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Biomedical subjects

W Berman

Publications and source records attributed to W Berman.

At least 91 records · Page 5Linked to original sources
PubMed1978

Congenital tricuspid incompetence simulating pulmonary atresia with intact ventricular septum: a report of two cases.

Two infants with isolated congenital tricuspid incompetence appeared to have associated right ventricular outflow tract obstruction at diagnostic evaluation, including catheterization and cineangiography. One infant died during surgery; the other improved rapidly and survived with medical therapy. We discuss the problem of establishing the presence of patency of the right ventricular outflow tract in infants with massive tricuspid incompetence and outline an approach to the management of infants whose diagnosis remains unclear even after careful evaluation.

Angiography↗
PubMed1978

Pacemakers in young patients: 1977.

Recent experience with implanted cardiac pacemakers in nine young patients is reported. Advance in technology include improved pacemaker generator design and placement, and improved lead design and placement. No patients died; our only complication, failure to capture, required repositioning of the lead. All pacemaker replacements were elective. This series helps to define the more favorable current prognosis for the young patient needing pacemaker therapy.

Heart Block↗
PubMed1978

Digoxin therapy in low-birth-weight infants with patent ductus arteriosus.

Digoxin therapy was evaluated retrospectively in a group of 30, and prospectively in a group of 16 low-birth-weight, premature infants with cardiorespiratory symptoms due to persistent patency of the ductus arteriosus. The response to decongestive therapy was equivocal. Digoxin levels in serum varied between 1.5 and 13 ng/ml. Digoxin half-life in serum exceeded three days in four patients. Fourteen of the combined group of 46 infants had signs of toxicity of digoxin. High dosage, inadvertent overadministration, and variable clearance of digoxin, as well as special characteristics of the patients studied, are postulated as explanations for the high incidence of toxicity. This study suggests that digoxin therapy in low-birth-weight, premature infants with patent ductus arteriosus is not without risk.

Digoxin↗
PubMed1978

Effects of pharmacologic agents on umbilical blood flow in fetal lambs in utero.

We studied the effects of pharmacologic agents on umbilical blood flow and umbilical-placental vascular resistance in 18 fetal lambs in utero. Three groups of drugs were identified: the first had no effect on umbilical blood flow or umbilical-placental vascular resistance; the second altered umbilical blood flow secondary to changes in heart rate and placental perfusion pressure, but did not change umbilical-placental vascular resistance; the third decreased umbilical blood flow and increased umbilical-placental vascular resistance. The studies suggest mechanisms by which umbilical blood flow is regulated in the fetal lamb.

Acetylcholine↗
PubMed1978

The development of pulmonary vascular obstructive disease after successful Mustard operation in early infancy.

Pulmonary vascular obstructive disease developed postoperatively in an infant with aortopulmonary transposition and intact ventricular septum who underwent a Mustard operation in 3 months of age. Preoperative catheterization had shown normal pulmonary artery pressures. Four months after surgery, catheterization showed pulmonary artery systolic pressure above the systemic level and a tortuous, attenuated pulmonary vascular tree visualized angiographically. Early corrective surgery may not preclude the development of pulmonary vascular obstructive disease in patients with aortopulmonary transposition.

Blood Pressure↗
PubMed1978

Enterococcal endocarditis: duration and mode of treatment.

This report summarizes data on sixteen patients with enterococcal endocarditis treated with penicillin and streptomycin. The experience reported suggests that a four week period is adequate for routine therapy in these patients, as in other forms of streptococcal endocarditis. It provides an additional group of patients successfully treated with penicillin and streptomycin. Two relapses were encountered. One of these received inadequate daily doses of penicillin. The other patient was clearly a failure of penicillin and streptomycin, but the failure in this instance could not be attributed to foreshortened treatment (6 weeks) or to high level streptomycin resistance of the infecting strain of Enterococcus.

Adult↗
PubMed1978

Furosemide in hyaline membrane disease.

In a randomized clinical trial designed to evaluate the effect of diuresis on infants with hyaline membrane disease, seven infants were treated with furosemide (2 mg/kg intravenously) and five received 5% dextrose water in 0.225% sodium chloride (control group). Arterial blood gas analyses performed before and during the six hours after treatment showed no significant difference between control and treated infants. Urine output and urine sodium and calcium loss were significantly increased (P less than .05) in the infants receiving furosemide. The diuresis seemed to have no effect on left atrial size determined echocardiographically, whereas measurements of dynamic skinfold thickness suggested mobilization of subcutaneous water. One infant became seriously dehydrated and hypotensive secondary to a massive diuresis. We concluded that furosemide had a potent diuretic effect in infants with hyaline membrane disease but does not improve cardiorespiratory function acutely. This may be because of failure to mobilize pulmonary interstitial fluid in the time period tested. It may also be possible that the presence of pulmonary interstitial fluid does not play an important role in the impairment of gas exchange in the acute stage of hyaline membrane disease.

Carbon Dioxide↗
PubMed1978

Triventricular heart with three atrioventricular valves in a conjoined twin.

An infant, who was conjoined to a partially formed twin, died from congenital cardiac disease which could not be diagnosed accurately by catheterization and cineangiography. Pathologic examination showed a triventricular heart with three atrioventricular valves. One great vessel system was present, and the aorta was transposed. The findings in this infant suggest that the incorporation of cardiac anlage from an incompletely or abortively formed fetus may explain the presence of supernumerary structures in complex congenital cardiac malformations.

Abnormalities, Multiple↗
PubMed1978

Effects of scoring norms on adolescent psychiatric drug users' and nonusers' MMPI profiles.

The present study compared the effects of scoring norms on adolescent psychiatric inpatient drug users' and nonusers' MMPI profiles. The results indicated that regardless of drug usage or nonusage the application of adolescent norms yielded less pathological profiles than did the use of adult norms. A further finding was that Scale O, Social Introversion, is the only clinical scale from differentiated users' from nonusers' profiles.

Adolescent↗
PubMed1977

Differential effects of digoxin at comparable concentrations in tissues of fetal and adult sheep.

Electrocardiogram (ECG) electrodes and carotid arterial and superior vena caval (SVC) catheters were placed in eight nonpregnant ewes and 11 fetuses (109-129 days gestation) to measure heart rate, arterial presssure, P-R interval, left ventricular pre-ejection period (PEP), and left ventricular ejection time (LVET), before and after digoxin infusion into the SVC. After the ewes were killed, the steady state concentration of digoxin in plasma was related to the concentration in midbrain and left ventricular free wall. Although concentrations of digoxin in tissue differed between fetuses and ewes, tissue-plasma ratios were similar; the myocardial-plasma ratio was 87 for fetuses and 90 for ewes and the midbrain-plasma ratios were 6.4 and 5.3, respectively. In spite of these similarities, physiological and toxic effects differed at comparable plasma concentrations. Reduction in PEP/LVET ratio was greater in ewes than fetuses, and P-R interval prolongation was linearly related to digoxin concentration in fetuses but uncommon at plasma concentrations below 2 ng/ml in ewes. Arrhythmias occurred in six ewes, but in only one fetus, even though the mean steady state concentration of digoxin in plasma was 4.5 ng/ml in the fetuses and 2.3 ng/ml in the ewes. Atropine had little effect on digoxin-induced P-R interrval prolongation, and isoproterenol produced no tachyarrhythmias in the fetuses. Age-related differences in inotropic and arrhythmogenic effects of digoxin exist exist and are related to differences in drug response rather than drug kinetics; this provides experimental support for the different dosage responses.

Animals↗
PubMed1976

Intracranial pressure monitoring in Reye's syndrome.

Reye's syndrome is difined as fatty degeneration of the viscera with encephalopathy. The signs are change in consciousness after recovery of a viral illness, vomiting, high fever, and progresseve deterioration of the level of consciousness. Signs of brain stem involvement quickly follow. The clinical findings are: mild elevations of serum transaminases (SGOT and SGPT), normal to slightly elevated bilirubin, abnormal blood-clotting functions, normal to low blood glucose, high blood ammonia, and normal cerebrospinal fluid which may be under increased pressure. Death is due to increased intracranial pressure. Therapy is used to stabilize these signs. It includes: infusion of hypertonic glucose followed by insulin, peritoneal dialysis, and exchange transfusion. Intracranial pressure was monitored continually to determine when therapy should be administered.

Brain Diseases↗
PubMed1976

Relationships between pressure and flow in the umbilical and uterine circulations of the sheep.

We studied the relationship of fetal and maternal vascular pressures to umbilical and uterine blood flow in the unanesthetized ewe and in the sheep fetus in utero by placing electromagnetic flow transducers around both the common umbilical and uterine arteries. Reductions in umbilical arterial pressure or elevations in umbilical venous pressure decreased umbilical blood flow without affecting either the uterine arterial blood flow or other maternal cardiovascular variables which were studied. Elevations in uterine venous pressure or reductions in uterine arterial pressure decreased uterine arterial flow but these interventions had no effect on umbilical blood flow until fetal hypoxemia and bradycardia occurred. When the bradycardia of the fetal hypoxic response was inhibited by atropine, alterations in maternal vascular pressure had no effect on umbilical arterial flow. These data do not support the presence of a "sluice" or "waterfall" effect in the umbilical-placental circulation of the sheep fetus in utero.

Animals↗