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Biomedical subjects

G M Lackmann

Publications and source records attributed to G M Lackmann.

At least 37 records · Page 2Linked to original sources
PubMed1995

The predictive value of elevation in specific serum enzymes for subsequent development of hypoxic-ischemic encephalopathy or intraventricular hemorrhage in full-term and premature asphyxiated newborns.

Serum lactate dehydrogenase (LDH), aspartate aminotransferase (ASAT), and hydroxybutyrate dehydrogenase (HBDH) activities are significantly elevated in asphyxiated newborns within the first days of life. The approach of the present study was to evaluate firstly if serum levels of these enzymes correlate with the development of hypoxic-ischemic encephalopathy (HIE) and periventricular-intraventricular hemorrhage (PIVH) in full-term and premature asphyxiated newborns, and secondly if postnatally elevated enzyme activities could be predictive for these disorders. ASAT, LDH and HBDH activities were measured in 98 asphyxiated newborns. Blood samples were taken serially at five fixed times: 0 (cord), 12, 24, 72, and 144 hours post partum. All newborns were examined for the development of HIE and PIVH using standardized scoring systems. Fifty percent of the newborns were full-term and 50% were premature. Ten of the full-term (20.4%) and 21 (42.8%) of the premature newborns developed HIE. Nineteen newborns (19.4%) suffered PIVH (full-term/premature, 7/12). The full-term asphyxiated newborns with HIE or PIVH showed significantly elevated ASAT, LDH, and HBDH activities within the first 72 hours of life. In case of the premature asphyxiated newborns, the enzyme activities did not differ significantly between the study groups. The overall predictive values showed a high sensitivity (HIE/PIVH, 90.0%/71.4%), a high specificity (71.0%/88.1%), an acceptable negative predictive value (44.9%/50.0%), and a high positive predictive value (96.5%/94.9%) for the development of HIE and PIVH in full-term asphyxiated newborns. It is concluded that measurements of ASAT, LDH, and HBDH activities are reliable predictors for the development of HIE and PIVH in full-term asphyxiated newborns.(ABSTRACT TRUNCATED AT 250 WORDS)

Asphyxia Neonatorum↗
PubMed1993

Aneurysmal cyst of the petrosal bone.

An aneurysmal cyst of the petrosal bone presenting as hearing loss and recurrent bacterial meningitis is reported. None of the clinical or radiographic signs described previously were present. Because other diagnostic methods are not reliable, it is recommended that coronal thin section computed tomography be performed in every case of suspected malformation of the skull base and in the diagnosis of recurrent bacterial meningitis.

Bone Cysts↗
PubMed1993

Serum enzyme activities in full-term asphyxiated and healthy newborns: enzyme kinetics during the first 144 hours of life.

Little is known about the kinetics of most serum enzymes during the first hours of life, and even less about the effect on such enzyme activities of perinatal hypoxia-ischaemia. It was the aim of the present study to evaluate the serum kinetics of seven differently located cell enzymes in healthy and asphyxiated newborns during the 1st week of life. The serum activities of cytoplasmic and mitochondrial [aspartate aminotransferase (ASAT), creatine kinase (CK), glutamate dehydrogenase (GLDH), lactate dehydrogenase (LDH), and hydroxybutyrate dehydrogenase (HBDH)] and membrane-bound (gamma-glutamyl-transferase and leucine arylaminidase) enzymes were prospectively measured in full-term asphyxiated (n = 49) and healthy (n = 87) newborns during the first 144 h of life. The blood samples were taken serially at five fixed times: 0 (cord), 12, 24, 72, and 144 h postpartum. The asphyxiated newborns had significantly increased serum activities of ASAT, LDH, and HBDH up to 72 h postpartum, whereas healthy newborns showed higher CK and GLDH activities. Only the activities of ASAT, LDH, and HBDH seemed to depend on the oxygen supply of the fetus or newborn. If other causes of increased serum enzyme activities, e.g. liver diseases, haemolytic disorders, tumours, or inborn errors of metabolism, are excluded, elevated serum activities of ASAT, LDH, and HBDH should draw one's attention to a perinatal hypoxic-ischaemic insult of the newborn.

Aging↗
PubMed1993

[Aneurysmal bone cyst of the petrous bone. A rare cause of recurrent bacterial meningitis].

Occult malformations of the skull base are very rare disorders which cannot initially be diagnosed clinically. They become first symptomatic, if complications arise. The most frequent clinical manifestation is a recurrent bacterial meningitis. Based on the unique case of a presumably congenital aneurysmal bone cyst of the petrosal bone, which imposed clinically as hearing loss and recurrent bacterial meningitis, we have evaluated the extensive literature on this theme. Considering mostly atypical clinical findings, solely coronal thin-section computed tomographic scans of the skull base allow a reliable diagnosis. The possible risks of this investigation (necessary sedation up to insufflation anesthesia and the radiation exposure of the child's lens) are justifiable and subordinate to the diagnostic importance.

Adolescent↗
PubMed1992

[Enzyme activity in serum of healthy newborn infants. Normal values of CPK, gamma-GT, GOT, GLDH. LAP, LDH and HBDH in the first 144 hours of life].

QUESTION: There are no available enzyme determinations for the neonatal period taking in account the considerable changes during the first hours of life. Moreover, in former studies the number of probands has been small and no standardized and optimized methods have been used for the determinations. It was the aim of the presented study to evaluate reference ranges for these enzymes in healthy newborns for the first week of life. METHODS: We realized a controlled-prospective study about the serum activities of CPK, GGT, GOT, GLDH, LAP, LDH, and HBDH in healthy newborns (n = 87). The enzyme determinations were done for the first time in a serial manner at five fixed times: post partum (cord), 12, 24, 72, and 144 hours post partum with optimized test-kits. RESULTS: The evaluated serum enzyme activities are stated with median, 25th, and 75th percentile by rank. We propose these results as reference ranges for these enzyme activities during the first 144 hours of life. CONCLUSION: For the first time reference ranges for serum enzyme activities concerning the striking activity changes during the first hours of life are evaluated for healthy newborn infants. These results enable comparative investigations in the case of newborn diseases.

Aspartate Aminotransferases↗
PubMed1992

[Etiology and diagnosis of cerebral infarcts after the neonatal period].

QUESTION: After the neonatal period, cerebral infarctions are very rare in childhood. In the present study we aim to evaluate the etiology and diagnostic procedures of this disorder on the basis of our own experience. METHODS: We saw four children aged 3 2/12 to 11 4/12 years with a cerebral infarction at our hospital. Three children were followed up until 6 months after the infarction. The case reports are presented. On the background of the literature, the etiology and diagnostic possibilities and requirements are discussed. RESULTS: As the underlying cause, we saw a hemolytic-uremic syndrome in one case, and a (post-)infectious vasculitis following measles resp. scarlet fever in two cases. CCT, NMR, and transcranial Doppler sonography are the diagnostic methods of choice, although none of these by itself is able to diagnose this disorder with any certainty. Therapeutic measures are restricted to the causative disease. The prognosis is good quoad vitam, although serious regarding neurologic sequelae. CONCLUSIONS: An early diagnosis of this disorder is essential, because the only known effective therapy is the management of a possibly underlying disorder. Intensive physiotherapy as an additional measure is helpful to avoid neurological sequelae.

Cerebral Infarction↗
PubMed1991

[Neonatal focal seizures and transitory inappropriate ADH secretion syndrome due to an infarction in the region of the middle cerebral artery].

Cerebral arterial infarction is a very rare condition during the neonatal period. In recent times, cerebral infarctions with an atypical bland course are reported in healthy, unsuspected newborns. For the first time, we saw focal seizures and a transient syndrome of inappropriate ADH secretion in a full-term, male newborn with an infarction of the middle cerebral artery as the first sign of this disorder. On the basis of these rare clinical manifestations, the literature about neonatal cerebral infarction is reviewed. The diagnostic possibilities and prognostic expectations are discussed. It is the aim of this case report to call attention to this rare disease in order to avoid a delay in diagnosis and therapy, even if the initial manifestations are atypical.

Cerebral Arteries↗
PubMed1990

[Facial injuries caused by dog bites in childhood. Clinical staging, therapy and prevention].

Dog bite injuries are a frequent cause of facial injuries in childhood. Between 1986 and 1990 we treated 16 children with facial dog bite injuries. Based on these experiences we suggest a clinical classification, corresponding therapeutic rules and prophylactic possibilities, summarized according to the literature. It is our aim to establish guidelines for the physician concerned with the therapy of these injuries, and advice to involved families.

Animals↗
PubMed1989

[Acute, non-traumatic paraplegia syndromes in children].

Acute, non-traumatic paraplegia is a very rare condition in childhood. Because of this the correct diagnosis is not recognized in time. We want to call attention to this illness by reporting on four patients we treated between the years 1984 and 1986. We put together and analyzed the literature on this disorder for the first time, and established guide lines-first, to recognize those causes of the disorder which by all means have to be treated in time, and second, how to proceed further diagnostically.

Adolescent↗
PubMedDate not supplied

Surgical treatment of facial dog bite injuries in children.

Although today most injuries of face and head are the result of car and motorcycle accidents, dog bites are a frequent cause of facial injuries in children. In recent years, general guidelines have been established concerning the surgical treatment of facial dog bite injuries in children. We have seen 16 children with such lesions at our hospital in the last 4 years. All children have been treated surgically, under general anaesthesia, by primary closure of the wound with interrupted sutures after having adapted the margins by subcutaneous sutures. In addition, all children have been evaluated 3 months-5 years after the accidents in order to objectify the results of our treatment. Special attention has been attached to the functional and aesthetic outcome. In all cases, we saw good-to-excellent results. Based on this experience we suggest a clinical classification of these injuries in regard to a special therapeutic regime for each stage. In this way, guidelines may be established for the surgeon dealing with these injuries.

Adolescent↗
PubMedDate not supplied

[Papules on the dorsal interphalangeal joints and an unspecific immunostimulating agent].

We report the case of an 8-year-old girl with skin eruptions on both hands that were thought to be of viral origin and, therefore, had been treated with an unspecific immunostimulating agent, containing large amounts of inosine. Under this therapy, which is - despite contrasting knowledge - still thought to be harmless and without serious side effects in the opinion of many physicians and especially medical laymen, the girl's condition worsened rapidly. Diagnosis of juvenile dermatomyositis was made. Because inosine is able to enhance T-cell proliferation and reverse immunosuppression in vitro, both mechanisms may have aggravated the disease course in our patient, once the autoimmune process of dermatomyositis has been initiated.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Primary observation of a congenital intracranial teratoma in a twin with a healthy brother].

Primary intracranial teratomas are rare germ cell tumors arising from embryonic tissues, which contain cellular or tissue derivates from all three germ layers. Today the early intrauterine diagnosis by ultrasound is possible. We first describe a patient with such a tumor which was diagnosed by routine ultrasound in the 33rd week of gestational age in a twin-pregnancy, of which the 2nd twin developed normally. This must be considered in the obstetrical situation. In such a case the parents should be advised accordingly.

Brain Neoplasms↗