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Biomedical subjects

F S Sherman

Publications and source records attributed to F S Sherman.

At least 19 recordsLinked to original sources
PubMed2001

Use of terbutaline in the treatment of complete heart block in the fetus.

Between 1989 and 2000, 21 fetuses were diagnosed with complete atrioventricular block. Seven women with fetal ventricular rates of less than 60 were given oral terbutaline, and 6 of these had an initial increase in the fetal ventricular rate. Four fetuses (57%) maintained an increased average rate of 60 beats per minute and survived. Two fetuses returned to rates below 55 and died. The final fetus, with hypertrophic cardiomyopathy, was unresponsive. Terbutaline, therefore, is initially effective in raising the fetal ventricular rate, but this effect may be transient.

Adrenergic beta-Agonists↗
PubMed1997

Cardiovascular reactivity to stress and left ventricular mass in youth.

We studied the relationships of cardiovascular reactivity during mental stress with left ventricular mass index in a group of prepubertal children 8 to 10 years old and in a group of peripubertal or postpubertal adolescents 15 to 17 years old. One hundred fifteen participants, varying in age group, sex, and race (black and white), took part in a laboratory stress protocol consisting of a reaction-time task, a mirror tracing task, a cold forehead challenge, and a stress interview. Cardiovascular measures included blood pressure and heart rate, as well as cardiac output, stroke volume, total peripheral resistance, and preejection period obtained noninvasively with impedance cardiography. Measures of left ventricular mass were made by echocardiography. Results indicated that across all participants, left ventricular mass index was associated with cardiovascular responses during the mirror tracing and cold forehead tasks, especially with those responses reflecting increased vasoconstriction. Subgroup analyses showed that these associations were significant for males and sometimes adolescents but not for females and children. As mirror tracing and cold forehead tasks most consistently produce alpha-adrenergic activation, the results suggest a model in which vasoconstriction due to mental stress is related to increased left ventricular mass in susceptible individuals, even at a young age.

Adolescent↗
PubMed1993

Hypertrophic cardiomyopathy associated with dexamethasone therapy for chronic lung disease in preterm infants.

To assess whether long-term dexamethasone therapy for chronic lung disease (CLD) in infancy is associated with any deleterious cardiac structural effects, we conducted a retrospective review of all preterm infants with CLD born between October 1, 1989, and October 1, 1990, who had serial echocardiographic data available. These infants were divided into three groups based on the length of their exposure to dexamethasone. Group 1 contained nine infants with CLD who did not receive dexamethasone. Group 2 was comprised of six infants who received dexamethasone for less than 8 days. Group 3 contained one infant who received a 26-day course, and 13 infants who received at least one 42-day course of dexamethasone for CLD. Left ventricular hypertrophy was noted in 8 of 14 (57%) infants in group 3; hypertrophy usually was noted near the end of the treatment course. Five of these eight affected infants died; the hypertrophic cardiomyopathy was considered to have contributed to mortality in three of these five infants. Regression of the hypertrophy was noted in the three surviving infants in group 3 after the dexamethasone course was completed. We speculate that prolonged dexamethasone treatment for CLD is associated with hypertrophic cardiomyopathy in a significant portion of preterm infants.

Cardiomyopathy, Hypertrophic↗
PubMed1990

Totally anomalous pulmonary venous connection in an infant with tricuspid atresia.

The occurrence of tricuspid atresia in association with totally anomalous pulmonary venous connection is a rare one. This combination has been described in the literature only twice previously. Such a case is presented with special regard to the therapeutic options and the need for cardiac catheterization.

Cardiac Catheterization↗
PubMed1989

Elucidation of the natural history of ventricular septal defects by serial Doppler color flow mapping studies.

Two-dimensional echocardiography has provided information to aid in the diagnosis and management of infants with ventricular septal defect, but its inability to resolve very small ventricular septal defects and problems with defining ventricular septal defect orifice size (because of overlying muscle or tricuspid tissue) have made it unsuitable as a standard for defining the natural history of ventricular septal defect. In this study, 114 serial two-dimensional Doppler color flow mapping studies were performed to define ventricular septal defect anatomy, location and color flow diameter as an indicator of shunt size in 66 patients (over a 40 month period). Twenty-five patients first studied at 6 months of age (mean age at most recent study 15.9 months) had congestive heart failure and 41 (mean age 45 months) did not. In the congestive heart failure group, there were 24 perimembranous and 1 muscular ventricular septal defect and aneurysm formation was present in 17. Mean (+/- SD) color flow diameter was 8.2 +/- 1.9 mm and color flow diameter/aortic root diameter ratio was 0.63. In the 30 patients who underwent cardiac catheterization, color flow diameter bore a close relation to angiographic diameter (r = 0.96) and pulmonary/systemic flow ratio (Qp/Qs) (r = 0.88). In the patients with congestive heart failure, 4 of the 25 ventricular septal defects, all with aneurysm present or positioned adjacent to the tricuspid valve, became smaller but none closed. Of the 41 patients without congestive heart failure, 21 had a perimembranous defect (15 with aneurysm), 18 had a muscular ventricular septal defect and 2 had a supracristal ventricular septal defect.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗
PubMed1988

Cine magnetic resonance imaging for evaluation of congenital heart disease: role in pediatric cardiology compared with echocardiography and angiography.

Cine magnetic resonance imaging was used for preoperative and postoperative evaluation of 91 patients with congenital heart disease. Their ages ranged from 6 weeks to 14 years. The quality of study was excellent in 81% of the cases, in which it provided complete documentation of diagnostic features; substantial diagnostic information was provided in another 14%, and the study was nondiagnostic in only 5%. This technique was most useful for evaluating areas of the right ventricle (95%), great arteries (95%), vena cava (94%), and pulmonary venous system (91%). The anatomic delineation of these areas was comparable to that obtained by cineangiography and was superior to echocardiography, especially in postoperative patients. For complex venous anomalies, magnetic resonance imaging provided better anatomic details than did angiography or echocardiography. The capability of multiplanar imaging allows complex angled views through the desired planes of the heart and great vessels. Proper sedation is essential to obtain maximum diagnostic information. Our preliminary experience suggests that this new modality provides excellent anatomic information in infants and children with congenital cardiac defects and will play an increasing role in pediatric cardiac diagnosis.

Adolescent↗
PubMed1988

Color Doppler flow mapping in patients with coarctation of the aorta: new observations and improved evaluation with color flow diameter and proximal acceleration as predictors of severity.

We performed color Doppler flow mapping in 15 patients, 1 week to 17 years old (mean 42 months), with coarctation of the aorta that was confirmed subsequently by angiography and/or surgery. Twelve patients had native coarctation and three had mild recoarctation after surgical repair. Color Doppler flow maps were analyzed with a digital analysis package and a Sony computer system. The diameter in the region of coarctation from the color Doppler flow map (mean = 2.0 +/- 0.8 mm [SD]) correlated well with the coarctation diameter measured at angiography (mean = 1.8 +/- 0.8 mm; r = .83, SEE 0.43 mm) in the 10 patients with native coarctation undergoing angiography, but the coarctation diameter measured by two-dimensional echocardiography (3.9 +/- 1.5 mm) was poorly predictive of the angiographic severity (r = .23). Additionally, spatial acceleration was seen in all patients proximal to the coarctation site, with an aliased and accelerating stream narrowing progressively as it proceeded toward the coarctation site, a pattern that is not seen in healthy subjects. Computer analysis of the color Doppler images provided pseudo three-dimensional and digital velocity maps for blue, red, and green (turbulent) flow velocities to allow an enhanced appreciation of the accelerating stream, easily separating this from normal descending aortic aliasing patterns. The narrowing of the acceleration area in the proximal descending aorta (distal/proximal acceleration zone ratio) was also predictive of the angiographic severity of coarctation (r = .83). The distribution of low-level turbulence seen proximally paralleled the distribution of the proximal accelerating stream.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1988

Cine magnetic resonance imaging for evaluation of anatomy and flow relations in infants and children with coarctation of the aorta.

Sixteen cine magnetic resonance imaging (MRI) studies were performed in 14 patients aged 1 week to 17 years (mean age, 46 months), who had coarctation of the aorta confirmed at angiography or surgery. Conventional echocardiographic-gated MRI was first performed in axial and rotated sagittal views and was used to identify the slice locations for cine MRI. Cine MRI was performed by gradient-recalled acquisition in steady state with a 30 degree flip angle, 12-msec echo time, 22-msec pulse repetition time, and a 128 x 256 acquisition matrix. Coarctation anatomy was extremely well defined in all but one patient who had vascular clips at the coarctation repair site. The smallest descending aortic flow diameter on cine MRI showed excellent agreement with angiography (r = 0.90). Lucent jets of high-velocity flow through the site of coarctation were imaged in eight patients, and jet length correlated well with the angiographic severity of coarctation (r = -0.81). Two patients were restudied after surgery, and they exhibited excellent repair and normal flow patterns. Cine MRI provides high-resolution imaging of coarctation anatomy with a dynamic spatial and temporal visualization of flow and with excellent detail of vascular anatomy and flow both proximal and distal to the coarctation.

Adolescent↗
PubMed1987

Pediatric Doppler echocardiography 1987: major advances in technology.

The major advances in the capabilities of pediatric cardiologists to evaluate the heart by ultrasound that have occurred in the last 5 years have been reviewed. In addition to the new Doppler methods, the evolution of higher resolution echo techniques have provided a comprehensive means of evaluating the heart noninvasively. This information has relegated catheterization to a more therapeutic arena, leaving ultrasound as the major diagnostic technique for evaluation of congenital heart disease, both before and after birth.

Child↗
PubMed1987

Two-dimensional Doppler color flow mapping for detecting atrial and ventricular septal defects. Studies in an animal model and in the clinical setting.

In experimental studies in six dogs as well as in clinical studies in eleven patients with atrial septal defect and 27 patients with ventricular septal defect, the diagnostic usefulness of color Doppler echocardiography in detection of small septal defects and multiple defects was analyzed. The study showed that atrial or ventricular septal defects with a size of 2.5 to 3 mm or more, which eluded detection with two-dimensional echocardiography, were easily identified with the color Doppler method. Additionally, multiple defects were reliably demonstrated. In atrial septal defects, according to the results of this study, the shunt area in the color Doppler image enables a semiquantitative estimation of the shunt volume.

Adolescent↗
PubMed1986

Real-time Doppler color flow mapping for detection of patent ductus arteriosus.

In this study, ultrasound Doppler color flow mapping systems were utilized to examine flow in the pulmonary artery in 31 premature and term infants (aged 4 hours to 9 months) with patent ductus arteriosus accompanying respiratory distress syndrome, as an isolated lesion, or with patent ductus in association with other cyanotic or acyanotic congenital heart disorders. The flow mapping patterns were compared with those of a control population of 15 infants who did not have patent ductus arteriosus. In unconstricted ductus arteriosus, the flow from the aorta into the pulmonary artery was detected in late systole and early diastole and was distributed along the superior leftward lateral wall of the main pulmonary artery from the origin of the left pulmonary artery back in a proximal direction toward the pulmonary valve. In constricted patent ductus arteriosus, or especially in a ductus in association with cyanotic heart disease, the position of the ductal shunt in the pulmonary artery was more variable, often directed centrally or medially. Waveform spectral Doppler sampling could be performed in specific positions guided by the Doppler flow map to verify the phasic characteristics of the ductal shunt on spectral and audio outputs. Shunts through a very small patent ductus arteriosus were routinely detected in this group of infants, and right to left ductal shunts could also be verified by the Doppler flow mapping technique. This study suggests substantial promise for real-time two-dimensional Doppler echocardiographic flow mapping for evaluation of patent ductus arteriosus in infants.

Blood Flow Velocity↗
PubMed1986

Calcification of subcutaneously implanted type I collagen sponges. Effects of formaldehyde and glutaraldehyde pretreatments.

Although collagen-containing implants are widely used in various surgical applications, there has been relatively little attention paid to the possibility that this type of biomaterial may undergo pathologic calcification which could compromise its function. The present study reports for the first time the calcification of a series of implants of purified collagen sponges prepared with graded degrees of aldehyde-induced cross-linkages (assessed by shrinkage-temperature, wetting time, and collagenase digestibility). Type I collagen sponges were pretreated with either glutaraldehyde (0.1% to 2.0% aqueous solution, for 5-180 minutes) or formaldehyde (as vapors for 15 minutes to 15 hours), and implanted subcutaneously for 21 days in weanling rats. Although specimens not pretreated with either aldehyde reagent and the formaldehyde sponges pretreated for 15 minutes were resorbed without evidence of calcification, all other aldehyde-pretreated implants mineralized. The degree of calcification did not correlate with extent of cross-linking. Formaldehyde-pretreated implants calcified more extensively (Ca2+ = 87.8 +/- 2.8 micrograms/mg, mean +/- standard error of the mean; n = 58) than did glutaraldehyde-pretreated implants (Ca2+ = 40.9 +/- 1.4 micrograms/mg; n = 52). It is concluded that both glutaraldehyde- and formaldehyde-pretreated Type I collagen sponges calcify after subdermal implantation in young rats. Although aldehyde pretreatment of Type I collagen sponge implants is a prerequisite for their eventual mineralization, the threshold level of aldehyde-induced cross-linking required to potentiate their maximal pathologic calcification is low.

Aldehydes↗
PubMed1983

Studies on metatherian sex chromosomes. XII. Sex-linked inheritance and probable paternal X-inactivation of alpha-galactosidase A in Australian marsupials.

An investigation of genetic variation in the electrophoretic mobility of the enzyme alpha-galactosidase A (EC 3.2.1.22) has been carried out for 33 species of Australian metatherian (marsupial) mammals. The results are compatible with the enzyme being sex-linked in macropodids (kangaroos and wallabies) and probably in dasyurids (marsupial 'mice', etc.), as it is in eutherian (placental) mammals. The results also suggest that the mode of dosage compensation for this locus is the same as for other sex-linked loci in kangaroos, i.e. paternal X inactivation, rather than the random X inactivation system of eutherian mammals. The bearing of the enzyme mobility data on phylogenetic relationships among macropodid species is discussed.

Animals↗