[Individualized Somatic Classification of Newborns Using Birth Weight Percentiles Based On Maternal Body Height and Weight (Results of a Validation Study)].

Introduction: Birth weight is influenced by maternal anthropometry. The SGA-rate of newborns of short and light mothers (<158 cm,<53 kg) and the LGA-rate of tall and heavy mothers (>177 cm,>79 kg) are overestimated. The LGA-rate of newborns of shorter mothers and the SGA-rate of taller mothers are underestimated.

Individualized sex-specific birth weight percentiles for gestational age based on maternal height and weight.

Objectives: The maternal body size affects birth weight. The impact on birth weight percentiles is unknown. The objective of the study was to develop birth weight percentiles based on maternal height and weight.

Effect on work of breathing of different continuous positive airway pressure devices evaluated in a premature neonatal lung model.

Objective: A device for the application of continuous positive airway pressure to switch injected breathing gas to the outlet during expiration, known as Infant Flow, claims to reduce work of breathing and peak pressure change. So far the Infant Flow system has been investigated in lung models with tidal volumes of not <12 mL. However, premature neonates below 1000 g of weight generate a tidal volume of approximately 4 mL only.

Tumor necrosis factor-α promoter -308 G/A polymorphism and susceptibility to sepsis in very-low-birth-weight infants.

Objectives: To determine whether the tumor necrosis factor-α -308 G/A polymorphism is associated with blood culture-proven sepsis in two large cohorts of very-low-birth-weight infants.

Design: Genetic association studies.

Setting: Prospective, population-based, multicentered cohort of 1944 very-low-birth-weight infants born in 14 German study centers between 2003 and 2008 and 976 mothers, and a second prospective cohort of 926 very-low-birth-weight infants born in 2009 (German Neonatal Network).

Surfactant without intubation in preterm infants with respiratory distress: first multi-center data.

Background: Recently in a report of a single center a method has been described to apply surfactant via a thin endotracheal catheter to very low birth weight infants spontaneously breathing with nasal continuous positive airway pressure. We now analyzed available multicenter data.

Patients And Methods: In a multicenter study investigating genetic risk factors, clinical and outcome data and data of antenatal and postnatal treatment of infants with a birth weight below 1,500 g were prospectively recorded.

Polymorphisms in the Renin-Angiotensin system and outcome of very-low-birthweight infants.

Background: The insertion/deletion polymorphism of the angiotensin-converting enzyme (ACE-ins/del) and the angiotensin II type 1 receptor 1166A/C polymorphism (ATR1166A/C) were reported to be associated with several unfavorable outcome parameters in preterm infants like bronchopulmonary dysplasia, persistent ductus arteriosus and impaired insulin sensitivity.

Objective: To confirm the above-mentioned associations in a large cohort of very-low-birthweight (VLBW) infants.

Method: Clinical data of VLBW infants were prospectively recorded.

Extraabdominal malposition of the gallbladder.

Anomalies of the biliary system are rare. Anomalies of the gallbladder and anomalies of the bile ducts are distinguished. We observed a newborn with a gallbladder in an extraabdominal malposition, an anomaly that has not been previously described.

Limitation of measurements of expiratory tidal volume and expiratory compliance under conditions of endotracheal tube leaks.

Objective: Endotracheal tube leaks (ETTLs) occur in neonates ventilated with uncuffed tubes. Assuming that the influence of ETTLs might be neglected during expiration, only expiratory tidal volume is measured for calculation of expiratory compliance in cases of large ETTLs. However, expiratory ETTL might be substantial.

Very low birth weight infants as a model to study genetic influences on neonatal weight gain.

In a cohort of 829 preterm infants (birth weight below 1500 g) we identified 13 monozygotic, 10 same-sex dizygotic, and 12 same-sex matched singleton pairs. The difference in daily weight gain within pairs was significantly lower in monozygotic twins compared with dizygotic twins or matched singleton pairs. Our data support a strong genetic influence on postnatal growth in preterm infants.

Congenital diaphragmatic hernia, etiology and management, a 10-year analysis of a single center.

Objective: To analyze congenital diaphragmatic hernia (CDH) during a 10-year period at the University of Kiel, from 1995 through 2004, in order to develop a strategy to improve prenatal diagnosis, to be able to consider endoscopical treatment for selected cases and to assess the current postnatal treatment strategies.

Methods: Data were obtained from the fetal medicine ultrasound department, from the birth registry, from the postmortem registry, from the neonatal intensive care unit, from pediatric surgery and from the genetic database. Data were subselected for chromosomes, genetic syndromes, for isolated CDH and for associated anomalies, the lung to head ratio and lung volumes were assessed.

Calculation of intratracheal airway pressure in ventilated neonatal piglets with endotracheal tube leaks.

Objective: In ventilated neonates, only the applied pressure of the ventilator is adjusted and monitored. When an endotracheal tube leaks, intratracheal pressure decreases depending on the size of the endotracheal tube and of the leak. Furthermore, an increase in resistance and/or compliance might delay the increase of intratracheal pressure during inspiration and its decline during expiration.

Correction of compliance and resistance altered by endotracheal tube leaks and non-linear pressure/volume-relationships.

Measurements of lung compliance (C) and resistance (R) are influenced by endotracheal tube leaks (ETTL) as well as non-linear pressure/volume relationships (P/V relationship). To keep C and R reliable, we developed an algorithm to mathematically correct inspiratory and expiratory volume (V) and flow. In this study, a ventilated lung model for non-linear P/V relationship with adjustment of an increasing ETTL was studied.

Correction of compliance and resistance altered by endotracheal tube leaks.

Objective: Measurements of lung compliance and resistance are influenced by endotracheal tube leaks. To keep compliance and resistance reliable, we developed an algorithm to correct inspiratory and expiratory volume and flow mathematically.

Design: Prospective, clinical study.

Detection and correction of endotracheal-tube position in premature neonates.

Due to the short airways in premature children, an accurate position of the endotracheal tube (ETT) is crucial for adequate mechanical ventilation. Verification of ETT-position is done in chest radiographs. However, ETT-position varies substantially with head movement.

Oral mature teratoma containing epididymal tissue in a female neonate.

We describe a female neonate with an oral teratoma showing bone, teeth, and epidermis, but also epididymal (male) tissue. PCR amplification of Y-chromosomal DNA clearly showed male DNA from paraffin-embedded tumour tissue. The girl had a normal female karyotype without abnormalities of the genital organs.

Improvement in respiratory compliance after surfactant therapy evaluated by a new method.

Descriptions of the effects of intratracheally applied surfactant on respiratory system compliance (C(rs)) have been somewhat controversial because the commonly used methods for assessing pulmonary function were designed for a linear pressure/volume (P/V) relation of the respiratory system. In infants with lung disease a linear P/V relation cannot be expected. Therefore, a new method (APVNL) was employed which enabled us to calculate respiratory system compliance (C(rs)) and resistance (R(rs)) based on changes in volume (V).

Homozygous deletion of arginine-173 in the CYP11B2 gene in a girl with congenital hypoaldosteronism. Corticosterone methyloxidase deficiency type II.

The first child of consanguineous parents presented with failure to thrive and feeding problems at age 6 weeks. Important laboratory findings were low plasma sodium and elevated potassium and renin. Salt wasting was caused by an enzymatic defect in the terminal aldosterone biosynthesis.

A new method to analyze lung compliance when pressure-volume relationship is nonlinear.

Changes in dynamic lung compliance during inspiration and expiration cannot be modeled accurately with conventional algorithms. We developed a simple method to analyze pressure-volume (P/V) relationships under condition of nonlinearity (APVNL) and tested it in a lung model with known resistance and nonlinear P/V relationship. In addition, pulmonary mechanics in 22 infants, 11 of them with nonlinear P/V relationships, were analyzed with the new method.

The influence of mode of delivery on hematologic values in the umbilical vein.

A variable white blood cell count without clinical signs of sepsis or hematological disorders is often observed in newborns. The intention of this study was to investigate the effect of mode of delivery on hematologic measurements, especially white blood cell count in the umbilical vein. 121 term newborns were investigated prospectively.

Patient-triggered ventilation: a comparison of tidal volume and chestwall and abdominal motion as trigger signals.

Patient-triggered synchronized ventilation requires reliable and early detection of the infant's inspiratory effort. Several trigger methods have been developed that frequently lack the sensitivity to detect inspiration in small preterm infants (trigger failure), or show a high rate of breaths triggered by artifacts in the respiratory signal (autotrigger). The purpose of this study was to determine the effectiveness of the following trigger signals: abdominal movement sensed by a newly developed induction technique, chestwall motion detected by changes in transthoracic impedance, and tidal volume measured by anemometry at the endotracheal tube connector.

Comparison of umbilical arterial versus umbilical venous blood pH correlated with arterio-venous glucose difference and cardiotocographic score.

The value of clinical parameters and umbilical arterial blood pH as indicator of prenatal hypoxia is disputed. In a prospective study of 86 vaginally delivered full-term infants, cardiotocographic (CTG) findings obtained 0-30 min and 30-60 min before birth were compared to pH values, O2 and CO2 partial pressures and glucose difference in umbilical arterial and venous blood. CTG findings were expressed as a score, higher values indicating fetal hypoxia.

Cloning properties of T lymphocyte subpopulations after treatment with 8-methoxypsoralen and UVA irradiation.

The cloning rate of PHA-stimulated T lymphocytes after treatment with 8-methoxypsoralen plus UVA irradiation described by Wunder and Reischmann (1983) gives a linear dose-effect relationship at low dosages. However, with increasing doses a flattening of the negative gradient occurs. This relationship deviates from the classical exponential curve which can be observed when fibroblasts are treated with mutagens and which is explainable by a 'recovery plateau' at lower dosages.