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Featured researches published by Lothar Schrod.


European Journal of Obstetrics & Gynecology and Reproductive Biology | 1999

Risk factors associated with early-onset sepsis in premature infants

Joachim Martius; Thomas Roos; Beate Gora; Martin K. Oehler; Lothar Schrod; Thomas Papadopoulos; Uwe Groß

OBJECTIVE To define perinatal factors associated with early-onset neonatal sepsis. STUDY DESIGN Maternal and neonatal variables were analysed retrospectively in 343 infants born before 35 weeks using univariate and multivariate statistical analysis. RESULTS Logistic regression analysis identified risk factors for probable neonatal sepsis: gestational age at delivery (odds ratio 0.9, 95% confidence interval (CI) 0.91-0.96), premature rupture of the membranes (odds ratio 2.9, 95% CI 1.004-8.56), Apgar score after 1 min (odds ratio 0.7, 95% CI 0.53-0.96), and histological chorioamnionitis and/or funisitis (odds ratio 4.1, 95% CI 1.36-12.12). There was a strong association between probable sepsis and intracranial haemorrhage of the infant (odds ratio 4.3, 95% CI 1.07-17.40). Funisitis had a high specificity (91%) and positive predictive value (82%) for the detection of neonatal sepsis < or =32 weeks. CONCLUSIONS Independent obstetrical risk factors for early-onset neonatal sepsis in premature infants may help to identify newborns who benefit from maternal antibiotic prophylaxis before birth. The histological examination of the umbilical cord can be used as an additional diagnostic test to detect newborns at risk of infection.


Neonatology | 1996

Immunologic Parameters in Cord Blood Indicating Early-Onset Sepsis

Thomas Lehrnbecher; Lothar Schrod; Petra Rutsch; Thomas Roos; Joachim Martius; Hans-Burckhard von Stockhausena

Different immunologic parameters were measured in cord blood to test their usefulness in the early diagnosis of early onset sepsis. Cord blood levels of circulating intercellular adhesion molecule-1 (cICAM-1), interleukin-6 (IL-6) and interleukin-8 (IL-8) were significantly elevated in septic compared to nonseptic neonates. No significant difference between either population was seen for cord blood C3a and elastase-alpha 1-proteinase inhibitor complex (E alpha 1 PI). Measured concentrations of cICAM-1, IL-6 and IL-8 in fetal and maternal blood did not correlate, indicating that the neonates response to sepsis is clearly different from the mother. Our data suggest that cord blood measurements of cICAM-1, IL-6 and IL-8 might be useful in identifying neonates with early-onset sepsis.


Pediatric Neurology | 1999

Critical illness neuropathy in pediatric intensive care patients

Birgit Petersen; Christiane Schneider; Hans-Michael Strassburg; Lothar Schrod

Critical illness neuropathy is an axonal polyneuropathy recognized more frequently in adult intensive care patients with sepsis and multiple organ dysfunction. In children the diagnosis is rarely made. Within 1 year the authors observed two children with critical illness neuropathy. Both patients, a male 6 years, 6 months of age with a brain contusion and a male 2 years, 6 months of age who underwent craniectomy for Crouzons disease, required prolonged mechanical ventilation and developed sepsis with multiple organ dysfunction. Three to 4 weeks after successful treatment of the sepsis, a flaccid tetraparesis was noticed in both patients. Laboratory investigations of blood and cerebrospinal fluid and spinal magnetic resonance imaging revealed normal results. Electrophysiologic examinations were indicative of an axonal polyneuropathy. Spontaneous improvement occurred within several months. It is likely that critical illness neuropathy occurs more often in critically ill children than previously thought. Careful neurologic examination and early electrophysiologic investigations are necessary to establish the diagnosis. Important differential diagnoses of acquired lower motor neuron weakness in pediatric intensive care medicine are discussed.


Neonatology | 2002

Effect of Head-Up Body Tilt Position on Autonomic Function and Cerebral Oxygenation in Preterm Infants

Lothar Schrod; Julia Walter

Skin-to-skin care (kangaroo) of premature infants causes orthostatic stress. Therefore, the effect of head elevated body tilt position (HETP) of 30% following HETP determined by near infrared spectroscopy. After stabilization within several minutes, prolonged tilting did not result in any further significant changes of tHb, heart rate, mean arterial pressure and oxygen saturation measured by pulseoxymetry. Respiratory frequency was reduced by 6–12%. Spectral analysis of heart rate variability revealed a greater increase in low frequency than high frequency activity following HETP reflecting a relative increase in sympathetic versus vagal activation. Only preterm infants ≤1,500 g showed a significant decrease of regional cerebral oxygen saturation (rSO2) of about 2–5% from day 2 to 8. As this mild decrease in rSO2 is clinically insignificant, there were no severe side effects of prolonged tilting in stable preterm infants even during the first days of life. However, the initial decline of tHb might be critical in very immature infants and needs further investigations.


Pediatric Radiology | 2001

Sonographic appearances of the abdominal manifestations of hereditary angioedema.

Hans-Peter Dinkel; J. Maroske; Lothar Schrod

Abstract Hereditary angioedema (HAE) is the autosomal dominant deficiency of C1-esterase inhibitor. There have hitherto been no reports on the US appearances of HAE. The unique case of a 12-year-old girl with recurrent abdominal pain is reported, in whom HAE was diagnosed by US and family history of paroxysmal dyspnoea, cutaneous swelling and attacks of abdominal pain. Pertinent US features were intestinal oedema and ascites. Sonographic evidence of intestinal swelling was only seen on the initial day of an episode of abdominal pain. Oedema, as demonstrated by MRI the following day, regressed rapidly, whereas ascites persisted for at least 3 days. It is therefore important to perform imaging in the acute phase to demonstrate the massive intestinal oedema, which is characteristic for the disease.


Neonatology | 1997

Possible Role of Uric Acid as an Antioxidant in Premature Infants

Lothar Schrod; T. Neuhaus; Christian P. Speer; H. Girschick

Uric acid (UA) is a water-soluble antioxidant in human body fluids. In umbilical cord blood of 172 neonates with gestational ages between 22 and 42 weeks, UA concentrations were between 50 and 990 mumol/l. There was no correlation with gestational age. Infants with an umbilical cord pH < 7.0 had markedly lower UA concentrations in cord blood than neonates without severe acidosis. UA levels increased during the first 24 h of life and subsequently declined within 2 weeks to lower levels than in older children. In tracheal aspirates (TA), UA at concentrations of about 10(-4) mol/l was found capable of effectively scavenging free oxygen radicals. Luminol-dependent chemiluminescence activity of isolated TA phagocytes or alveolar macrophages was suppressed by UA dose dependently, with a 100% reduction at UA concentrations of 10(-3) mol/l. On the assumption that oxidative stress contributes to the development of chronic lung disease (CLD), in premature infants the ratio of the antioxidant UA and malondialdehyde (MDA) as a marker of oxidative injury was measured in serially obtained TA of 102 ventilated premature infants with birth weights < 1,500 g. At the age of 3-14 days, infants who later developed severe CLD had significantly lower TA UA/MDA ratios than infants without CLD development. In infants with moderate CLD, UA/MDA ratios were comparable to those in the non-CLD group until day 5. During the next 2 weeks, decreasing ratios of UA/MDA paralleled lung injury with increased oxygen requirement and microvascular permeability. Serum UA concentrations did not differ between groups. It is speculated that UA may be physiologically important as an antioxidant in the epithelial lining fluid of the respiratory tract in neonates during the 1st week of life.


Biochemical and Biophysical Research Communications | 1991

Evidence for a structural mutation (347Ala to Thr) in a German family with 3-ketothiolase deficiency

Toshiyuki Fukao; Seiji Yamaguchi; Shunji Tomatsu; Tadao Orii; George Frauendienst-Egger; Lothar Schrod; Takashi Osumi; Takashi Hashimoto

The molecular basis of 3-ketothiolase deficiency (3KTD) was examined in a 3KTD family. Immunochemical analyses showed that mitochondrial acetoacetyl-CoA thiolase (T2) biosynthesized in the patients fibroblasts (GK06) was unstable and that the parents and brother were obligatory carriers of 3KTD. When sequencing the PCR-amplified patients T2 cDNA, we noted a G to A replacement which caused 347Ala to Thr substitution of the mature T2 subunit. Transfection analysis revealed that this substitution resulted in an instability of the T2 protein. Analyses of the T2 cDNA and gene of the family indicated that the patient was a compound heterozygote; the allele that derived from the mother had a point mutation (347Ala to Thr) and the other allele from the father has a mutation which would abolish the T2 gene expression. This report is apparently the first definition of a mutant allele for 3KTD, at the gene level.


Infection | 1992

Possible reasons for failure of conventional tests for diagnosis of fatal congenital toxoplasmosis: Report of a case diagnosed by PCR and immunoblot

U. Groß; Jürgen Heesemann; J. Müller; Thomas Roos; Lothar Schrod

Diagnosis of subclinical congenital toxoplasmosis has to rely on serological methods or isolation of the parasite. We present a case of congenital toxoplasmosis, in which conventional tests failed to establish the diagnosis. It was shown that this infant developed an intrathecal antibody response that was directed only against one of twoToxoplasma gondii strains used for routine diagnosis. In contrast to conventional tests, the diagnosis of cerebral toxoplasmosis could be established by using immunoblot and polymerase chain reaction (PCR). We therefore suggest that in unclarified cases, PCR and immunoblot, using at least two different strains ofT. gondii, should be considered as additional tools for diagnosis of an infection withToxoplasma and that examination of cerebrospinal fluid may be critical. Die Diagnose der subklinischen kongenitalen Toxoplasmose basiert auf serologischen Methoden oder der Erregerisolierung. Wir stellen hier ein Neugeborenes mit kongenitaler Toxoplasmose vor, bei dem die konventionelle Diagnostik versagte. Es konnte gezeigt werden, daß dieses Kind intrathekal Antikörper bildete, die jedoch nur gegen einen von zwei routinemäßig verwendetenToxoplasma gondii Laborstämmen gerichtet waren. Im Gegensatz zu konventionellen Labormethoden konnte die Diagnose einer zerebralen Toxoplasmose mittels Immunoblot und Polymerase-Ketten-Reaktion (PCR) bestätigt werden. Wir schlagen deshalb vor, daß in unklaren Fällen die PCR und der Immunoblot mit mindestens zwei verschiedenenToxoplasma-Stämmen zusätzlich zur bestehenden Labordiagnostik angewandt werden sollte und daß die Untersuchung des Liquors entscheidend sein kann.SummaryDiagnosis of subclinical congenital toxoplasmosis has to rely on serological methods or isolation of the parasite. We present a case of congenital toxoplasmosis, in which conventional tests failed to establish the diagnosis. It was shown that this infant developed an intrathecal antibody response that was directed only against one of twoToxoplasma gondii strains used for routine diagnosis. In contrast to conventional tests, the diagnosis of cerebral toxoplasmosis could be established by using immunoblot and polymerase chain reaction (PCR). We therefore suggest that in unclarified cases, PCR and immunoblot, using at least two different strains ofT. gondii, should be considered as additional tools for diagnosis of an infection withToxoplasma and that examination of cerebrospinal fluid may be critical.ZusammenfassungDie Diagnose der subklinischen kongenitalen Toxoplasmose basiert auf serologischen Methoden oder der Erregerisolierung. Wir stellen hier ein Neugeborenes mit kongenitaler Toxoplasmose vor, bei dem die konventionelle Diagnostik versagte. Es konnte gezeigt werden, daß dieses Kind intrathekal Antikörper bildete, die jedoch nur gegen einen von zwei routinemäßig verwendetenToxoplasma gondii Laborstämmen gerichtet waren. Im Gegensatz zu konventionellen Labormethoden konnte die Diagnose einer zerebralen Toxoplasmose mittels Immunoblot und Polymerase-Ketten-Reaktion (PCR) bestätigt werden. Wir schlagen deshalb vor, daß in unklaren Fällen die PCR und der Immunoblot mit mindestens zwei verschiedenenToxoplasma-Stämmen zusätzlich zur bestehenden Labordiagnostik angewandt werden sollte und daß die Untersuchung des Liquors entscheidend sein kann.


Medicine and Science in Sports and Exercise | 2003

Head size and motor performance in children born prematurely

Helge Hebestreit; Waltraud Schrank; Lothar Schrod; Hans-Michael Strassburg; Susi Kriemler

PURPOSE The objective of this study was to determine the relationship between head circumference (HC) and motor performance in 6- to 12-yr-old children born prematurely (PRE: birthweight < or = 1500 g, gestational age < or = 32 wk) and in children born at term (CON). METHODS Thirty-three PRE and 21 CON without an apparent neurological deficit participated in this study. HC was measured on the day of testing and was rated as small HC (SHC, HC more than 1 SD below the 50th percentile of reference data) or as normal HC (NHC). Subjects were examined by an experienced neuropediatrician, and whole-body coordination was assessed by the Körper-Koordinationstest für Kinder (KTK). Peak exercise performance was determined by a Wingate test and an incremental cycling test to volitional fatigue. Net oxygen cost of cycling was measured during four different tasks lasting 5-7 min each. Subjects pedaled at an intensity corresponding to 30% and 60% of peak oxygen uptake ([OV0312]O(2peak)) at a cadence of 36 and 76 rpm, respectively. RESULTS Prematures with SHC showed no statistically significant difference in their neurological examination and whole-body coordination compared with prematures with NHC. Wingate test performance and [OV0312]O(2peak) relative to body mass were similar among SHC, NHC, and CON. In SHC, but not in NHC and CON, net oxygen cost of cycling increased significantly (P < 0.05) when cadence was increased from 36 to 76 rpm. CONCLUSION At the age of 6-12 yr, SHC have a higher oxygen cost of cycling in exercise tasks requiring high velocity, which might be explained-at least in part-by an impaired neural control of intra- and intermuscular coordination.


Pediatric Radiology | 2001

The effect of dexamethasone on respirator-dependent very-low-birth-weight infants is best predicted by chest X-ray.

Lothar Schrod; Thora Neuhaus; Alfred E. Horwitz; Christian P. Speer

Background. Chronic lung disease (CLD) in premature infants shows a variable clinical course with different radiological manifestations. Objective. To evaluate the correlation between parameters of transmembrane permeability [albumin/secretory component (SC)] and oxidative stress [malondialdehyde (MDA)/SC] in tracheal aspirate fluid (TAF) and radiological findings with the effect of a 5-day course of dexamethasone (0.5 mg/kg per day). Materials and methods. Fifty ventilator-dependent premature infants with birth weights < 1,500 g (gestational ages 23–31 weeks) and radiological signs of early chronic lung disease (CLD) were treated with dexamethasone at day of life 5–27 (median 10 days) because of respiratory deterioration. TAF was collected serially. Chest X-rays taken before and 8–10 days after dexamethasone were scored for changes of opacification, consolidation and hyperinflation/emphysema, and classified into three groups. Results. Twenty-four infants had a positive response to dexamethasone, defined as a reduction of the ventilation index FiO2× mean airway pressure > 40 % at day 5, compared to pretreatment values. About 80 % of the responders showed homogeneous lung opacification on chest X-ray, reflecting leaky lung syndrome. In contrast, seven of eight infants with predominantly emphysema on radiology were non-responders; 80 % of infants with a mixed radiological picture characterized by predominance of consolidations alternating with regions of emphysema were also non-responders. Ratios of albumin/SC and MDA/SC in TAF decreased significantly within 3 days after the onset of dexamethasone. However, MDA/SC was persistently higher in non-responders compared to responders. Opaque lungs were largely improved by dexamethasone, in contrast to streaky or patchy consolidations and emphysema. In a logistic regression model, radiographic classification was the most important factor influencing the response to dexamethasone with a positive predictive value of 86 %, followed by albumin/SC ratio. Conclusions. The optimum timing of dexamethasone treatment may be determined by the stage of developing CLD and radiological findings rather than by the age of the premature infant.

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Thomas Roos

University of Würzburg

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Erik Harms

University of Münster

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Frank Louwen

Goethe University Frankfurt

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Jiří Zeman

Charles University in Prague

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Josef Houštěk

Academy of Sciences of the Czech Republic

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