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Biomedical subjects

H Singer

Publications and source records attributed to H Singer.

At least 37 records · Page 2Linked to original sources

[Surgical treatment of patent ductus arteriosus Botalli in the premature infant. Indications and results of treatment].

125 preterm infants with persistent ductus arteriosus (PDA) had surgical ligation between November 1978 and December 1984. In an additional case the situation was complicated by severe coarctation, which had not been diagnosed prior to surgery. The mean birth weight was 1340 +/- 448 g (85 infants weighed less than 1500 g). Gestational age was 30.6 +/- 2.5 weeks. Age at surgical ligation was 13 +/- 7 days for all patients. Preterm infants from our hospital were operated on with a mean age of 9.5 days. Indications for surgical ligation were clinical and radiographic signs of large PDA, during the last two years supported by the results of pulsed doppler ultrasonography. Only one preterm infant with PDA and coarctation died intraoperatively. The overall results showed a mortality rate of 21.6%. This rate has decreased from 30.4 to 11.7% in the last year. Important improvement could be obtained by early ligation, with carefully maintained body temperature during surgery. Preoperative ventilation parameters were kept constant and changes in arterial blood pressure during operation were avoided. The percentage of permanent handicaps was lowered from 15.2 to 5.9% in the last year of our study. According to failure of indomethacin therapy in the very beginning of PDA treatment, it is our policy now to ligate PDA in preterm infants early and without delay by a trial with indomethacin therapy.

Ductus Arteriosus, Patent

[Fetal arrhythmias. Differential diagnosis, clinical significance and prognosis].

Between June 1979 and June 1984 the authors observed 40 fetal arrhythmias in 11,122 births (0.36%). Initially there were problems of differential diagnosis with cardiotokography and fetal abdominal ECGs. However, these problems were surmounted with real-time sonography, supplemented with split-image echocardiography (M-mode technique) with video recording. In three-quarters of the cases supraventricular and ventricular extrasystoles were found. These forms of arrhythmias were clinically harmless. Follow-up examinations of the children confirmed the favorable long-term prognosis. One-quarter of the arrhythmias were high-risk cases. Supraventricular tachycardias, total AV block, sinus tachycardia and bradycardia, and congenital atrial fibrillation were found. There were five cardiac abnormalities in this group. Heart failure occurred in six fetuses and neonates. Four of ten infants died. Three infants remained in pediatric cardiologic care. In the light of the authors' experience, it is still too early to invest great hope in intrauterine treatment of the fetus. Intrauterine diagnosis at the earliest possible time and intensive cardiologic care, starting immediately after birth, can improve the prognosis in cases with high-risk arrhythmias.

Arrhythmias, Cardiac

[The smallpox vaccination strain MVA: marker, genetic structure, experience gained with the parenteral vaccination and behavior in organisms with a debilitated defence mechanism (author's transl)].

The MVA virus is a lab virus ideally suited for vaccination of both man and animal which can be differentiated from the known Vaccinia strains by the use of numerous biological markers. Its reduced virulence for the chick embryo, for experimental animals and for man is a particularly characteristic feature. With the exception of chick embryo fibroblasts, the MVA virus grows in cell cultures only abortively. This applies particularly to cells of human origin in which the cytopathic effect and plaque formation are completely missing. The restriction analysis of the DNS of the MVA virus demonstrates that its genetic structure differs from that of the CVA basic virus and other orthopox viruses. In contrast to the WHO reference strain Elstree, the MVA virus has a genome shortened by about 9 per cent. The use of the MVA virus for human vaccination is particularly indicated in persons to be vaccinated for the first time and likely to entail a risk (on account of allergies etc.) because it brings about a state of revaccination without complications. The MVA virus can be administered in intracutaneous, subcutaneous or intramuscular injections. Innocuoursness and successful vaccination have been demonstrated in more than 120000 persons. While other Vaccinia strains, such as the Elstree virus, experience a drastic increase of virulence in the immunosuppressed organism (subjected to whole-body irradiation), the MVA virus cannot be activated not even in this situation.

Animals

[Pulmonary valve aplasia with ventricular septal defect. Hemodynamics and embryology].

The combination of absent pulmonary valve with ventricular septal defect, subvalvular pulmonic stenosis and aneurysm of the pulmonary artery presents a characteristic heamodynamic and clinical profile. It should be differentiated from other morphologically related cardiovascular malformations. According to the degree of right ventricular outflow tract obstruction, the circulatory pattern and the clinical picture is varying widely. We are differentiating an obstructive and a congestive form of the disease. An own case is demonstrated. After a short review of the literature the clinical and haemodynamic findings are discussed. The important role of the ductus arteriosus in fetal circulation is emphasized. The development of a huge pulmonary aneurysm and the premature closing of the ductus arteriosus are considered to be secondary to the serious disturbance of fetal haemodynamics.

Angiocardiography

[Treatment of heart-rhythm disorders in infancy and childhood].

According to own experiences and after a review of the literature a survey of therapy of cardiac arrhythmias in infancy and childhood is given. In this age group most of the occurring cardiac arrhythmias are harmless and pass without serious circulatory disturbances. Therefore in these cases no specific treatment is necessary, except of course the treatment and management of the disease which is causing the arrythmia. This report is concerned more detailed with the therapy of rhythm disturbances which are life threatening or will become fatal if they continue untreated for a longer period. In spite of the therapeutic recommendations given we are aware of the fact that it is impossible to predict the success of therapy. This turned out to be so especially in the case of tachycardias. The difficulties in long-term management of postoperative heart block are mentioned. Antiarrhythmic drugs, their indications, efficacy, side-effects and contraindications are listed in separate tables ("FdM-Tabellen für die Praxis" Nr. 30/1975, Fortschr. Med. 93, 30: 1447, 1975).

Age Factors

Partial trisomy 10p.

It is reported on a boy of 4 years 9 months with trisomy of the distal part of the short arm of a chromosome 10, due to a balanced 7/10 translocation in the father. Besides multiple minor dysmorphias the patient showed severe mental retardation, small stature, hypotonia, retarded bone age. The high and bulky forehead was especially remarkable, because this sign has also been noted in formerly reported cases with trisomy 10p.

Abnormalities, Multiple