Changes in electrophysiological static and dynamic human brain functional architecture from childhood to late adulthood.

This magnetoencephalography study aimed at characterizing age-related changes in resting-state functional brain organization from mid-childhood to late adulthood. We investigated neuromagnetic brain activity at rest in 105 participants divided into three age groups: children (6-9 years), young adults (18-34 years) and healthy elders (53-78 years). The effects of age on static resting-state functional brain integration were assessed using band-limited power envelope correlation, whereas those on transient functional brain dynamics were disclosed using hidden Markov modeling of power envelope activity. Brain development from childhood to adulthood came with (1) a strengthening of functional integration within and between resting-state networks and (2) an increased temporal stability of transient (100-300 ms lifetime) and recurrent states of network activation or deactivation mainly encompassing lateral or medial associative neocortical areas. Healthy aging was characterized by decreased static resting-state functional integration and dynamic stability within the primary visual network. These results based on electrophysiological measurements free of neurovascular biases suggest that functional brain integration mainly evolves during brain development, with limited changes in healthy aging. These novel electrophysiological insights into human brain functional architecture across the lifespan pave the way for future clinical studies investigating how brain disorders affect brain development or healthy aging.

[Effect of birth weight on hip maturation in the newborn infant]. / Der Einfluss des Geburtsgewichts auf die Hüftreifung des Neugeborenen.

In 2018 consecutive newborn ultrasound examination of the hip was performed according to the method of Graf within the first 14 days of life (average 4th day). Typ IIa was seen as normal in newborn child. Birth weight was classified according to standards of Lubchenco and Hohenauer. Newborn with high birth weight (LGA) revealed an incidence of CDH (Typ IIc according to Graf or worse) nearly twice as high as in normal weighted newborn (AGA) (6.11% vs 3.51% [Lubchenco] and 7.95 vs 3.09 [Hohenauer]). Even in children with birth weight between 75th and 90th percentile we found a CDH incidence of 5.54%. Ultrasound examination of the hip is suggested in newborn children with high birth weight because of a higher risk for development of a CDH. Other risk-factors like breech position or of CDH.

Blood glucose determinations in newborns: four instruments compared.

Four portable analyzers, HemoCue B-Glucose (I), Accu-Check III (II), One-touch II (III), and Glucometer Elite (IV), with different measuring principles were tested for their suitability for measuring blood glucose in neonates. Precision of all instruments is satisfactory. In the analysis of capillary blood from newborns, two instruments show an excellent accuracy; however, the scatter of the results for instrument (II) is about 1.6 times greater than for instrument (I). The inaccuracy of instruments (III) and (IV) is not acceptable from a clinical point of view. All devices show an influence of hematocrit, the magnitude of which varies between 5% (I) and 12% (III) for every 10% change of hematocrit. Instruments II and IV show that temperature has a marked influence on the readings; the same is true for oxygen in instrument IV. In conclusion, only instrument (I) has met the requirements of accurate and precise blood glucose determinations in neonates.

[Is reliable blood glucose determination in the newborn infant possible with the small reflectance meter Reflolux S?]. / Ist eine zuverlässige Blutglucosebestimmung beim Neugeborenen mit dem Kleinreflektometer Reflolux S möglich?

With the reflectance meter Reflolux S (Accucheck III) high as well as low blood glucose levels can be determined with excellent precision irrespective of the sample's hematocrit value. Within the range from 20-50 mg/dl we found an average deviation from the expected value of less than 2 mg/dl; in selected samples, however, a difference of up to 10 mg/dl was recorded. The scatter can be explained by the influence of hematocrit values on the results. An increase of 10% in hematocrit lowered the measured glucose value by approximately 10%. At glucose concentrations below 40 mg/dl and in the presence of high resp. low hematocrit values any results obtained with this glucose meter will only have screening character; they should be re-run using an established method.

[Diaplacental transmission of varicella zoster virus antibodies after chickenpox at the time of birth]. / Diaplazentare Ubertragung von Varizella-Zoster Virus-Antikörpern nach Windpocken am Geburtstermin.

A pregnant woman with post-term birth developed a varicella rash on the day, when birth was to be initiated. The date was then postponed, until varicella zoster virus (VZV) IgG-antibodies could be proved in the mother, so as to allow the child to achieve an adequate diaplacental passive immunisation. Cesarean section was performed on the 7th day after the rash, but a comparison of the child's blood (from the umbilical cord) with the mother's blood showed, that the VZV antibodies developed by the mother during this time were only present in a tenfold reduced amount in the child. Antibodies to herpes simplex virus, already present in the mother's blood before the VZV infection, also increased because of the close relationship of the virus to VZV. Similar to the VZV antibodies, these antibodies did not increase in the baby as in the mother. Our results show that maternal antibodies are not transferred rapidly to the baby, and therefore it seems reasonable, that in the case of chickenpox at the time of delivery, the birth should be delayed, not only until seroconversion in the mother's blood, but - if possible - a few days longer.

[Reference values for IgE concentration in serum of children. Method: ImmunoCAP-FEIA system]. / Referenzbereiche für die IgE-Konzentration im Serum von Kindern. Methode: ImmunoCAP-FEIA-System.

UNLABELLED: Age specific IgE reference values were determined in serum of 224 children by the aid of the ImmunoCAP fluorescence enzyme immunoassay method. RESULTS: Cord blood: less than 0.35 kU/l; Till 0.5 year: less than 2.0 kU/l; 0.5-2 years: up to 3.8 kU/l; 2-5 years: up to 16.0 kU/l; 5-8 years: up to 26.2 kU/l; 8-12 years: up to 34.6 kU/l; 12-16 years: up to 26.3 kU/l. These IgE reference values can be used for the diagnosis of pathological elevated IgE concentrations in serum of children.

Whole-body cesium 137 activity up to 4 years after the Chernobyl reactor accident in premature newborns, newborns, infants, and children.

Cesium 137 activity was measured after the Chernobyl incident in a whole-body radiation counter (4-pi-scintillation counter) in 85 premature and mature newborns (group 1), 174 infants and young children up to 2 11/12 years (group 2), and 48 children between 3 and 8 years (group 3) from Bonn (Germany) and surroundings. In 1987 the mean level of radioactivity in group 2, at 3.7 Bq/kg body weight corresponding to a mean radiation exposure of 11 muSv/y, was lower than that of group 1 (5.8 Bq/kg, 17 muSv/y) and 3 (9.4 Bq/kg, 28 muSv/y). Up to 1990 the values of all groups revealed a continuous decrease. The latest measurements showed mean values of 0.5 Bq/kg (1.5 muSv/y) in group 1, 0.6 Bq/kg (1.8 muSv/y) in group 2, and 0.8 Bq/kg (2.4 muSv/y) in group 3. A comparison with present cesium 137 values and determinations of the end of the 1950s and beginning of 1960s, both in adults, showed good agreement. The effective dose-equivalent rates amounted to less than 1% of that from natural radiation exposure. These levels should present no teratogenic risks to the population studied and, while there are theoretical mutagenic risks, the dose is so low that no increase in measurable mutagenic effects should be observed.

[The course of pregnancy and teratogenicity of antiepileptic agents in 66 patients with epilepsy]. / Untersuchungen zum Schwangerschaftsverlauf und zur Teratogenität der Antiepileptika bei 66 Epilepsie-Patientinnen.

We report on 79 pregnancies in 66 female outpatients with epilepsy. An increase of seizure frequency was significantly more frequent in complex partial seizures than in grand mal seizures and in absences. The reason for these disparities are not clear. In most patients a raised frequency of seizures during pregnancy decreased again after delivery. Carbamazepine was the antiepileptic drug prescribed most frequently followed by valproic acid. The course of the blood levels of carbamazepine and valproic acid was nonuniform during pregnancy. Total concentrations of carbamazepine in cord blood were on average 84.5% of those in maternal blood (n = 22). Valproic acid blood levels were on average 183% of those in maternal blood (n = 15). It is still unclear whether these differences are clinically relevant. During the last weeks of pregnancy we found an increase of the free fraction of carbamazepine and valproic acid. Simultaneously the total protein concentration decreased. Until now these findings are without clinical relevance. The course of labor did not differ from normal population concerning the ratios of spontaneous labor, cesarean section and delivery by forceps. Miscarriage and perinatal mortality were 2.7% each and outnumbered the risk in the general population. In 42.8% of the neonates one to three perinatal complications were observed. The ratio of perinatal complications is not different between patients with monotherapy and combined therapy respectively. There was a tendency to lower values of length, weight and head circumference in the male neonates but not in the female neonates. The risk of minor malformations was 26%, the risk of major malformations was 14% (including one case of suspected malformation) without a discernible correlation with a specific antiepileptic drug.

[Trisomy 22--prenatal findings in various developmental stages]. / Trisomie 22--Pränatale Befunde unterschiedlicher Entwicklungsstadien.

Four cases of trisomy 22 in different stages of pregnancy are reported, one of them showing a mosaicism. The diagnosis was made in three of the observations during the first trimenon, in one in the third trimenon. A typical pattern of malformations of developmental retardation could be demonstrated in the embryonic as well as in the extraembryonic tissues. Our findings confirm the different frequency of the single chromosome abnormality in the various stages of development in pregnancy.

Diastrophic dysplasia: a specific prenatal diagnosis by ultrasound.

In a pregnant woman without increased genetic risk, the presence of distrophic dysplasia of the fetus was diagnosed sonographically at 31 weeks' gestation and definitively distinguished from other skeletal dysplasias. In all prenatal diagnosis of diastrophic dysplasia reported so far, this autosomal recessive congenital condition had occurred in the family's previous children and this made the diagnoses of fetal diastrophic dysplasia easier. The reported case was diagnosed due to evidence of an extreme shortening of all long bones of the extremities associated with other skeletal deformities which, taken as a whole, are typical of this syndrome: micrognathia, cervical kyphosis, persistent extension limitation in elbow and knee joints, club feet, ulnar diviation of hands, shortened phalanges, and, in particular, abduction of thumbs ('hitchhiker thumbs') and big toes.

[Determination of bilirubin in capillary plasma by a direct photometric method (DPM, bilirubinometer) and the chemical determination of bilirubin in the bilirubin determination (2,5-dichlorophenyldiazonium method) in serum of venous blood samples]. / Bilirubinbestimmungen mit einer direkten photometrischen Methode im Kapillarplasma (DPM, Bilirubinometer) und mit einer chemischen Bilirubinbestimmung (DPD-Methode) im Serum von venösen Blutproben.

The determination of bilirubin in serum was performed by the 2.5-dichlorphenyldiazonium method (DPD) and in capillary plasma by the direct photometric method (DPM). Both methods showed a good precision and accuracy. The investigation was carried out in 135 samples with a bilirubin concentration up to 25 mg/dl. The comparison of the two methods in 62 samples with a bilirubin concentration up to 10 mg/dl showed a correlation coefficient of r = 0.862 and in 73 samples with a bilirubin concentration between 10 and 25 mg/dl a correlation coefficient of r = 0.893. In 29 cases (21.5%) we found differences between the two methods of 1.5-4.0 mg/dl. Most of them were in the critical higher range. Discussion of the DPD and DPM methods.

[Nonimmunologic hydrops fetalis--a review of 31 cases]. / Nicht-immunologischer Hydrops Fetalis--eine Ubersicht über 31 Fälle.

Non-immunologic hydrops fetalis-a review of 31 cases: 31 Patients with non-immunologic hydrops fetalis (NIHF) seen between 1984 and 1987 are described. 13 infants survived. The infants with major congenital malformations and connatal infections died. In 8 of the patients who died a cause for NIHF could not be identified. 10 of the survivors presented chylous ascites and/or chylothorax without major congenital anomalies. 2 infants had fetal tachyarrhythmia and 1 patient showed severe anemia due to fetomaternal hemorrhage.

[One year after Chernobyl. Cesium-137 levels in premature, newborn and nursing infants and in younger and older children of Bonn and environs]. / Ein Jahr nach Tschernobyl. Cäsium-137-Gehalt von Frühgeborenen, Neugeborenen, Säuglingen, Kleinkindern und Kindern aus Bonn und Umgebung.

From May to August 1987, 137Cs activity was measured in a total-body counter (4 pi counter) in 33 premature and mature newborns (group I), 40 infants and young children up to 2 4/12 years of age (group II), and 15 children between 3 and 6 8/12 years (group III), all from Bonn or its environs. The mean of measurements in group II, at 3.7 Bq/kg body-weight, was lower than that of group I (5.8 Bq) and III (9.4 Bq). Mean radiation exposure, calculated from these data, was 1.7 mrem/a for group I, 1.1 mrem/a for group II, and 2.8 mrem/a for group III. A comparison with present Cs values in adults and measurements made at the end of the 1950's and beginning of 60's showed good agreement. There were no significant differences, as regards Cs activity, between newborns or infants who had been formula-fed or breast-fed. The measured radiation exposure of the three groups is about 1% of natural radiation exposure. Thus, present-day results indicate that there will be no damage to health outside the natural scatter.

Hydrops fetalis as an indication for prenatal chromosome analysis with the example of the diagnosis of a duplication 15q11 and 17q25 due to a familial translocation 15/17.

A child with a combined trisomy 15q11 and 17q25 shows the typical phenotype of partial duplication 17q. The male fetus developed in the 3rd trimenon of pregnancy a nonimmune hydrops fetalis (NIHF). Analysing the chromosomes of 54 cases with NIHF during the 2nd and 3rd trimenon and after birth we found chromosomal abnormalities in 33% of them.

Listeriosis: a cause of non-immune hydrops fetalis.

A case of prenatally diagnosed non-immune hydrops fetalis, that was later shown to be caused by listeriosis, is presented, and the clinical course, as well as the appropriate diagnostic and therapeutic procedures are described. We conclude, that listeriosis should be excluded, whenever a non-immune hydrops fetalis is associated with septicemia, influenza-like illness and fever of unknown origin.

Protein binding of valproic acid in maternal and umbilical cord serum.

The serum valproic acid levels of 18 maternity patients at the time of delivery were compared with the valproic acid levels in the umbilical cord serum. The levels in the umbilical cord serum were 1.1-4.6 times higher than those in the maternal serum, with a mean value of 1.38. One explanation for this difference apparently is an increased protein binding of valproic acid in the infant's serum. Protein binding was determined in nine patients, in six by equilibrium dialysis and in three by ultrafiltration. The median value of the free fraction of valproic acid was 9.1% (range, 5.8-16.4%) in the umbilical cord serum (equilibrium dialysis) and 15% (range, 12.7-35.3%) in the maternal serum. The difference between the infant and the maternal serum is significant.

Carbamazepine levels in breast milk.

The carbamazepine (CBZ) concentration of breast milk was determined in 19 epileptic patients of whom 13 were receiving CBZ monotherapy. Two lactation periods under CBZ monotherapy were followed in 2 of these 13 patients. The CBZ concentration of the breast milk was 36.4% of the maternal CBZ serum level (mean value). The correlation coefficient was 0.44; the regression line follows the equation y = 0.12X + 1.63. The CBZ concentration was measured in a total of 50 milk samples during the lactation period (cases of monotherapy plus combination therapy). The CBZ concentration ranged from 1 to 4.8 micrograms/ml (mean 2.5 micrograms/ml). The free CBZ concentration in the maternal serum was measured in four patients. The correlation between CBZ in the breast milk and free CBZ levels was 1.6 to 1.8. The ratio of carbamazepine-epoxide (ECBZ) in the milk to ECBZ determined in serum was 0.53. Continuing galactorrhea after delivery was observed in one patient. The CBZ and ECBZ levels determined 3.5 years after delivery were higher in the milk than in the serum. The observations of breast-fed and non-breast-fed children whose mothers were on CBZ monotherapy disclosed poor suckling in only 1 of 15 infants.

Vitamin D, 25-hydroxy-vitamin D and 1,25-dihydroxy-vitamin D in cow's milk, infant formulas and breast milk during different stages of lactation.

Vitamin D and its metabolites were determined in cow's milk, infant formulas, and colostrum, transitional and mature breast milk by specific protein-binding assays following HPLC (high-pressure liquid chromatography). Cow's milk contains (mean +/- SEM) 50.4 +/- 4.1 pg/ml vitamin D (n = 10), 499 +/- 47 pg/ml 25-OH D (n = 10) and 9.7 +/- 1.0 pg/ml 1,25 (OH)2D (n = 3). 86.6% of the added vitamin D3 was recovered from infant formulas. The mean content (mean +/- SEM) of 25-OH D and 1,25(OH)2D of infant formulas are 299 +/- 35 pg/ml and 5.4 +/- 0.9 pg/ml (n = 9), respectively. Vitamin D concentration of colostrum and mature breast milk is 122 +/- 3.4 pg/ml (n = 7, mean +/- SEM) and 38 +/- 3.3 pg/ml (n = 9) respectively; the 25-OH D content increases from 294 +/- 50.6 pg/ml (n = 10) to 845 +/- 190 pg/ml (n = 14) during lactation. The increase of 1,25-(OH)2D from early to mature breast milk (3.2 +/- 0.6 pg/ml, n = 8 versus 5.3 +/- 0.7 pg/ml, n = 20) is still statistically significant.