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Biomedical subjects

B Werner

Publications and source records attributed to B Werner.

205 records · Page 12Linked to original sources
PubMedDate not supplied

Anomalies of the coronary arteries in children.

BACKGROUND: Anomalies of the coronary arteries in children occur very rarely. Congenital coronary anomalies may be isolated, or they may accompany other congenital heart defects, such as Fallot's Syndrome, transposition of the great arteries, or pulmonary atresia. The most common cause of acquired abnormalities of the coronary vessels in children is Kawasaki Disease. The purpose of the present study is to analyze the clinical picture and diagnostic methodology for coronary anomalies in children. MATERIAL AND METHODS: In 62,320 children a routine echocardiographic assessment was made of the ostium and the course of the initial segment of the coronary arteries. Anomalies of the coronary arteries were found in 29 children, ranging in age from 1 day to 12 years. In 25 of these cases the diagnosis was established on the basis of two-dimensional echocardiography with Doppler flow mapping, confirmed in 16 cases by aortography. In 3 children with Fallot's Syndrome and in 1 child with common arterial trunk, the coronary anomalies were found in angiocardiography. RESULTS: Isolated abnormalities of the coronary vessels were found in 18 children, including 13 cases of anomalous left coronary artery from the pulmonary artery, 1 case of anomalous right coronary artery from the pulmonary artery, and four cases of coronary fistula. In 9 children anomalies of the coronary arteries accompanied other congenital heart defects: 4 children with Fallot's Syndrome were found to have left descending coronary artery arising from the right coronary artery; 1 child with a common arterial trunk was diagnosed with anomalous common origin of coronary arteries; 3 children with transposition of the great arteries were found to have coronary anomalies (including 2 cases of anomalous circumflex branch from the right coronary artery, and 1 case of intramural course of the left coronary artery), and one child with pulmonary atresia was found to have coronary fistulas. Of the 2 children with Kawasaki Disease, one was diagnosed with an aneurysm in the left coronary artery, and the other with dilatation of the coronary arteries. The infants with abnormal divergence of the left coronary artery showed clinical and electrocardiographic signs of myocardial ischemia, while the newborns with fistulas presented with symptoms of circulatory insufficiency. These children required emergency surgical treatment. CONCLUSIONS: The clinical picture of children with anomalies of the coronary vessels may be heterogeneous, ranging from a lack of symptoms to very acute, even life-threatening symptoms. Infants with anomalous left coronary artery from the pulmonary artery and with hemodynamically significant fistulae require emergency surgical treatment. Echocardiographic examination enables the diagnosis of anomalies of the coronary arteries. In the majority of cases an aortography test is necessary before the patient is referred for surgery.

Adolescent↗
PubMedDate not supplied

[Recent aspects of antirheumatic therapy in the elderly].

Consequences have to be derived in respect to the antirheumatic treatment from recent withdrawals of several non-steroidal anti-inflammatory drugs (NSAID). This especially applies for elderly patients with reduced renal function. The dosage has to be carefully adjusted to the individual problems of the patient. No attempts should be made to achieve a completely pain-free state by use of highest dosages: the lower the dose maintaining the patient's mobility, the safer the therapy. NSAID with long elimination half-life time carry a special risk of adverse effects for the elderly due to accumulation. Reduced renal function of the elderly may also result in hypertension and heart failure. Combination of NSAID with glucocorticoids may enhance the antiinflammatory effect, but also causes an increase of adverse effects. Therefore, the combined use appears to be justified only in special situations of severe inflammatory activity no sufficiently controlled by NSAID in which the glucocorticoids are used in the lowest effective dose applied according to the circadian rhythm. The duration of treatment is to be limited, since the adverse effects of glucocorticoids increase with time.

Aged↗
PubMedDate not supplied

Superoxide production by neutrophils in children with malignant tumors treated with recombinant human granulocyte colony-stimulating factor.

BACKGROUND: Human recombinant granulocyte colony-stimulating factor (rhG-CSF), widely used to combat chemotherapy-induced neutropenia, stimulates both in vivo and in vitro intra- and extra-cellular O2- production in human polymorphonuclear cells (PMNs). PATIENTS AND METHODS: Twelve patients with solid tumors or acute lymphoblastic leukemia were treated during induced aplasia with rhG-CSF (5 micrograms/kg/day). Intra- and extracellular O2- production by PMNs isolated from these patients after 5 days of rhG-CSF therapy was assessed following both fMLP and PMA stimulation. RESULTS: All patients showed a rise in PMN count; administration of rhG-CSF enhanced intra- and extracellular O2- release after fMLP but not after PMA stimulation. CONCLUSIONS: rhG-CSF potentiates in vivo O2- production by PMNs stimulated with receptor-mediated agonists via G-protein (e.g. fMLP), but not by those stimulated with agonists that bypass receptors via protein kinase C (e.g. PMA).

Adolescent↗
PubMedDate not supplied

[Residential gerontopsychiatry or who helps homes in management of psychiatric elderly patients? A study of all old age and nursing homes of the Gütersloh district 1991].

In 1991, there existed 20 homes and nursing homes for the elderly in the district of Gütersloh (Nordrhein-Westfalen, Federal Republic of Germany) with a total of 1518 beds. 56,000 persons aged 60 years and more rsp. 41,000 persons aged 65 years and more are living in this area. This means 2.7 beds per 100 persons aged 60 years and more are provided, or 3.7 beds per 100 persons aged 65 years and more. 22.5% of the home residents are in need of care, grade II (care is necessary for some activities of daily living), 55.6% are in need of care, grade III (care is necessary in most or all activities of daily living). Only three of the homes have a special department or ward for residents with high grades of need of care; in all the other homes residents with high grades of need of care are supported together with residents with lower grades of need of care. One home has a special psychogeriatric department with two wards, another one a single psychogeriatric ward. The leading staff members of the homes assessed that 831 out of 1861 residents in the whole year 1991 were mentally disordered, i.e., a rate of 44.65% in which is similar to the results of comparable studies. 75% of the admissions of mentally disordered persons are arranged by family members or relatives. Only 7% come directly from the psychogeriatric department of the responsible psychiatric clinic in the area (Westfälische Klinik für Psychiatrie).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

Superoxide release by human polymorphonuclear leukocytes in the presence of deferoxamine.

BACKGROUND AND OBJECTIVE: Anecdotal reports in patients with acute and chronic iron overload have recently indicated that the efficacy and safety of an alternative chelation program including intravenous and/or continuous delivery of deferoxamine (DFO) may be in contrast with the risk of developing lung injury. Production of oxygen radicals has been postulated to be an important mechanism by which polymorphonuclear leukocytes (PMNs) could cause tissue injury in patients undergoing this alternative treatment method. METHODS: PMNs obtained from healthy donors were incubated at 37 degrees C for 30 min with DFO (across the drug concentration 0.125 to 10 mg/mL). Superoxide (O2) production was measured by superoxide inhibitable cytochrome c reduction as well as by an NBT densitometric kinetic test. In the same run the effect of lipid peroxidation was demonstrated by means of a malonyl-dialdehyde (MDA) assay. RESULTS: Preincubation of PMNs with any study concentration of DFO significantly enhanced O2 release as well as MDA production upon PMA stimulation. Maximal intracellular and extracellular O2-release as well as MDA production occurred at certain drug concentrations. INTERPRETATION AND CONCLUSIONS: Our in vitro findings suggest that O2-release may be an additional detrimental contribution to tissue injury in some patients who develop pulmonary toxic effects while on intravenous and/or continuous DFO administration.

Antidotes↗
PubMedDate not supplied

[Granular cell tumor of the esophagus: report of two cases with endoscopic removal and immunohistochemistry].

The authors present two cases of granular cell tumor affecting the esophagus. The patients, one male and one female, were 48 and 52 years old. Although both tumors were small (1 and 1.5 cm in diameter), they produced local symptoms. Endoscopical removal was done in both patients and histological examination revealed granular cell tumors. Immunohistochemistry showed positivity for S 100 protein in both cases further corroborating to a Schwann cell origin for these legions.

Endoscopy, Digestive System↗