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Biomedical subjects

M Burdelski

Publications and source records attributed to M Burdelski.

At least 145 records · Page 8Linked to original sources
PubMed1978

Quantitative changes of serum lipoprotein-X after cholestyramine administration in infants with cholestatic biliary tract and liver disease.

Lipoprotein-X (LP-X) was determined before and after the administration of cholestyramine in fifty-five infants with persistent cholestatic jaundice to differentiate between intra- and extrahepatic disease. In twenty-seven infants with biliary atresia, serum LP-X prior to cholestyramine ranged from 0.87 to 11.42 g/l (mean: 3.43 g/l; the average concentration was significantly lower (P less than 0.001) in males. After cholestyramine, LP-X rose in twenty-three, remained the same in two, and decreased slightly in two infants. Serum LP-X was present in twenty of the twenty-eight infants with intrahepatic cholestasis prior to cholestyramine in concentrations from 0.84 to 14.19 g/l (mean: 3.13 g/l). After cholestyramine, LP-X decreased in all by an average of 78% (P less than 0.005). The other eight infants did not have LP-X before or after cholestyramine. This study shows that LP-X in the serum of infants with cholestatic jaundice indicates severe cholestasis, but is not itself diagnostic of biliary atresia. The differentiation of biliary atresia from other diseases is readily achieved, as the administration of cholestyramine for 2-3 weeks causes a marked decrease of serum LP-X in patients with patent extrahepatic bile ducts. The absence of serum LP-X excludes biliary atresia.

Bile Ducts, Intrahepatic↗
PubMed1976

[Congenital saccharase-isomaltase deficiency: a six-year survey (author's transl)].

Saccharase-isomaltase deficiency was discovered in five children. The diagnosis was made on the basis of an abnormal oral saccharose loading response and demonstrating decreased activity of intestinal saccharase and isomaltase in the presence of normal small-intestinal mucosa. Three children failed to thrive, and all had recurrent diarrhoea. The diagnosis was made in children aged six to twenty-two months. Treatment consisted of saccharose-free diet or feeding with an enzyme preparation, Bi-Myconase. Saccharose-containing foods were increasingly tolerated beyond the second year of life so that children aged 2 1/2 to 3 1/4 years no longer required special treatment.

Age Factors↗
PubMed1976

[Intestinal suction biopsy in childhood of experiences during 1968-1975 (author's transl)].

From 1968 to 1975 532 intestinal suction biopsies were obtained in 371 children and adolescents using the paediatric Watson capsule. The youngest patient was 2 months old; a 9 months old infant has the lowest body weight of 3 520 g. Mucosal specimens were mainly taken from the upper jejunum. The whole procedure mostly required not more than 30 minutes. No serious complications were seen. Due to technical troubles several attempts were ineffective; the rate of successful biopsies was 89%. The paediatric Watson capsule proved to be easy to handle, mostly reliable, and therefore very suitable for intestinal biopsy in childhood. The dissecting microscope and histological findings were classified into four groups: normal mucosa, slight, moderate and severe mucosal lesions. Severe lesions were almost only demonstrated in patients with coeliac disease: in the active phase, in the early phase of remission under gluten free diet and during gluten loading or normal diet respectively, furthermore in an infant with protracted diarrhoea and in a child with agammaglobulinemia. A flat mucosa is not pathognomonic for coeliac disease but a constant morphological attribute and conclusive for diagnosis. Moderate mucosal lesions were seen in the remission of coeliac disease or during gluten loading and in some cases with protracted diarrhoea of infancy and with chronic malabsorption of unknown origin, furthermore in a child with immunoglobulin deficiency and in another one with iron deficiency anemia. The examination with the dissecting microscope can be performed very easily and makes obvious a very exact diagnostic information which is completed by the histological examination.

Adolescent↗
PubMedDate not supplied

Experiences with liver transplantation in Hannover.

Ninety orthotopic liver transplantations in 86 patients performed between 1972 and 1983 in the Medical University of Hannover are reviewed. Results in tumor patients (n = 46) are characterized by a high rate of early tumor recurrence. A few patients survived for prolonged periods, and some were cured. More experience is required to define more precisely suitable kinds and stages of malignancies so that liver grafting in tumor patients can be confined to situations with a favorable prognosis. The main problem of liver transplantation in cirrhotics (n = 40) is the appropriate time of indication. It is suggested that liver grafting be performed more often in an "elective" situation. This phase during the course of cirrhosis must be optimally defined by analysis of the underlying disease and by individual situation. Results of liver grafting in elective situations are better than those in emergency situations and may offer a tangible chance for cure. Liver grafting in pediatric patients gives the best results, although procurement of small donor organs is a major problem. More experience, better immunosuppression with cyclosporin A, and the search for the appropriate time of indication contribute to improvement in the results of liver grafting.

Adolescent↗
PubMedDate not supplied

Recurrent septicemias with Enterococcus faecium.

A 17-year-old male patient with extrahepatic biliary atresia underwent an orthotopic liver transplantation in September 1994. In blood cultures drawn in November and (6 weeks later) December 1994, from bile secretions in May 1995, stool in June 1995 an wound abscess in August 1995, ampicillin-resistant Enterococcus faecium was isolated. Pulsed-field gel electrophoresis demonstrated the clonal identity of the isolates. To our knowledge, repeated infections with the same E. faecium strain over a period of 9 months have not been described before. As multiple-resistant enterococci may colonize and reinfect liver transplant recipients for such a long time, preoperative antibiotic therapy should be administered cautiously in order not to select these organisms.

Adolescent↗