[Experiences in therapy of bradycardic cardiac arrhythmias in childhood with ipratropium bromide]. / Erfahrungen zur Therapie bradykarder Herzrhythmusstörungen im Kindesalter mit Ipratropiumbromid.

Ipratropiumbromid is used in adults for a variety of bradyarrhythmias. In contrast this therapy has not yet been established in childhood, where symptomatic bradyeardias are less frequent. Since Ipratropiumbromid has less side effects (especially concerning the central nervous system) and a longer half time than atropin, we investigated the efficacy of Ipratropiumbromid in 12 children (mean age 7.2 yrs.) in the course of 2 1/2 years. We found a significant increase of the minimal and mean heart rate in Holter-Eeg-recordings. Only in 7 of 12 patients we obtained a sufficient therapeutic effect. In one patient we had to terminate the therapy because of side effects. In two patients with atrioventricular block and two children with higher degree sinus node dysfunction could be removed only by implantation of a pacemaker. In another case we observed the proarrhythmical effect of Ipratropiumbromid. Summarizing we think, that the therapy with Ipratropiumbromid may be useful in symptomatical supranodal bradyarrhythmias in childhood in regard of side effects.

[Children after an electric injury. A retrospective 10 year study]. / Kinder nach Stromunfall. Eine retrospektive 10-Jahres-Studie.

We analysed the clinical and laboratory findings of 31 patients who had undergone electrical injuries and who were treated in our hospital from 1979 to 1988. Only in two out of 30 injuries in the low voltage range we found arrhythmias of the heart caused by the accident. The paraclinical findings did not show any unambiguous pathological values. In accordance with the bibliography we are of opinion that children who underwent low voltage electrical shock may be considered as not endangered, of the case history is known and if clinical status and electrocardiogram are normal, so that they should not stay in hospital. Seldom complications and exeptions are mentioned. Because of the higher incidence in the early childhood and the special risk by nonprotected sockets measures should be propagated to increase the safety in the domestic environment of the children.

15N tracer kinetic studies on the validity of various 15N tracer substances for determining whole-body protein parameters in very small preterm infants.

Reliable 15N tracer substances for tracer kinetic determination of whole-body protein parameters in very small preterm infants are still a matter of intensive research, especially after some doubts have been raised about the validity of [15N]glycine, a commonly used 15N tracer. Protein turnover, synthesis, breakdown, and further protein metabolism data were determined by a paired comparison in four preterm infants. Their post-conceptual age was 32.2 +/- 0.8 weeks, and their body weight was 1670 +/- 181 g. Tracer substances applied in this study were a [15N]amino acid mixture (Ia) and [15N]glycine (Ib). In a second group of three infants with a post conceptual age of 15N-labeled 32.0 +/- 1.0 weeks and a body weight of 1,907 +/- 137 g, yeast protein hydrolysate (II) was used as a tracer substance. A three-pool model was employed for the analysis of the data. This model takes into account renal and fecal 15N losses after a single 15N pulse. Protein turnovers were as follows: 11.9 +/- 3.1 g kg-1 d-1 (Ia), 16.2 +/- 2.5 g kg-1 d-1 (Ib), and 10.8 +/- 3.0 g kg-1 d-1 (II). We were able to demonstrate an overestimation of the protein turnover when Ib was used. There was an expected correspondence in the results obtained from Ia and II. The 15N-labeled yeast protein hydrolysate is a relatively cheap tracer that allows reliable determination of whole-body protein parameters in very small preterm infants.

15N-tracer-kinetic studies on the nitrogen metabolism of very small preterm infants on a diet of mother's milk.

Protein synthesis and breakdown, nitrogen flux and other parameters of nitrogen metabolism were measured in five male preterm infants with a mean gestational age of 30.4 +/- 1.95 complete weeks of gestation and a mean body weight of 1592 +/- 517 g. The infants were fed on mothers' milk; the measurements were made at a post-conceptional age of 31.6 +/- 1.9 weeks of gestation (Ia) and were repeated at 34.4 +/- 1.9 weeks of gestation (Ib). [15N]-glycine (95 atom per cent) was used as a tracer, administered as a single enteral dose of 20 mg/kg. Whole-body protein parameters were calculated from an assumed three-pool model. The results were compared with data from moderately small preterm (II) and full-term (III) infants measured at post-conceptional ages of 36.1 +/- 1.4 and 48.0 +/- 2.8 weeks respectively. Protein synthesis rates tended to decrease with increasing post-conceptional age: 14.3 +/- 4.5 g/kg/d (Ia); 11.8 +/- 2.9 g/kg/d (Ib); 7.9 +/- 2.7 g/kg/d (II); and 7.7 +/- 1.4 g/kg/d (III). Protein breakdown and nitrogen flux showed the same trends. Possible consequences for the appropriate nutrition of very small preterm infants are discussed.

[Determination by 15N tracer kinetics of the half-life of total body protein in premature and mature infants]. / Zur 15N-tracerkinetischen Bestimmung der Halbwertszeit des Gesamtkörperproteins bei frühgeborenen und reifgeborenen Säuglingen.

Based on 15N-tracer techniques important data of the intermediary protein metabolism can be assessed by compartment analysis. We calculated the half-life of whole body proteins in five preterm and five full term infants in addition to commonly used parameters of the protein metabolism e.g. protein synthesis rate, protein breakdown rate, N-turnover rate, size of metabolic pool, half-life and reutilization of aminoacid-N and the rate of endogenous urinary-N. The infants were aged 27 +/- 4 and 31 +/- 13 days resp. The half-life of whole body proteins were found to be 7.5 +/- 1.8 days in the premature infants and thus significantly shorter than the 16.0 +/- 3.8 days for the full term infants. The differences in the half-life of protein as well as protein synthesis rate and protein breakdown rate reflect the rapid proteinturnover in premature infants in comparison to full term infants.