Dignity of the perinatal optimality score of Prechtl.
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Biomedical subjects
Publications and source records attributed to H Manzke.
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A case of a 10-year old boy suffering from asthma bronchiale following pleuropneumonia is reported. Paradoxically, bronchospasmolysis tests using physiological saline + salbutamol or ipratropium bromide impaired the lung function of this patient. Salt solutions inhaled in increasing doses until 1.4% generated severe bronchoconstriction, however, inhalation of DNCG + salbutamol normalized the lung function completely.
The protective effects of inhaled MgS04 on exercise-induced asthma were studied in 13 children aged 6-13 years. The patients performed 6 min. running test on 3 separate days. Spirometry (FEV1, SRAW, VK, PF) was recorded on each test day 10 min. after medicament inhalation directly before and instantly, 2, 5, 10 and 20 min after the running test. t-tests on the mean revealed no significant effects on spirometric measurements (p less than 0.1), but in 6 patients MgS04-inhalation prevented FEV1--decreases greater than 20%. The combination gave better protection compared to salbutamol alone demonstrated from the measurements after exercise testing. Thus, MgS04-inhalation could be useful in the protective treatment of asthma.
Two healthy volunteers were treated with hypoxanthine 3 x 1 g and allopurinol 3 x 100 mg daily for 1 week. During this treatment serum oxypurine concentration and urinary oxypurine excretion increased as expected. No side effects were observed except for some mild daytime drowsiness and lethargy. Measurements of urinary serotonin (5-HT) excretion showed decreases to as much as 60% below initial values. Decreased urinary 5-HT excretion was also found in a patient with incomplete Lesch-Nyhan syndrome during treatment with high doses of hypoxanthine. His neurological symptoms improved slightly. The results suggest that high doses of hypoxanthine exert a nonspecific sedative effect on both patients with Lesch-Nyhan syndrome and healthy controls. The cause is probably a reduced synthesis or release of 5-HT.
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Extremely low birth weight infants are particularly prone to rickets (osteopenia) due to their rapid growth and to deficient intake of calcium and phosphate. In some premature infants suffering from phosphate depletion hypercalcemia syndrome may precede bone demineralisation. Additionally, the adverse effects of calciprivic drugs (phenytoin, phenobarbital, glucocorticoids, furosemide, heparin) contributing to the development of neonatal rickets are discussed. Phosphorus depleted or heparin treated experimental animals develop impairment of mineralisation as manifested by rickets or osteomalacia. Some clinical cases of neonatal rickets are reported and a dosage schedule for parenteral infusion of minerals is given.
Within the sample of 1783 children from the prospective study "Schwangerschaftsverlauf und Kindesentwicklung" (Course of pregnancy and development of children) followed-up until the age of 6 years the mothers of 182 suffered from late gestosis (10.2%). The values of the systolic blood pressure and of the protein concentration in the urine of the mothers measured at their last examination before onset of labour were crucial for the diagnosis of gestosis. According to this definition 95 mothers with systolic pressure greater than or equal to 150 mm Hg were classified as hypertensive (group of the hypertension children) and 87 mothers with both systolic pressure greater than or equal to 150 mm Hg and proteinuria greater than 1 g/l as being preeclamptic (group of the preeclamptic children). The control groups contained the same number of children (matched pairs). There were no significant differences in the findings between the different groups. Apparently, the prognosis of the child's development is favourable provided that the gestosis does not last long and does not lead to placental insufficiency.
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This description of the physiology and pathophysiology of the calcium and phosphate balance in neonates is based on our own studies and a short review of the literature. In general, the higher the calcium concentration in the umbilical cord blood the greater its decrease during the first two days of life. With asphyxiated newborns the decrease in the serum level of both the total calcium and the ionized calcium surpasses that in nonasphyxiated newborns by approximately a third. There are various causes for neonatal hypocalcemia. The most striking causes for the early form of hypocalcemia are likely to be a transient hypoparathyroidism or a failure of end-organ responsiveness. In nearly all newborns we found a low urinary cAMP excretion on the first day of life increasing significantly until the fourth day. Measurements of the urinary cAMP excretion are an appropriate parameter for recognizing the parathormone effect. By measuring both the parathormone level in the serum and the urinary cAMP excretion it is possible to distinguish hypoparathyroidism from pseudoparathyroidism . Several cases with different forms of hypocalcemia are discussed.
Cardiazol induced seizures in rabbits showed that the highest oxypurine concentrations can be detected in the CSF 1 hour after the convulsions. There is a sharp decline continuing until the third hour. After that the CSF values remain nearly constant until the 24th hour being about ten times higher than in the controls. There is a good correlation of these results obtained through the densitometric thin-layer, enzymatic-oxymetric, and HPLC-methods. Creatinine and potassium were raised only during the first two hours postconvulsively. Uracil appeared in the CSF slightly higher at the 1 hour and at the 12 and 24 hour values. A parallel increase of the oxypurine and creatinine concentrations was found in the serum between 30 to 120 minutes postconvulsively. After that the raised serum values decreased slowly to the initial values. CSF samples were examined in 31 children postconvulsively: Hypoxanthine was found to be raised in 8 of 12 patients with severe grand mal seizures, 1 of 6 patients with hypsarrhythmia, 1 of 8 patients with short seizures (less than 2 min) and in all 5 patients with petit mal status. In contrast to these groups the hypoxanthine concentrations was raised only in 2 of 20 children with aseptic meningitis. The difference between the group of children with convulsions and the group of children with aseptic meningitis is significant (p less than 0.005). Also, the frequency of raised uric acid concentration is higher in the group of children with convulsions (70%) than in the group of children with aseptic meningitis (40%); (p less than 0.05).
Oxypurine analysis was done in the CSF of 190 children with different diseases. The patients could be divided into four groups: Group A, serving as controls, consisted of 56 children suffering from diseases without neurological signs, for example, leukaemia. 16% of them had raised hypoxanthine values greater than 7.5 mumol/l and 32% raised uric acid values greater than 12.0 mumol/l. Group B comprised 97 children suffering from diseases with neurological signs, for example, meningitis. For these patients the frequency of raised hypoxanthine and uric acid values in the CSF was twice as high as in Group A. Group C comprised 31 patients with different forms of cerebral convulsions. Among these patients 52% had raised hypoxanthine and 70% raised uric acid values. The findings of these patients are described in a previous paper (Manzke et al. 1981). Group D comprises 6 patients from whom CSF samples were taken postmortally. All these deceased patients showed extremely high hypoxanthine + xanthine and uric acid concentrations in their CSF.
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Serum creatinine, uric acid, and hypoxanthine and xanthine concentrations were determined in 17 mother-infant pairs at the time of delivery. Creatinine and uric acid levels were nearly similar, but hypoxanthine and xanthine were more than twice as high in the blood of the infants than in the blood of their mothers. In the same newborns the urinary excretion of creatinine, uric acid, hypoxanthine and xanthine, uracil, cAMP, and cGMP was measured on the first and fourth day of life. Creatinine, uracil, and cAMP increased, hypoxanthine and xanthine, and cGMP decreased, whereas the output of uric acid was nearly the same on both days. Correlations of the excreted substances to each other were calculated.
This paper suggests that there is probably a dominant, sex-linked type of chondrodysplasia punctata. Clinical data are reported for three girls with such a disorder. Two of their mothers showed a mild form of cicatricial alopecia. The pathognomonic dermatological findings in the children include erythematous skin changes and striated ichthyosiform hyperkeratosis during the first months of life. Later on, patterned ichthyosis, follicular atrophoderma, coarse, lusterless hair and cicatricial alopecia become evident. It is assumed that about one fourth of all cases with chondrodysplasia punctata reported in the literature belong to the dominant sex-linked type.