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Biomedical subjects

H van Loon

Publications and source records attributed to H van Loon.

7 recordsLinked to original sources

Pervasive developmental disorders not otherwise specified. A developmental-psychopathological approach for the development of made-to-measure treatment planning.

Diagnosis and classification of autism and related pervasive developmental disorders is both easy and difficult. Infantile autism is a characteristic syndrome on which many publications have appeared in the last 50 years. Conversely, the diagnosis and even the classification of children with pervasive developmental disorders related to autism is difficult. Although children with these disorders are twice as numerous as children with infantile autism, growing attention has been directed to at the latter group since the last decade. In this paper, autism and related disorders are described as a developmental disorder as well as a spectrum disorder. The spectrum of clinical symptoms can be explained, of which infantile autism is the most severe and prototypical manifestation. A working model is presented which accounts for all the problems of children with pervasive developmental disorders. An illustration of working with the model in practice is also given. The main lines of treatment and stages in treatment are briefly described.

Autistic Disorder↗

Coronary stenting with a new, radiopaque, balloon-expandable endoprosthesis in pigs.

BACKGROUND: Intracoronary stents may be effective when used as "bail-out" devices for acute complications after percutaneous transluminal coronary angioplasty. Furthermore, preliminary reports have demonstrated some promising results with stents with regard to the reduction of restenosis. Several stent devices are available for preclinical and clinical evaluation. The use of these stainless-steel stents has been limited by poor visibility during fluoroscopy and thrombogenicity during the first days to weeks after implantation. We therefore investigated the immediate and short-term effects on arterial patency of a new, radiopaque, balloon-expandable coil stent in normal coronary arteries of pigs. METHODS AND RESULTS: In 10 animals, a stent was placed in two of the three epicardial coronary arteries. During the implantation procedure, the animals received heparin; after the procedure, no antithrombotic drugs were administered. After 1 week (five animals and 10 stents) or 4 weeks (five animals and 10 stents), repeat angiography was performed, followed by pressure-fixation of the coronary arteries for light and electron microscopic examination. Angiographic analysis revealed that all stented coronary segments were patent and without signs of intraluminal defects. Scanning electron microscopy showed complete endothelial covering of all stents within 7 days. Light microscopy showed a reduced tunica media locally under the stent wires, which resulted from exerted pressure. The neointima on top of the stent wires measured 56 microns (range, 42-88 microns) after 1 week and 139 microns (range, 84-250 microns) after 4 weeks. CONCLUSIONS: Results from this study show that this radiopaque endoprosthesis can be safely placed in normal coronary arteries of pigs. After 4 weeks, all stents were patent and there was no need for additional antithrombotic treatment, whereas neointimal proliferation was limited.

Angiography↗

Arterial stenting with self-expandable and balloon-expandable endoprostheses.

Coronary angioplasty is complicated by acute occlusion (within 24 hours) and late restenosis (within 6 months) in 2-5% and 20-40% of the cases, respectively. Vascular endoprostheses (stents) may provide the cardiologist with a solution to some of these complications. Several stent-devices are now available for experimental and clinical evaluation. In this study we describe our experience with two metallic stents in normal arteries of swine. Self-expandable, stainless steel stents (3.5 mm diameter) were implanted in 17 peripheral arteries, eight of which were deendothelialized by prior balloon angioplasty. Following implantation, the animals received antithrombotic therapy with acenocoumarol and aspirin (8 stents), or aspirin alone (9 stents). After 1 week repeat angiography was performed, which showed patency of all stented arteries. Microscopy showed complete covering by neointima, 80 microns in thickness. This self-expandable stent (SES) and a balloon-expandable stent (BES), constructed of tantalum, were implanted in normal coronary arteries. SES (3.0 and 3.5 mm) receiving animals were treated with coumadines (10 stents) or received no antithrombotic treatment (16 stents) after implantation. BES receiving animals were also not treated (10 stents). Three untreated animals with SES died suddenly within 48 hours. Postmortem examination showed partial or complete thrombosis of all six stents in these animals, resulting in a patency rate of 62% after 1 week. All animals with SES, which were treated with coumadines, and all animals with BES (untreated) had patent stents after one week. It is concluded that SES implanted in normal coronary arteries of pigs, which do not receive additional antithrombotic treatment, show a 38% occlusion rate within 48 hours, but show 100% patency after 1 week, when the animals are treated with coumadines. BES implanted in normal coronary arteries of pigs, which do not receive antithrombotic drugs, are 100% patent after 1 week.

Angioplasty, Balloon, Coronary↗

Adenosine as adjunct to potassium cardioplegia: effect on function, energy metabolism, and electrophysiology.

Adenosine is known to induce rapid cardioplegic arrest and to improve postischemic recovery in the isolated rat heart. Long exposures to high doses of adenosine impair postischemic recovery, however. In this paper we tested the combination of low-dose adenosine (1 mmol/L) with potassium (26 mmol/L), with the aim of achieving rapid arrest (as with high-dose adenosine) but eliminating the need for postarrest washout of adenosine. Cardioplegic solutions studied were (1) Krebs-Henseleit potassium (26 mmol/L) (K); (2) K plus adenosine (1 mmol/L) (KA); (3) K plus an adenosine deaminase inhibitor [erythro-9-(2-hydroxy-3-nonyl)adenine] (0.1 mmol/L) (KE); and as control (4) Krebs-Henseleit potassium (6 mmol/L) (C). We induced cardiac arrest in Langendorff-perfused rat hearts by infusing the cardioplegic solution for 3 minutes at 3 ml/min. Total ischemia lasted 20 minutes at 37 degrees C, followed by reperfusion for 30 minutes. High potassium decreased the arrest time from 260 +/- 16 seconds (group C, mean values +/- standard error of the mean) to 22 +/- 4 seconds (group K). A further decrease to 10 +/- 2 seconds was observed with KA (p = 0.016 versus K). KE, which increased endogenous adenosine, gave intermediate effects. All hearts recovered during reperfusion; the product of developed tension and heart rate (grams per minute) was superior in KA hearts (6250 +/- 740 versus K hearts 4380 +/- 390; p = 0.050). KE gave an intermediate result (5290 +/- 900), while C showed the worst recovery (3180 +/- 830). Our electrophysiologic studies with sinus node and atrial tissue suggest that adenosine induced hyperpolarization and an increase in potassium permeability, thereby arresting the sinus node before depolarization of the membrane by potassium (26 mmol/L). We conclude that low-dose adenosine as an adjunct to potassium shortens the arrest time in this model and improves postischemic recovery.

Adenine↗

Genetic and environmental variation in the birth weight of twins.

Two novel approaches to the analysis of twin data are illustrated with data from birth weight in twins. First, two possible covariates of birth weight are fitted to the data simultaneously, allowing for linear effects of these variables, and their correlation. Second, information on chorionicity is used to estimate the effects of chorion type on birth weight. The data were collected from a large sample of twins born in East Flanders, Belgium. Variation and covariation in twins were considered as a function of sex, chorionicity, maternal age, gestational age, and genotype. No evidence for sex differences in causes of variation was found. As expected, the largest source of variation in bith weight was associated with gestational age. Other common environmental influences were non-significant. Heritability was significant, constituting approximately 40% of variation not associated with maternal and gestational age. A small but significant effect of chorionicity was found, such that dichorionic twins show a greater similarity than monochorionic.

Birth Weight↗

Nutritional anthropometry in children from 0 to 6 years of age in different geographical areas.

Anthropometric data of 12,769 clinically normal children 0-6 years of age from 12 different geographical areas in Africa and Asia are presented. Height, weight, arm circumference and triceps skinfold thickness were measured and presented for age. Derived variables, as muscle circumference, muscle area and muscle proportion-for-age were computed. Weight, arm circumference and muscle area-for-height were calculated. Comparison of these 12 cross-sectional growth patterns shows important differences between groups. The observed differences show that height-for-age, weight-for-age, arm circumference-for-age and weight-for-height are not sufficient to describe adequately and to interpret the variations in nutritional status.

Africa↗