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Biomedical subjects

T Bömelburg

Publications and source records attributed to T Bömelburg.

18 recordsLinked to original sources
PubMed1993

Is there a relationship between cytarabine pharmacokinetics and keratitis?--A case report.

While on therapy for acute myeloid leukemia, a 15-year-old girl developed extensive punctate keratitis of both eyes following high-dose cytarabine therapy (HD-Ara-C). Pharmacokinetic monitoring showed an increase of the Ara-C plasma levels up to twice the steady-state level within 10 minutes after discontinuation of the Ara-C infusion. Calculations of Ara-C plasma half-life, plasma clearance and volume of distribution were within the expected range. Owing to the short half-life of Ara-C in blood due to rapid deamination, varying infusion velocities will result in markedly varying plasma levels. Higher peak plasma levels lead to proportionally higher diffusion into compartments like tears, aqueous humor and cerebrospinal fluid. In compartments which lack noteworthy deaminase activity, dose intensity will be much more enhanced than in plasma. Peak plasma levels, therefore, may be associated with multifold local toxicity without concurrent increase of hematological toxicity. Especially when the drug is given in small volumes of infusion, these considerations should be taken into account. Precise control of infusion parameters and application of artificial tears for dilution of the Ara-C concentration on the corneal surface should be part of keratitis prophylaxis.

Adolescent↗
PubMed1992

Intrahepatic and portal venous gas detected by ultrasonography.

During a 3-year period, sonographic evidence of portal venous gas (PVG) was found in 11 patients. Of these, 10 patients were examined for clinically suspected necrotizing enterocolitis (NEC). In the 11th patient, suffering from nephroblastoma, PVG was detected by routine sonography. Radiographic examination, performed in nine of 11 patients did not show any PVG. Intestinal pneumatosis was radiographically identifiable in only four of these children, whereas eight of 11 patients with sonographically detectable PVG also had sonographic evidence of intramural gas. Follow-up examinations in five patients showed cessation of PVG soon after onset of adequate therapy, indicating that ultrasonography is also a reliable method for monitoring NEC. Sonographic evidence of PVG, however, may be limited to the time before onset of therapy.

Child↗
PubMed1992

Invasive aspergillosis complicating induction chemotherapy of childhood leukaemia.

Two children with acute leukaemia developed histologically confirmed invasive aspergillosis within 2 weeks after onset of polychemotherapy. One child had received only prednisone and one pulse of vincristine and daunorubicin before. This child showed classical roentgenographic signs of aspergilloma following an upper pulmonary lobe infiltration. The second patient developed caecal aspergillosis obscured by clinical signs of appendicitis. He died of disseminated aspergillosis several weeks later in spite of systemic antifungal therapy. Both case reports illustrate that the possibility of invasive aspergillosis must also be expected in young patients soon after onset of induction chemotherapy.

Aspergillosis↗
PubMed1992

Sonographic findings in infants with suspected necrotizing enterocolitis.

During a three-year period, 27 infants with clinical signs of necrotizing enterocolitis (NEC) underwent ultrasonography; 22 of these infants also had abdominal radiographs within a few hours. Sonographically, portal venous gas (PVG) was seen in 10 and intestinal pneumatosis without PVG in 8 infants. Six children underwent laparotomy within 24 hours after ultrasonography and showed evidence of recent NEC. Three other children, laparotomized weeks later were found to have intestinal strictures as signs of previous NEC. None of the patients died from NEC. Nine infants without abnormal gas distribution did not develop overt NEC. With respect to PVG, sonography is able to support the tentative diagnosis of NEC prior to radiography. However, absence of PVG does not exclude NEC.

Enterocolitis, Pseudomembranous↗
PubMed1992

Disturbance of GABA metabolism in pyridoxine-dependent seizures.

In an infant with typical pyridoxine-dependent seizures, CSF GABA level, was determined before treatment with pyridoxine. Before onset of treatment, level of GABA in CSF was highly lowered (16 pmol/ml), pyridoxine level in serum was within normal range. Immediately after application of 80 mg pyridoxine fits stopped and the EEG was without seizure activity. The data substantiate previous findings in brain tissue from a patient with pyridoxine-dependent seizures. They are proof of a disturbed GABA metabolism in pyridoxine dependent seizures.

Brain↗
PubMed1991

Intestinal ultrasonographic findings in Schönlein-Henoch syndrome.

Thirteen children with Schönlein-Henoch syndrome were evaluated for ultrasonographic changes of the gastro-intestinal tract. One patient was examined twice because of a relapse 1 year later. Out of 14 sonographic scans 10 showed abnormal findings, consisting of circumscribed hypo-echoic asymmetrical enlargement of the intestinal wall, the sonographic result of intramural effusions. One patient also had ileocoecal intussusception. Our results suggest that sonography of the intestine is useful to detect changes of the intestinal wall in Schönlein-Henoch syndrome.

Abdominal Pain↗
PubMed1990

Acoustic power measurements of Doppler ultrasound devices used for perinatal and infant examinations.

Acoustic power output levels were measured in four different pulsed Doppler systems (transcranial, Duplex mode, colour mode, miniature for continuous monitoring) currently used for examination of fetal and infant blood flow velocities. The frequencies of the transducers ranged from 2 to 8 MHz. The devices were studied at three to five different intensity settings. The measurements were performed using the radiation force balance of the Fraunhofer-Institut, which was especially adapted for this study. Each of the four devices was tested while running in its commonly used mode, and comparison showed that their acoustic power values varied widely: 96.8 mW (2 MHz, EME TC2-64B), 8.7 mW (5 MHz, ATL Mk 500), 61.9 mW (3.5 MHz, Acuson 128) and 13.5 mW (5 MHz, HP 77020). All transducers had total power output levels below the limits recommended by the American Institute for Ultrasound in Medicine and Biology in the conclusions on a thermal bioeffects mechanism, which were approved in October 1987.

Acoustics↗
PubMed1990

[Long-term transcranial Doppler ultrasound monitoring in increased cerebrospinal fluid pressure caused by brain concussion].

Blood flow velocities of the basal cerebral arteries were studied by transcranial Doppler sonography in a 6 year old girl, comatous after cerebral contusion. Under progressive increase of cerebral pressure, Doppler sonographic long-term monitoring of the middle cerebral artery was performed parallel to the intracranial pressure until dissociated brain death. The results correlated closely with the cerebral perfusion pressure. Even before onset of the excessive increase in cerebral pressure no hyperventilation effect was seen in the contusion foci. Transcranial Doppler sonography represents an additional monitoring method for further improvement of treatment of severe head injuries.

Blood Flow Velocity↗
PubMed1989

Abnormal blood flow patterns in renal arteries of small preterm infants with patent ductus arteriosus detected by Doppler ultrasonography.

Blood flow velocities and pulsatory indices in both renal arteries (RAs) and in the internal carotid artery (CAI) were measured by pulsed Doppler ultrasonography in ten preterm infants with patent ductus arteriosus (PDA), before and after surgical ligation. The results obtained in the RAs were compared to those found in a reference group of 22 stable preterm infants. In the RAs the diastolic steal volume of the PDA led to a marked decrease in diastolic blood flow velocity (range 3 to -23 cm/s). Seven infants showed retrograde diastolic flow, whereas only three infants had these flow patterns in the CAI. In the RAs, the peak systolic blood flow velocities (range 56 to 135 cm/s) exceeded the values found in the reference group by 85% on average. The pulsatility indices reached values of above 1,00. In spite of the increase in systolic flow velocities before surgery, the time mean of maximum velocities was significantly lower than those measured after surgery and in the reference group. After PDA ligation, blood flow velocities normalized. The present study shows that a large PDA may induce abnormal flow patterns even in the RAs. These flow patterns may predispose to renal hypoperfusion and subsequent impairment of renal function.

Blood Flow Velocity↗
PubMed1989

Aseptic osteonecroses in the treatment of childhood acute leukaemias.

The incidence of aseptic osteonecroses in the therapy of acute leukaemias in children has been studied. Out of 551 children treated at the Children's Hospital in Münster from 1971 to 1985, 6 developed osteonecrosis, an incidence of 1.09%. Of these children, 5 showed unilateral or bilateral necrosis of the femoral head. The osteonecroses occurred 8-109 months after initiation of the primary therapy or of the relapse treatment. The corticoid doses did not differ from those administered to other leukaemia patients without necrosis. Only 1 patient had received prednisone continuously for 1 year, at a total dose of 20.5 g/m2 of body surface area. Of these 6 children, 4 had been immobilized for several weeks before or during therapy. Two children had presented with pain-related relieving posture of the joints in which subsequently the osteonecrosis developed. Inactivity associated with the cortisone therapy seems to be an important factor in the development of aseptic osteonecroses.

Adolescent↗
PubMed1989

Cerebral blood flow velocity assessed by Doppler technique after intravenous application of diazepam in very low birth weight infants.

Studies on the side effects of diazepam on the particularly vulnerable brain of preterm infants have not been done so far. We studied changes of blood flow velocity in the anterior, basilar and internal carotid artery by Doppler technique in 11 preterm infants less than 1,500 g who were given 0.5 mg/kg i.v. diazepam. The flow velocities in the internal carotid and basilar artery did not change significantly and values for carbon dioxide tension, mean arterial blood pressure and HF remained stable. There was a marked increase of flow velocity in the anterior cerebral artery. We conclude that diazepam in this dosage does not cause dangerous haemodynamic changes in the premature brain.

Blood Flow Velocity↗
PubMed1988

Investigations of renal artery blood flow velocity in preterm and term neonates by pulsed Doppler ultrasonography.

So far, echo-Doppler studies of the renal arteries have only been performed in adult subjects. They dealt with qualitative parameters of blood flow, but absolute velocity values could not be determined. This paper presents a method for measurement of absolute values of renal artery blood flow velocity in infancy with a well-defined steep angle of insonation of less than 25 degrees by using a range-gated Doppler system with Duplex-scan. The renal blood flow patterns were studied at specified sites by placement of the transducer below the costal arches on the right flank and left flank, respectively. Thus, a reference collective of 65 infants (26-40 weeks of gestational age, 650-3990 g body weight and 1-145 days of postnatal age at the time of examination) were studied. The time mean of maximum velocity significantly increased with the body weight from 17 cm/s below 1000 g to 29 cm/s above 3000 g of body weight. Whereas the pulsatility indices were independent of body weight. The reproducibility of the method, coefficient of variation (CV) 3%-9%, is comparable with the studies of cerebral vessels.

Blood Flow Velocity↗
PubMed1987

Median cleft face syndrome in association with hydrocephalus, agenesis of the corpus callosum, holoprosencephaly and choanal atresia.

A premature female infant had the characteristic features of the median cleft face syndrome in association with holoprosencephaly, agenesis of the corpus callosum, hydrocephalus and choanal atresia. Whereas the nervous system is rarely affected in patients with the median cleft face syndrome, severe mental retardation has been reported in three previously published cases and is suggested in our own patient. All had an associated agenesis of the corpus callosum.

Abnormalities, Multiple↗
PubMed1987

[Chronic fetomaternal macrotransfusion].

A case of massive chronic fetomaternal transfusion with a loss of 500 ml blood is reported. A review of 24 cases covering the last 10 years shows that chronic fetomaternal transfusions do not lead to intrauterine dystrophy. During birth there is a danger of acute decompensation, which led to an irreversible shock and death in five of the 24 children. Hepatomegaly (7/24) often accompanies cardial insufficiency. The histories of the pregnancies are usually normal. In 5 of 17 women fetal distress was only indicated by antepartal cardiotocography; premature delivery was induced in these cases.

Adult↗
PubMed1986

[Femur head necrosis in sickle cell anemia].

The clinical course and therapy of femoral head necrosis after a minimal trauma in a 14 year old Turkish girl with sickle cell anemia is described. In this hemoglobinopathy one must be aware of complicated clinical courses even after minor accidents. The immediate start of therapy in an acute crisis and the early diagnosis of bone infarction and femoral head necrosis are necessary to avoid large bone defects.

Adolescent↗
PubMedDate not supplied

[Pethidine analgesia and cerebrovascular circulation in very small premature infants].

Aim of the study was the assessment of possible side effects of analgesia with pethidine on the intracerebral circulation of very immature preterm infants. For this purpose the blood flow velocity in the internal carotid artery, basilar cerebral artery and the anterior cerebral artery was measured by pulsed Dopplersonography before and 5-10 min after i.v. injection of 1.0 mg/kg pethioine on 10 preterm infants with a gestational age of 24-30 weeks. Furthermore values for the parameter mean arterial blood pressure, heart frequency and tcpCO2 were obtained. None of the measured parameters showed a significant difference with the i.v. bolus injection of pethidine. As even very immature preterm infants do feel pain and can show potential dangerous physiological pain reactions and as this study proves the tolerance of the drug, analgesia with morphine derivates is recommended.

Blood Flow Velocity↗
PubMedDate not supplied

[Determination of methotrexate concentration in serum: comparison between capillary and venous blood].

The methotrexate serum concentrations of 15 patients were measured in capillary and veneous blood samples. All of the patients had received methotrexate infusions because of their underlying oncologic disorder. The drug levels of 42 pairs of capillary and veneous drawn serum samples were analysed with a homogeneous enzyme immunoassay technique on a semi-automatic instrument system. In 15 pairs of samples the drug levels were below the range of the assay, in 3 they were just above. Here the capillary samples were measurable, whereas the veneous ones were not. 24 pairs of samples which had drug levels within the range of the assay showed a good correlation of capillary and veneous serum levels. The correlation factor of 0.934 shows, that the methotrexate concentrations can also be measured in capillary blood samples.

Bone Neoplasms↗