| 1. |
- Bjure, Jan, et al.
(författare)
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Regional cerebral blood flow abnormalities in Rett syndrome.
- 1997
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Ingår i: European child & adolescent psychiatry. - 1018-8827. ; 6 Suppl 1, s. 64-6
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Tidskriftsartikel (refereegranskat)abstract
- Sixteen Rett syndrome (RS) girls and 1 24 year old RS woman were compared with 16 neurologically healthy children as to the regional cerebral blood flow (rCBF). Hypoperfusion of the frontal lobes and parts of the midbrain was found in RS, with significant differences to controls at latest by the age of three to four years. The findings were in accordance with previous reports of morphological, neuroradiological and functional abnormalities in these areas, compatible with a statement that structures in the midbrain and in the frontal lobes may have particular pathophysiological relevance in RS.
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| 2. |
- Emanuelson, Ingrid, 1955, et al.
(författare)
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Computed tomography and single-photon emission computed tomography as diagnostic tools in acquired brain injury among children and adolescents.
- 1997
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Ingår i: Developmental medicine and child neurology. - 0012-1622. ; 39:8, s. 502-7
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Tidskriftsartikel (refereegranskat)abstract
- Twenty children with acquired brain injuries were investigated with CT and SPECT. The findings were related to the clinical outcome judged at discharge following acute care after the injury and at follow-up 5 years later. The abnormalities that were found were classified for each lobe on a scale ranging from 0 (normal) to 5 (severe abnormality). The patients were divided into two groups showing mild and severe injury. CT and SPECT revealed similar results in the patients with severe injury, but in the group of mildly injured children the number of affected lobes and scores indicated by SPECT were significantly higher than those indicated by CT. SPECT also differentiated more effectively between the two outcome groups. This supports the hypothesis that SPECT could be used as an instrument to objectivise minor sequelae and that SPECT and CT are both useful methods for forecasting outcome.
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| 3. |
- Holmgren, Daniel, 1945, et al.
(författare)
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Transcutaneous blood gas monitoring during salbutamol inhalations in young children with acute asthmatic symptoms.
- 1992
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Ingår i: Pediatric pulmonology. - 8755-6863. ; 14:2, s. 75-9
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Tidskriftsartikel (refereegranskat)abstract
- The effect of salbutamol inhalations on transcutaneous blood gases was investigated in 23 children (aged 11 months-2.5 years) with asthmatic symptoms. After one salbutamol inhalation there was a mean increase in transcutaneous PO2 (tcPO2) of 0.5 kPa (P less than 0.01); after a second dose given 30 minutes later, the mean increase was 1.2 kPa (P less than 0.001). The increase in tcPO2 after only one dose of salbutamol was significantly correlated to age (P less than 0.01). No such correlation was observed after a second dose. The overall increase in tcPO2 after two salbutamol inhalations showed a negative correlation to the duration of the current symptomatic period (P less than 0.05). We conclude that salbutamol inhalations have beneficial effects in young children with acute asthmatic symptoms, even below the age of 18 months, provided that an adequate dose reaches the lung and preferably at an early stage of obstruction.
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| 4. |
- Råstam, Maria, 1948, et al.
(författare)
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Regional cerebral blood flow in weight-restored anorexia nervosa: a preliminary study.
- 2001
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Ingår i: Developmental medicine and child neurology. - 0012-1622. ; 43:4, s. 239-42
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-one individuals (19 females, two males) with teenage-onset anorexia nervosa (AN), 19 of whom were weight restored, were assessed using single-photon emission computed tomography (SPECT) 7 years after onset of AN, at a mean age of 22 years. For comparison we recruited a younger group without neuropsychiatric disorder (mean age 9:8 years; five females, four males) who underwent SPECT at follow-up after an operation for coarctation of the aorta or because of lymphatic leukaemia. Ethical considerations precluded the study of regional cerebral blood flow (rCBF) in participants with completely normal development. The group with AN showed marked hypoperfusion of temporal, parietal, occipital, and orbitofrontal lobes compared to the contrast group. rCBF was not correlated to body mass index in any of the groups. Results suggest that, even long after re-feeding has occurred, AN may be associated with moderate to severe cerebral blood flow hypoperfusion in the temporoparietal (or temporoparietooccipital) region and in the orbitofrontal region. A limitation of the study is that the young contrast group in this study could be expected to have a higher global rCBF than the group with AN. However, this should not significantly affect the relative values used in this study.
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| 5. |
- Uvebrant, Paul, 1951, et al.
(författare)
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Brain single photon emission computed tomography (SPECT) in neuropediatrics.
- 1991
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Ingår i: Neuropediatrics. - 0174-304X. ; 22:1, s. 3-9
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Tidskriftsartikel (refereegranskat)abstract
- The clinical value in neuropediatrics of [99mTc]HM-PAO brain single photon emission computed tomography was preliminary evaluated by the consecutive investigation of 79 children. Planned epilepsy surgery was the most common indication for the investigation. In 56 children investigated because of epilepsy, SPECT yielded relevant information in 79% of cases examined. The corresponding figures for magnetic resonance imaging and CT were 49% of 35 and 36% of 56 cases, respectively. All 22 children with an epileptic focus, ascertained by freedom from seizures after removal of the area or by consistent neurophysiological and neuroradiological findings, also had abnormal perfusion in the relevant area. Twenty-three children were examined because of neurological signs and symptoms other than epilepsy. SPECT findings were useful for elucidating neonatal brain impairments. Hypoperfused areas in the brain of asphyxiated infants and in posthemorrhagic hydrocephalus corresponded to neuroradiological and autopsy findings. SPECT was found to be an excellent tool when analysing cerebrovascular accidents. In cases with signs and symptoms of a diffuse severe encephalopathy, SPECT did not clarify the etiology but provided information on the distribution of the lesions and probable underlying pathophysiological mechanisms.
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| 6. |
- Uvebrant, Paul, 1951, et al.
(författare)
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Evaluation of cerebrospinal fluid shunt function in hydrocephalic children using 99mTc-DTPA.
- 1992
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Ingår i: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. - 0256-7040. ; 8:2, s. 76-80
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Tidskriftsartikel (refereegranskat)abstract
- The increasing numbers and survival of children with shunt-treated hydrocephalus make it mandatory to refine the methods for cerebrospinal fluid (CSF) shunt function evaluation. Radionuclide shuntography with 99mTc-DTPA, which has proved to be a safe and effective method, was performed in eight children with suspected CSF-shunt dysfunction. Characteristic shuntography patterns were found for proximal and distal CSF-shunt catheter obstruction as well as for overdrainage and normal CSF-shunt function. Shuntography contributed to the explanation of suspected CSF-shunt dysfunction in all children investigated.
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| 7. |
- Wennergren, Göran, 1947, et al.
(författare)
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A case of near-miss SIDS developing an abnormal respiratory reaction to hypoxia.
- 1983
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Ingår i: Acta paediatrica Scandinavica. - 0001-656X. ; 72:5, s. 793-5
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Tidskriftsartikel (refereegranskat)abstract
- A SIDS sibling is described who showed a normal respiratory regulation at 1.5 months but who was equipped with an apnea monitor at home on psychological indications. At 3 months he had a near-miss SIDS episode. He was then found to have developed a reaction to hypoxia with appearance of periodic breathing. With theophylline this response pattern was normalized but despite theophylline medication episodes of prolonged apnea occurred.
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| 8. |
- Wennergren, Göran, 1947, et al.
(författare)
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Hypoxia reinforces laryngeal reflex bradycardia in infants.
- 1989
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Ingår i: Acta paediatrica Scandinavica. - 0001-656X. ; 78:1, s. 11-7
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Tidskriftsartikel (refereegranskat)abstract
- The laryngeal chemoreflex involves bradycardia, apnea, swallowing and peripheral vasoconstriction. This reflex was studied in twelve infants, aged 5 days-28 weeks, who had sustained an apparent life-threatening event or were siblings of infants who had died of the sudden infant death syndrome. The bradycardic and apneic components of the reflex were found to be significantly, and sometimes powerfully, reinforced when elicited by pharyngeal water instillation during acute, mild hypoxia (transcutaneous PO2 4.6-8.3 kPa). Apnea duration during normoxia was 0.7-15 sec, and during hypoxia 2-30 sec. Heart rate change ranged from +26% to -21% during normoxia, as compared with -4% to -63% during hypoxia. The percentage change in heart rate was found to inversely correlate with the transcutaneous PO2-level prevailing when the reflex was elicited. The conclusion is that there is a significant reinforcement of the cardiorespiratory adjustments when the laryngeal reflex is activated during simultaneous excitation of the peripheral arterial chemoreceptors. One infant, showing a particularly strong increase of the cardiorespiratory response to laryngeal receptor stimulation during hypoxia, later died of sudden infant death syndrome.
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| 9. |
- Wennergren, Göran, 1947, et al.
(författare)
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Laryngeal reflex.
- 1993
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). Supplement. - 0803-5326. ; 82 Suppl 389, s. 53-6
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Forskningsöversikt (refereegranskat)
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| 10. |
- Wennergren, Göran, 1947, et al.
(författare)
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The epidemiology of sudden infant death syndrome and attacks of lifelessness in Sweden.
- 1987
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Ingår i: Acta paediatrica Scandinavica. - 0001-656X. ; 76:6, s. 898-906
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Tidskriftsartikel (refereegranskat)abstract
- Infants who died showing the syndrome of sudden infant death (SIDS) and infants who survived attacks of lifelessness (AL) were examined in a prospective epidemiological multicentre study over 24 months covering close to 40% of all births in Sweden. Seventy SIDS cases and 34 cases of AL were observed, giving an incidence for SIDS of 0.94/1000 and for AL of 0.46/1000. This SIDS incidence is higher than that observed during the seventies. The boy/girl ratio was 1.4:1 for SIDS and 1.6:1 for AL. The age distribution for AL resembled that for SIDS. Similarities were also seen with regard to place of occurrence. Sixty per cent of the SIDS cases occurred during the daytime/evening. Twenty-nine per cent of the infants with AL had more than one apneic spell during the three-day-period around the attack, indicating a period of respiratory instability, but only 12% had such spells later on. None of the infants who had had AL died from SIDS. The possible relationship between AL and SIDS is discussed.
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| 11. |
- Wennergren, Göran, 1947, et al.
(författare)
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Transcutaneous oxygen and carbon dioxide levels and a clinical symptom scale for monitoring the acute asthmatic state in infants and young children.
- 1986
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Ingår i: Acta paediatrica Scandinavica. - 0001-656X. ; 75:3, s. 465-9
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Tidskriftsartikel (refereegranskat)abstract
- Measurement of transcutaneous PO2 and PCO2 in addition to a clinical symptom grading system was used to monitor the acute asthmatic attack in children under two years of age. tcPO2 was lowered already at signs of mild obstruction and decreased in parallel with clinical deterioration. tcPCO2 was almost unchanged at mild to moderate obstructive symptoms. With clinical deterioration tcPCO2 rose steadily. An increase of the oxygen concentration to 30-40% in the inspired air increased tcPO2, on the average by 70%, but did not change the tcPCO2, level. Continuous recording of tcPO2 and tcPCO2 as well as the clinical grading system are valuable tools when monitoring severely obstructive infants and young children.
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| 12. |
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| 13. |
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| 14. |
- Österlundh, Gustaf, 1956, et al.
(författare)
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Regional cerebral blood flow and neuron-specific enolase in cerebrospinal fluid in children with acute lymphoblastic leukemia during induction treatment.
- 1999
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Ingår i: Journal of pediatric hematology/oncology : official journal of the American Society of Pediatric Hematology/Oncology. - 1077-4114. ; 21:5, s. 378-83
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate possible side effects on the central nervous system from intrathecal methotrexate given during induction treatment for acute lymphoblastic leukemia in childhood. PATIENTS AND METHODS: Twenty-five children with acute lymphoblastic leukemia were examined by cerebral single photon emission computed tomography at the beginning of treatment (16 untreated, 9 during the first week) and after 4 weeks of treatment. Cerebrospinal fluid was sampled for analyses of neuron-specific enolase on four occasions in 54 patients. RESULTS: Regional cerebral blood flow became impaired during treatment in all patients. The single photon emission computed tomography score for nonhomogeneous perfusion increased from 6.4/50 to 16.6/50. Hypoperfusion was global without any clear preference for any lobe. The cerebellum was not affected. Neuron-specific enolase increased significantly during treatment, with a peak after 1 week, followed by a gradual decrease, but it was still significantly elevated after 4 weeks. CONCLUSIONS: Nonhomogeneous cerebral hypoperfusion was found in all patients during induction treatment, including repeated intrathecal administration of methotrexate, but before systemic high-dose methotrexate. Signs of neuronal injury, in the form of a moderate increase in neuron-specific enolase in the cerebrospinal fluid, were found early in the treatment. Follow-up is needed to evaluate the long-term impact of these findings.
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| 15. |
- Österlundh, Gustaf, 1956, et al.
(författare)
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Studies of cerebral blood flow in children with acute lymphoblastic leukemia: case reports of six children treated with methotrexate examined by single photon emission computed tomography.
- 1997
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Ingår i: Journal of pediatric hematology/oncology : official journal of the American Society of Pediatric Hematology/Oncology. - 1077-4114. ; 19:1, s. 28-34
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Cranial irradiation has been widely used in order to prevent central nervous system (CNS) relapse of acute lymphoblastic leukemia (ALL) in childhood. Owing to the risk of late side effects, the Nordic Society for Pediatric Hematology and Oncology (NOPHO) replaced CNS irradiation with systemic high-dose methotrexate (HDMTX) in 1992. A prospective study of the effects of HDMTX and intrathecal MTX on CNS function is in progress at our center. PATIENTS AND METHODS: Six ALL patients underwent (99m)Tc-HMPAO single-photon emission computed tomography (SPECT) examination of regional cerebral blood flow (rCBF): three owing to neurological symptoms during treatment for ALL and the other three as part of the study. RESULTS: All the patients had various degrees of disturbed rCBF, which was more pronounced in the patients with neurological symptoms. One patient had severe symptoms and impaired rCBF after three intrathecal injections of MTX but before administration of HDMTX. CONCLUSIONS: Impaired cerebral perfusion was found in patients with and without neurological symptoms during treatment for ALL. The impact of these findings is still unknown, from both the long- and the short-term perspective. The possibility that intrathecal MTX alone or in combination with HDMTX may affect rCBF through vascular damage should be further investigated, in terms of both mechanisms and clinical significance.
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