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Biomedical subjects

L Gortner

Publications and source records attributed to L Gortner.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Treatment of unilateral space-occupying pulmonary interstitial emphysema with positioning measures and high-frequency ventilation].

Five very low birthweight infants manifested unilateral tension pulmonary interstitial emphysema (PIE). All infants required intermittent positive pressure ventilation for respiratory distress syndrome. PIE was managed by positioning the infant on his (or her) side with PIE and by shortening the inspiratory time, in four patients also by shortening exspiratory time resulting in a higher frequency ventilation. PIE resolved within 3-6 days after institution of this treatment. This was paralleled by a reduction of FiO2 as well as peak inspiratory pressures. All infants could successfully be extubated 2-6 weeks after birth.

Combined Modality Therapy↗
PubMed1986

Estimation of digoxin dosage in VLBW infants using serum creatinine concentrations.

Digoxin steady state plasma concentrations (Css) and the corresponding serum creatinine concentrations were studied in 17 VLBW infants. Birth weight was in the range of 760-1 500 g (mean 1 068 g), gestational age ranged from 26 to 32 weeks (mean 28.7 weeks). Digoxin steady state plasma concentrations were found in the range of 0.5-6.5 ng/ml (mean 1.88 ng/ml) during maintenance therapy with 1.6-8.4 micrograms/kg BW/24 h (mean 4.4 micrograms/kg BW/24 h) given in two divided doses intravenously. No digoxin-like immunoreactive substance could be detected in the plasma of 18 infants (10 patients with a birth weight less than or equal to 1 500 g, 8 patients with a birth weight of 2 100-4 730 g) that were not treated with digoxin. The calculated digoxin clearance ranged from 0.38-4.03 ml/min/kg BW. Serum creatinine concentrations were found in the range of 35-274 mumol/l (0.4-3.1 mg/100 ml). A hyperbolic correlation may be derived from the digoxin clearance and the corresponding serum creatinine concentration. A linear relationship was observed between the dose normalized digoxin concentrations (y = Css/dose in 24 h) and the respective creatinine concentrations x (y = 0.52x-0.05; n = 17; s = 0.24; r = 0.86; p less than 0.01). According to this equation we suggest a dosing schedule for digoxin in VLBW infants with impaired renal function. Digoxin maintenance dose is derived from the digoxin target and the creatinine serum concentration. This dose recommendation proved reliable on four VLBW infants (birth weight 770-1 260 g) with decreased renal function.

Creatinine↗
PubMed1986

[Exchange transfusion via a peripheral arteriovenous vascular access in premature infants].

Exchange transfusions were performed in two very low birth weight infants using peripheral arteries and veins. Patient 1, a 1020 g infant of 34 weeks gestation developed cholestatic jaundice with plasmatic coagulation disturbance and hyperkalemia, patient 2 a 820 g preterm baby of 26 weeks gestation manifested hyperbilirubinemia. After cannulation of the radial artery blood was withdrawn from the arterial catheter, while simultaneously equal volumes of warmed donor blood were replaced by a second operator through a venous catheter. Subependymal hemorrhage which was demonstrated by ultrasound in both patients prior to the exchange transfusion did not enlarge.

Arteries↗
PubMed1975

Influence of isoprenaline and salbutamol on the threshold of electrically induced ventricular fibrillation in anaesthetized guinea pigs.

Fibrillation threshold and heart rate were measured after increasing doses of (-)-isoprenaline and (plus or minus)-salbutamol. The initial values of 212 plus or minus 10 muA (x plus or minus SEM) and 211 plus or minus 10muA were decreased to 74 plus or minus 10 muA by low doses of (-)-isoprenaline (10-11- to 10-10 moles/kg i.v.), and to 89 plus or minus 11 muA by (plus or minus)-salbutamol (10-9- to 10-8- moles/kg i.v.). Higher doses, paradoxically, increased fibrillation threshold to initial values, (-)-isoprenaline: 2x10-9- moles/kg; (plus or minus)-salbutamol: 2x10-6- moles/kg. A linear increase in heart rate per 10-fold increase of either drug was observed, (-)-isoprenaline: 25 beats - min-1-; (plus or minus)-salbutamol: 14 beats - min-1-. The apparent beta2-selective property of salbutamol is documented by its low potency in changing fibrillation threshold and heart rate.

Albuterol↗
PubMedDate not supplied

[Early auditory evoked potentials in very small premature infants].

BACKGROUND: Brainstem auditory evoked response (BAER) is a sensitive test of the functional integrity of the auditory pathway. Latencies and amplitudes of measured waveforms reflect maturation of this brainstem pathway and may allow a prediction for neurological outcome. PATIENTS AND METHODS: BAER were measured prospectively in preterm infants with a birthweight less than 1500 g at 3 to 4 day following birth and during treatment on neonatal intensive care unit (NICU) every two weeks. Pre- and postnatal risk factors and frequency of apnea were evaluated. Outcome was scored after 1 year corrected age by neurological examination. RESULTS: There were no significant differences in latencies of waves between 5 children with severe asphyxia and/or IVH resulting in major neurological handicaps after 1 year. However, two of these children have bilateral abnormalities. The slope of decay of wave latencies decreased between 30 and 32 weeks gestational age, while the number of registered apnea increased. In follow up investigations during treatment on NICU there was a decrease in interpeak latencies wave V to wave III from 24/25 weeks gestational age to term infants and increase in amplitudes. CONCLUSION: Early performed BAER alone is not a good predictor for neurological outcome of preterm infants because of great interindividual variability of normal neonates and the anatomical site of cerebral lesions. The method contributes information on the brainstem maturation and may also reflect the different maturational stages of the respiratory system.

Asphyxia Neonatorum↗
PubMedDate not supplied

[Wilson-Mikity syndrome as a cause of respiratory insufficiency of prematurity].

The Wilson-Mikity syndrome is a differential diagnosis of chronic lung disease in the neonate and primarily related to immaturity. It is characterized by the absence of typical clinical and radiological findings of the respiratory distress syndrome (RDS). Infectious causes are being discussed.

Bronchopulmonary Dysplasia↗
PubMedDate not supplied

[Leishmaniasis with cutaneous and visceral involvement in a 13-month old boy].

Leishmaniasis is an anthropozoonosis caused by infection with leishmania parasites with either cutaneous, mucosal or visceral (kala-azar) involvement. While the benign cutaneous form is self-limited death occurs in approximately 80% of children with kala-azar when untreated. The diagnosis of kala-azar should not be missed in children presenting with fever, hepatosplenomegaly and pancytopenia especially with a history of sand fly bites. We report the case of a 13-month-old boy with both cutaneous and visceral involvement.

Animals↗
PubMedDate not supplied

[Treatment of hepatitis B virus-associated membranous glomerulonephritis with interferon alfa in a 7 year old boy].

BACKGROUND: The association between Hepatitis B virus infection and membranous nephropathy has been confirmed by sources in several countries. Most commonly, the illness is seen as a nephrotic syndrome. Optimal treatment remains undefined. Antiviral therapies observed with recombinant human interferon alpha may be the best treatment option. CASE REPORT: We present a 7-year old boy with membranous glomerulonephritis and nephrotic syndrome. Twelve months after the initial hospitalization therapy was started with recombinant alpha-interferon s.c. three times weekly for six months. After the therapy the patient is stable, without proteinuria, edema or renal failure. He was seronegative for HBsAg, HBV-DNA and antibody to HBeAg. CONCLUSIONS: This case report suggests that alpha interferon is effective in the complete resolution of proteinuria in HBV membranous nephropathy.

Antiviral Agents↗
PubMedDate not supplied

[Neonatal ascites: meconium ileus with perforation in mucoviscidosis].

Many conditions are known associated with neonatal ascites such as cardiac and vascular malformations, as well as malformations of the brain, kidney, lung and bone, chromosomal abnormalities, infections, fetal anemias, tumors, metabolic and maternal conditions. In 30% no reason can be found. Meconium ileus is a causal gastrointestinal abnormality. We report about a preterm infant 35 weeks of gestation with complicated meconium ileus because of mucoviscidosis.

Ascites↗
PubMedDate not supplied

[Cutaneous lesions and blood count changes in a 9-month old girl with glutaric aciduria type I].

Non-specific cutaneous lesions are common in patients suffering from acute myeloid leukemia (AML). Leukemic skin infiltrates are present in about 30% of cases of monoblastic or myelomonocytic leukemia. The appearance of specific skin lesions can precede bone marrow involvement. We report the case of a 9-month-old girl with acute myelogenous leukemia (FAB M5) and glutaric aciduria type I which initially presented with cutaneous lesions, anemia and leukopenia.

Amino Acid Metabolism, Inborn Errors↗
PubMedDate not supplied

[Familial Mediterranean fever].

BACKGROUND: Familial Mediterranean fever (FMF) is characterized by febrile attacks, acute abdominal pain, pleuritis or arthritis and predominantly observed in ethnic groups of the Mediterranean area (Sephardic Jews, Turks, Armenians). Its most ominous manifestation is amyloidosis potentially leading to chronic renal failure. FMF is an inherited disorder caused by mutations of the FMF-gene, which first was described in 1997. CASE REPORT: We report a 10-year old turkish boy and his family presenting with an increased blood sedimentation rate (WBC) and recurrent attacks of acute abdominal pain. A molecular analysis was carried out, confirming a typical mutation of the FMF-gene. The patient remained free of symptoms after starting therapy with colchicine. CONCLUSION: Investigation of the FMF gene enables an early diagnosis in case of clinical suspect findings, subsequent colchicine administration may prevent amyloidosis.

Abdominal Pain↗
PubMedDate not supplied

[MCTD in the differential diagnosis of cerebellar ataxia].

Mixed connective tissue disease is a rare disorder in childhood and seldom affects the CNS. The detection of U1-n-RNP antibodies in blood and CSF as well as speckled immunofluorescence pattern are diagnostic.

Antibodies, Antinuclear↗
PubMedDate not supplied

Protein content and biophysical properties of tracheal aspirates form neonates with respiratory failure.

BACKGROUND: We aimed at assessing the quality and quantity of protein-leakage across the alveolar-capillary membrane and its influence on surfactant function during the early neonatal period in preterm infants compared to newborns both with respiratory failure. PATIENTS AND METHODS: We therefore prospectively analyzed total protein, elastase-alpha1-proteinase inhibitor complex (E-alpha1-PI) and alpha2-macroglobulin concentrations in tracheal aspirates from 31 infants < or = 32 weeks gestational age (group 1 : 29.3 +/- 2 weeks, 1214 +/- 410 g [means +/- SEM]) and from 21 neonates > 32 weeks (group 2 : 37.5 +/- 3 weeks, 2890 +/- 600 g [means +/- SEM]) and measured their surface activity in the pulsating bubble surfactometer. RESULTS: Day 1 total protein and alpha2-macroglobulin levels indicated an initial high leakage that declined to day 3 in both groups (from 1652 +/- 241 to 708 +/- 227 mg/l; p < 0.05; resp. from 28 +/- 6 to 12 +/- 4 mg/l [means +/- SEM]). In group 2 E-alpha1-PI concentrations were significantly elevated at day 1 compared to group 1 (15 754 +/- 5766 versus 3320 +/- 1056 microg/l [means +/- SEM]). In both groups a high minimum surface tension (15 - 30 mN/m) was recorded from day 1 - 4. CONCLUSIONS: These results suggest in larger newborns a secondary surfactant deficiency due to protein-leakage to play an important role in the pathogenesis of respiratory failure. The increased alveolar-capillary membrane permeability might be caused by inflammatory ARDS-like mechanisms.

Birth Weight↗
PubMedDate not supplied

[Hereditary deficiency of C1-esterase inhibitor presenting with recurrent abdominal pain].

Hereditary deficiency of C1-esterase inhibitor (C1-INH) which clinically manifests as hereditary angioedema is a rare disorder. In previously not diagnosed cases, a fatality rate of up to 30 % has been reported. The diagnosis of C1-esterase inhibitor deficiency should not be missed in patients presenting with angioedema in the face, stem or extremities. We report the case of a 17-year-old girl with recurrent abdominal pain and swelling of the hands.

Abdominal Pain↗