COX6A1 transcripts in heart; both methods identified several clusters of transcription initiation sites, indicating that COX6A1 mRNA is heterogeneous at the 5' end. The proximal 5' flanking region is AT-rich and contains potential basal promoter elements, such as TATA and CCAAT boxes, associated with tissue-specific genes. A single consensus binding site for the muscle-specific transcription factor, MyoD1, was also located within this AT-rich region. The distal promoter region contained a perfect AP4 site plus potential binding sites for enhancer elements (NRF-1, Mt1, Mt3, and Mt4) proposed to regulate expression of genes for mitochondrial proteins.
Amino Acid Sequence↗
Growth failure in children with inflammatory bowel disease: a prospective study.
BACKGROUND: Growth failure frequently complicates the clinical course of inflammatory bowel disease (IBD) in children. This study was designed to investigate the role of disease activity versus steroid therapy on growth faltering in this disorder. METHODS: We studied growth failure and its relationship to disease activity and steroid therapy in 69 children who have IBD by prospectively monitoring height for a maximum of 3 years. Disease activity and steroid use were recorded at entry into the study. RESULTS: The prevalence of growth failure was 24%, 23%, and 39% by height velocity, Z score, and height-for-age criteria, respectively; deficits were equally prevalent regardless of the stage of pubertal development. A delay in linear growth persisted throughout puberty and was not reversed after surgery. Patients who had Crohn's disease were twice as likely to have growth abnormalities than patients who had ulcerative colitis. We detected significant negative associations between linear growth and disease activity but not steroid therapy. CONCLUSIONS: In a unique group of children, growth failure is an early, "prepatterned" manifestation of IBD. The inflammatory process, rather than steroid use, has a predominant influence on the development of growth faltering.
Administration, Oral↗
Hyperoxic lung injury in Fischer-344 and Sprague-Dawley rats in vivo.
Supplemental oxygen remains an important therapy for pulmonary insufficiency, despite the potential adverse effects of hyperoxic exposures. Recently, He et al. reported that hyperoxic ventilation more readily damaged isolated perfused lungs from Fischer-344 rats than from Sprague-Dawley rats (Am. J. Physiol. 259:L451), which correlates with the previously reported strain differences in hepatic responses to diquat-induced oxidant stress in vivo (J. Pharmacol. Exp. Ther. 235:172). We therefore examined the differences in hyperoxic lung injury in Fischer-344 and Sprague-Dawley rats in vivo. Adult male rats were exposed to > 95% O2 and were sacrificed after 24, 48, or 60 h. Control animals were maintained in room air. Dramatically greater increases in pleural effusions and bronchoalveolar lavage protein concentrations in response to hyperoxia were observed in the Fischer-344 rats than in the Sprague-Dawley rats (p < .05 at both 48 and 60 h for both measurements). Additionally, the glutathione concentrations in alveolar lining fluid decreased from 800 microM to 115 microM in Fischer-344 rats after 60 h of > 95% O2, but did not change in Sprague-Dawley rats. We conclude that the greater susceptibility of Fischer-344 than of Sprague-Dawley rats to hyperoxic lung injury in vitro reported previously also is observed in vivo and that this strain difference offers unique opportunities to study mechanisms of hyperoxic lung injury.
Animals↗
The effects of indomethacin and terbutaline on human fetal umbilical artery velocimetry: a randomized, double-blind study.
OBJECTIVE: Our purpose was to study the effects of indomethacin and terbutaline on umbilical artery impedance as measured by the systolic/diastolic ratio. STUDY DESIGN: Normal, low-risk patients at 26 to 32 weeks' gestation were enrolled. A baseline evaluation of the umbilical artery systolic/diastolic ratio was performed. The patients were then randomized to one of three groups and received a coded capsule that contained either terbutaline (5 mg), indomethacin (50 mg), or placebo. Repeat evaluation of the umbilical artery systolic/diastolic ratio was performed 4 hours later. The ratios before and after administration of the medication were compared in the control and study groups. Analysis of variance and paired Student t test were applied. RESULTS: Fifteen patients received indomethacin, 14 placebo, and 12 terbutaline. Pretreatment and posttreatment systolic/diastolic ratios were 3.2 and 3.1 for the indomethacin group, 3.2 and 3.3 for the placebo group, 3.0 and 2.8 for the terbutaline group, respectively. The changes in the systolic/diastolic ratio in the indomethacin and terbutaline groups, as compared with the placebo group, were not found to be significant. CONCLUSION: Terbutaline and indomethacin do not have a significant effect on the human umbilical artery impedance as measured by the systolic/diastolic ratio.
Diastole↗
Higher total energy expenditure contributes to growth faltering in breast-fed infants living in rural Mexico.
To investigate the energy requirements of infants living under unfavorable environmental conditions in rural Mexico, we measured the total energy expenditure (TEE) of 40 Otomi infants at approximately 4 or approximately 6 mo of age. Total energy expenditure was estimated by the doubly labeled water method: 100 mg 2H2O/kg and 250 mg 18O/kg were administered orally, after which urine was collected serially for 7 or 10 d. Isotopic enrichment of urine samples was analyzed by gas-isotope-ratio mass spectrometry. Weight and length were measured monthly from birth to 6 mo. Fat free mass was estimated from 18O dilution spaces. Total energy expenditures (mean +/- SD) were 310 +/- 58 and 318 +/- 29 kJ.kg-1 x d-1 at approximately 4 and approximately 6 mo, respectively. Total energy expenditure was higher than that previously observed for breast-fed infants reared under more protected environments (268 +/- 29 kJ.kg-1 x d-1). Weight, length and weight gain were 5.9 +/- 0.8 kg, 60 +/- 2 cm and 2.9 +/- 2.4 g.kg-1 x d-1 at 4.25 mo and 7.1 +/- 0.8 kg, 65 +/- 2 cm and 1.0 +/- 1.2 g.kg-1 x d-1 at 6.27 mo. Growth faltering was evident at 6 mo by clinically significant declines in growth velocities and National Center for Health Statistics Z-scores. Body fat of the Otomi infants averaged 21 +/- 6 and 18 +/- 5 g/100 g at approximately 4 and approximately 6 mo, respectively. Higher rates of TEE narrowed the margin of energy available for growth and thereby contributed to growth faltering in the Otomi infants.
Adolescent↗
Lack of effect of clinical research protocol participation on morbidity measures in human immunodeficiency virus-infected children.
Explore the source record for details and available documents.
Adolescent↗
Fatal occupational injuries in the New Jersey construction industry, 1983 to 1989.
Work in the construction industry involves about a threefold increased risk of fatal injury compared with all industries combined. The purpose of this study was to identify potential risk factors for fatal injury in the construction industry in New Jersey. Multiple data sources including death certificates, medical examiner reports, Occupational Safety and Health fatality files, and Workers' Compensation reports were used to identify 200 construction-related fatalities in New Jersey during the years 1983 to 1989. All deaths were in men. The death rate was 14.5 per 100,000 employed person-years over the study period. Death rates tended to diminish with increasing age after 34 until age 65 when the death rate was the highest (27.7). Death rates were higher for Hispanics (34.8) and African-Americans (24) than whites (10.6). Ironworkers and roofers had highest rates (109.0 and 56.2, respectively) among specific occupational groups within the construction industry. The leading cause of death was falls (46%). These data suggest that intervention efforts directed toward workers at heights is needed. Further research is warranted to elucidate the factors contributing to the elevated fatality rate of workers over age 65, and to Hispanic and African-American workers.
Accidents, Occupational↗