[Acoustic frequency analysis of auscultation findings in neonates]. / Akustická frekvencní analýza auskultacních nálezu u novorozencu.

The authors analyzed 280 auscultation findings of 35 neonates with birth weights of 1800-4500 g and 65 pathological neonates with birth weights of 1150-3600 g. For recording of the auscultation findings an electronic phonendoscope EST 40 (Bosch) was used and the finding was recorded on a microtape recorder (Olympus). The frequency analysis was made on a Sonagraf analyzer (Kay Elemetric), using a 45 Hz filter a time range of 2.4 sec. From the results of the work ensues that in physiological neonates two basis types of sonagrams can be detected: 1. the record presenting itself as a continuous zone of noise with maximal cumulation of acoustic energy up to 500 Hz where the ratio of acoustic energy is equal in both stages of the respiratory cycle. The clinical correlate is "alveolar respiration". 2. a record with a discontinuous zone of noise with a more expressive ratio of acoustic energy up to 2500 Hz during inspiration. The clinical correlate is "sharper bronchoalveolar respiration". In the group of pathological neonates with different pneumopathies further sonagraphic phenomena were detected: a) "rales" as discontinuous acoustic phenomena persisting for 7-35 msec with a frequency range up to 3000 Hz, without a harmonious structure, present during inspiration as well as expiration, b) "transmitted phenomena"--discontinuous acoustic phenomena persisting for 75-150 msec with a frequency range up to 6000 Hz, without a harmonious structure, c) "wheezing"--continuous acoustic phenomena with a clearly marked harmonious acoustic structure lasting 540 +/- 240 msec with a frequency of the basic sound of 500 +/- 240 msec.(ABSTRACT TRUNCATED AT 250 WORDS)

[Sonographic analysis of postextubation stridor in neonates and children with low birth weight after long-term artificial ventilation]. / Sonagrafická analýza postextubacního stridoru novorozencu a detí nízkých porodních hmotností po dlouhodobé artificiální ventilaci.

In a group of 23 neonates with mean birth weights of 1470 g (range 1200-3980 g) who had orotracheal intubation for an average period of 12.6 days (range 5-96 days) sonagraphic frequency analysis of 86 stridors 1-3 hours after intubation was performed. According to the results of the frequency analysis more than 97.6% of the stridors are supraglottic (84 of 86 analyzed stridors). The laryngeal and tracheal type of stridor was recorded only in two children. The finding is surprising and does not confirm the widely accepted view that neonates after extubation are threatened with oedema of the larynx or stricture at this or a distal level. As elective postextubation laryngoscopy is controversial, acoustic frequency analysis of stridor after extubation is a suitable alternate method in investigations of the clinical condition of the infant and serves the clinician as an indication on the level of stenosis of the airways.

[Transcranial Doppler measurement of hemodynamics in the major cerebral arteries]. / Transkraniální dopplerovské merení hemodynamiky hlavních tepen mozku.

Using a pulsed Doppler velocity meter, the authors assessed by a transcranial approach, in order to obtain an idea on the normal haemodynamics of the basal cerebral arteries, the maximal systolic blood flow (Vmax., m.s-1) in these arteries in a group of 25 healthy young men and in 20 healthy children. In different arteries of the two groups the following mean values of Vmax. were recorded: middle cerebral artery 0.73 +/- 0.11 parallel 0.80 +/- 0.17 m.s-1; anterior cerebral artery 0.55 +/- 0.06 parallel 0.51 +/- 0.09 m.s-1 and posterior cerebral artery 0.44 +/- 0.04 parallel 0.40 +/- 0.02 m.s-1. The assessed values of Vmax. are in agreement with data of other authors. Using the transcranial Doppler method (TD), the authors recorded in 10 children examined in the acute and subsequent stage of cerebrovascular disease recanalization of original occlusions in the anterior, middle and posterior cerebral arteries in the carotid siphon and in the basal artery and improved cerebral haemodynamics in A-V malformation in the basal ganglia. The TD method thus makes it possible to diagnose and follow up the course of these diseases. To illustrate the assessment of the function of the circle of Willis we made in three of our followed up patients with stenosis of extracranial internal carotid arteries static compression tests of both common carotid arteries. The TD method makes it possible to follow up the course of haemodynamic changes in diseases of the cerebral arteries and along with the angiographic examination it extends and supplements the evaluation of the pathological condition of the cerebral arteries and its extent.