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Biomedical subjects

B Niggemann

Publications and source records attributed to B Niggemann.

At least 163 records · Page 9Linked to original sources
PubMed1992

Diurnal variation of urinary histamine and 1-methylhistamine excretion in healthy children.

In order to establish a noninvasive method of monitoring immediate hypersensitivity reactions in children, we studied the diurnal variation of urinary histamine and 1-methylhistamine excretion and the influence of food intake in a group of 14 healthy nonatopic children (aged 2-16 years). Histamine and 1-methylhistamine in spontaneous urine samples were determined by radioimmunoassay. Mean variation of 2-h intervals was much higher for urinary histamine than for 1-methylhistamine (45% of base-line level versus 24%). There was no circadian rhythm or influence of food intake. The short half-life of histamine released into blood circulation may be the main reason for the higher variation of histamine excretion. In children, urinary 1-methylhistamine is less influenced by diurnal variation and is therefore more suited to monitor immediate hypersensitivity reactions than urinary histamine itself.

Adolescent↗
PubMed1992

Three cases of adolescent near-fatal asthma: what do they have in common?

Three adolescent asthmatics are described, who suffered from near fatal asthmatic attacks. The events occurred suddenly and required intubation and ventilation. However, the bronchial obstruction was fully reversible within less than 24 hours and the recovery complete. The similarities are discussed and a hypothesis for the differentiation to other well-known severe asthma attacks is introduced. Our three cases might be representative of a certain risk group of asthmatics.

Adolescent↗
PubMed1992

[Allergic rhinoconjunctivitis--past and present aspects].

Allergic rhinoconjunctivitis can be divided into two forms: a seasonal one (pollen-induced) and a perennial one (e.g. provoked by house dust mites). There is still a tendency for underdiagnosing the disease, especially concerning the perennial form. Besides the typical diagnostic procedures, measurement of mediators in the nasal lavage are used for scientific research as well as for clinical reasons nowadays. The clinical picture is described with the terms "sneezer", "blower" and "blocker". During an acute phase of the disease the patients feel generally sick--due to the immunological inflammation. The new nonsedating oral antihistamines are the first choice for the saisonal form, whereas topical steroids are the "gold standard" for the perennial form. Guidelines for therapy are discussed.

Allergens↗
PubMed1991

[Therapy of status asthmaticus in childhood. A current review].

The treatment of acute severe asthma in childhood should be focused on the control of bronchial obstruction and on the prevention of mechanical ventilation. These aims can only be achieved by a rapid and vigorous procedure using multiple therapeutic concepts. beta 2-Mimetics still play a major role. The inhalative route has priority; if necessary, even a continuous nebulization can be carried out. In some cases the intravenous route is of additional help. Corticosteroids should be administered parenterally and in high doses. Supplying oxygen has to be amongst the first therapeutic steps in ventilatory disorders with impending respiratory insufficiency. Mechanical ventilation should be undertaken in a gentle hypoventilating way under sedation and relaxation. Main attention has to be paid to preventive measures in order to ensure out-patient care with a maintenance therapy including antiinflammatory agents.

Administration, Inhalation↗
PubMed1989

[Extreme hyperphosphatemia with hypocalcemia within the scope of cell lysis syndrome in a child with T-ALL].

In a 10 3/4-year-old girl suffering from a T-ALL with an extremely high leukocyte blood cell count (400,000/microliters) we observed a tumor-lysis syndrome with hyperphosphatemia and hypocalcemia accompanied by clinical signs of tetany. The therapeutic application of calcium gluconate resulted in vascular calcification by exceeding by far the calcium-phosphate solubility product. The fast lysis of T-lymphoblasts with their high phosphate concentration is etiologically involved in the hyperphosphatemia. Our patient died of multiorganic failure. Regular monitoring of phosphate in urine might be helpful in instituting early therapeutic procedures.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Urinary arginine-vasopressin (AVP) excretion in cystic fibrosis (CF).

Free water handling is impaired in chronic obstructive lung disease (COLD). We studied the role of AVP in this mechanism with a sensitive urinary AVP radioimmunoassay (RIA) in 13 patients with CF. The mean age was 14.7 +/- 1.27 SE years. The control group was age and sex matched. While the 24-hour urine volume was not significant different in both groups, urine osmolality was higher in CF (788 mosmol/kg +/- 182 SE vs. 622 mosmol/kg +/- 218 SE; p = 0.05). The 24-hour urinary AVP excretion in CF patients was found to be significantly elevated (174 ng/day +/- 99 SE vs. 74 ng/day +/- 48 SE; p = 0.01). This difference becomes even greater if these values are corrected for body weight (4.4 ng/(kg X day) +/- 2.1 SE vs. 1.5 ng/(kg X day) +/- 0.9 SE; p = 0.005). Lung function studies were available in 8 patients. We used a body plethysmograph to measure FEV1 (1 sec forced expiratory volume) and MEF25 (forced expiratory flow at 25% of vital capacity) as sensitive indices of airway obstruction. There was a significant negative correlation between urinary AVP excretion and MEF25 (r = .76) and FEV1 (r = .65): the more pronounced the airway obstruction the higher the AVP excretion. We conclude that AVP plays a major role in the impaired water handling in COLD. Increased AVP secretion is already present under clinically stable conditions and is dependent on the degree of airway obstruction. In treating those patients one has to be aware of the possibility of water intoxication.

Adolescent↗
PubMed1985

[Aggressive behavior as a side effect of ethylenediamine (but not of theophylline)].

In accordance with a case report of a 7-year-old boy with bronchial asthma, who was twice treated with aminophylline and each time reacted upon this with an aggressive behaviour, which was completely abolished after stopping the medication and which did not appear after application of theophylline, we became suspicious, that this side effect could be due only to the ethylenediamine.

Aggression↗
PubMed1984

Liposome-entrapped [125I]anti-tetanus immunoglobulin G: evidence for entry into spinal cord neurons of the rat.

Intrathecally administered free anti-tetanus immunoglobulin G (IgG) diffuses through the spinal cord but does not enter nerve cells. In order to facilitate entry into neurons, 125I-labeled anti-tetanus IgG was entrapped in liposomes. After injection into the cerebrospinal fluid of rats, however, only a very low specific radioactivity of the spinal cord could be calculated from gross counts and no neuronal labeling was seen in autoradiographs. Therefore, it was assumed that the liposomes were unable to cross the basement membrane of the spinal cord surface. To circumvent this barrier the liposome-entrapped [125I]IgGs were injected directly into the grey matter. Histoautoradiographs then showed marked accumulations of radioactivity in neurons. Direct intraspinal injection of free [125I]IgG, on the other hand, failed to produce heavy neuronal labeling.

Animals↗
PubMed1984

The electrocardiogram in patients with acute myocardial infarctions treated with intracoronary Streptokinase infusion.

In 37 consecutive patients with acute myocardial infarction undergoing Streptokinase infusion and acute coronary angiography, the electrocardiographic findings were compared with the findings during angiography. All 15 patients with an occluded right coronary artery demonstrated an electrocardiographic pattern of an acute inferior wall myocardial infarction, and 12 of 13 patients with an occluded left anterior descending coronary artery exhibited a pattern of an acute anteroseptal wall myocardial infarction. In six out of nine instances of an occluded circumflex artery, an inferior infarction pattern evolved, and in three cases, an anteroseptal wall myocardial infarction was demonstrated. precordial ST segment depression more than 1 mm in patients with acute inferior wall myocardial infarction did not correlate with disease of the left anterior descending coronary artery as suggested by others. The specificity of this finding was only 25 percent with a predictive value of 60 percent.

Adult↗
PubMed1979

[Kidney transplantation in children].

Ten years' experience of renal transplantation in 40 children (aged 5--18 years) is reviewed. Including 3 second transplantations 40 cadaver grafts and 3 living donor grafts were transplanted. Mean graft survival was found to be 19 months, the longest being 8 years. At the time of last examination 24 children were alive wtith a functioning graft (mean serum creatinine level 1.5 mg/dl). After graft failure 9 children were again on intermittent hemodialysis. 7 children had died mainly because of infections or cardiovascular complications. Cumulative survival rate of patients and cadaver grafts after 2 years was 84 and 53% respectively. Growth velocity was variable but improved in the majority of patients compared to the previous dialysis period. Full social rehabilitation could be achieved in every case. Main complications were acute rejections (irreversible in 7 of 67), chronic rejections (irreversible in 6 of 10), side effects of immunosuppressive drugs (infections; hematologic, metabolic, and bone disorders), hypertension (60%), recurrence of primary renal disease (in 5 of 9 patients with focal segmental glomerulosclerosis) and surgical complications (28%). Therapeutic guide-lines are given emphasizing the role of specialized children's centres and the cooperation between pediatric nephrologists, immunologists, urologists and psychologists including the time before, during and after transplantation.

Adolescent↗
PubMedDate not supplied

[The protective effect of theophylline in exercise-induced asthma in childhood].

In order to study the protective effect of theophylline on exercise-induced asthma in children, we investigated the lung function of 16 children with documented bronchial asthma. Exercise provocation was performed by running on a treadmill for 6 minutes before and after two dose regimens of theophylline (10 and 20 mg/kg body weight). While for FEV1 the low dose regimen only showed a trend (p < 0.1), there was a slight but significant improvement in the high dose regimen (p < 0.05). Concerning sRaw both groups showed a small but significant improvement compared with the baseline values (p < 0.05). We conclude that in addition to its bronchodilatory effect theophylline may modulate exercise induced bronchospasm in asthmatic children.

Adolescent↗
PubMedDate not supplied

[Homozygous alpha-1 antitrypsin deficiency (PiZZ) and bronchial asthma in childhood--is there a connection?].

Ten children and adolescents (aged four to 21 years) with the homozygous form of alpha-1-antitrypsin deficiency (PiZZ) were investigated with regard to obstructive airway disease. Besides the recording of the history, tests of lung function and allergy tests were performed. It was shown that bronchial asthma occurred in three out of ten patients. However, we could not demonstrate any statistically significant increased incidence of bronchial asthma in our unselected PiZZ-patients compared to the overall population. There was no indication of emphysema in any of the nine patients.

Adolescent↗
PubMedDate not supplied

[Massive ascites formation due to unabsorbed cerebrospinal fluid following abdominal surgery in ventriculoperitoneal shunt. A case report].

A 15-year-old girl with a congenital heart disease (pulmonary stenosis and aortic insufficiency), who had a ventriculoperitoneal shunt operation because of hydrocephalus internus at the age of two years, 12 years later underwent colectomy because of juvenile colonic polyposis. After this operation, enormous production of ascites began which, because of progressive development, finally required ventriculoatrial shunt operation. A total volume of 17 liters of fluid was removed in two ascites drainages before and during the latter operation. Postoperatively the ascites production stopped completely.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

[Bronchial asthma and homozygous alpha-1-antitrypsin deficiency (PiZZ) in 3 members of a family].

We report on a family of an 8-year-old boy who suffers from bronchial asthma. In a routine screening for Alpha-1-antitrypsin-deficiency we discovered a homozygote PiZZ-type which is asymptomatic with regard to complications of the liver or a lung-emphysema. Two other members of the family show the same coincidence of bronchial asthma and Alpha-1-antitrypsin-deficiency, while two further members of the family with a heterozygote PiMZ-type are free of symptoms of the lower airways. Possible relations are discussed.

Asthma↗
PubMedDate not supplied

Enhanced basal and stimulated PMN chemiluminescence activity in children with atopic dermatitis: stimulatory role of colonizing staphylococci?

In adults, intense staphylococcal skin colonization and hyperactivity of polymorphonuclear leukocyte (PMN) oxidative metabolism are characteristic features of atopic dermatitis. Precise data on childhood atopic dermatitis are lacking. In a prospective study we analysed the PMN chemiluminescence activity with special reference to staphylococcal stimuli in 19 children (mean age 6.2 years) with mild to moderate atopic dermatitis. Staphylococcus aureus was isolated from 17/19 (90%) of children with atopic dermatitis and 13/45 (29%) of healthy age-matched controls (p less than 0.001). The mean (SEM) chemiluminescence activity of unstimulated atopic dermatitis-PMN was 0.34 (0.009) (controls: 0.092 (0.003) x 10(6) cpm/10(6) PMN/min (p less than 0.02). Staphylococcal antigens (S. aureus, S. epidermidis, S. haemolyticus) induced a 1.9-3.1-fold higher peak chemiluminescence response in children with atopic dermatitis than in controls (p less than 0.05). The time interval until peak chemiluminescence activity was considerably shorter for all stimuli in atopic dermatitis. We conclude that PMN of children with atopic dermatitis are "primed", showing enhanced release of reactive oxygen metabolites even in the "resting" state, and are easily stimulated by staphylococcal antigens present on the skin of patients with atopic dermatitis from early childhood on. We speculate that PMN hyperreactivity may contribute to chronic skin damage in atopic dermatitis.

Adolescent↗