bluuebunny/crossref_metadata_2025 huggingface dataset:
Circulating Class II Transplantation Antigen‐Expressing T Lymphocytes in Children with Insulin‐Dependent Diabetes Mellitus at Diagnosis
Authors: KARLSSON‐PARRA A. , KOBBAH M. , EWALD U. , TUVEMO T. , FORSUM U. , KLARESKOG L.
Published: January 2008

ABSTRACT. The occurrence of circulating class II antigen‐expressing T lymphocytes was examined in 25 children with insulin‐dependent diabetes mellitus using an indirect double immunofluorescence assay on prefixed cell samples. In order to exclude sensitization to heterologous insulin as a possible factor affecting the results, the patients were investigated at the day of clinical onset, before receiving insulin. An increased percentage of T cells (CD3+ cells) expressing class II antigens was seen in 19 out of 25 patients and class II expression was observed on cells within both the CD4+ and CD8+ T cell subsets. No correlation was found between the levels of class II expressing T cells and the individual degree of metabolic derangement or indicators of recent infection. Re‐testing of 16 patients after one year on insulin treatment revealed a significant decrease of class II expressing T cell levels. Our data suggest that the increased levels of class II expressing T cells seen in IDDM of recent onset directly reflects immune reactions that are related to the disease process.
Breast Milk Anti‐Escherichia coli Heat‐Labile Toxin IgA Antibodies Protect against Toxin‐Induced Infantile Diarrhea
Authors: CRUZ J. R. , GIL L. , CANO F. , CACERES P. , PAREJA G.
Published: January 2008

ABSTRACT. A prospective study to assess whether milk IgA antibodies against Escherichia coli heat labile‐toxin protect breast‐fed children against labile toxin‐induced gastroenteritis was carried out among infants of a marginal urban area in Guatemala. One hundred and thirty children were kept under surveillance for diarrhea by periodic home visits. Stool specimens were collected from each child routinely every 2‐3 weeks and during diarrheal episodes, to study the excretion of labile toxin‐producing Escherichia coli. Milk samples from the children's mothers were obtained concomitantly with the fecal specimens of the infants to be analyzed for anti‐labile toxin antibodies. Twenty infections by heat‐labile toxin‐producing Escherichia coli as a sole agent were documented among breast‐fed infants. Nine of these infections resulted in gastroenteritis, while the remaining 11 were asymptomatic. At the time of infection children who became sick were ingesting breast milk with significantly (p=0.028) lower titers of antilabile toxin IgA than those who remained healthy. Only one of the 8 infected children receiving breast milk with high titers (≥256) of anti labile toxin IgA developed diarrhea, compared to 8 of the 12 subjects being fed milk with low titers (≤64) (p=0.025). This is the first report documenting protection by IgA antibodies in milk against labile toxin‐induced gastroenteritis in infected breast‐fed infants.
Fibronectin in Bronchoalveolar Lavage Fluid and Plasma from Children with Chronic Inflammation of Lungs
Authors: NAGY B. , KATONA É. , ERDEI J. , SZÉKELY E. , MÁRIALIGETI T. , KARMAZSIN L. , FACHET J.
Published: January 2008

ABSTRACT. Fibronectin/albumin ratios in plasma and in bronchoalveolar lavage fluid were evaluated in patients (1–6 years of age) with recurrent obstructive bronchitis and different interstitial lung diseases. These inflammatory reactions were characterized by increased influx of macrophages on the bronchoalveolar surface, but an increase in the proportion of lymphocytes or neutrophils was also detected in the group of patients with lymphocyte‐macrophage or neutrophil‐macrophage alveolitis. There was no considerable difference in plasma fibronectin concentrations obtained from healthy children and patients with moderate obstructive bronchitis and slight inflammation of the bronchial mucosa observed bronchoscopically. Levels of plasma fibronectin were elevated in patients with serious bronchial inflammation and different alveolitis, but they were within the normal range. A comparison of lavage fibronectin/albumin ratios with plasma fibronectin/albumin ratios with plasma fibronectin/albumin ratios indicated significant local production of fibronectin in subjects with serious bronchial inflammation and interstitial lung disorders. Fibronectin detected on the bronchoalveolar surface seems to be an important factor in mediating cell‐to‐cell interactions in the repair of the bronchoalveolar structures, and in tracing the activity of the inflammatory reactions not only in patients with interstitial lung diseases, but also in patients with serious chronic bronchial inflammation.
Early Changes of Some Serum Proteins and Metals in Diabetic Children
Authors: KOBBAH A. M. , HELLSING K. , TUVEMO T.
Published: January 2008

ABSTRACT. Serum concentrations of prealbumin, albumin, orosomucoid, magnesium, zinc and calcium were studied in 30 children with newly diagnosed IDDM aged 3–15 years, during the first two years of the disease, and in 44 healthy control children. On admission serum prealbumin was significantly lower in IDDM children (149±48 mg/1) (M±SD) than in healthy controls (194±39 mg/1) (p<.001). During the two years follow‐up prealbumin increased significantly, but did not reach the level of healthy controls. Serum albumin was slightly increased at diagnosis (p<0.01), but later decreased significantly (p<0.01). Orosomucoid concentrations did not differ between diabetics and controls. Serum magnesium was initially within the reference interval but later decreased, and after 2 years of IDDM it was highly significantly reduced (p<0.001). Serum zinc was significantly reduced in IDDM children at diagnosis (p<0.001), but was within the reference interval after one and 2 years. Serum calcium was increased in the IDDM group at diagnosis (p<0.01), but later normalized. It is concluded that in early IDDM there is a decrease in serum prealbumin and albumin, and serum magnesium decreases progressively, while serum zinc is only transiently reduced.
Prevalence of Bronchial Asthma among Schoolchildren in a Swedish District
Authors: BRÅBÄCK L. , KÄLVESTEN L. , SUNDSTRÖM G.
Published: January 2008

ABSTRACT. The prevalence of asthma among 10527 children aged 7–16 years was investigated in 1985. Children were assigned to the asthma group when replies to a questionnaire stated that at least two of four stipulated symptoms had been experienced in the preceding year. A validation study, comprising exploration of medical history, pulmonary auscultation and physiological tests (spirometry and methacholine inhalation challenge) was performed in 73 children. The overall prevalence of asthma was 4%. The most common symptom‐inducing factors were physical exertion, upper respiratory tract infection, contact with animals and tobacco smoke. The methacholine test had limited value as a diagnostic aid, being positive in only 25% of children with a clear history of asthma.
The Epidemiology of Lost Residual β‐cell Function in Short Term Diabetic Children
Authors: DAHLQUIST G. , BLOM L. , PERSSON B. , WALLENSTEEN M. , WALL S.
Published: January 2008

ABSTRACT. Using the country‐wide Swedish childhood diabetes register 526 children, who had had diabetes for 6–30 months were traced for measurements of 24‐hour urinary C‐peptide. Lost ft‐cell function was defined as a 24‐hour urinary C‐peptide excretion per kg body weight less than 10% of the mean for healthy children (<0.025 nmol/kg). The estimated cumulative incidence of lost β‐cell function was 0.64 at 30 months. The incidence of lost β‐cell function did not differ by sex. Neither was there any significant variation in season at onset for cases with lost β‐cell function. A significant age dependency was shown for the cumulative incidence of lost β‐cell function with the highest incidence in the young age groups, i.e. a reversed age dependency compared to that of clinical onset. In contrast to the clinical onset of diabetes no significant geographical variation was found for lost β‐cell function when comparing standardized morbidity ratios. The urinary C‐peptide excretion was significantly correlated to age at onset but not to degree or duration of ketonuria at onset. It is concluded that there are striking differences when comparing the epidemiology of lost β‐cell function to that of clinical onset in terms of age, sex, seasonal and geographical variations. The timing of clinical onset may thus partly be determined by factors different from those determining the rate of fall in β‐cell function.
Juvenile Neuronal Ceroid Lipofuscinosis (JNCL): Quantitative Description of Its Clinical Variability
Authors: KOHLSCHÜTTER A. , LAABS R. , ALBANI M.
Published: January 2008

ABSTRACT. The clinical courses of 17 JNCL patients were analyzed retrospectively with the use of a simple, disease‐specific scoring system. The mean observation period was 14 years (range 8–18 years). Scores of 0 (maximal dysfunction) to 3 (normal function) were assigned to each patient's vision, intellect, language, motor function, and epilepsy for each year of observation. The lapse of medians and ranges of all patients' scores were established from age 3 to 20 years. This scoring system allowed quantitative description of an individual course in context of the wide natural variability of the disease. Patients with seizures starting before the age of 10 years tended to have intractable epilepsy, to receive multiple antiepileptic drug therapies, and to have poor courses including problems not related to epilepsy. One patient had a course clearly outside the usual variability of JNCL and is thought to represent a genetic variant.
INH and Streptomycin in Ethiopian Children with Tuberculosis and Different Nutritional Status
Authors: ERIKSSON MARGARETA , BOLME PER , HABTE DEMISSIE , PAALZOW LENNART
Published: January 2008

ABSTRACT. The plasma concentration of INH and streptomycin was followed in 45 Ethiopian children with tuberculosis. The children were grouped according to their nutritional status as normal, underweight, marasm and kwashiorkor. INH was well absorbed in all nutritional groups to give therapeutically active plasma levels. When terminal half life (t 1/2) of INH was calculated for individual patients there were more children in all nutritional groups with t1/2 ≥2 hours than <2 hours, indicating a slow acetylation of INH. Streptomycin was well absorbed in all nutritional groups and therapeutic levels were obtained with 20 mg/kg i.m. After 30mg/kg i.m. of streptomycin kwashiorkor children had an increased t1/2 of streptomycin in‐dictaing a decreased renal excretion of the drug in kwashiorkor. The clinical follow‐up of the children indicated that serious tuberculosis could be successfully treated with INH and strpetomycin in the doses used.
Nephrotic Syndrome in a Child with Cystic Fibrosis
Authors: Roussey M. , Dabadie A. , Lennon A. , Gie S. , Legall E. , Le Marec B.
Published: January 2008

Cases of renal pathology in cystic fibrosis (CF) have been reported in increasing numbers, especially amyloidosis (1, 2). However, the association of primary nephrotic syndrome with CF seems to be fortuitous, and rare enough to be worth reporting.
THE INFANT AS A MEMBER OF SOCETY
Authors: RHEINGOLD HARRIET L
Published: January 2008

Abstract. An analysis of the social development of the infant and young child offers a salutary view of human nature. To defend that claim I use as an example a recent study of how boys and girls in the second year of life assist their mothers and fathers and other persons in performing some everyday tasks. Although the behavior falls under the rubric of social behavior, it will be examined by the different components comprising it. In turn I consider the social, emotional, cognitive, and motor components of the children's helping and briefly trace their development. Their behavior revealed a well‐developed concept of self and despite the children's immaturity deserved the appellation of prosocial.

Although wide differences appeared among pairs of children and parents, no differences were found by sex of child or parent, and no differences by culture are anticipated.

No current theory of the development of social behavior encompasses all the facets of the whole child here portrayed as active and perceptive, enterprising and creative, and above all responsive.

The parents of this study, as well as those of other studies, such as sharing and care giving, and even obeying, by children in the second year of life, seemed scarcely aware of these socially valued behaviors. In fact, parents, like the rest of us, tend to ignore what goes right and fasten on what goes wrong. Not only a good start to mental health but a better start can come from recognizing and rewarding such behaviors at their onset. If we wait until we think children are ready to be taught them, we pay the penalty of a lost opportunity.

At any age children are indeed important members of families, but above all they qualify as members of society by providing a glimpse of what could be accomplished by nurturing the early and spontaneous development of their praiseworthy behavior.
The Duration for Which Exclusive Breast‐feeding Is Adequate
Authors: HIJAZI S. S. , ABULABAN A. , WATERLOW J. C.
Published: January 2008

ABSTRACT. The object of this study was to determine the length of time for which exclusive breast‐feeding supported adequate growth in a cohort of infants from families in and around Amman, Jordan. The infants were described as “faltering” if their incremental growth over 4 weeks fell below 2 standard deviations of the increments reported by Fomon in the USA. The infants were examined every 2 weeks until they faltered, or, without faltering, were started on supplementary foods. In general, up to the time of faltering, growth was satisfactory by international standards. The median time of faltering was 6 months. The results support the view that, at least in this relatively well‐nourished community, exclusive breast‐feeding is satisfactory for 4–6 months. However, further examination is needed of the risk factors that lead to early faltering in some breast‐fed children.
Reversible Pulmonary Arterial Hypertension in a 6‐Year‐Old Girl with Extrinsic Allergic Alveolitis
Authors: øSTERGAARD J. R.
Published: January 2008

ABSTRACT. A case is reported of a 6‐year‐old girl who developed extrinsic allergic alveolitis due to hypersensitivity to her pet budgerigars. Pulmonary artery pressure measurements obtained by a cardiac catheterization demonstrated a significant increase in the pulmonary vascular resistance during the acute stage of the disease. Six months after exclusion of exposure to the budgerigars the hemodynamic of the pulmonary circulation was normalized. The present case thus shows that a reversible increase in the pulmonary vascular resistance in extrinsic allergic alveolitis of childhood may occur without development of an irreversible pulmonary fibrosis.
Coexisting Hereditary Methaemoglobinaemia and Heterozygous β‐Tialassaemia
Authors: KUMAR RAJIVE , TANDON RAJ , BADAMI K. G.
Published: January 2008

ABSTRACT. Cyanosis was noted within a few weeks after birth in two sisters. On investigation the cause of cyanosis was found to be congenital methaemoglobinaemia due to NADH diaphorase deficiency. Heterozygous β‐thaiassaemia was present as an additional incidental finding in one of the sisters, but did not contribute to the symptoms, thus showing that the two diseases, when coexistent, do not pose additional haematological problems. However, it is possible that the β‐thalassaemia counteracts the tendency to compensatory erythrocytosis induced by methaemoglobinaemia
Effect of an Acidified Milk on Diarrhoea and the Carrier State in Infants of Low Socio‐Economic Stratum
Authors: BRUNSER O. , ARAYA M. , ESPINOZA J. , GUESRY P. R. , SECRETIN M. C. , PACHECO I.
Published: January 2008

ABSTRACT. The effect on diarrhoeal disease of an acidified, modified powdered cow's milk infant formula (Pelargon®) was evaluated in 82 infants (Group I) for six months; 104 infants who received the same formula but non acidified, served as controls (Group II). Nutritional status remained satisfactory in both groups throughout the observation period. Some children rejected the taste of the acidified milk. The incidence of diarrhoea was lower in Group I (p<0.001). The proportion of days in which the children suffered from acute diarrhoea, and the duration of the episodes were also lower in the children given the acidified milk (p<0.001). The rate of detection of enteropathogens and the species identified were comparable in both groups. Carrier rates for bacterial enteropathogens fell over time in Group I while they rose in Group II (p<0.001). Carrier rates for enteric parasites were comparable to those expected in our setting for this age group. These results suggest that acidified milk exerts a protective effect against diarrhoeal disease.
Clinical Significance of Urinary C‐Peptide Excretion in Children with Insulin‐Dependent Diabetes Mellitus
Authors: HUTTUNEN N.‐P. , KNIP M. , KÄÄR M.‐L. , PUUKKA R. , ÅKERBLOM H. K.
Published: January 2008

ABSTRACT. In order to evaluate the accuracy of urinary C‐peptide determination and the clinical significance of C‐peptiduria for the early course of insulin‐dependent diabetes (IDDM), the rate of urinary excretion of C‐peptide was determined in 32 children and adolescents with IDDM and correlated with serum C‐peptide concentration, urinary excretion of albumin and β‐mic‐rogloublin and with the glomerular filtration rate (GFR) measured in terms of the clearance of 99mTc‐DTPA. The age of the subjects ranged from 9.1 to 17.1 years (mean 13.1) and the duration of diabetes from 0.3 to 11.9 years (mean 4.6). There was a good correlation between postprandial serum C‐peptide concentration and the 24‐hour urinary C‐peptide excretion rate (r=0.81; p<0.001). GFR and urinary albumin excretion were slightly elevated in the diabetic patients as compared with non‐diabetic subjects (p<0.05 and p<0.001, respectively), but C‐peptide excretion was unrelated to the degree of hyperfiltration or albuminuria, neither was there any correlation between the excretion rate of β2‐microglobulin and C‐peptide. Glycaemic control was poorer in the diabetic children who had only trace amounts of C‐peptide in their urine (<0.05 nmol/m2/24 h) than in those with minimal (0.05–1.0 nmol/m2) or moderate 24‐hour urinary C‐peptide excretion (>1.0 nmol/m2). It is concluded that urinary C‐peptide excretion serves very well to reflect residual β‐cell function and is unrelated to the slight renal hyperfunction and albuminuria often seen in diabetic subjects. Even minimal C‐peptide excretion ranging from 0.05 to 1.0 nmol/m2/24 h still seems to indicate clinically significant insulin secretion.
Reference Values of Anthropometric Measurements in Dutch Children
Authors: GERVER W. J. M. , DRAYER N. M. , SCHAAFSMA W.
Published: January 2008

ABSTRACT.In the period 1979–1980 the following anthropometric measurements were recorded in 2351 healthy Dutch children from 0–17 years of age: height, weight, sitting height, arm span, lengths of upper‐arm, lower‐arm and hand, tibial length, foot length, biacromial diameter, biiliacal diameter, and head circumference. Corresponding percentile values were constructed on the basis of normality assumptions, the mean and standard deviation at agetbeing determined by a cubic spline approximation. The results are compared with other studies and given in the form of growth charts.
Bowel Frequency in Healthy Children
Authors: FONTANA M. , BIANCHI C. , CATALDO F. , NIBALI S. CONTI , CUCCHIARA S. , CASALI L. GOBIO , IACONO G. , SANFILIPPO M. , TORRE G.
Published: January 2008

ABSTRACT. Bowel frequency was recorded, on a diary sheet basis, in 662 children from six Italian cities. There is a wide interindividual variability, showing a sharp decrease with age; we report the distribution of the percentiles in the different age groups. Among infants, the breast‐fed ones pass significantly more stools than the formula‐fed.
Ultrasonic Features of the Congenital Nephrotic Syndrome of the Finnish Type
Authors: LANNING P. , UHARI M. , KOUVALAINEN K. , LANNING M.
Published: January 2008

ABSTRACT. Ultrasonic features of the kidneys of seven infants with congenital nephrotic syndrome of the Finnish type under active conservative treatment are described. In all cases the kidneys were enlarged and the cortex more echogenic than the liver and spleen parenchyma. The pyramids were small with hazy borders resulting in an indistinct or lost corticomedultary border. At follow‐up the echogenity of the renal cortex increased still further in four infants and the pyramids became invisible. The differential diagnosis is discussed.
Bacteraemia as Predictor of HIV Infection in African Children
Authors: LEPAGE PHILIPPE , PERRE PHILIPPE VAN DE , NSENGUMUREMYI FRANÇOIS , GOETHEM CHRISTIAN VAN , BOGAERTS JOS , HITIMANA DEO GRATIAS
Published: January 2008

ABSTRACT. In Rwanda, both HIV infection and bacteraemia represent major health problems among paediatric populations. We carried out a prospective study to determine if bacteraemia is a marker of HIV infection among ambulatory and hospitalized Rwandese children. All children presenting at the Department of Paediatrics of the Centre Hospitalier de Kigali and who had their blood cultured during a two‐month period were eligible for the study. One hundred and thirty‐five children were included in the study. A pathogen was isolated from 36 children (26.7 %): S. typhimurium (10 cases), S. enteritidis (6), S. typhi (4), Str. pneumoniae (9). H. influenzae (6) and S. aureus (1). No association was found between bacteraemia and HIV seropositivity when all the children were considered. However, among patients less than 2 years old, bacteraemic subjects were more frequently (p≤0.05) HIV seropositive (44 %) than those with negative blood cultures (19 %). Our study shows that in young children in Central Africa, the presence of bacteraemia may be an important marker of HIV seropositivity.
Sandifer Syndrome Reconsidered
Authors: MANDEL H. , TIROSH E. , BERANT M.
Published: January 2008

ABSTRACT. Three children with Sandifer syndrome are described. One patient was at first erroneously diagnosed as having neurological disease; the two others had true neurological damage, which led initially to misinterpretation of their bizarre dystonic features. Awareness of this entity will spare such children needless investigations and suffering, while giving them the benefit of proper treatment.
Monomeric Calcitonin Secretion in Infants with Congenital Hypothyroidism
Authors: ZAMBONI G. , AVANZINI S. , GIAVARINA D. , TATÒ L.
Published: January 2008

ABSTRACT. We have determined CT levels in whole serum (iCT) and by an extraction method (exCT) in 25 infants affected by congenital hypothyroidism (CH)–11 athyreotic and 14 dysgenetic–at age 25 days, before the institution of therapy, and at age 2 years. In hypothyroid patients at age 25 days the iCT and exCT levels were similar to those found in controls of the same age. At age 2 years the iCT and exCT levels decreased in both groups of patients. However, whereas the levels of iCTin hypothyroids were similar to those found in controls of the same age, the levels of exCT were significantly lower in hypothyroids than in controls; moreover they were significantly lower in athyreotic than in dysgenetic patients. At this age, after calcium infusion, exCT levels significantly increased in dysgenetic but not in athyreotic patients. We hypothesize that CT deficiency in CH is due to increased degradation of human CT by the substitutive therapy, which, stimulating proteolytic enzymes, destroys the biologic activity of CT. An extraction procedure improves the sensitivity and specificity of the CT assay and it must be used when CT deficiency is suspected. In addition we suggest that the measurement of exCT levels after Ca infusion might be useful to distinguish dysgenetic from athyreotic patients.
Early Pregnancy Varicella and Associated Congenital Anomalies
Authors: HAMMAD ELHAM , HELIN INGEMAR , PACSA ALEXANDER
Published: January 2008

ABSTRACT. A case of congenital anomalies following varicella infection in the 8th week of gestation is described. Though the baby demonstrated a majority of the features characteristic of the congenital varicella syndrome and had positive immunofluorescent and ELISA tests for VZ specific antibodies, no vesicles or depigmented skin areas were seen.
Congenital Cytomegalovirus Infection Associated with Fetal Ascites and Intrahepatic Calcifications
Authors: YAMASHITA YUSHIRO , IWANAGA RIKAKO , GOTO AMIKO , KANEKO SHINYA , YAMASHITA FUMIO , WASEDA NAOKO , SHIMATSU JUNJII , HAMADA TEIJI
Published: January 2008

ABSTRACT. A fetus at 20 weeks’gestation was shown by ultrasonography to have ascites and intrahepatic calcifications. We aspirated the fetal ascites at 29 and 30 weeks’gestation to decompress the fetal lungs due to the progression of the ascites and the concomitant compression in the fetal lungs. The newborn had neither hypoplasia of the lungs nor any respiratory complication, though congenital cytomegalovirus infection was present. This is the first report of such congenital cytomegalovirus infection associated with fetal ascites and intrahepatic calcifications. Careful monitoring and early intervention is necessary for a good prognosis.
An Approach to the Estimation of Growth Standards: The Univariate Case
Authors: FRYER J. G. , KARLBERG J. , HAYES M.
Published: January 2008

ABSTRACT.This paper shows how reference values can be determined when the underlying characteristic (say, weight) follows a distribution that is not too distant from the Gaussian. Application of the normalizing Box‐Cox power transformation is the basis of our approach. This transformation is monotonic and hence invertible, so offering the choice of two scales of measurement on which to work—the original and the Gaussian. Modified versions of the procedure are provided allowing use of the basic transformation in the presence of certain deficiencies in the data, principally measurement error and misclassification. It is shown that application of Box‐Cox to a cohort at several points in time can be quite revealing. When the data are already symmetrical the Box‐Cox transformation has no effect: in this case the John‐Draper modulus transformation and modifications of it are shown to be helpful. All of this is illustrated by using data from the Swedish Longitudinal Growth Study.
A Three‐Dimensional Representation of Linear Growth and Skeletal Maturation
Authors: RUDLIN C.R.
Published: January 2008

Rudlin C.R. (4600 Grove Avenue, Richmond, Virginia, USA). A three‐dimensional representation of linear growth and skeletal maturation. Acta Paediatr Scand [Suppl] 356: 46, 1989.

Traditional two‐dimensional (2‐D) growth charts do not distinguish between the effects of a particular pathology or therapy on skeletal maturation and the effects on linear growth. In this study, longitudinal data from two growth studies on children were analysed using a computer technique to produce a growth chart in three dimensions. The three‐dimensional (3‐D) surface of the graph represents both the linear growth and the skeletal maturation of the patients. If the height and the chronological and bone ages of an individual patient are plotted to give a line in 3‐D space, the line can be compared with the 3‐D surface of the graph. This permits qualitative assessment of the relative effect of a pathology or treatment on skeletal maturation as compared with linear growth. Quantitative assessment is also possible by expressing the data in polar coordinates. The technique can be applied to clinical trials as well as to individual patients.
Changes in Skeletal Muscle after Discontinuation of Growth Hormone Treatment in Young Adults with Hypopituitarism
Authors: RUTHERFORD O.M. , JONES D.A. , ROUND J.M. , PREECE M.A.
Published: January 2008

Rutherford, O.M., Jones, D.A., Round, J.M. and Preece, M. (Department of Medicine, Rayne Institute, University College and Middlesex School of Medicine; and the Department of Growth and Development, Institute of Child Health, Great Ormond Street, London, UK). Changes in skeletal muscle after discontinuation of growth hormone treatment in young adults with hypopituitarism. Acta Paediatr Scand [Suppl] 356: 61, 1989.

Skeletal muscle strength and size were measured for 1 year following discontinuation of human growth hormone (hGH) treatment in 11 patients with hypopituitarism. Quadriceps and forearm flexor maximum voluntary isometric strength and size were measured. At the end of the study, endocrine status was reassessed by an insulin tolerance test. Three of the 11 subjects were found to have normal hGH secretion and were not included in the analysis. At 12 months, quadriceps strength, size and fibre areas were 94.0 ± 8.5%, 94.5 ± 6.3% and 85.6 ± 17.7% (mean ± SD), respectively, of baseline values. Forearm flexor strength and size were 101.4 ± 7.9% and 92 ± 9.2% of control values. Although these changes are relatively small, they suggest a role for growth hormone in the maintenance of muscle in the adult.
Cerebral Blood Flow during Experimental Hypoxaemia and lschaemia in the Newborn Piglet
Authors: ODDEN JAN‐PETTER , STIRIS TOM , HANSEN THOR W. R. , BRATLID DAG
Published: January 2008

Odden, J.‐P., Stiris, T., Hansen, T. W. R. and Bratlid, D. (Neonatal Research Laboratory, Department of Paediatric Research, Institute for Surgical Research and Department of Paediatrics, Rikshospitalet, University of Oslo, Oslo, Norway). Cerebral blood flow during experimental hypoxaemia and ischaemia in the newborn piglet. Acta Paediatr Scand Suppl 360: 13, 1989.

The effect of selective hypoxaemia or ischaemia on cerebral blood flow was studied in 14 newborn piglets with the microsphere method. Surgery and experiments were performed under general anesthesia with 70% nitrous oxide. The spontaneously breathing piglet was then exposed to either low (zero) oxygen in the inspired air (hypoxaemia), or a graded tourniquet (3–5 kg string weight) of the neck above the level of the tracheostomy (ischaemia). Cerebral blood flow was measured at baseline, during the hypoxaemic/ischaemic insult, and 30 and 60 min thereafter. Brainstem blood flow was remarkably stable during both ischaemia and hypoxaemia. The reduction in blood flow to the cerebrum and to the cerebellum was greater during ischaemia than during hypoxaemia. Reactive hyperaemia followed hypoxaemia but was not obvious after selective ischaemia. Ischaemia and hypoxaemia thus seem to have different effects on cerebral blood flow.
Standardization of Growth
Authors: PREECE M.A.
Published: January 2008

In considering the development of growth standards, four general questions need to be addressed. First, it is necessary to know why the standards are being prepared and in particular what questions will be asked of them. Second, the need for regular revision of these standards must be considered, together with the choice of interval between such revisions. Third, the relative value of national (as opposed to international or reference) standards must be established, and fourth, the requirements for the development of such standards should be taken into account.
Growth Survey of Schoolchildren in Akita Prefecture: Preliminary Report
Authors: OKAMURA T.
Published: January 2008

Okamura T. (Department of Paediatrics, Yuri Nokyo General Hospital, Honjo City, Akita Prefecture, Japan). Growth survey of schoolchildren in Akita prefecture: preliminary report. Acta Paediatr Scand [Suppl] 349: 73, 1989.

This report presents the results of a preliminary epidemiological study of growth in Akita prefecture. Data were collected from 5672 pupils from nine elementary schools in the region. Previous epidemiological investigations of growth have set the screening standard for growth retardation at ‐ 2.58 SD below the mean. On the basis of this figure it was estimated that 22 out of the 5672 pupils screened in this preliminary study (0.39%) would suffer from growth retardation. When this standard is applied to all 102,193 elementary school students in Akita prefecture, 396 children in the region are estimated to be growth retarded. An epidemiological investigation in Niigata prefecture in 1985 found that 10.5% of growth‐retarded patients suffered from growth hormone deficiency. While this percentage is known to vary between different studies and with different methods of statistical analysis, application of this rate to the estimated number of 396 growth‐retarded patients in Akita prefecture suggests that there may be 41 or 42 patients with growth hormone deficiency.
Red Cell Enzymes and Intermediates in AGA Term Newborns, AGA Preterm Newborns and SGA Term Newborns
Authors: RAMOS JOSÉ LAURO A. , NONOYAMA KIMIYO , QUINTAL VIRGÍNIA S. , BARRETTO ORLANDO CESAR DE O.
Published: January 2008

ABSTRACT. Red cell enzyme activities and 2,3‐diphosphoglycerate and adenosine‐triphosphate levels in cord blood of three groups of newborn infants were studied. The groups were classified according to birthweight in relation to intrauterine growth and gestational age. Only phos‐phofructokinase, glyceraldehyde‐3‐phosphate dehydrogenase and enolase activity values differed significantly among the groups. The activity of phosphofructokinase was lower in small‐for‐date term infants (TSGA) and preterm adequate for gestational age (PTAGA) in comparison to term infants adequate for gestational age (TAGA). Glyceraldehyde‐3‐phosphate dehydrogenase activity was higher in TAGA, in comparison to PTAGA, with no other difference among the groups. Enolase activity was found to be higher in TSGA compared to TAGA and higher in PTAGA compared to TAGA. No differences were found between PTAGA and TSGA.
Bioavailability of Urea Nitrogen for the Low Birthweight Infant
Authors: DONOVAN SHARON M. , LÖNNERDAL BO , ATKINSON STEPHANIE A.
Published: January 2008

ABSTRACT. Previous studies have demonstrated increased retention (40%) of dietary urea nitrogen by term infants recovering from infection compared to healthy infants (13%), possibly due to a higher requirement for nitrogen. Since low birthweight infants also have a high requirement for nitrogen, the bioavailability of urea nitrogen was investigated in low birthweight infants using 15N, 15N‐urea. Four low birthweight infants (gestational age = 30 ±2.2 weeks [mean ± SD, birthweight = 1.4 ±0.3 kg) were fed formula enriched with 15N, 15N‐urea. Metabolic balance studies (72 hours) were performed with urine and fecal collections. Nitrogen was quantitated by Kjeldahl analysis and 15N, 15N‐urea by gas chromatography/mass spectrometry. Mean nitrogen intake was 489 ± 32 mg/kg/d, with 75 % nitrogen absorption and 62% nitrogen retention. Maximum urinary enrichment was 8%. Cumulative 15N, 15N‐urea excretion was 72%, resulting in 28% retention. Thus the bioavailability of urea nitrogen for low birthweight infants appears to be intermediate between compromised and normal term infants.
Nicotine and Cotinine Concentrations in the Nursing Mother and Her Infant
Authors: DAHLSTRÖM A. , LUNDELL B. , CURVALL M. , THAPPER L.
Published: January 2008

ABSTRACT. Twenty‐two smoking mothers and their healthy newborn infants (mean postnatal age of 3.7 days) was studied in the maternity ward. A close correlation was found (r=0.94) between nicotine concentrations in the mothers' plasma and milk after smoking, the milk: plasma ratio being 2.9. The amount of nicotine transferred to the infant increased from 0.09 to 1.03 μg/kg infant body weight when mothers smoked before breast‐feeding. The daily dose of nicotine via the mothers' milk was 6 μg per kg infant body weight. Cotinine but not nicotine concentrations in the plasma and milk of the mothers and the urine of the infants reflected the smoking habits of the mothers during pregnancy. There was no correlation between nicotine and cotinine concentrations in the infant's urine and the amount of nicotine given to the infant via the mother's milk.
Chest X‐ray Appearances in Pneumonia and Bronchiolitis
Authors: FRIIS B. , EIKEN M. , HORNSLETH A. , JENSEN A.
Published: January 2008

ABSTRACT. Chest X‐ray findings were related to virus diagnosis, age and secretory bacterial findings in 128 infants and children under 7 years of age with clinical pneumonia and bronchiolitis. They belonged to a cohort examined in connection with the introduction of rapid methods for virological diagnosis. Seventy‐six children had a virus infection diagnosed by examination of nasopharyngeal secretion and/or by serological methods. Thirty‐seven of these children were classified as having pathogenic bacteria of importance in the respiratory tract. Four groups were compared: virus infected children with or without bacteria in the secretion and the corresponding virus negative groups. The X‐rays were normal significantly more often in the virus positive/bacteria negative group compared with the other groups. Alveolar pneumonia appearing as lobar or segmental consolidations (“lobar” pneumonia) was observed with equal frequency and without relation to bacterial findings in the virus positive and the virus negative groups. But it was more often observed in the respiratory syncytial virus (RSV) infected children under 6 months of age compared with the older RSV children. In comparison disperse alveolar infiltrations (“bronchopneumonia”) mostly appeared in the virus positive group. Interstitial pneumonia and peribronchitis were often present together in children over 6 months of age. There was no significant difference in the X‐ray appearances in the groups with and without bacterial findings in the tracheal secretion except for a higher frequency of normal chest radiographs in the bacteria negative group.
Reduced Glomerular Filtration and Elevated Urinary Protein Excretion in Diabetic Ketoacidosis
Authors: MILTÉNYI M. , SZABÓ A. , TULASSAY T. , KÖRNER A. , KENESEI E. , DOBOS M.
Published: January 2008

ABSTRACT. Glomerular filtration rate (GFR) was measured by two methods in 9 children with diabetic ketoacidosis (DKA), directly by true creatinine clearance and indirectly by means of serum beta‐2‐microglobulin levels. We found significantly reduced GFR in the first hours of DKA. The rapid improvement in GFR after fluid and electrolyte replacement indicates that volume depletion is the major cause of low filtration rate. In spite of the reduced GFR we observed pronounced albuminuria and low molecular weight (LMW) proteinuria. We conclude that the pathological albuminuria and microalbuminuria in DKA are caused not by glomerular hyperfiltration but by tubular dysfunction
Rapidly Progressive Type III Gaucher Disease: Deterioration Following Partial Splenectomy
Authors: KYLLERMAN M. , CONRADI N. , MÅNSSON J. ‐E. , PERCY A. K. , SVENNERHOLM L.
Published: January 2008

ABSTRACT. Total splenectomy has been found to accelerate disease progression in Type III Gaucher disease, therefore partial splenic resection was performed in a 28 month old girl with rapidly progressive (non‐Norrbottnian) Type III disease to alleviate the effects of hypersplenism. Surgery failed to arrest the disease process and splenomegaly recurred within three months. The erythrocyte glucosylceramide level increased post‐operatively. Post‐mortem studies revealed dense accumulation of Gaucher cells in spleen, liver, lungs, bone marrow and within the central nervous system. The glucosylceramide content of brain and liver was elevated to the range previously noted in splenectomised Norrbottnian patients. Thus, in rapidly progressive Type III Gaucher disease, neither total nor partial splenectomy alone provides a favourable outcome.
Pathological Heart Rate Responses Associated with Body Movements in Neurologically Damaged Infants during Sleep
Authors: ERKINJUNTTI M. , KERO P.
Published: January 2008

ABSTRACT. Simultaneous electrocardiogram (ECG) and static charge sensitive bed (SCSB) method recordings were carried out in fifteen healthy and twenty‐one neurologically damaged infants during sleep at the age of one week, one month and three months. The SCSB method allows continuous long‐term recording of body movements without electrodes connected to the subject. The heart rate response to body movements was studied. Healthy newborns had clear heart rate (HR) acceleration response to body movements. A rapid HR deceleration response occurred at the end of body movements. In the neurologically damaged infants the HR response to body movements was significantly hyperactive or delayed. The abnormal heart rate acceleration‐deceleration response to body movements in damaged infants can best be explained by disturbed function of the autonomic nervous system.
Fragility of the Centromeric Region of Chromosome 1 Associated with Combined Immunodeficiency in Siblings A Recessively Inherited Entity?
Authors: FASTH A. , FORESTIER E. , HOLMBERG E. , HOLMGREN G. , NORDENSON I. , SÖDERSTRÖM T. , WAHLSTRÖM J.
Published: January 2008

ABSTRACT. Instability of the centromeric region of chromosome 1, and multibranched configurations formed by the short and long arms were seen in a brother and sister with facial dysmorphism, mental retardation and recurrent infections. No chromosomal abnormalities were seen in the parents, who were first cousins. The fragility of chromosome 1 was identified in amniotic fluid cells of the sister. A combined immunodeficiency characterized by a lack of immunoglobulin production, low numbers of T cells and a lack of cells with NK cell markers was diagnosed. This is the first report of familial occurrence of this unique chromosomal aberration. The cause may be an autosomal recessive gene defect.
Four Years' Experience with Cyclosporin A in Pediatric Kidney Transplantation1
Authors: HOYER P. F. , OFFNER G. , OEMAR B. S. , BRODEHL J. , RINGE B. , PICHLMAYR R.
Published: January 2008

ABSTRACT. From 1982 to 1987 sixty‐three children were treated with cyclosporin A and low dose prednisolone after kidney transplantation. Patient survival rate at 4 years after transplantation was 98.3 %, survival rate of living related grafts 100 % (n = 10), and survival rate of cadaveric grafts 73 % (n = 53). Adequate cyclosporin blood levels were achieved in all children with a dosage regimen related to body surface area. Major concerns during the observation period were the loss of glomerular filtration rate from 51.8 to 40.5 ml/min/1.73 m2, a hypertension rate of 77.8 %, and hyperuricemia. Cyclosporin A‐side effects were mild. Infections occurred in 11.1 %. Growth retardation in prepu‐bertal children improved by 0.74 standard deviations of normal height, and in pubertal children by 0.51. We conclude that cyclosporin A treatment in children enables excellent long term graft survival rates with improved growth rehabilitation, however, the prevention of the cyclosporin associated nephrotoxicity and hypertension remains the major problem.
Clinical and Laboratory Features Associated with Persistent Gross Splenomegaly in Nigerian Children with Sickle Cell Anaemia
Authors: ADEODU O. O. , ADEKILE A. D.
Published: January 2008

ABSTRACT. Two age‐matched groups of patients with sickle cell anaemia (SS), one with persistent gross splenomegaly (PGS) and the other without palpable spleens, were studied to determine the clinical and laboratory features associated with PGS. The group with PGS had significantly larger mean liver size, higher serum indirect bilirubin levels, but lower mean haematocrit, blood cell counts and serum albumin : globulin ratio when compared to the control group without splenomegaly. Large palpable livers (> 6 cm below the coastal margin) among the PGS group tended to be associated with digital clubbing. A retrospective analysis of their case files showed that patients with PGS had had predominantly anaemic crises while those without splenomegaly had had predominantly vaso‐occlusive crises over a 2‐year period. No difference was found between the 2 groups, in respect of anthropometric data, prevalence of hepatomegaly or frequency of hospital admissions and blood transfusions.
The Value of Neonatal Serum Thyroglobulin Determinations in the Follow‐up of Patients with Congenital Hypothyroidism
Authors: ILICKI A. , ERICSSON U.‐B. , LARSSON A. , MORTENSSON W. , THORELL J.
Published: January 2008

ABSTRACT. Serum thyroglobulin was determined in 68 newborn infants with positive screening tests for congenital hypothyroidism. In 38 infants the diagnosis was confirmed (patients), but the remaining 30 were euthyroid at follow‐up (controls). The mean thyroglobulin concentration at the age of 2 weeks did not differ significantly between the patients and the controls (179 vs. 125 μg/l). Thyroid scintigraphy was performed in 15 patients. All seven with thyroid aplasia, based on 99mTc pertechnetate scintigraphy, had measurable thyroglobulin (> 2 μg/l) and thyroid hormones in their serum. This indicates that total absence of thyroid tissue is very rare in Swedish patients with congenital hypothyroidism. Scintigraphy based on 99mTc does not permit detection of small amounts of thyroid tissue. The neonatal concentrations of thyroglobulin did not correlate with the results of Griffiths test at 3 years and are therefore not useful for prognosis of psychomotor development. We conclude that neonatal measurement of thyroglobulin is of limited value in the follow‐up of patients with congenital hypothyroidism.
Immunologically Mediated Damage to the Intestinal Mucosa
Authors: STROBEL STEPHAN
Published: January 2008

ABSTRACT. This review discusses experimental and clinical evidence for the existence of immunologically mediated damage to the intestinal mucosa. The discussion of mechanisms of gastrointestinal immunoregulation and lymphocyte recirculation via recently described homing receptors is preceded by a summary of the basic structures of the gut‐associated lymphoid tissues (GALT). The relevance of food‐induced systemic hyporesponsiveness (oral tolerance) to the prevention of immunologically mediated damage to intestinal mucosa is discussed in the light of anaphylactic (Type I) and delayed type (Type IV) hypersensitivity reactions. Other, less well defined, mechanisms of allergic injury are also briefly discussed. It is postulated that the abrogation and/or modulation of orally induced tolerance is the pathogenetic mechanism underlying the induction of food‐sensitive enteropathies.
Gonadotrophin‐Releasing Hormone Agonist Treatment of Central Precocious Puberty: an Analysis of Growth Data in a Developmental Context
Authors: BOEPPLE P.A. , MANSFIELD M.J. , CRAWFORD J.D. , Jr J.F. CRIGLER , BLIZZARD R.M. , Jr W.F. CROWLEY
Published: January 2008

ABSTRACT. Growth and skeletal maturation was assessed in 83 girls with central precocious puberty (CPP) during pituitary—gonadal suppression induced by treatment with a gonadotrophin‐releasing hormone agonist (GnRHa). The mean pretreatment chronological age (CA) was 6.3 years and the mean bone age (BA) was 10.6 years. During the suppression of gonadal sex steroid secretion, mean height velocity (HV) decreased from a pretreatment value of 10.8 cm/year to 5.9 (year 1, n = 83), 4.9 (year 2, n = 72), 4.2 (year 3, n = 49, and 4.4 (year 4, n = 23) cm/year. During each interval, there was a negative correlation between HV and the pretreatment BA. In addition, the rate of skeletal maturation was reduced during GnRHa treatment (ΔBA/ΔCA = 0.6 ± 0.1 over 3 years, n = 45). The rate of skeletal maturation during therapy was also negatively correlated with pretreatment BA. Predicted adult stature, based upon z‐scores of height for BA, increased significantly and progressively during therapy but the changes in height SDS for BA varied significantly. Since HV, ΔBA/ΔCA, and the change in height SDS for BA (ΔHT SDS for BA) during pituitary—gonadal suppression all correlated with the initial degree of skeletal maturation, the effect of GnRHa therapy on Final adult height in children with CPP will be best understood if growth data are assessed within a developmental framework.