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Biomedical subjects

M Wilken

Publications and source records attributed to M Wilken.

33 records · Page 2Linked to original sources
PubMed1993

[Therapy of postoperative ectopic junctional tachycardia by surface hypothermia].

Postoperative junctional ectopic tachycardia is associated with a poor prognosis in patients after open-heart surgery. This dysrhythmia has been shown to be resistant to medical treatment as well as to epicardial pacing and external cardioversion. Successful therapy with surface hypothermia in an infant with junctional ectopic tachycardia (ventricular rate 210-230 bpm) after repair of tetralogy of Fallot is presented. Hypothermia (rectal temperature 32-34 degrees C) was effective in decreasing the ventricular rate of the dysrhythmia (< 170 bpm). After spontaneous cessation of the tachycardia, sinus rhythm resumed, resulting in stable hemodynamics.

Combined Modality Therapy↗
PubMed1993

[Emergency 12-hour transesophageal stimulation in a 21-month-old infant].

In a 21-month-old child with complex cyanotic congenital heart disease an aortopulmonary shunt was created as preparation for a modified Fontan operation. During the early postoperative period low cardiac output with right atrial pressures of 20 mm Hg developed due to a slow ventricular tachycardia (ventricular rate 135 bpm). Pharmacological interventions (isoprenaline 0.01 mg/kg hourly and lidocaine 1 mg/kg hourly were without any effect. As epicardial pacing leads had not been implanted during surgery, atrial pacing was performed via the transoesophageal route using a 9.5-F bipolar electrode catheter with an interelectrode distance of 15 mm. Atrial capture could be established with an impulse width of 9.9 ms and 10 mA output at a rate of 150 bpm. With restoration of atrioventricular synchronicity, right atrial pressure finally decreased to 10 mm Hg with consecutive stabilization of the cardiovascular status. After 12.5 h transoesophageal pacing could be stopped without any problems due to spontaneous cessation of ventricular tachycardia. No clinical signs of oesophageal injury were noted. It is concluded that transoesophageal pacing is a practical, safe and effective method for emergency cardiac pacing.

Cardiac Output, Low↗
PubMed1992

Pulmonary artery sling with tracheal stenosis: primary one-stage repair in infancy.

Pulmonary artery sling is often associated with tracheal stenosis. In many cases repair of the vascular anomaly alone does not relieve dyspnea. Primary one-stage repair with long segment tracheal resection (2.4 cm) and relocation of the left pulmonary artery using cardiopulmonary bypass and deep hypothermic circulatory arrest is described in a 6.5-month-old girl weighing 6.5 kg. This technique resulted in normal ventilation and pulmonary flow distribution.

Bronchi↗
PubMed1991

[Complex cyanotic heart defect in a newborn infant with cat eye syndrome].

In a cyanotic newborn with characteristic features of Cat-Eye-Syndrome, cytogenetic examination disclosed a supernumerary small bisatellited chromosome. Angiography showed Tetralogy of Fallot with pulmonary atresia and a narrow patent ductus arteriosus with additional stenosis of the bifurcation of the pulmonary artery. At an age of 14 weeks, the patient died after the attempt of corrective cardiac surgery. Congenital cardiac malformation is present in more than one third of patients with cat-eye-syndrome and is usually the lifelimiting malformation in this syndrome.

Abnormalities, Multiple↗
PubMed1988

The DiGeorge syndrome. I. Clinical evaluation and course of partial and complete forms of the syndrome.

This study describes clinical signs and symptoms in 16 patients with the DiGeorge syndrome (DGS). Diagnosed on the basis of typical facial stigmata, a broad spectrum of severity is seen with respect to congenital heart disease, hypoparathyroidism and immunologic parameters. A simple index of severity is introduced that clearly differentiates complete forms of the syndrome (cDGS) with poor prognosis from partial forms of the syndrome (pDGS). Of 13 pDGS patients, 12 are still living; 8 underwent corrective heart surgery without infectious complications. Moderate to severe mental retardation is seen in all pDGS patients. Due to the lack of thymus function, immunodeficiency is a result of cDGS, whereas immunoregulatory disturbances (hypergammaglobulinaemia, high titres of specific antibody production) prevail in pDGS patients.

Adolescent↗
PubMed1987

Modification of beta-2-microglobulin in sera from patients with small cell lung cancer: evidence for involvement of a serine protease.

Modification of beta-2-microglobulin has been shown to occur in vitro in serum of patients suffering of small cell lung cancer, where it clearly correlated to the clinical course of disease. The cause of serum beta-2-microglobulin modification occurring in these patients is investigated in the present study. This revealed that modification of beta-2-microglobulin is due to cleavage by a serine protease, which is dependent on divalent cations and has a trypsin-like specificity. The process showed the following characteristics: pH optimum at 8.5, heat inactivation by incubation at 56 degrees C for 20 min and temperature optimum at 20 degrees C.

Carcinoma, Small Cell↗
PubMed1985

Expression of an antigen defined by a monoclonal antibody (SA-1) on normal and malignant cells.

A monoclonal antibody (SA-1) has been characterized. The antibody was derived from the fusion of the X-63 myeloma cell-line with splenocytes from a mouse immunized with human acute megakaryoblastic leukaemia cells. The antibody reacted with blast cells from 65% of patients with AML without correlation to morphologic classification. The antibody further reacted with a subset of myeloid cells from normal bone marrow, and with peripheral neutrophil granulocytes. In lymph nodes the antibody showed reactivity with subsets of dendritic reticulum cells. In skin biopsies the antibody reacted with subsets of Langerhans cells, subsets of indeterminate cells and activated T-lymphocytes. The antigen was not expressed on non-activated T-lymphocytes. Neither was it expressed on B-lymphocytes, erythrocytes, platelets nor blast cells from patients with ALL. The antigenic target for the antibody SA-1 was a surface exposed polypeptide (mol. wt. 15 000 D).

Antibodies, Monoclonal↗
PubMed1985

Reliability of the Hitachi sodium and potassium electrodes assessed.

We compared the Hitachi 705 E sodium/potassium electrode system with the Radiometer flame photometer for measuring concentrations of sodium and potassium ions in serum and plasma. Our data show that the Hitachi results are slightly but significantly (less than 0.001) lower than the flame photometer results: Na+ 1.33 mmol/L for serum and 2.24 mmol/L for plasma; K+ 0.062 mmol/L for serum and 0.082 mmol/L for plasma. The magnitude of the bias varied considerably from day to day, ranging from -0.10 to 2.33 mmol/L for Na+ in serum and from 0.00 to 0.11 mmol/L for serum K+; for plasma specimens the corresponding ranges were -0.03 to 5.97 mmol/L and 0.00 to 0.17 mmol/L. These variations probably reflected difficulties in reproducing the calibration from day to day, because the daily means for a serum pool varied in parallel. We occasionally encountered serious problems with reproducibility.

Autoanalysis↗
PubMed1983

Demonstration and partial characterization of chronic lymphocytic leukemia lymphocyte-associated antigens by crossed immunoelectrophoresis of Triton X-100 extracts.

Crossed immunoelectrophoresis was used to study the antigens of chronic lymphocytic leukemia lymphocytes. A reference pattern was obtained and 20 samples from 18 patients were compared with this pattern. Extensive variation in the expression of individual antigens was observed. The antigens in the reference pattern were further characterized by modifications of crossed immunoelectrophoresis, viz. labelling of intact lymphocytes by lactoperoxidase-catalyzed iodination, affinity crossed immunoelectrophoresis with phenyl-Sepharose and Lentil lectin-Sepharose, charge-shift crossed immunoelectrophoresis and postelectrophoretic incubation in (125I) Lentil lectin. Six antigens were identified as surface membrane glycoproteins, 5 as cytoplasmic proteins while 5 could not be classified. Two antigens were finally identified as HLA-ABC and HLA-DR by application of small amounts of monospecific rabbit antiserum and monoclonal antibody, respectively.

Aged↗
PubMed1982

Monoclonal immunoglobulin of CLL lymphocytes detected by radioimmunofixation with 125I-protein A of Triton X-100 solubilized lymphocyte material.

A sensitive radioimmunofixation method (detection limit 1 mg/1 for monoclonal IgM) utilizing 125I Protein A and immunofixation for demonstration of monoclonal immunoglobulin in Triton X-100 extracts of isolated chronic lymphocytic leukemia (CLL) lymphocytes is presented. Thirty-two untreated patients with clinically typical CLL were studied and the results compared to those obtained by immunofluorescence. Monoclonal IgM was detected with similar frequency by the two methods (69% and 75%), but IgD was detected less frequently by radioimmunofixation (25% and 40%). When the results obtained with the two methods were combined, all of the cases were immunoglobulin positive. Two complete IgM type M-components were demonstrated in two cases, an excess of seemingly free heavy chains was found in four cases, and an excess of seemingly free light chains in six cases.

Antibodies, Monoclonal↗
PubMedDate not supplied

[Accuracy of measurements of Kontrol 7840, Nellcor N200 and Radiometer OX13 pulse oximeters in infants and young children].

Comparative validation studies of pulse oximeters from different manufacturers have predominantly been performed in adult patients. However, due to differences in the patient-sensor interface, the results from those studies may not be transferable to the paediatric population. We therefore performed 123 simultaneous measurements (37 patients) of transcutaneous O2-saturation (StcO2) from 3 pulse oximeters and compared these with the arterial O2-saturation (SaO2) from a co-oximeter (Radiometer OSM 3). The median age of the 37 patients at the time of study was 2.0 months (range 1 day-5 years), their weight 4.7 kg (0.8-15.0 kg). The mean difference between StcO2 and SaO2 was -0.6% (SD 5.2%) for the Kontron 7840 pulse oximeter, -0.9% (SD 2.3%) for the Nellcor N200, and -1.2% (SD 3.5%) for the Radiometer OXI3 pulse oximeter. The corresponding 95% intervals were -7.4(-) + 9.6%, -5.7(-) + 4.3% and -7.0(-) + 6.3% for the Kontron, Nellcor and Radiometer instrument, respectively. These results demonstrate that neither of the 3 instruments systematically under- or overestimated SaO2. However, there were differences in precision, particularly in the low range of SaO2.

Child, Preschool↗
PubMedDate not supplied

[Menstrual toxic shock syndrome].

A 15 year old girl presented twice with severe symptoms of multiorgan disease during a period of 4 weeks resulting in intensive care necessary to control illness. According to case definition criteria, a toxic shock syndrome was diagnosed on second admission. This could be confirmed by proof of TSST-1. Beside antibiotics, no specific treatment was used and complete clinical recovery occurred with symptomatic therapy. Discussing the menstrual toxic shock syndrome we point out different aspects of the pathogenesis of the disease including the possible role of tampon use. With regard to the results of several investigators, clinical symptoms of toxic shock syndrome could be the consequence of an uncontrolled immunologic reaction. Looking at this concept, more effective therapy may be available in the near future.

Adolescent↗
PubMedDate not supplied

[Thrombotic occlusion of the abdominal aorta in the neonatal period--successful thrombolytic treatment].

Aortic thrombosis during neonatal period is rare and usually related to an umbilical artery catheter. In an infant (birth weight 3110 gm) with complete thrombosis of the abdominal aorta distal to the renal arteries of unknown etiology we started a fibrinolytic therapy with streptokinase at the age of 12 days (streptokinase intravenously with an initial loading dose of 3000 U/kg, maintenance 1000 U/kg/hr for 2 days). This was followed by a heparinisation (10,000 U/m2/d, 24 hours later 200 U/kg/d). 72 hours after onset of therapy there was no blood pressure difference between upper and lower limbs. Side-effects of therapy did not occur; the success of medical treatment continued after termination of the heparinisation.

Aorta, Abdominal↗
PubMedDate not supplied

[Value of thrombolytic therapy in childhood].

Indications for fibrinolytic therapy in infants and young children differ significantly from those in adults. In preterm and newborn infants, it is mostly the catheter-associated thrombosis following catheterisation of the umbilical artery or vein that requires fibrinolytic therapy. In young children the main indication is arterial thrombosis after cardiac catheterisation. Based on the current literature and our own experience guidelines as well as recommendations for dosages are given for systemic and local therapy with streptokinase, urokinase and recombinant tissue plasminogen activator.

Blood Coagulation Tests↗