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Biomedical subjects

F Kotlarek

Publications and source records attributed to F Kotlarek.

At least 19 recordsLinked to original sources
PubMed2001

Neurodevelopmental outcome related to cerebral risk factors in children after neonatal arterial switch operation.

BACKGROUND: Neurodevelopmental outcome after neonatal arterial switch operation for complete transposition of the great arteries is an important topic needing prospective assessment. METHODS: A group of 33 unselected children (3.0 to 4.6 years) operated on as neonates with combined deep hypothermic circulatory arrest and low flow cardiopulmonary bypass and a control group of 32 age-matched healthy children (3.0 to 4.8 years) underwent evaluation of socioeconomic and clinical neurological status and a standardized test comprising all areas of child development. Results of patients were related to those of the control group, to population norms, and to preoperative, perioperative, and postoperative cerebral risk factors. RESULTS: Clinical neurological status was normal in 26 patients (78.8%) and reduced in 7 (21.2%). Complete developmental score and the subscores for motor function, visual perception, learning and memory, cognitive function, language, and socioemotional functions were not different compared to population norms. Compared to the patients, the children of the control group scored higher on tests of complete development, cognition, and language, but also on socioeconomic status. Complete developmental score and the scores for motor, cognitive, and language functions were weakly inversely related to the duration of circulatory arrest, but not to the duration of bypass. Cerebral risk factors such as serum levels of the neuron-specific enolase, perinatal acidosis, perinatal asphyxia, peri- and postoperative cardiocirculatory insufficiency, or clinical seizures were not correlated to the test results. CONCLUSIONS: Neonatal arterial switch operation with combined circulatory arrest and low flow bypass is associated with neurological impairment, but not with reduced development as assessed by formal testing of motor, cognitive, language, and behavioral functions. Perioperative serum level of the neuron-specific enolase is not a valid marker for later developmental impairment.

Arteries↗
PubMed1999

[Tuberous sclerosis and organic bipolar disorder in a 15-year-old adolescent].

We present the case of a 15-year-old girl with tuberous sclerosis who developed rapid cycling bipolar disorder under treatment with the anticonsulvant oxcarbazepine. Because of first occurrence of grand mal-seizures combined treatment with Valproate became necessary, but failed to prevent relapses of bipolar disorder. Mood stabilization was noticed under additional treatment with lithium, which was complicated by an increase of serum potassium.

Adolescent↗
PubMed1999

Mid-term follow-up after multiple system organ failure following cardiac surgery in children.

Multiple system organ failure after cardiac surgery in children is a severe complication with unknown mid- and long-term sequelae. We therefore evaluated 11 children (aged 20-126 mo, median: 67 mo) having survived multiple system organ failure after cardiac operations for congenital cardiac defects in a cross-sectional follow-up study 12-76 mo (median: 32 mo) after surgery. Clinical and laboratory examinations included cardiac, pulmonary, renal, hepatic, neurological and psychological function tests. All patients had adequate cardiac function. Lung mechanics were abnormal in three children and glomerular renal function was abnormal in two patients. Slight elevation of gamma-glutamyl transpeptidase and coagulation factor deficiency was present in six and seven patients, respectively (five of whom had undergone the Fontan operation). Severe neurological sequelae such as diplegia (n = 1) and mental retardation (n = 1) were observed in two patients. In addition, five children presented delayed motor, graphomotor and/or speech development. Two children were found to have abnormal intelligence. We conclude that with the exception of neurological impairment, mid-term sequelae of multiple system organ failure after cardiac surgery in children are mild. However, longer follow-up using an appropriate control group is mandatory.

Cardiac Surgical Procedures↗
PubMed1993

Clinical application of a noninvasive multi-electrode array EMG for the recording of single motor unit activity.

Using a recently developed noninvasive EMG recording technique with multi-electrode arrays we investigated the pattern and distribution of motor unit action potentials (MUAP) following maximal voluntary contraction of the musculus abductor pollicis brevis. An additional parameter, i.e. muscular conduction velocity (CV) in single motor units, was calculated from the multi-electrode array EMG recordings. From 63 healthy children of various age the normal EMG pattern and CV were derived and compared to the EMG of diagnosed patients known to suffer from Duchenne muscular dystrophy and from spinal muscular atrophy. In normal individuals the muscular CV in neonates was lowest at 1-2 m/s and gradually reached a plateau of 2.9-4 m/s from the age of 4 years onwards. The EMG in 31 children with Duchenne muscular dystrophy showed an abnormal pattern with low amplitude action potentials. In 30 out of 31 patients a significantly lower muscular CV was found. In 10 children with spinal muscular atrophy the EMG showed action potentials of abnormally large amplitude and a reduced recruitment of firing motor units. The muscular CV remained within the normal range. Compared to classical needle EMG the application of this new noninvasive EMG technique in children is painless and offers an easy-to-handle diagnostic tool to differentiate between neuromuscular diseases of denervating or of myopathic origin.

Adolescent↗
PubMed1992

[Diagnosis of complications of ventriculo-peritoneal and ventriculo-atrial shunts].

The value of imaging (cranial CT, cranial and abdominal sonography, plain film surveys) was examined retrospectively in 28 shunted children in whom 82 instances of suspected dysfunction arose. There were 23 obstructions, 12 dislocations, 1 disconnection, 6 infections, 3 overdrainages and 5 slit ventricle syndromes. Impaired absorption with ascites, a peritoneal liquor cyst and a seroma occurred in the peritoneal part of the shunt. Progressive dilatation of the ventricle system shown by CCT (89%) or ultrasound was the most sensitive sign of high-pressure hydrocephalus. Periventricular hypodensity and flattening of the gyri (15%) were found less often. An examination strategy in suspected shunt dysfunction is suggested on the basis of these findings.

Cerebrospinal Fluid Shunts↗
PubMed1985

[Endogenous foreign body meningitis due to a spinal epidermoid].

We present a two year old child with recurrent aseptic meningitis due to a spinal epidermoid in the subdural space. A dermal sinus had been operated earlier in this child. The connection between dermal sinus and spinal epidermoid is demonstrated. Computed tomography (CT) examination should be used as a screening in all patients with congenital dermal sinus with special reference to visualizing anatomical details.

Child, Preschool↗
PubMed1984

Predominant sensory Guillain-Barré syndrome in hereditary sensory neuropathy--case report of a three-year-old boy.

We observed a three-year-old boy with increasing ataxia over a period of two weeks, which cleared up completely within four months. The electroneurographic features and their course in the child and the father allow us to suspect the additional existence of a hereditary sensory neuropathy. The authors put forward the hypothesis that the genetic disturbance of the sensory nerves is responsible for this clinical variant of Guillain-Barré syndrome.

Child, Preschool↗
PubMed1983

Microprocessor-based long term cardiorespirography. II. Status evaluation in term and premature newborns.

In 1965 URBACH et al. and RUDOLPH et al. [35, 39] described a loss of heart rate variability in severely ill neonates. In this study we investigated the correlation between instantaneous heart rate patterns and status diagnosis. We used a microprocessor-based cardiorespirography system. Seventy five newborn infants (51 prematures and 24 term neonates) were studied for about 12 hours each. Twenty nine patients had a second record after the first investigation. Parameters were: Type of frequency and oscillation, long time variability (LTV), short time variability (STV) and the newly introduced P-value (maximal difference between two successive R-peaks in five minutes). We found clear differences between the study groups. With increasing severity of illness mean values ("group mean values") of long time variability, short time variability and P-value decreased. Fixed heart rate became predominant. The most pronounced loss of heart rate variability was seen in infants with severe intracranial bleeding, thus offering a tentative diagnosis. For statistical analysis long time variability and the silent oscillation type have been proved as best parameters for this diagnosis. Severely decreased heart rate variations also have been seen in infants with acute renal failure--possibly because of brain edema--, after application of muscle relaxants, repeated doses of sedatives, and after prolonged anesthesia. Otherwise, the heart rate variability was probably dependent on age and gestational age in prematures and newborn infants without intracranial bleeding. It is possible to use microprocessor-based long time cardiorespirography as a simple screening method for the diagnosis of neonatal intracerebral bleeding. In future experiences transcutaneous measurements of oxygen tension should be included.

Cerebral Hemorrhage↗
PubMed1981

Chromosomal investigations in epileptic children during long-term therapy with phenytoin or primidone.

In epileptic children the long-term therapy with anticonvulsant drugs is absolutely necessary. However, anticonvulsant drugs have been suspected to be mutagenic and teratogenic. To investigate this problem metaphase chromosome observations were performed using short-time culture of peripheral blood lymphocytes from twenty children. Ten of the children had been treated with phenytoin and the other ten with primidone on monotherapy. The long-term administration of anticonvulsant drugs was monitored by measurement of the serum concentrations of phenytoin and primidone, by seizure anamnesis, and by repeated EEG investigations. Analyzing 100 mitoses from each proband, we found no increase of structural or numerical aberrations in our patients compared with six controls. In adults, however, anticonvulsant drugs have been found to cause structural aberrations and chromosomal damage. The absence of these lesions in children may reflect the higher efficiency of DNA-repair in local DNA-damage.

Adolescent↗
PubMed1981

[Computed tomography in subdural effusions of infancy (author's transl)].

31 out of 128 infants with abnormal neurological signs show areas of decreased radiodensity of computed tomography (CT) over the cerebral hemispheres, primarily frontal. It is emphasized, that the diagnosis of subdural effusions is permitted in cases with decreased density over the frontal lobes and hardly visible cerebral sulci as well as wedge-shaped widening of the interhemispheric fissure. But in cases with decreased density over the frontal regions and prominent cerebral sulci a subdural effusion cannot be excluded. In association with signs of increased intracranial pressure these CT findings are yet indicative of subdural effusion. Are there to delimitate two spaces of different density between skull and cortex the diagnosis of subdural effusion is certain already by means of CT-morphological criteria. The therapeutic regimen is dependent upon the clinical symptoms.

Diagnosis, Differential↗
PubMed1981

[Benign intracranial hypertension in childhood following mastoiditis (author's transl)].

Case report concerning a three years old boy with benign intracranial hypertension. The typical symptoms are results of increased intracranial pressure, associated with headache, vomiting, choked disk, occasionally dehiscence of cranial sutures and sixth nerve paresis. In computed tomography there were no tumor signs. In childhood a possible cause in thrombosis of the lateral sinus following an occult mastoiditis after antibiotic therapy. Mastoidectomy, intensive antibiotic therapy as well as serial lumbar punctures led to complete recovery in most cases.

Abducens Nerve↗
PubMed1981

Computed tomographic findings in congenital hemiparesis in childhood and their relation to etiology and prognosis.

40, 1-14-year-old children suffering from congenital hemiparesis were re-examined neurologically and admitted to CT. According to our morphological results we found three different types of CT patterns: 1. unilateral enlargement of the lateral ventricle or parts of it (20 patients), 2. cavity in the cortex and subcortical white matter within the supply area of the middle cerebral artery (17 patients), 3. normal CT scans (3 patients). Patients with a cortical and subcortical cavity consistently had a moderate to severe hemiparesis and suffered more often from epilepsy and intellectual impairment than patients with unilateral ventricular enlargement and those with normal CT findings. Most patients with cortical defects had a history of perinatal complications, while abnormal pregnancies and prematurity prevailed in patients with unilateral ventricular enlargement. We believe that a cavity in the cortex and subcortical white matter is of arterial-ischemic origin, whereas unilateral ventricular enlargement with destruction of the deep white matter is related to venous hemorrhage. But it must be emphasized that CT cannot detect the causes, mechanisms and timing of the underlying brain lesions in congenital hemiparesis.

Adolescent↗
PubMed1981

[Spinal epidural abscess in an 11-year-old boy (author's transl)].

Spinal epidural abscesses can occur in childhood. Neurological defects are late manifestations in the course of this disease. Recognition of the early symptoms followed by immediate neurosurgical intervention can prevent these defects. This report describes the course of an epidural abscess in an 11 year old boy. The painful febrile spinal syndrome of the cervical column was the outpointing initial symptom. Lateron disturbances of the autonomic nerve function appeared, such as acute abdomen. The differential diagnosis of the early symptoms is discussed.

Abdomen, Acute↗
PubMed1980

Cerebellar ataxia. Clinical and CT findings in two cases of rare etiology.

Two low density lesions of the cerebellum which did not occupy space are reported. The neuropathological diagnosis of one case was subacute leucencephalitis. In the other case, the diagnosis of a Pelizaeus-Merzbacher's disease is discussed, taking into consideration the clinical observation, development and the CT findings.

Adolescent↗