[Longitudinal physical development of healthy children 0 to 18 years of age. Body length/height, body weight and growth velocity]. / Longitudinale Körperentwicklung gesunder Kinder von 0 bis 18 Jahren. Körperlänge/-höhe, Körpergewicht und Wachstumsgeschwindigkeit.

In addition to the Dortmunder longitudinal growth study we investigated development of height, weight and height velocity in 213 healthy boys and girls 15-18 years old. Number of children decreased in the age group of 17 and 18 years old to 143. The study was performed in a longitudinal way, the measurements were taken in an one year distance. The median height gain in boys between 15 and 18 years amounted to 9.3 cm, in girls to 2.1 cm, respectively. 18 years old boys are 180.1 cm tall, girls 167.9 cm. The median increment of body weight in boys from 15-18 years amounted to 7.3 kg, in girls 4.4 kg, respectively. Median weight in 18 years old boys amounted to 65.2 kg, in girls to 58.0 kg. International comparison with other longitudinal growth studies shows a trend of somewhat higher weight, height and height velocity of the children from our study.

[The effect of osteopenia prevention in very small premature infants on hormonal parameters of calcium metabolism and bone mineralization]. / Der Einfluss der Osteopenie-Prophylaxe bei sehr kleinen Frühgeborenen auf die hormonellen Parameter des Calciumstoffwechsels sowie die Skelettmineralisation.

In 23 very low birth weight infants the influence of mineral supplementation with 0.4 mmol calciumgluconate and 0.2 mmol glucose-1-phosphate/dl human milk on concentrations of 25-OH-D3, parathyroid hormone, calcitonine, calcium, phosphorus and activity of alkaline phosphatase was studied on days 3, 8, 28 and 56. On days 28 and 56 respectively, degree of bone mineralisation was classified. 8 preterm infants received supplementation before day 28, 7 infants after day 28, 8 infants had no supplementation. All preterm infants received beginning with day 7 vitamin D3 1000 IU/day. In all preterms mean concentrations of 25-OH-D3 were normal and increasing with age. Concentrations of parathyroid hormone and calcitonine were first of all increased and decreased with age, especially in supplemented infants. Light metabolic bone disease without fractures occurred in 4 infants of supplemented groups. Non-supplemented group contains 5 infants with severe metabolic bone disease without fractures. Results indicate intact metabolism and secretion of 25-OH-D3, parathyroid hormone and calcitonine. Decrease of calcitonine concentration in mineral supplemented preterms is a reference to a better mineral supply. Mineral supplementation is followed by an increase in bone mineralisation with prevention of severe metabolic bone disease.

[The growth rate of healthy children in the first 16 years: Bonn-Dortmund longitudinal developmental study]. / Die Wachstumsgeschwindigkeit gesunder Kinder in den ersten 16 Lebensjahren: Longitudinale Entwicklungsstudie Bonn-Dortmund.

Standards for supine length/height velocity from birth to 16 years (percentiles, mean and standard deviation) are presented, based on the longitudinal growth studies from Bonn and Dortmund. During the first two years of life growth velocity is twice to three times higher as in the following years. Many things point to the growth velocity during the first two years being of decisive significance for the observed secular acceleration of height. International comparisons with other longitudinal growth studies show a trend of somewhat higher growth velocity of the children from the Bonn and Dortmund studies.

[An interdisciplinary coordinated therapy concept exemplified by the Cornelia de Lange syndrome]. / Ein interdisziplinär koordiniertes Therapiekonzept am Beispiel des Cornelia de Lange-Syndroms.

This is a case-report of a male infant with typical signs of Cornelia de Lange syndrome. Coordination to subtype I or II of the disease is difficult, as somatical and intracerebral dysplasia (partial cerebellar aplasia) are combined. The etio-pathogenetic back-ground and the symptoms of the disorder will be discussed. Finally we point out to a omnidirectional therapeutic concept including several surgical and nonsurgical disciplines with the aim, to make life as easy as possible for these children.

Vitamin B6- and protein concentrations in breast milk from mothers of preterm and term infants.

The vitamin B6 and protein composition of milk obtained during the first 75 days postpartum from 16 mothers delivering preterm and 24 mothers delivering at term was determined. Both groups of mothers had supplemental intake of 5 mg vitamin B6 beginning with the 2nd trimester of gestation but not during lactation. Milk from mothers delivering preterm contained significantly higher concentrations of vitamin B6 and protein than milk from mothers delivering at term. Vitamin B6-protein relationship, however, was significantly lower in milk from mothers delivering preterm than in milk from mothers delivering term. Both, concentrations of vitamin B6 and protein, and vitamin B6-protein ratio decreased with increasing time of lactation. Supplemental vitamin B6 intake during pregnancy is made responsible for this phenomenon. Milk of mothers with preterm infants is adequate to meet the maintainance requirements for vitamin B6 and protein for a premature infant.

[Development of body surface area during childhood (author's transl)]. / Wachstum der Körperoberfläche während des Kindesalters.

Using the formula of Haycock et al. development of body surface area was calculated in children according to the results of the Dortmund longitudinal growth study. Form birth to the 16th year of life the increase in mean body surface area amounts to 1.49 m2 in boys and 1.39 m2 in girls. Development of body surface area does not follow a Gaussian distribution. The presentation of the development of body surface area as percentiles allow a clearer and an easier application for the clinical use.

[Longitudinal data of physical growth of healthy children. Lengths of trunk, hand, forearm, upper arm, whole arm, lower leg, thigh and whole leg of children aged 2,5 to 15 years. (author's transl)]. / Longitudinale Längenentwicklung von Rumpf, Hand, Unterarm, Oberarm, Gesamtarm, Unterschenkel, Oberschenkel und Gesamtbein von gesunden 2,5- bis 15jährigen Kindern.

From 1968-78 a longitudinal study was performed concerning development of lengths of trunk, hand, forearm, upper arm, whole arm, lower leg, thigh and whole leg in 709 healthy boys and 711 girls aged 2,5 to 15 years. In boys the mean increase in lengths of trunk amounted to 17.7 cm, of hand to 8.1 cm, of forearm to 12.2 cm, of upper arm to 16.1 cm, of whole arm to 36.8 cm of lower leg to 21.5 cm, of thigh to 27.3 cm, and of whole leg to 54.0 cm. The corresponding lengths in girls amounted in 16.9 cm, 7.2 cm, 11.0 cm, 14.0 cm, 32.6 cm, 18.7 cm, 24.5 cm, and 46.4 cm. Lengths investigated increase almost linearly between 3 and 11 years of age both in boys and girls. Beginning with 12 years boys have an increased development of all lengths when compared with girls.

[Longitudinal data of physical growth of healthy children. IV. Shoulder breadth, thorax breadth, thorax depth, hand breadth, 2 pelvic and epicondylic breadths of children aged 2.5 to 15 years (author's transl)]. / Longitudinale Körperentwicklung gesunder Kinder. IV. Schulterbreite, Brustbreite, Brusttiefe, Handbreite, Beckenund Epicondylenbreiten von Kindern im Alter von 2,5--15 Jahren.

From 1968--1978 a longitudinal study was performed concerning development of shoulder and thorax breadths, thorax depth, breadths of hand, pelvis, humeral and femoral epicondylus in 709 boys and 711 girls aged 2.5 to 15 years. During time studied mean increases in boys amounted in shoulder breadth to 15.1 cm, in thorax breadth to 9.8 cm, in thorax depth to 6.6 cm, in hand breadth to 3.1 cm, in breadths of pelvis I to 10.9 cm, of pelvis II to 8.5 cm, in breadth of humeral epicondylus 2.5 cm and of femoral epicondylus 3.5 cm. The corresponding data in girls amounted to 14.0 cm, 8.0 cm 4.8 cm, 2.5 cm, 11.0 cm, 8.0 cm, 2.0 cm and 2.9 cm. The parameter measured developed both in boys and girls almost linearly until year 12. Beginning with year 13, development of breadths increased in boys are remained unchanged in girls. Development of breadth in boys was always increased compared with girls except pelvic breadth I.

[Longitudinal data of physical growth of healthy children. V. Acromial, radial, styleoideal, daktylion, ileospinal, tibial and medial malleolus heights of children aged 2.5 to 15 years (author's transl)]. / Longitudinale Körperentwicklung gesunder Kinder. V. Akromial-, Radial-, Stylion-, Daktylion-, Ileospinal-, Tibial- und Malleolus medialis-Höhen von Kindern im Alter von2,5 bis 15 Jahren.

From 1968--1978 a longitudinal study was performed concerning development of acromial, radial, styleoideal, daktylion, ileospinal, tibial and medial malleolus heights in 709 boys and 711 girls aged 2.5 to 15 years. During time studied, mean increases in boys amounted in acromial height to 70.0 cm, in radial height to 53.8 cm, in styleoideal height to 41.5 cm, in daktylion height to 33.4 cm in ileospinal height to 52.0 cm, in tibial height to 25.4 cm and in medial malleolus height to 3.8 cm. Corresponding data in girls amounted to 62.8 cm, 49.3 cm, 42.4 cm, 31.2 cm, 46,7 cm, 22.4 and 3.2 cm. Boys had a more intensive development of heights than girls except for styleoideal height. The heights measured developed almost linearly in boys and girls 4 to 10 years old. Development of heights decreased in 11 and 12 years old boys and increased again with year 13. In girls, intensity of growth decreased beginning with year 13.

[Diagnosis of overnutrition and overweight. A new somatogram (author's transl)]. / Zur Diagnostik von Uberernährung und Ubergewicht.

From 1968-1978 weight, height and thickness of triceps-, subscapular-, and suprailiacal skinfolds were longitudinally investigated in 1593 healthy children. Thickness of the three skinfolds measured was indicated as sum. Weight and sum of skinfold thickness were related to height and represented in form of a somatogram. Development of body weight and skinfold thickness does not follow a gaussian distribution. Therefore it was necessary to express the 2-sigma deviation asymmetrically. The somatogram represents the physical development of healthy infants and children in West Germany. The combination of a height/weight/skinfold thickness somatogram permits to differentiate between overweight and overnutrition.

[Longitudinal data of blood pressure and pulse frequency during childhood (author's transl)]. / Longitudinale Entwicklung von Blutdruck und Pulsfrequenz während des Kindesalters.

From 1968-1980 the development of blood pressure and pulse frequency in 221 healthy boys and 230 healthy girls aged 2-16 years was studied longitudinally. An automatic blood pressure device recording on a paper tape pulse frequence as well was used. Systolic readings are taken at the first appearance, diastolic readings at the disappearance of the Korotkoff sounds. A steady increase of the systolic, and to a lesser extent, of the diastolic pressure can be observed. Boys have a more pronouned increase of systolic pressure than girls. From year 2-16 the 50th percentile increases from 90 mm Hg to 128 mm Hg in boys and from 92 mmHg to 116 mm Hg in girls. The 50th percentile of diastolic pressure increases from 61 to 66 mm Hg in boys and 65 to 71 mm Hg in girls. Pulse frequency of boys is comparable to that of girls. The 50th percentile decreases from 100 to 75 beats. Increasing age is paralleled by decreasing pulse frequency.

Activity of red cell glutamic oxaloacetic transaminase in children suffering from disturbed motion.

Vitamin B6 status was investigated in 37 children suffering from disturbed motion and in 25 healthy children by mean of determination of activity of red cell glutamic oxaloacetic transaminase. 7 out of 37 patients were treated with antiepileptic drugs. Patients had a biochemical vitamin B6 deficiency when compared with controls. There was no significant difference in the degree of the vitamin B6 deficiency between patients with and without antiepileptic treatment. The biochemical vitamin B6 deficiency seems to be due to a decreased nutrient intake in patients with disturbed motion.

[Longitudinal data of physical growth of healthy children. II. Height, weight, skinfold thickness of children aged 1.5--16 years (author's transl)]. / Longitudinale Körperentwicklung gesunder Kinder. II. Grösse, Gewicht, Hautfettfalten von Kindern im Alter von 1,5 bis 16 Jahren.

From 1968--1978 a longitudinal study was performed concerning development of height, weight and skinfold thickness in 709 boys and 711 girls 1.5--16 years old. Increase in height during time studied amounted to 92 cm in boys and 82 cm in girls. Mean increases in weight amounted to 49.3 kg and 41.2 kg respectively. Boys had highest increase in growth from 13 to 15 years, girls from 11 to 13 years. Skinfold has been thicker in girls than in boys. Triceps Skinfolds had been ped wave-like in both sexes. Following an unchanged decreased phase, the skinfolds remaining developed its thickness constantly. The phase of stagnation paralleled time of highest increase in growth.

[Longitudinal data of physical growth of healthy children. III. Circumferences of thorax, upper arm, thigh and calf of children aged 2 to 15 years (author's transl)]. / Longitudinale Körperentwicklung gesunder Kinder. III. Burst-, Oberarm-, Oberschenkel- und Wadenumfang von Kindern im Alter von 2,0 bis 15 Jahren.

From 1968--1978 a longitudinal study was performed concerning development of thorax, upper arm, thigh and calf circumferences in 709 boys and 711 girls 2--15 years old. In boys the mean increase in thoracic circumference amounted to 32.9 cm, in upper are circumference to 8.3 cm, in thigh circumference to 20.6 cm and in calf circumference to 13.0 cm. The corresponding circumferences in girls amounted to 30 cm, 7.9 cm, 22.4 cm and 12.7 cm. In boys the circumferences developed almost linearly until year 15. Girls had the same linear development until year 13. Between years 14 and 15 girls had in increased development of all circumferences studied.

[Longitudinal growth data of development of weight, height, skinfold thickness, head-, chest- and abdominal circumferences in healthy children (author's transl)]. / Longitudinale Entwicklung von Körpergewicht, Körperlänge, Hautfettfaltendicke, Kopf-, Brust- und Bauchumfang bei gesunden Kindern. I. Säuglingsalter.

From 1974--1977 anthropometric investigations were performed in 173 healthy infants during the first year of life. Weight, height, skinfold thickness, head-, chest-, and abdominal circumferences had been measured as parameters for growth. Birth weight increased ceased threefold on 12th month in males only. There is no difference in the increase of height in males and females. Width of skinfold thickness increases rapidly until month 5, except abdominal skinfold. A radual decrease follows thereafter. The difference in decreasing velocity of skinfold thickness indicates changes in distribution of subcutaneous fat tissue during infancy. Growth of head-, chest-, and abdominal circumferences of males are similar to that of females.

[Concentrations of hemoglobin, hematocrit and serum iron in healthy infants and children aged 1 month to 16 years (author's transl)]. / Konzentrationen von Hämoglobin, Hämatokrit und Serumeisen bei gesunden Säuglingen und Kindern im Alter von 1 Monat bis 16 Jahren.

10,126 determinations of hemoglobin concentration, 10,055 of hematocrit and 4,420 of serum iron were performed in 7,753 infants and children aged 1 month to 16 years to give normal values for this period in a large town. Both, concentrations of hemoglobin and hematocrit decreased during the 3rd and 8th month. The first decrease in serum iron level appeared later in month 4, the time of the second fall was identical with that of hemoglobin and hematocrit. In females, a third decrease of iron levels appeared with 13 years. Between the 2nd and 8th year of life, a period of instable iron nutriture became apparent. Concentrations of hemoglobin, hematocrit as well as serum iron depend on age. 0.4% of males and females showed a deficient concentration of hemoglobin. 2.9% of males and 1.1% of females had a low, nonacceptable hemoglobin value. Iron deficiency occurred in 8.5% of males and in 8.3% of females. It is probable that the number of children with a pre-latent or latent iron deficiency is much higher.

[The obese child and its nutrition]. / Das dicke Kind und seine Ernähung.

Obesity in infancy is accompanied by an increase in number and size of adipose cells. These changes in adipose tissue are due to a false relation of nutrient intake to physical activity. Obesity is not caused by an increased nutrient intake alone, since our long-term investigations have shown obese children to take in 300 kcal per day more than normal children. Fat intake of obese children is slightly enhanced. An exact method for estimation of obesity is the measurement of triceps, subscapular and suprailiacal skinfold. With this method used in 12,000 children during the period 1970--1977 we could detect a frequency of obesity of 15% in children 3--6 years old and of 25% in children aged 6--14 years. Extreme obesity is recommended for treatment in a hospital. The moderate forms of obesity should be treated by the paediatrician with a reduction of calories, clear recommendations of the nutrient amount and education to regularity.

Biochemical assessment of thiamine nutrition in childhood.

The activity of red cell transketolase and TPP-effect were determined in 1028 infants and children, aged 1 month to 14 years, using a micromethod. All the children were healthy and without evidence of malnutrition. Transketolase activity decreased in the second year of life, followed by a constant increase up to the 6th year. Activity did not change in the next four years, then a steady decrease occurred. TPP-effect was not as stable as transketolase activity, and decreased significantly from years 3 to 5 and increased significantly from years 5 to 7. Beginning with year 10, TPP-effect decreased gradually. 6.6% of all children investigated had marginally deficient TPP-effects and 1.3% were biochemically deficient without clinical signs of avitaminosis. A group of 37 adults had transketolase activities and TPP-effect comparable to those of the 13 year-olds. Effect appeared to be marginal in 5.4% and deficient in 2.7%.

[Remarks concerning the treatment of hyperkinetic children with the so-called "diet poor in phosphate (author's transl)]. / Bemerkungen zu einer sogenannten phosphatarmen Diät für Kinder mit Hyperkinetischem Syndrom.

Compared with normal diets, the so-called "diet poor in phosphate" is really not poor in phosphate. Phosphate intake amounts only to 3% when ingested as food stuffs with phosphate additions permitted by law. The so-called "diet poor in phosphate" is poor in carbohydrates, dietary fiber and ascorbic acid. Animal proteins and fats, however, are high in this diet there by increasing the cholesterol intake. We cannot recommend this so-called "diet poor in phosphate" for children.