bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPUTER‐BASED SURGICAL AUDIT PROGRAMS: A REVIEW OF THREE CURRENT OPTIONS
Authors: Colledge D. N. , White S.
Published: January 2008

Background: In order to find the most useful computerized auditing system for the needs of the QE II Hospital surgical department three surgical auditing software programs were assessed.

Methods: The Otago University Surgical Auditing Program, the Australian Surgical Auditing Program, and RACS‐Audit were trialled for a period of 1 month each. The software programs were evaluated to find the time requirements for data entry, the level of surgical knowledge needed for effective audit information entry, and the perceived usefulness of the generated reports.

Results: It was found that the Otago University program best suited the needs of the department. This system was designed for use in a hospital environment with multiple users. The method of data collection was simple and rapid. Entry of data into the program was logical, well structured and able to be performed by both junior medical staff and clerical staff. Reports generated by this system included information in an appropriate format for the departments' morbidity and mortality meetings.

Conclusion: Personal computers are an ideal tool for the undertaking of surgical audit. Software programs are designed for different uses and should be critically assessed to ensure that the method of data entry, the time involved, and the reports generated enable an efficient and effective audit to be carried out.
ADVERSE IMPACT OF PNEUMOPERITONEUM ON INTRAPERITONEAL IMPLANTATION AND GROWTH OF TUMOUR CELL SUSPENSION IN AN EXPERIMENTAL MODEL
Authors: Mathew George , Watson David I. , Rofe Alan M. , Ellis Tanya , Jamieson Glyn G.
Published: January 2008

Background: An investigation of the effect of laparoscopy and CO2 pneumoperitoneum on the pattern of tumour implantation and growth in the peritoneal cavity was carried out.

Methods: A suspension of viable adenocarcinoma cells was introduced into the left upper quadrant of the peritoneal cavity of 36 syngeneic immune‐competent rats at laparotomy, laparoscopy with CO2 insufflation, and gasless laparoscopy (12 rats in each group). Six days later the peritoneal cavity and surgical wounds were examined for macroscopic evidence of implanted tumour. The abdominal cavity was divided into sectors and macroscopic tumour implantation was determined for each sector and wound. This was confirmed by histological examination.

Results: While tumour implantation occurred in the vicinity of the tumour suspension introduction site in the laparotomy and gasless laparoscopy groups, implantation occurred throughout the peritoneal cavity, including areas remote to the introduction site, in the laparoscopy with CO2 insufflation group. Tumour growth was more likely in the port wounds of rats undergoing laparoscopy with insufflation than without.

Conclusions: In this model, CO2 insufflation during laparoscopy resulted in widespread tumour dissemination and implantation, when compared to laparotomy and gasless laparoscopy, supporting the postulate that wound metastasis and tumour spread may be more likely following laparoscopic cancer surgery in humans when CO2 insufflation is used.
THE ROLE OF LAPAROSCOPY IN EVALUATION OF THE IMPALPABLE UNDESCENDED TESTIS
Authors: Mark S. D. , Davidson P. J. T.
Published: January 2008

Background: The evaluation and management of the impalpable testis remains controversial. The authors' experience with laparoscopy for the treatment of this condition is reported here.

Methods: All children with impalpable testes underwent an examination under anaesthetic and if negative, a laparoscopy was performed to locate the testis. A prospective evaluation was undertaken to determine the success and morbidity of this approach.

Results: Thirty‐six children (median age 2.5 years) underwent laparoscopy to localize 40 impalpable testes. In 32 patients with unilateral impalpable testis, 10 were intra‐abdominal, nine were absent. In 13 patients, the vas and vessels entered the groin, and in 12 of these a small testis remnant was excised and in the other a normal‐looking testis was brought down. In four patients with bilateral impalpable testes, one testis was absent, three testes were intra‐abdominal and four were small testis remnants in the groin. The average laparoscopy time was 15 min, and 34 of 36 children were operated on as day‐stay cases. One child had an omental hernia via a port site.

Conclusion: Laparoscopy is safe and effective at localizing impalpable testes in children and can be performed as day‐stay procedures in the majority of cases.
PARÉ AS A NEUROSURGEON
Authors: Simpson Donald
Published: January 2008

The Cowlishaw Collection gives a splendid representation of the works of Ambroise Park (1510–1590). His Complete Works, in the great French edition edited by J. F. Malgaigne, are essential in any study of Paré's achievement, but the 1649 English edition provides a good basis for consideration of Paré's practice in what would now be termed neurosurgery. Paré had a large clinical experience in head injury management. His patients included Henri II King of France, who died from a penetrating orbital wound, and he described a number of other craniofacial wounds sustained in war or in warlike sports. His surgical instruments and operative techniques do not appear very innovative, but were doubtless good in their day; his methods of trephination compare favourably with those of the English surgeon John Woodall, his younger contemporary. He operated on head injuries and cranial infection, but had no capacity to treat intradural conditions, such as cerebral abscesses and tumours: his technical limitations are obvious, and the physicians on whom he had to rely could give him no guidance in neurological diagnosis. He was keenly interested in developmental malformations, and described several conditions that would now be referred to a paediatric neurosurgeon. Paré is of great historical importance as an outstanding Renaissance surgeon, whose influence extended throughout the literate world, and as far as Japan. With him, France replaced Italy and Spain in leadership in European surgical progress, a position that France retained at least until the age of Hunter.
ELECTROHYDRAULIC LITHOTRIPSY: AN EFFECTIVE AND ECONOMICAL MODALITY OF ENDOSCOPIC URETERIC LITHOTRIPSY
Authors: See A. C. H. , Ng F. C. , Ch'ng H. C.
Published: January 2008

Background: Electrohydraulic lithotripsy (EHL) has been available for endoscopic treatment of urinary calculi since 1960, but the large probe size and concerns regarding safety had previously restricted its use to the treatment of bladder calculi. However, recent refinements have made it particularly suitable for the treatment of ureteric calculi.

Methods: The authors report their initial experience using EHL in conjunction with mini‐ureteroscopy in the treatment of 94 ureteric calculi in 89 patients. The size of the calculi ranged from 3 to 19 mm in diameter, with a mean of 8.2 mm. The mean operating time was 29 min, ranging from 10 to 120 min.

Results: A complete fragmentation rate of 91.5% of the calculi was achieved. There were no major complications and a low incidence of minor complications: haematuria (2.2%), urinary tract infection (3.4%) and postoperative ureteric colic (2.2%). There were four cases of minor ureteric perforations (4.5%); all were successfully treated using conservative measures.

Conclusions: It is concluded that EHL is a safe and effective method of treating ureteric calculi.
ANOMALOUS AZYGOS VEIN: A POTENTIAL DANGER DURING ENDOSCOPIC THORACIC SYMPATHECTOMY
Authors: Sieunarine K. , May J. , WHITE G. H. , Harris J. P.
Published: January 2008

A report of a patient with an azygos lobe and an associated anomalous azygos vein covering the upper thoracic sympathetic chain. This anomaly poses a significant risk during the procedure of endoscopic thoracic sympathectomy. A chest X‐ray is useful in detecting this anomaly and alerting the surgeon to potential problems.
FINE NEEDLE ASPIRATION BIOPSY IN CHILDREN
Authors: Orford J. E. , Gollow I. , Brennan B. , Hallam L.
Published: January 2008

Background: Fine needle biopsy (FNB) in children has been slow to gain acceptance compared with the use of the technique in adults where it is regarded as standard clinical practice in screening significant lymphadenopathy and suspicious masses. We report our early experience with FNB in the paediatric population.

Methods: Fifty‐two biopsies were performed between June 1991 and June 1993. The age of the children ranged from 6 months to 14 years (median 2 years, mean 5 years).

Results: A definite diagnosis on cytology alone was obtained in 67%. The pathologist was certain of malignant or nonmalignant potential in 79% (67% benign and 12% malignant) and unsure in 21% (17% benign and 4% malignant). There were no false positive or false negative diagnoses of malignancy. Surgical excision or biopsy was performed in 33%. Fine needle biopsy assisted in planning surgery in 12%. Surgery was necessary for a definite diagnosis in 21% and FNB assisted 42% of the patients to avoid surgery altogether.

Conclusions: Fine needle biopsy is simple, minimally invasive and useful in the evaluation of children with suspicious lymph nodes and masses.
METAL‐ON‐METAL ARTICULATION IN TOTAL HIP ARTHROPLASTY: PRELIMINARY RESULTS IN 57 CASES
Authors: Randle Raymond , Gordiev Katherine
Published: January 2008

Background: Aseptic loosening of hip prostheses may lead to implant failure and necessitate revision surgery. Metal‐on‐metal hip articulation has characteristics that may minimize prosthesis loosening when compared with other forms of hip articulation. The purpose of the present prospective study was to identify early problems that may contraindicate the use of the ‘prosthesis femorale modulaire’ (PFM) metal‐on‐metal prosthesis.

Methods: The preliminary results of 57 metal‐on‐metal total hip arthroplasties performed by one surgeon (RR) from 1994 to 1996 in Lismore, New South Wales, are presented here. Data were obtained using patient questionnaires, physical examination and by examination of radiographs.

Results: A total of 87.6% of patients had an excellent or good outcome, according to the Harris rating system, at the latest review. The two patients with poor results had obvious alternative causes for their continuing symptoms. There was no radiological evidence of bone or prosthesis failure during the period of follow‐up.

Conclusions: The preliminary results are comparable with those of other authors who have examined the early results of metal‐on‐metal total hip arthroplasty.
THE SURGICAL MANAGEMENT OF OSSEOUS CRANIAL BASE TUMOURS IN CHILDREN
Authors: Holmes Anthony D. , Klug Geoffrey L. , Breidahl Alan F.
Published: January 2008

Background: Osseous cranial base tumours in children present as a diverse collection of both benign and malignant pathologies. Concerns raised by the difficulty in accurate diagnosis and local recurrence of benign lesions and by the long‐term sequelae of radiotherapy for malignant cranial tumours (marked local growth disturbances, pituitary dysfunction, visual disturbances, late new tumour induction) prompted an evaluation of surgical resection of cranial base tumours in children, with specific regard to safety, efficacy and aesthetic result.

Methods: A retrospective review was performed of 10 consecutive children presenting with tumours either arising from or eroding into bone of the cranial base who were managed by surgical resection in a 10‐year period from 1986 to 1996. The patients demonstrated a great variation in both presentation and pathology. All underwent surgical resection of tumour with reconstruction where indicated.

Results: There were no postoperative complications or mortality. All patients remained clinically free of disease at follow‐up, which ranged from 17 months to 9 years (mean 6 years and 4 months).

Conclusion: The aggressive surgical resection and craniofacial reconstruction of cranial base tumours in the paediatric population offers a safe and efficacious mode of treatment that obviates problems of diagnosis and local recurrence for benign lesions and of the long‐term sequelae of radiotherapy for malignant lesions.
FUNCTIONAL LAPAROSCOPIC REVERSAL OF A LONG GASTROPLASTY
Authors: Bird P. A. , Jamieson A. C.
Published: January 2008

Gastroplasty operations for obesity occasionally require surgical reversal. A laparoscopic technique is described for the successful functional reversal of a case who had a Long vertical gastroplasty.
COLORECTAL DISEASES: COMMENT
Authors: Loder Peter B.
Published: January 2008

Professor Isbister is to be commended on his skilful overview of colorectal diseases.1 In general, he has presented a balanced, succinct and eminently readable summary of much of the specialty of colorectal surgery. However, several statements deserve to be challenged.
THE POTENTIAL IMPACT OF BREAST CANCER SCREENING IN HONG KONG
Authors: Lau Y. , Lau P. Y. , Chan C. M. , Yip A.
Published: January 2008

Background: Breast cancer is the second most common cancer and cause of death in women from Hong Kong. The Well Women Clinic at Kwong Wah Hospital offers breast cancer screening (physical examination and mammography) for women over 40 years of age.

Methods: Results of screening over a 2‐year period revealed an overall malignancy detection rate of 2.6 per 1000 screens with a strong selection bias for symptomatic women.

Results: Screening only slightly increased the proportion of stage I cancers detected; of the malignancies detected, a significant percentage were in situ cancers with doubtful effects on breast cancer mortality. Teamwork and communication were useful in keeping a low referral rate to the surgical clinic of 6.1%, as well as a low biopsy rate for mammographic abnormalities.

Conclusions: A re‐evaluation of the real risk of breast cancer in young women together with the lack of proven value from screening has suggested a need for reconsideration of offering screening to women 40 years and over in Hong Kong.
MANAGEMENT OF COLONIC LIPOMAS
Authors: Chung Y. F. A. , Ho Y‐H. , Nyam D. C. N. K. , Leong A. F. P. K. , Seow‐Choen F.
Published: January 2008

Background: Little is known of colonic lipomas, especially in an Asian population, and their management is controversial.

Methods: A computerized colonoscopy database was analysed and patients with colonic lipomas were reviewed.

Results: There were 16 colonic lipomas (incidence of 0.15%) in a series of 10 658 consecutive colonoscopies. There were seven men and nine women, with a mean age of 61.8 years (range: 28–80 years). The size of the lipomas ranged from 1.5 to 6 cm; all those larger than 3.5 cm were symptomatic (P= 0.05). The most common symptom was mild bleeding per rectum. Right‐sided lipomas were palpable while left‐sided lipomas presented with obstructive symptoms. Colonoscopic removal by hot biopsy or snare polypectomy was possible where the lipomas were 2.5 cm and pedunculated. Surgery was performed in six patients (four open, two laparoscopic) for symptoms and to exclude malignancy. There was no morbidity or mortality.

Conclusions: Small or pedunculated lipomas may be safely removed colonoscopically and the diagnosis confirmed histologically. Larger lipomas require surgical resection for relief of symptoms or to exclude malignancy.
New Economic Indicators for Australia, 1949‐84
Authors: Boehm Ernst. A. , Moore Geoffrey H.
Published: January 2008

This article attempts to identify and describe the main characteristics of Australia'a business cycles during the period 1949 to 7984 with the aid of leading, coincident, and lagging indicators, using the methodology of the International Economic lndicator project at the Center for lnternational Business Cycle Research, Columbia University, New York.

The methodology to identify Australia's classical cycle and growth cycle chronologies is discussed. Reviews are made of the lead‐lag patterns of, first, both chronologies in relation to the specific cycles of the individual coincident indicators, and second, the growth chronology in relation to the leading and lagging indicators.

Australia's growth cycle chronology is compared with the chronology of other countries, notably of United States, United Kingdom, and Japan. The general uses of an indicator analysis are reviewed. An appendix compares the reference cycle chronologies previously available for Australia and the indicators used to obtain them.
What Does Privatisation Achieve?—A Comment on Quiggin
Authors: Domberger Simon
Published: January 2008

Abstract

John Quiggin's ‘Does Privatisation Pay?’ is critically assessed in this short article. The following issues are specifically addressed: un‐derpricing, sovereign risk, the equity premium, fiscal illusion, welfare considerations, and the efficiency of private and public enterprises. The article concludes that privatisation need not be a poor economic bargain for the community and that it ought to be considered on a case‐by‐case basis.
ON THE EVOLUTION OF BONY FISHES DURING THE TRIASSIC PERIOD
Authors: BROUGH JAMES
Published: January 2008

The Palaeoniscidae was the dominant group of bony fishes during Carboniferous and Permian times. This large and varied group of fishes has usually been called the “family Palaeoniscidae”, but it appears to consist of several independent lines.

The Holostei were evolved from the Palaeoniscidae before the beginning of the Triassic, Acentrophorns, the earliest member, appearing in the upper Permian.

About the close of the Palaeozoic era the Palaeoniscidae gave rise to several independent families which become modified to a greater or less extent toward the holostean grade of structure.

These groups are referred to as the sub‐holostean families. The parallel modifications they display include the reduction of the scaly lobe of the tail, reduction of the fin rays, loss of the cosmine layer of the scales, and the swinging forward of the suspensorium. The modifications proceeded much further in some groups than in others.

It is shown that although these Triassic families did not give rise to the Holostei, they provide a perfect Sci of intermediate forms between the palaeoniscid and the holostean condition.

One of the sub‐holostean families, the Catopteridae, is analysed and its evolving characters separated into those which are parallel (also undergone by other groups) and those which are characteristic of the family.

Reasons are Sci out for supposing the Catopteridae to have been derived from the Dicellopygae group of the Palaeoniscidae.
THE CONCEPT OF NERVE‐MUSCLE SPECIFICITY
Authors: STRAUS WILLIAM L.
Published: January 2008

(1) The concept of nerve‐muscle specificity postulates the existence of an inherent, specific attraction between given striated muscle fibres and given nerve fibres or neurons. (2) The chief theories of nerve‐muscle specificity, those of Furbringer and Cunningham, are considered. Furbringer's theory–that there is an unvarying, specific relationship between particular macroscopic, peripheral nerve branches and particular muscles–is founded upon a false embryological concept and is completely negated by both comparative and experimental data. Cunningham's theory–that there is a constant relationship between given neurons and given muscles but which recognizes variability in pathways adopted by axons and hence in macroscopic innervation –has some comparative anatomical support but is denied by the findings of experimental embryology. The theory that muscular nerve supply is inconstant, and that there may be secondary innervation, especially in phylogeny, is more in accordance with known facts. (3) Existing knowledge of the development of nerve‐muscle relationships–the outgrowth of nerve fibres, the formation of peripheral nerve patterns, and the establishment of terminal connexions–is reviewed. Although a number of important questions remain to be answered, there is nothing to indicate the existence of anything approaching a true nerve‐muscle specificity. (4) It is concluded that present evidence is against the concept of nerve‐muscle specificity. Thus resemblances in muscular nerve supply must merely reflect general similarity in development. Because of this, innervation is of great aid in homo‐logizing the muscles of animals belonging to one vertebrate class, but not in homologizing the muscles of animals of different classes. It is shown that urodeles so differ from other tetrapod vertebrates respecting nerve‐muscle relationships that they form a group unto themselves.
THE EFFECTS OF CLONIDINE ON ELECTRICALLY‐INDUCED CONTRACTIONS OF RAT DETRUSOR STRIPS IN VITRO
Authors: SANTICIOLI P. , MAGGI C. A. , MELI A.
Published: January 2008

Clonidine (10–9–3 times 10–6M) produced a concentration dependent inhibition of field stimulation‐induced contractions of rat detrusor muscle strip at 0.1 and 1 Hz which were completely abolished by tet‐rodotoxin (5 times 10–7M) but were unaffected by hexamethonium (10–5M).

Pretreatment with yohimbine (10–8–10–7M) did not modify the amplitude of contractions but produced a rightward parallel shift of clonidine's cumulative response curve without a depression of the maximal response. The corresponding pA2 value for yohimbine was 8.44 ± 0.1.

Atropine (3 times 10–6M) produced a partial inhibition of contractions at both frequencies. In the presence of atropine the cumulative response curve of clonidine was significantly reduced at 1 but not at 0.1 Hz.

Indomethacin (5 times 10–5M) and theophylline (2 times 10–4M) produced a partial inhibition of amplitude of contractions at both frequencies without any interference with the effect of a supramaximal concentration of clonidine.

Prazosin (10–6M), propranolol (10–6M), chlorpheniramine (10–6M), ranitidine (10–6M), haloperidol (10–7M), pizotifen (10–6M), naloxone (10–6M), quinidine (10–6M), strychnine (10–5M) or picrotoxin (10–5M) neither affected the amplitude of contractions at either frequency nor antagonized clonidine effects.

The contractile response of non stimulated strips to acetylcholine (10–5M), carbachol (3 times 10–6M) and ATP (10–3M) were not significantly influenced by pretreatment with clonidine (3 times 10–6M).

7 These results suggest that stimulation of prejunctional α2‐adrenoreceptors located on postganglionic nerve endings might reduce the output of excitatory neurotransmitter(s) in rat urinary bladder.
ATTENUATION BY CAPTOPRIL OF PRESSOR RESPONSES TO SYMPATHETIC STIMULI: EFFECTS OF PROCEDURES REDUCING ACTIVITY OF THE RENIN‐ANGIOTENSIN SYSTEM
Authors: BOURA A. L. A. , RECHTMAN M. P. , WALTERS W. A. W.
Published: January 2008

Low doses (0.1–1.0 mg/kg) of the converting enzyme inhibitor captopril given intravenously to pithed rats were followed by long lasting falls in systolic and diastolic arterial blood pressures. Concomit‐antly pressor responses were reduced to either electrical stimulation of the thoraco‐lumbar sympathetic outflow or intravenous injection of the ganglion stimulant McNeil‐A‐343. Positive chronotropic responses of the heart to cardiac nerve stimulation were unchanged after relatively large doses of the drug (3.0 mg/kg).

The reductions in arterial blood pressure and pressor responses to McNeil‐A‐343 caused by captopril persisted following β‐adrenoreceptor blockade, renal sympathectomy or unilateral nephrectomy, but did not occur after acute bilateral nephrectomy nor during sodium and water retention due to unilateral nephrectomy plus subacute administration of desoxycorticosterone and saline.

Pressor responses to noradrenaline were reduced after 1.0 mg/kg captopril i.v. whereas those to methoxamine or vasopressin were unaltered after 5.0 mg/kg.

It is concluded that in the rat, after elimination of sympathetic tone by pithing, the level of the arterial blood pressure and the magnitude of pressor responses to peripheral sympathetic nerve activation depend on the basal activity of the renin‐angiotensin system. This maintains sufficient angiotensin II production to ensure retention of some tone in resistance vessels together with presynaptic augmentation of noradrenaline output at a sympathetic postganglionic nerve endings. The latter effects are abolished after converting enzyme inhibition with captopril, consequent to reduced tissue levels of angiotensin II and perhaps potentiation of the actions of bradykinin.
EVIDENCE AGAINST PURINERGIC NERVE FIBRES IN THE HYPOGASTRIC NERVES OF THE CAT
Authors: THEOBALD R. J.
Published: January 2008

Hypogastric nerve stimulation (HGS) produced a transient contraction of the cat urinary bladder and inhibition of pelvic nerve evoked bladder contractions.

Pretreatment by guanethidine (GUA) antagonized HGS inhibition of pelvic nerve evoked bladder contractions, but had no effect on the HGS‐induced transient contractions.

GUA pretreatment had no effect on ATP or APPCP‐induced contractions of the urinary bladder.

Pretreatment by 6‐hydroxydopamine (6‐OHDA) antagonized both the transient contraction and the inhibition of pelvic nerve evoked bladder contractions induced by HGS.

6‐OHDA pretreatment had no effect on ATP or APPCP‐induced contractions of the urinary bladder.
Heterogeneity of vascular muscarinic receptors
Authors: Eglen R. M. , Whiting R. L.
Published: January 2008

Muscarinic receptors mediate diverse effects on the vasculature. Recently, a consensus has been arrived at with regard to muscarinic receptor classification (Levine and Birdsall, 1989). As a result, it may now be possible to clarify the role of each subtype in the responses of vascular tissues to muscarinic agonists. It is apparent that vascular muscarinic receptors form a heterogeneous population. M1 receptors contract canine venous tissue, whilst M3 receptors contract porcine and bovine coronary arteries. M3 receptors also mediate EDRF‐dependent relaxant responses in the majority of tissues studied to date. M2 receptors elicit relaxations by a decrease in sympathetic outflow in canine femoral vein, rabbit ear artery and rat portal vein. These conclusions are primarily derived from functional estimations of equilibrium dissociation constants, since comparable radioligand binding data are both scarce and contradictory. It is concluded that all three major subtypes of receptors are present in the vasculature. However, the limited selectivity of the available antagonists, the lack of extensive use of such compounds and the unavailability of selective agonists clearly indicate the need for more definitive studies to be undertaken.
A Rare Form of Congenital Heart Disease
Authors: BERGYAN W. , MORALES O.
Published: January 2008

Unusual case of congenital heart disease consisting of a total atresia of the mitral ostium combined with a small interauricular septal defect, a very large interventricular septal defect, a strnosis of the isthmus of aorta, and a patent ductus arteriosus.
The Effect of Methylscopolamine‐nitrate (Scopyle) on the Stomach in Hypertrophic Stenosis of the Pylorus
Authors: HEIKEL PER‐ERIK
Published: January 2008

A short account of the roentgenologically noticeable effect of methylscopolamine‐nitrate (scopyle) on the stomach in 17 cases of hypertrophic stenosis of the pylorus in infancy. The peristalsis of the stomach was weakened in 13 cases, no effect being noticeable with regards to the opening time of the stenosis or its width. In 11 of the cases the quantity of contrast which passed the stenosis over a 1½ hour period was less than at the control examination. Comparison with an investigation of the use of pilocarpine hydrochloride seems to show that pilocarpine brings about a more evident improvement of the evacuation of the stomach during the same length of time.

Un court compte rendu de la radiologic ?un effet notable de la méthylscopolamine‐nitrate (scopyle) sur ľestomac, dans 17 cas de sténose hypertrophique du pylore des nourrissons. Les mouvements péristaltiques de ľestomac étaient affaiblis dans 13 cas mais on ne pouvait constater aucun effet au sujet du moment ni de ľampleur de ľouverture de la sténose. Dans 11 cas la quantity de contraste qui passe par la sténose en 1 h ½ de temps était moindre que lors de ľexamen de contrôle. Un examen comparatif dans lequel on s'est servi de pilocarpine hydrochloride semble montrer que la pilocarpine facilite plus manifestement ľevacuation de ľestomac dans le meme espace de temps.

Ein kurzer Bericht über den merkbaren Effekt von Methyl‐scopolamin‐nitrat (Scopyl) auf den Magen in 17 Fällen von hyper‐trophischer Pylorusstenose bei Kindern. Die Peristaltik des Magens wurde herabgesetzt in 13 Fällen, in Bezug auf die Öff‐nungszeit der Stenose und deren Weite konnte kein Effekt be‐obachtet werden. In 11 Fällen war die Kontrastmenge, welche die Stenose im Laufe von 1½ Stunden passierte, geringer als bei der Kontrolluntersuchung. Eine Vergleichsuntersuchung mit An‐wendung von Pilocarpin‐hydrochlorid scheint zu zeigen, dass Pilocarpin eine deutlichere Verbesserung der Entleerung des Magens während der gleichen Zeit bewirkt.

Un breve informe sobre el notable efecto roentgenológico del nitrato metilescopolamina (escopilo) sobre el estómago en 17 casos de estenosis hipertrófica del píloro durante la infancia. La peristalsis del estómago se debilityó en 13 casos; no se notó ningún efecto en cuanto al tiempo de abertura de la estenosis o de su anchura. En once de los casos la cantidad de contraste que pasó por la estenosis durante un período de 1.1/2 horas fué menor que durante el examen de control. Una comparación con un estudio del uso de pilocarpina clorhidrato parece demostrar que la pilo‐carpina ocasiona, en el mismo espacio de tiempo, un mejoramiento más evidente de la evacuatión del estómago.
Exanthema Subitum and Febrile Convulsions
Authors: MÖLLER KJELL L.
Published: January 2008

Out of 448 cases of febrile convulsions admitted to the Children's Hospital, Gothenburg, during 1945–1954, at least 7.6% (34 cases) occurred in connection with exanthema subitum.

Among the children with febrile convulsions who were 12 months old or younger, exanthema subitum was the cause of fever in 16.2%.

The 34 cases of exanthema subitum had a median age of 12.5 months, the remaining 414 children with convulsions had a median of 20.8 months.

Exanthema subitum is supposed to cause convulsions not only because of fever, but because of a specific cerebral effect.

Persisting cerebral lesions may occur, resulting in new attacks of convulsion later on.

Sur 448 cas de convulsions fébriles admis à l'hopital de Gothembourg au cours des années 1945 à 1954, 7,6% d'entr'eux au moins présentaient une association avec un exanthème subit. Cet exanthème était la cause de l'hyperpyrexie dans 16,2% des cas, chez les enfants d'un âge égal ou supérieur à 12 mois. L'âge moyen des enfants présentant de l'exanthème subit était de 12,5 mois, et celui des autres de 20,8 mois. L'exanthème subit semble être la cause des convulsions; non, par la fièvre qui s'y associe, mais en raison d'une atteinte cérébrale spécifique. Des lésions cérébrales peuvent d'ailleurs persister, provoquant de nouveaux accés convulsifs, ultérieurement.
Steroid Therapy in Some Types of Post‐infectious Encephalomyelitis
Authors: ÖBERG GÖSTA
Published: January 2008

Summary

The neurological complications of the contagious exanthemata may be very severe and dangerous. Residual symptoms are not uncommon. Even transitory anoxemia can cause cerebral lesions. Treatment by tracheotomy and respirator is somtimes life‐saving. There is much evidence in support of the opinion that neurological signs following measles, chicken pox, and rubella are of anaphylactic origin. Attempts at steroid therapy may be justified. Treatment should be applied only for a few days, and then only during a stage of the illness when good antibody production can be counted on. The clinical course in three cases successfully treated with cortisone and in two cases treated with prednisone without improvement are described. Until we know more about this therapy it should be reserved for severe cases with signs of cerebral oedema or cranial nerve paralysis.
Myocardial Changes Following Oxygen Inhalation An Experimental Study on Rabbits
Authors: BERFENSTAM R. , ZETTERGREN L.
Published: January 2008

Summary

A variety of myocardial changes, predominantly in the left ventricle, were observed in 38 of 46 rabbits which were exposed to 70 to 80 per cent oxygen until they died. In the majority of animals the changes took the form of vacuolar degeneration, altered stainability of the muscular tissue and interstitial edema. In addition, the animals exhibited major structural changes leading to myolysis and development of myocarditis‐like foci. It is the authors' contention that the changes in question are secondary to such pulmonary lesions as are caused by oxygen inhalation and, hence, that at least partially they are caused by hypoxia.
Further Observations on the Bacteriology of Impetigo and Pemphips Neonatorum
Authors: PARKER M. T. , WILLIAMS R. E. O.
Published: January 2008

Six hundred and nine impetigo lesions were examined bacteriologically and the presence in them of certain types of Staph. aureus and of Str. pyogenes thought to be specifically associated with impetigo was determined.

On the basis of the bacteriological findings, 47% of the cases were considered to be staphylococcal, 21% streptococcal and 11% mixed. No specific pathogen was isolated from 21%.

Among children seen in school minor ailment clinics, staphylococcal cases predominated when impetigo was prevalent, but at all times a fifth or more of the cases were streptococcal. Cases referred to the out‐patient department of a skin hospital were, however, nearly all staphylococcal.

It is probable that impetigo includes a more severe, often bullous, skin infection due to Staph. aureus Type 71, and a less severe condition associated with certain types of Str. pyogenes.

Staph. aureus Type 71 was also responsible for a number of outbreaks of skin infection among newborn infants in hospital. Cases were of all degrees of severity from a mild vesicular eruption to a fully developed pemphigus neonatorum, and a few cases of generalised exfoliative dermatitis were seen.

Similar cases due to Type 71 were occasionally seen in domiciliary practice, infected either from the midwife or from an older child with staphylococcal impetigo.

The characteristic skin lesion caused by Staph. aureus Type 71 is an intraepidermal vesicle or bulla with little inflammatory reaction in the deeper tissues.
Exudative Enteropathy
Authors: DOOREN L. J. , GELDEREN H. H. van , VINK C. L. J.
Published: January 2008

Three patients with essential hypoproteinaemia are described. In all of them, signs and symptoms suggested an intestinal lesion. In two of them a PVP test was performed and gave a pathological result. Our cases and those of others strongly support the hypothesis that many cases of unexplained hypoproteinaemia are caused by intestinal disease. The poor general condition of one of the patients led us to perform a laporotomy. Biopsies showed distinct lesions of the small intestine. A large part of the diseased small intestine was resected without benefit.

In some chronic cases surgical intervention may be tried. The PVP test, as first described by Gordon, is of great diagnostic aid in such cases.
A Study of Immunoglobulins in the Blood Serum of Infants with Interstitial Plasma Cellular Pneumonia
Authors: KOLTAY M. , ILLYÉS M.
Published: January 2008

The behaviour of the three immunoglobulins (gammaglobulin, or IgG, beta 2A globulin, or IgA and beta 2M globulin, or IgM) has been examined, using paper electrophoresis and immunological methods, in the blood serum of 43 infants suffering from interstitial plasma cellular pneumonia. The level of the immunoglobulins was generally found t o be decreased in those cases, where the symptoms of the disease were mild or of medium intensity, and appeared in infants between 4‐8 weeks of age, i.e. in the period of the physiological hypogammaglobulinemia.

If, however, the disease caused grave symptoms and was manifested in older infants, an increase of beta 2M immunoglobulin was found to be characteristic; in some cases, the elevation of all the three immunoglobulins occurred.

Our observations suggest that in interstitial plasma cellular pneumonia of infants, antibodies of the beta 2M‐type must play an important part, but that there is no direct correlation between the common antibody deficiency syndromes and the infantile interstitial plasmacellular pneumonia occurring in this country.
Malabsorption of Vitamin B12
Authors: HIPPE ERIK
Published: January 2008

A 1‐year‐old boy with a characteristic entity which was first described by Imerslund [12] and Grasbeck et al. [S] is presented. The disease manifests itself as a megaloblastic anaemia caused by a selective malabsorption of vitamin B12 from the intestinal tract. The content of acid and intrinsic factor in the gastric juice is normal. The blood picture becomes normal after parenteral administration of vitamin B12. Furthermore, the patient has persistent proteinuria. We tried to establish the aetiology of malabsorption of vitamin B12 by administering intestinal juice from normal subjects, by which procedure an increased intestinal absorption of vitamin B12 was demonstrated. This finding indicates the absence in these patients of a factor (“releasing factor”?) which is normally present in the intestinal juice and which is of importance for the absorption of vitamin B12. Our present knowledge as to the absorption of vitamin B12 is reviewed briefly, and a theory is advanced, partly founded on experiments, to the effect that vitamin B12 is normally absorbed in a peptide‐bound form.
HYPOTHALAMIC HYPERPHAGIA, OBESITY AND DISTURBED BEHAVIOUR IN ACUTE LEUKEMIA
Authors: Barak Y. , Liban E.
Published: January 2008

Hyperphagia with excessive weight gain and behaviour disturbances without other neurological signs appeared during a remission of acute lymphatic leukemia in a 4 year old boy. At autopsy, in addition to leukemic involvement of almost all organs, extensive infiltrations were noted in the medial hypothalamus, the meninges and in some other parts of the brain. 14 similar cases collected from the literature were reviewed. The conclusion was drawn, that the “hypothalamic syndrome” may be the only sign of extensive cerebral leukemic involvement. Its recognition may be of value in early diagnosis and correct treatment of cerebral leukemic complications.
LYSOSOMAL ENZYMES IN JUVENILE AMAUROTIC IDIOCY
Authors: Öckerman P. A.
Published: January 2008

The activity of several acid hydrolases was measured in tissues and plasma from patients with juvenile amaurotic idiocy (JAI). Increased activities were found for β‐galactosidase, β‐glucuronidase, β‐acetylglucosaminidase, acid phosphatase and α‐fucosidase. No significant changes were found for α‐mannosidase, except a slight decrease in plasma. The results show similarities to the findings in gargoylism and a new disease, resembling Hurler's syndrome. These two diseases are supposed to be caused by primary lysosomal enzyme defects. It is suggested that the role of the lysosomes in the pathogenesis of JAI should be studied in more detail.
THE ELECTROLYTE AND PROTEIN CONTENTS AND OUTPUTS IN DUODENAL JUICE AFTER PANCREOZYMIN AND SECRETIN STIMULATION IN NORMAL CHILDREN AND IN PATIENTS ITH CYSTIC FIBROSIS.1
Authors: ZOPPI G. , SHMERLING D. H. , GABURRO D. , PRADER A.
Published: January 2008

The total pancreatic outputs and the secretion rates of fluid volume, protein, bicarbonate, sodium, potassium, calcium and magnesium were studied after pancreozymin and secretin stimulation in 12 control children and in 5 patients with cystic fibrosis of the pancreas (CF). Duodenal contents were collected through a double‐balloon, triple‐lumen rubber tube, thus avoiding contamination by gastric juce and distal losses. In CF patients, compared to the normal controls, decreased outputs of fluid volume, protein and electrolytes were found.

Secretion rates, calculated per kg body weight and per min of fluid volume protein and electrolytes were analyzed separately for the post‐pancreozymin and the post‐secretin periods. In control children the secretion rates of sodium aad bicarbonate were higher after secretin stimulation, whereas those of protein, calcium, and magnesium were higher after pancreozymin stimulation; secretion rates of fluid volume and potassium did not show any significant difference.

In CF patients the secretion rates of sodium, potassium and magnesium were more reduced after secretin whereas those of calcium and protein are more reduced after pancreozymin; the secretion rates of fluid volume and bicarbonate are similarly reduced after both hormonal stimulation.

The possible role of a disturbance of the tubular and the acinar secretion of the pancreas in the pathogenesis of cystic fibrosis is discussed.
HYPOSENSITIZATION IN HOUSE DUST ALLERGY ASTHMA
Authors: AAS KJELL
Published: January 2008

A double‐blind controlled study of the effect of house dust hyposensitization was conducted in 93 patients allergic to house dust. The allergy diagnosis was established by bronchial provocation tests, and the degree of bronchial sensitivity to house dust extracts (bronchial threshold dose for allergen) was assessed before and after 2 1/2–3 years' injection treatment.

The specific hyposensitization with two different house dust extracts was superior to placebo injections.
PYCNODYSOSTOSIS: Six Cases with New Symptoms and an Autopsy
Authors: NIELSEN ERIK LYKKEGARD
Published: January 2008

Abstract. Lykkegaard Nielsen, E. (Department of Paediatrics, Sundby Hospital, Copenhagen, Denmark.) Pycnodysostosis. Six cases with new symptoms and an autopsy. Acta Paediatr Scand, 63: 437, 1974.–Six patients with pycnodysostosis, all of whom had characteristic case‐histories, are presented. Five of the patients had symptoms which have not hitherto been recognized in this condition. They all had varying degrees of respiratory distress, tendency to vomit and long soft palates. One of the patients died at the age of 21 months on account of vomiting and pulmonary aspiration. Autopsy revealed normal conditions in the lungs. The vital prognosis is usually stated to be good in this disease, but this study shows that during the first years of life it is possibly poorer. Occurrence of progressive acmteolysis in pycnodysostosis has been discussed previously. In one of the patients in this material slight increase in the bony substance in the distal phalanges of the fingers was observed on repeated radiografic examination while in another both break‐down and new bone formation were observed in the processus unguiculares. In a third patient cyst‐like defects in some of the ungual tufts of the fingers were present. These conditions are thus incompletely elucidated at present.
PRESUMED DISSEMINATED BCG IN A BOY WITH CHRONIC GRANULOMATOUS DISEASE OF CHILDHOOD
Authors: VERRONEN PAULA
Published: January 2008

ABSTRACT. Verronen, P. (Department of Paediatdcs, Central Hospital, Tampere, Finland). Presumed disseminated BCG in a boy with chronic granulomatous disease of childhood. Acta Paediatr Scand 63: 627, 1974.—A male. child suffering from chronic granulomatous disease of childhood, confirmed by a Irucocyte bactericidal function test and a nitrobluc tetrazolium test, was given a BCG inoaulatlon in the neonatal pcrfod. He had draining lesions at the sites of vaccination and later miliary infiltration of the lungs, which responded favourably to antituberoulous therapy. Cultures for tb‐bacilli were negative. An older sister is suspected to be a carrier of the trait responsible for chronlc granulomatous disease. Her sole clinlcal manifestation was miliary infiltration of the lungs at the age of 3 9/12 years.
POSTNATAL DEVELOPMENT OF RENAL HYDROGEN ION EXCRETION CAPACITY IN RELATION TO AGE AND PROTEIN INTAKE
Authors: SVENNINGSEN N. W. , LINDQUIST B.
Published: January 2008

ABSTRACT. Svenningsen, N. W. and Lindquist, B. (Department of Paediatrics, University Hospital, Lund, Sweden). Postnatal development of renal hydrogen ion excretion capacity in relation to age and protein intake. Acta Paediatr Scand,63:721, 1974.—The cumulative and maximum renal hydrogen ion excretion capacity after induced acidosis has been studied in six term and twenty preterm infants at 1–3 and 44 weeks of postnatal age corresponding to for preterm babies 34–36 and 37–39 and for term babies 41–43 and 44–46 weeks of gestational age. The maximum net hydrogen ion (H+NAE) excretion capacity is lower in preterm than in term infants at 1–3 weeks of postnatal life. However, when approaching full gestation there is a considerable increase of the H+NAE excretion capacity of pretem infants almost equal to that found in term infants at 1–3 weeks of age. High dietary protein intake lasting for in average two to three weeks in preterm infants does not change the maximum renal H+ excretion during induced acidosis, but significantly enhances the initial increment of excretion rate of titratable acid (H+TA) in comparison to preterm infants fed low protein diets. The findings of the present investigation suggest that the development of renal hydrogen ion excretion capacity in preterm infants during the first weeks of life is related primarily to gestational age. This development may, however, to a certain degree respond to increased excretory needs imposed by dietary load.
OXYGEN AFFINITY OF HAEMOGLOBIN AND RED CELL 2,3‐DIPHOSPHOGLYCERATE IN CHILDHOOD DIABETES
Authors: DITZEL J. , ANDERSEN H. , PETERS N. DAUGAARD
Published: January 2008

ABSTRACT: Ditzel, J., Andersen, H. and Daugaard Peters, N. (Section of Endocrinology, Department of Medicine, Department of Paediatrics and Department of Clinical Chemistry, Aalborg Regional Hospital, Aalborg, Denmark). Oxygen affinity of haemoglobin and red cell 2,3‐diphosphoglycerate in childhood diabetes. Acta Paediatr Scand, 64:355, 1975.–Red cell 2,3‐diphosphoglycerate (2,3‐DPG) and the oxygen haemoglobin dissociation curve (ODC) were determined in 32 ambulatory, non‐acidotic diabetic children and in 49 healthy children. Despite the fact that the diabetic children had, on average, an increased haemoglobin concentration, their erythrocytes contained significantly more 2,3‐DPG than normal. Both in diabetic and in healthy children a negative relationship was found between the content of 2,3‐DPG and the haemoglobin concentrations. No relationship was present between the plasma glucose and the 2,3‐DPG concentration. The concentration of plasma inorganic phosphate (Pi) in the diabetic children was significantly higher than in the control children, and for all children there was a significant relationship between the 2,3‐DPG and the Pi. In the diabetics 2,3‐DPG was positively correlated to the P50 (7·40) and to the P50 (in vivo pH) of the ODC. However, despite the significant increase in 2,3‐DPG among the diabetic children the average P50 (7·40) and P50 (in vivo pH) was not increased as compared with the control children. The inhibitory factor preventing the oxygen affinity from decreasing among the diabetics was strongly correlated to an increase in the mean corpuscular haemoglobin concentration. The result of this study suggests the presence of an increased amount of a haemoglobin fraction with high oxygen affinity (haemoglobin Alc) in the red cells of juvenile diabetics.