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Biomedical subjects

H Stopfkuchen

Publications and source records attributed to H Stopfkuchen.

At least 73 records · Page 4Linked to original sources
PubMed1977

The anatomy of the heart in the sonogram. A comparison between anatomic and ultrasonic cross-section.

Cardiac sonography has only recently been introduced as a diagnostic procedure. In order to facilitate the interpretation and evaluation of the ultrasonic cardiac cross-section displayed by this two-dimensional technique, we performed anatomic cross-sections corresponding to ultrasonic cross-sections. The ultrasonic cross-sectional images were taken from children with a real-time-motion scanner. The anatomic cross-sections were taken from adult hearts. Two ultrasonic transverse cross-sections are compared with the two corresponding anatomic cross-sections and three ultrasonic longitudinal cross-sections with one corresponding anatomic cross-section. The direct comparison between anatomic and ultrasonic cross-sections best promotes the understanding of the latter: such a comparison shows certain gaps of information in the ultrasonic display, mostly due to the physical prerequisites of the technique. Morphological details, therefore, should be interpreted with great care. In spite of these disadvantages, sonography is the only non-invasive method that provides an exact analysis of the heart's structure. In addition to this, the real-time-motion technique allows observation of the movements of cardiac structures.

Child↗
PubMed1977

Congenital sinus bradycardia combined with congenital total atrioventricular block.

Sinus bradycardia and total atrioventricular block were found at the age of seven months in a boy who is now 16 1/2 years old. According to Yaters (1929) criteria, these are likely to be congenital disorders. While the frequency of the ventricular impulse generator in the upper bundle of His only slowed in accordance with age during the period of observation, the sinus node activity deteriorated considerably. Finally potentials could only be sporadically demonstrated. Under heavy stress and with a simultaneous slight increase in ventricular frequency, a re-occurence of regular but slow sinus node activity came about. The cause of this binodal disorder of rhythm is unknown. There is no indication of family affliction or of myocarditis in early childhood. Congenital heart disease could also be excluded.

Adolescent↗
PubMed1976

[Adriamycin cardiomyopathy in a child with Wilms tumor and liver metastases (author's transl)].

Nephrectomy with irradiation was performed in a 3;2 year old boy with Wilms tumor stage IV (livermetastases (liver metastases). Six months later a hemihepatectomy was performed on account of the liver metatases which persisted under a combined Actinomycin Vincristin therapy. A monotherapy with Adriamycin was instituted. The patient developed acute congestive heart failure. The patient developed acute congestive heart failure and showed typical EKG changes after a total dose of 700 mg/M2 of Adriamycin. In comparison to adults children reportedly tolerate somewhat higher total doses of Adriamycin. Therefore it is discussed, if in this case a limitation of liver function by hemihepatectomy and by irradiation has favored the appearance of the Adriamycin-induced cardiomyopathy.

Acute Disease↗
PubMed1976

[Purpura fulminans associated with varicella and polyvalent protective inoculations (author's transl)].

We report about a 10 5/12 years old boy, who developed the rare disease of Purpura fulminans following Varicella, after having received the trivalent Poliomyelitis vaccine of Sabin and a diphtheria-tetanus booster during the incubation period of Varicella. The acute stage of the disease was overcome by symptomatic therapy; extensive skin necrosis especially in the lower extremities had to be treated surgically. The etiology of Purpura fulminans has not yet been established. Since diffuse intravascular clotting (DIC) plays an essential part in the pathogenesis of this disease. Heparintherapy is now used as the treatment of choice. At the present state of knowledge we believe that the protective inoculations given in the incubation period of Varicella possibly provoced Purpura fulminans as a rare complication of Varicella.

Chickenpox↗
PubMed1975

[Moving-picture corss-sectional echocardiography in normal children].

Using a parallel-scan B-mode ultrasonic system (Vidoson, Siemens) 200 children with clinically normal hearts were examined. Using a cross-section parallel to the left sternal border, rapid and easily reporducible multi-frame echocardiograms were obtained with simultaneous presentation of the aortic, pulmonary and mitral valves. Interpretation of this cross-section, with echos from the three valves, the aortic route, pulmonary artery, right and left ventricles and left atrium, was checked against post-mortem studies and in-vivo contrast studies with ultrasonic contrast medium (indocyanine-green). As the described method is not ECG-triggered, only important morphological changes are demonstrable.

Adolescent↗
PubMed1975

[Inconstant left bundle-branch block with a dependent wenckebach period in childhood].

Paroxysmal supraventricular tachycardia with left bundle branch block was found in a six-year-old girl. After prophylactic treatment with digitalis and with beta-adrenergic blocking agents, intermittent left bundle branch blocks appeared frequently. Thereby one could see repeatedly the pattern of a dependent Wenckebach phenomenon not yet described in childhood. Dependent Wenckebach phenomenon means the gradual development of a complete bundle branch block depending on the increasing atrial frequency drugin respiratory sinusarrhythmia. Immediately after complete bundle branch block, when the atrial frequency decreases significantly, the conductiondisturbance again normalized. Contrary to this, preexisting left bundle branch block disappeared when the frequency was increased by Orciprenalininfusions and be exercise. An evident explanation for this contrary behaviour cannot be given.

Arrhythmia, Sinus↗
PubMed1975

[Cyclic agranulocytosis (author's transl)].

Report about cyclic agranulocytosis in a 10 1/2 years old girls, having stomatitis, sore throat and fever up to 39 degrees C in the interval of approximately 3 weeks since the age of 6 months. By the prophylactic treatment with pulverized tetracyclin, which is already given 2 days prior to the expected decrease of the neutrophils, the patient stays clinically asymptomatic since 7 months.

Agranulocytosis↗
PubMedDate not supplied

Echocardiographic diagnosis of Candida endocarditis of the tricuspid valve and of the right atrium in a young infant.

Systemic candidiasis developed in a seven-week-old premature baby after 6 weeks treatment with antibiotics for suspected septicemia. At that time the echocardiogram showed a dense layer of echoes posteriorly to the anterior tricuspid leaflet during atrial systole. The diagnosis of Candida endocarditis with vegetations on the tricuspid valve and with right atrial thrombus secondary to the Candida infection was verified by autopsy.

Anti-Bacterial Agents↗
PubMedDate not supplied

[What is a Sufficient Blood Pressure in the Preterm Newborn?].

Hypotension is diagnosed in a high percentage of very low birth weight infants, particularly in the first 24 hours after birth and the resultant clinical approach is to support the blood pressure vigorously. However, the research base is not yet available to give a definite answer to the question, which blood pressure is really unacceptable in a given clinical situation. The clinical approach usually relies on reference blood pressure data or on clinical considerations. Reference blood pressure ranges established from observations of rather stable preterm infants and commonly used in "normal" premature infants are age- and weight related so-called "normal" blood pressures and "rules of thumb" while cerebral autoregulation adapted or outcome related lower limits of arterial blood pressure could be promising alternatives. Clinical signs, results of laboratory studies and cardiac function monitoring are tools used in stable and unstable premature infants for assessing if an acute blood pressure is adequate to prevent tissue malperfusion. In this rather unsatisfactory situation there is a growing body of evidence that also in premature infants systemic or regional blood flow and not blood pressure are the crucial hemodynamic parameters and that also in this age group there is at best a weak correlation between mean arterial blood pressure and left ventricular output or regional blood flow.

Age Factors↗
PubMedDate not supplied

[Low molecular heparin for treatment of venous thrombosis in two very low-birth-weight pre-term infants with genetic risk factors].

We describe the use of low molecular weight heparin to treat venous thrombosis in two very low-birth-weight pre-term infants (GA: 30 and 27 weeks) both with genetic and acquired prothrombotic risk factors. Initially both infants were treated with unfractionated heparin. Since in one infant no effect on the thrombus size was observed and in the other infant there was an increase in size, the anticoagulation therapy was switched to subcutaneously injected low molecular heparin (Enoxaparin). During enoxaparin therapy the anti-Xa-level was carefully monitored and dosages were adjusted accordingly. Partial resolution of the thrombosis was achieved in both infants during enoxaparin therapy. No clot extension or recurrence of thrombosis occurred. An accidental overdose of Enoxaparin (100 times the required dosage) was administered to one infant without any consequences. Our data suggest that the use of low molecular weight heparin (Enoxaparin) for treatment of venous thrombosis in our two preterm infants was practical, safe and effective.

Dose-Response Relationship, Drug↗
PubMedDate not supplied

[Drowning accidents in childhood].

This paper reviews the pathophysiology and therapy of the multiorgan failure which occurs with submersion injury of children. First, the influence of hypothermia, the pulmonary, cardiovascular, neurologic and renal changes and the blood gas, acid-base and bloodvolume and serum electrolyte disturbances are discussed in detail. The therapeutic procedures are separated in the cardiopulmonary resuscitation at the scene of the accident and in the management of the children within the hospital where all near-drowned children should be taken. The intensity of the treatment at the hospital depends on the level of consciousness and on the respiratory and cardiovascular problems of the near-drowned child. For the treatment of comatose children with abnormal patterns of respiration and cardiovascular derangements the routine management and a more aggressive approach to therapy are presented. The rational for the aggressive therapy is to improve cerebral salvage. The urgency for an extensive monitoring system is underlined.

Body Temperature Regulation↗