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Biomedical subjects

M Schlemmer

Publications and source records attributed to M Schlemmer.

49 records · Page 3Linked to original sources

[The operated ASDI (author's transl)].

The postoperative course of 37 children with atrial septal defect primum type with or without a cleft in the septal mitral or tricuspid valve, is traced. The mortality rate, the number of postoperative rhythmic disorders and the success of functional restitution of the mitral valve are emphasized. The number of patients between 1962-1979 was 37. The age was between 3 years and 5 month and 14 years and 9 month. As a parameter of success or failure of the operation the pre- and postoperative symptoms, the ECG and PCG, the X-ray of the chest and the postoperative echocardiogram were considered.

Adolescent↗

[Romano Ward syndrome].

About syncopal attacks caused by cardial arrhythmias had been frequently reported. In one family we found female members of three generations affected by characteristical prolongation and alteration of the QT-interval in ECG. All patients suffered from attacks with loss of consciousness which could not be defined as epileptic fits. Ventricular arrhythmias have to be considered as reason for the attacks. This combination of symptoms without additional malformations (i.e. congenital deafness) is well known in literature as Romano Ward Syndrome. Mode of inheritance, pathogenetic mechanisms and possibilities of therapy are discussed. Therapy witha beta blocking medication (propranolol) made our younger patient free of attacks, the other two patients have no complaints since two years without any therapy.

Adult↗

[Noonan syndrome in the differential diagnosis of Turner syndrome].

In children with growth retardation and the typical face, particularly with valvar pulmonary stenosis, the Noonan syndrome is the be suspected. In early infancy, these patients show very severe developmental retardation and muscular hypotony. Mental retardation is frequent but not compulsory. The most important diagnostic tool is the chromosomal analysis. In our patient, the syndrome was diagnosed becaused of the typical appearance and the angiocardiographic findings in connection with a normal chromosomal sequence.

Child↗

[Tracheal compression by the innominate artery (author's transl)].

A five week old male infant is treated under suspicion of whooping cough because of pertussis like cough, cyanosis, and attacks of reflex apnea. These attacks are seen up to 40 times per day. After exclusion of a cerebral genesis there was found a ventral indentation of the trachea. It was also seen by tracheoscopy, but this part of the trachea was not pulsating. In the angiography the compriming structure was identified as the innominate artery. The genesis of this anatomic variant, the often threatening symptoms in this case without inspiratoric stridor, and the diagnostic and therapeutic steps are discussed.

Brachiocephalic Trunk↗

Fatal complications after pacemaker implantation in a baby.

In a three day-old infant with congenital heart block a pacemaker had to be inserted. Prolonged intravenous pacing led to septicaemia with fatal thrombotic complications. The potential spread of infection along the electrodes, and the danger of the presence of an intracardiac foreign body, suggest that myocardial electrodes may be superior in small infants.

Electrodes, Implanted↗

[Experiences with aldactone in pediatric cardiology (author's transl)].

In Pediatric Cardiology for many years the usage of spironolactone (Aldactone) and Canreonat-K+ (Aldactone pro injectione) had been experienced. The efficiency of aldactone was controlled by clinical parameters, electrolytes, discontinuity of the drug and in some cases by radioimmunologic measurement of the plasma aldosterone concentration. The treatment with aldactone in combination with digitalis gave good clinical results in cases with and without signs of secondary hyperaldosteronism. The recommended dosage i. v. and orally was for infancy 2--3 mg/kg/die the first 2--4 days and afterwards 1,5--2 mg/kg/die, for later childhood 4--5 mg/kg/die for 3--5 days and afterwards 2--3 mg/kg/die. Special attention should be paid to hyperkaliemia, over 6 mval serum K+ the aldactone administration was interrupted.

Child↗

[Left ventricular aneurysm in an eight-year-old girl (author's transl)].

A female patient with a heart murmur typical for mitral insufficiency that was first heard, when she was 17 months old, is reported. In the ECG flattened T-waves in the left praecordial leads are seen. Because of a typical x-ray seven years later the diagnosis of leftventricular aneurysm was suspected, guaranteed by angiocardiography and because of repeated supraventricular tachycardias the congenital aneurysm was operated. A differentiation between congenital diverticulum and congenital aneurysm is established, the clinical symptoms of this malformation and the therapeutic consequences are discussed.

Angiocardiography↗

[Serum concentrations of proteinase inhibitors, complement components and of acid alpha-1-glucoprotein in children with myocarditis (author's transl)].

We examined 4 panels of children and 40 control patients for their serum levels of the complement components C3, C4 and the C3 activator, the proteaseinhibitors alpha-1-antitrypsin, alpha-2-macroglobulin and acid alpha-1-glycoprotein. Children of the group with active myocarditis revealed the consumption of the complement system, increased protease inhibitors and elevated acid alpha-1-glycoprotein. Group 2, children with the clinical diagnosis chronic myocarditis or status post myocarditis showed in six of seven cases low complement levels and elevated alsGP. 4 children showed increased A1AT and five increased A2MG. In the third panel: status post myocarditis, we estimated in five of eight patients complement activation, 4 children showed increased A2MG and alsGP and in 3 cases elevated A1AT levels were detected. Group 4 children revealed no complement consumption and showed no increased levels for the other proteins estimated, with the only exception of 1 case with increased alsGP. The children of the control group showed normal levels for the six proteins. By means of the examinations an inflammatory process can be detected, tissue injury can be indicated and the participation of the immune system can be shown.

Adolescent↗

[Cognitive development of children and adolescents after correction of transposition of great vessels].

BACKGROUND: To study the effect of transposition of the great arteries on later cognitive functioning. PATIENTS: Twentyeight children and adolescents underwent psychometric testing 3.5 to 13.7 years following operation. METHODS: A battery of intelligence, attention and visual memory tasks as well as the Draw-a-Man-Test were administered. Parents completed standardized questionnaires on developmental milestones. RESULTS: Both, mean verbal (93 +/- 15) and performance IQs (97 +/- 21) were normal. The length of interval between operation and psychologic test but not age at repair was a significant predictor of intelligence quotient. Half of the children (9/18) showed attention deficits, 7/11 (64%) were identified as suspect of brain dysfunction. Performance on the Draw-a-Man-Test disclosed 12 (43%) as slightly mentally retarded. CONCLUSIONS: (1) Cognitive functions in children with TGA are more impaired than suggested by the results of intelligence tests. (2) Psychological and neurologic follow-up should be mandatory from early on. (3) Previous studies have overestimated children's intelligence due to unrecognized changes of test norms.

Adolescent↗