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Biomedical subjects

R Michaelis

Publications and source records attributed to R Michaelis.

At least 19 recordsLinked to original sources

Bilateral spastic cerebral palsy--pathogenetic aspects from MRI.

Thirty eight children with bilateral spastic cerebral palsy underwent MRI at the age of 5 years and more. Twenty nine showed correlates of periventricular leucomalacia, which were found especially in preterms (20 out of 21) but also in 9 of 15 fullterms without birth asphyxia. These findings suggest compromising events in the peri- and neonatal period especially in preterms and prenatal 3rd trimenon compromise in most of the fullterms without birth asphyxia.

Adolescent

The Rett syndrome: magnetic resonance imaging and clinical findings in four girls.

The clinical and laboratory findings in 4 girls with the Rett syndrome are presented. The MRI results at different disease stages with detailed descriptions of the techniques applied-including quantification of T1 and T2 relaxation times in the brain-are reported. There were no pathological signal intensities in T1- or T2-weighted images. Thus, MRI does not provide any significant additional help in the diagnosis of the Rett syndrome. However, it does indicate that disturbances of myelinization or the brain water content are not probable etiologies in this syndrome.

Adolescent

Hypomelanosis of Ito--report of four cases and survey of the literature.

Four cases of hypomelanosis of Ito with typical skin depigmentation and various noncutaneous findings were described. This neurocutaneous syndrome has been well documented by clinical investigations, especially computerized tomography and magnetic resonance imaging of the brain. The literature is surveyed giving special consideration to related neurologic manifestation. The most frequent neurologic abnormality was psychomotor retardation. Hearing loss in two patients and varicosis in one patient was striking. In one more patient, the symptoms resembled neurodegenerative disease.

Adolescent

[Results and consequences using Prechtl's concept of optimal conditions. Obstetrical and Postnatal complications (author's transl)].

An extended list of Prechtl's list of optimal obstetric conditions was used to describe the history of 200 newborns, randomly chosen from a defined population born in 1972. Differences between the population from Groningen (Prechtl's) and Tübingen, and different definitions of the items used in the list are discussed. Reduced optimal conditions in the history of the mother effectively reduced the optimal conditions in the newborn aswell. This was particularly so in case of: Preterm deliveries and miscarriages, bleedings in the first trimester, preterm onset of labour, operative deliveries, less than 38 weeks of gestational age, and an Apgar score below 7.

Abortion, Spontaneous

[Distribution of obstetrical and postnatal risk-factors in 400 randomly selected newborns. A study using Prechtl's concept of optimal conditions (author's transl)].

The distribution of obstetrical and postnatal risk-factors in a population of 400 newborns was investigated. For documentation, an extended list of Prechtl's list of optimal obstetric conditions was used. The newborns had been selected randomly from two populations, born 1972 in two different hospitals (County hospital, University hospital). The reduction of optimal conditions was calculated by percentiles. It was found that the number -3 (of 52 items, representing full optimal conditions) defined the 10th percentile of the population; number -5 the median, and number -10 the 90th percentile. In addition, percentiles were calculated regarding the history of the mother and the history of the infant respectively. Using the distribution of reduced obstetrical and postnatal optimal conditions allows to compare the history of a single newborn or the histories of a population of newborns with defined problems. Newborns with rather low negative numbers of reduced optimal conditions are at lower risk regarding their psychomotor development wheras newborns with high negative numbers carry a much higher irsk in this respect.

Birth Injuries

[Results of intensive care and intensive therapy of very low birth-weight infants (author's transl)].

Newborns of less than 1500 g birth-weight are thought to be especially at risk with regard to their psychomotor development. Among 71 such infants admitted to the University Childrens Clinic, Tübingen, in 1974-1975, 43 survived (38% mortality). All but two of them were followed serially and assessed for their psychomotor development. Five were found to be abnormal (12%), three of them most probably having sustained CNS damage prenatally.

Child, Preschool

[Clinical aspects of pathogenesis of alcohol embryopathy (author's transl)].

68 cases of alcohol embryopathy are reported. The main symptoms are intrauterine and postnatal growth retardation (91%), microcephaly (87 per cent), psychomotor and mental retardation (84 per cent) and a typical craniofacial dysmorphism. Other malformations are frequently found such as cardiac defects (31 per cent), anomalies of joints (23 per cent) and genitalia (50 per cent). There is a marked variation in the intensity of the malformations. Taking into account the extent of the craniofacial dysmorphism and the cerebral damage, a classification into three types (I-111) of alcohol embryopathy is proposed. That ethanol has a teratogenic effect seems to be confirmed. The mother's clinical history suggests that the quantity of alcohol consumed has no marked influence on birth weight, length of gestation and severity of the symptoms. Possibly a defective ethanol metabolism in the severely affected mothers may account for the dysplasias.

Abnormalities, Drug-Induced

[On the embryo-fetal alcohol syndrome (author's transl)].

The symptomatology in 24 patients with the embryo-fetal alcohol syndrome in this study corresponded essentially to the clinical picture described by Lemoine et al., and Jones et al., although we were not able to confirm the maxillary hypoplasia and microphthalmia mentioned in the latter. In addition, we observed in 2 girls a virilization of the genitalia which corresponded to female pseudohermaphroditism. Auxologically a nearly regular pattern of the parameters measured was found. The intra-uterine hypotrophy continues after birth. In particular, the head circumference, reflecting the brain growth, remains low. The cerebral damage leads to oligophrenia with a typical pattern of psychic and motor behaviour. Moderate cases tend to improve. Concerning the pathogenesis, the clinical observations in connexion with recent animal experiments permit the following conclusions. Neither the malnutrition nor the liver damage of the mothers are necessary presuppositions. Ethanol itself appears to play the main teratogenetical rôle. Acetaldehyde, which is the primary metabolite of ethanol, is cytotoxic too. However, the liver of the embryo and the fetus, in consequence of its deficient alcohol dehydrogenase content, is not able to metabolize ethanol.

Abnormalities, Drug-Induced

A rare type of low birthweight dwarfism: the Dubowitz syndrome.

Two patients with the Dubowitz syndrome are presented. This presumably recessive inherited syndrome was first defined by Grosse et al. (1971). So far 11 patients with this syndrome have been described. Major clinical findings are intrauterine and postnatal growth retardation, considerable microcephaly, mild mental retardation, hyperactivity, hyperextensibility of joints, eczema and a characteristic appearance of the face due to marked epicanthic folds, blepharophimosis, broadening of the bridge and tip of the nose and retrognathia. Minor anomalies as clinodactylyl of the firth digits, cutaneous syndactyly of toes, foot deformity, sacral dimple and cryptorchidism may be seen. The exclusion of the non genetic fetal alcohol syndrome presents serious diagnostic problems.

Birth Weight