[Simplified surgical procedure for closure of the ductus arteriosus in premature infants].

The necessity of closing a hemodynamically significant patent ductus arteriosus (PDA) in a premature neonate is unequivocal. Until 12/86 the PDA was disected and ligated and a chest tube was inserted (127 pts.) Since 1/87 45 pts.

[Surgery of congenital heart defects in deep hypothermic cardiovascular arrest: postoperative renal function].

We investigated early postoperative renal function in 55 consecutive infants who underwent cardiac surgery in deep hypothermic circulatory arrest (DHCA). In 15 of these patients detailed studies of glomerular and tubular function of the kidneys were performed. Mean time of circulatory arrest at 20 degrees Celsius rectal temperature was 53 +/- 15 minutes.

[Determination of brain death in children: 99mTc-HM-PAO and 123(I)-amphetamine scintigraphy as a new, noninvasive method].

In comatose children and infants, clinical signs of brain death and EEG monitoring may be of limited value, whilst determination of cerebral blood flow can provide more direct information. Beside radionuclide bolus angiography of polar radiopharmaceuticals with sequential technique, two radioisotopes are introduced as suited for static brain images. Injection of 123I-amphetamine or 99mTc labelled lipophilic complex HM-PAO into the peripheral venous circulation enables a precise static imaging of parenchymatous brain perfusion and cellular function so that critical deficits or complete loss of cerebral perfusion can be readily documented.

[Successful resuscitation in accidental hypothermia following drowning].

After breaking through thin ice, a 4-year-old boy drowned in a lake. A quickly alerted rescue helicopter found and recovered the child, drifting underneath the clear, thin ice. Primary resuscitation by the helicopter crew was unsuccessful.

[Acute epiglottitis: therapeutic consequences of change in the resistance of Haemophilus influenzae serotype B].

From July 1977 to May 1987, 27 children with acute epiglottitis were treated in our intensive care unit. Haemophilus influenzae type b was identified by positive blood culture in 14 of 27 cases. Until 1983 the first 11 children were treated with ampicillin (100 mg/kg) for a mean duration of 10 days according to the standard therapeutic regimen and/or proven sensitivity from blood cultures (5 of 11 cases).

99mTc-HM-PAO and 123I-amphetamine cerebral scintigraphy: a new, non invasive method in determination of brain death in children.

Determination of brain death in infants and children is difficult and criteria used in adult brain death are regarded insufficient in pediatric cases. In comatose children, clinical signs of brain death and EEG monitoring may be of limited value, while intercerebral blood flow estimations can provide more direct information. Beside radionuclide bolus angiography of polar radiopharmaceuticals with sequential technique, two radioisotopes are introduced for static brain images.

Determination of brain death with 123I-IMP and 99mTc-HM-PAO.

Brain imaging with radiolabeled amines, 123I-IMP and 99mTc-HM-PAO, is a rapid, safe, and specific bedside test for confirming brain death in the absence of cerebral blood flow. Therapeutic phenobarbital or thiopental levels do not interfere with the cerebral penetration ability of the lipophilic radiopharmacons.

Renal functional maturation: renal handling of proteins by mature and immature newborns.

Renal clearance of creatinine (Ccr), total protein excretion, urinary protein composition and renal clearance of albumin (Calb) were measured and calculated in male premature and mature infants of gestational age 29-41 weeks and in mature infants 1 and 3 months of age. Total protein excretion decreased slightly but not significantly during maturation. The urinary protein composition changed significantly as the fraction of low molecular weight proteins decreased from 48% at a gestational age of 29-33 weeks to 24% in mature infants aged 3 months, the albumin fraction increased from 39%-46% and the proportion of higher molecular weight proteins increased from 12%-29%, respectively.

[Liver transplantation in childhood].

From 1977 to 1985 altogether 143 children were referred to our hospital for liver transplantation. These children were aged 6 months to 15 years. According to the results of a defined examination protocol liver transplantation was indicated in 102 of these children.

Urinary protein analysis in the early detection of acute rejection episodes after renal transplantation in children.

The purpose of the present longitudinal investigation was to assess the predictive value of urinary protein analysis in the early detection of rejection crisis after renal transplantation. Forty-one children were studied consecutively over a period of 6 months applying the following methods: creatinine clearance (Ccr); urinary total protein (UTP); and electrophoretic differentiation of urinary proteins according to their molecular size by microgradient-gel electrophoresis (MGGE) with a continuous concentration gradient of 4-40% of polyacrylamide. Protein fractions analyzed were albumin (69,000 d), low molecular weight proteins (LMW-proteins, less than 69,000 d), and high molecular weight proteins (HMW-proteins, greater than 69,000 d).

Acute renal failure in children: prognostic features after treatment with acute dialysis.

A 12-year review (1972-1983) is presented of 76 children who were dialysed because of acute renal failure. The causes of acute renal failure were mainly the haemolytic-uraemic syndrome (53%), trauma (16%) and operation (13%). Fifty-eight children (76%) survived, 18 children (24%) died.

Renal albumin reabsorption in normal and sodium maleate-treated rats.

The normal filtered load of albumin at the rat glomerulus was estimated to be 18 mg/24 h X g kidney weight by means of micropuncture studies. Total nephron fractional reabsorption was 91%. The proximal convoluted tubule accounted for 72% of total reabsorption followed by an additional 12% in the loop of Henle.

Acute interstitial nephritis in childhood.

Three children aged 11 to 14 years with acute interstitial nephritis (AIN) are presented. In one patient AIN developed following antibiotic treatment with trimethoprim/sulfamethoxazole (TMP/SMX). In two patients no infection, drug, or toxin could be implicated.

[Mechanism of proteinuria: filtration and resorption of plasma proteins].

Glomerular filtration and tubular reabsorption of endogenous serum proteins were measured using micropuncture technique in the rat kidney. Data resulting from experiments on the single nephron level are compared with human overall kidney function. Reabsorption of filtered protein was virtually complete (84 to 96%) at endogenous serum levels.

Plasma protein handling in the rat kidney: micropuncture experiments in the acute heterologous phase of anti-GBM-nephritis.

Glomerular filtration and tubular uptake of plasma proteins have been studied in the rat using micropuncture techniques. 1. Under control conditions the glomerular capillary wall is an effective barrier, only 7.

An ultrastructural study of the mechanisms of proteinuria in rat nephrotoxic nephritis.

Nephrotoxic nephritis was induced in Sprague-Dawley and Munich-Wistar rats by the injection of rabbit antirat kidney serum. A biphasic pattern of proteinuria was induced: the heterologous phase with a peak of proteinuria occurring at 10 to 16 hours, and the autologous phase with a peak at 10 to 15 days. For morphologic studies, glomeruli were fixed by perfusion, or by drip-fixation during good blood flow.