PubMed HealthSearch

Biomedical subjects

A Celiker

Publications and source records attributed to A Celiker.

11 recordsLinked to original sources

Cardiac electrophysiologic study in children. Preliminary report from Turkey.

Eighteen children (10 females, 8 males; age range 5.5 to 17 years, median: 10 years) who suffered from recurrent syncope, drug refractory supraventricular tachycardia and atrioventricular block or bradycardia were evaluated by cardiac electrophysiologic study between August 1988-April 1990. During the study, basal intervals were measured and the conduction system and sinus node functions were investigated. In some patients the mechanism of the tachycardia was investigated and drug-electrophysiologic studies also performed. Two of 6 cases with recurrent syncope had positive electrophysiologic findings and adequate treatment resolved the symptoms. The others have been followed. The mechanism of the tachycardia was determined in 5 cases with drug refractory supraventricular tachycardia and drug-electrophysiologic studies were done in all of them. The site of block was determined in 7 patients with atrioventricular block and pacemaker implantation was done in 5 patients. The results emphasized the usefulness of cardiac electrophysiologic study in childhood arrhythmias.

Adolescent

Endomyocardial biopsy in children. Usefulness in various myocardial disorders.

Endomyocardial biopsy studies in adults have demonstrated the usefulness of this method. It is possible that studies will be more productive in determining the etiology and clinical status in patients with clinically diagnosed myocardial diseases. A prospective study conducted over 16 months included 17 children, aged 14 months to 18 years, with the diagnosis of dilated, restrictive cardiomyopathy and myocarditis. In 16 patients right, and in 1 patient left heart endomyocardial biopsies were performed. The specimens were evaluated by light and electron microscopy. There were no serious complications after the procedure. In 1 of 17 children histology showed no myocardial tissue. Electron microscopy evaluations were currently available in 9 patients. Endomyocardial biopsy findings were found to be diagnostic in 41.2%, helpful in 29.4% and of no help in 29.4% of patients. In conclusion, endomyocardial biopsy technique is highly sensitive in children with myocardial disorders. In future it will be the major diagnostic tool for invasive but safe detection of myocardial disease.

Adolescent

[Unilateral paralysis of the abdominal wall musculature caused by thoracic intervertebral disk displacement].

Herniated thoracic discs are rare. Many cases present with local radicular or cord symptoms. We describe a case which became symptomatic by a unilateral paresis of the muscles of the abdominal wall. This radicular syndrome has only been described for lumbar disc herniations before. The differential diagnosis is discussed as well as the importance of myelography and the value of Myelo-CT.

Abdominal Muscles

Detection of right-sided endocarditis in children with congenital heart disease by two-dimensional echocardiography.

Right-sided endocarditis is rare in children. Since the clinical picture is nonspecific and the frequency of sterile blood cultures is high, the clinical and laboratory diagnosis is difficult. Recent reports suggest that echocardiography is a useful method to detect the presence of right-sided endocarditis. We studied 8 patients with congenital heart disease and right-sided endocarditis detected by two-dimensional echocardiography. All the patients were shown to have one or more vegetations in the two-dimensional echocardiographic examination. The 4 patients who did not respond to antibiotic therapy underwent elective cardiac surgery. One of these patients additionally had recurrent emboli to the lungs. Another of these 4 patients died during surgery due to myocardial failure. Apart from these 4 cases, urgent surgical intervention had to be carried out in 2 cases because of very large vegetative masses. Surgical confirmation of the diagnosis was available in all 6 cases. According to these results, we can conclude that two-dimensional echocardiography assumes a specific diagnostic role in cases with right-sided endocarditis.

Child

Cutaneous anthrax.

The case of a 9-year-old boy diagnosed and treated for cutaneous anthrax is presented. We discuss the clinical features and course of this disease, encountered today only rarely in less developed regions where humans are in contact with infected animals.

Anthrax

Echocardiographic findings in endomyocardial fibrosis.

An 18-month-old infant diagnosed as having endomyocardial fibrosis by echocardiography is presented. Most patients with endomyocardial fibrosis reported in the literature are either older children or adults. To our knowledge, our patient was the youngest ever to have been reported. Echocardiographic studies showed obliteration of the left ventricular apex and increased echo reflectance at the left ventricular endocardium and subendocardium. The left atrium and right ventricle were significantly enlarged. Doppler echocardiography showed minimal mitral, but significant tricuspid regurgitation. In regard to the contribution of echocardiography in the diagnosis, we recommend this method for suspected cases. Contrary to the other patients reported, there was no thickening of the atrioventricular valves. Mitral valve insufficiency was related to the restriction of the ventricular filling rather than to valve involvement occurring with the disease.

Cineangiography

Idiopathic long Q-T syndrome.

The association of Q-T interval prolongation, syncope and sudden death is known as the long Q-T syndrome. The syndrome may be familial, associated with congenital deafness, or idiopathic. The diagnosis is based on the electrocardiographic finding of a prolonged Q-T interval with or without T wave abnormalities. In this article, we present a nine-year-old boy admitted to the Hacettepe University Children's Hospital with complaints of syncopal episodes. The prolonged Q-T syndrome was diagnosed as the cause of the syncopal attacks. In addition, the same syndrome was detected in his father. The prolonged Q-T syndrome should be considered in the differential diagnosis of cases with recurrent, unexplained syncope in the pediatric age group.

Child

Experience with propafenone for the treatment of cardiac arrhythmias in children.

The aim of this prospective study was to evaluate the efficacy of propafenone in suppressing various arrhythmias in a group of children who were patients in the Pediatric Cardiology Unit of Hacettepe University Children's Hospital. Seven of the 13 children (53.8%) with ventricular ectopics, all three children with paroxysmal re-entry atrioventricular tachycardia, and two of the three children with paroxysmal atrial tachycardia were treated successfully with propafenone. The drug did not cause any side effects or arrhythmogenesis. The median dosage of propafenone at discharge was 300 mg/m2/day (range 250-400 mg/m2/day) every eight hours. Our findings confirm the efficacy and safety of propafenone for the treatment of childhood arrhythmias.

Adolescent

Exercise-induced ventricular tachycardia in children.

Two children with exercise-induced tachycardia, one with idiopathic long-QT syndrome, are presented. The patients were evaluated by exercise testing and electrophysiologic study. From the onset of treatment with the beta-blocking agent, pindolol, the patients have been symptom-free. These findings emphasize that children with syncope must be evaluated by ECG, exercise testing, 24-h Holter-monitoring, and finally, electrophysiological study.

Adolescent

Percutaneous transluminal balloon pulmonary valvuloplasty: immediate and medium-term results.

Ten patients with pulmonary stenosis, (six males and four females) whose ages ranged between five and ten years (mean age 7 years) underwent cardiac catheterization and balloon valvuloplasty. Right ventricular systolic pressure before valvuloplasty ranged from 90 to 200 mm Hg (mean 133.5 +/- 33.3 mm Hg). It fell to 50-90 mm Hg (mean 64.5 +/- 13.8 mm Hg) immediately after the procedure. The peak systolic gradient across the pulmonary valve before valvuloplasty ranged from 70 to 180 mm Hg (mean 114.5 +/- 35.4 mm Hg) and decreased significantly to 30-70 mm Hg (mean 43.0 +/- 13.8 mm Hg) immediately after dilation. Doppler echo studies confirmed these results. At repeat cardiac catheterization in three patients, five to 15 months after valvuloplasty, restenosis was noted in one patient while there was no change in the others. All patients had been followed up by Doppler echocardiography. Patients with isolated valvular pulmonary stenosis can be adequately and safely treated with balloon valvuloplasty which results in excellent immediate and medium-term results.

Catheterization