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Biomedical subjects

J Luken

Publications and source records attributed to J Luken.

8 recordsLinked to original sources

Indomethacin therapy in premature infants with patent ductus arteriosus and oliguria.

Simultaneous administration of one dose of indomethacin (0.3 mg/kg, i.v.) and furosemide (1 mg/kg, i.v.) was given to 8 consecutive premature infants who had patent ductus arteriosus (PDA), and oliguria because of prerenal failure. Four infants responded with ductus closure and 2 infants showed improvement in echocardiogram and clinical distress. There was a significant increase in U/O, GFR, FENa and FECl following drug administration. This study suggests that simultaneous administration of indomethacin and furosemide can be safely used in infants with PDA and oliguria.

Anuria↗

Indomethacin treatment in small versus large premature infants with ductus arteriosus. Comparison of plasma indomethacin concentration and clinical response.

An analysis of clinical response and plasma indomethacin concentration was performed on 10 small (less than or equal to 1000 g) and 12 large (greater than 1000 g) premature infants who had symptomatic ductus arteriosus and required intravenous indomethacin therapy (0.3 mg/kg per day). The postnatal age, daily fluid intake, and cardiopulmonary status of the two groups at time of study were comparable, The small premature infants had a significantly lower peak plasma indomethacin concentration and lower concentration in the first four hours after infusion, and lower plasma concentration X time integral than that of the larger premature infants. There was a significant difference between the groups in proportion of response (2/10 vs 9/12) after one dose of indomethacin; this difference was not seen after two to three doses. The results of the study suggest that small premature infants do respond to indomethacin treatment, but compared to the larger infants may require repeated doses.

Birth Weight↗

Clinical evaluation of premature infants with patent ductus arteriosus: a scoring system with echocardiogram, acid-base, and blood gas correlations.

To provide a clinical assessment of cardiovascular dysfunction (CVD) in premature infants with patent ductus arteriosus (PDA), a scoring system (CVD score) was devised and correlated with blood gases, acid-base balance, and echocardiogram. The score consisted of evaluation of heart rate, quality of peripheral arterial pulsation, degree of precordial pulsation, duration of murmur and cardiothoracic ratio on chest roentgenogram. There were 116 observations made on 55 premature infants who had PDA and required medical or surgical treatment. Significant positive correlations were seen for CVD score with left atrial (LA)/aortic (Ao) ratio (p less than 0.001), left ventricular and diastolic dimension (DD) (p less than 0.001), blood pH (p less than 0.01), and blood PCO2 (p less than 0.01). The scoring system may by used as a clinical guide when echocardiogram or angiogram is not available.

Blood Gas Analysis↗

Two-dimensional echocardiographic visualization of the left coronary artery in anomalous origin of the left coronary artery from the pulmonary artery. Pre- and postoperative studies.

Three young children with anomalous origin of the left coronary artery (LCA) from the pulmonary artery were studied by two-dimensional echocardiography. The LCA was shown to be in confluence with the left posterior aspect of th pulmonary artery root in the two patients studied preoperatively. In one of these patients, and in another patient 2 years after surgery, studied after direct surgical implantation of the LCA to the aorta, the LCA was shown to be confluent with the left anterior aspect of the aortic root. In all, the LCA could be followed beyond the branching point. This study demonstrates the feasibility of noninvasive diagnosis of anomalous origin of the LCA from the pulmonary artery by direct visualization with two-dimensional echocardiography.

Aortography↗

Endocardial cushion defect associated with cor triatriatum sinistrum or supravalve mitral ring.

Clinical and angiographic or autopsy data, or both, on three children with a subdivided left atrium (cor triatriatum) and an associated endocardial cushion defect are reviewed. (One child had ostium primum defect, and two had complete atrioventricular [A-V] canal.) A fourth patient demonstrates the difficulties in differentiating subdivided left atrium from supravalve mitral stenosis in the presence of an endocardial cushion defect. The clinical findings are greatly influenced by the endocardial cushion defect. A pressure gradient between the pulmonary wedge and (left or right) ventricular end-diastolic pressures in patients with an endocardial cushion defect indicates pulmonary venous obstruction and should alert one to the possibility of these combined lesions. The exact diagnosis is made with injections of angiographic contrast medium into the proximal and distal left atrial chambers, to documented the respective relations of the pulmonary veins, left atrial appendage and A-V valves to these atrial chambers. All three patients with an endocardial cushion defect and a subdivided left atrium had an associated patent ductus arteriosus. The common association of subdivided left atrium with intracardiac, pulmonary venous and aortic anomalies is again demonstrated.

Cardiac Catheterization↗