Search PubMed⌕ Search

Biomedical subjects

H Bode

Publications and source records attributed to H Bode.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Intra-individual variation of cerebral blood flow velocity in sleeping and awake children].

A considerable intraindividual variability of blood flow velocities in the middle and posterior cerebral artery was found in 74 children by continuous transcranial Doppler recording during EEG registration. The coefficient of variation of the mean flow velocities in the posterior cerebral artery was higher than in the middle cerebral artery, and higher in restless children than in calm children. During hyperventilation the mean flow velocities decreased to about 50 per cent of the baseline values. They increased to 130-140 per cent of the baseline values after hyperventilation. Repeated variations of the velocities of more than 30 per cent of the baseline values were observed during non-REM sleep in the majority of the children. They may be caused by a lower damping of the cerebral autoregulatory response. The intraindividual variability of cerebral blood flow velocities in children has to be kept in mind in pathological conditions and during Doppler monitoring.

Arousal↗
PubMed1992

[Cerebral Doppler measurements in risk newborn infants do not have a prognostic value].

PROBLEM: The prognostic value of cerebral doppler for the neonatal and the developmental prognosis was studied. METHODS: A prospective longitudinal study on 175 newborns at risk was performed. The blood flow velocities were recorded transcranially in the middle cerebral, posterior cerebral and internal carotid artery on day 1, 3-5 and 8-10 of life. Neonatal mortality and cerebral sonography gave the criteria for neonatal prognosis. Developmental prognosis was determined at a corrected age of 9 months by neurological examination and Griffth's test. RESULTS: In 60 neonates abnormal flow velocities were obtained at least at one recording. Ultrasound revealed cerebral hemorrhage in 20, hypoxic-ischemic encephalopathy in 5 children. 14 infants died during the neonatal period, 5 in the following months. Premature babies with birth weights below 1501 g and abnormal flow velocities presented more cerebral hemorrhages and deaths than those with normal flow velocities. At the age of 9 months a slight handicap was observed in 10, a severe handicap in 6 of the surviving 156 infants. The majority of infants with abnormal neonatal doppler-recording had a normal neurodevelopmental status. CONSEQUENCE: Cerebral doppler seems to be of little value to determine the prognosis of newborns at risk.

Asphyxia Neonatorum↗
PubMed1991

[Aspects of cerebral circulation in children].

Investigation of cerebral circulation represents an essential diagnostic adjunct to pediatric neurology. Doppler-sonography is presented as one of the diverse techniques to examine cerebral hemodynamics. The human cerebral circulation is controlled by autoregulatory mechanisms. Factors such as hematocrit, pulse, orthostasis and physical activity modulate the cerebral blood supply. The demand for blood depends essentially on arterial pCO2 but also on behavioural situations such as mental activity, effect of sensory stimuli or sleep. Bioelectric activity and perfusion of the central nervous system are closely linked. The cerebral perfusion in infants is characterized by a rapid increase in flow over the first couple of years to values exceeding those of adults. Disturbances of the cerebral perfusion are found in a variety of pediatric diseases. The patterns of perinatal brain damage depend on the maturity of the newborn. They are mainly sequels of impaired cerebral perfusion. In prematures periventricular leukomalacia and intracerebral hemorrhage are frequent whereas in infants at term cerebral edema and infarcts are more common. Acute hemiplegia in childhood can be of thromboembolic or vascular origin, however of etiologies different from those in adulthood. Prevention is the best treatment for disturbances of cerebral perfusion in childhood. Continuous monitoring techniques and pharmacotherapy need further clinical investigation.

Blood Flow Velocity↗
PubMed1991

Cerebral blood flow velocities during orthostasis and physical exercise.

The peak flow velocities in the middle cerebral artery were continuously recorded by transcranial Doppler sonography in 29 children. Arterial blood pressure and heart rates were measured every minute. The values observed during orthostasis and physical exercise were compared to baseline values obtained in the supine position. During orthostasis the velocities were, on average, reduced to 87%-94%, the minimal values being 75%-78% of the baseline values. The heart rate increased whereas blood pressure showed only minor alterations. Upon standing up the systolic peak flow velocity remained unchanged while the mean- and enddiastolic peak flow velocities decreased to 66% and 39% respectively. On average, the velocities increased to 103%-108% during physical exercise. Systolic blood pressure increased to the same extent, the heart rate even more. Continuous recording of cerebral blood flow velocities may be more useful than intermittent measurements of blood pressure to differentiate children with and without symptoms of orthostasis.

Adolescent↗
PubMed1991

[Brain circulation in residual cerebral damage. A Doppler ultrasound study].

Transcranial Doppler recordings of flow velocities in 5 cerebral arteries were performed in children with cerebral palsy or with focal epileptic discharges. In 22 children with severe bilateral cerebral palsy as an average the flow velocities were 55% of the norm. In 8 of 10 children with spastic hemiplegia, the velocities were reduced at least in one artery of the affected side. 7 of 11 children with a mixed focus and 4 of 18 children with a pure epileptic focus in the EEG presented reduced velocities within the artery belonging to the focus. The results and other studies indicate a reduced cerebral blood flow in severe cerebral palsy with may be caused by vascular, metabolic, bioelectric or pharmacologic factors.

Adolescent↗
PubMed1990

[An unusual "tumor-like finding" between the head of the pancreas and the duodenal wall].

A 48-year-old woman complained of right-sided upper abdominal pain and recurrent vomiting, and had lost 10 kg in 4 months. Ultrasound and computed tomography showed a solid, space-occupying lesion in the head of the pancreas, not separable from the duodenum. Despite thorough investigation the nature of the lesion remained obscure. Operation revealed a divided pancreas with stenosis of the accessory duct at the papilla. Histological examination showed pseudosarcomatous myofibroblastic proliferation within the duodenal wall in the vicinity of a duodenal wall cyst which had been destroyed by inflammation. In cases of divided pancreas it is the accessory duct which drains the main bulk of the pancreas, while the main duct carries little or no secretion; the stenosis of the accessory duct in this patient had therefore led to low-grade pancreatitis involving the head of the pancreas.

Chronic Disease↗
PubMed1990

Origin of the left coronary artery from the right pulmonary artery and ventricular septal defect in a child of a mother with raised plasma phenylalanine concentrations throughout pregnancy.

A child with anomalous origin of the left coronary artery from the right pulmonary artery, ventricular septal defect, fetal growth retardation, and facial abnormalities was born to a woman in whom plasma phenylalanine concentrations had been raised throughout pregnancy. The cardiac abnormalities were diagnosed by angiography when the child was eight months old. The anomalous coronary artery was imaged in a subsequent echocardiogram. Development retardation was caused by maternal phenylketonuria, which may also have been responsible for the development of the ventricular septal defect and the coronary anomaly. If dietary treatment of the mother had been started before pregnancy damage to the child might have been prevented.

Abnormalities, Multiple↗
PubMed1990

[Translocation trisomy 4q in 2 siblings as a sequela of paternal balanced reciprocal translocation: t(1;4)(q44;q31)].

In a sister and a brother with striking similarity of facial dysplasias, severe disturbance of expressive speech, and mild mental retardation a partial trisomy of the long arm of chromosome 4 was identified as cause of these anomalies. The partial trisomy 4q was due to a balanced translocation between the chromosomes 1 and 4 in the father of both children.

Abnormalities, Multiple↗
PubMed1989

Transient stenoses and occlusions of main cerebral arteries in children--diagnosis and control of therapy by transcranial Doppler sonography.

Flow disturbances in main cerebral arteries may cause severe neurological symptoms. Using transcranial Doppler sonography (TCD) the blood flow velocities in the basal cerebral arteries (BCA) can be recorded at any age. Transient stenoses or occlusions of main cerebral arteries were detected in 11 children by this method and confirmed by other techniques. Vasospasm produced a marked increase in flow velocities in the affected arteries which was reduced by nimodipine, the calcium channel blocker. Vasospasm also occurred in severe bacterial meningitis. In acute hemiplegia due to cerebral arterial obstruction no flow velocities could be recorded at the corresponding site. If distal branches were obstructed reduced flow velocities were found proximally. Increased flow velocities or reversed flow in anastomoses indicated the collateralization. The transient nature of the occlusions was shown by repeated recordings. TCD is a reliable, noninvasive and rapidly available technique for diagnosing or excluding transient flow disturbances in the main cerebral arteries as the cause of neurological symptoms in children. It indicates the necessity and most advantageous stage for therapy.

Adolescent↗
PubMed1989

[Transcranial Doppler sonography in childhood. 1. Study technic and biological effect magnitudes].

The blood flow velocities in the basal cerebral arteries can be recorded at any age by transcranial Doppler sonography. Using a standardised examination technique the vessel identification is reliable even without visual control. A stable state of vigilance is necessary to obtain constant recordings. Age has a definite influence on the flow velocities. Velocities increase linearily during the first weeks and later on more slowly until they reach their maximum around the 6th year of life. The influence of CO2 partial pressure, gestational age, birth weight and haematocrit on the flow velocities must be taken into consideration. Heart rate and arterial blood pressure are relevant only in case of extreme values.

Birth Weight↗
PubMed1989

[Transcranial Doppler sonography in children. 2. Clinical uses].

Transcranial Doppler sonography of basal cerebral arteries is helpful for diagnosis and control of the course of paediatric diseases like patent ductus arteriosus, perinatal brain damage, increased intracranial pressure, cerebral malformations and stenoses and occlusions of main cerebral arteries. The technique also allows control of hyperventilation therapy of cerebral oedema. With a few exceptions, the Doppler results are not specific for a particular disease. However, they do supply important information on the specific pathophysiology of cerebral haemodynamics. The evaluation of the recordings should take into account the clinical condition of the child, the laboratory results, the results of imaging methods and intra- and interindividual comparisons.

Brain↗
PubMed1989

Transcranial Doppler sonography in children.

The blood flow velocities in the basal cerebral arteries can be recorded at any age by transcranial Doppler sonography. By a standardized examination technique, the vessel identification is reliable even without visual control of the site of the sample volume. A stable state of vigilance is necessary to obtain constant recordings. Age has a tremendous influence on the flow velocities. The velocities increase rapidly during the first weeks and reach their maximum around the sixth year of life. The influence of carbon dioxide partial pressure, gestational age, birth weight, hematocrit, and vigilance on the velocities has to be considered. Heart rate and arterial blood pressure are relevant only in cases of extreme values. The clinical applications of transcranial Doppler sonography cover diseases like patent ductus arteriosus, perinatal brain damage, increased intracranial pressure, cerebral malformations, brain death, and stenoses and occlusions of main cerebral arteries. The technique is helpful for control of certain therapies. A continuous recording technique has also been developed for this purpose. Care should be taken in deriving a prognosis from Doppler recordings.

Adolescent↗
PubMed1989

[Herlitz syndrome and "pyloric atresia"].

The aetiological and pathogenic relation between junctional epidermolysis bullosa (Herlitz) and prepyloric and pyloric obstruction in newborns with junctional epidermolysis bullosa is still unknown. There are two different hypotheses; one suggesting two distinct genetically related disorders (namely junctional epidermolysis bullosa and congenital pyloric atresia), the other suggesting an intrauterine mucosal damage in junctional epidermolysis bullosa. We report two infants suffering from junctional epidermolysis bullosa, Herlitz-type, verified by electron microscopy, and from connatal prepyloric and pyloric obstruction. In both cases we could demonstrate proliferative inflammation at the prepyloric antrum and pylorus as the cause of the obstruction but no complete obliteration of the pyloric channel. These findings point to an intrauterine event impacting the mucosa of the gastrointestinal tract in patients with junctional epidermolysis bullosa of the Herlitz-type and don't comply with the hypothesis of two different but genetically related diseases.

Epidermolysis Bullosa↗
PubMed1988

Diagnosis of brain death by transcranial Doppler sonography.

The blood flow velocities in the basal cerebral arteries can be recorded at any age by transcranial Doppler sonography. We examined nine children with either initial or developing clinical signs of brain death. Soon after successful resuscitation increased diastolic flow velocities indicated a probable decrease in cerebrovascular resistance; this was of no particular prognostic importance. As soon as there was a clinical deterioration, there was a reduction in flow velocities with retrograde flow during early diastole, probably due to an increase in cerebrovascular resistance; this indicated a doubtful prognosis. In eight of the nine children with clinical signs of brain death a typical reverberating flow pattern was found, which was characterised by a counterbalancing short forward flow in systole and a short retrograde flow in early diastole. This indicated arrest of cerebral blood flow. One newborn showed normal systolic and end diastolic flow velocities in the basal cerebral arteries for two days despite clinical and electroencephalographic signs of brain death. Shunting of blood through the circle of Willis without effective cerebral perfusion may explain this phenomenon. No patient had the typical reverberating flow pattern without being clinically brain dead. Transcranial Doppler sonography is a reliable technique, which can be used at the bedside for the confirmation or the exclusion of brain death in children in addition to the clinical examination.

Basilar Artery↗
PubMed1988

Age dependence of flow velocities in basal cerebral arteries.

Flow velocities in the basal cerebral arteries were studied by transcranial Doppler sonography. A longitudinal study was undertaken on 25 healthy newborn babies during the first 20 days of life, and a cross sectional study was performed on 112 healthy children between 1 day and 18 years of age. A rapid linear increase of flow velocities was found within the first 20 days with higher velocities in neonates of higher birth weight and gestational age. Maximal values were recorded at the age of 5 to 6 years. After that the velocities decreased linearly to 70% of their maximum at the age of 18 years. Reference values were derived from the data considering age and birth weight. The increasing flow velocities probably reflect the increasing cerebral blood flow during the first years of life. Our results also support the hypothesis of a decrease in cerebrovascular resistance during infancy. With the technique of transcranial Doppler sonography and the introduced reference values normal and abnormal intracranial flow velocities can now be assessed by non-invasive methods in all paediatric age groups.

Adolescent↗