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  • 1
    Electronic Resource
    Electronic Resource
    Acute pulmonary oedema due to laryngeal spasm (1982)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 37 (1982), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Postoperative laryngeal spasm is an emergency which generally responds to ventilation of the lungs without further complication. In the life-threatening case presented here, severe laryngeal spasm was associated with the development of acute pulmonary oedema.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1982.tb01787.x
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  • 2
    Electronic Resource
    Electronic Resource
    127. Bilaterale Endarterektomie der Carotisgabeln — ein größeres Risiko in einenn Operationsgang? (1978)
    Springer
    Langenbeck's archives of surgery 347 (1978), S. 632-632 
    Details
    ISSN: 1435-2451
    Keywords: Endarterectomy, bilateral carotid ; bilateral carotid ; Bilaterale Carotisendarterektomie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Man hat 136 Carotisendarterektomien bei 68 Patienten (46 M., 22 F., durchschnittlich 60,1 Jahre) in den Jahren 1967–1976 ausgeführt. 16 Patienten hatten eine Hemiparese gehabt, 43 litten an TIA-Symptomen, 9 Operationen waren prophylaktisch. 3 Patienten (4,4 %) starben 1–3 Tage p. op. an Hirninfarkt. Bei 3 Patienten gab es vorübergehende, bei weiteren 4 bleibende cerebrale Ausfallsymptome. In der Folgezeit (1/2–10 J.) waren noch 10 Patienten, davon 2 an Hirninfarkt, gestorben. 1 Patient erlitt 6 Monate p. op. eine Hemiplegie, einer hatte TIA-Symptome. 49 Patienten (72 %) waren symptomfrei oder gebessert.
    Notes: Summary During the years 1967–1976, 68 patients (46 men, 22 women, average 60.1 years) underwent a bilateral carotid endarterectomy. Thus a total of 136 carotid endarterectomies were performed. Sixteen patients had a history of previous hemiparesis, 43 had TIA, and in 9 cases the operation was performed prophylactically. There were 3 deaths (4.4 %) related to the operation. Postoperatively, transient neurologic defects were noted in 3 patients, and permanent neurologic defects in 4 patients. During the follow-up (0.5–10 years) period, there were 10 late deaths, 2 due to stroke. Forty-nine patients were asymptomatic.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01579419
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  • 3
    Electronic Resource
    Electronic Resource
    Value of C-reactive protein in reflecting the magnitude of complement activation in children undergoing open heart surgery (1990)
    Springer
    Intensive care medicine 16 (1990), S. 128-132 
    Details
    ISSN: 1432-1238
    Keywords: C-reactive protein ; Complement ; Cardiopulmonary bypass ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The kinetics of C-reactive protein (CRP) were studied prospectively in 30 children (aged 21 days – 16 years) undergoing open heart surgery. CRP was related to the kinetics of total haemolytic complement, complement C3a and postoperative complications. Two (7%) patients died and ten (33%) had postoperative complications. The patients with complications were younger (p〈0.035), underwent longer perfusions (p〈0.001) and had longer aortic cross-clamping times (p〈0.003). The mean peak CRP level after surgery (108 mg/l) was reached, on the average, in 43 h. No statistical difference in CRP concentrations was found between the complication and non-complication groups. Extensive complement activation was seen in every patient. CRP did not reflect the magnitude of complement activation induced by cardiopulmonary bypass. The patient sample was too small to draw reliable conclusions about the value of CRP in detecting postoperative complications after open heart surgery in children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01699860
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  • 4
    Electronic Resource
    Electronic Resource
    Prolonged gramulocyte activation, as well as hypoxanthine and free radical production after open heart surgery in children (1996)
    Springer
    Intensive care medicine 22 (1996), S. 500-506 
    Details
    ISSN: 1432-1238
    Keywords: Heart surgery ; Granulocyte ; Hypoxanthine ; Free radical
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To investigate granulocyte activation, as well as hypoxanthine and free radical production in children during the first day after cardiopulmonary bypass.Design: A prospective study of pediatric patients undergoing either cardiac surgery with a cardiopulmonary bypass or thoracotomy and extracardiac vascular surgery not requiring a cardiopulmonary bypass. Setting Operative and intensive care units, Children's Hospital, University of Helsinki, Finland. Patients Seven consecutive patients undergoing elective correaction of a ventricular septal defect and six patients undergoing extracardiac surgery for ligation of a patent ductus arteriousus or repair a coarctation of the aorta. Measurements and main results Plasma concentrations of myeloperoxidase (140–334 μg/l preoperatively, 460–1692 μg/l at 0.2 h after declamping, 471–1386 μg/l at 0.5 h after declamping) and lactoferrin (77–258 μg/l preoperatively, 533–1783 at 0.2 h 404–1482 μg/l at 0.5 h) as markers of granulocyte activation, and hypoxanthine (0–5.7 μmol/l preoperatively, 4.3–17.0 μmol/l at 0.2 h, 6.5–17.9 μmol/l at 0.5 h) increased in a biphasic manner at 0.2–0.5 h and 6–10 h postoperatively (allp〈0.05). Expired ethane, as an index of free radical activity, increased at 10 h postoperatively (36–119 pmol/kg per min preoperatively, 72–152 pmol/kg per min,p〈0.05). Conclusion Granulocyte activation, and hypoxanthine and free radical production occur at least 10 h after cardiopulmonary bypass. In children undergoing open heart surgery, attempts to reduce free radical activity should be extended to the postoperative period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712176
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  • 5
    Electronic Resource
    Electronic Resource
    Hyperamylasemia after cardiac surgery in infants and children (1996)
    Springer
    Intensive care medicine 22 (1996), S. 959-963 
    Details
    ISSN: 1432-1238
    Keywords: Key words Hyperamylasemia ; Pancreatitis ; CRP ; Cardiac surgery ; Infants ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: This study was conducted to clarify the incidence of hyperamylasemia after cardiac surgery in infants and children. Design and patients: 186 infants and children operated on at Children’s Hospital, Helsinki, during an 11-month period were enrolled in the study. Serum samples were taken before and on 3 consecutive days after cardiac surgery at the intensive care unit and before discharge from the hospital. Measurements: We measured serum total amylase and serum pancreatic amylase with two different assays: (1) reduction of salivary amylase from total amylase activity and (2) measurement of mass concentration with monoclonal antibodies. Results: Preoperative values for both total amylase and pancreatic isoenzymes were strongly agerelated. At least one of the three tests showed postoperative hyperamylasemia (〉+2 SD above starting values of the age group and maximal value 〉3 times the individual starting value) in 64/186 (34%) patients. 22/186 (12%) patients had abnormal results in all assays. A more than tenfold rise in pancreatic amylase, suggesting pancreatitis, was found in 14 patients (8%). Mortality was 21% in this subgroup, but 5% in the rest of the patients. Hyperamylasemia was more common after 1 year of age, and after open-heart surgery, especially homograft implantation or cardiac transplantation. Conclusions: Hyperamylasemia is a common finding after cardiac surgery in pediatric patients. Amylase isoenzyme measurements are needed for clinical decision making. Age-group-related reference values are mandatory for the right interpretation of amylase values.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050194
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  • 6
    Electronic Resource
    Electronic Resource
    Hyperamylasemia after cardiac surgery in infants and children (1996)
    Springer
    Intensive care medicine 22 (1996), S. 959-963 
    Details
    ISSN: 1432-1238
    Keywords: Hyperamylasemia ; Pancreatitis ; CRP ; Cardiac surgery ; Infants ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective This study was conducted to clarify the incidence of hyperamylasemia after cardiac surgery in infants and children. Design and patients 186 infants and children operated on at Children's Hospital, Helsinki, during an 11-month period were enrolled in the study.Serum samples were taken before and on 3 consecutive days after cardiac surgery at the intensive care unit and before discharge from the hospital. Measurements We measured serum total amylase and serum pancreatic amylase with two different assays: (1) reduction of salivary amylase from total amylase activity and (2) measurement of mass concentration with monoclonal antibodies. Results Preoperative values for both total amylase and pancreatic isoenzymes were strongly agerelated. At least one of the three tests showed postoperative hyperamylasemia (〉+2 SD above starting values of the age group and maximal value 〉3 times the individual starting value) in 64/186 (34%) patients. 22/186 (12%) patients had abnormal results in all assays. A more than tenfold rise in pancreatic amylase, suggesting pancreatitis, was found in 14 patients (8%).Mortality was 21% in this subgroup, but 5% in the rest of the patients. Hyperamylasemia was more common after 1 year of age, and after open-heart surgery, especially homograft implantation or cardiac transplantation. Conclusions Hyperamylasemia is a common finding after cardiac surgery in pediatric patients. Amylase isoenzyme measurements are needed for clinical decision making. Age-group-related reference values are mandatory for the right interpretation of amylase values.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02044123
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  • 7
    Electronic Resource
    Electronic Resource
    Guidelines for a training programme in intensive care medicine (1996)
    Springer
    Intensive care medicine 22 (1996), S. 166-172 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01720724
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  • 8
    Electronic Resource
    Electronic Resource
    Prolonged granulocyte activation, as well as hypoxanthine and free radical production after open heart surgery in children (1996)
    Springer
    Intensive care medicine 22 (1996), S. 500-506 
    Details
    ISSN: 1432-1238
    Keywords: Key words Heart surgery ; Granulocyte ; Hypoxanthine ; Free radical
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective:To investigate granulocyte activation, as well as hypoxanthine and free radical production in children during the first day after cardiopulmonary bypass. Design: A prospective study of pediatric patients undergoing either cardiac surgery with a cardiopulmonary bypass or thoracotomy and extracardiac vascular surgery not requiring a cardiopulmonary bypass. Setting: Operative and intensive care units, Children’s Hospital, University of Helsinki, Finland. Patients: Seven consecutive patients undergoing elective correction of a ventricular septal defect and six patients undergoing extracardiac surgery for ligation of a patent ductus arteriosus or repair a coarctation of the aorta. Measurements and main results: Plasma concentrations of myeloperoxidase (140–334 μg/l preoperatively, 460–1692 μg/l at 0.2 h after declamping, 471–1386 μg/l at 0.5 h after declamping) and lactoferrin (77–258 μg/l preoperatively, 533–1783 at 0.2 h, 404–1482 μg/l at 0.5 h) as markers of granulocyte activation, and hypoxanthine (0–5.7 μmol/l preoperatively, 4.3–17.0 μmol/l at 0.2 h, 6.5–17.9 μmol/l at 0.5 h) increased in a biphasic manner at 0.2–0.5 h and 6–10 h postoperatively (all p〈0.05). Expired ethane, as an index of free radical activity, increased at 10 h postoperatively (36–119 pmol/kg per min preoperatively, 72–152 pmol/kg per min, p〈0.05). Conclusion: Granulocyte activation, and hypoxanthine and free radical production occur at least 10 h after cardiopulmonary bypass. In children undergoing open heart surgery, attempts to reduce free radical activity should be extended to the postoperative period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712176
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  • 9
    Electronic Resource
    Electronic Resource
    Renal transplantation in children with emphasis on young patients (1994)
    Springer
    Pediatric nephrology 8 (1994), S. 313-319 
    Details
    ISSN: 1432-198X
    Keywords: Renal transplantation ; Cadaver donor ; Cyclosporine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report the results of 41 consecutive renal transplantations performed on 39 children (median age 2.7 years). Twenty-six recipients were less than 5 years old. Twenty-one recipients (13 under the age of 5 years) received cadaver (CAD) grafts. All grafts except 2 were from adult donors and were placed extraperitoneally. Patients were on triple immunosuppression (cyclosporine plus azathioprine plus methylprednisolone). Mean followup time was 2.3 years. No vascular and only one ureteral complication was seen. Acute tubular necrosis occurred in 3 patients (7.3%). No grafts were lost due to acute rejection. Three-year patient survival and 1-year graft survival were 100%. The overall 3-year actuarial graft survival was 86%. Three-year survival of grafts from living-related donors (LRD) was 92% and that of CAD grafts 75%. In recipients younger than 5 years, 3-year LRD graft survival was 89% and CAD graft survival 73%. No significant differences in graft survival between recipients of different age groups or between LRD and CAD grafts were found. We conclude that results of renal transplantation in children under 5 years of age are comparable to those of older children, even using CAD grafts, when adult donors and triple immunosuppression are used.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00866346
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  • 10
    Electronic Resource
    Electronic Resource
    Long-term follow up of renal function and histology after renal allograft transplantation in early childhood (1998)
    Springer
    Transplant international 11 (1998), S. S39 
    Details
    ISSN: 1432-2277
    Keywords: Key words Kidney transplantation ; Small children ; Graft survival ; Function ; Histopathology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Survival rates, renal function, and histopathology were evaluated in 49 prospectively followed patients transplanted under 5 years of age at our center. Most patients (84 %) suffered from congenital nephrosis of the Finnish type. Triple immunosuppression with cyclosporine administered in three daily doses to pre-school children was used. Patient survival 7 years after transplantation was 98 % and graft survival 88 %. All graft losses were due to post-transplantation nephrosis. The proportion of pathological findings in the follow-up biopsies did not change substantially with time. Five years after transplantation, 47 % showed a normal histology and after 7 years this rose to 67 %. Mean glomerular filtration rate (GFR) was 68 and 55 ml min per 1.73 m2 5 years and 7 years, respectively, after transplantation. The decline in GFR with time was significant. We conclude that good long-term results can be achieved with individually tailored triple immunosuppression in the youngest age group, even with cadaveric donors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050422
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