[Morphology of the pancreas in permanent fistulization of the major pancreatic duct].
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Animals↗
Biomedical subjects
W Engelhardt
Publications and source records attributed to W Engelhardt.
Absorption of volatile fatty acids, tritiated water and antipyrine from the abomasum of goats.
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Abomasum↗
Multicentre study for diagnostic evaluation of an assay for simultaneous detection of antibodies to HIV-1, HIV-2 and HIV-1 subtype 0 (HIV-0).
The aim of the study was to evaluate a new ELISA for detection of HIV-1, HIV-2 and HIV-1 subtype 0 (HIV-0) antibodies. The assay format is based on the antigen sandwich principle. To enable specific detection of HIV-0 antibodies, in addition to HIV-1 and HIV-2 antigens HIV-0 antigen is used for coating the solid phase and for the conjugate. The results show that all 12 HIV-0 samples tested were detected with a high degree of reactivity, as were all the 1,144 anti-HIV-1 and 424 anti-HIV-2 positive samples. The capacity of the test to enable early detection of seroconversions is equivalent to that of other sandwich ELISAs. The specificity of the assay was determined to be 99.89/99.94% (initial/after retest) using 58,366 samples, which is superior to the other ELISAs used for comparison. Even with difficult samples (i.e. samples of African origin, samples known to cause false-positive reactivity in different ELISAs, or samples containing potential interference factors) there were very few false-positive reactions. Therefore, the new assay is well suited for screening blood donations as well as for evaluating samples from patients of different geographic origin.
Enzyme-Linked Immunosorbent Assay↗
Long-term pancreatic duct occlusion impairs the entero-insular axis in the dog--failure of plasma VIP to respond as "incretin".
The response of VIP to either an oral glucose load (OGT) or intravenous glucose (IV glucose), aimed at reproducing the plasma glucose level after OGT, was studied in trained, conscious, sham-operated (Sham; n = 6) dogs, and dogs having initially (12 months before the glucose experiments) undergone occlusion of the pancreatic duct by the prolamine glue technique (Occ; n = 5). As a result, prior to glucose studies, the exocrine pancreas function was found subtotally reduced, as indirectly evaluated by the para-aminobenzoic acid (PABA) test, but no signs of diabetes were detected. The two studies with glucose administration designed to demonstrate the release of insulin, VIP, somatostatin into plasma as modified by enteric signals (represented by the difference of plasma peptide concentration during OGT minus peptide concentration during IV glucose) revealed the following: (1) basal plasma glucose, insulin, VIP, somatostatin did not differ between Sham and Occ dogs; (2) after OGT in Occ dogs the plasma glucose was elevated, whereas plasma insulin was markedly reduced, and VIP, somatostatin were largely unchanged; (3) the integrated output of insulin only was impaired when considering the so-called entero-insulin axis, while integrated VIP, somatostatin were unaltered. It was concluded (a) the Occ procedure in the dog has the capacity to subtotal destruction of the pancreatic acinar tissue, and of the entero-insular axis of insulin, the latter through yet unknown pathways, (b) the Occ technique may be a useful tool for investigation of the nature of "incretin," (c) VIP and somatostatin do not respond to elevated blood glucose and may have no role in the "incretin" concept of enteric modulation of the B-cell.
Animals↗
[Anticoagulation with phenprocoumon in early childhood: dosage, complications, effectiveness].
The dose-response relationship of the Vitamine-K-antagonist Phenprocoumon (Marcumar) was studied in a group of 11 children and 10 adults receiving anticoagulation postoperatively after mechanical valve replacement. The dose in children was found to be lineally correlated to the body surface area and similar to that in adults (saturation dose: 16.0 +/- 3.2 mg/m2; maintenance dose: 11.2 +/- 1.6 mg/m2/week). During the follow up period (265 patient months) one child died from mitral valve thrombosis, two children developed traumatic haematomas, and in one child interactions with 2 other drugs were observed. The incidence of thrombembolism or serious bleeding complications was 4.5 and 9.0 instances per 100 patient-years, respectively. The efficiency of prothrombin time control was established over a six months period and showed 70.3% of the values within, 23.% above, and 6.5% below the therapeutic range. During this period, the prothrombin time was measured 2.5 times per patient and month at the average. We conclude from our experience, that an anticoagulation therapy with Phenprocoumon can be performed in children with only mildly elevated risk of bleeding complications as effectively as in adults provided it is monitored closely.
4-Hydroxycoumarins↗
[Congenital pulmonary vein stenosis as a rare cause of pulmonary hypertension].
We report on the history, the diagnostic, and the operative procedure in an infant with congenital stenosis of all pulmonary veins. First symptoms such as failure to thrive, tachydyspnea, tachycardia and hepatomegaly occurred in the eighth week of life. Electrocardiography, 2-dimensional echocardiography and radiography of the chest were unspecific. After recurrent episodes of pulmonary oedema cardiac catheterization was performed: bilaterally elevated pulmonary artery wedge pressure and a normal left atrial pressure proved pulmonary venous obstruction. Severe stenosis of all pulmonary veins was apparent cineangiographically only by selective injections into the right and left pulmonary artery branches in wedge position. The operation (excision of the stenotic area and reimplantation using autologous pericardium) was unsuccessful as in most cases described in the literature. Congenital stenosis of all pulmonary veins is a rapidly progressive malformation. Death occurs usually in the first year of life with and without operation.
Cardiac Catheterization↗
[Percutaneous removal of embolized catheters from pulmonary arteries or the right heart in children].
We report on our experience in four children with disconnected and embolized venous catheter segments in the pulmonary arteries or the right heart. In three of these, a percutaneous retrieval of the detached catheter via the femoral vene was successful. In one girl, all trials to grasp the catheter segment within the upper pulmonary lobe artery failed. For retrieval, either a snare wire or a Dotter-basket-catheter was used. Additionally, in two cases a tip deflecting guide wire system was proved as helpful for mobilisation of the catheter to better attainable sites of the heart. We conclude that pervenous retrieval of embolized catheter segments in children is possible and should be tried.
Adolescent↗
Basal gastric secretion, mucosal blood flow and associated fasting blood hormones in the rat. Effects of various forms of sympathectomy.
After various types of sympathectomy (surgical, chemical, isolated adrenodemedullation; AMX, combined procedures) in the rat, basal gastric secretion, gastric mucosal blood flow (MBF), associated glucose and a variety of hormones in the blood were measured. With the exception of the ineffective surgical sympathectomy, all the other forms variously influence gastric secretion qualitatively (volume, acidity, pepsin) and quantitatively (output per unit time). Chemical sympathectomy has an augmenting effect both on acid (volume, acidity, output) and on pepsin. In general the MBF parallels acid, but the MBF is decreased after AMX despite stable or increased gastric secretion. Sympathectomy, except procedures involving AMX or AMX + surgical sympathectomy, increases spontaneous gastric mucosal lesions. With AMX glucose is diminished, but is elevated following surgical and chemical sympathectomy. Gastrin, insulin and somatostatin are always higher than in sham-operated controls, glucagon after surgical sympathectomy only. It is concluded that (1) the sympathoadrenal system in the rat modulates both basal gastric secretion and blood hormones; (2) the adrenal medulla may participate in the control of gastric MBF, and (3) gastric mucosal lesions are not correctly reflected by the ration MBF/acidity.
Animals↗
[Diagnosis and therapy of fetal brady-arrhythmia].
Fetal rhythm disorders are one cause of intrauterine bradycardia. Diagnosis can be made by fetal echocardiography. Echocardiographic pattern and clinical course of the 4 most important fetal bradyarrhythmias are described and compared to the corresponding CTG findings. Intermittent sinus bradycardia, atrial extrasystoles with 2:1 block and ventricular bigemini have a good prognosis, whereas the outcome of the fetus with congenital atrioventricular (av)-block is depending upon degree of bradycardia and association of congenital heart malformation. The CTG feature of bigeminal blocked atrial or ventricular extrasystoles is characterized by rapid change of fetal heart rate between two different frequency levels. In sinus bradycardia or in congenital av-block no typical CTG pattern is evident. Longlasting or repetitive bradycardia should stimulate fetal echocardiography to detect rhythm disorders in order to better plan the further course of pregnancy.
Adult↗
[Intrauterine therapy of fetal supraventricular tachycardia with digoxin and verapamil].
Fetal supraventricular tachycardia may cause intrauterine heart failure and thus require transplacental treatment. During a period of nine years, we treated nine of eleven fetuses (gestational age ranging from the 26th to the 36th week) suffering from paroxysmal supraventricular tachycardia (10) or atrial flutter (1). The remaining two fetuses did not receive antiarrhythmic therapy because of only short lasting supraventricular tachycardia. Two fetuses were hydropic at the onset of therapy. Diagnosis of the rhythm disorder was established by m-mode echocardiography. All nine fetuses treated received digoxin after diagnosis of supraventricular tachycardia. Three of these reverted to sinus rhythm, one remained in supraventricular tachycardia which, however, was well tolerated. Five fetuses (three because of failure of digoxin alone and two because of a severely symptomatic supraventricular tachycardia) were treated with a combination of digoxin and verapamil. All five fetuses responded to the combined treatment, two of them, however, were delivered prematurely because of recurrence of supraventricular tachycardia in one and amnion-infection syndrome in the other. All patients survived and no severe fetal or maternal side effects were observed. Our experience confirms that digoxin and verapamil are usually effective in treating fetal supraventricular tachycardia. Some fetuses with short lasting and self limiting supraventricular tachycardia may not need any treatment, and a few not responding to digoxin and verapamil may require other antiarrhythmic drugs.
Cardiotocography↗