[Congenital heart defects: prevalence and course during the school years (8 to 16 years)]. / Angeborene Herzfehler: Vorkommen und Verlauf während der Schulzeit (8. bis 16. Lebensjahr).

In continuation of former studies regarding the first year of life and the preschool period, the prevalence and course of congenital heart disease in children during compulsory schooling has been studied. Compared with the preschool period, few cardiac defects are discovered, the prevalence up to 16 years of age being 9.9/1000. The mortality rate (2.7%) and also the rate of spontaneous normalization (4%) is significantly lower (compared to 18.7% and 21% respectively in the preschool period). Medical measures are needed less frequently, with 10 times fewer operations and 15 times fewer heart catheterizations being performed. Apart from the decline of hospital stays, checkups in the outpatient clinic also declined 3-4 times in comparison with the period between birth and school entry. School performance is very good. Only 4% of the children are unable to attend a normal school for cardiac reasons, and the percentage of pupils attending secondary school is higher than normal. In 5% of the children exercise tolerance is decreased due to the cardiac condition. In 85%, the quality of life is normal during the compulsory school period. Impairment is most often caused by additional non-cardiac malformations or very severe heart disease.

Morphometry of the human pulmonary acinus.

The geometry and morphometry of intraacinar airways in human lungs were studied on silicone rubber casts from two adult lungs. We defined acini as the complex of alveolated airways distal to the terminal bronchioles--that is, beginning with the first-order respiratory or transitional bronchiole. The morphological properties of pulmonary acini are described. The acinar volume averages 187 mm3 (SD +/- 79 mm3). Intraacinar airways branch dichotomously over about 9 generations (range 6-12). The internal airway diameter falls from 500 micron to 270 micron between acinar generations 0 and 10, whereas the outer diameter (including the sleeve of alveoli) remains constant at 700 micron. Towards the periphery the size of alveoli increases and clusters of alveoli become more numerous. The longitudinal path length of acinar airways (defined as the distance along the ducts from the transitional bronchiole to the alveolar sacs) averages 8.8 mm (+/- 1.4 mm). The morphometric data collected in this study are used to construct an idealized model of human acinar airways that can be related to existing models of the human bronchial tree.