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Biomedical subjects

S H Gould

Publications and source records attributed to S H Gould.

3 recordsLinked to original sources

Lipoprotein(a) levels in black and white children and adolescents with IDDM.

OBJECTIVE: To examine the relationship between levels of lipoprotein(a) [Lp(a)], diabetes, and glycemic control in white and black nondiabetic control and insulin-dependent diabetic (IDDM) children and adolescents, fasting blood analyses were conducted on a subject sample drawn from referral-based diabetes and endocrine clinics and a primary-care general pediatric clinic. RESEARCH DESIGN AND METHODS: Thirty-six white and 16 black children with IDDM who volunteered to participate in this study were compared with 30 white and 42 black nondiabetic control children. RESULTS: Lp(a) protein levels were significantly higher (P less than 0.05) in both groups of black children compared with whites (black vs. white nondiabetic children 6.8 +/- 0.95 vs. 3.1 +/- 0.68 mg/dl and black vs. white diabetic children 7.5 +/- 1.52 vs. 3.0 +/- 0.64 mg/dl). Lp(a) protein levels directly correlated with the level of glycosylated hemoglobin (r = 0.46, P less than 0.01) in white diabetic children but not in black diabetic children. Well-controlled white diabetic children (n = 12, glycosylated hemoglobin less than 10%) had a mean Lp(a) protein level of 1.4 +/- 0.3 mg/dl compared with poorly controlled white diabetic children (n = 10, glycosylated hemoglobin greater than 13%) whose mean Lp(a) protein level was 5.7 +/- 1.7 mg/dl (P less than 0.01). CONCLUSIONS: We conclude that circulating levels of Lp(a) protein are increased in hyperglycemia. A genetically determined elevated level of Lp(a) is a risk factor for atherosclerotic disease in white and Asian adults. Elevated Lp(a) should be investigated as an independent risk factor for atherosclerotic disease in IDDM. It could prove to be an additional mechanism for the development of diabetic complications in selected populations.

Adolescent

Interpositional microvascular vein grafting.

The application of interpositional microvascular vein grafting in replantation surgery, a detailed account of the technique developed and utilised in the microvascular research and training laboratory, and clinical experience with this technique are described. Vein grafting is of particular value to eliminate tension in anastomoses, bridge vascular defects, and has made feasible the salvage of severe crushing and avulsion amputation in the hand.

Amputation, Traumatic

A mechanised microirrigation system.

A mechanised microirrigation system for microvascular surgery, which is operated by a foot pedal, utilises a large sterile reservoir, and allows control of flow rate and volume, has been designed for use in the laboratory and operating room.

Humans