Transient renal medullary hyperechogenicity in ultrasound studies of neonates: is it a normal phenomenon and what are the causes?

A prospective ultrasound study of the renal morphology of 51 neonates with no clinical signs of renal impairment showed transient medullary hyperechogenicity of varying intensity in 37%. These findings were made in the first few postnatal days, were not accompanied by any other echographic changes, and disappeared again within the first week of life. They were encountered twice as often in full-term as in premature babies. In parallel with this phenomenon, the concentration of Tamm-Horsfall protein, calcium, and uric acid, and the osmolality were determined in the daily urine of 44 of these neonates. The analyses did not provide any definite clues as to the etiology of the ultrasound findings. It is therefore suggested that the term "Tamm-Horsfall nephropathy or proteinuria" should no longer be used for such sonographic phenomena in the neonatal kidney, but rather, they should be regarded as normal. Furthermore, the term "tubular stasis nephropathy" should be reserved for cases with clinically demonstrable impairment of renal function.

Use of non-ionic contrast media for tracheobronchography in neonates and young infants.

The paper describes the experience gained with tracheobronchography in 11 neonates and young infants with severe pulmonary disease--most of them on artificial respiration--using isotonic solutions of iopromide (17 series) and iotrolan (14 series). Both contrast agents were tolerated without any obvious problems when instilled into the lungs. Because of its higher content of iodine and greater viscosity, iotrolan was superior to iopromide as regards both the demonstration even of the more peripheral bronchial morphology and the duration of the contrast coating.

[Formaldehyde sediment in incubators following disinfection]. / Formaldehydrückstände in Inkubatoren nach der Desinfektion.

Measurements in incubators revealed the presence of formaldehyde concentrations involving a health risk for premature and normal newborns kept and cared for in incubators. Prior to measurements, the incubators had been disinfected by means of formaldehyde vapours in an "Aseptor" disinfecting cabinet (Drägerwerk AG, Lübeck) and then ventilated in strict adherence to operating instructions. The elevated formaldehyde concentrations found had been due to residues of paraformaldehyde and urotropin on the surfaces of the disinfected apparatus, liberating formaldehyde by hydrolysis depending on temperature and relative humidity. There should be a basic reconsideration of the present practice of incubator disinfection. From experiments with activated-carbon filters in incubators it would seem that there is a chance of reducing such formaldehyde concentrations.