[Conductometry in determining measurements of urine electrolyte concentration (author's transl)]. / Die Konduktometrie zur orientierenden Messung der Harnelektrolytkonzentration.

1. Na+ concentration, measured by the flame photometer, cryoscopic osmolality, and the specific electrolyte conductivity of urine show a close statistical correlation if only small amounts of a molecular disperse solution are dissolved in the urine. 2. Since conductance of a fluid is an expression of its ion concentration, better relationships exist between Na+ concentration and conductivity than between Na+ concentration and osmolality. 3. In the presence of large amounts of glucose in the urine, osmolality no longer represents the electrolyte content, and therefore no longer serves as a parameter of renal concentration power. On the other hand, the close correlation between conductance and Na+ concentration remains. 4. Conductometry supplements osmometry significantly by its selective capacity to determine electrolyte components in the urine. 5. Owing to the short time spent on the method and small errors in technique, it remains debatable whether conductometry is preferable to osmometry in normal cases for determining measurements in concentration in the urine.

[Transmural potential difference of the gastrointestinal tract: its diagnostic value in placing small intestine catheters without roentgen exposure]. / Die transmurale Potentialdifferenz (tPD) des Gastrointestinaltraktes: Ihre diagnostische Nutzung zur röntgenbelastungsfreien Plazierung von Dünndarmsonden.

Functional disorders of the upper gastrointestinal tract frequently require the placement of biopsy tubes into the duodenum. At present, monitoring of correct placement of these tubes usually entails the use of x-rays involving a single or repeated exposures. For accurate placement of duodenal tubes, the difference in TPD between the stomach and the duodenum has been employed as a criterion. Measurement of the TPD is technically simple, can be done at the bedside and obviates the need for using x-rays. Suitable hardware and the procedure are described in detail.

[Studies on the function of blood-liquor barrier in newborn infants]. / Untersuchungen zur Funktion der Blut-Liquor-Schranke bei Neugeborenen

Simultaneous measurement of the electrolytic conductivity of the cerebrospinal fluid and the blood serum in newborns has revealed a concentration gradient suggesting an active transfer of electrolytes into the liquor space. The extent of this concentration drop is regarded as expressing the functional capacity of the blood-liquor barrier. Comparative investigations in healthy older children shown that constant values, corresponding to the adult age, are reached approximately at the end of the first year of life.

Relevance of socio-economic data for the establishment of solution models based on international statistical material.

Using the official data of WHO statistics, the impact of some social, biological and medical factors on infant mortality rates (IMR) was compared for countries with very high, high, moderate and low IMR: Factors reflecting a low quality of life (illiteracy, low level of women's education, low urbanization, malnutrition etc.) showed a highly significant statistic correlation with increased IMR. The lack of a nationwide family planning program and a low level of medical care (prenatal care, presence of medical personnel during delivery, availability of contraceptives etc.) act in the same direction. In developing countries the GNP per capita did not markedly influence the IMR nor the rate of infants of low birth weight (UGR). One of the main reasons of this phenomenon is probably the wide gap of the income between different social groups in these countries. In contrast to this the GNP in economically developed countries (Europe, Australia, North America) correlates very closely with IMR and UGR. The impact of family planning differs between countries with legally artificial abortion and those with a more restrictive legislation. The nutritional status (i. e. in these countries hyperalimentation) shows a positive correlation with UGR but no impact on IMR. Some countries (in Europe Greece, Spain, Ireland/Yugoslavia, Romania) show a significant deviation (positive/negative) from the mean calculated according to the WHO data. These deviations can be (and should be) analysed for detecting and evaluating factors which could be influenced by strategies of social or/and medical interventions in order of further improvement of IMR.

[Informatics in pediatrics]. / Informatik in der Pädiatrie.

Survey on the use of information and data processing techniques in pediatrics, in particular for epidemiologic problems, data collection and creating of referral letters, the use of computers in connection with functional diagnostic procedures etc. Aspects of further development in this field are briefly discussed.

[Incidence of spina bifida occulta in relatives of children with myelodysplasia. Indications for high-risk screening]. / Inzidenz der Spina bifida occulta bei Angehörigen von Kindern mit Myelodysplasie. Indikationen zum High-risk-Screening.

Consanguineous relatives (parents, siblings) of patients with myelodysplasia show an increased incidence of spina bifida occulta compared to a normal population. According to this and considering the obvious familiarity of neural tube defects, in all cases of a spina bifida occulta known in relatives a high-risk-screening (AFP, B-scan ultrasound) should be performed during early pregnancy. Patients with a spina bifida occulta should be informed about their anomaly and in case of pregnancy instruct the obstetrician to provide a careful screening examination.

[Quality control from the viewpoint of clinical obstetrics]. / Qualitätskontrolle aus der Sicht der klinischen Geburtshilfe.

Recommendation of the Society for Perinatal Medicine of the GDR for quality control in clinical obstetrics and early neonatology. A continuous data collection and periodical summary of the recommended most important figures are the supposition for internal and external comparison and the prediction of average efficiency for hospitals with different specialisation in obstetrics and early neonatology.

[Relations between pneumoencephalographic and electroencephalographic findings in childhood]. / Beziehungen zwischen pneumenzephalographischen und elektroenzephalograpischen Untersuchungsbefunden im Kindesalter

During simultaneous testing of electro-encephalograms and pneumoencephalograms in 200 children of various ages a proven correlation of statistics between both test procedures emerged as a well-defined parameter for evaluation. When making a statement about the correlation in findings between E.E.G. and P.E.G. the age of development in a child must be taken into consideration. Thus it emerged that in infants pronounced enlargement of the ventricular system correlates with active tension E.E.G. at increased inter-cranial pressure, while the coincidence of focal changes in E.E.G. and P.E.G. with advancing years becomes at first more pronounced after the tenth year of life (or puberty) but afterwards lessens.

[Variability of percentile values of body measurements of newborn infants (with special reference to body weight)]. / Zur Variabilität von Perzentilwerten der Körpermasse Neugeborener (Unter besonderer Berücksichtigung des Körpergewichts).

The percentile curves for fetal growth between the 25th and 42nd week of gestation calculated for more than 52,000 newborns in East Germany in 1985 were compared with the rates defined for the same population in 1973-74 and showed a significantly lower mean birth weight. Besides methodological differences (primarily a more precise estimation of gestational age in the new study by using ultrasound fetometry), the differences seem to be mainly the result of changes in the reproductive behaviour of the population over that period (decrease in parity). When comparing different populations independently of ethnic specificities, a number of modifying factors have to be taken into account which significantly influence the birth weight, namely: parity, spacing, age and stature of the mother. These variables have also to be remembered when assessing the maturity of newborns in order to standardize the birth weight in relation to mortality and morbidity. As a basis for calculating percentile curves the cumulative frequency distribution should be preferred, rather than assuming a normal distribution, since fetal diseases or developmental anomalies result in an uneven distribution with an over-representation of small for date fetuses. The selection of data for calculating normal values must be rejected because of the arbitrary decisions which this entails.

[Gestational age related correction of birth weight by parity. Body height and weight of the mother]. / Gestationsaltersbezogene Korrektur des Geburtsgewichts durch Parität, Körperlänge und -gewicht der Mutter.

Corrections to the real birthweight of infants are proposed from the 28th to 42nd week of pregnancy. These take account of the influence of parity and maternal height and weight. The effect of these three characteristics on the birthweight is calculated both one and two dimensionally by combining the characteristics with the actual duration of pregnancy. Thus, for example, after 40 full weeks of pregnancy 560g of the birthweight would be considered the weight correction. For newborn infants of relatively short light-weight mothers, this account should be added to the real birthweight ascertained, and for the babies of relatively tall, heavy mothers it would be subtracted. Only after this correction can the two dimensional classification of neonates into hypotrophic, eutrophic or hypertrophic take place according to birthweight and duration of gestation.

[Perinatal injuries of skeletal system]. / Perinatale Verletzungen des Skelettsystems.

Perinatal injuries to the skeletal system are quite rate and observed in no more than something between one and three per cent of all newborns. Injury of the mother short time before childbirth, metabolic disorders, inflammatory processes, genetic defects or intrapartum complications, which call for no-delay control in the interests of mother and child, are some of the common causes. Reference is made to diagnosis, differential diagnosis, and treatment for various types of injuries, against the background of the authors' own experience.

[Measurement of kidney concentrating ability in children with nonrenal glycosuria]. / Die Messung des Konzentrationsvermögens der Nieren bei Kindern mit nichtrenaler Glukosurie

In non-renal (diabetic) glucosuria we did not find any statistically real relations between the concentration of glucose in the urine and cryoscopically measured osmolality in children with healthy kidneys. The close negative correlation of the conductance of the urine to the concentration of glucose is not only to be explained by changes of the viscosity, but is an expression of an increased re-absorption of sodium as a result of a compensatory hyperaldosteronism. In renal insufficiency the electrolytic conductibility of the urine is lower than the borderline area of the normal, even when under influence of the glucose excretion the osmolality of the urine is still to be found normal. Thus also on the conditions of a considerable glucosuria we can further judge the concentrating ability of the kidney in diabetes mellitus with the help of the measurement of the conductance of the urine.

Photodegradation of bilirubin as enhanced by photosensitizers in vitro.

Photosensitizers such as methylene blue or riboflavin enhance the rate of bilirubin photodegradation in vitro. This effect is studied with respect to dose-response and time-response relationships, the influence of concentrations of bilirubin and albumin, and the oxygen consumption. The results are discussed in view of the probability that the effects described also occur in vivo and that riboflavin supplementation to neonates could improve the phototherapy of neonatal hyperbilirubinaemia.

[New percentile values for birth weight, body length, head and breast circumference of newborn infants in East Germany]. / Neue Perzentilwerte für das Geburtsgewicht, Körperlänge, Kopf- und Brustumfang von Neugeborenen in der DDR.

Somatometric data of 51,570 newborns (singles) delivered between the 28th and 42th week of gestation from different, representative areas of the G.D.R., concerning birth weight, body length, head and breast circumference are presented as tables and percentile curves separately for either sex. The values are recommended as reference values for the assessment of fetal development related to gestational age in the G.D.R.

[The effect of acetylsalicylic acid on gastric transmural potential difference in healthy children and in children with inflammatory diseases]. / Der Einfluss von Azetylsalizylsäure (ASS) auf die gastrale transmurale Potentialdifferenz (tPD) bei gesunden Kindern und Kindern mit entzündlichen Erkrankungen.

The transmural potential difference (tpd) of the gastric mucosa was investigated in relation to age and sex of the patients. The administration of acetylsalicylic acid in healthy children causes no significant decrease in gastric potential difference. In children with acute of chronic inflammatory diseases (elevated blood sedimentation velocity) the tpd was found to be increased compared with normal controls. After local ASA application a temporary, significant decrease of the tpd to normal values could be observed.

[Pathogenesis of bilirubin encephalopathy and subsequent therapeutic consequences]. / Zur Pathogenese der Bilirubinenzephalopathie und daraus resultierenden therapeutischen Konsequenzen.

At present the classic "kernicterus" has nearly disappeared, but toxic effects of bilirubin, nevertheless, play an important role in the etiology of late neurologic sequelae in VLBW infants. Even in very low concentrations of serum bilirubin CNS damages have to be expected when other metabolic disturbances induce the opening of blood-brain-barrier. Since safe criteria for predicting toxic effects of bilirubin do practically not exist, in VLBW infants with perinatal metabolic disorders early preventive phototherapy is indicated to keep the serum bilirubin level as low as possible. Experimental studies in animals showed brain protective effects of barbiturates apart from enzyme induction.

Measuring the impedance of erythrocytes in patients with cystic fibrosis.

A study of the dielectric properties of fresh, washed erythrocytes from three groups of 13 children, one with cystic fibrosis, and one each of healthy children of comparable age and comparable weight, was conducted after resuspension in their own plasma or in sodium phosphate buffer. The erythrocytes of the patients with cystic fibrosis showed significant variations in impedance, especially compared to the control group of comparable age. Further studies are required to ascertain whether these results are of diagnostic significance.

[Quality assessment in neonatology]. / Qualitätsbeurteilung in der Neonatologie.

After discussing some general factors influencing the result of medical care at all (socio-economic conditions, biological factors), the difficulties of neonatal quality control compared with the assessment of quality in obstetric care are pointed out (greater variability of the data, evaluation of long-term effects). In addition to the obstetric system of data collection a similar evaluation of neonatal data is recommended to be introduced and definitions for general use are given. The recommendations are based on own investigations of the predictive value of some data gained within the perinatal period (history, physical examination, laboratory tests etc.). The high expenditures of personnel and equipment, at present, don't allow a nationwide introduction of such records. But in future perinatal centers should collect their data in an unique way according to this recommendations for comparing the efficiency of perinatal care in voluntary programs of quality control. The experiences collected by those analyses will be of great value concerning planning the design of a nationwide data recording system in perinatal medicine.