Digoxin in sinus rhythm.
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Biomedical subjects
Publications and source records attributed to R Railton.
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The loss of reproductive capacity of Chinese hamster cells has been studied using 60Co gamma-rays and DT neutrons singly or combined in fixed proportions. Surviving fractions were measured down to 2 times 10-4. Interaction between the effects produced by neutrons and gamma-rays in the mixed irradiations has been demonstrated. The results are compared with those predicted by the cellular inactivation model developed by Katz and co-workers from their delta-ray theory of track structure.
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Sixty patients presenting with retinal detachment have been examined using a Nuclear Enterprises Diasonograph 4102; 25 with no identifiable cause (primary), the remainder due to causes such as vitreous haemorrhage, trauma, inflammatory eye disease, aphakia and neoplasm. In the diagnosis and management of retinal detachment echography has a definite but limited application, particularly in patients who have cloudy or opaque media and in whom detachment secondary to a malignant melanoma is suspected. In patients with trauma or vitreous haemorrhage important therapeutic considerations depend upon a precise knowledge of the structure of the globe and complicating features such as vitreous fibrosis or retinal detachment. In such patients the value of echo amplitude measurements in combination with B-scan echography is described. In primary retinal detachment because of vitreous haziness, the extent, size and degree of displacement of the retinal detachment may be more precisely demonstrated echographically than by conventional ophthalmoscopy, facilitating surgical management.
The use of grey scale echography may be advantageous in some diagnostic situations, e.g. liver investigations. The effects on the recorded grey scale of different types of signal processing in conjunction with various settings of the brilliance control were investigated using a standard ultrasonic machine. The most satisfactory results were obtained when operating at a high baseline brilliance and modulating the display with signals proportional to the echo amplitude. A series of comparative pictures are shown to demonstrate these effects.
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Despite better control of diabetic patients with morbidity and mortality from heart disease is significantly higher than in non-diabetics. While this may be a result of premature atherosclerosis or primary diabetic cardiopathy, the possibility of oral hypoglycemic agents have adverse cardiac effects must be considered. Using nuclear angiography the effect of the acute administration of 1 g tolbutamide on left ventricular ejection fraction (EF) in a group of 10 Type-1 diabetics was investigated. There was no difference in the response of the EF when compared to the response in 10 diabetic controls given i.v. saline. While i.v. tolbutamide may have adverse cardiac effects when administered to animals or in vitro this does not necessarily apply to human diabetics.
Eleven type-I (insulin-dependent) diabetic patients with abnormal changes in left ventricular function in response to cold stress (CS) were investigated to try and determine the cause of these abnormal responses. Resting M-mode echocardiography demonstrated that all 11 patients had normal left ventricular dimensions and wall motion, thereby excluding overt cardiomyopathy. Thallium-201 scintigraphy was used to assess myocardial perfusion during CS and eight patients were found to have perfusion defects during stress which persisted in four. It is possible that CS unmasks evidence of myocardial ischemia but it is also possible that the abnormal responses to CS reflect altered vasomotor reactivity in the diabetic patient, producing coronary spasm. Left ventricular function may be influenced by many factors in diabetes and an abnormal CS test may not necessarily indicate structural disease. Such tests, however, may help in the further understanding of the pathophysiology of heart disease in diabetes.
Four dynamic tests of cardiac function were compared in a group of 13 long-standing insulin-dependent diabetics who had no clinical evidence of cardio-respiratory disease. One patient developed abnormal features during 24 hour ambulatory electrocardiograms while all 13 patients had normal exercise electrocardiograms. The change in left ventricular ejection fraction during dynamic supine exercise as measured by gated blood-pool scintigraphy was not significantly different from control subjects (p less than 0.1) while during cold stimulation testing the change in left ventricular ejection fraction in the diabetics was highly significantly different from the control subjects (p less than 0.01). Five of the patients had one or more abnormal tests of autonomic function. The cold stimulation test may be a sensitive index of cardiac dysfunction in diabetics but as the mechanism is unclear alternative explanations are possible. While the etiology of heart disease in such patients is uncertain it is likely to be multifactorial and this test may prove useful in investigating the natural history and pathogenesis of cardiac disease in diabetics.
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Commercially available transport incubators are sophisticated and expensive since they are designed to provide life support for premature or critically ill neonates. In maternity hospitals with inadequate heating systems, some healthy infants have difficulty maintaining their body temperature in wards and during transfer within the hospital. These babies do not require the sophistication of commercial incubators. We describe a simple insulated cot which meets these requirements at minimal cost.