Investigations of the rhythmic function of heart rate, blood pressure and temperature in neonates.

Over a period of 24-30 h in 10 min intervals, the systolic diastolic and mean arterial blood pressure, heart rate, rectal and skin temperature were measured simultaneously in 17 full-term babies on the 2nd day of life, and in 11 of them again at the age of 4 weeks. Each profile was analysed individually by the Cosinor method. On the 2nd day of life, a statistically significant circadian rhythm could be detected in 12 of the 17 neonates for systolic blood pressure and heart rate, in 16 for skin temperature and in all 17 neonates for rectal temperature. Summarizing the data of the 17 newborns the circadian rhythm was the most frequent component in all functions. A high portion of ultradian rhythms was observed as well. With increasing postnatal age, the variance of acrophases decreased, particularly for the temperature rhythms. This means that synchronization with the environment is beginning. Furthermore, we found an increase in the mesor of heart rate and blood pressure and an increase in amplitude of temperature.

[Oral ciprofloxacin therapy in juvenile patients with cystic fibrosis--results of a prospective pilot study]. / Orale Ciprofloxacin-Therapie bei juvenilen Patienten mit zystischer Fibrose--Ergebnisse einer prospektiven Pilotstudie.

Efficacy and safety of oral ciprofloxacin were studied in a prospective study at three cystic fibrosis centres, covering 24 in-patients suffering from cystic fibrosis and acute bronchopulmonary exacerbation. The patients were between 10 and 17 years of age. Pseudomonas infection was present in 75% of these patients. Despite frequent persistence of the pathogens, clinical improvement was noted in 75% of the treated children. A definite increase of the average MIC was not seen in 20 cases of persisting strains. No serious side effects occurred during the 14-day oral treatment course. Ciprofloxacin is a useful alternative to conventional parenteral treatment with antibiotics in patients suffering from cystic fibrosis and infections of the airways.

[Proteolytic enzymes in meconium--studies of healthy newborn infants and premature infants]. / Proteolytische Enzyme des Mekoniums--Untersuchungen bei gesunden Neugeborenen und bei Frühgeborenen.

Peptidatic activity of meconium of 200 newborns and 100 preterm babies. Protein content of meconium is higher in preterm babies than in healthy newborns referred to fresh weight. Enzymatic activity opposite to Gly-D-Leu is higher in term than in preterm newborns. It is on the contrary in the case of alanine-aminopeptidase, dipeptidyl-peptidase IV and the activities opposite to Leu-NA and Arg-NA. The good correlated enzymatic activities opposite the different substances give a hint to the presence of alanine-amino-peptidase (EC 3.4.11.2.)

[Assessment of hemodynamics in the cerebral cortex in newborn infants]. / Die Erfassung der Hämodynamik im Bereich der Hirnrinde bei Neugeborenen.

Determinations of blood velocity in vessels of cerebral cortex have been done using a 20 MHz impulse Doppler unit. In comparison we registered the blood flow pulsation curves at the anterior cerebral artery with aid of a 5 MHz-cw-Doppler system. The peripheral resistance index was calculated and it could be proved a strong correlation between the results of the anterior cerebral artery and the vessels of cerebral cortex. Another study showed that the results of the method could be reproduced. The problem of the impulse Doppler examinations of cerebral cortical vessels is the fact, that the exact topography of the vessels examined cannot be defined exactly.

[Modification of cerebral hemodynamics by invasive routine diagnostic procedures]. / Die Beeinflussung der zerebralen Hämodynamik durch invasive diagnostische Routinemassnahmen.

By means of cw-Doppler-ultrasonics pulsation curves of anterior cerebral arteries were recorded before, during and after a necessary capillary blood sampling in 12 premature newborns. Patients were stable and needed no oxygenation. Blood pressure and transcutaneous oxygen saturation have been recorded simultaneously. The most important hemorheological parameters were within normal range. Immediately following irritation pulsatility indices increased, partly diastolic reflux phenomena could be observed. Finishing irritation values went back to starting position very fast. It is supposed such strong changes of cerebral vascular resistance could be the reason of cerebrovascular damages in non sedated premature newborn babies.

[Ultrasound cw Doppler studies of cerebral hemodynamics]. / Ultraschall-cw-Doppler-Untersuchungen der zerebralen Hämodynamik.

Using ultrasound-Doppler-system UBD 2 the pulsation curves of mean blood velocity and mean flow of anterior cerebral artery have been registered and examined. In 95 healthy newborns (mean age 36th to 41st gestational week) normal values and correlation for age have been determined for transit time as parameter independent from curve shape and pulsatility index and peripheral resistance index as parameters of curve form. Position test enables testing the autoregulative function of cerebral hemodynamic under physiologic conditions. This shows a postnatal ripening within the first five days of live.

[Frequency distribution of DNA in blood and bone marrow cells of children with acute non-lymphatic leukemia using impulse cytophotometry]. / Untersuchungen der DNS-Häufigkeitsverteilung in Blut- und Knochenmarkzellen von Kindern mit akuter nichtlymphatischer Leukämie mittels Impulszytophotometrie.

1. As compared with the peripheral blood lymphocytes of healthy subjects the cells in the mononuclear fraction of peripheral blood and in the bone marrow of children with ANLL show a significant higher S- and G2 + M-phase. 2. A high proliferative activity correlate with a bad prognosis or with reaching no haematological remission. 3. Frequently, aneuploid cell populations will occur in the morphological subtypes M 4 and M 5.

[Impulse cytophotometry studies of bone marrow and blood cells in children with acute lymphoblastic leukemia (ALL). 2. Lymphatic cells in blood]. / Impulszytophotometrische Untersuchungen von Knochenmark- und Blutzellen bei Kindern mit akuter lymphoblastischer Leukämie (ALL). 2. Mitteilung: Lymphatische Zellen des Blutes.

The DNA-content of mononuclear cells of the peripheral blood of infantile and juvenile ALL patients was investigated using Pulse Cytophotometry. The fraction of cells in S- and G2 + M-phase is significantly increased in comparison with samples of healthy probands. The fraction of DNA-synthesising cells (S-phase) of both peripheral blood (mononuclear cells) and bone marrow of leukemia patients cannot be significantly distinguished by mathematical methods. On the other hand, the fraction of cells in later phases of cell cycle (G2 + M-phase) is significant enhanced in the bone marrow in comparison with the peripheral blood. A high correlation was found between the number of leukocytes and fraction of G2 + M-phase cells in the peripheral blood of SR- and MR-patients. No correlation was found between the number of leukocytes and S-phase-fraction. The occurrence of aneuploid cell populations in the mononuclear fraction of peripheral blood in the acute state of ALL could be of importance for prognosis and regime of therapy.

[Impulse cytophotometric studies of bone marrow and blood cells in children with acute lymphoblastic leukemia (ALL). 1. Bone marrow cells]. / Impulszytophotometrische Untersuchungen von Knochenmarkund Blutzellen bei Kindern mit akuter lymphoblastischer Leukämie (ALL). 1. Mitteilung: Knochenmarkzellen.

1. Compared with the peripheral blood lymphocytes of healthy children the cell fractions in the S- and G2 + M-phase are significantly higher in the bone-marrow of those children affected with ALL. This increase was proved in the SR- and MR-group irrespective of the cytomorphological subtype and cytochemical reaction. In patients with relapses the percentage of S-phase cells is below 6%. 2. In about 30% of our patients (mainly in the SR-group with L1-morphology) an initial DNA-aneuploidy was identified. As the risk of relapse is higher in children without DNA-aneuploidy, this symptom has a pretherapeutical-prognostic significance. 3. In the phase of hematological full remission, DNA-frequency distribution correlates with the proliferative activity of normal hematopoiesis. It provides no additional information about the pretherapeutical risk.

[Blood glucose and serum insulin levels in newborn infants of diabetic mothers during feeding with an oligosaccharide mixture]. / Blutglucose- und Seruminsulinspiegel von Neugeborenen diabetischer Mütter bei Ernährung mit einem Oligosaccharidgemisch.

Macrosome newborns from mothers with an insulin-bound diabetes mellitus and also from mothers with a gestational diabetes show in the cord blood nearly always insulin levels additional to increased glucose values, which, compared with the normal controls are ten-fold higher in some cases. During the first three hours of life the blood glucose values decrease extremely. To prevent central injuries, caused by stronger hypoglycaemia, the early supply of oligosaccharides by continuous gastric infusion has proved as the most careful procedure. Stronger increases of blood glucose do not occur by this method and the insulin levels show a continuous tendency to normalisation.

[Suppression of lymphocyte proliferation in the blood of children with infectious mononucleosis. Flow cytometry study]. / Uber das Proliferationsverhalten von lymphatischen Zellen des Blutes bei Kindern mit infektiöser Mononukleose. Untersuchungen mit dem Impulszytophotometer.

The investigation of lymphatic cells from venous blood shows an increase of cells in the S-phase during the acute stage of infectious mononucleosis, which is connected with a decrease of G1-phase cells. G2 + M fraction will remain within the normal range. These changes will completely recede within the first four weeks of the disease. In contrast to that, there is an increase in the percentage of G2 + M phase cells in the bone-marrow at the onset of the disease. The other fractions are within the normal range.

[Side effects of therapy with antihuman lymphocyte globulin]. / Nebenwirkungen der Therapie mit Anti-Humanlymphozyten-Globulin (AHLG).

The most important side effects during AHLG-treatment of 34 children suffering from juvenile chronic arthritis, collagenoses, autoimmune chronic hepatitis, aplastic anaemia and acute lymphoblastic leukemia are: Thrombocytopenia, urticaria, fever, anaphylactic reaction. They all are reversible a short time after cessation of AHLG-administration.

[Bone marrow cytology in diseases of autoimmune pathogenesis in childhood and its changes during therapy with anti-human lymphocyte globulin (AHLG)]. / Das Knochenmarkzellbild bei Krankheiten mit Autoimmunpathogenese im Kindesalter und seine Veränderungen unter der Therapie mit Anti-Humanlymphozyten-Globulin (AHLG).

Among the organs of the immune system the bone marrow is comparably simple accessible. Autoimmune diseases are characterized by reactive cytomorphological symptoms. Due to own investigations the granulo-erythropoietic index (G/E-index Rohr) as a parameter of inflammatory activity as well as the amount of plasma cells as an indication of humoral reactivity are described--before and under treatment with anti-human lymphocyte globulin.

[Clinical effects of anti-human lymphocyte globulin in the treatment of collagenoses in childhood]. / Klinische Effekte von Anti-Human-Lymphozyten-Globulin (AHLG) bei der Behandlung von Kollagenosen im Kindesalter.

9 children with collagenoses were first treated with AHLG "Dessau" in combination with corticosteroids and then with Imurek (azathioprine). The children seemed to be vitally endangered and suffered from panarteritis, dermatomyositis, polyserositis or corticosteroid-resistent systemic juvenile rheumatoid arthritis. As assessed by decrease of inflammation and clinical symptoms the treatment appeared in one case to be very good and in another good; in four other children it was good for a short period; in three children there was no effect at all. Side effects occurred relatively frequently (thrombocytopenia, anaphylactoid reactions). The justification of an immuno-suppressive treatment together with anti-human-lymphocyte-globulin is discussed in relation to todays knowledge of the pathogenesis of collagenoses and of the mechanisms behind the effects of the AHLG.