PubMed Health⌕ Search

Biomedical subjects

H Hörnchen

Publications and source records attributed to H Hörnchen.

At least 55 records · Page 3Linked to original sources
PubMed1979

[Diabetic ketoacidosis and hyperosmolar diabetic coma in childhood. Low-dose continuous intravenous infusion of insulin (author's transl)].

Continuous intravenous infusion of low doses of insulin has been successfully used since 1972 in the treatment of "diabetic coma". The achieved levels of plasma insulin satisfy the transport of glucose and the inhibition of lipolysis. We are to report upon 8 children (mean age: 8.5 years), 6 with diabetic ketoacidosis and 2 with hyperosmolar diabetic coma. Blood sugar levels of 300 mg/dl or less were reached after averagely 8 hours of therapy and an average consumption of 0.8 U insulin/kg. Sodium and potassium levels, osmolality and acid base parameters for the first 24 hours are described. Low-dose continuous intravenous insulin infusion was effective, simple and safe in all cases. The presently recommended dosage of 0.1 insulin/kg x hour is to be used flexibly (range: 0.05--0.2 U/kg x hour). The administration of bicarbonate should be cautiously used for patients with severe acidosis. Infusion of hypotonic solutions as part of the treatment of the hyperosmolar diabetic coma can be dangerous. A new therapeutic regime based on our results is proposed.

Adolescent↗
PubMed1979

[Total and partial parenteral feeding of premature and newborn infants: nitrogen balances and serum amino acid chromatograms].

We report upon 30 critically ill premature and newborn infants (mean birth weight: 2,350 g). In all cases we applied initially total parenteral nutrition with increasing supplies, subsequently partial parenteral nutrition. Donors of nutritive substance and calories were a 6% mother-milk adapted amino-acid solution, a glucose solution 10% and 20% and a 20% lipid emulsion. Serum electrolytes, urea, glucose, serum aminograms and nitrogen balances were determined at regular intervals. Serum aminograms were found altogether acceptable in relation to those of breast-fed newborns and small infants and to normal values, which we evaluated among 45 premature and newborn infants before supplying protein.

Amino Acids↗
PubMed1978

Human fetal cells. I. Mitogenic responses.

Human fetal cells from 10 prematures and newborn infants (28--38 weeks of gestational age) and isolated or non-isolated fetal cells circulating in the blood of 9 primigravidae were studied in their ability to respond to phytohemagglutinin, pokeweed, dextran sulfate and lipopolysaccharide. An age-dependent responsiveness of fetal cells obtained from the prematures to all mitogens tested was detected as well as a clear graduation of mitogenic capacity with phytohemagglutinin to produce the highest stimulation. Though a moderate mitogenic response to lipopolysaccharide and dextran sulfate was noted in the blood cultures of the infants, LPS and in part DS transformation of fetal cells obtained from maternal blood appeared to be reduced or absent. A selective stimulation of fetal cells occurring in the circulation of primiparae sufficient for prenatal diagnosis could not be achieved with the mitogens tested. The findings suggest that fetal cells crossing to the mother are different from normal fetal lymphocytes. The present study was performed to elucidate in as quantitative a manner as possible the responses of human fetal cells to different T- and B-cell mitogens. Cells were obtained from various sources for comparing the mitogenic responses of isolated and non-isolated fetal cells. Our results demonstrate that mitogenic responses depend on the gestational age of the fetal cells, the source of the cells and on experimental conditions.

Cells, Cultured↗
PubMed1978

[Extra-alveolar air in ventilated newborn infants (author's transl)].

Successive manifestations of acute air leak phenomenona are reported in a ventilated premature infant with aspiration of amniotic fluid. The increasingly reported incidence of pulmonary interstitial emphysema is emphasized. After its first occurrence there is a serious need for careful clinical and radiological observation because of the great risk of further complications.

Amniotic Fluid↗
PubMed1978

[Hyperosmolar nonketotic diabetic coma. Treatment with continuous low-dose insulin infusion (author's transl)].

We report the case of a boy aged 9 1/2 years with hyperosmolar, nonketotic diabetic coma. He was not known to be diabetic prior to the onset of coma. Pathogenetic aspects of this rare manifestation of juvenile diabetes are discussed. It is dangerous to decrease osmolarity too rapidly during infusion of very hypotonic solutions. Treatment with continuous low-dose insulin infusion may cautiously be tried.

Child↗
PubMed1977

[Children of mothers with phenylketonuria (author's transl)].

Microcephaly and considerable motor and mental retardation occurred in two non-phenylketonuric children of an untreated mother with phenylketonuria. The cerebral damage of the children must be considered the consequence of the maternal metabolic disorder. Since the first phenylketonuric children who were treated on strict diet are now reaching the age of marriage and pregnancy, the problem of maternal phenylketonuria is becoming topical. Published reports indicate that of 72 well documented cases with a maternal phenylalanine level above 200 mg/1 (1210 mumol/1) 39 offspring had microcephaly, in 33 intra-uterine growth had been retarded and in 25 there are cerebral palsy and seizures. Almost all had mental retardation. At the same time there have been reports about three normal children whose mothers had kept to a phenylalanine-low diet during their pregnancy.

Adolescent↗
PubMed1977

[The clinical data of infected umbilical sinus].

We report the case of a female baby, three months of age, with anemia of chronic infection, hematuria and umbilical sinus. The patient did survive a sepsis and the extirpation of the umbilical sinus and died in a septic shock. Diagnosis and therapy of the anomalies of the umbilicus are discussed and a possible explanation for the hematuria is presented.

Anemia↗
PubMed1977

[The bronze-baby-syndrome: a complication of phototherapy (author's transl)].

A case of intense grey-brown discoloration of the skin, serum and urine in a premature twin is reported when phototherapy was used to reduce hyperbilirubinemia. All features made the diagnosis of bronze-baby-syndrome most probable. We were able to detect an increased level of coproporphyrin in serum. The patient did not show any signs of a kernicterus. Possible speculations about the pathogenetic and prognostic value of elevated levels of coproporphyrins in newborn infants under treatment with phototherapy are discussed. In these cases we must be aware of possible neurotoxic effects, since increased concentrations of bilirubin breakdown products may not be excreted as well through the normal biliary passage as normally.

Color↗
PubMedDate not supplied

[Water loss through the skin and rectal temperature under phototherapy with a doped halide radiating lamp].

A new metal-halid phototherapy-lamp with a bilirubin-effective radiant energy of 11 W/m2 (focus distance 45 cm) was tested with regard to its influence on transepidermal water loss ("TEWL") and rectal temperatures. 23 term and preterm newborn infants (gestational age 28-40 weeks, body weight 980-3450 g) were examined on the first days after birth using the Evaporimeter-method. The mean value of TEWL in babies weighing greater than 2000 g (33 gestational weeks) calculated by a special graphic method (approximation) was 14 ml H2O/kg X 24 h increasing in the smallest babies in an exponential relationship. We recommend to compensate the raised TEWL with 10 ml/24 h and only in preterm babies weighing less than or equal to 1000 g (less than or equal to 28 gestational weeks) with 15 ml/24 h. Rectal temperatures raised only insignificantly under phototherapy.

Body Temperature↗
PubMedDate not supplied

[Combination therapy of high frequency oscillatory ventilation, NO inhalation and surfactant replacement in a child with acute respiratory distress syndrome].

We report about a child with severe ARDS after burning trauma who did not respond to conventional treatment with controlled pressure ventilation under conditions of permissive hypercapnia and changing of the infants's body position. A combined treatment with high frequency oscillatory ventilation, inhalation of nitric oxide and surfactant replacement improved the pulmonary status. Twelve days after the accident the boy could be extubated and 5 weeks later he could be discharged without any pulmonary and neurologic handicap. The use of these therapeutic tools may help to avoid the necessity of the invasive extracorporeal life support.

Acute Disease↗
PubMedDate not supplied

[Computer-assisted monitoring in the neonatal intensive care unit].

Computerized monitoring in a neonatal intensive care unit allows continuous registration and complete storage of vital parameters. The stored data can be used for detailed retrospective analysis of critically ill patients and the graphical presentation of the vital parameters may lead to an earlier recognition of clinical deterioration. This computer system which can be established in any intensive care unit demonstrates the improvement in neonatal intensive care monitoring at low financial costs.

Computer Graphics↗
PubMedDate not supplied

Amino acids for parenteral nutrition in premature and newborn infants. Use of a mother's milk-adapted solution.

Crystalline L-amino acids are now used almost exclusively to meet the amino acid (AA) requirements in parenteral nutrition (PN). Important criteria for judging the solutions, which are composed of different AA patterns, are: attainment of a positive nitrogen (N) balance, absence of acidosis, hyperammonemia, or toxic side effects. Presently, great importance is attached to the analysis of AA concentrations in serum or plasma under infusion conditions. Within the scope of the infused regimen, type and amount of additional calorie supplies also must be taken into account. Orally administered nutrients must be balanced when the patient is switched to partial PN.

Amino Acids↗
PubMedDate not supplied

[Fiberoptic measurement of arterial oxygen saturation in premature and term neonates].

BACKGROUND: Non-invasive oxygen monitoring with pulse oximetry or transcutaneous monitoring has gained widespread use in neonatology. Different factors like arterial hypotension, peripheral vasoconstriction and edema adversely affect the accuracy of both methods. To ensure reliable monitoring of oxygen saturation in critically ill patients we measured oxygen saturation with a fiberoptic catheter via umbilical artery. METHODS: In ventilated premature infants (FiO2 > 0.4) a 4F-fiberoptic catheter (Oximetrix)-3, Abbott) was inserted to the descending aorta (Th 6-8). Simultaneously pulse oximetry (SaPO2) was performed with the Ohmeda Biox 3700. To compare the reliability of both methods, blood was analysed for arterial partial oxygen pressure (PaO2), fetal hemoglobin (HbF) and arterial oxygen saturation (SaO2) by complete co-oximetry (Radiometer Copenhagen OSM3) as reference. RESULTS: In 10 premature infants (median gestational age 30.5 weeks; median birth weight 1360 g) oxygen saturation was measured with the fiberoptic catheter (SaFO2) over a total period of 935 hours. In all, 137 blood samples were analysed for arterial saturation (SaO2) by co-oximetry. The mean difference between the SaO2 and SaFO2 was -1.89% (+/- 1.53); the mean difference between SaO2 and the values obtained by pulse oximetry (SaPO2) was -3.09% (+/- 2.33). The SaFO2 results correlated closely with the co-oximetry values (r = 0.97; p < 0.0001). CONCLUSION: In critically ill patients, if non-invasive oxygen monitoring fails, a fiberoptic catheter offers the possibility of continuous and reliable measurement of oxygen saturation.

Blood Gas Monitoring, Transcutaneous↗
PubMedDate not supplied

[Not Available].

Explore the source record for details and available documents.

Equipment and Supplies↗
PubMedDate not supplied

[Mortality and morbidity of premature infants weighing less than or equal to 1,000 grams: a retrospective analysis 1976 to 1987].

In a retrospective study performed at the university department of pediatrics at Aachen the development of the mortality rate of extreme low birth weight infants (less than or equal to 1000 grams) born from 1976 to 1987 has been under investigation. During this period a decline of the neonatal mortality rate from 79.5% to 29.8% could be observed. Sex, gestational age, birthweight, place of birth and delivery mode were important factors influencing the outcome of the patients. Premature babies who were born by caesarean section had a significantly higher survival rate than babies who had been delivered vaginally. Premature babies born in the university hospital at Aachen (inborns) had a remarkably lower neonatal mortality rate than infants who postpartum had been transferred to the intensive care unit from surrounding hospitals (outborns). A second aspect of this study was the development of neonatal morbidity. For some diseases like intracranial hemorrhage a decrease in frequency could be noticed. Especially high-graded intraventricular hemorrhage (IVH greater than or equal to III degrees) occurred significantly less frequent between 1985 and 1987. The comparison of morbidity rates between inborns and outborns revealed a lower incidence of hyaline membrane disease, pneumothorax and intracranial hemorrhage in inborn patients. The results of this study imply that the intensive care of extreme low birth weight infants is justified. To achieve even lower mortality and morbidity rates the importance of regionalization has to be emphasized.

Cause of Death↗
PubMedDate not supplied

[Primary hyperparathyroidism and pregnancy. Aspects of neonatal morbidity].

Primary hyperparathyroidism has to be accused to cause serious morbidity during pregnancy not only on the maternal, but also on the fetal side: the fetus is threatened by prematurity, dystrophy and an increased risk of stillbirth. Postpartually hypocalcaemia and tetany may be observed as the result of neonatal hypoparathyroidism caused by maternal and thus also fetal hypercalcaemia. We report the case of a 32-year-old pregnant woman suffering from a severe form of primary hyperparathyroidism caused by an adenoma of the parathyroidea. The tumor was removed in the 34. week of pregnancy. Six weeks later the patient delivered a healthy boy (birth weight 3450 g). A survey is given of the therapeutical procedures that should be arranged individually by interdisciplinary consulting depending on the degree of maternal disease and on the gestational age.

Adenoma↗