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Biomedical subjects

H King

Publications and source records attributed to H King.

At least 73 records · Page 4Linked to original sources
PubMed1990

Cor triatriatum: clinical presentation and surgical results in 12 patients.

Twelve patients with cor triatriatum have been seen at our institution since 1979. The clinical presentation, diagnostic evaluation, and surgical results are outlined in this retrospective review. Operation is the treatment of choice for this rare congenital cardiac defect. One patient died 1 day before scheduled operation, and 2 patients died postoperatively, yielding a surgical mortality rate of 17% and an overall mortality rate of 25%. Resection of the obstructing atrial membrane was performed using hypothermic cardiopulmonary bypass in all cases. Left atriotomy was performed in 6 patients, and right atriotomy was performed in 7. The two postoperative deaths occurred in patients who had serious associated cardiac defects. Associated anomalies include atrial septal defect, persistent left superior vena cava, and partial anomalous pulmonary venous return. The postoperative course has been excellent in all 9 surviving patients; all remain asymptomatic. Cor triatriatum is amenable to surgical repair with excellent results when diagnosed early and when not complicated by other severe cardiac anomalies.

Child, Preschool↗
PubMed1990

Congenital aneurysm of the left atrial wall in infancy.

A 5-month-old male infant with congenital left atrial aneurysm is reported. The youngest patient previously reported was 2 1/2 years old. This case is unusual because the patient was an infant and because of the degree of mitral insufficiency and acute cardiac decompensation observed in the patient.

Heart Aneurysm↗
PubMed1990

Effect of omental, intercostal, and internal mammary artery pedicle wraps on bronchial healing.

Bronchial transection and devascularization is necessary in the course of sleeve resection or lung transplantation, leaving distal bronchial segments ischemic and subject to stricture or dehiscence. Thirty mongrel dogs underwent left lung autotransplantation. The bronchial anastomosis was wrapped with omentum (n = 9), intercostal muscle pedicle (n = 9), or internal mammary artery pedicle grafts (n = 6). Six control animals underwent bronchial anastomosis without an external wrap. Bronchial revascularization by capillary ingrowth from the pedicle to the bronchial submucosal plexus was demonstrated with all three types of vascular pedicle grafts; however, more consistent and confluent vascular ingrowth was provided by internal mammary artery pedicle grafts. Additionally, the bronchial anastomotic cross-sectional area was significantly better in the internal mammary artery group (84.5 +/- 3.3) as compared with that of the omental (68.4 +/- 8.3), intercostal muscle (66.9 +/- 10.9), or control groups (70.2 +/- 7.6). An internal mammary artery pedicle graft and the presence of dense confluent submucosal vascular ingrowth from any pedicle graft were independently predictive (p less than 0.05) of minimizing bronchial anastomotic narrowing. These data are consistent with previous findings suggesting that omental and intercostal muscle pedicle grafts promote early bronchial revascularization; moreover, the data demonstrate the superiority of an internal mammary artery pedicle graft to provide submucosal vascular ingrowth and to minimize anastomotic stenosis.

Anastomosis, Surgical↗
PubMed1990

Plasma glucose and insulin responses in young Papua New Guineans (aged 10-19 years).

A study of rural and periurban children aged 10-19 years in the Tolai population of Papua New Guinea has demonstrated a higher average plasma glucose concentration and relative hyperinsulinaemia after an oral glucose challenge in the periurban group. The findings could not be explained by differences in age or adiposity. In the rural children, plasma insulin concentration remained consistently low throughout the range of glucose tolerance, indicating a high degree of insulin sensitivity. In the periurban children there was a marked increase in plasma insulin concentration with increasing plasma glucose concentration, possibly suggesting the development of insulin resistance, or an antecedent state, and incipient glucose intolerance. In view of the potential public health implications of these findings, further ecological studies of insulin response in children and adolescents would appear warranted. These should include appropriate measures of pubertal development, which is a possible confounding factor not addressed in the present study, as well as addressing the role of nutritional factors.

Adolescent↗
PubMed1989

Insulin-treated diabetes in Tasmania: population-based clinical characteristics and their possible implications for diabetic health care in Australia.

The Tasmanian Insulin-treated Diabetes Register recruited 1233 eligible (treatment with insulin on May 1, 1984) subjects with insulin-treated diabetes, which enabled the description of a population-based profile of clinical characteristics. Approximately one-third of both the male and female subjects who were recruited was considered to have insulin-dependent diabetes mellitus. As would be expected, subjects with insulin-dependent diabetes mellitus were considerably younger, had a longer average duration of disease, and had had fewer hospital admissions compared with subjects with non-insulin-dependent diabetes mellitus. However, in some cases, both forms of diabetes were of long duration and had resulted in multiple hospital admissions. More than 90% of subjects with insulin-dependent diabetes mellitus and approximately half the subjects with non-insulin-dependent diabetes mellitus were hospitalized at diagnosis; an absence of a secular trend in diabetes-stabilization practices was noted, which suggested a low utilization of facilities for ambulatory stabilization in Tasmania to date. To monitor metabolic control, approximately half the subjects performed self-monitoring of their blood glucose levels exclusively, which indicated the widespread acceptance of this form of evaluation (which has been introduced into Australia only within the past decade). Approximately one-quarter of the subjects continued to perform urine testing exclusively and a small proportion of subjects did not monitor their metabolic control in any way.

Adolescent↗
PubMed1989

Glucose tolerance in Papua New Guinea: ethnic differences, association with environmental and behavioural factors and the possible emergence of glucose intolerance in a highland community.

That Melanesians of non-Austronesian genetic ancestry may be relatively resistant to glucose intolerance was supported by the results of a study of two semitraditional non-Austronesian villages in the Papua New Guinean highlands in 1983, in which an absence of diabetes and a high degree of glucose tolerance and insulin sensitivity were observed. The second of this series of surveys was conducted in 1985 in three non-traditional communities: a periurban, non-Austronesian village in the highlands, and rural and periurban Austronesian villages in coastal locations. Although an absence of diabetes was demonstrated once again in the highlanders, these periurban subjects showed an unexpectedly high insulin response which may be a precursor of glucose intolerance. The notion that highland communities that are living in non-traditional circumstances in Papua New Guinea presently are in "metabolic transition" towards diabetes and other non-communicable diseases, if correct, is of importance to the public health of the nation. In the periurban, coastal-dwelling Austronesians, diabetes with severe hyperglycaemia was demonstrated, and there was some evidence of a secular trend towards increasing glucose intolerance. The two-hour plasma glucose concentrations were shown to be associated with obesity, modernity and Seventh-Day Adventist religious persuasion. However, important and unexplained differences in glucose tolerance remained between rural and periurban coastal dwellers after taking these factors into account.

Adult↗
PubMed1989

A prospective single-blind trial of minocycline and doxycycline in the treatment of genital Chlamydia trachomatis infection in women.

A total of 2124 women who attended the Richmond Family Planning Association Clinic in Melbourne consecutively were screened for the presence or absence of Chlamydia trachomatis. One hundred and three women were found to have Chl. trachomatis infection of the cervix and were invited to participate in a clinical trial of minocycline and doxycycline for the treatment of chlamydial infection. A 10-day course of either drug resulted in a negative result of a chlamydial culture for all patients at the follow-up assessment, which occurred between 11 days to 12 weeks after the therapy. Minocycline and doxycycline showed equal effectiveness in the eradication of mycoplasmas in over 80% of the treated patients. Minocycline appeared to have a slight advantage with respect to the resolution of the gynaecological symptoms that were associated with the chlamydial infection. The number of adverse events that were recorded during the trial was similar for both treatment regimens. Gynaecological symptoms were associated with chlamydial infection in approximately 50% of the women in the study. The lack of association between chlamydial infection and gynaecological symptoms has led to the instigation of routine testing for the presence of Chlamydia spp. in young women who have more than one sexual partner.

Adult↗
PubMed1989

Clinical and hemodynamic course of infants and children with anomalous left coronary artery.

The clinical history of all 17 patients with anomalous left coronary artery presenting over the last 20 years was studied, with special emphasis on those who underwent reimplantation of the anomalous coronary artery into the aorta, a procedure that became our "treatment of choice" during this period. These patients were also evaluated for ventricular performance, residual mitral regurgitation, and wall integrity. Early in our experience with reimplantation, two patients died while we waited for them to achieve a more favorable size for surgery. Eight of nine survived reimplantation; three of these were under 1 year of age when operated upon. One of these eight patients has required additional mitral valvuloplasty, but all are doing well clinically up to 12 years after operation. Preoperative left ventricular ejection fraction of 0.37 +/- 0.16 increased to 0.67 +/- 0.07 (p less than 0.001) by 1 year after surgery, despite ventricular wall abnormalities in four patients. Thus reimplantation of the anomalous left coronary artery should be undertaken upon diagnosis, since surgery can be performed successfully in infancy, with resultant improvement in ventricular function and an adequate clinical condition for at least 12 years.

Adolescent↗
PubMed1989

An assessment of the dual-analyte enzyme immunoassay for ovulation timing.

In a search for simpler, more efficient methods of monitoring ovulatory function, either to assist in the investigation of the infertile couple or for contraceptive or fertility control purposes, a number of new methods have been developed. One of these, the OVEIA dual-analyte system is now available for laboratory use. The principle behind the system is the simultaneous measurement of urinary oestrone-glucuronide and pregnanediol-glucuronide. The resultant signal is quantified using an enzymatic photometric endpoint denoted by the relative absorbance (RA%). The application of the OVEIA system to the monitoring of urine samples over the periovulatory period in ovulatory and non-ovulatory cycles from regularly cycling but infertile women is described and the changes in RA% compared with synchronously measured changes in plasma LH and plasma oestradiol concentrations, salivary progesterone profiles and measurements of follicular volume. It is concluded that the OVEIA system is simple and quick to perform and the results obtained compare reasonably well with equivalent direct and indirect indicators of impending ovulation (e.g. increasing plasma oestradiol concentrations or changes in the volume of the follicle). However, as is the case with other endocrine methods, definitive information about the presence or absence of follicular rupture cannot be obtained.

Adult↗
PubMed1989

Family resemblance for glucose tolerance in a Melanesian population, the Tolai.

Path analysis of family resemblance for plasma glucose concentration, 2 h after an oral glucose challenge, failed to detect significant genetic heritability. There were no intergenerational differences and marital resemblance was moderate. Over one-third of sibling environmental similarity was due to non-inherited factors. Cultural inheritance was very strong, tending to mimic genetic inheritance, and cultural heritability was considerable. Measures of obesity were included in the environmental index, an estimate of familial environment, in this analysis, for comparability with previous studies. Since obesity appears, in part, to be a heritable trait, in future studies a bivariate approach to family resemblance for both glucose tolerance and obesity could yield important additional insight.

Adolescent↗
PubMed1989

A modernity score for individuals in Melanesian society.

Assessment of individual modernity has considerable implications for the prevention of non-communicable disease in high-risk populations experiencing rapid modernization. A scoring system for the classification of the relative modernity of individuals in Melanesian society is described. The score consisted of eight components relating to area of origin, employment, length of employment, father's employment, education, years spent in an urban centre, housing and an increment determined by the score of the spouse of the individual. The score was used in surveys of non-communicable disease in Papua New Guinea in 1985 and was validated, in one of the three communities studied, by the independent assessment of two local informants. With the use of analysis of variance and linear regression, the score was shown to be associated with obesity in both sexes. An association was also shown with age by both techniques in females. In males, age and glucose tolerance were associated with the score when using analysis of variance, but not when applying linear regression. Only three components, father's employment, education and the spouse increment proved useful when the score was used as the dependent variable in the linear regression equation. The utility of the other components may have been constrained by the narrow distribution of their scores in the populations studied.

Adult↗
PubMed1988

Prevalence of ischaemic ECG abnormalities according to the diabetes status in the population of Fiji and their associations with other risk factors.

The prevalence of ECG abnormalities indicating the presence of coronary heart disease was examined in the Melanesian (444 men and 457 women) and Asian Indian (408 men and 435 women) population living in Fiji. The aim of the present analysis was to determine the levels of coronary risk factors in people with diabetes, impaired glucose tolerance (IGT) or normal glucose tolerance. The prevalence of ECG abnormalities suggesting coronary heart disease (Q-waves, ST-depression or T-wave changes) was higher among women than men and among Asian Indians than Melanesians. The prevalence of ECG abnormalities was highest in diabetic subjects, intermediate in people with IGT and lowest in people who had normal glucose tolerance. People with IGT were more likely than others to have high risk factor levels. In people with IGT the increased levels of other coronary risk factors might explain a great deal of the increased prevalence of the ECG abnormalities as compared with the prevalence in those with normal glucose tolerance. Also in diabetic subjects, the levels of other coronary risk factors were increased in those who had ECG abnormalities, but not more than was the case with IGT, so that diabetes itself seemed to remain as the major identified risk factor for ECG abnormalities. The prevalence of diabetes in our study populations, especially in Asian Indians, was very high. This suggests that diabetes is the major risk factor for coronary heart disease in such populations.

Black People↗
PubMed1988

Glucose tolerance in Polynesia: association with obesity and island of residence.

Data on five Polynesian populations, obtained by standardized population surveys conducted during the years 1978-1980, were examined for associations between glucose tolerance and both obesity and island of residence. In both sexes, after allowing for the influence of age and obesity, there was a significant difference in glucose tolerance between the three populations considered, subjectively, to be the less traditional and the two considered as retaining a more traditional lifestyle. Regression models predicting diabetic status were weaker than those using glucose tolerance as the dependent variable, probably due to the small number of diabetic subjects in the samples. As all subjects were of Polynesian ancestry, and the results could not be explained by knowledge of ancestral affiliations between the five populations, environmental, rather than genetic factors may have been the determinants of the observed differences in glucose tolerance. This finding highlights the need for a more sophisticated approach to the study of the association between socio-cultural modernization and chronic disease in the Pacific.

Adult↗