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Biomedical subjects

W L Kramer

Publications and source records attributed to W L Kramer.

At least 19 recordsLinked to original sources
PubMed2003

[Hypertrophic pyloric stenosis in infants: laparoscopic pyloromyotomy].

OBJECTIVE: To evaluate the results of laparoscopic pyloromyotomy in infants with hypertrophic pyloric stenosis (HPS). DESIGN: Retrospective. METHOD: Data from medical records were collected on all children who underwent laparoscopic extramucosal pyloromyotomy for hypertrophic pyloric stenosis in the period from 1 October 1993 to 31 March 2001 in the Wilhelmina Children's Hospital of the Utrecht University Medical Centre, the Netherlands. RESULTS: A total of 133 children were operated: 108 boys (81%) and 25 girls (19%). The mean age on the day of operation was 35.3 days (SD: 15.4). Of these children, 17 (13%) were ex-prematures and 8 (6%) were ex-dysmatures, and 40 (30%) had a positive family history for HPS. The mean operating time was 29 min (SD: 10); per surgeon, the first 5 operations required over 30 minutes on average and the following operations lasted an average of 26 minutes. Postoperatively, 84 patients (63%) no longer vomited. Four children required a second operation. The mean period from operation to discharge was 61.6 hours (SD: 46.0). Complications included: perforations of the mucosa (n = 4; 3%), wound infections (n = 4; 3%) and small incisional hernias (n = 5; 4%). CONCLUSION: Laparoscopic pyloromyotomy is an efficient and safe operative technique for the treatment of infants with HPS.

Female↗
PubMed2001

Once-daily versus multiple-daily gentamicin in infants and children.

In this prospective randomized trial, the efficacy and safety of once-daily administration of gentamicin were compared with multiple-daily administration in infants and children. In addition, pharmacokinetic variables were calculated. Gentamicin therapy was started at a dose of 5 mg/kg per day under individual dose or dosage interval adjustments to achieve target levels. Fifty-two infants and children aged 1 month (postterm) to 16 years were enrolled. The duration of fever from the start of therapy, the percentage decline of C-reactive protein (CRP) on day 3 of treatment, and the clinical outcome were used as efficacy parameters. Nephrotoxicity was evaluated using creatinine serum levels. Basic characteristics in both groups were comparable. A good clinical response was observed in both groups. Fever may have resolved faster with multiple-daily administration, but this was not statistically significant. The percentage of decline of CRP was also comparable in both groups. Nephrotoxicity occurred in six patients, three per group. Many patients were too ill or too young to perform hearing tests, but no clinical signs of ototoxicity were observed. Mean doses of 6.8 mg/kg per day (multiple-daily administration) and 7.3 mg/kg per day (once-daily administration) were necessary to meet the target gentamicin levels. Triple-daily doses had to be reduced to a twice-daily regimen in 17 of 26 children. Dose and dosage interval adaptations can be performed by Bayesian forecasting using a one-compartment model with one set of K(e) and V(d) parameters. The authors consider both regimens equally effective, with a comparable incidence of nephrotoxicity. A starting dose of 6.5 mg/kg once daily is advised.

Adolescent↗
PubMed2001

Acute dyspnoea resulting from pulmonary oedema as the first sign of a phaeochromocytoma.

The day after undergoing neck dissection, a 42-year-old woman developed acute dyspnoea due to pulmonary oedema. Measurements with a Swan-Ganz catheter revealed not only cardiac depression but also a greatly increased peripheral vascular resistance: 5,400 dyn x s x cm(-5)/m2. A phaeochromocytoma with acute cardiac failure leading to pulmonary oedema was considered. Treatment with alpha- and beta-blockers was complicated by severe hypotension and later ventricular fibrillation. Mechanical ventilation was required for 6 days following resuscitation. Investigation of the urine subsequently showed greatly increased catecholamine concentrations, while imaging revealed bilateral adrenal tumours. Our case history shows that acute pulmonary oedema may be the presenting manifestation of a phaeochromocytoma. The pulmonary oedema resulted partly from backward failure following tachycardia, myocyte necrosis and the greatly increased peripheral vascular resistance, and partly from increased permeability of the capillary network in the lungs.

Adrenal Gland Neoplasms↗
PubMed2001

Record of Aedes albopictus in Nebraska with notes on its biology.

Adult Aedes albopictus were collected in Nebraska on August 10, 1992, at a scrap tire pile in Douglas County. Subsequent collections in 1992 revealed the presence of adult Ae. albopictus at a tire storage yard in West Point, NE. During 1995 and 1996, an ecological study of Ae. albopictus at the West Point site was conducted. Aedes albopictus populations were determined to be able to survive winter conditions in this region.

Aedes↗
PubMed1999

[A woman with an advanced malignant clear cell hidradenoma].

A 67-year-old patient was admitted for diabetes mellitus. Incidentally a large ulcerating tumour was found on the right upper leg. The patient had been suffering from the lesion for six years but had never dared to show it to her physician. Notwithstanding negative outcome of thin needle aspiration oncological dissection was carried out. Histopathological examination proved the tumour to be a malignant clear cell hidradenoma, which is a rare eccrine tumour. This tumour is known to be aggressive and easily spreads to locoregional lymph nodes. Even though it is a rare disease, the aggressive behaviour and the poor prognosis warrant alertness to this neoplasm.

Acrospiroma↗
PubMed1999

Seasonal incidence and geographical variation of Nebraska mosquitoes, 1994-95.

A mosquito survey was conducted in Nebraska during 1994-95. Mosquitoes were collected by CO2-baited CDC light traps at 11 localities throughout Nebraska. Total mosquitoes collected was 685,581 per trap (mean = 790) and 1,163,741 per trap (mean = 1,372) during 1994 and 1995, respectively. Twenty-seven mosquito species representing 8 genera were collected. The most abundant mosquitoes collected statewide were Aedes vexans at 74% of the 2-year total, Culex tarsalis at 11%; Aedes trivittatus, 5%; Aedes melanimon, 1.5%; and Aedes triseriatus, 1%. The floodwater mosquitoes were more prevalent in eastern Nebraska while standing-water mosquitoes, especially Culex tarsalis, were more prevalent in the west.

Animals↗
PubMed1998

Surveillance for arthropod-borne viral activity in Nebraska, 1994-1995.

A 2-yr arbovirus surveillance program was established in Nebraska following the midwest flood of 1993. CDC light traps were used to collect mosquitoes at 11 localities throughout Nebraska. In 1994, we collected 685,582 mosquitoes, and we tested 1,359 pools of Culex mosquitoes for arbovirus infection, with St. Louis encephalitis virus isolated from 2 pools collected in Scotts Bluff County in western Nebraska. In 1995, 1,163,741 mosquitoes were collected and 2,788 pools tested, with 36 positive for western equine encephalomyelitis (WEE) virus. Thirty of the WEE-positive pools were collected in Scotts Bluff County, 4 pools from the city of Norfolk and 2 from the city of Grand Island. All viruses were isolated from Culex tarsalis Coquillett. The highest minimum infection rate of 3.81 per 1,000 mosquitoes was observed in Scotts Bluff County on 13 September 1995. The seasonal minimum infection rate for WEE was 0.52 in Scotts Bluff County. No human or horse disease attributed to arboviral infection was reported in Nebraska during 1994 and 1995.

Animals↗
PubMed1996

Carcino-embryonic antigen--no help with the differential diagnosis.

Two patients who were referred because of an increase in serum carcino-embryonic antigen (CEA) were diagnosed after a number of years as having a medullary thyroid carcinoma. The relationship between CEA and medullary thyroid carcinoma is discussed. The serum level of CEA is neither sensitive nor specific enough to serve as a diagnostic tool. Its determination, however, is useful in the follow-up of patients with carcinoma of the breast, colo-rectal carcinoma and medullary thyroid carcinoma.

Aged↗
PubMed1990

Isolation of arboviruses from Culicoides midges (Diptera: Ceratopogonidae) in Colorado during an epizootic of vesicular stomatitis New Jersey.

An arbovirus survey was conducted in Colorado and Utah during an epizootic of vesicular stomatitis New Jersey (VSNJ) that occurred in the western United States in 1982-1983. From 120,422 insect specimens assayed, 106 viruses were isolated. Four were rhabdoviruses (VSNJ), three were orbiviruses (bluetongue serotype-11), 92 were Bunyamwera group (65 Main Drain and 27 Lokern), and seven were Simbu group (Buttonwillow) bunyaviruses. Culicoides spp. accounted for 105 viral isolates (C. (Selfia) spp., C. variipennis (Coquillett), C. stellifer (Coquillett), and C. cockerellii (Coquillett], and one was from Simulium bivittatum Malloch. C. (Selfia) spp. accounted for 59% of all pooled specimens and was the source of 89.6% (95) of the isolates. Insects from two sites accounted for 44% (52,802) of all pooled specimens and 67% (71) of the viral isolates. The isolations of VSNJ, Main Drain, Lokern, and Buttonwillow viruses from C. (Selfia) spp. are the first arbovirus isolations reported for this subgenus; this is the first time these viruses have been isolated from Culicoides species other than C. variipennis.

Animals↗
PubMed1990

Culicoides spp. (Diptera: Ceratopogonidae) associated with cattle in St. Croix, Virgin Islands, and their relevance to bluetongue virus.

Potential biting midge vectors were collected at two sites on St. Croix as part of an ongoing study on the epidemiology of bluetongue viruses in the Caribbean region. Six species of Culicoides were trapped in a New Jersey light trap (mean = 173 biting midges/trap night) near cattle on a dairy farm. C. furens (Poey) and C. insignis Lutz were the predominant phototactic species, and C. pusillus Lutz, C. trilineatus Fox, C. jamaicensis Edwards, and C. phlebotomus (Williston) were collected less frequently. Four species of Culicoides were aspirated from bovine bait during the morning and evening crepuscular periods with a modified car vacuum. C. furens was aspirated primarily from the ventral portions of the bovine host, whereas C. insignis and C. pusillus were collected principally from the dorsum, and C. trilineatus was collected equally from all aspects. At least one individual of each of these aspirated species was blood engorged. Because C. furens, C. insignis, C. pusillus, and C. trilineatus were most abundant and feed on cattle, they deserve further consideration as vectors of bluetongue virus on St. Croix.

Animals↗
PubMed1987

Epizootic vesicular stomatitis in Colorado, 1982: epidemiologic and entomologic studies.

An epizootic of vesicular stomatitis (VS) caused by the New Jersey serotype of VS virus affected livestock and humans in 14 western states in 1982-1983. Epidemiological observations were made on at least 10% of the cattle in 4 dairy herds that were located in the vicinity of Grand Junction, Colorado. High rates of neutralizing antibody to the New Jersey serotype were seen in all cattle regardless of whether livestock in the dairy had clinical VS or a decrease in mild production. Antibody titers remained high in these cattle for as long as 2 years after the epizootic. No virus isolations were made from 32 humans with clinical signs compatible with viral disease. Entomological information was obtained during the epizootic from 23 premises in northwestern Colorado. Insect collections yielded 4 isolates from Culicoides spp. midges, 2 from C. variipennis, and 1 each from C. stellifer and C. (Selfia) spp. This is the first report of VS virus isolations from field-collected Culicoides.

Aedes↗