bluuebunny/crossref_metadata_2025 huggingface dataset:
A Follow‐up of 103 Children Recovered from Tuberculous Meningitis
Authors: WASZ‐HÖCKERT OLE , DONNER MÄRTA
Published: January 2008

A general review of the results of follow‐up examinations of 103 children who have recovered from tuberculous meningitis is presented.

The length of the follow‐up period ranged from 5 to 12 1/2 years, the mean being 8 1/2 years. The age distribution of the series at the end of the follow‐up period was from 8 to 26 years, the mean age being 16 years. There were 9 cases with increased incidence of infections, according to the case history. The general health was good in 99, subnormal in 2 and poor in 2 cases. There were 4 cases of endocrine disturbance as sequelae to the disease — one case of precocious puberty (menarche at 8 years of age) and 3 cases of obesity. Roentgenological examination of the chest revealed bronchial gland calcifications in 9 cases, parenchymatous calcifications of the lungs in 33 cases and other changes (pleural adhesions, scar lines, atelectasis) in 5 cases. Skull x‐ray showed the existence of intracranial calcifications in 26 out of the 101 cases examined. Neurological symptoms of markedly varying severity were observed in 56 cases. Gross EEG changes were noted in 15 cases, minor changes in 35 cases out of the 85 examined by EEG.

There was one case of blindness and another with severe visual handicap. Eight of the children were deaf, one of them congenitally, and 8 other children had a markedly impaired hearing. Mental subnormality occurred in 20 and slight mental retardation in 27 cases. Serious behaviour disturbances were reported in 3 children. The school record was below average in 18 and very poor in 14 cases.

To conclude, it may be stated that most of the children had some sort of sequelae of their past illness as revealed by careful clinical examinations by different specialists. However, some 58 of the 103 examined were already supporting themselves or certainly will be able to do so when grown up. About a third (36 cases) had minor handicaps, but they will, doubtless, manage reasonably well in the future. The rest of the children (9 cases) were so severely handicapped that they will need the support of the community to exist.

For details of the clinical examinations see the special sections in this same issue.
Late Ophthalmological Sequelae of Tuberculous Meningitis
Authors: MIETTINEN PENTTI , WASZ‐HÖCKERT OLE
Published: January 2008

One hundred and three patients who had recovered from tuberculous meningitis in 1949—54 were thoroughly re‐examined ophthalmologically an average of 8 1/2 years (range 6—12 1/2 years) after recovery. One blind patient and one with severe visual impairment were found. In addition to these, a number of cases with ophthalmological sequelae of minor importance were found; partial structural and functional lesions of the optic nerve were found in 17 cases (including 1 case with associated abducens nerve palsy), nystagmus was found in 2, pupillary disturbances in 6 and scars of choroidal tubercles in 16 cases. Thus 36 cases (35 per cent) showed ophthalmological sequelae of the past illness. Permanent visual disability was found in the 2 cases mentioned above, both of them being late cases with a high block treated with trephination. Of the other sequelae of the disease only intracranial calcification showed some degree of correlation with the ophthalmological sequelae.
Anabolic Steroids and Digitoxin in the Treatment of Progressive Muscular Dystrophy
Authors: HEYCK H. , LAUDAHN G. , LÜDERS C. J. , MÜLLER‐STEPHANN H. , SCHMIDT‐PETER P.
Published: January 2008

A total number of 51 cases of progressive muscular dystrophy were treated in two groups: one group received 19‐norandrostenolone‐decanoate together with digitoxin over a period of 3 months, a second group was treated with the steroid alone over a period of 3–5 months. The doses for the steroid were 50 mg per week, for digitoxin 0.1 mg daily.

In the first group (steroid +digitoxin) of 21 cases. Controls of 15 different enzymes in muscle tissue showed a decline in activity in all of the enzyincs. The depletion of muscle enzymes was significant for CPK, GOT, GPT, ICDH and LDH. At the same time, a significant raise in serum enzyme activity could be demonstrated for ALD and CPK in the Duchennc‐typc and for ALD, CPK and LDH in the other more benign types of the disease.

In the second group (steroid only) clinical observation revealed no functional improvement. I n some of the Duchenne cases the physical weakness was slightly accelerated. Laboratory findings showed no demonstrable changes in histopathology in this group. The increase of serum enzyme activitics was not Significant. MDH show‐ ed a significant fall in activity. Changes in tissue enzyme activities were not typical.

I n none of the groups a raise of extractable muscle protein was seen. I n addition to rather severe virilizing effects in most of the cases, an increase of joint‐contractures in some of the cases of both groups could be observed. The increase of serum enzymes under the treatment with the steroid which can only be explained by enhanced loss of enzyme proteins from the diseased muscle tissue as a result of the increasing cell permeabilky becumes most obvious and significant when the steroid treatment is combined with digi‐ toxin. The study demonstrates that the treatment of progressive muscular dystro‐ phy with 19‐nd shows no use and involves unfavorable side effects while the combined use of the steroid with digitoxin leads to a clear and significant acceleration of the process of muscle wasting.
Introduction
Authors: Smith Clement A.
Published: January 2008

This is a time during which life is more dynamic than static, for in no other equally brief span of existence do such profound alterations and adjustments occur as in the weeks, or even the days or hours following birth.'
Studies on the Streptococcus Group A Infection: The Carrier State and Latent Infection among Childen
Authors: MOZZICONACCI P. , GERBEAUX J. , BACULARD A. , GERBEAUX CL. , CARAVANO R. , FOURNIER G. , LEMAIRE J. , ROTH C.
Published: January 2008

A longitudinal study has been conducted on 114 children in a hospital for primary tuberculosis, in order to determine the incidence of Group A latent streptococcal infection. The subjects were regularly examined for the presence of Group A streptococcus in the throat, the level of streptococcal antibodies in the sera; a daily methodical investigation was also performed in the search of any clinical symptoms of infection.

The analysis of the modes of infection shows that several degrees exist between the subject remaining free of any contact with group A streptococcus and that one who presents a clinically acute infection; some children are truly healthy carriers, but more frequently the acquisition of the germ is followed by a rise of serological reactions. This infection may be clinically latent, 01: may show Clinical Symptoms of disease.

Children classified as chronic carriers may harbour a single type of streptococcus or two or more types which may or may not be present concurrently within the carrier.
Rutherfurd's Syndrome: A Familial Oculo‐Dental Disorder
Authors: HOUSTON I. B. , SHOTTS NINA
Published: January 2008

The association of corneal dystrophy, hypertrophy of the gingivae and failure of tooth eruption is described in five generations of a family believed to be the same one as that described by Rutherfurd in 1931. The abnormalities are inherited together through an autosomal dominant gene but no gross abnormalities of chromosomal size, shape or number have been identified.
The Behaviour of Foetal Haemoglobin in the enhanced Heinz Body Formation in Red Cells of Newborn Infants
Authors: ULUKUTLU LAMIA , KLEIHAUER ENNO , BETKE KLAUS
Published: January 2008

Heinz body formation by incubation of blood with acetylphenylhydrazine was more pronounced in erythrocytes of newborns than in erythrocytes of adults, the ratio being approximately 5:1. In haemolysates cord haemoglobin was denatured only slightly faster by acetylphenylhydrazine than was adult haemoglobin. By differentiating HbA‐cells from HbF‐cells in blood smears from newborns with the acid elution technic it could be shown that Heinz body formation proceeded nearly as fast in erythrocytes containing HbA as in erythrocytes containing HbF.

HbF therefore does not play a significant role for the enhanced Heinz body formation in red cells of newborn infants. Since the amount of reduced glutathione has no decisive significance either, there must be some other characteristic property of the red cells of newborns making them labile in this respect.
Serum Lipids in Premature Infants on Vegetable Fat Diet
Authors: KRASILNIKOFF P. A. , VESTERDAL J.
Published: January 2008

Serum lipids were studied in premature infants on different diets: human milk, an ordinary 50% cow's milk formula and a cow's milk preparation (Olac) where the butter fat had been replaced with vegetable fat, so that the content of unsaturated fatty acids was practically similar to that of human milk.

The total lipids and phospholipids showed no significant differences on these diets. Serum cholesterol was significantly lower on feeding with Olac than on human milk, but no differences with regard to the cholesterol were seen between infants on human milk and infants on 50 % cow's milk formula. These findings are in accordance with previous investigations.

As the amount of unsaturated fatty acids is practically identical in human milk and in Olac, we cannot explain why serum cholesterol is lower when the latter is given. Nor can it be explained why serum cholesterol is similar on human milk and on 50% cow's milk formula, the content of unsaturated fatty acids in fact being more than three times as high in the former as in the latter.

Apparently the total amount of polyunsaturated fatty acids is not the factor responsible for these results. Our figures do not permit the conclusion that any single fraction of the lipids is the factor in question. This problem needs further investigation.
Foetal Exsanguination from Hemangioendothelioma of the Skin
Authors: SVANE SIVERT
Published: January 2008

A case of intrauterine foetal exsanguination is reported. The bleeding was due to a congenital, ulcerated hemangioendothelioma of the skin.
Disaccharidases and Histology of Duodenal Mucosa in Congenital Lactose Malabsorption
Authors: LAUNIALA KARI , KUITUNEN PEKKA , VISAKORPI J. K.
Published: January 2008

A study has been made of the disaccharidase activities and histology of duodenal mucosa in two infants with typical congenital lactose malabsorption. The mucosal samples were taken by means of peroral intestinal biopsy. At the time Of biopsy, the patients were 2½ and 4½ months old and they had been on lactose free diet 39 days and 3 ½ months respectively.

Both patients demonstrated a typical clinical picture of lactose and cellobiose malabsorption. In the mucosal samples, lactase and cellobiase activities were almost absent in both patients, whereas other disaccharidase activities were within the normal range. The histological picture of the mucosa was normal in one patient, and slight, partial villous atrophy was seen in the other.

This study confirms that the cause of congenital lactose malabsorbtion is an enzyme defect of the intestinal mucosa which histologically may appear normal.
Vaccinia Gangrenosa with Normal Humoral Antibodies A Case Possibly Due to Deficient Cellular Immunity Treated with N‐Methylisatin β‐Thiosemicarbazone (Compound 33T57, Marboran)
Authors: HANSSON O. , JOHANSSON S. G. O. , VAHLQUIST B.
Published: January 2008

A case of vaccinia gangrenosa with normal antibodies and deficient cellular immunity against vaccinia‐antigen is presented. Administration of hyperimmune vaccinia1 gamma globulin failed to stop the progression of the disease. Treatment with Compound 33T57 was successful.
The Oxygen Cost of Minor Changes in Heat Balance of Small Newborn Infants
Authors: SILVERMAN WILLIAM A. , SINCLAIR JOHN C. , AGATE F. J.
Published: January 2008

Measurements of gaseous metabolism small newborn infants whose anterior abdominal skin temperatures were stabilized at fixed levels (35, 36 and 37°C) for 15 to 25 hours revealed that mean oxygen consumption was lowest in the 36°C condition. From the oxygen cost of small departures in heat balance it is suggested that a “neutral thermal state” small neonates may be achieved when environmental conditions are adjusted to maintain the abdominal skin temperature between 36 and 37°C. The deep body temperature in the “neutral thermal state” is lower in these very small babies than is generally considered to be a normal deep body temperature in human subjects.

The relationship between temperature and metabolism in undergrown as compared with normally grown infants should be investigated further.
Incidence In infants and Mortality from Congenital Malformations of the Circulatory System
Authors: KERREBIJN K. F.
Published: January 2008

This study comprises an investigation into the incidence of congenital malformations of the circulatory system in all live births in 1958 among the inhabitants of the municipality of Leiden, and an analysis of the figures concerning congenital malformations of the circulatory system as an underlying cause of death in the Netherlands in the years 1951–1962.

In 15 of 1817 children (8%) a congenital malformation of the circulatory system was found. A discussion is included of possible sources of error in the calculation of the incidence reported.

The results can be considered as representative for the Netherlands as a whole. This means that the number of infants born alive in this country with a congenital malformation of the circulatory system will currently be about 2000 annually.

Up to the present there has not been a decline in mortality figures for congenital malformations of the circulatory system in the Netherlands. Mortality ensues in 80 % of the cases in infancy. The number of infants dying from congenital malformations of the circulatory system is at the moment about 500 annually. One third die in the first week of life, half within the first month.
Primary Cold Injury in the Newborn
Authors: LEONIDAS JOHN C. , GOLEMATIS THEMIS
Published: January 2008

The well recognised syndrome of primary cold injury or neonatal hypothermia was seen in a full‐term healthy newborn infant, apparently not exposed to extremely low levels of temperature and in the absence of any other intrinsic precipitating factors. Rewarming of such infants should be gradual, otherwise convulsions might be induced.
QUANTITATIVE STUDIES OF THE HUMAN NEONATAL CIRCULATION
Authors: HANSON JOHN S. , ARCILLA RENÉ A. , OHM WILLIAM , WALLGREN ÖRAN , LIND JOHN
Published: January 2008

Principles and techniques for the application of indicator‐dilution studies to the newborn period are discussed. A simple method for in vivo dye curve calibration is described, and a modification of the forward triangle factor for cardiac output estimation in this age group is presented: Methods of calculation of cardiac output and shunts are given. Many problems unique to the neonatal period are suited to study by careful application of these techniques.
THE EFFECTS OF ENVIRONMENTAL TEMPERATURE CHANGES ON THE METABOLIC RATE OF NEWBORN BABIES
Authors: Grausz J. P.
Published: January 2008

The oxygen consumption of 27 normal babies was measured at an environmental temperature of about 35°C, approaching this temperature either from 30°C or 40°C. There was a decrease in oxygen consumption at an ambient temperature of 40°C compared with 35°C, provided the baby remained asleep and motionless.

The oxygen consumption at an environmental temperature of 35°C when this had been reached by coming from 40°C was 15% higher than when it had been reached by warming from 30°C. This difference could not be explained by differences in skin‐air temperature gradients nor by a Q 10 effect.
STUDIES ON ERYTHRO‐KINETICS IN INFANCY X. Red Cell Volume of Newborn Infants in Relation to Gestational Age
Authors: Bratteby Lars‐Eric
Published: January 2008

Red cell volume measurements were performed with a 51Cr‐dilution method in 27 newborn infants with a gestational age of 222–295 days. The results were in agreement with and supplemented earlier findings. A positive correlation was found between red cell volume and gestational age. After 230 days (±10 days) of intrauterine life, the red cell volume varied between 45 and 100 ml. After a gestational period of 280 days (±10 days) the red cell volume was 120–190 ml. The main source of the large variation probably arises from errors in determining the gestational age, and variations in amount of placental transfusion.
ENDOGENOUS FORMATION OF CARBON MONOXIDE IN NEWBORN INFANTS III. ABO Incompatibility
Authors: Fällström S. P. , Bjure J.
Published: January 2008

The carboxyhaemoglobin (COHb) concentration in blood, which is assumed to reflect the degree of haemoglobin catabolism, was determined in 62 newborn infants selected because of significant jaundice associated with ABO incompatibility, and in 46 infants with ABO incompatibility, selected without regard to the degree of bilirubinaemia. Furthermore, the COHb level was determined in 46 icteric infants without haemolytic disease, and in 61 infants of ABO homospecific pregnancies, selected without regard to their bilirubin level.

In infants with ABO incompatibility increased COHb concentrations were found not only in infants with unequivocal signs of haemolytic disease but also in infants with a clinical picture indistinguishable from physiological jaundice. During the first days the relation between COHb and bilirubin in infants with ABO incompatibility was the same, whether the infants were selected because of significant jaundice or irrespective of the degree of bilirubinaemia. This indicates a common pathogenesis of the bilirubinaemia in the two groups.

The COHb and bilirubin levels in infants of ABO heterospecific pregnancies and in infants of ABO homospecific pregnancies, selected without regard to the degree of bilirubinaemia, were compared. It is concluded that the COHb level probably is a more sensitive indicator of haemolysis than the bilirubin concentration.

Increased COHb concentrations were also found in icteric infants without blood group incompatibility, but the relation between COHb and bilirubin indicates that in ABO incompatibility increased haemolysis is of greater importance in the pathogenesis of the jaundice.
STUDIES OF URINARY TRACT INFECTIONS IN INFANCY AND CHILDHOOD X. Short or Long‐term Treatment in Girls with First or Second‐time Urinary Tract Infections Uncomplicated by Obstructive Urological Abnormalities
Authors: Bergström T. , Lincoln K. , Redin B. , Winberg J.
Published: January 2008

The aim of the present investigation, concerned with 279 girls with their first‐time, or in a few cases second‐time urinary tract infection, was to explore the possibility to improve the “1‐year cure rate” by means of long‐term sulfonamide therapy (2 months) instead of short‐term sulfonamide therapy (10 days). A “1‐year cure” was then defined as an eradication of the index infection and freedom from infection during the following year. The “1‐year cure rate” was found to be equal in the two therapy groups i. e. 64 per cent.

The material showed some characteristics which might permit some general statements about uncomplicated first or second‐time urinary tract infections in girls. The material showed a marked predominance of the younger age groups. This finding is discussed with regard to the pathogenesis of urinary tract infection. The bacteria isolated at the initial infections were in 90 percent E. coli and also in 90 per cent sensitive to sulfonamide. Thus for the present there is no reason to abandon sulfonamide as the drug of choice in uncomplicated first‐time infections in girls.

The first recurrence had a tendency to appear shortly after the original infection rather than late. Observations suggest that recurrences, even those occurring immediately after cessation of therapy, were usually a reinfection and not a recrudescence. These findings are discussed in relation to the pathogenesis of recurrent urinary tract infections.

The first recurrence was in 1/3 of the cases asymptomatic, in the other 2/3 symptomatic. During long term prophylaxis asymptomatic infections even outnumbered the symptomatic ones. Therapy thus may mask an infection.

The bacteria isolated at the first recurrences after the index infection were in 30–90 per cent resistant to sulfonamide, the rate being related to the time interval between the cessation of therapy and the recurrence. The therapeutic consequences of the difference in sulfonamide sensitivity of the initial infection and the recurrences are discussed.
EOSINOPHILIC LEUKEMIA ‐ AN IMMUNOPATHOLOGICAL REACTION?
Authors: Bengtsson Elias
Published: January 2008

An account is given of eosinophilic leukemia in a 5‐year‐old boy, who died after 2 months' illness. Post mortem examination disclosed a large tumor in the thymic region, as well as infiltrates of eosinophilic leukocytes, mainly immature, in the thymus, lymph nodes, spleen, lungs, heart and kidneys.

After 3 weeks' illness, the number of atypical mononuclear leukocytes in the peripheral blood increased markedly. This was followed by an increase in the number of eosinophilic leukocytes. Concurrently, a pronounced rise took place in the serological titers for antipneumolysin and Toxoplasma.

The mechanism of development of the changes is discussed against the background of a suggested immunopathological process, in which the thymus may have played a central role.
The Development of Children in a Swedish Urban Community. A Prospective Longitudinal Study
Authors: KARLBERG PETTER , ENGSTRÖM INGA , LICHTENSTEIN HENRIK , SVENNBERG INGA
Published: January 2008

The physical growth was followed longitudinally from birth to 3 years of age in a group of 212 randomly sampled children from the Stockholm urban area, 122 boys and 90 girls. The children were measured on eight occasions at fixed intervals.

Recumbent length, crown‐rump length, weight, femur bicondylar and humerus bi‐condylar width, biacromial and pelvic width, circumference of head and chest, subcutaneous tissue at four different sites and the anterior fontanel were measured.

The mean values for these measurements with S.D. as well as the percentiles are given. The increments were calculated and are also given as means with S.D. and percentiles.

The pattern of growth is discussed. Differences between boys and girls were found, particularly with respect to the skeletal and the subcutaneous tissue, the former being more developed in boys and the latter in girls.
The Development of Children in a Swedish Urban Community. A Prospective Longitudinal Study
Authors: KLACKENBERG G.
Published: January 2008

The study is part of a prospective longitudinal investigation, which comprises 212 children chosen randomly from a Swedish urban community. The sleep behaviour of the children which is reported here was followed up to the age of 3 years. Mean values with standard deviations for duration of sleep (total, day sleep and night sleep) at 6, 9, 12, 18, 24, and 36 months are presented. The length of night sleep increases slightly, but because the day sleep decreases much more, the 3‐year‐old will, on an average, sleep nearly 21/2 hours less per 24 hours than will a 6‐month‐old baby. The total length of sleep per 24 hours does not vary with the amount of day‐light hours. A calculation of correlation also shows that the possibilities to predict the length of sleep at a later stage of the child's life are small. The length of sleep showed no statistical correlation with a great number of tested environmental factors. The latter included overcrowding and the mother being gainfully employed.

Analyses were made of various forms of sleep disturbances, their frequency at 8 different age‐levels, and their continuity and associations with various environmental and constitutional factors, For yearlong periods resistance to bedtime preparations, evening wakefulness, and night waking form a recurrent feature in the sleep‐behaviour pattern of some children. The incidence of night waking, which at no age is below 23%, is highest at 1 month, being 75%. The interruptions of night sleep show no relationship to the tested environmental variables, whereas the disturbances in the evening and in connection with bedtime preparation were found to be related to external stimuli and strange experiences to the child, such as separation from the mother.

Finally, a comparison was made between children who had been bad sleepers for just over 2 years and the extreme group of children who had slept without disturbances. Among the tested variables, only marked overcrowding and prolonged breast‐feeding were related to a tendency to wakefulness.
EVALUATION OF PROGNOSIS AND TREATMENT IN BELL'S PALSY IN CHILDREN
Authors: Salam Ekram Abdel , Elyahky Wageeh S.
Published: January 2008

Nerve‐excitability measurements performed early in the course of the disease are of a good prognostic value. The results show that when excitability is maintained unimpaired after 72 hours of the onset, there is a chance of 100% spontaneous cure. When the excitability is diminished by less than 50%, 90% recovery may occur, but when it is markedly diminished or absent the prognosis is bad.

The schedule of treatment to be followed should be based on the result of nerve excitability measurement early in the course of the disease.

Systemic vasodilators, as nicotinic acid early in the course of the disease has excellent effect as it cuts the vicious circle of arteriolar spasm without increasing pressure within the facial canal.

It is advisable that early short wave therapy should be avoided as it may increase nerve compression through local vascular congestion in the vicinity of the nerve.

Incidence of physiological block is higher in children with Bell's palsy than in corresponding adult patients who, as a result have a higher incidence of nerve degeneration and worse prognosis.

The severity of paralysis does not indicate the degree of nerve lesion.
BLOOD GLUCOSE OF THE HUMAN FETUS PRIOR TO AND DURING LABOR
Authors: Raivio K. O. , Teramo K.
Published: January 2008

With the technique of scalp capillary blood sampling, the blood glucose levels of human fetuses were studied in normal cases as well as in cases with toxemia, Rh‐immunization or prolonged pregnancy. Before the onset of labor the mean level was 61.5 mg/100 ml, and an increase was demonstrated as labor progressed. The maternal concentration was always somewhat higher than that in the fetus, and an analogous increase was observed during labor. No significant differences could be demonstrated between the normal and abnormal cases, either prior to or during labor.
NEONATAL HYPOGLYCEMIA I. Occurrence of Hypoglycemia in Patients with Various Neonatal Disorders
Authors: Raivio Kari O. , Hallman Niilo
Published: January 2008

Two or more serial blood glucose determinations were performed before the age of five days in 964 neonates treated in the Children's Hospital. Two or more values of 20 mg/100 ml or less, considered to indicate significant hypoglycemia, were observed in 55 infants, or 5.7% of those studied. The incidence of significant hypoglycemia was 20% in dysmature infants, 16% in infants of diabetic mothers and 15% in critically ill infants dying within ten days of birth. No other important predisposing factors were detected. A screening procedure for the early diagnosis of neonatal hypoglycemia is described.
LOW BIRTH WEIGHT, THE “SMALL FOR DATES” SYNDROME AND PERINATAL MORTALITY IN A LOW FAMILY INCOME GROUP
Authors: Rahimtoola Razia J. , Mir Sarah , Baloch S.
Published: January 2008

In 1100 consecutive deliveries the “prematurity” rate was found to be 22%. Mean birth weight was 6.2 lb, or 2800 g. 17% showed a birth weight of less than 2500 g in spite of gestational age over 36 weeks. Intrauterine mortality was 4% and neonatal mortality 5%. Still births were predominantly in the antenatally neglected lower income groups and the causes of neonatal mortality is considered as mainly secondary to poor ante‐ and post‐natal care.
STUDIES ON ERYTHRO‐KINETICS IN INFANCY:XIII. The mean Life Span and the Life Span Frequency Function of Red Blood Cells Formed during Foetal Life
Authors: Bratteby Lars‐Eric , Garby Lars , Groth Torgny , Schneider Werner , Wadman Bengt
Published: January 2008

Equations were developed for the relation between the production rate, the life span frequency function and the number of circulating erythrocytes and for the relation between the production rate, the life span frequency function and the relative number of circulating cells after random labelling.

With the help of explicit expressions for the production rate and the life span frequency function of erythrocytes formed during the latter part of foetal life, the increase in number of circulating cells during this period and the relative decrease in circulating labelled cells in a simulated cord red blood cell survival experiment were calculated on a digital computer and compared with experimental data. Through the simulation procedure, the parameters in the life span frequency function and the production rate function were estimated.

The life span frequency function of the red blood cells did not change appreciably during the last 60 days of foetal life.

The mean cell life span was found to be between 45 and 70 days. The life span frequency function was skew with the majority of cells dying before the mean life span.

The relative rate of production of erythrocytes during the last two months of gestation was found to be 3–5 times that of normal adults.
ECG COMPARED WITH MYOCARDIAL ULTRASTRUCTURE IN ANOXIC FOETUSES OF NORMAL AND HYPERGLYCAEMIC RABBITS
Authors: Gelli M. G. , Ericsson J. L. E. , Enhörning G.
Published: January 2008

The heart function, as recorded by ECG, was correlated to the ultrastructural state of the myocardial cells.

The material consisted of 4 rabbit mothers. Two were used as experimental animals, and were given 120 ml of 30% glucose solution intravenously on the 29th day of pregnancy. The other two served as controls. After the infusion, the rabbits were sacrificed, and their foetuses removed by laparotomy. One foetus was placed in a paraffin bath at 37°C for ECG recording, and the others were placed in physiological saline. The two parameters, i. e., ECG and ultrastructural state of the myocardial cells, were correlated at various times. Pathological changes in the ECG were found to be reflected in ultrastructural changes in the cells. These changes were similar in the experimental animals and in the controls, but occurred earlier in the latter animals than in the former.
DE LANGE SYNDROME A Study of Nine Examples
Authors: Abraham J. M. , Russell Alex
Published: January 2008

A comprehensive study of 9 typical cases of de Lange syndrome revealed no pathognomonic marker but two helpful aids to the essentially clinical diagnosis: short thick first metacarpal bone and suggestive dermatoglyphs. The series includes an example with parental consanguinity; but the mode of inheritance remains uncertain. Endocrine investigations showed normal to high hypothalamic‐pituitary‐adrenal axis response, with six of the nine examples showing evidence of hypothyroidism on functional testing, secondary in four and primary in two. Abnormality within the hypothalamic area or affecting its connections with higher centres, perhaps as part of a diffuse brain pathology, could explain some of the findings in this syndrome.
CONGENITAL HAEMANGIOENDOTHELIOSARCOMA OF THE LIVER
Authors: Lund J. Swane
Published: January 2008

A case of haemangioendotheliosarcoma of the liver in a newborn boy is reported. The patient died 15 hours after birth. The autopsy findings are described, and the rare occurrence of this tumour is discussed. It does not appear to have been previously diagnosed immediately after birth. A few cases have manifested themselves in the 2nd‐5th month of life. Recent improvement in the prognosis for patients with hepatic tumours treated by surgery is mentioned.
IMMUNOGLOBULIN LEVELS IN INFANTS WITH LOW BIRTH WEIGHTS
Authors: Berg Torsten
Published: January 2008

The different immunoglobulins G, M, A and D were studied in 65 infants with birth weights less than 2500 g, during their first weeks of life. The initial IgG concentration was very well correlated to gestational age, but by no means so well correlated to birth weight. Infants of low gestational age had, on the average, low IgG concentrations at birth and in the course of their first months of life there was a tendency towards more or less pronounced hypogammaglobulinaemia. Infants with low birth weights had, as a rule, a good capacity for early IgM synthesis but the increase in IgM levels during the first few weeks of life was, however, considerably less rapid in infants of very low gestational age. This may be due to the fact that such infants are less exposed to infections, owing to incubator care and various kinds of precautions. It may also, however, be an expression of an inferior capacity for IgM synthesis in these infants. As regards immunoglobulins A and D in infants with low birth weights, no pronounced differences were found on comparison with previous findings in full‐term infants.
MOTOR CONDUCTION VELOCITIES IN NEWBORN INFANTS OF VARIOUS GESTATIONAL AGES
Authors: Blom Sigfrid , Finnström Orvar
Published: January 2008

The motor conduction velocities, in the ulnar and peroneal nerves of newborn infants, of various postmenstrual ages were studied. It was found that:

1. The conduction velocities, in children of a short gestational age is significantly lower than those of fullterm infants.

2. The conduction velocities, of the peroneal nerve, is slightly but significantly lower than those of the ulnar nerve, in both groups of children.

It is also concluded that the determination of motor conduction velocities seems to be an additional method, of value, in assessing the degree of maturity at birth, and in determining the gestational age.
ELECTROMYOGRAPHIC EVIDENCE OF A MUSCLE LESION IN HOMOCYSTINURIA
Authors: Hurwitz L. J. , Chopra J. S. , Carson Nina A. J.
Published: January 2008

In seven out of nine patients with homocystinuria, electromyographic examination suggested a myopathy. The E. M. G. was also abnormal and of myopathic type in three of the parents. The implication of this finding in homocystinuria and in unaffected relatives is discussed. It is concluded that there is a muscle lesion in homocystinuria which is probably myopathic and is one factor producing the peculiar gait present in this disease.
YERSINIA ENTEROCOLITICA AS A CAUSE OF ACUTE MESENTERIC LYMPHADENITIS
Authors: Jansson E. , Wallgren G. R. , Ahvonen P.
Published: January 2008

Two cases of acute mesenteric lymphadenitis caused by Yersinia enterocolitica in children aged 11 and 12 years are described. At appendectomy the appendix was found innocent, but in the ileocecal region and in the mesentery there were lymph nodes from which bacterial culture grew Y. enterocolitica. In one patient, agglutinins against Y. enterocolitica were established in the titre 12 80 and in the other in the titre 20.

The importance of etiologic studies in cases of acute mesenteric lymphadenitis is emphasised.
IDIOPATHIC APLASTIC ANAEMIA IN CHILDREN
Authors: KILLANDER ANDREAS , KARL‐MARTIN  , LUNDMARK  , SJOLIN STIG
Published: January 2008

The results of treatment of 19 children with idiopathic aplastic anaemia is reported. Initially the patients received testosterone‐prednisone therapy. When a satisfactory haemoglobin level had been reached metandienon was substituted for testosterone and the corticosteroids withheld. 8 patients died without signs of response, 2 patients responded initially but died later. The remaining 9 patients are alive but in only 3 of them was it possible to discontinue all therapy without signs of relapse. The rate of remission varied considerably. One patient required 23 months of combined therapy to achieve a normal haemoglobin level. A moderate hypoplasia of the bone^marrow at the start of therapy was the most favourable prognostic sign in this series. Therefore, it may be concluded that every effort should be made to diagnose the disease before the bone‐marrow changes have progressed to severe hypoplasia.
BILE ACID EXCRETION AND MALABSORPTION IN INTRAHEPATIC CHOLESTASIS OF INFANCY (“NEONATAL HEPATITIS”)
Authors: NORMAN ARNE , STRANDVIK BIRGITTA , ZETTERSTROM ROLF
Published: January 2008

Bile acid excretion has been studied in four patients with intrahepatic cholestasis of infancy neonatal hepatitis) after intramuscular administration of cholic acid‐24‐14.C

Bile acid secretion to the intestines was found to be highly impaired and the main route of excretion was via the urine. Practically all of the administered labeled cholic acid was conjugated prior to excretion. The main conjugates were glycocholic and taurocholic acid. At least three additional conjugates of cholic acid were isolated from the urine.

Analysis of bile obtained from three of the patients in connection with operative cholangiography showed a very low concentration of bile acids, phospholipids and cholesterol. The bile was of normal colour owing to the presence of bilirubin.

Severe steatorrhea and markedly impaired absorption of vitamin A was demonstrated when the patients were jaundiced. The impairment of bile acid excretion to the gut and the degree of steatorrhea were well correlated. In some of the patients steatorrhea persisted after the disappearance of jaundice. In those instances, the impairment of bile acid excretion to the gut was found to persist.
RENAL VEIN THROMBOSIS IN A NEWBORN INFANT OF A DIABETIC MOTHER
Authors: AURELIUS GÖRAN
Published: January 2008

A newborn infant of a diabetic mother is described, suffering from a renal vein thrombosis with hematuria and a palpable mass in the flank. The general condition was unaffected and the symptoms disappeared after two weeks. Nephrectomy was performed after four months because of an arterial hypertension and a pathologic intravenous urography.

In these cases a high hematocrit value and a hypercoagulability may play a great part of the pathogenesis. Therefore venesectio and treatment with heparin may be of value.
DEFIBRINATION SYNDROME IN A NEWBORN, AND ITS TREATMENT WITH EXCHANGE TRANSFUSION
Authors: SKYBERG DAG , JACOBSEN CARL D.
Published: January 2008

A male infant was born asphyxiated, but after few minutes of artificial respiration, spontaneous breathing was established. During the next few hours he developed a severe bleeding tendency with signs of intracranial hemorrhage. In the palms of the hands and soles of the feet there were symmetrical large ecchymoses with a sharp border to normal skin. Coagulation studies showed the characteristics of a defibrination syndrome. He was treated with one exchange transfusion of heparinised blood, and corticosteroids for one week. After the exchange transfusion a rapid and marked improvement was noted. He was followed up during his first year of life, and the development has been quite normal. No permanent disabilities have been found. It is possible that asphyxia was the trigger mechanism for the defibrination syndrome in this case.

Early recognition of the acute defibrination syndrome and immediate start of therapy may be lifesaving.
RAPIDLY DEVELOPING CONSTRICTIVE PERICARDITIS IN AN INFANT SIMULATING MITRAL VALVE OBSTRUCTION
Authors: SCHLESINGER Z. , KAHANA D. , KRAUS Y. , NEUFELD H. N.
Published: January 2008

A case is reported of rapidly developing constrictive pericarditis in a 9‐month‐old infant, apparently the youngest yet described.

Unusual features of this case were the failure of the heart size to decrease as expected, and electrocardiographic, roentgenographic, angiocardiographic and hemodynamic data, which indicated “mitral valve obstruction”. These unusual features resulted from the peculiar location of the pericardial constriction over the left ventricle, which took the form of a pericardial cyst hampering left atrial emptying.
SEVERE ILLNESSES DUE TO ADENOVIRUS TYPE 7 IN CHILDREN
Authors: STEEN‐JOHNSEN J. , ÖRSTAVIK I. , ATTRAMADAL A.
Published: January 2008

Four patients presenting a severe pneumonia due to adenovirus type 7 are reported. One of them died, and intranuclear inclusion bodies characteristic for the illness were found. In infants and small children, this infection might in addition give meningoencephalitic symptoms, hepatomegaly, vascular disorders and hemorrhagic tendency, as some of these patients demonstrated. Intravascular coagulation initiated by the virus infection could explain several of the symptoms and signs in such serious cases.
DOWN'S SYNDROME TRANSMITTED THROUGH MATERNAL MOSAICISM
Authors: AARSKOG DAGFINN
Published: January 2008

Two families are reported in which Down's syndrome was transmitted through phenotypi‐cally normal mosaic mothers. In the first family the mother had normal/G‐trisomy mosaic, and on two successive pregnancies at the age of 22 and 24 years she gave birth to two sibs with regular G2i‐trisomy and Down's syndrome. In the other family the mother had a mosaic of normal and balanced D/G21 translocation cells, and at the age of 32 years she gave birth to a child with D/G2t translocation trisomy and Down's syndrome.

Mosaic mothers carry a considerable risk of having children with Down's syndrome. Exact prediction of the risk cannot be given since the extent of gonadal involvement in the mosaicism is unknown.
GONADAL DYSGENESIS WITH LYMPHOCYTIC THYROIDITIS AND DELETION OF THE LONG ARM OF THE X CHROMOSOME
Authors: MELIN KERSTIN , SAMUELSON GÖSTA
Published: January 2008

A 17‐year‐old girl with several stigmata of gonadal dysgenesis and a 45, X/46, XXq˜ mosaicism is presented. She had small hypoplastic ovaries and regular menstruations, and a lymphocytic thyroiditis. The relationship between gonadal dysgenesis and lymphocytic thyroiditis is discussed.
COARCTATION OF THE AORTA WITH MULTIPLE ARTERY ANOMALIES IN IDIOPATHIC HYPERCALCEMIA OF INFANCY
Authors: BLIDDAL J. , DUPONT B. , MELCHIOR J. C. , OTTESEN O. E.
Published: January 2008

A case of idiopathic hypercalcemia of infancy with multiple anomalies of the arteries is described. This patient demonstrated a combination of supravalvular pulmonary artery stenosis, supravalvular aortic stenosis, hypoplasia of the aortic arch, coarctation of the aorta and multiple stenoses of the branches of the abdominal aorta. The pathogenesis of arterial hypertension in this syndrome is discussed.
Dynamic and static lung volumes of school children with cerebral palsy
Authors: BJURE JAN , BERG KRISTINA
Published: January 2008

The dynamic and static lung volumes were measured in 22 subjects with cerebral palsy. There were no signs of airway obstruction. The total lung capacity was significantly reduced, averaging 85 per cent of the predicted normal values. In the 14 subjects with spasticity, the functional residual capacity was significantly reduced to 75 per cent of the predicted value, whereas the eight subjects with dyskinesia showed a marked and significant increase in the residual volume (156 per cent of the predicted value). This difference in the distribution of the lung volumes resulted in a 50 per cent decrease in the vital capacity för subjects with dyskinesia compared with a 67 per cent decrease för subjects with spasticity. These deviations in lung volumes from the predicted normal values and the differences between the two groups can be explained by the reduced ability of voluntary muscular control.
Somatic adaptation in cerebral palsy ‐ summary and general discussion
Authors: BERG KRISTINA
Published: January 2008

Fourty‐one school children with severe affliction of cerebral palsy participated in one or more studies on adaptory mechanisms in cerebral palsy.

The studies dealt with the physical working capacity, lung volumes, body composition, nutrition, and spontaneous activity. Effects of therapy with physical training and improved nutrition were also studied.

Data from the different studies were integrated and gave the following results.

Thea abnormal body composition during growth directly affects body weight (BW). rörelsehinder this reason, body cell mass (BCM), representing the active metabolic mass, is suggested as the reference value rörelsehinder subjects with cerebral palsy, with respect to metabolic data, including gross body composition.

The mean physical working capacity berörelsehindere training was 71 per cent of that of healthy children per kg BCM. The main limits to maximal work were considered muscular. The severity of the handicap appeared to be the factor most closely related to the original low working capacity of the factors studied.

The physical working capacity significantly increased to a mean of 90 per cent of normal values.

The total lung capacity was reduced when compared to the predictions för height (BH), but adequate when correlated to BCM. The subjects with dyskinetic cerebral palsy had an abnormal volume distribution of air with increased residual volume.

Malnutritive changes were found in the body composition with a decrease of BCM to 85 per cent of the prediction för BH and with an increase of extracellular water (ECW) from a predicted mean of 0.56 per kg BCM to 1.06. In addition 7 of 23 subjects had a BH below the 2.5 per cent population limit för age. The physical training alone, and in combination with an improved nutrition, significantly reduced ECW, but did not effect BCM. BF was significantly increased by training only. Improved nutrition alone had no significant effects, which indicated that the malnutrition was not severe. The increased extracellular mass (ECW+ BF) may cause a metabolic load on the cells and abnormal conditions för transport.

The spontaneous physical activity correlated well with total body potassium (Ke, BCM). Factors which may modify the habitual activity such as age and BF were studied.

The difference in neuromotor disturbance between the spastic and the dyskinetic group caused minor differences, concerning volume distribution of air in the lungs, voluntary control of movements after exhaustion and body fat amounts.

The severity of handicap was found to be of importance in causing unspecific somatic complications. The motor disability restrains the physical activity and creates subjects with a low energy need. The consequences of this can be softened by a proper management, which provides a variety of physical activities and a diet with a high content of essential nutrients per unit energy.
ELECTROENCEPHALOGRAPHIC SECTION: Introduction and literature
Authors: BLOM S. , RUNE V.
Published: January 2008

1. No differences were found with respect to the presence of normal and/or pathological EEG patterns between a head injury material cared for in hospital, a head injury material cared for at home and an unselected control material.

2. The limited size of the materials does not permit a reliable detailed ana‐lysis of possible differences between the groups with respect to the types of abnormalities that were found.

3. From the clinical point of view, the EEG should be evaluated with great caution after head injury in children (following the acute phase), especially if it is not possible to compare the find‐ings with the EEG pattern before head injury.