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Biomedical subjects

H King

Publications and source records attributed to H King.

At least 109 records · Page 6Linked to original sources
PubMed1987

Health effects of migration: U.S. Chinese in and outside the Chinatown.

Previous studies on the health effects of migration at the international level have seldom been directed to those concentrated in segregated enclaves. This study hypothesizes that in spite of the known deviations in certain demographic and socioeconomic characteristics of Chinatown (San Francisco-New York City) residents from the US Chinese population, no consistent relationship seems to exist between these attributes and health risks, as reflected in the mortality levels of the 2 populations. A convergence in mortality was observed for a noticeable number of causes of deaths, with but a few disease-cause sets of non-convergence with statistical significance. The study results were interpreted in terms of varying degrees of acculturation experience.

Acculturation↗
PubMed1987

Pathogenesis of aneurysm formation opposite prosthetic patches used for coarctation repair. An experimental study.

Patch graft angioplasty for coarctation repair has been associated with late aneurysm formation opposite the prosthetic patch in some patients. Etiologic possibilities for this aneurysm formation include congenital abnormality of the aortic wall, surgical interruption of the vasa vasorum, intimal disruption because of extensive excision of the coarctation web, and rigidity of the prosthetic patch. To assess the effect of extensive intimal excision on the development of aneurysms, we operated on 12 dogs, performing a left thoracotomy and aortoplasty with Dacron (n = 6) or polytetrafluoroethylene patches (n = 6) and concomitant intimal excision opposite the patch. Ten control dogs underwent angioplasty with Dacron (n = 5) and polytetrafluoroethylene patches (n = 5) without excision of the intima. Serial aortograms of all animals showed aneurysm formation of the aorta opposite the patch in eight of the 12 dogs undergoing intimal excision. In contrast, no aneurysms developed in the control dogs (p less than 0.001). An additional five dogs underwent longitudinal aortotomy, intimal excision, and primary closure. Three dogs in this group demonstrated an aneurysm angiographically (p less than 0.02). Histologic analysis of the aneurysms and the control aortas revealed hyperplastic ingrowth of the intima over the denuded surface in the animals undergoing intimal excision. The elastic fibers in the media were intact and organized except in two aneurysmal specimens. We conclude that extensive resection of the intima with or without patch angioplasty predisposes aneurysm formation opposite the aortotomy and should be avoided during coarctation repair.

Animals↗
PubMed1987

Hyperplastic and neoplastic alterations in the livers of white perch (Morone americana) from the Chesapeake Bay.

White perch (Morone americana) sampled from 15 estuaries of the Chesapeake Bay contained a variety of hyperplastic and neoplastic alterations in their livers. The lesions were derived from bile ductular epithelium and/or hepatocytes. The biliary lesions consisted of hyperplasias and adenomas. The hepatocellular lesions consisted of focal populations of altered cells and neoplasms, of clear-cell and basophilic morphologic appearance. The hepatocellular lesions were conspicuous in the absence of the decreased amount of copper accumulation. In this respect, the cells comprising these lesions are reminiscent of cells from hepatocellular neoplasia in mice and rats resistant to accumulation of iron.

Adenoma↗
PubMed1987

Immunoproliferative small-intestinal disease: clinical features and outcome in 30 cases.

Experience with 30 patients with immunoproliferative small intestinal disease followed prospectively between 1971 and 1986 is described. All presented with malabsorption or growth retardation and had similar clinical, biochemical, and radiological features, irrespective of the presence of lymphoma or immunological abnormality. Alpha-chain disease protein was detected in 4 of the 11 patients who had a non-lymphomatous, predominantly plasmacytic infiltration of the small bowel; and in 5 of the 19 cases with diffuse intestinal lymphoma. The importance of exploratory laparotomy to include full-thickness intestinal biopsy in patients who have a benign infiltrate on peroral biopsy is demonstrated by the finding of lymphoma in operative specimens in 9 of 15 patients with mature, lymphoplasmacytic cells, and 5 of 8 patients with atypical, lymphoplasmacytic cells. The majority of patients with fully established benign disease, even those elaborating alpha-chain disease protein, appeared to have a good prognosis. No patient with immunoproliferative small intestinal disease developed immunologically demonstrated alpha-chain disease or frank lymphoma, when this was not found initially at explorative laparotomy.

Adolescent↗
PubMed1986

Glucose tolerance in Polynesia. Population-based surveys in Rarotonga and Niue.

Glucose tolerance and the prevalence of impaired glucose tolerance (IGT) and diabetes in the Polynesian populations of Rarotonga and Niue were studied in 1980. Both Rarotongans and Niueans have been considerably influenced by sociocultural modernization and (in the case of Rarotonga) tourism. In both populations, the prevalence of abnormal glucose tolerance exceeded 10% in men and 15% in women. There was an association between glucose tolerance and age and obesity in both sexes, but not between glucose tolerance and physical activity. Glucose tolerance did not differ between Rarotongans and Niueans after allowing for differences in age and obesity. Comparisons between normal subjects, those with impaired glucose tolerance (IGT) and diabetic subjects with respect to factors that are traditionally associated with glucose intolerance provided some support for IGT as a truly intermediate diagnostic category of glucose tolerance.

Adult↗
PubMed1986

The Tasmanian Insulin-treated Diabetes Register. Inception and progress in the first 12 months.

A Statewide register of insulin-treated diabetic patients has been established in Tasmania. The register is the first of its kind in Australasia. Insulin treatment was chosen as the criterion for admission to the register because it was a suitably "hard" end-point, and because the completeness of the register could be validated easily by insulin prescription statistics. Both subjects with insulin-dependent diabetes mellitus and those with non-insulin-dependent diabetes mellitus (who happened to be treated with insulin as of the prevalence date, May l, 1984) are eligible for registration in the prevalent population. Furthermore, no age restrictions have been placed upon entry. It is to be hoped that this all-inclusive policy will assist in the development of an epidemiological definition of insulin-dependent diabetes mellitus. Access to cases has been by hospital records, general practitioners, lay bodies and general publicity. Of over 600 diabetic subjects who were contacted during the first 12 months of the study (approximately one-half of the estimated prevalent population), only three declined to join the register. Once fully established and validated, the register will be used to test aetiological hypotheses in addition to providing descriptive cross-sectional information about diabetes in Tasmania. It is intended that a longitudinal study of insulin-treated diabetes will follow once the cross-sectional information is complete.

Age Factors↗
PubMed1986

Surgical repair of anatomically corrected malposition of the great arteries.

Anatomically corrected malposition of the great arteries is a rare malformation in which the aorta and pulmonary artery arise from their appropriate ventricles but in an abnormal spatial relationship. This report describes 2 patients with anatomically corrected malposition who underwent closure of a ventricular septal defect and placement of a right ventricle-pulmonary artery conduit. A review of the literature indicates that surgical results have been good (92% survival) in those patients with situs solitus and atrioventricular concordance [S,D,L]. However, when there is atrioventricular discordance, that is, [S,L,D] or [I,D,L], hypoplastic right heart structures, or both conditions, the outcome after palliative procedures has been poor (29% survival). The results of surgical treatment should improve as this entity is recognized earlier and prompt surgical treatment is undertaken.

Adolescent↗
PubMed1986

Emergent pulmonary embolectomy: the treatment for massive pulmonary embolus.

Massive pulmonary embolus usually leads to in-hospital mortality if not treated aggressively. Four patients were seen with severe cardiorespiratory compromise resulting from massive pulmonary emboli. Emergent pulmonary embolectomy was followed by marked clinical improvement, and 3 patients were subsequently discharged from the hospital. The clinical courses of these patients are described, and massive pulmonary embolus and its management are discussed.

Acute Disease↗
PubMed1986

Impaired glucose tolerance in the biethnic (Melanesian and Indian) populations of Fiji.

We report a cross-sectional study of impaired glucose tolerance conducted on data collected during the Fiji Cardiovascular and Metabolic Disease Survey, which was performed in 1980. Both Melanesian Fijians and migrants from the Indian subcontinent were studied. Impaired glucose tolerance and diabetes were defined according to current WHO criteria. When impaired glucose-tolerant subjects were compared with normals and diabetics with respect to selected physiological, biochemical and environmental factors, those with impaired glucose tolerance showed greater affinities with the diabetics than with the normal subjects. This finding was true of both the Melanesian and Indian populations, but was in contrast to a study of Micronesians in Kiribati (using standardized survey methods and similar analyses) in which subjects with impaired glucose tolerance held an intermediate position between normals and diabetics, with respect to the chosen factors. A possible explanation for the discrepant findings of the 2 studies is that the cut-off point in the distribution of plasma glucose concentration which defines diabetes may vary in populations of different ethnic origin, and the studies support the concept of heterogeneity within the category of impaired glucose tolerance.

Age Factors↗
PubMed1985

Polymyalgia rheumatica/giant cell arteritis in a Cambridge general practice.

The aim of this study was to establish the incidence and prevalence of polymyalgia rheumatica/giant cell arteritis in general practice. Patients with this disorder, whether previously diagnosed or not, were ascertained by using a questionnaire administered by interview, and all received full clinical and laboratory assessment. A total of 579 patients aged 65 and over was seen, and 19 (33/1000) had been diagnosed or developed symptoms within the previous eight years. Thus the calculated annual incidence in those aged 65 and over was about 4/1000. The figures from this first large scale study of polymyalgia rheumatica/giant cell arteritis in general practice are much higher than those from studies carried out in hospital. The questionnaire was effective in both identifying known cases of polymyalgia rheumatica/giant cell arteritis and detecting new cases. As this is a treatable disorder, it is important that doctors become aware of how common it is in elderly people.

Aged↗
PubMed1985

Ventricular function in transposition of the great arteries: evaluation by radionuclide angiocardiography.

Right ventricular ejection fraction and tricuspid regurgitation were estimated by radionuclide angiocardiography to quantitate systemic ventricular function in "simple" transposition of the great arteries. Mean right ventricular ejection fraction was 0.52 +/- 0.07 for 18 pre Mustard operation infants, 0.54 +/- 0.07 for 23 patients operated upon less than a 1 year before, and 0.57 +/- 0.08 for 14 patients operated upon more than 3 years earlier. Eight patients were evaluated before and following the Mustard operation; ejection fraction rose in three, fell in three, and remained constant in two. Mean right ventricular ejection fraction was not different between groups nor when compared to our "normal." The left ventricle:right ventricle stroke volume ratio of the postoperative patients was compatible with tricuspid regurgitation in four patients. This radionuclide study suggests that following surgery for transposition of the great arteries: mean right ventricular systolic ejection fraction remains at levels consistent with values usually found for the "normal" right ventricle; group right ventricular function does not deteriorate in the years following surgery; and tricuspid regurgitation may be detected in the early postoperative years.

Aging↗
PubMed1985

Surgery for discrete subvalvular aortic stenosis: actuarial survival, hemodynamic results, and acquired aortic regurgitation.

Discrete membranous subaortic stenosis (DMSS) accounts for 8 to 30% of congenital left ventricular outflow obstruction. The immediate effectiveness of surgical resection of this discrete obstructing membrane has been well documented, but little has appeared regarding late clinical and hemodynamic follow-up. Fifty-three patients with DMSS underwent operation at our institution from 1957 to 1983. Most (78%) were symptomatic, 79% had left ventricular hypertrophy (LVH) by electrocardiogram, and 92% had roentgenographic evidence of cardiomegaly preoperatively. Catheterization revealed a mean preoperative left ventricular-aortic gradient of 89 mm Hg. Twenty-eight patients had associated aortic insufficiency (AI) on the initial aortogram. Seven patients acquired AI in the interim between the first and second preoperative catheterization. Our patients have been followed for up to 12 years postoperatively. There have been 2 early and 3 late deaths. (Actuarial analysis revealed 5- and 10-year survival of 95% and 83%, respectively.) Seventy-one percent of the previously symptomatic patients noted relief of their preoperative complaints, and 45% of those with LVH had a regression in voltage. Cardiomegaly as determined by chest roentgenogram decreased in 45%. The left ventricular-aortic gradient fell to an average of 35 mm Hg a year postoperatively. Surgical treatment of congenital subvalvular aortic stenosis is effective in reducing the preoperative symptoms and the left ventricular-aortic gradient. It appears that DMSS causes AI.

Actuarial Analysis↗
PubMed1985

Isthmus flap aortoplasty: an alternative to subclavian flap aortoplasty for long-segment coarctation of the aorta in infants.

The ideal operation for infants with coarctation of the aorta remains controversial. Subclavian flap aortoplasty is the most popular technique for this age group. The 5 to 20% recurrence rate is attributed to regrowth of the coarctation web or inadequate length of the subclavian flap, particularly when the aortic isthmus is long and narrow. Severe arm ischemia following subclavian flap aortoplasty, although rare, is a disturbing complication. The purpose of this study is to report the results with a new technique we call isthmus flap aortoplasty for coarctation of a long segment of the aorta in infants. This technique avoids the limitations of subclavian flap aortoplasty. A short segment of aorta, including the ductal entrance and coarctation web, was resected in 4 infants (mean age, 35.5 days) with long-segment coarctation. The posterior wall of the long isthmus was opened longitudinally to the level of the transverse aortic arch. The descending aorta was mobilized and advanced to the level of the aortic arch where the posterior half was sutured. The anterior flap of attached isthmus was then sewn into a longitudinal incision made in the anterior wall of the descending aorta. All infants survived this procedure and had no gradient at completion of the repair. The mean transconduit gradient at rest was zero and rose to 7.0 +/- 0.93 mm Hg after angiography at a mean follow-up of 42 months. Aortograms demonstrated that the reconstructed area had grown in girth and attained a normal caliber in each child.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗