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Biomedical subjects

F M Wagner

Publications and source records attributed to F M Wagner.

26 records · Page 2Linked to original sources

Heart-lung transplantation in a patient with pulmonary atresia and ventricular septal defect.

Operation for pulmonary atresia and ventricular septal defect is challenging, as in most patients the pulmonary arteries are hypoplastic, nonconfluent, or in part absent. In these cases, combined heart-lung transplantation may be the surgical treatment of choice. In the described case, the morphology of pulmonary atresia and ventricular septal defect was present in combination with completely atretic main, left, and right pulmonary arteries. In this patient, successful heart-lung transplantation was performed.

Adult↗

[Neutron flow measurements in the d(14) + Be neutron radiation field from the cyclotron in Essen].

It exists the possibility in the neutron therapy of specific tumours to increase the local energy dose in the tumour by treatment with fast neutrons under use of B-10. Thermal neutrons cause the neutron capture reaction B-10(n, alpha)Li-7 in tissue. A sufficiently high number of thermic neutrons is necessary combined with a possibly selective concentration of B-10 in the tumour as target volume for the clinical application. Gold foils were activated in a water phantom at several depths for the quantitative determination of the thermal neutron fluence. A result of this measurements is a maximal thermal neutron fluence of 1.44 X 10(10) cm-2 at depth of 5 cm with applied total energy dose of 0.8 Gy.

Fast Neutrons↗

First experiences with fission neutrons in the radiation therapy of cancer patients.

16 patients have been treated until October 1987 at the mixed reactor beam of the RENT-facility in Munich-Garching. All of them received a single dose of 200 to 250 cGy after complete conventional radiotherapy and in same cases also surgery because of the lack of complete tumor resection or local tumor control after radiation control. The ages ranged from 40 to 84 years. The follow-up amounted between two and 28 months, 8.5 months on the average. The tumors selected appeared to be particularly suitable because of their growth in poorly perfused tissues, after the previous surgery and/or radiotherapy. All cases are briefly reported. The general experience from the very limited study is promising. The local effects to the tumor tissue so far are impressive. No severe side effects which could be related to the RENT-session were observed until now.

Adult↗

Treatment of autonomic dysreflexia with phenoxybenzamine.

Our 9 patients with severe autonomic dysreflexia treated with phenoxybenzamine, an alpha-sympatholytic agent, had a dramatic relief of symptoms. Bladder and urethral pressure studies before and after treatment with this agent suggest that the inappropriate rise in urethral resistance in these patients is a result of an appropriate but extraordinary response to bladder filling.

Autonomic Nervous System↗

Toxoplasmosis after heart transplantation: diagnosis by endomyocardial biopsy.

Protozoal infections such as toxoplasmosis are known complications in heart transplant recipients. Diagnosis of the disease is often difficult. This article describes the course of a patient who had a febrile illness with leukocytosis and neurologic disorders after heart transplantation; all microbiologic and serologic tests of the peripheral blood and the cerebrospinal fluid failed to identify the responsible pathogen. Infection with Toxoplasma gondii was finally diagnosed by endomyocardial biopsy. We conclude that in heart transplant recipients with infections of unclear origin and neurologic disorders, endomyocardial biopsy may be helpful in the diagnosis, especially in cases of toxoplasmosis.

Biopsy↗

How successful is OKT3 rescue therapy for steroid-resistant acute rejection episodes after heart transplantation?

OKT3 is recommended as rescue therapy for cases of steroid-resistant, clinically persistant acute rejection episodes after heart transplantation. In this study we determined the efficacy of such treatment. One hundred thirty-two patients were included in this study. The postoperative immunosuppressive regimen consisted of triple-drug therapy and perioperative antithymocyte globulin. During a follow-up of 10 to 108 weeks (mean, 51 +/- 20 weeks) 281 treatment-requiring acute rejection episodes (International Society for Heart and Lung Transplantation > or = II) were observed. In 29 cases (10.3%) the grade of the acute rejection episodes was either unchanged after two series of intravenous steroid pulse therapy, was worsened after the first steroid course, or the patient experienced clinical deterioration as a result of the acute rejection episodes. These patients were considered to have steroid-resistant acute rejection episodes and received a 10-day rescue therapy with OKT3, followed by control endomyocardial biopsy. In 17 cases, control endomyocardial biopsy revealed normal myocardium (group I). In 10 cases acute rejection episodes remained unchanged (group II); twice a deterioration was found (group III). However, 12 of the 17 patients from group I experienced a rebound of the acute rejection episodes (International Society for Heart and Lung Transplantation > or = II) 1 to 3 weeks later. Side effects of OKT3 treatment were fever, chills, intestinal complications, hemodynamic response, convulsions, and viral infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗