bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum Growth‐promoting Activity in Human Newborns
Authors: BOZZOLA M. , CHIRICO G. , CHIARA A. , GASPARONI A. , SCHIMPFF R. M.
Published: January 2008

ABSTRACT. Thymidine Activity (TA) was measured by the effect of serum upon incorporation of 3H‐thymidine into human lectin‐activated lymphocytes in 54 newborns: 32 full‐term, 11 pre‐term and 11 with intra‐uterine growth retardation (IGR). Capillary blood was collected at 0‐6 hours, with routine samplings. TA values were lower in preterm (0.476±0.079 U/ml) than in IGR (0.910±0.118 U/ml, p<0.01) and in full‐term neonates (1.237±0.60, p<0.001), and also in IGR newborns than in newborns of normal weight (p<0.025). In preterm neonates TA was significantly correlated with gestational age (r=0.715, p<0.02), but no such correlation existed in IRG and full‐term neonates. When TA values were plotted against birth weight, a correlation was found in preterm (r=0.715, p<0.02) and in IGR newborns (r=0.714, p<0.02), but not in full‐term neonates. Longitudinal study up to 21 days did not show significant changes in full‐term newborns, while in preterm and IGR neonates TA increased progressively to reach normal values at the 21th day. The correlations observed in newborns between TA, birth weight and gestational age, and the postnatal normalization in newborns with low birth weight, show that TA directly reflects the nutritional state of the fetus.
Myocardial Ischaemia in Aphyxia Neonatorum
Authors: PRIMHAK R. A. , JEDEIKIN R. , ELLIS G. , MAKELA S. K. , GILLAN J. E. , SWYER P. R. , ROWE R. D.
Published: January 2008

ABSTRACT. Serial electrocardiograms and creatine kinase (CK) isoenzyme activities were studied prospectively in 20 asphyxiated term newborn infants and 43 normal neonates. By adapting a previously described grading system for ischaemic changes, a degree of electrocardiographic ischaemia was defined which occurred almost solely in asphyxiated infants. Infants with this degree of abnormality had signficantly higher mean CK‐MB and MM activities than other asphyxiated infants at 0, 8 and 28 hours. Histological changes of peripartum myocardial necrosis were seen in 4 of the 5 infants on whom an autopsy was performed, and either electrocardiogram or CK‐MB was abnormal in all four. It is concluded that myocardial injury in the newborn period is often associated with CK‐MB release, but in view of the lack of cardiac‐specificity of CK‐MB in newborn infants, caution is urged in the interpretation of elevated isoenzyme activity in the neonate.
A 16‐month‐old Boy with Infectious Mononucleosis, Parotitis and Bell's Palsy
Authors: ANDERSSON J. , STERNER G.
Published: January 2008

ABSTRACT. The case of a 16‐month‐old boy with infectious mononucleosis who developed bilateral parotitis and unilateral Bell's palsy is presented. The diagnosis was confirmed by the development of specific antibodies for various Epstein‐Barr virus antigens typical of primary Epstein‐Barr virus infection. Serological tests for other viruses were negative. The Bell's palsy subsided within three months, while the clinical signs of infectious mononucleosis and parotitis persisted for three weeks.
Potential Effects of Nutritional State on Pulmonary Function in Cystic Fibrosis
Authors: HUGHES R. L. , SAHGAL V. , CRAIG R.
Published: January 2008

ABSTRACT. There are a number of observations which suggest that malnutrition and decreasing pulmonary function are parallel phenomena in chronic lung disease. Causality for either has not been established. A potential link between the two may he the diminishing function of respiratory muscles which accompanies weight loss. Data from adult patients with chronic obstructive lung disease are presented which suggest that respiratory muscle fibers progressively atrophy, not hypertrophy, in the face of increasing airway obstruction. This lack of compensation is probably nonspecific since nonrespiratory muscles demonstrate the same trend. This observation may explain some of the impaired respiratory muscle function which has been documented in patients with chronic lung disease. There are no morphologic data available for older patients with cystic fibrosis, but the processes which impair muscle function may prove to he similar in both groups of patients. The effect of malnutrition on respiratory muscle fiber size remains to be determined.
Perinatal Mortality in a Swedish County 1973–1978
Authors: EKSMYR R. , LARSSEN K.‐E. , BAKKETEIG L. S. , BERGSJØ P. , FINNE P. , LAURINI R. , WASÉN G. , KNOFF H.
Published: January 2008

ABSTRACT. The decline in perinatal mortality in a Swedish county during a six year period is examined and analyzed by use of perinatal audit. The decline coincided with an increased rate of in utero transfers of infants, particularly those with low birth weights, to the specialized county hospital. The perinatal audit revealed that the proportion of deaths which were classified as potentially avoidable, decreased significantly over the study period.
The Diagnostic and Predictive Value of Cerebrospinal Fluid Lactate in Children with Meningitis
Authors: NELSON N. , EEG‐OLOFSSON O. , LARSSON L. , ÖHMAN S.
Published: January 2008

ABSTRACT. One hundred and thirty‐three children with suspected meningitis aged from 11 days to 16 years were investigated with routine cerebrospinal fluid (CSF) laboratory methods: microscopy of a Gram‐stained smear, bacterial culture, determination of leukocytes, lactate, and the CSF/blood glucose ratio. On the basis of bacterial cultures and clinical course, the children were classified into three groups: bacterial meningitis (n=18), aseptic meningitis (n=28), and a control group (n=87). The main intention was to study the relation between current diagnostic methods and lactate. CSF lactate levels and cell counts, related significantly (p<0.01) better to the presence of bacterial meningitis than CSF/blood glucose ratios. Lactate levels exceed 2.4 mmol/l in all children with bacterial meningitis, but in none of the control group. Of 28 children with aseptic meningitis 3 had lactate in the range 2.5‐2.7 mmol/l, while the others had values of 2.4 mmol/l or less. We consider CSF lactate to be the best predictor in the clinical decision to institute antibiotic treatment of children with suspected bacterial meningitis.
Alloimmune Neonatal Thrombocytopenia and Hydrocephalus
Authors: PETERSEN STEN , JANSEN JETTE , TAUDORF KAREN , THOMSEN MOGENS , TAANING ELLEN
Published: January 2008

ABSTRACT. In 27 mothers to infants with hydrocephalus determinations of platelet antigen Zwa, HLA‐typing and ABO‐typing were performed in order to evaluate whether undiagnosed alloimmune neonatal thrombocytopenia (AINT) could be an aetiological factor in hydrocephalus. All mothers were Zwa‐positive, and the frequency of HLA‐antigens and ABO‐antigens was as in the normal population. Though sporadic cases of hydrocephalus following AINT are reported, this is not a common cause of intracranial haemorrhage and hydrocephalus.
Renal Involvement in the Laurence‐Moon‐Biedl Syndrome
Authors: LINNÉ T. , WIKSTAD I. , ZETTERSTRÖM R.
Published: January 2008

ABSTRACT. The renal abnormality of the Laurence‐Moon‐Biedl syndrome (LMBS) was investigated in six patients. The glomerular filtration rate (CIn) and the effective renal plasma flow (CPAH) were evaluated by standard clearance techniques and the single injection method, and the maximal concentration capacity was estimated by the ddAVP test. The kidney surface area and length were related to the body surface area, as well as the lumbar vertebrae L1‐L3, and the relationship with the GFR was studied. All six patients showed renal abnormalities: Five had small kidneys with reduced GFR and concentrating ability, and one had hyperaminoaciduria (but normal kidney size). Two patients developed terminal renal failure (one of them was successfully transplanted), illustrating the progressive character of the renal lesion. Three of the patients had had recurrent urinary tract infections, but the radiological changes of the kidneys were of the same character as in the others (symmetrical and irregular parenchymal reduction, and blunting and clubbing of the calyces). Since renal abnormalities, with considerable risk for progression to terminal renal failure, are common in the LMBS, regular urine cultures and blood pressure measurements are probably of great importance.
Normal Growth of Nephrotic Children during Long‐term Alternate‐day Prednisone Therapy
Authors: POLITO C. , OPORTO M. R. , TOTINO S. F. , LA MANNA A. , DI TORO R.
Published: January 2008

ABSTRACT. Statural growth has been evaluated in 20 prepubertal nephrotic children who received alternate‐day prednisone therapy for a year at least. Bone age was assessed in 16 of these children after 1‐4 years of therapy. During the follow‐up 12 children showed variations in height standard deviation score (SDs) below 0.5, 7 gained more than 0.5 SDs and 1 lost 0.5 SDs. Bone age fell within the normal range for chronological age in all the children studied. On the while alternate‐day prednisone therapy does not affect statural growth and bone maturation of children with lipoid nephrosis.
The Effects of Cranial Irradiation on Growth Hormone Secretion
Authors: AHMED S. R. , SHALET S. M. , BEARDWELL C. G.
Published: January 2008

ABSTRACT. Growth hormone (GH) secretion has been studied under physiological conditions and in response to standard pharmacological stimuli in 14 children, who had previously received cranial irradiation between two and fourteen years earlier. All fourteen showed a blunted GH response to insulin hypoglycaemia and, in twelve, the GH response to arginine stimulation was also subnormal. Physiological GH secretion was studied by measuring integrated GH concentrations in 30 min blood samples collected over a 24 hour period by a continuous withdrawal pump. Compared to normal controls (n=5), the irradiated patients showed a significant reduction in the mean integrated GH concentration (2.2: 8.8 mU/l; p< 0.002), the total 24 hour GH output (mean 105.7 mU vs. 391.7 mU; p< 0.002) and the mean GH output during the first six hours of sleep (mean 48.2 mU vs. 226 mU; p< 0.002). There was no significant correlation between the maximum peak GH response to either pharmacological test and the total 24 hour GH output. Conventionally most short children undergo two provocative tests of GH release and if the GH response to one of the two tests is normal, it is usually assumed that GH production is adequate. Adopting these criteria in this study it would have been assumed incorrectly that GH production was normal in two children. Nonetheless all 14 children showed a blunted GH response to an ITT as well as a reduced total 24 hour GH output. Therefore we would suggest that in children suspected of radiation‐induced GH deficiency pharmacological tests of GH secretion remain useful, the ITT being the test of choice because of the marked radiation sensitivity of the GH response to hypoglycaemia.
Reye's Syndrome in Denmark
Authors: DAUGBJERG P. , RANEK L.
Published: January 2008

ABSTRACT. We tried to determine the incidence of Reye's syndrome (RS) in Denmark in a retrospective study. As RS is often preceded by influenza B, we chose the year 1979, where an epidemic of influenza B was registered in Denmark. All children aged 1 month to 18 years, who died, were identified, excluding children who died from accidents or malignant diseases. Two hundred and forty‐two children died in hospital. Review of the records revealed one case of RS. One hundred and five died outside hospital. Reviewing death certificates and autopsy reports, none of these fulfilled the criteria for RS. All paediatric departments were asked if they had made a diagnosis of RS. None had. In 1979 approximately 1.1 mill, children aged 1 month to 14 years lived in Denmark. This gives an incidence of 0.09 per 100000 for 1979. Although this is a minimum figure, the incidence of RS in Denmark, for unknown reasons, seems very low.
Treatment of Cushing's Disease in Childhood and Adolescence by Stereotactic Pituitary Irradiation
Authors: THORÉN M. , RÄHN T. , HALLENGREN B. , KAAD P. H. , NILSSON K. O. , RAVN H. , RITZÉN M. , PETERSEN K. E. , AARSKOG D.
Published: January 2008

ABSTRACT. Eight children with Cushing's disease aged 6‐18 years were treated with external radiation to the pituitary gland using 60Co gamma radiation given with stereotactic technique. The dose given varied between 50 and 70 Gy. The observation time was 2.6 to 6.75 years. Seven children had a clinical remission with normal urinary Cortisol excretion. One child had insufficent effect of two irradiations and underwent bilateral adrenalectomy. In the patients in remission the growth velocity increased during the first year after treatment but growth retardation occurred again during the second year. Insufficient growth hormone secretion was demonstrated in all subjects. Two patients were given thyroxine substitution and three showed evidence for secondary hypogonadism. In conclusion, stereotactic pituitary irradiation was effective in normalizing the excessive glucocorticoid production in children with Cushing's disease. However, with the doses used, it was not possible to maintain a normal anterior pituitary function.
Viral Findings in Children under the Age of Two Years with Expiratory Difficulties
Authors: KORPPI M. , HALONEN P. , KLEEMOLA M. , LAUNIALA K.
Published: January 2008

ABSTRACT. Viral findings were prospectively studied in lower respiratory tract infections in small children with and without expiratory difficulties. On first admission, a viral aetiology was found in 71 of 127 children (56%). On re‐admission, a viral etiology was found in only two of 31 cases (6%). Respiratory syncytial viruses (RSV) were responsible for 71% of the cases with viral diagnoses. A recently‐developed method for the direct detection of viral antigens in nasopharyngeal specimens by radio‐immunoassay was more sensitive than complement fixation serology, especially in patients aged less than six months. Viral diagnosis was reached using this new method alone in 43% of infections caused by RSV and in 27% of infections caused by other viruses. In children under six months, RSV were found in 89% by direct antigen detection and in 22% by serology. We suggest that direct antigen detection should be used as the primary virological method in small children with lower respiratory tract infections. The aetiological agents were the same in cases with and without expiratory difficulties, RSV being found in about 40% of children in both instances. It is concluded that host factors are critical to the development of expiratory difficulties.
A Boy with Complete Triploidy and Unusually Long Survival
Authors: ARVIDSSON C.‐G. , HAMBERG H. , JOHNSSON H. , MYRDAL U. , ANNEREN G. , BRUN A.
Published: January 2008

ABSTRACT. A boy with complete triploidy and extensive external and internal congenital malformations who survived for almost seven months is presented. He was born after 31 weeks of gestation, was utterly small for gestational age and the delivery was induced because of intrauterine asphyxia. The infant had typical features of the complete triploidy syndrome. He did not develop mentally or motorically even to a normal neonatal level. Banding analysis of chromosomes and HLA‐antigen typing of the patient and his parents suggested that the abnormal cell division had occurred during the oogenesis. The boy suffered a fatal Pneumocystis carinii infection, suggesting defective cellular immunity. In the vast majority of previously reported cases of complete triploidy the infant has died either before birth or within the first postnatal hours and except for four patients, all reported patients have died before the age of 2 months. Our patient illustrates the fact that with modern neonatal intensive care, infants with severe malformation syndromes can survive for longer periods than previously, but in the case of patients with the complete triploidy syndrome without developing mentally at all. The ethical problem of artificially prolonged survival in severely handicapped children is discussed.
Oral Rotavirus Vaccination in Breast‐ and Bottle‐Fed Infants Aged 6 to 12 Months
Authors: VESIKARI TIMO , RUUSKA TARJA , DELEM ANDRÉE , ANDRÉ FRANCIS E.
Published: January 2008

ABSTRACT. Oral bovine rotavirus vaccine RIT 4237 was tested at two dose levels in 217 children between 6 and 12 months of age who received either breast milk or bottle milk (cow's milk or infant formula) before vaccination. Of the children 65% were initially seronegative for rotavirus ELISA IgG and IgM antibody. The full vaccine dose (108,3 50% tissue culture infective doses, TCID50) induced seroconversion rates 81% and 86% and booster response rates 69% and 64% in breast and bottle‐fed children, respectively. There was no difference in the vaccine response of infants receiving cow's milk or infant formula either. It is concluded that the RIT 4237 rotavirus vaccine at the dose level 108,3 TCID50, gives a satisfactory response in both breast‐ and bottle‐fed children in this age group, but multiple vaccinations may be needed for maximal efficacy.
Prophylactic Treatment with Valproic Acid or Diazepam in Children with Febrile Convulsions
Authors: LEE KIRSTEN , TAUDORF KAREN , HVORSLEV VIBEKE , Jailing Birgitta
Published: January 2008

ABSTRACT. The purpose of this study was to limit prophylactic treatment of children with febrile convulsions to patients who have the highest risk of recurrence. Two hundred and thirty‐one children with a first febrile seizure were divided into high‐ and low‐risk groups according to estimated risk of recurrence. All high‐risk children were offered treatment with valproic acid. If this was declined they were offered treatment with diazepam instead. Low‐risk children were untreated. Valproic acid and diazepam were found to be equally effective in reducing the risk of recurrence of febrile convulsions. By selecting for prophylactic treatment according to estimated risk of recurrence it is possible to reduce the rate of recurrence of febrile seizures in children at high‐risk (60%) to the same level as that of untreated low‐risk children (23%). Only about half of all children with febrile convulsions need treatment and follow‐up according to these criteria.
GH Deficient Children Receiving GH Replacement Do not Grow during Intermittent Infectious Illness
Authors: HERMANUSSEN M. , GEIGER‐BENOIT K. , SIPPELL W. G.
Published: January 2008

ABSTRACT. Five growth hormone deficient children, aged 5.3 to 12.6 yrs, were measured regularly once or twice weekly by knemometry, a novel and noninvasive technique of accurate lower leg length measurement. The total period of observation was 40 months in the 5 children. During this time all children received replacement therapy with extractive human pituitary growth hormone 12 IU/m2/week by daily S.C. injections. 11 intermittent infectious illnesses occurred within the observation period of 40 months. During the infectious diseases a significant decrease of the mean lower leg growth velocity down to ‐0.012 mm/day was observed. During the following convalescent period (14 days) mean lower leg growth velocity rose up to +0.107 mm/day (p< 0.001). Growth hormone substitution was not changed throughout the period of observation.
Mild Anaemia in African School Children: Effect on Running Performance and an Intervention Trial
Authors: GREISEN GORM
Published: January 2008

ABSTRACT. Blood haemoglobin concentrations and reticulocyte counts were determined in 430 school children in grades 1, 3 and S in a small township in rural Zambia at the end of the rainy season. Running capacity was estimated by the 12‐min running test. Age, sex, height, weight, social and nutritional indicators were recorded. Mean haemoglobin was 125.3 g/l ± T2.3 SD. Low haemoglobin was associated with indicators of a traditional way of life. After a controlled trial of iron, folic acid, tetrachlorethylene and chloroquine lasting for 6 weeks, mean haemoglobin in all the children was 128.8 g/l ± 10.0 SD. The mean haemoglobin was significantly higher in the 218 children who received iron than in the 212 children who did not receive iron. There were no other significant differences among the treatment grops. In a subgroup of 377 children who completed two running tests, those with lower haemoglobin ran significantly shorter distances, even when possible confounding factors were partialled out. The effect was reduced by excluding 12 children with haemoglobin less than 100 g/1 or 48 children with reticulocyte counts of 15%± or more, but remained statistically significant.
Oesophageal Function and Symptoms in Moderate and Severe Asthma
Authors: GUSTAFSSON P. M. , KJELLMAN N.‐I. M. , TIBBLING L.
Published: January 2008

ABSTRACT. Fifty‐five children and adolescents, 8 to 19 years of age, with moderate or severe asthma, and 28 healthy volunteers, 11 to 16 years of age, were interviewed about oesophageal and bronchial symptoms and investigated with oesophageal manometry combined with pH‐reflux tests, an acid perfusion test and an acid clearing test. Oesophageal dysfunction (OD) was significantly more common in asthmatic (60%) than in healthy (14%) subjects (p<0.01). Ten of 18 subjects (56%) with frequent nocturnal or morning asthma had a positive acid perfusion test as compared to 16% of patients with less severe asthma (p<0.01). Non‐allergic asthma was not significantly more related to OD than was allergic asthma. Presence of OD was not related to present beta2‐stimulant or theophylline medication. Symptoms of OD had a sensitivity of 52% and a specificity of 100% regarding OD in the asthmatic subjects. In conclusion, asthma was frequently associated with OD. There is indirect evidence that OD, especially acid hypersensitivity of the oesophagus, can aggravate asthma.
Congenital Myotonic Dystrophy
Authors: WESSTROM G. , BENSCH J. , SCHOLLIN J.
Published: January 2008

ABSTRACT. Congenital myotonic dystrophy HMD) is characterized by hypotonia, facies myopathica, feeding and respiratory problems, skeletal deformities and polyhydramniosis. It is an auto‐somal‐dominant disorder transmitted via the mother. The diagnosis can as a role be confirmed by examining the mother, but can fail as she might be asymptomatic. During a nine year period, eight children were diagnosed as CMD which means an incidence of one case per approximately 3500 live births. The diagnosis was confirmed in six of the mothers. The two floppy infants, where positive inheritance could not be proven, showed most of the signs and symptoms described in CMD. Four children died, two from respiratory insufficiency and two suddenly and unexpectedly. CMD may be one less common cause of sudden infant death syndrome (SIDS). The four children who survived displayed delayed psychomotor development.
Infant Self‐Regulation of Breast Milk Intake
Authors: DEWEY K. G. , LÖNNERDAL B.
Published: January 2008

ABSTRACT. In an experimental study to determine whether augmentation of maternal milk supply affects infant intake, 18 mothers of exclusively breast‐fed infants stimulated milk supply by daily expression of extra milk for 2 weeks. Infant milk intake was recorded before, during and after this expression phase. All but 4 mothers increased milk production by >73 g/day over baseline, with an average increase of 124 g/day. On the average, the 14 infants of mothers who increased milk production took in significantly more milk immediately following the expression phase (849 vs. 732 g/day), but about half of them returned to near baseline levels of milk intake after 1‐2 weeks. Net change in infant intake at the end of the study was positively correlated with infant weight‐for‐length (r=0.59) and age (r=0.58), and was unrelated to baseline milk intake (r=‐0.06). Therefore, the wide range in breast milk volume in well‐nourished populations is due more to variation in infant “demand” than to inadequacy of milk production.
Dysgenesis of the Corpus Callosum and Hypopituitarism
Authors: SMITH P. J. , HINDMARSH P. , KENDALL B. , BROOK C. G. D.
Published: January 2008

ABSTRACT. A high resolution CT scan demonstrated the unexpected finding of dysgenesis of the corpus callosum in addition to the expected finding of pituitary hypoplasia in three children who presented with growth failure secondary to hypopituitarism. Several of the clinical features reported in association with dysgenesis of the corpus callosum may be ascribed to hypo‐thalamo‐pituitary dysfunction. These children emphasize the need to assess the endocrine function of patients with midline structural defects. It should not be assumed that the clinical manifestations are related solely to the anatomical abnormality.
Diets of Healthy Swedish Children 4‐24 Months Old
Authors: KYLBERG E. , HOFVANDER Y. , SJOLIN S.
Published: January 2008

ABSTRACT. In a semi‐longitudinal investigation comprising a total of 81 infants studied at one or more of the ages 4, 9, 15 and 24 months, the food intake was recorded on three consecutive days at 4 months and on seven consecutive days at 9, 15 and 24 months (40, 40, 38 and 40 infants, respectively in the four age groups). The median energy intake was lower than the Recommended Dietary Allowances in all age groups. The energy intake derived from fat was low among some of the 9‐month‐old infants. The contribution of sucrose to energy was as high as 10% at 24 months.
Serum‐Sickness‐Like Disease is a Common Cause of Acute Arthritis in Children
Authors: KUNNAMO I. , KALLIO P. , PELKONEN P. , VIANDER M.
Published: January 2008

ABSTRACT. Among 283 children in a prospective study of arthritis we found 15 patients with a self‐limited serum‐sickness‐like disease consisting of urticaria or joint erythema and mostly polyarticular arthritis. The mean duration of joint symptoms was 5.9 days. A preceding infection was reported in 12 patients and 12 had received drugs, the therapy starting on average 12.8 days before the onset of joint symptoms. In 9 cases the drug was penicillin. Four patients had recurrent attacks. Circulating immune complexes were detected in the serum of 12 patients, but specific IgE antibodies to penicillin only in 3 patients. The estimated annual incidence of the condition was 4.7/100000 children under age 16.
Infective Endocarditis in Swedish Children
Authors: SCHOLLIN J. , BJARKE B. , WESSTROM G.
Published: January 2008

ABSTRACT. 66 cases of infective endocarditis (IK) during 1971‐1980 were studied. The infection was in most cases located to the mitral or aortic valve. Major complications were found in 43 children. In 17 children there was a long history of infection for which medical consultation had previously been sought prior to correct diagnosis. Antibiotics were administered to 60 children, in 58 intravenously while 2 received oral therapy only. Acute surgical intervention was necessary in six children and three of these children died. In all, 15 (23%) children died as a consequence of the infection.
Loperamide Associated Necrotising Enterocolitis
Authors: CHOW C. B. , LI S. H. , LEUNG N. K.
Published: January 2008

ABSTRACT. Two cases of necrotising enterocolitis (NEC) occurring in infants beyond the neonatal period were reported. They did not have any predisposing factors to NEC but both had paralytic ileus after loperamide therapy for their mild diarrhoea prior to the onset of NEC. The possible role of loperamide in the pathogenesis of NEC was discussed.
Clinical Experience with Somatrem in Growth Hormone Deficiency
Authors: VICENS‐CALVET E. , POTAU N. , CARRACOSA A. , ALBISU M. , GUSIÑER M. , CUATRECASAS J.M. , STRINDBERG B. , FLODH H.
Published: January 2008

ABSTRACT. Three studies of human growth hormone (hGH) in hGH deficiency were initiated. In the first of these, adolescent patients were switched from pituitary hGH to somatrem (SI preparation) for 1 month. No significant differences were noted in any of the clinical parameters measured during treatment with either preparation. In the second study, nine patients (six of them naïve) were treated with somatrem (SII preparation) for 9–12 months. The naïve patients exhibited catch‐up growth, and bone age developed in parallel to chronological age during the study period. Somatomedin activity increased and correlated positively with growth. Antibodies to hGH and Escherichia coli polypeptide (ECP) developed in some patients, but titres and binding capacities were low. In the third study, 21 patients are currently being treated with Somatonorm; the first 3–6 months are evaluable. Growth velocities increased to normal values. Antibodies to hGH and ECP were present in several patients, but again the titres and binding capacities were low, and Somatonorm was less antigenic than the SI and SII preparations.
Clinical Experience with Authentic Recombinant Human Growth Hormone
Authors: B.RANKE MICHAEL
Published: January 2008

ABSTRACT. Studies of authentic recombinant human growth hormone (rhGH) began very recently in Germany. In this study, one group of patients with hGH deficiency is naïve (no previous hGH treatment), and the second group has been treated with pituitary hGH. The mean age of diagnosis of 17 naïve patients so far accepted is about 8 years; patients who have previously received pituitary hGH are older and slightly taller. No other data are yet available for analysis.
Estimation of Stroke Volume Using Doppler Echocardiography and Left Ventricular Echocardiographic Dimensions in Infants and Children
Authors: CAIDAHL K. , MELLANDER M. , SABEL K.‐G. , ERIKSSON B. O.
Published: January 2008

ABSTRACT. To evaluate the accuracy of noninvasive determination of stroke volume in infants and children, 28 patients (age range 4 weeks to 19 years) were studied. Stroke volume was calculated according to Teichholtz from M‐mode echocardiographic tracings of left ventricular dimensions in 8 subjects. Agreement with thermodilution performed within 60 min of echocardiography was good (r=0.995, y=0.91x+1.59, SEE=1.8 ml). Since stroke volume correlated to body size we corrected for (height)3. After this correction there was still good agreement to thennodilution (r=0.88, y=1.29x‐7.13, SEE=7.1 ml/H3). M‐mode echocardiography was then used as a reference method for evaluating two ditrerent Doppler methods in the remaining 20 subjects. Continuous wave Doppler stroke distance, calculated from the mean velocity, was combined with aortic root area (Method I), and stroke dstance calculated from maximum velocity was combined with the aortic interleaflet area (Method II). Good agreement was found with Method I (r=0.95, y=l.01x‐0.14, SEE=8.1 ml) and Method II (r=0.95, y=1.04x‐1.14, SEE=8.4 ml). However, when stroke volume was normalized for (height)3, Method I was found to be superior to Method II.
Clinical Outcome and Circulatory Effects of Fetal Cardiac Arrhythmia
Authors: LINGMAN G. , LUNDSTRÖM N.‐R. , MARŠÁL K.
Published: January 2008

ABSTRACT. By means of abdominal fetal ECG and non‐invasive ultrasound blood flow studies 113 cases of fetal cardiac arrhythmia were classified according to the origin of arrhythmia. Pregnancy outcome was characterized by an increased frequency of fetal distress and heart malformation, and increased fetal and neonatal mortality. The following types of arrhythmia were identified: supraventricular extrasystoles (n=84), paroxysmal tachycardia (n=6), sinus bradycardia (n=3), atrial flutter (n=1), ventricular extrasystolw (n=14), and atrioventricular block (n=5). In 37 cases the combined Doppler and real‐time ultrasound tehnique was used to measure fetal aortic blood flow as a means of studying the circulatory effects of the arrhythmia. Increased peak velocity, risiig slope and acceleration were found in the first post‐pausal beat after a supraventricular extrasystole or a missed beat; this supports the validity of Frank‐Starling law for the fetal heart and suggests that a strong relationship exists between these variables and myocardial contractility, In two cases of intra‐uterine heart failure, the effect of digoxin treatment in utero on the fetal aortic flow variables was studied, results indicating a positive inotropic effect of the drug on the fetal myocardium. The estimation of fetal aortic volume blood flow in cases of fetal cardiac arrhythmia is useful for early detection of fetal cardiac failure, and for monitoring the effects of intra‐uterine treatment.
Determinants of Microangiopathy in Growth‐onset Diabetes
Authors: STERKY GÖRAN , WALL STIG
Published: January 2008

In a quasi‐experiment all diabetic children in a defined area were exposed either to an intense clinical treatment or served as a constructed control. The cohort of 146 diabetics was observed prospectively for at least 15 years as to diabetic control, mainly glycosuria, and cross‐sectionally examined for microangiopathy on four occasions. Data on family background, social situation, smoking, blood pressure, biochemical status, anthropometry, HLA factors and mortality were also gathered. Throughout the analysis duration was considered and treated as a concomitant variable.

Two different strategies have been followed in the analysis, one trying to predict microangiopathy at a fixed and predetermined duration, the other to study determinants of the pattern of microangiopathy occurrence over time. Multiple logistic regression and Cox analysis have been used to fit these strategies.

The prevalence of microaneurysms or more advanced stages of retinopathy at 10 years duration was 30 per cent and within 20 years 81 per cent. About 52 per cent had haemorrhages after 20 years. Mild and severe nephropathy after 20 years have been contracted by 50 and 15 per cent respectively.

No clear sex differences were seen. Variables significantly explaining retinopathy within 10 years were post‐pubertal duration, blood pressure, place of medical supervision and the HLA/DR4 marker. The mean glycosuria was high during puberty irrespective of age at onset. The overall pattern of retinopathy occurrence seemed to be influenced by place of medical supervision, age at onset, blood pressure, family history of ischaemic heart disease and glycemic control. For the progression of retinopathy the role of factors reflecting medical supervision and control of diabetes seemed even greater. Even after accounting for degree of diabetic control the experimental group had a more favourable outcome, suggesting additional quality of care components. Mild nephropathy was less predictable from the above risk factors while previous findings of the important role of elevated blood pressure for severe nephropathy was confirmed. We estimate that half of retinopathy cases were preventable by the “experimental” care and conclude the near‐normalization of glycaemia under routine conditions favourably influences the development of diabetic retinopathy.
Influence of Dopamine on Atrial Natriuretic Peptide Level in Premature Infants
Authors: TULASSAY T. , RASCHER W. , HAJDU J. , LANG R. E. , TÓTH M. , SERI I.
Published: January 2008

ABSTRACT. The role of dopamine (DA) in the activation and/or release of atrial natriuretic peptide (ANP) was investigated in 11 premature infants during the early postnatal period. Mean plasma concentration of ANP and free DA level before DA infusion was 252.6±210 fmol/ml, and 0.4±0.2 ng/ml, respectively. DA infusion in a dose of 2μg/kg/min caused a rise in plasma free DA level to 59.7±21.5 ng/ml and a significant increase in GFR, diuresis, sodium excretion and fractional sodium excretion. The plasma concentration of ANP, however, remained unchanged (252.6±210.0 vs. 213±143.0 fmol/ml). Thus, our data failed to demonstrate a stimulatory effect of DA on ANP release in premature infants. The role of the high plasma concentration of ANP in preterm neonates immediately after birth has to be clarified.
Evidence for Transient Peripheral Resistance to Parathyroid Hormone in Premature Infants
Authors: KRUSE K. , KÜSTERMANN W.
Published: January 2008

ABSTRACT. Serum immunoreactive parathyroid hormone (iPTH), ionized calcium, the urinary cyclic AMP/creatinine ratio (cAMP/Cr) and some indices of bone turnover (alkaline phosphatase (AP), serum osteocalcin, and the urinary total hydroxyproline/creatinine ratio (OH‐P/Cr)) were measured in 26 preterm infants during the first 4 weeks of life. Despite of stimulated parathyroid gland activity cAMP/Cr, AP, osteocalcin and OH‐P/Cr were low during the first week. Thereafter iPTH decreased, whereas cAMP/Cr, and the indices of bone turnover increased, reaching high‐normal values (in comparison to full‐term infants) during the second and third week of life. Serum iPTH was negatively correlated to cAMP/Cr in the first week (r=–0.61, p<0.01), whereas the relationship became positive during the second (r=0.47, p<0.05) and third (r=0.54, p<0.05) week of life indicating maturation of the renal response to PTH. The study supports the concept that in premature infants a transient pseudohypo‐parathyroid‐like state is present during the first week of life reflecting an immaturity of renal and possibly bone response to PTH. This may be an etiological factor in hypocalcemia of prematurity.
Total Anomalous Pulmonary Venous Connection in Siblings
Authors: SOLYMAR LASZLO , SABEL KARL‐GÖRAN , ZETTERQVIST PER
Published: January 2008

ABSTRACT. Three pairs of siblings with total anomalous pulmonary venous connection (TAPVC) are reported. The types of the anomalous venous return (supra‐ or infracardial connections) varied within the families indicating that genetic regulation deals with the left atrial connection to the intrapulmonary veins. Having failed to establish this connection the intrapulmonary veins can attach themselves to any adjacent venous structure; hence the variety of connections at birth. Our observations also indicate the possibility that specific genetic mechanisms operate in at least some families. Since signs, such as murmurs and cardiomegaly typical of a cardiac anomaly, are not always present in TAPVC, special attention should be paid to any neonatal abnormality in siblings of known cases with TAPVC.
Hearing Impairment in Connection with Preauricular Tags
Authors: KANKKUNEN A. , THIRINGER K.
Published: January 2008

ABSTRACT. Between 1977 and 1984, 230 newborns (5.4/1000 livebirths) were registered at the two maternity hospitals of Goteborg as having preauricular tags. Of these 188 were available for hearing assessment. In 10 children (5%) the tag was associated with other malformations of the ear/face region. All these children had hearing impairment (HI), 8 conductive, 1 sensorineural and 1 mixed. In 178 neonates the tag was the only defect. Of these, 23 (13%) were found to have HI, all sensorineural and of mild to moderate degree. In the total group of children a positive family history for HI was found in 29% and for malformation in 24%. In the children where HI was found (33 cases in total) the figures for heredity rose to 67% (HI) and 30% (malformation). In the 23 cases with ear tag and HI, a hereditary tendency for HI was found to be 78%. Accordingly there is a clearly elevated risk for HI in connection with ear tags and we therefore recommend routine hearing assessment in all children with preauricular tags.
Fryns Syndrome in a Girl Born to Consanguineous Parents
Authors: SCHWYZER U. , BRINER J. , SCHINZEL A.
Published: January 2008

ABSTRACT. An overweight female newborn with multiple congenital anomalies died shortly after birth. The parents were cousins. The following abnormal findings were noted: Broad, square‐shaped head with flat nose, misshapen ears, cleft palate, receding chin, short neck with additional skinfolds, disproportionately short limbs, transverse palmar creases, distal digital hypoplasia with hypoplastic finger‐ and toenails. Autopsy disclosed a number of further malformations including: dysplasia of the hippocampus, atypical lobation of the lungs with cystic‐adenomatoid malformation of the left upper lobe, malrotation of the intestine, bilateral cystic renal dysplasia, bilateral atretic ureters plus a right accessory hydroureter, hypoplastic urinary bladder, uterus and vagina duplex and elongated, partly cystic ovaries. The pattern of malformations in this girl is very similar to that of 7 previously reported patients including two sets of siblings and one instance of parental consanguinity. All patients died shortly after birth. For proper genetic counselling and for prenatal ultrasonographic diagnosis in a further pregnancy, it is important to recognize patients with the Fryns syndrome.
Recumbent Cranial Diabetes Insipidus
Authors: VILLADSEN A. B. , PEDERSEN E. B.
Published: January 2008

ABSTRACT. A male, aged 16, with chronic Hypernatremia, adipsia, polyphagia, and poikilothermia was studied regarding regulation and secretion of arginine vasopressin. During recumbency at night, low plasma arginine vasopressin levels and increased volumes of dilute urine were found; whereas plasma arginine vasopressin levels and urine osmolalities rose and urine volumes decreased during ambulation in the daytime. Neither a 25% reduction of mean arterial pressure nor hypertonic saline infusion increased plasma arginine vasopressin or urine osmolalities. Treatment with 1‐desamino‐D‐arginine‐vasopressin at 6 p.m. and a scheduled fluid intake according to actual body weight eradicated Hypernatremia and hyperosmolality. These data demonstrate a complete loss of arginine vasopressin secretion to osmotic stimulation, a partial defect of arginine vasopressin secretion to non‐osmotic stimulation, an abolished response to stimulation of high‐pressure‐baroreceptors, but an intact responsiveness to stimulation of low‐pressure‐baroreceptors.
The Effects of Intermittent Positive Pressure Ventilation on Cerebral Arterial and Venous Blood Velocities in the Newborn Infant
Authors: COWAN F. , THORESEN M.
Published: January 2008

ABSTRACT. Cerebral arterial and venous blood velocities were measured using pulsed Doppler ultrasound in 25 newborn infants requiring intermittant positive pressure ventilation (IPPV). The aim was to investigate whether these velocities altered in relation to the peak inflation pressure (PIP) used. Continous recordings were made on the superior sagittal sinus and an intracranial artery both at the clinically prescribed PIP, and while this was altered in steps. A majority of the infants had, at some stage of their illness, variations in their venous and arterial velocities in phase with IPPV and related to the PIP used. These variations could be reduced by lowering the PIP. This was done in 5 infants whilst we were still able to maintain adequate ventilation.
Impaired Vascular Reactivity in Newborn Infants of Smoking Mothers
Authors: AHLSTEN G. , EWALD U. , TUVEMO T.
Published: January 2008

ABSTRACT. A transcutaneous PO2 technique was used to study the influence of cigarette smoking during pregnancy on postocclusive reactive hyperaemia of the skin of newborn infants and their mothers. Forty‐seven mothers and their infants were studied on two occasions (24–48 and 96–144 h) after birth. Twenty of the mothers were habitual smokers, 27 were non‐smokers. All mothers were healthy and their pregnancies and deliveries were normal. The infants were all healthy throughout their first week of life. The mothers had more marked reactive hyperaemia than their newborn infants (p<0.001). Infants of smoking mothers had a significantly weaker postischaemic hyperaemic response 24–48 h after birth than infants of nonsmoking mothers (p<0.01). This difference had disappeared 96–144 h after birth. Smoking mothers also showed a significantly weaker hyperaemic response to ischaemia than the control mothers at the first investigation (p<0.05). This difference was smaller and not statistically significant at the second recording. A decreased capacity for postocclusive reactive hyperaemia might be particularly harmful in asphyctic infants, but it may also be detrimental for a normal postnatal circulatory adaptation.
Influence of Different Protein Intake on Renal Growth in Young Rats
Authors: JAKOBSSON BIRGIR , CELSI GIANNI , LINDBLAD BO S. , APERIA ANITA
Published: January 2008

ABSTRACT. We have examined the effect of high protein intake on kidney growth and function in growing rats. The rats were kept on an isocaloric diet containing 12%, 21% and 50% protein, from weaning (16 days) until the time of investigation (18, 20, 24,40 or 80 days). There was no significant difference between the 12% and 21% protein groups in any of the parameters studied. 50% protein increased body weight (BW) and kidney weight (KW). The increase in kidney weight was already evident after 2 days and exeeded the increase in body weight in all age groups. At 24 days renal cortical DNA and the protein/DNA ratio were significantly increased in the 50% protein group. At 40 days the cortical DNA content, but not the protein/DNA ratio, was significantly increased in the 50% group. The glomerular filtration rate (GFR) was studied at 40 days. Total GFR as well as GFR/BW was significantly higher in the 50% group than in the 21% group. In one protocol the diet was discontinued at age 40 days and the rats were studied at age 80 days. In these rats all parameters of renal size and function were the same as in the rats that had had a normal (21%) protein intake from weaning. We conclude that in young rats high protein intake reversibly increases GFR out of proportion to BW and selectively and reversibly stimulates kidney growth by stimulating cell proliferation.
The Prevalence of Allergy and IgE Antibodies to Inhalant Allergens in Swedish School Children
Authors: HATTEVIG G. , KJELLMAN B. , BJÖRKSTÉN B. , JOHANSSON S. G. O.
Published: January 2008

ABSTRACT. Out of 242 children (10 and 14 years of age) in one school‐district 221 (93 %) were evaluated for atopy/allergy by a questionnaire, interview, physical examination and determination of S‐IgE and IgE‐antibodies (RAST) to pollen, animal danders and house dust mite. Eighteen months after the initial examination all 221 children were re‐interviewed. All children with previous or current symptoms of atopy/allergy, all children with positive RAST despite a negative history and 20 non‐atopic/non‐allergic RAST‐negative children were tested with a skin prick test (SPT). At the initial examination the cumulative incidence of atopy/allergy was 32.6% and positive RAST was obtained in 40 children (18.1%). At the follow‐up the incidence of atopic/allergic symptoms during the last 18 months was 25.8%. The current prevalence of allergy to pollen and danders, assessed by interview only, was 19 % and 9 % respectively while determined by both interview and positive SPT 15 % and 5 % respectively. The mean S‐IgE (78 kU/l) of the children with current symptoms differed significantly (p<0.001) from that (19 kU/l) of the non‐atopic ones. There was no relationship between S‐IgE and the stage of puberty. Ten of the 11 children with positive RAST, but no atopy/allergy intially, developed clinical atopy/allergy during the follow‐up.
The Varied Clinical and Laboratory Manifestations of Type II Gaucher's Disease
Authors: LAKS Y. , WELL J. PASS
Published: January 2008

ABSTRACT. An infant of Arab extraction with the Type II form of Gaucher's disease is described. His clinical presentation was unusual because in addition to the extensive neurological involvement and marked hepatosplenomegaly a severe congestive cardiomyopathy and renal tubular dysfunction were present. In addition, marked hypergammaglobulinemia and raised serum angiotensin converting enzyme levels were found. It is suggested that these varied manifestations may be ascribed to the consequences of glucocerebroside deposition within the macrophages of the reticuloendothelial system.