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Biomedical subjects

H Stopfkuchen

Publications and source records attributed to H Stopfkuchen.

At least 19 recordsLinked to original sources
PubMed2000

Normal values of M mode echocardiographic measurements of more than 2000 healthy infants and children in central Europe.

OBJECTIVE: To obtain normal M mode (one dimensional) echocardiographic values in a substantial sample of normal infants and children. DESIGN: Data were obtained over three years from a single centre in central Europe. PATIENTS: 2036 healthy infants and children aged one day to 18 years. METHODS: In line with recommendations for standardising measurements from M mode echocardiograms, and using digital echocardiographic equipment, measurements were obtained of the following: right ventricular anterior wall thickness at end diastole, right ventricular end diastolic dimension, thickness of interventricular septum at end diastole and end systole, thickness of posterior wall of the left ventricle at end diastole and end systole, left ventricular dimension at end diastole and end systole, pulmonary and aortic valve diameter, and left atrial dimension. RESULTS: Measurements are presented graphically on centile charts with respect to body surface area, and as tables with mean and 2 SD values for newborns in relation to body weight, and for infants and children in relation to body surface area. Best fitting regression equations are given for each measured variable, using the 50th centile values. CONCLUSION: In comparison with previously published normal values, the presented charts and tables make it possible to judge echocardiographic measurements of a particular patient as normal or abnormal.

Adolescent↗
PubMed1999

[Prehospital emergencies (emergencies and acute cases) in childhood].

OBJECTIVE: To determine incidence and management of prehospital emergencies in children. METHODS: Between November 15, 1994 and March 14, 1995 in the City of Mainz (200,000 inhabitants) children with the diagnosis of a prehospital emergency were identified. RESULTS: 390 children were discovered, 62% in the age group 0-3 years. 85% of the emergency conditions occurred at home. In 71% the medical practitioner providing prehospital care was a paediatrician, in 14% an emergency physician. 48% of the children were transported to the Children's Hospital by the parents. 32 different types of emergency were diagnosed, 8 types more than 10 times. A retrospective analysis of 386 emergencies demonstrated an acute life-threatening situation in 12%. Lacking a final diagnosis in 19%, first and final diagnosis were identical in 64% of all children evaluated. CONCLUSIONS: In Germany acute life-threatening emergencies are rare. Paediatricians are mainly involved also in the care of children with emergency conditions. Most pediatricians and nonpaediatricians are familiar with the relevant prehospital emergency conditions in the young children mainly concerned.

Acute Disease↗
PubMed1999

Congenital diaphragmatic hernia: ultrasonic measurement of fetal lungs to predict pulmonary hypoplasia.

OBJECTIVE: The purpose of this study was to assess the value of biometric lung measurements for the prediction of severe fetal pulmonary hypoplasia in congenital diaphragmatic hernia and to determine whether a correlation between lung measurements and autopsy findings or neonatal outcome could be established. DESIGN: Prospective study, between 1991 and 1997. SUBJECTS: Nineteen fetuses with congenital diaphragmatic hernia. METHODS: In addition to standard biometry, sonographic measurement of the transverse thoracic diameter, sagittal thoracic diameter, fetal lung diameters at the level of the four-chamber view and lung/thoracic circumference ratio were performed. These were compared with the standard curves defined by Merz and colleagues. Autopsy examinations were performed to determine lung weight, lung weight/body weight ratio and radial alveolar count. RESULTS: Five fetuses (26%) were terminated before 24 weeks of gestation. All of these fetuses had lung measurement values below the 5th centile. Eleven of 14 fetuses (78.6%) with pulmonary hypoplasia diagnosed after 24 weeks of gestation died postnatally. The mortality rate was 70% (7/10) in the fetuses without associated anomalies. The sonographic diagnosis of fetal pulmonary hypoplasia was made in all fetuses who died postnatally. All fetuses with a lung diameter/thoracic circumference ratio below 0.09 died. Three fetuses, which had values within the normal range, survived. In contrast, measurements of the bony thorax (transverse and sagittal thoracic diameters, thoracic circumference) did not provide an indication of the presence of fetal pulmonary hypoplasia. Pulmonary hypoplasia was confirmed at autopsy in all fetuses on the basis of lung weight, lung/body weight ratio or radial alveolar count. Concomitant with pulmonary hypoplasia was polyhydramnios in ten fetuses (71.4%), mediastinal shift in 11 fetuses (78.6%), intrathoracic herniated stomach in six fetuses (42.9%) and associated malformations in four fetuses (28.6%). Postnatal mortality for these conditions was 80%, 78.6%, 100% and 100%, respectively. Postnatal mortality was 75%, 70% and 100% in the fetuses with an isolated diaphragmatic hernia. CONCLUSION: The results of this investigation suggest that the assessment of fetal lung diameter and the use of the lung diameter/thoracic circumference ratio are further useful prognostic parameters in the management of congenital diaphragmatic hernia.

Biometry↗
PubMed1998

Physical performance in long-term survivors of acute leukaemia in childhood.

UNLABELLED: The aim of this study was to assess the physical performance in long-term survivors of acute leukaemia in childhood and to evaluate the effects of anthracycline therapy. Electrocardiography, echocardiography and spiroergometry were carried out on 56 patients aged 9-28 years, of whom 44 patients had been treated with 15-483 mg/m2 doxorubicin (or equivalent). Acute leukaemia had been diagnosed 1.5-16 years earlier. Of the patients 75% reached normal maximal oxygen uptake, 69% normal oxygen uptake at the anaerobic threshold and 95% normal maximal work rate. Of the patients 75% achieved adequate values for maximal heart rate and 78% normal blood lactate concentration. No difference was seen between patients treated with and without anthracyclines. CONCLUSION: The results of this study provide little evidence for cardiopulmonary impairment in long-term survivors of ALL. Both the cardiac function, as evaluated by ECG and echocardiography, and the physical performance in spiroergometry are normal in a large number of these patients. Anthracycline treatment does not appear to have a negative effect on these parameters.

Adolescent↗
PubMed1998

Prenatal diagnosis of major malformations: quality control of routine ultrasound examinations based on a five-year study of 20,248 newborn fetuses and infants.

Antenatal ultrasound screening for birth defects is increasingly becoming a routine procedure of prenatal care. Prenatal detection of malformations and subsequent adjustment of obstetric management are essential for secondary prevention. It is unknown whether ultrasound screening is effective in all pregnant women, or should only be performed in high risk populations. From 1990-1994, 20,248 livebirths, stillbirths and abortions underwent physical and sonographic examinations and anamnestic data were collected. To identify the high risk group, case control analyses of births with one of the 23 selected major malformations (controls) were performed with respect to anamnestic risk factors. All women had at least three routine ultrasound scans. The selected malformations were diagnosed in 298 children; 95 (30.3 per cent) were diagnosed antenatally. Detection rates were: CNS (68.6 per cent), gastro-intestinal tract (42.3 per cent), urinary system (24.1) per cent), heart (5.9 per cent). Complications during pregnancy were calculated as indicators of congenital anomalies: premature labour (< 28 week) OR 4.7 (3.8-5.9), placental insufficiency OR 1.9 (1.1-2.7) and vaginal bleeding OR 1.5 (1.2-1.8), etc. Antenatal routine ultrasound screening is not effective risk populations. Anamnestic risk factors risk factors during pregnancy may be essential indicators for identifying high risk populations. We propose screening of the described high risk pregnancies (about 22 per cent of all pregnancies) to be performed by specially trained and highly experienced ultrasonographers to increase sensitivity rates and benefit cost effectiveness.

Central Nervous System↗
PubMed1994

[Anaphylactic shock].

Anaphylactic shock is a cardiovascular collapse that occurs after the interaction of antigen and antibody. Common causes of anaphylactic shock are drugs, foods, venoms, and heterologous serum. Mechanisms of anaphylactic shock are thought to be peripheral vasodilatation, enhanced vascular permeability, leakage of plasma, and intravascular volume depletion. The recognition of an anaphylactic shock rests on the observation of cardiovascular collapse in association with temporal exposure to a foreign substance. In addition to cardiovascular collapse, cutaneous, respiratory and/or gastrointestinal events can occur, constituting other serious aspects of anaphylaxis. Anaphylactic shock is a true medical emergency. Initial therapy consists of the administration of intravenous fluids (saline, colloid), and epinephrine.

Anaphylaxis↗
PubMed1992

Evaluation of the valve area underestimation by the continuity equation.

During the last years, noninvasive determination of the aortic valve area by Doppler echocardiography using the continuity equation became popular. However, a systematic valve area underestimation of about 15% compared to invasive measurements using the Gorlin formula has been reported. The cause therefore is unknown. The purpose of this study was to evaluate whether the valve area underestimation by the Doppler method might be due to differences in the hydrodynamic background of both methods. This comparison is facilitated by the fact that the Gorlin formula is based on the continuity equation. Compared to the continuity equation, there are four changes within the Gorlin formula: (1) the additional use of a discharge coefficient, which leads to valve area overestimation by the factor 1.17; (2) neglect of the pre-stenotic velocity, causing further overestimation by the factor 1.036 (in mild stenosis this factor may be 1.18 and more); (3) the wrong calculation of the mean pressure drop, which leads to a mean change by the factor 0.95, and (4) the incorrect substitution of the height by the pressure drop in the derivation of the Gorlin formula causes underestimation by the factor 0.97. Combining these four factors results in valve area overestimation of the Gorlin formula compared to the continuity equation by the factor 1.12. This explains to a large extent the valve area underestimation by the continuity equation.

Aortic Valve↗
PubMed1992

The effect of antenatal intravenous immunoglobulin on ascending intrauterine infection after preterm premature rupture of the membranes: a pilot study.

Ascending infection is a serious threat in pregnancies complicated by preterm premature rupture of the membranes (PROM). In a controlled randomized prospective pilot study (n = 18) we have evaluated the effect of intravenous IgM enriched immunoglobulin given to the mothers 24-48 hours after preterm PROM in reducing ascending infection. Using a validated infection score from laboratory and clinical data at birth, we found a significant reduction of probable infection in the neonates of the treatment group compared to the control group (p = 0.0022). Histopathological investigation of the placentas, membranes and umbilical cords revealed significantly lower stages and grades of chorioamnionitis in the treatment group (p = 0.036). From these preliminary results we conclude, that intravenous broad spectrum immunoglobulin given antenatally to patients with preterm PROM may reduce ascending infection. However, studies with a much larger cohort of patients are necessary to confirm these preliminary results and to detect potential clinical benefits from this treatment mode.

Adult↗
PubMed1991

Effects of dopamine infusion on plasma catecholamines in preterm and term newborn infants.

Newborn infants (21 preterm and 13 term) received dopamine infusions at a low (2.5-3.4 micrograms/kg per min) and/or high (5-10 micrograms/kg per min) infusion rate and changes in plasma catecholamines were monitored. The mean baseline values for dopamine, noradrenaline and adrenaline were between 240 and 560, 125 and 144 and 62 and 82 pg/ml, respectively. During low-rate infusion of dopamine, there was a significant increase in plasma dopamine (20-100 fold), noradrenaline (three- to five-fold) and adrenaline (threefold). Administration of dopamine at the high rate resulted in an even larger increase in the plasma catecholamines (dopamine, 100-300 fold; noradrenaline, seven- to eightfold; adrenaline, four- to sixfold). In a double-log plot, there was a highly significant correlation between the plasma concentrations of dopamine and noradrenaline (r = 0.77; P less than 0.001). In conclusion, infusion of dopamine in term and preterm newborn infants is accompanied by an enhanced sympatho-adrenal tone which may contribute to the cardiovascular effects of dopamine in these patients.

Dopamine↗
PubMed1990

Cardiovascular responses to dobutamine determined by systolic time intervals in preterm infants.

We investigated the effects of dobutamine therapy on myocardial function in premature infants. Left ventricular performance was assessed by measuring left ventricular systolic time intervals: rate-corrected pre-ejection period (PEPI), rate-corrected left ventricular ejection time (LVETI), and pre-ejection period to left ventricular ejection time ratio (PEP/LVET) which was obtained by echocardiography. Measurements were performed in 17 hemodynamically unstable premature infants who had an elevated PEP/LVET ratio before and 30 min after starting dobutamine infusion (10 micrograms/kg.min). Dobutamine infusion resulted in a significant decrease in PEPI (from 108 +/- 16 [SEM] to 95 +/- 17 msec; p less than .01) and in PEP/LVET ratio (from 0.55 +/- 0.16 [SEM] to 0.45 +/- 0.17; p less than .01), and in a significant increase in LVETI (from 255 +/- 15.7 [SEM] to 264 +/- 16.2 msec; p less than .01). Heart rate increased significantly from 146 +/- 17 (SEM) to 163 +/- 16 beat/min; p less than .01. Mean arterial pressure increased in 12 of 14 infants. These results show that dobutamine enhances left ventricular performance in premature infants who have depressed left ventricular function.

Birth Weight↗