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Biomedical subjects

A Lischka

Publications and source records attributed to A Lischka.

At least 37 records · Page 2Linked to original sources
PubMed1992

Benign rolandic epilepsy of childhood: topographic EEG analysis.

Topographic EEG investigation with instant voltage mapping showed maximal negativity of 'rolandic' spikes over central or midtemporal electrodes with spread to parietal or upper frontal areas, and a dipole distribution (centrotemporal negativity, frontal positivity). There was no correlation of spike amplitude or duration with spread to adjacent areas. No other focal abnormalities, such as focal slowing, occurred. Spike activity was pronounced during light sleep and was often associated with generalized spike-wave activity, and thus was a sign of functional disturbance rather than the sequelae of brain damage. A review of the literature indicates that this pattern is helpful in differentiating this from focal abnormalities due to brain lesions.

Adolescent↗
PubMed1990

[Function and structure of families with an epileptic child].

Although the impact of psycho-social factors on the individual patient with epilepsy has been widely investigated, the influence of the illness on the family as a whole is still underestimated. By means of the Family Assessment Measure (FAM III), a well-validated instrument, we investigated which measurable influence the epilepsy of one child had on the functioning of the families. Data from a group of 72 families with a child suffering from epilepsy (EG), but without any other handicap were analysed and compared with those of 75 families with a child with severe mental retardation (SMG) and 76 control families (CG). Data were gathered through home visits. Only complete families were studied. Results showed that the EG was similar to the SMG in all 3 scales of FAM III, but differed significantly from the CG. In 26% of the families in EG and in 19% of the SMG clear signs of family malfunctioning were found, as compared with 6.5% of the CG. Family disfunctioning in EG was of a greater variety that in SMG. We found that within the EG the type of seizures (41 patients with generalized tonic clonic fits, 10 with complex partial seizures and 21 with absences) did not have any impact on the results. In addition, neither the duration of the illness nor the absolute length of seizure-free periods seemed to matter. Only families who had the subjective feeling that their children were still suffering from epilepsy showed significantly higher rates of family malfunctioning. Summarizing, we found that epilepsy in a child can have a severe impact, not only on his individual life and on the mother-child relationship, but on the functioning of his family as the whole. This fact should be taken into account in the treatment of these children and should influence family counselling, as well.

Adaptation, Psychological↗
PubMed1990

[Neuroimmunologic parameters in therapy refractory epilepsy in children].

In a prospective study comprising 48 children (21 boys, 27 girls, age 12 months to 15 years) the hypothesis was tested whether an alteration in the light chain immunoglobulins kappa (kappa) and lambda (lambda) is an expression of autoimmune mechanisms and could be used as a diagnostic parameter. Immunoglobulins were analysed by kinetic nephelometry. The patients were grouped according to clinical and laboratory parameters. A high kappa/lambda ratio caused by high concentration of the kappa chain was found in children with therapy-resistant epilepsy. 60% showed a high kappa/lambda ratio, no distinct association was ascertainable in 26% cases and in 14% of the cases false positive results were obtained. In seizure-free children immunological markers were specific in 72% of cases, whilst 24% could not be characterized and 4% showed false positive results. The kappa/lambda ratio, therefore, is a good diagnostic aid in the treatment of therapy-resistant epilepsies.

Adolescent↗
PubMed1990

[Benign Rolandic epilepsy in children. Topographic EEG analysis].

Topographic EEG investigation with instant voltage mapping showed maximal negativity of "Rolandic" spikes over central or midtemporal electrodes with spread to parietal or upper frontal areas with a dipol formation (centro-temporal negativity, frontal positivity). Spike amplitude or duration was not correlated with spread to adjacent areas. No other focal abnormalities, such as focal slowing, occurred. Spike activity was pronounced during light sleep and was often associated with generalized spike wave activity, which is more likely to be a sign of functional disturbance rather than the sequelae of brain damage. A review of literature shows that this pattern is helpful in the differentiation from focal abnormalities due to brain lesions.

Adolescent↗
PubMed1990

[Computerized tomography in epilepsy in children].

We present a retrospective study of 160 children attending our epilepsy out-patient department. Computed tomography (CT) was performed on 123 (77%) patients, namely all children with the exception of those with febrile seizures, typical absence seizures, and benign Rolandic epilepsy. Incidence of CT abnormalities and their correlation with clinical features were evaluated. The CT scan was normal in 84 and abnormal in 39 patients. Although in general, the detection of abnormality on CT will not alter the management of the child, in a small percentage (2%) of our cases a lesion treatable by surgery was discovered. The indications for CT are summarized.

Anticonvulsants↗
PubMed1989

Diagnosis of peripheral androgen insensitivity in a male infant excretion analysis.

The hypothesis of peripheral androgen insensitivity (AIS) was examined in a boy with congenital growth hormone deficiency associated with micropenis and cryptorchidism by steroid excretion analyses compared with dihydrotestosterone (DHT) receptor analyses of foreskin biopsy homogenate. Urinary T metabolite 3 alpha,17 beta-dihydroxy-5 beta-androstane (3 beta-diol) was below the limit of detection (capillary gas chromatography) at age 1 year, but on several occasions (n = 7) normal basal values were found at age 3 years (patient: 78.9 +/- 25.4 micrograms/24 h, M +/- SD; controls, n = 15: 100.5 +/- 50.2). Normal basal- and hCG-induced excretion was noted for 3 alpha,17 beta-dihydroxy-5 alpha-androstane (3 alpha-diol) at age 1 and 3 years, respectively. Additionally, basal 3 alpha-diol excretion (n = 7) at age 3 years was 66.7 +/- 21.1 micrograms/24 h, M +/- SD; controls (n = 15) 75.8 +/- 50.4. Analysis of urinary androgens might be an alternative, noninvasive procedure for the diagnosis of peripheral AIS.

Androgens↗
PubMed1988

[Discrimination between epileptic and non-epileptic seizures using defined prolactin studies].

Prolactin blood levels (HPRL) increase within 20 minutes postictally after generalized epileptic, especially generalized tonic-clonic seizures and return to normal values within one hour. Elevated HPRL levels were also observed after complex partial seizures, but usually in less extent, exceeding normal ranges only slightly. Therefore baselin HPRL measurements are necessary for estimation of spontaneous fluctuations in comparison to changes after seizures. Unchanged PRL levels after attacks do not support their epileptic origin. Rage attacke showed no clear pattern of PRL changes.

Adolescent↗
PubMed1988

Sympatho-adrenal response to hypoglycaemia in infants.

The response of the sympathoadrenal system to hypoglycaemia of different etiology was studied in seven infants, aged 10-189 days. Five infants had hyperinsulinism secondary to nesidioblastosis or to a beta-cell adenoma of the pancreas, one infant had neonatal sepsis due to staphylococcal infection and one infant congenital growth hormone (HGH) and adrenocorticotropic hormone (ACTH) deficiency. In babies with hyperinsulinism, plasma noradrenaline increased from 0.29 +/- 0.03 to 0.61 +/- 0.09 ng/ml (P less than 0.01), whereas adrenaline increased only in three, but did not change in two babies. Increases in heart rate and blood pressure paralleled these changes. In hypoglycaemia due to congenital sepsis, noradrenaline increased from 0.39 to 1.64 ng/ml and adrenaline from 0.05 to 0.86 ng/ml. This was associated with marked haemodynamic changes. In congenital HGH and ACTH deficiency, the low basal plasma levels of noradrenaline (0.12 ng/ml) and adrenaline (0.01 ng/ml) remained unchanged in response to hypoglycaemia. Heart rate and blood pressure were unaffected. The sympathoadrenal system was activated by hypoglycaemia in all infants except in congenital HGH and ACTH deficiency. In contrast to adults, noradrenaline was the preferentially released catecholamine, suggesting an involvement of noradrenaline in glucose counter regulation in infancy.

Adrenal Glands↗
PubMed1988

Elevated 7B2 levels during normal human pregnancy.

In a cross-sectional study the plasma concentrations of immunoreactive 7B2, a novel protein originally isolated from the pituitary gland, was measured in 60 healthy pregnant and postpartum women. The mean circulating concentration of 7B2 immunoreactive equivalents was found to be significantly increased throughout pregnancy (10 to 12 weeks, 52.2 +/- 13.1 pmol/L; 20 to 22 weeks, 74.4 +/- 20.1 pmol/L; 30 to 32 weeks, 56.0 +/- 12.9 pmol/L; and 36 to 40 weeks, 85.7 +/- 13.6 pmol/L) when compared with a group of 32 age-matched nonpregnant controls (19.7 +/- 5.0 pmol/L); (p less than 0.01). The highest 7B2 plasma concentrations were found shortly before delivery (36 to 40 weeks) and fell sharply after birth, returning to normal within 4 to 6 weeks. Fetal plasma from both umbilical artery and vein was found to have particularly high concentrations of 7B2-like immunoreactivity (396 +/- 19 and 361 +/- 24 pmol/L, respectively), and 7B2 was extractable from the placenta. Chromatographic analysis of plasma and tissue extracts showed the main peak of immunoreactivity to coincide with that originally described in the pituitary gland. Although the function of 7B2 is at present unknown, our data suggest that 7B2 immunoreactivity in fetal blood originates from the fetus and may play an important role in pregnancy.

Adolescent↗
PubMed1988

Non-enzymatic glycation of fetal tissue in diabetic pregnancy. Estimation of the glucitollysine content of umbilical cord extracts.

Non-enzymatic glycation of fetal tissue was studied by determining the glucitollysine content of umbilical cord extracts from twelve infants of diabetic mothers and fourteen infants of healthy, non-diabetic women (controls). The single, glycated amino-acid glycitollysine, which reflects the extent of glycation processes in biological samples, was measured by a standard amino acid ion exchange chromatography followed by reverse phase high pressure liquid chromatography. Infants of diabetic mothers had significantly higher cord glucitollysine levels than infants of control mothers (14.3 + 4.6 vs. 5.5 + 2.1 ng/mg dry tissue; M + SD, p less than 0.001). Moreover, five infants of diabetic mothers with congenital anomalies had strikingly high glucitollysine levels, higher than the mean +4 SD of the controls. We conclude, that non-enzymatic glycation of fetal tissue does occur as a result of an in utero exposure to cumulative glycemia. Major congenital anomalies in diabetic pregnancies are associated with a greater extent of non-enzymatic glycation of umbilical cord tissue.

Adult↗
PubMed1987

[Can muscle relaxation prevent the development of pneumothorax in artificially ventilated newborn infants?].

A retrospective study was conducted on 37 ventilated newborn infants to find out whether muscle paralysis by pancuronium had prevented pneumothorax (pt) in those severely ill newborn infants. In the group of 21 newborns who developed pt, 17 (81%) had been paralyzed with pancuronium. In the group of 16 newborns without pt, 10 (61%) had received pancuronium (chi 2 = 1,568, ns). Thus, muscular paralysis had not prevented pt. Since the newborns in both groups were equally severely ill (mean compliance of the respiratory system 0.48 +/- 0.17 ml/cm H20 in the group with pt, 0.38 +/- 0.12 in the group without pt), we assume that pancuronium was unable to prevent pt in ventilated premature and full-term newborn infants. We therefore caution against the use of pancuronium as a paralytic drug known to have deleterious side effects.

Humans↗
PubMed1987

Psychogenic relapses in childhood epilepsy in puberty and adolescence.

Epileptic patients who, after years of being free from symptoms, have relapses during puberty or adolescence (some-times coinciding with a reduction in therapy) pose special therapeutic and diagnostic problems. Because of pubertal lability, the cause of a relapse might seem to be "organic", especially if the EEG also shows a "deterioration", yet psychogenic factors must not be disregarded. On the basis of typical case studies, a characteristic constellation is presented. The achievement of a "well-behaved" child at first dramatically improves and this correlates with the success of antiepileptic therapy. Then individuation and further development cannot adequately take place because the family unit is not functioning properly. At a critical stage of development, the excessive expectations of the parents lead to too much stress on the child, thus destroying the balance within the family system, which has hitherto been maintained only with difficulty. Attempts to improve the situation by changing the medication (increasing the dose or switching to another drug) fail. If, however, it is realized that the symptoms are of psychogenic origin, adequate therapeutic interventions (e.g. adequate schooling or professional training as well as psychotherapy) promise good results.

Adolescent↗
PubMed1987

Carbamazepine and benzodiazepines in combination--a possibility to improve the efficacy of treatment of patients with 'intractable' infantile spasms?

Therapeutical efforts in epilepsies with infantile spasms (IS) often show unsatisfying results, especially if neurological impairments are found. In a clearly negatively selected group of 24 children with IS and 10 patients with symptomatic myoclonic-astatic epilepsies--pretreated without success with ACTH and/or benzodiazepines (BDZ) alone or combined with other anticonvulsants--we tried a two-drug therapy of BDZ with carbamazepine (CBZ). Dosage of both drugs was within the usual range. In a follow-up period of 1-5 years, 8 of the IS patients and 4 of those with myoclonic-astatic seizures became seizure-free; furthermore, 6 children showed a marked reduction in their seizure frequency: 3 more than 80%, 3 more than 50%. Besides the fact that the patients did not develop a so-called escape-phenomenon--as often seen in therapy with benzodiazepines--they also showed fewer and less intensive side-effects. Without optioning for antiepileptic polytherapy in general, we conclude that in cases of "intractable" IS the combination of BDZ with CBZ might be more successful than the single drug. To confirm these preliminary findings further controlled studies have to be carried out.

Carbamazepine↗
PubMed1987

C-reactive protein: an early marker for neonatal bacterial infection due to prolonged rupture of amniotic membranes and/or amnionitis.

The C-reactive protein (CRP) concentration was determined in 25 infants whose mothers had presented with prolonged rupture of amniotic membranes (PROM) and/or amnionitis. CRP was positive (i.e. greater than or equal to 6 mg/l) within the first 6 hrs of life in 10 and negative in 15 infants. Clinically, all infants with positive CRP developed symptoms suggesting bacterial infection and both the absolute immature neutrophil counts as well as the ratio immature/total neutrophils were significantly higher in them on day 2 of life than in infants with negative CRP. Blood cultures were only positive in infants with positive CRP. Thus CRP can be regarded as an early marker for neonatal bacterial infection due to PROM and/or amnionitis.

Bacterial Infections↗
PubMed1987

Molecular biology of androgen action in genital hypoplasia associated with congenital growth hormone deficiency: a "transitory androgen insensitivity syndrome"?

Androgen receptor analyses of foreskin homogenate from a boy with congenital growth hormone deficiency revealed at age 1 and 3 years a decreased number of cytosolic binding sites for testosterone (T) and dihydrotestosterone (DHT), compared with controls of similar age. Nuclear T receptor was not detectable at age 1 but showed abnormal high-binding capacity at age 3 years. Nuclear DHT receptor was within normal limits at both age 1 and 3 years. Receptor affinities were normal. Maximum reaction velocity of tissue-specific androgen 5 alpha-reductase A5R was decreased at age 1 year but within the normal range at age 3 years. Stretched penile length was below the third percentile at age 1 and increased to a 25th percentile at age 3 years, respectively. As the receptor and A5R data seem to indicate a "catch-up" growth, i.e., normalization of the external genitalia, we therefore postulate a "transitory" course of an androgen insensitivity in this particular patient.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1986

Glycated plasma proteins in normal and diabetic mothers and their offsprings.

Glycated plasma proteins (GPP) and glycated hemoglobin (G Hb) has been evaluated in 134 non-diabetics (ND), 299 women with potential abnormality of glucose tolerance (pot.AGT), 75 with impaired glucose tolerance (IGT) and 34 insulin dependent diabetics (IDDM) during pregnancy or postpartum including 94 cord blood determinations. Mean HbA1c levels were significantly elevated in IDDM (6.6 +/- 1.3% M +/- SD) compared to ND (5.1 +/- 0.7%; P less than 0.01), but were similar for the other groups studied. Mean GPP were increased for the IDDM (0.58 +/- 0.29 nmol 5- HMF/mg protein; M +/- SD) and the IGT-group (0.53 +/- 0.22) over ND (0.3 +/- 0.13; P less than 0.01) and the Pot.AGT group (0.37 +/- 0.14; P less than 0.01). 6% of the ND, 15% of the Pot AGT-, 52% of the IGT- and 62% of the IDDM group were found to have GPP values exceeding the 97% confidential limit of the ND. However, the large overlap of individual values from patients with different degrees of glucose intolerance with the normal range of pregnancy precludes the use of GPP as a screening parameter for IGT during pregnancy. A 30-35% reduction of fetal hemoglobin- and plasma protein glycosylation relative to maternal values was observed.

Blood Proteins↗
PubMed1984

Determination of glucitollysine for the quantitation of non-enzymatic glucosylation by ion exchange chromatography and reverse phase liquid chromatography.

A specific and sensitive method for the quantitative determination of the stable, reduced glucose-lysine adduct, glucitollysine (GL), in plasma protein samples is described. The method uses standard amino acid ion exchange chromatography followed by reverse phase high performance liquid chromatography after derivatisation of GL to a fluorescent product. Moreover, GL was characterised and identified in plasma samples by means of mass spectroscopy. GL measured in plasma samples of eleven type I diabetics and two healthy controls showed a significant linear correlation to concomitantly determined haemoglobin AI and glucosylated plasma proteins, but did not correlate with plasma glucose levels. This method allows the estimation of non-enzymatic glucosylation in biological samples with a high degree of specificity and sensitivity down to the low nanogram range.

Adolescent↗