The development of heart and brain function in low-birth-weight infants fed with taurine-supplemented formula.
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Aging↗
Biomedical subjects
K H Deeg
Publications and source records attributed to K H Deeg.
[Doppler sonographic detection of reduced flow velocity in the celiac trunk of the newborn infant with patent ductus arteriosus Botalli compared to a healthy control group].
Pulsed doppler recordings were obtained in the truncus coeliacus in 12 premature born infants (gestational age 30.3 +/- 2.5 weeks) with the clinical signs of patent ductus arteriosus Botalli (PDA) and compared to a control group of 24 healthy infants (gestational age 40.5 +/- 5.3 weeks). In all children the maximal systolic velocity, the endsystolic and the enddiastolic velocity and the pulsatility-index were measured. The 24 healthy newborns showed the following velocities: Maximal systolic velocity: 77 +/- 16 cm X s-1; endsystolic velocity: 31 +/- 10 cm X s-1; enddiastolic velocity; 18 +/- 9 cm X s-1. The pulsatility-index was 0.75 +/- 0.11. In children with PDA the maximal systolic velocity was 72 +/- 21 cm X s-1, the endsystolic velocity 15 +/- 14 cm X s-1 and the enddiastolic velocity -5 +/- 8 cm X s-1. The pulsatility-index was 1.08 +/- 0.12. All infants with large PDA showed a significant decrease of the endsystolic velocity and enddiastolic velocity, whereas the pulsatility-index was significantly increased. The decrease of the endsystolic and enddiastolic velocity in infants with large PDA in comparison to the healthy control group may lead to hypoxemic-ischemic lesions of the intestinal organs. The increased incidence of necrotizing enterocolitis in premature infants with large PDA may be the result of hypoperfusion of the small bowel.
Blood Flow Velocity↗
[Sonographic diagnosis of solid space-occupying abdominal lesions in childhood].
Between 1981 and May 1986 31 children with solid abdominal tumor masses were observed in our clinic. The first diagnostic procedure was a sonographic examination, followed by further radiological investigations if necessary. 30 cases were examined histologically; in one case the sonographic findings were confirmed by an angiography. The most frequent abdominal masses were neuroblastomas and Wilms tumors (7 cases each). A mesoblastic nephroma was diagnosed in 3 cases, a lymphoma, a hepatoblastoma and a rhabdomyosarcoma 2 times each. One time we found a pancreas carcinoma, a teratoma, a hemangiomatosis of the liver, a malignant Schwannoma, a Ewing sarcoma, an adenoma of the adrenal gland, a pheochromocytoma and an osteosarcoma. According to our own experience and recent reports in the literature it seems possible in most cases, to predict the correct diagnosis of solid abdominal masses using the informations of sonographic imaging. Sonography is a highly specific non-invasive diagnostic tool for planning treatment (e.g. early surgery, cytostatic therapy and/or radiation) of solid abdominal masses. Nevertheless the histological examination should be performed in every case to confirm the definitive diagnosis.
Abdominal Neoplasms↗
[Detection of reduced flow velocities in the anterior cerebral artery in premature and newborn infants and in older infants with cerebral hemorrhages using pulsed Doppler sonography].
34 infants with intracerebral haemorrhage (intraventricular haemorrhage 26; subdural haemorrhage 2; epidural haemorrhage 2; subarachnoidal haemorrhage 4) were investigated by pulsed Doppler-sonography. Absolute flow velocities were measured in the anterior cerebral arteries in infants with intracranial haemorrhage and compared with the flow velocities of a healthy control group of identical gestational age, actual age and weight. All flow velocities were significantly reduced in premature and full-term infants with intracranial haemorrhage, whereas the pulsatility-index was significantly increased. 10 infants with severe intracranial haemorrhage developed a shunt-depending posthaemorrhagic hydrocephalus. These children showed a significant reduction of all flow velocities in the anterior cerebral arteries in comparison to the healthy control group. The diastolic forward flow was more reduced than the maximal systolic velocity resulting in a significant increase of the pulsatility index. In rapidly progressive hydrocephalus, often no diastolic flow or even a retrograde diastolic flow could be found. After shunt-implantation normalisation of the flow velocities could be observed. Reduced flow velocities could be observed. Reduced flow velocities in the anterior cerebral arteries in infants with subdural, epidural and subarachnoidal haemorrhage were associated with a bad outcome: 1 infant died, 1 infant developed severe leucomalacia, and 1 infant showed atrophy of one cerebral hemisphere. Normal flow velocities in the intracranial arteries in subdural, epidural and subarachnoidal were associated with a favourable prognosis. Absent or even retrograde diastolic flow indicates a dramatic decrease of cerebral perfusion. The longer the pathologic flow patterns were demonstrable the worse was prognosis.
Blood Flow Velocity↗
[Group B streptococcal panophthalmia in neonatal infection].
Hemolyzing streptococci of group B were isolated from an ulcerative keratitis in a 14-day-old girl (gestational age: 39 weeks, birth weight: 3230 g) suffering from septicemia. The differential diagnosis includes all bacteria and virus species able to penetrate the intact cornea, e.g. Pseudomonas sp., N. gonorrhoeae and Herpes simplex virus II. Perinatal infection may be via the birth canal.
Bacteriological Techniques↗
[Chronic hemorrhagic pancreatitis in gallbladder polyposis as an initial symptom of metachromatic leukodystrophy].
A 4 1/2 year old boy without previous neurologic disorders developed chronic hemorrhagic pancreatitis and was shown to have polyposis of the gallbladder. Neurologic symptoms emerged at the age of 5 years. The sonographic pattern of an echogenic gallbladder was suspect of metachromatic leukodystrophy. The definitive diagnosis was made by the findings of very low arylsulfatase A activity in the white blood cells and deposits of sulfatides in the stroma of the polyps of the gallbladder.
Cerebroside-Sulfatase↗
[Intralobar lung sequestration. Diagnosis using the duplex-scan technic].
A 3 7/12 year old boy, suffered from a intralobar sequestration of the lung and recurrent pneumonia. In the area of the right lower lobe, a plain film showed a limited density. The ultrasonographic evaluation demonstrated a homogenous tumor above the diaphragm. We found pulsatile flow patterns by pulsed doppler sonography within the arteries feeding the sequestration. Aortography finally clearly showed the anomalous arteries leading from the descending aorta to the sequestrum. Bronchoscopy and bronchography demonstrated, that the sequestered area of the lung had no open connexion to the rest of the bronchial tree. Surgical treatment is the only possible method to remove the cause of the recurrent infections.
Aortography↗
[Surgical treatment of patent ductus arteriosus Botalli in the premature infant. Indications and results of treatment].
125 preterm infants with persistent ductus arteriosus (PDA) had surgical ligation between November 1978 and December 1984. In an additional case the situation was complicated by severe coarctation, which had not been diagnosed prior to surgery. The mean birth weight was 1340 +/- 448 g (85 infants weighed less than 1500 g). Gestational age was 30.6 +/- 2.5 weeks. Age at surgical ligation was 13 +/- 7 days for all patients. Preterm infants from our hospital were operated on with a mean age of 9.5 days. Indications for surgical ligation were clinical and radiographic signs of large PDA, during the last two years supported by the results of pulsed doppler ultrasonography. Only one preterm infant with PDA and coarctation died intraoperatively. The overall results showed a mortality rate of 21.6%. This rate has decreased from 30.4 to 11.7% in the last year. Important improvement could be obtained by early ligation, with carefully maintained body temperature during surgery. Preoperative ventilation parameters were kept constant and changes in arterial blood pressure during operation were avoided. The percentage of permanent handicaps was lowered from 15.2 to 5.9% in the last year of our study. According to failure of indomethacin therapy in the very beginning of PDA treatment, it is our policy now to ligate PDA in preterm infants early and without delay by a trial with indomethacin therapy.
Ductus Arteriosus, Patent↗
[Cerebral ultrasound diagnosis in brain abnormalities].
Gray scale ultrasonography of the brain was performed in 93 infants with cerebral malformations. The most common malformation was the Chiari-malformation (56 children), characterized by the caudal displacement of the cerebellar vermis into the foramen magnum. The rest of the cerebellum, pons and medulla oblongata were displaced caudally and dysplastic. All children with Chiari-syndrome showed more or less severe hydrocephalus. The Dandy-Walker-malformation (3 children) was characterized by a huge retrocerebellar cyst communicating with the fourth ventricle. The cerebellar vermis was dysplastic. In alobar holoprosencephaly (2 children) a large singular midline ventricle could be shown. Both thalami and plexus chorioidei were fused in the midline. Absence of the falx cerebri, interhemispheric fissure, corpus callosum and septum pellucidum was characteristic for alobar holoprosencephaly. Stenosis of the Sylvian aqueduct (4 children) was characterized by enlarged lateral ventricles and third ventricle, whereas the fourth ventricle was normal in size. Porencephalic cysts (7 children) were spheric echofree lesions of various size, usually located symmetrically in both cerebral hemispheres. In hydranencephaly (4 children) both hemispheres were replaced by echofree space occupying bubbles. In 5 children with agenesis of the corpus callosum no corpus callosum could be demonstrated by sonography. Coronal sections displaced the typical bull's head shape, formed by the enlarged third ventricle and the side ventricles as well as randomly arrayed sulci around the lateral ventricles, which are pathognomonic for agenesis of the corpus callosum. Agenesis of the septum pellucidum (5 children) was characterized by fusion of the frontal horns of the lateral ventricles. One child with aneurysmatic malformation of the vein of Galen showed dilated sinus rectus and pulsations of a cyst, located behind the third ventricle. Pulsed doppler recording showed pulsatile arterial flow patterns within the cyst.
Agenesis of Corpus Callosum↗
[Sonographic diagnosis of hypertrophic pyloric stenosis in childhood].
In most cases, diagnosis of hypertrophic pyloric stenosis is now based on real-time ultrasound examination. We employed the criteria stated in literature for sonographic diagnosis of hypertrophic pyloric stenosis, to evaluate our results. We studied 15 patients with symptoms of hypertrophic pyloric stenosis via real-time ultrasound, as well as 15 healthy infants. 10 patients were boys and 5 were girls, between 19 and 83 days of age (average age 45 days). 15 healthy infants of the same age were studied (average age 41 days) for comparison. In the healthy group, the average transverse pyloric diameter was 1.0 cm (0.6-1.5 cm); the mean wall thickness was 0.24 cm (0.2-0.3 cm) and mean pyloric length was 1.29 cm (1.0-1.6 cm). Analysis of the results in hypertrophic condition showed that the mean transverse pyloric diameter was 1.6 cm (1.2-1.9 cm). The wall thickness ranged from 0.4 to 0.8 cm with an average of 0.56 cm. The muscle length ranged from 1.7 to 2.5 cm with an average of 2.1 cm. On comparing the data of both groups we found significant differences in wall thickness and length. There was no false negative scan. Sonographic diagnosis was confirmed in all cases by surgical intervention. Our results agree with those obtained by other authors.
Female↗
[Sonographic diagnosis and follow-up study of a congenital brain tumor].
In a newborn with neurologic abnormalities a congenital brain tumor was found by gray scale sonography. By its dense structures the tumor could easily be separated from the surrounding healthy brain. Development of hydrocephalus and cystic degeneration of both hemispheres was observed by serial ultrasonography studies, which were in accordance with computerized tomography and post mortem examination.
Brain Neoplasms↗
[Sonographic detection of subdural effusions in infancy].
Using the open fontanelle as an acustic window, small frontoparietal subdural effusions are often missed on conventional sagittal or coronar ultrasonographic sections. Using horizontal and frontal skull sections during the first 12 months of life intracranial structures can equally be visualized. In a study of 14 infants aged 6 days to 11 months gray scale ultrasonography was compared to computed axial tomography. The results suggest that horizontal and frontal ultrasonographic skull sections are equally efficient to localize even small subdural effusions without the adverse risks of radiation.
Brain↗
[Sonographic characteristics of the Arnold-Chiari syndrome and hydrocephalus in children with meningomyelocele].
22 children with myelomeningocele had serial examination by gray scale ultrasonography through the open fontanelle as an acoustic window. 18 children (82%) developed a progressive hydrocephalus and were eventually shunted. In 18 children the hydrocephalus was caused by an Arnold-Chiari-II-malformation with the sonografic signs of a caudal displacement of the dysplastic cerebellum, brainstem, 4th ventricle and cisterna magna. The forth ventricle was elongated and flattened in all babies with Arnold-Chiari-syndrome. The cisterna magna was not visible in any child. The Arnold-Chiari-II-malformation caused an occlusive hydrocephalus which was characterized by the dilatation of the occipital horns (91%) and frontal horns (86%) of the side ventricles, whereas the temporal horns were normal in size (86%). The dysplastic 3. ventricle was displaced caudally and ventrally and showed a prominent suprapineal recess in 41%. Associated malformations of the brain were a large massa intermedia (55%), a prominent plexus choriodeus (50%) and agenesia (36%) or fenestration (9%) of the septum pellucidum. Gray scale ultrasonography is the best method not only for early diagnosis of Arnold-Chiari-malformation and resulting hydrocephalus in infants but also for further controls after shunt implantation, especially for early detection of shunt complications and shunt insufficiency.
Arnold-Chiari Malformation↗
[Diagnosis and clinical course of cerebral hemorrhage in infants based on sonography].
Infants of very low birth weights (less than 1500 g) born before the 32nd week of gestation have a high incidence of neonatal intracranial hemorrhage (ICH). Beside perinatal and postnatal asphyxia the main risk factor for ICH is the immaturity of the infant. Mild intracranial hemorrhages resolve within a few weeks. Severe ICH, which were seen in very immature babies before 30 weeks of gestation and with birth-weights below 1250 g had a fatal outcome. The mortality rate in severe ICH was 50%. The infants which survived severe ICH developed posthemorrhagic hydrocephalus (PHH). Using the open fontanelle as an acoustic window gray scale ultrasonography of children's brain is able to visualize ICH and PHH. We suggest early sonografic brain investigation within the first days of life in all prematurely born infants with perinatal asphyxia. Infants with severe ICH should have weekly sonografic controls, to detect PHH as soon as possible.
Age Factors↗
[Placental insufficiency and intermittent hyperbaric oxygenation. Animal experimental model].
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Animals↗
[Ischemia of the brain stem caused by compression of the vertebral arteries by head rotation--an etiology for SIDS?].
UNLABELLED: Hypoperfusion of the brainstem during head rotation may be a risk factor for the development of SIDS. On this background we established a Doppler sonographic screening programme of the basilar cerebral arteries to evaluate the dependency of blood flow on head and body position. PATIENTS AND METHOD: We investigated 3840 newborns (1872 girls and 1968 boys) with a birth weight of 3399 +/- 497 g and a gestational age of 39.2 +/- 1.4 weeks. The investigations were performed in the neonatal period with an average age of 4.7 +/- 3 days. In all infants blood flow was measured in the basilar artery (BA) in supine position with the head in the midline. From the flow profile peak systolic flow velocity Vs and time average flow velocity TAV were measured. Additionally flow measurements were performed in supine and prone position with rotation of the head to the right and left side. A decrease of blood flow velocities below 50% of the value in neutral position was considered to be abnormal. Retrograde or biophasic flow profiles during rotation were considered to be pathologic. In infants with abnormal or pathologic flow during rotation of the head flow measurements in the vertebral arteries (VA) were additionally performed. Blood flow velocities in the VA were measured in supine and prone position with the head in the midline position and after rotation to the right and to the left. In neutral position unilateral vertebral hypoplasia, aplasia and normal VA were differentiated. The judgement after rotation was performed such as in the BA. RESULTS: In 3807 infants (99.14%) blood flow velocities during head rotation did not decrease below 50% of the value measured in neutral position. In 33 infants (0.86%) a decrease of blood flow velocities below 50% could be found during rotation. In 7 infants (0.18%) a pathologic flow could be found during head rotation. 27 of the 33 infants with abnormal and pathologic blood flow in the BA during rotation showed anatomic abnormalities of the VA. 20 of these infants (61%) had unilateral vertebral hypoplasia (11 right, 9 left side), 7 (21%) had unilateral vertebral aplasia (4 right, 3 left side). 32 of the 33 infants with abnormal flow in the BA showed a decrease of blood flow in the contralateral VA during head rotation. 9 infants had an abnormal, 19 a pathologic flow within the contralateral VA. In 4 infants the corresponding VA could not be measured during head rotation. The decrease of blood flow velocities in the BA during head rotation was caused by compression of the contralateral VA at the craniocervical junction. CONCLUSION: Blood flow within the basilar artery of healthy infants is independent of body position and rotation of the head. A decrease of the flow velocities below 50% during rotation has to be considered as an abnormality. The incidence of pathologic blood flow during head rotation with 1.8@1000 approximates the incidence of SIDS. Hypoperfusion of the brainstem during head rotation may be a risk factor of SIDS.
Blood Flow Velocity↗
[Sonographic and Doppler color sonographic findings in osteosarcoma].
Till now bone tumors are diagnosed radiologically. In this paper we describe the characteristic sonographic and colour Doppler sonographic features in 5 patients with histologically confirmed osteosarcoma. A large soft tissue tumor with echogenic osteosclerotic areas and echo-free caverns could be shown in all patients. Characteristic signs were destructions of the cortical layer and reactions of the periosteum. Compared to normal tissue an increased number of blood vessels with increased blood flow were visible by colour coded Doppler sonography in the region of the tumor. Sonography and colour coded Doppler sonography are important additions of conventional radiology to describe the structure, extension and blood supply of an osteosarcoma.
Adolescent↗
[Abdominal Doppler sonography in childhood].
With the help of pulsed Doppler sonography and colour coded Doppler sonography noninvasive measurements of blood flow within the abdominal vessels are possible. Cystic and tubular abdominal masses and vascular structures can be differentiated. Laminar and turbulent flow as well as arterial and venous flow can be distinguished. The direction of blood flow can be shown. Regarding liver circulation Doppler sonography of portal hypertension, portal vein thrombosis, veno-occlusive-disease, Budd-Chiari-Syndrome and transplant rejection or other vascular complications after liver transplantation can be shown. The circulation of the spleen should be examined if aneurysms, thrombosis or portal hypertension are suspected. Mesenterial circulation should be investigated in suspected vascular occlusion, arterial stenosis and necrotizing enterocolitis. Renal Doppler sonography is helpful for the diagnosis of renal artery stenosis, arterio-venous fistulas, renal vein thrombosis and acute transplant rejection.
Abdomen↗