[Judo in a training group for children with asthma]. / Judosport in einer Trainingsgruppe mit asthmakranken Kindern.

15 asthmatics of 7-14 years of age were trained in a special judo training group together with healthy children. The step-like training programme was composed in such a manner that an exercise-induced bronchospasm was kept as low as possible whereas the coordination, flexibility, physical and psychical resistance were improved. By means of adapted lung function tests the children were controlled, the aim was not so much to prove an improvement of functional values but rather to avoid injuries. Reactions confirmed by means of the sensitive flow-volume curve method did not present any clinical problems. Exercise-induced reactions occurred most frequently, if at all, after a warming-up phase and in the middle of the 14 training weeks. Both at the end of every lesson and at the end of the whole training course the number and internity of reactions decreased. Children suffering from exercise-induced asthma could be trained by means of judo sport without any problems. A combatant sport, such as judo, is particularly qualified for the improvement of motivation, coordination, dexterity and integration into the community of healthy children to increase self-confidence. Asthma sport groups are a medical and paedagogical necessity.

[Findings of combined ventilation/perfusion scintigraphy in children with abnormalities of the bronchi, the lung and lung blood vessels]. / Befunde der kombinierten Ventilations-/Perfusionsszintigraphie bei Kindern mit Fehlbildungen der Bronchien, der Lungen und Lungengefässe.

Combined ventilation/perfusion scintigraphy with 133Xe/99mTc-HAM was performed within the framework of bronchological diagnostics in 38 children suffering from malformations of the bronchi, lungs and pulmonary vessels, and in 9 children after surgery of hernia of the diaphragm. The findings in stenoses, cysts in the bronchial system and in children with pulmonary vessel malformations, in one child with pulmonary agenesia and in a few other malformations, are presented. The significance of these findings in bronchological diagnosis in case of pulmonary malformations or clinical follow-up is discussed. Combined ventilation/perfusion scintigraphy is a valuable contribution to preliminary diagnosis and in follow-up of children with pulmonary malformations.

[The significance of the flow-volume curve in pediatric lung diseases]. / Zur Bedeutung der Flussvolumenkurve in der pädiatrischen Pulmologie.

Even slight obstructions in small airways are detectable by means of the flow-volume curve. Therefore this method is to recommend for early diagnosis and especially in infancy. Advantages were demonstrable at the examination of different groups of asthmatics and in children with cystic fibrosis. The great sensitivity of the flow values was also shown at the bronchospasmolytic test and for provocation tests particularly. The flow-volume curve is an important routine method in pediatric pulmonology to determine the dimension and location of ventilation disorders and for follow-up studies and therapy supervision.

[Value of bronchography in childhood with special reference to nuclear medicine preliminary examinations]. / Stellenwert der Bronchographie im Kindesalter unter besonderer Berücksichtigung nuklearmedizinischer Vorfelduntersuchungen.

One month to 16 years old 288 children suffering from recurrent and chronic bronchitis, asthma, cystic fibrosis, malformations and various other lung diseases have been undergone 133Xe-Gas/99mTc-HAM lung scintigraphy. By means of results and taking in consideration scintigraphic findings the strategy of bronchographic indication is laid open being of higher load for the children based on anaesthesia and x-ray. Thus the number of bronchographs could be reduced from 47 (1984) via 33 (1985) to 22 (1986) by means of lung-scintigraphic imaging.

[Evaluation of free walking as a provocation method for detection of nonspecific bronchial hyperreactivity in children]. / Bewertung des freien Laufens als Provokationsmethode zum Nachweis einer unspezifischen bronchialen Hyperreaktivität bei Kindern.

The bronchial hyperreactivity alone does not stand for illness but it is typical of asthma. Nonspecific tests are on a low level of standardization and the results of various research groups are difficult to compare. We used the free running provocation test compared with the inhalation test of acetylcholine in a routine lung function laboratory. Using the flow-volume curve both methods were of a comparable value although not absolute equal. Running-provocation seems to be especially qualified for the ascertainment of exercise-induced bronchospasm. A preexisting obstruction more often led to a positive result with increased reaction. The MEF values on low level of FVC proved to be especially sensitive. Free-running using the flow-volume curve for evaluation of ventilation is a cheap, noninvasive, natural, and in our opinion qualified method for the estimation of nonspecific bronchial hyperreactivity.

[Electron microscopy studies of cilia of the bronchial tree in children with chronic bronchopulmonary diseases]. / Elektronenmikroskopische Untersuchungen der Zilien des Bronchialbaumes von Kindern mit chronischen bronchopulmonalen Erkrankungen.

The results of an ultrastructural analysis of cilia in 30 children at the age of 11 month to 16 years are presented. Children with marked symptoms of chronic bronchitis were consciously chosen for examination. One group of 15 children was suffering from chronic bronchitis with bronchiectases. No bronchiectasis was found in the second group of 15 children with chronic bronchitis. Specific changes were more evident in the first group, whereas nonspecific changes were of equal frequency in both groups. Only in 3 patients of group I generalized specific defects could be demonstrated. In these cases mucociliary clearance was nearly not present. Ultrastructural changes of cilia in children with chronic nonspecific lung diseases enclose a wide spectrum. Compared to it generalized structural defects are rare and only in 3 cases of our study demonstrable (negative selection of a bronchological centre).

[What is established in the immotile cilia syndrome?]. / Was ist gesichert beim Syndrom dysmotiler Zilien?

For the first time in 1975 ultrastructural defects of the sperm tail and the cilia of the respiratory tract were recognized as causing male sterility and chronic bronchitis. A spectrum of ultrastructural defects leading to a restricted mucociliary clearance and chronic bronchitis was found by further investigations. Whereas genetically determined primary structural defects appear generally, secondary ciliary changes caused by chronic infections are found sporadically and not bound to a fixed pattern. Congenital and acquired specific ciliary alterations in the tubulin-dynein-system should be distinguished from nonspecific acquired alterations. A summary of the presently known ultrastructural changes is illustrated by findings of the authors.

[Therapy of chronic bronchial foreign bodies in children (author's transl)]. / Zur Therapie chronischer Bronchialfremdkörper bei Kindern.

During infancy bronchoscopic removal of a foreign body firmly embedded in the granulation tissue sometimes causes considerable difficulties so that surgical procedures (bronchotomy) must be envisaged. On the basis of 4 observations, the distinct influence of daily prednisolone inhalations (25 mg of prednisolone) and antibiotic therapy on the retrogression of endobronchial granulation tissue has been proved: resulting in a spontaneous expectoration of the foreign bodies or in enabling the bronchoscopic removal of the foreign bodies. If chronic foreign bodies cannot be removed immediately and especially before undertaking surgical measures, treatment by prednisolone inhalation should be tried.

[Fibre optic bronchoscopy in children (author's transl)]. / Einsatz des Broncho-Fiberskops in der Kinderbronchologie.

Since 1974 the authors have used fibre optics of Olympus, Tokyo, particular the models BF Type 4B and BF Type 3A applicable for children. Even in children, tube bronchoscopy can not at all be replaced by fibre optic bronchoscopy. By fibre optic bronchoscopy diagnostics may by improved considerably. Laryngotracheoscopy proved to be of special advantage in newborns with the sign of stridor. Fibre optic bronchoscopy should be used as a supplementary procedure in bronchological centres for children.

[Bacteriological examinations of bronchial secretion in children with non-specific bronchopulmonary disease (author's transl)]. / Bakteriologische Untersuchungen des Bronchialsekrets von Kindern mit unspezifischen bronchopulmonalen Erkrankungen

One thousand specimens of bronchial secretion from children with non-specific respiratory diseases have been examined bacteriologically. In spite of the complex nature of acute and especially of chronic respiratory disease the role of bacterial infection should not be underestimated. Thirty per cent of the specimens were sterile. More than 20 per cent of the bacterial species isolated from bronchial secretion were pathogenic. Relatively frequent was the isolation of E. coli and of pathogenic staphylococci. Nearly 40 per cent of all isolated bacteria were alpha-haemolytic streptococci. The latter have been found more frequently in children with, than in children without bronchological alterations. The pathogenicity of alpha-haemolytic streptococci in the bronchial tree is discussed.