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Biomedical subjects

W Berman

Publications and source records attributed to W Berman.

At least 109 records · Page 6Linked to original sources

Surgical management of severe aortic coarctation and interrupted aortic arch in neonates.

Forty-four infants, 2 to 90 days of age, with severe obstructive lesions of the aortic arch, underwent emergency surgical correction between Jan. 1, 1966, and April 1, 1975. The typical clinical presentation was severe congestive heart failure and acidemia. Resection of an aortic coarctation with end-to-end anastomosis was performed in 31 patients. Eight (26 per cent) died after the operation. Since 1969, the mortality rate has been reduced to 14 per cent (3 of 22 patients) even though the incidence of major associated cardiac lesions has remained essentially constant (56 per cent from 1966 through 1969, 64 per cent from 1970 through March, 1975). This suggests that the higher survival rate has resulted from improved surgical techniques and postoperative care. The mortality rate in the infants operated upon during the second and third months of life was twice as high as that in those operated upon before the age of 1 month. Eight patients with Type A interrupted aortic arch were operated upon and 5 survived. Five patients with Type B aortic arch were operated upon and 3 survived.

Aorta↗

The effects of exchange transfusion on intracranial pressure in patients with Reye syndrome.

Intracranial pressure has been monitored in ten patients with Reye syndrome. All of the patients were comatose and all were treated with dexamethasone, mannitol, hyperventilation, and multiple exchange transfusions. Five of these children are alive and well; five died. In each case ICP monitoring allowed for immediate treatment and evaluation of the mode of therapy used to reduce elevated ICP. Exchange transfusions in all patients either reduced the increased ICP or made the pressure rises easier to manage. ICP is not always reflected by lumbar spinal fluid pressure or clinical state. In our hands, ICP monitoring has proved to be a safe technique for the investigation of the significance of raised ICP in the outcome of patients with Reye syndrome and of the effectiveness of a chosen therapy in reducing this pressure.

Brain Diseases↗

Measurement of umbilical blood flow in fetal lambs in utero.

We continuously measured umbilical blood flow in fetal lambs in utero by placing an electromagnetic flow transducer around the common umbilical artery. Umbilical arteries originate from a short common segment as the terminal branches of the descending aorta. This segment was isolated by a retroperitoneal surgical approach and encircled with a specially constructed electromagnetic flow transducer. Catheters were also placed in fetal vessles to monitor pressure and derive flow values by the radionuclide-labeled microsphere technique. The fetus and ewe were allowed to recover for two days before studies were performed. Average umbilical blood flow obtained in 11 animals with the transducer was 199 ml/kg per min. In seven animals flow measurements obtained with the transducer were compared with those derived from microsphere injections. Paired measurements varied by an average of only 5.3%. This technique makes possible the accurate and instantaneous measurement of umbilical blood flow in fetal lambs in utero over a prolonged period.

Animals↗

Combined immunodeficiency presenting as the Letterer-Siwe syndrome.

Four infants with skin rash, hepatosplenomegaly, lymphocytosis, eosinophilis, and histiocytic infiltration of the lymph nodes and skin are described; in each of these infants an initial diagnosis of the Letterer-Siwe syndrome was made. Postmortem findings of thymic dysplasia and poorly differentiated, lymphopenic peripheral lympoid tissue in each of the four infants, as well as antimortem clinical findings in one, established a diagnosis of severe combined immunodeficiency. From these and similar cases in the literature, we postulate that the Letterer-Siwe syndrome may not be an unusual presentation of combined immunodeficiency. Appropriate immunologic studies will help to differentiate the two disorders.

Autopsy↗