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Biomedical subjects

C Fusch

Publications and source records attributed to C Fusch.

At least 19 recordsLinked to original sources
PubMed2006

Sex-specific differences in birth weight due to maternal smoking during pregnancy.

INTRODUCTION: We investigated the sex-specific risk of maternal smoking during pregnancy on the birth weight and the proportion of small-for-gestational-age (SGA) newborns in 888,632 (49.9%) of 1,815,318 singleton births (ca. 80% of all singleton births in Germany from 1995 to 1997) in whom data on maternal cigarette consumption were available. RESULTS AND DISCUSSION: Newborns below the 10th percentile for weight and duration of pregnancy were classified SGA. Maternal smoking during pregnancy lowers the mean birth weight and increases the risk of SGA newborns. The negative effect depends on the daily number of cigarettes consumed, and is greater in girls than in boys. In non-smokers, 9.8% of the newborns were SGA, with a sex-ratio of females:males=1, but this percentage increased with increasing number of cigarettes consumed (p<0.001), as did the sex-ratio, i.e. the negative effect of smoking on growth was greater in girls than in boys. In mild smokers (1-5 cigarettes/day), the risk of giving birth to an SGA girl was 1.7275-fold (95% CI: 1.7266-1.7284) above normal, but was 1.7143-fold (95% CI: 1.7137-1.7150) in boys. More than 21 cigarettes/day increased the risk of SGA 3.15-fold for a boy, but 3.51-fold for a girl (p<0.001). CONCLUSION: In conclusion, particularly in heavy smokers, the negative effect of maternal smoking during pregnancy on the mean birth weight and risk of SGA is significantly greater in newborn girls than in newborn boys.

Birth Weight↗
PubMed2006

[Correlation between sex, intrauterine position and familial predisposition and neonatal hip ultrasound results].

AIM: To correlate findings of hip ultrasound on day 4-10 of life with sex, intrauterine position and a positive family history for congenital hip anomalies. METHODS: The SNiP-study ( Survey of Neonates In Pommerania) registered 2256 neonates (2030 term, 226 preterm) between May 2002 and March 2004. Hip ultrasound results of 1043 term and since October 2003 33 preterm neonates were analysed. Time of ultrasound was day 4-10 after birth. Preterm neonates were examined when reaching their corrected term gestational age. Ultrasound was applied with a 7.5 MHz linear scanner and results were classified according to Graf. Chi-square and Fishers exact test were used for statistical analysis. RESULTS: 4.9 % of the screened hips were classified as IIc or higher, 3.1 % were unilateral and 1.7 % bilateral. Incidence was significantly higher (p < 0.023) in females (6.6 %) than in males (3.2 %). There was no significant difference in intrauterine position or positive family history for hip anomalies with 3.7 % for mothers, 1.2 % of fathers and 2.4 % of siblings positive. There was a higher incidence for congenital hip dysplasia in preterms with 6.1 %, which is not significant due to the limited number. DISCUSSION: Current screening methods miss up to 18 % of newborns with severe hip dysplasia. We were able to demonstrate that screening for congenital hip dysplasia with ultrasound is a diagnostic tool even during the first days of life. There is a significantly higher incidence of congenital hip dysplasia in females, but in contrast to other studies we found no significant difference in intrauterine position or familial history. Earlier diagnosis and therapy on the base of relevant risk factors might correspond with an improved prognosis and outcome. Further studies are warranted to evaluate the significance in preterm neonates.

Female↗
PubMed2005

[Exposure to tobacco smoke (passive smoking) in the home and inpatient treatment of children under the age of 5 years in Germany].

BACKGROUND AND OBJECTIVE: Exposure to environmental tobacco smoke (ETS) poses an impact on the health of the newborns and infants. In Germany research about the tobacco-attributable morbidity and mortality has been conducted to a very small extent. This analysis examines all data from 16 federal states in regard to number and duration of hospitalization of children exposed to ETS up to 5 years of age. MATERIAL AND METHODS: Integration of two different data sets: (a) national data (number of households with children younger than 5 years exposed to a current smoker) with (b) hospital statistics (number and duration of hospitalisations by diagnoses) for all 16 federal states. Relative risks for tobacco-attributable diseases were taken from current research. RESULTS: In Germany the rate for tobacco-attributable hospitalisations of children between 0 and < 5 years range from 1.6 % to 3.8 % between states. Between 22.0 % and 27.1 % of all hospitalisations with the diagnosis of otitis media or respiratory diseases are attributable to passive smoking. CONCLUSION: Tobacco-attributable hospitalisations pose a serious but preventable problem for the health care system.

Asthma↗
PubMed2005

Smith-Lemli-Opitz syndrome with a classical phenotype, oesophageal achalasia and borderline plasma sterol concentrations.

The diagnostic biochemical hallmarks of Smith-Lemli-Opitz syndrome (SLOS) are elevated concentrations of the cholesterol precursors 7- and 8-dehydrocholesterol (7- and 8-DHC). We describe a patient with classical SLOS phenotype and oesophageal achalasia, which has not been reported in SLOS patients before. Plasma 7-DHC and 8-DHC were only marginally elevated. The diagnosis was confirmed by sterol analysis in cultured skin fibroblasts and mutation analysis.

Cell Culture Techniques↗
PubMed2004

Resting energy expenditure in obese children aged 4 to 15 years: measured versus predicted data.

AIM: To measure the relationship of resting energy expenditure (REE) and body composition, and to compare REE data calculated from anthropometric parameters using published equations with measurements obtained by indirect calorimetry (IC) in a population of obese paediatric patients. METHODS: The study included 82 healthy obese paediatric subjects (49 boys, 33 girls; body mass index 29.6 +/- 5.0 kg/m , age 1 1.4 +/- 2.6 y, weight 72.4 +/- 20.9 kg, height 155 +/- 14 cm). REE was measured by IC, body composition was determined by dual energy X-ray absorptiometry (DXA). Bootstrap analysis was performed to validate the step-down linear regression analysis results. RESULTS: Lean body mass (LBM) and weight were identified as the most significant determinants of REE. LBM was the best single predictor (r = 0.78; p < 0.001) for REE. Regression equations are given in the text. Prediction of REE on the basis of published anthropometric formulas was strongly dependent from the equation used. Some equations tend to underestimate REE in the population studied with a considerable systematic error. CONCLUSION: In the present paper we show that (1) the published equations to predict REE in obese subjects yield scattered data and some are even biased by a systematic error, and that (2) the inclusion of DXA-derived LBM improves accuracy and precision of predicted REE in boys and girls aged from 4 to 10 y and in boys from 11 to 15 y.

Absorptiometry, Photon↗
PubMed2003

Isotropic apparent diffusion coefficient mapping of postnatal cerebral development.

Diffusion-weighted imaging (DWI) allows us to image the motion of tissue water. This has been used to demonstrate acute ischaemia. Diffusion imaging is also sensitive to water movement along neuronal tracts. Our objective was to map brain maturation in vivo using maps of apparent diffusion coefficient (ADC). We studied 22 children without neurological disease aged between 2 and 720 days. MRI was performed at 1.5 tesla. Multislice single-shot echoplanar DWI was performed at b 0 and 1000 s/mm(2). ADC maps were generated automatically and measurements were performed in the basal ganglia, frontal and temporal white matter and the pons. There was a decrease over time in water diffusion in the areas examined, most marked in the frontal (0.887-1.898 x 10(-3) mm(2)/s) and temporal (1.077-1.748 x 10(-3) mm(2)/s)lobes. There was little change, after an initial decrease, in the basal ganglia (0.690-1.336 x 10(-3) mm(2)/s). There was a difference in water diffusion between the anterior (0.687-1.581 x 10(-3) mm(2)/s) and posterior (0.533-1.393 x 10(-3) mm(2)/s) pons. These changes correlate well with those observed in progressive myelination: the increased water content probably reflects incomplete myelination and the decrease with time in water motion reflects the increase in myelinated brain.

Brain Mapping↗
PubMed2002

Insulin-resistant patients with type 2 diabetes mellitus have higher serum leptin levels independently of body fat mass.

In obese people, an increase of plasma leptin levels is well-known and is seen as a consequence of the increased body fat mass. Moreover, a relationship between fasting concentrations of leptin and insulin has been described. Hyperinsulinemia is considered to be indicative of insulin resistance. We aimed at elucidating the interrelations between leptin, insulin and insulin resistance in type 2 diabetic patients. Under metabolic ward conditions, we investigated 21 moderately overweight men with type 2 diabetes. The patients had a mean age of 49.1 years, a mean body mass index (BMI) of 26.8 kg/m(2), and a mean diabetes duration of 82.5 months. All patients were treated with diet alone. We measured fasting leptin and insulin levels, body composition by determination of total body water, and insulin resistance by euglycemic hyperinsulinemic clamp technique. At univariate analysis, fasting leptin level significantly and positively correlated with BMI (r=0.49, p=0.02) and with fasting insulin (r=0.69, p=0.001), while it negatively correlated with the glucose disposal rate (r=-0.62, p=0.002). Furthermore, leptin was inversely correlated with HDL-cholesterol (r=-0.45, p=0.04). When excluding the influence of body fat mass or of BMI in partial correlation analysis, the correlations between leptin and insulin or insulin sensitivity remained significant. The relationship between insulin resistance (as measured directly in the clamp experiments) and leptin concentrations was also shown by subdividing the diabetic patients according to tertiles of insulin sensitivity. The highest fasting leptin levels were observed in those patients with the most expressed insulin resistance. Our data point to a functional relationship between insulin resistance and leptin concentrations in insulin-resistant type 2 diabetic men, independently of body composition. This relationship is believed to be mediated by insulin.

Adipose Tissue↗
PubMed2001

Diffusion-weighted MRI of middle cerebral artery stroke in a newborn.

Diffusion-weighted MRI of the brain is becoming clinically available as a tool to investigate cerebral ischaemia. We report a newborn girl presenting with seizures in whom diffusion-weighted MRI showed a large hyperintensity in the area perfused by the left middle cerebral artery. Short-term neurological follow-up before discharge was uneventful and the patient was discharged without sequelae. On follow-up clinical examination, right-sided spastic signs were noted which disappeared with time.

Female↗
PubMed2001

Physiological and pathological regulation of feto/placento/maternal leptin expression.

There is clear evidence of placental leptin production, as shown recently in trophoblast cultures and by dual in vitro placenta perfusion (median production of 225 pg/min per g of tissue; 98.4% released into the maternal and 1.6% into the fetal circulation). However, the physiological impact for the mother and the fetus is unclear. The classical role of leptin is to provide information about energy stores to the central nervous system, and to reduce appetite if the energy stores are full. In pregnancy, maternal plasma leptin concentrations are elevated, and lack the well established correlation with body fat energy stores that is observed in non-pregnant women, indicating an alternative function for leptin during pregnancy and fetal development. Maternal and fetal plasma leptin levels are dysregulated in pathological conditions such as gestational diabetes, pre-eclampsia and intra-uterine growth retardation, representing an effect or a cause of disturbances in the feto/placento/maternal unit.

Female↗
PubMed2001

Brain development (sulci and gyri) as assessed by early postnatal MR imaging in preterm and term newborn infants.

OBJECTIVE: To investigate fetal brain development in vivo using early postnatal cranial MRI in term and preterm newborn infants. STUDY DESIGN: 51 infants, 1.5-T whole-body system, extremity coil, spin-echo images obtained in all three planes (T1- and T2-weighted). Independent review by two neuroradiologists (blinded for gestational age and medical history) regarding the development of 12 sulci and 10 gyri using a modified scoring system. Gestational age was obtained either by ultrasound or from the first day of the last menstrual period. EXCLUSION CRITERIA: head circumference <10th or >90th percentile, cerebral malformation, chromosomal/metabolic disorder. RESULTS AND CONCLUSION: Age at study ranged from 23 5/7-43 0/7 postmenstrual weeks. Brain maturation starts in the central area and proceeds towards the parieto-occipital cortex. The frontal cortex develops last. Transition to degrees 1, degrees 2 and, degrees 3 starts at week 25, 32 and 35 in the central cortex and is completed at week 34, 36 and 39, respectively. Our data compare favourably with the two previously published reports about brain maturation. Early MR imaging seems therefore to be suited to study maturation of the fetal brain. This may be of pathophysiological relevance in neonatal intensive care and neurological follow-up studies.

Birth Weight↗
PubMed2001

Identification of interstitial maternal uniparental disomy (UPD) (14) and complete maternal UPD(20) in a cohort of growth retarded patients.

The association of uniparental disomy (UPD) and short stature has been reported for different chromosomes and in several conditions. Therefore, we investigated a cohort of 21 patients referred because of intrauterine and postnatal growth retardation for UPD of chromosomes 2, 7, 9, 14, 16, and 20. Typing of short tandem repeats showed maternal UPD(14) and maternal UPD(20) in two cases. In the first case, an interstitial UPD(14) was detected and the growth retarded newborn showed some additional clinical signs in common with the putative "maternal UPD(14) syndrome". The maternal UPD(20) patient showed minor features. However, since it is only the second maternal UPD(20) case it is too early to delineate a specific syndrome and the role of this constitution in growth remains to be investigated. Our data suggest that searching for UPD in growth retarded patients is a helpful approach to getting more information on the role of UPD in growth retardation. Based on our results, general considerations and indications for UPD testing are discussed.

Chromosome Aberrations↗
PubMed2000

Leptin production and release in the dually in vitro perfused human placenta.

There is clear evidence that the placenta produces leptin. However, it is still unclear to what extent leptin is released into the maternal and the fetal circulation. The aim of our study was to determine placental leptin release rates into these 2 compartments. In 10 term placentas, using dual in vitro perfusion of an isolated cotyledon, concentrations of leptin, hCG, and human placental lactogen (hPL) were determined in perfusates and in the tissue before and after perfusion. With perfusions lasting 270-840 min, total leptin production was 225 pg/g x min [median; interquartile range (IQR), 76-334 pg/g x min]. The release into the fetal circulation was very low (median, 2.5; IQR, 1.1-5.9 pg/g x min) compared with the release into the maternal circulation (median, 203; IQR, 79-373 pg/g x min) corresponding to 1.6% and 98.4% of net release. Only 0.05% of hPL and hCG were released into the fetal circulation and 99.95% into the maternal circulation, confirming previous results. Release into the fetal circulation correlated significantly with release into the maternal circulation for leptin (r = 0.648; P < 0.05) and hPL (r = 0.721; P < 0.05). Furthermore, release of leptin into the fetal circulation was positively correlated with release of fetal hCG (r = 0.661; P < 0.05). Most of the leptin produced by the placenta is released into the maternal circulation, but compared with other placental hormones (hCG and hPL), a considerably higher proportion of leptin is released into the fetal circulation. These findings may at least partially explain the marked increase in maternal serum leptin levels in pregnancy. The rapid postnatal decrease in leptin levels in both the mother and the neonate is also consistent with the concept of placental origin.

Chorionic Gonadotropin↗
PubMed2000

Measurement of water turnover using deuterium dilution: impact of periodically varying turnover rates on precision and accuracy.

Water metabolism may be non-invasively investigated using deuterium elimination from the body. Evaluation of elimination constants (kD) and pool sizes (N) becomes complicated when turnover rates vary periodically--a realistic scenario in free-living subjects. Unfortunately, phase and frequency of periodic variations are not a priori known and can therefore not be used for a sampling protocol. This study investigates the impact of periodical flux variations on the measurement of water turnover. For two models of periodic variation with identical apparent kD, data sets of tracer concentrations in body water were generated for two-hour intervals using a monoexponential decay equation. Data were analyzed using the two- and the multi-point method increasing observation periods stepwise. Apparent values for kD, N and water turnover (R(H2O)) were compared with values originally used in the model. Periodically varying turnover rates introduce considerable errors for kD and R(H2O) when the two-point method is used. The multi-point method gives a more robust estimate of R(H2O) already after short observation periods, however, due to slope-intercept correlations, still tends to overestimate R(H2O). Errors are more pronounced the more uneven flux rates are distributed. Stepwise analysis of tracer enrichments using the multi-point approach identifies periodical variation of flux rates.

Deuterium↗
PubMed1999

Neonatal body composition: dual-energy X-ray absorptiometry, magnetic resonance imaging, and three-dimensional chemical shift imaging versus chemical analysis in piglets.

An animal study to evaluate dual-energy x-ray absorptiometry (DXA) and magnetic resonance (MR) imaging and spectroscopy for measurement of neonatal body composition was performed. Twenty-three piglets with body weights ranging from 848 to 7550 g were used. After measuring total body water, animals were killed and body composition was assessed using DXA and MR (1.5 T; MR imaging, T1-weighted sagittal spin-echo sequence; MR spectroscopy, three-dimensional chemical shift imaging) as well as chemical carcass analysis (standard methods) after homogenization. Body composition by chemical analysis (percent of body weight, mean +/- SD) was as follows: body water, 75.3 +/- 3.9%; total protein, 13.9 +/- 8.8%; and total fat, 6.5 +/- 3.7%. Absolute content of fat and total ash was 7-674 and 35-237 g, respectively. Mean hydration of fat-free mass was 0.804 +/- 0.011 g/kg and decreased with increasing body weight (r2 = 0.419) independent of age. Using DXA, bone mineral content was highly correlated with calcium content (r2 = 0.992), and calcium per bone mineral content was 44.1 +/- 4.2%. DXA fat mass correlated with total fat (r2 = 0.961). Using MR, spectroscopy and chemical analysis were highly correlated with fat-to-water ratio (r2 = 0.984) and absolute fat content (r2 = 0.988). Total fat by MR imaging volumetry showed a lower correlation (r2 = 0.913) and overestimated total fat by a factor of 2.46. Conversion equations for DXA were developed (total fat = 1.31 x fat mass measured by DXA--68.8; calcium = 0.402 x bone mineral content + 1.7), which improved precision and accuracy of DXA measurements. In conclusion, both DXA and MR spectroscopy give accurate and precise estimates of neonatal body composition and may become valuable tools for the noninvasive assessment of neonatal growth and nutritional status.

Absorptiometry, Photon↗