Biomedical subjects
F C Sitzmann
Publications and source records attributed to F C Sitzmann.
[Under what circumstances should antipyretics be used in children with febrile infections if there are no risk factors for febrile convulsions].
Explore the source record for details and available documents.
Dose reduction in thorax radiography in simulated neonates with additional filtration and digital luminescence radiography.
PURPOSE: To determine the minimum acceptable radiation dose for an adequate image quality in thorax a.p. radiographs of neonates using mobile X-ray equipment. MATERIAL AND METHODS: The influence of additional filtration (1.0 mm Al + 0.1 mm Cu) on image quality and radiation dose was determined for the speed class 400 screen-film system (SFS) and digital luminescence radiography (DLR) by making radiographs of a test phantom. Conventional and digital thorax a.p. radiographs of a rabbit were produced using various tube current-time products. The quality of the rabbit radiographs was judged by eight radiologists applying image quality criteria according to the German guidelines and the recommendations of the European Community. RESULTS: The added filter resulted in a dose reduction of 39% at 66 kV. DLR gave a further dose reduction of 25% in comparison to the speed class 400 SFS while maintaining adequate image quality, i.e. the radiographs were clinically acceptable with regard to quality criteria. CONCLUSION: The radiation dose resulting from thorax a.p. radiographs of neonates can be reduced by approximately 50% with the use of additional filtration and DLR.
[N-acetyl-beta-glucosaminidase (beta-NAG) in urine: a parameter for early detection of diabetogenic nephropathy in childhood].
N-Acetyl-beta-D-glucosaminidase (NAG) can be found in kidney in high activity. By determination of this enzyme activity in urine nephropathies can be recognized reliably. We have measured this lysosomal enzyme in the urine (Colorimetric method by Noto) of 206 children suffering from diabetes mellitus to find out whether diabetic nephropathy can be detected as soon as possible. Additional beta 2-microglobulin (ELISA) was measured in urine, which is reabsorbed nearly complete in the tubulus. The several proteins in urine were identified by SDS-PAGE. A high excretion of beta-NAG was found in children and adolescents with a poor metabolic control (elevated HbA1c). There was no correlation between NAG activity, duration of the diabetes and the age of the children. An elevated excretion of beta-2-microglobuline could be found only in seven children with a duration of the diabetes about six years; their HbA1c levels were high. The SDS-PAGE showed a pattern of glomerular protein excretion according to the duration of the diabetes. However there was no significant correlation to the metabolic control. Only in four children we ascertained mixed proteinuria. The increasing levels of urinary NAG may represent the increasing severity of nephrotic damage by diabetes. The estimation of NAG levels in urine would seem to be reliable in the early detection of diabetic angiopathy also and may serve as an index of diabetic control independent of blood sugar levels.
[The interrelationship between the O2-dependent bactericidal mechanism and hyperbilirubinemia of newborn].
In order to investigate the influence of indirect bilirubin to O2-dependent bactericidal mechanism in adult and newborn phagocytes we use the NBT reduction activity of granulocytes and monocytes as index, by infiltrated granulocytes and monocytes in different concentration of indirect bilirubin with or without latex stimulator. The NBT reduction activity of granulocytes infiltrated in 20 mg/dl indirect bilirubin will increase slightly, compared to uninfiltrated; but with latex stimulator, the increment will decrease significantly, this change is reversible, when indirect bilirubin be washed, the stimulating capacity by latex stimulator in granulocyte will be stronger; there were no such change pattern in monocytes. Since there were a big difference in NBT reduction activity of granulocytes and monocytes between newborns, with or without latex stimulator, we can't get a satisfied result. Indirect bilirubin in cells will increase NBT reduction activity of monocytes, but not in granulocytes.
[Value of serum sialic acid determination in children].
In order to find out whether sialic acid (SA) is suitable as a tumor marker this compound was determined in the sera of 48 healthy and of 168 sick children. In healthy children under six months of age lower concentrations of SA were found (x = 41 +/- 5 mg/dl) than in subjects aged six months to 18 years (x = 68 +/- 8 mg/dl). Inflammatory diseases of various etiologies lead to a significant increase in both age groups (x = 93 +/- 28 mg/dl), the same could be observed in subjects up to 14 days after surgery. In children with malignant disorders the concentration of SA was significantly higher (x = 83 +/- 27 mg/dl) than in the healthy subjects, but not higher than in patients with inflammatory diseases. We conclude that SA might play a role in the follow up protocol of patients with malignant tumors.
Retinal blood flow in diabetic children and adolescents.
A total of 209 diabetic children and adolescents aged 6-17 years (mean, 12.6 +/- 2.3 years) were examined by ophthalmoscopy, video fluorescein angiography and hemoglobin (HbA1c) test. Microaneurysms were found in 26% of the children (ophthalmoscopy, 11%; angiography, 23%). The prevalence of retinopathy was 16% in patients aged 6-10 years, 27% in those aged 11-13 years and 36% in those aged 14-17 years. Only five diabetics aged 11-17 years showed lesions other than microaneurysms (hard exudates, intraretinal hemorrhages or retinal capillar leakage). Retinal blood flow was quantified using video fluorescein angiography. The arm-retina time (ART) and the arteriovenous passage time (AVP) as parameters of the retinal microcirculation were obtained using an image analysing system. The mean value for ART was 9.7 +/- 2.5 s and that for AVP was 1.43 +/- 0.52 s. AVP was significantly shorter in diabetic children and adolescents with good glycemic control (HbA1c, less than 7%; AVP, 1.35 +/- 0.44 s) than in those with bad glycemic control (HbA1c, greater than or equal to 9%; AVP, 1.65 +/- 0.51 s).
[Clinical evaluation of a test strip for measuring creatinine in capillary blood of children].
Basing on an enzymatic method for determining creatinine, the new reagent strip "Reflotron Creatinin" of the Reflotron system recently was presented. In this study, it will be compared with another enzymatic test (Creatinin-PAP) and with a Jaffe-based assay (Creatinin-Jaffe for Hitachi 737). The quality control (within-days and within-series) yielded a sufficient accuracy and precision (CV = 4%) for the charge of used test strips. The recovery of double measured values was very good (r greater than 0.94). As regards the method comparison, differences in both charges were seen. The values of the former charge lay 7% on an average below the Jaffe-values, those of the latter 28% below. The slope of the latter regression line was considerably steeper. Comparing both enzymatic tests, the regression analysis gave poor results (y = -0.33 + 1.35 x). Bilirubin had not remarkable influences, whereas an evelated hematocrit slightly depressed the values. It seems necessary to start further studies to clear up the difference in test strip charges and to check more capillary blood samples of newborn and children with a pathologic creatinine level.
Bare lymphocyte syndrome--combined immunodeficiency and neutrophil dysfunction.
A 4-year-old girl presented with recurrent infections. Immunoglobulin deficiency (serum and secretory IgA, serum IgG3) neutropenia and neutrophil dysfunction (defective spontaneous migration and chemotaxis) were found. T-lymphocyte counts were normal and they responded to phytohaemagglutinin but were not stimulated by Concanavalin A, pokeweed mitogen and microbial antigens in vitro. Delayed cutaneous hypersensitivity testing to purified protein derivative and candidin was negative. Despite bacille Calmette-Guérm vaccination and candidiasis, near normal beta-2-micro-globulin and human leucocyte antigen (HLA) class I concentrations were detected on mononuclear cells and phytohaemagglutinin-induced lymphoblasts. HLA class II antigens (HLA-DP, -DQ, -DR) were not expressed. These observations indicated a bare lymphocyte syndrome (BLS) type II. This is the first time neutrophil dysfunction has been noted in association with BLS.
[Intraspinal, extradural hemorrhage in a 7-year-old boy with hemophilia B].
A 7-year-old boy with severe hemophilia B suffered an intraspinal extradural hemorrhage without preceding trauma. Since the age of 3 years the patient is HIV-1 positive. The actual hemorrhage caused a strong pain in the thoracolumbar area without signs of spinal cord compression. It was diagnosed by CT-scan. By early high dose factor-IX substitution the hemorrhage was stopped and no neurological complications occurred. The further substitution regime is described.
The role of therapeutic plasma exchange in the management of pediatric disease.
Explore the source record for details and available documents.
[Therapeutic plasma exchange in the hemolytic-uremic syndrome].
Explore the source record for details and available documents.
Hemofiltration and plasmapheresis in premature infants and newborns.
Extracorporal detoxication methods in newborns are most unavailable, contraindicated because of technical problems. Herein are reported the experiences with a blood pump unit that was miniaturized for hemodialysis, hemofiltration, and plasmapheresis in newborns. In three premature infants with acute renal failure of different etiology (two newborns with severe Rh-erythroblastosis, 1 premature infant with hypoproteinemia) 13 single-needle hemofiltrations and 6 single-needle plasmaphereses were performed with double head pump, special tube systems, and small modules. The age of the patients ranged from 1 to 14 days, body weight was between 800 and 2,800 g. Four umbilical veins and two femoral veins were used as vascular access. The ultrafiltration rate during the treatment averaged 0.3 ml/min in single-needle hemofiltration and the plasma filtrate flow rate 1.3 ml/min in single-needle plasmapheresis. All treatments were well tolerated. Four patients died due to complications unrelated to the treatment, two patients recovered. These preliminary results show that both hemofiltration and plasmapheresis may be carried out without major problems in premature infants and newborns.
Platelet aggregation, rheological parameters and blood glucose profiles in diabetic children (type I) treated with human and porcine insulin.
In a three-year bicentric cross-sectional investigation on type I diabetic children between six and eighteen years of age, blood sugar profiles and spontaneous thrombocyte aggregation were assessed besides anamnestic and clinical data. In the children treated with human insulin raised spontaneous thrombocyte aggregation was significantly more frequent than in those treated with porcine insulin. At the same time blood sugar fluctuation from day to day measured between seven and nine a.m. tended to be raised in the children treated with human insulin; the fluctuation in the diurnal profile measured for fourteen days was indeed very much greater. Since the two groups were comparable as to sex distribution, age, duration of disease, quality of compensation, application and dose of insulin, the greater fluctuation of blood sugar in the children treated with human insulin appears to be the cause for the raised spontaneous thrombocyte aggregation.
[Contraindications and complications in vaccinations].
By immunizations many infectious diseases and their associated severe complications can be prevented. The high importance of vaccinations must be emphasized by the paediatricians. But it is also very important to know the contraindications and especially the rare complications and also adverse reactions following some immunizations e.g. against pertussis, tuberculosis, measles, rubella, diphtheria, tetanus and polio, which must be carefully investigated. The contraindications to immunizations must be paid attention, but they should not be dramatized. Slight adverse reactions following some immunizations some hours or days later may not be considered as complications (e.g. some children develop fever, become restless or have a broken sleep in the following night; reddening at the place of injection, a transitory exanthem and others). Incomplete knowledges and informations in side of some physicians must be removed by permanent graduate medical education.
[Spontaneous thrombocyte aggregation and blood sugar profile in children with diabetes mellitus type I treated with human and porcine insulin].
In a three-year bicentric cross-sectional investigation on type I diabetic children aged between 6 and 18 years, blood sugar profiles and spontaneous thrombocyte aggregation were reported besides anamnestic and clinical data. In the children treated with human insulin, raised spontaneous thrombocyte aggregation was significantly more frequent than in those treated with porcine insulin. At the same time, blood sugar fluctuation from day to day measured between 7 and 9 a.m. tended to be raised in the children treated with human insulin; the fluctuation in the diurnal profile measured over 14 days was indeed very much greater. Since the two groups were comparable as to sex distribution, age, duration of disease, quality of compensation, application and dose of insulin, the greater fluctuation of blood sugar in the children treated with human insulin appears to be the cause for the raised spontaneous thrombocyte aggregation.
[Selenium concentration in the cerebrospinal fluid of children].
Following a wet digestion of 0.5-2.0 ml cerebrospinal fluid in an open system using 2.0 ml nitric acid and 1.0 ml perchloric acid (240 degrees C) and a reduction step with 1.0 ml hydrochloric acid, Selenium can be determined polarographically after adding 100 micrograms Copper(II)-ions to the analyte (15 ml; water/perchloric acid). Selenium concentrations in cerebrospinal fluid of children younger than one year (2.49 +/- 1.67 ng/ml) are significantly higher (p = 0.0074) than those of older children (1.28 +/- 0.97 ng/ml). Independent of the childrens age and diseases the Selenium concentrations correlate distinctly with cell numbers and protein contents. A correlation between Selenium content and cell numbers alone could not be proved. The non-significant differences between the Selenium concentrations in cerebrospinal fluids of children with hydrocephalus, leukemia (with or without involvement of the central nervous system), and other diseases, respectively, may be interpreted by considering the protein content of the cerebrospinal fluid and the age of the children.
[Selenium concentration in the cerebrospinal fluid of children].
Following a wet digestion of 0.5-2.0 ml cerebrospinal fluid in an open system using 2.0 ml nitric acid and 1.0 ml perchloric acid (240 degrees C) and a reduction step with 1.0 ml hydrochloric acid, Selenium can be determined polarographically after adding 100 micrograms Copper(II)-ions to the analyte (15 ml; water/perchloric acid). Selenium concentrations in cerebrospinal fluid of children younger than one year (2.49 +/- 1.67 ng/ml) are significantly higher (p = 0.0074) than those of older children (1.28 +/- 0.97 ng/ml). Independent of the children age and diseases the Selenium concentrations correlate distinctly with cell numbers and protein contents. A correlation between Selenium content and cell numbers alone could not be proved. The nonsignificant differences between the Selenium concentrations in cerebrospinal fluids of children with hydrocephalus, leukemia (with or without involvement of the central nervous system), and other diseases, respectively, may be interpreted by considering the protein content of the cerebrospinal fluid and the age of the children.