THE EFFECT OF ANTEPARTUM HAEMORRHAGE ON THE HEALTH OF THE CHILD*

In this prospective study the infants born to mothers who suffered an antepartum haemorrhage after the 28th week of pregnancy were matched with a control series. The neonatal mortality and morbidity and later assessment at 6 weeks and 2 years of age regarding their general maturity were compared.     

A STUDY OF GROWTH IN CONGENITAL HEART DISEASE WITH A NOTE ON THE EFFECT OF SURGERY*

Failure of growth in congenital heart disease is an accepted finding (Taussig, 1947), and among the many factors which have been adduced to explain this failure are: respiratory infections (Mehrizi and Drash, 1962), haemodynamic difficulties, and parental size (Umansky and Hauck, 1962). This study is the report of an attempt to show the extent of the growth failure, to test its association with the factors mentioned, and to discuss briefly the effects of surgery upon the pattern of growth.     

DEVELOPMENT OF RENAL CONTROL OF SALT AND FLUID HOMEOSTASIS DURING THE FIRST YEAR OF LIFE

ABSTRACT: Aperia, A., Broberger, O., Thodenius, K. and Zetterstrom, R. (Department of Paediatrics, Karolinska Institutet, St Goran's Hospital for Children, Stockholm, Sweden). Development of renal control of salt and fluid homeostasis during the first year of life. Acta Paediatr Scand, 64:393, 1975.–This study describes the development of renal control of salt and water homeostasis. Twenty-three infants aged 3 weeks to 13 months were studied with respect to glomerular filtration rate (GFR) using single injection technique, ability to excrete an oral salt load, ability to excrete water, and diluting capacity. GFR developed exponentially, salt excretion linearly, water excretion was unchanged and diluting capacity actually decreased. A hypothesis is presented for the theoretical basis of this functional development taking into account the interdependence of the functional parameters studied. This theory might well explain the high incidence of hypernatremic dehydration in infants.     

THE SUBCLASSIFICATION OF CHILD FIRESETTERS

The possibility that child firesetters are a heterogeneous group was investigated in a cross-sectional case note and item sheet study of all children referred to an Inner London clinic between 1973 and 1981. Firesetters were most usefully subdivided by age, and secondarily by reason for referral. There were no links between enuresis and dangerousness or cruelty to animals. Methodological issues and the implications of the findings are discussed, with particular reference both to the development of the disorder and to the subclassifications drawn for conduct disturbance.     

A SURVEY OF AUSTRALIAN CHILDREN FOR ASYMPTOMATIC URINARY INFECTION

Cells and bacteria were studied in urine samples from children in whom there was no reason to suspect infection in the urinary tract. The study confirms the fact that criteria for the diagnosis of urinary infection in adults cannot be applied unreservedly to children. The survey showed an incidence of bacteriuria of 0.5% and an incidence of microscopic haematuria of 1.0% in girls, and an incidence of possible urinary tract disease in 0.47% of the boys.     

THE AUTISTIC CHILD''S APPRAISAL OF EXPRESSIONS OF EMOTION: A FURTHER STUDY

Autistic and matched non-autistic retarded children were selected for their ability to recognize the correspondence between schematic drawings and videotaped scenes involving people. The subjects of both groups were able to choose schematic drawings of gestures for a person's gestures of emotion enacted on videotape. However, the autistic children were significantly impaired in choosing which of the drawings of gestures should 'go with' videotaped vocalizations and facial expressions characteristic of four emotional states. The results were found to be consistent with results from a previous, related study in which the same subjects had chosen drawn or photographed faces to indicate their judgements of the same videotapes of emotional expression. It is suggested that these findings reflect an important aspect of autistic children's social disability.     

EFFECT OF P-GLYCOPROTEIN EXPRESSION ON OUTCOME IN THE EWING FAMILY OF TUMORS

This study was designed to determine the prognostic significance of multidrug resistance, mediated by P-glycoprotein (Pgp) expression, in Ewing sarcoma. The clinical and laboratory features, treatment protocol, and outcome of 75 patients with Ewing sarcoma or peripheral neuroectodermal tumor treated between 1972 and 1997 were reviewed. Pgp expression was tested with the monoclonal antibody JSB-1. Thirty-four (64%) of the 53 tissue samples from untreated patients stained positive for Pgp. Progression-free and overall survival were 44 and 59%, respectively, in patients with negative findings, and 28 and 41% in those with positive findings; neither difference was significant. Of the 12 relapsed patients, 6 (50%) expressed more Pgp after chemotherapy than at diagnosis and 4 (33%) expressed less. Within these subgroups, 5 out of 6 and 3 out of 4 died from the disease. No correlation was found between Pgp and known prognostic factors of Ewing tumors. Pgp expression is probably an intrinsic factor of Ewing tumors but has no correlation to prognosis.     

A METHODOLOGICAL STUDY OF THE DIAGNOSIS OF CYSTIC FIBROSIS BY INSTRUMENTAL NEUTRON ACTIVATION ANALYSIS OF SODIUM IN NAIL CLIPPINGS

Abstract. Kollberg, H. and Landström, O. (Department of Paediatrics, University Hospital, Uppsala and AB Atomenergi, Studsvik, Sweden). A methodological study of the diagnosis of cystic fibrosis by instrumental neutron activation analysis of sodium in nail clippings. Acta Paediatr Scand, 63: 405, 1974.–Instrumental neutron activation analysis (INAA) of nail clippings was used in the development of a diagnostic method for cystic fibrosis (CF). From CF patients and controls more than three years old, nail clippings were sampled for tests of different errors. As a result of this study a precise collection routine was outlined. Sodium is easily washed out from nail clippings. The risk of sodium contamination of the nails seems to be small. The sodium distribution in the nail is inhomogeneous, and the sodium content varies also from nail to nail in the same person. There is good evidence that the increased sodium in the nails of CF patients comes from the sweat. There seems to be a basic "intrinsic" sodium level, which is about the same in the nails of CF patients as in controls. The precision and accuracy of INAA for determining sodium in nails is considered satisfactory. It is concluded that INAA of the sodium concentration in nail clippings is a suitable method as an aid in the diagnosis of CF if a precise collection routine is used.     

SCREENING OF CORD BLOOD LOW-DENSITY-LIPOPROTEIN CHOLESTEROL IN THE DIAGNOSIS OF FAMILIAL HYPERCHOLESTEROLAEMIA: A STUDY OF 2000 INFANTS

Abstract. A prospective follow-up study of infants selected by cord blood total cholesterol (TC) and low-density-lipoprotein cholesterol (LDL-C) levels from 2000 consecutive live births was undertaken to reassess the role of cord blood screening in the diagnosis of familial hypercholesterolaemia (FH). Mean values for serum cholesterol were (mmol/l ± S.D.): TC, 1.83 ± 0.56; LDL-C, 0.90 ± 0.49; HDL-C, 0.70 ± 0.33; TG, 0.38 ± 0.16. Seventy-three of 117 infants who had had a cord TC and/or LDL-C >95th percentile, and 373 control group children (cord TC and/or LDL-C >95th percentile) were followed up at age 3–12 months. Six of the 117 were hypercholesterolaemic (HC), and one child had an HC parent: positive detection rate ≥0.05%; false positive rate ≥3.7%. Four control-group children were HC and had an HC parent; false negative rate ≥1.1%. With the possible exception of detecting FH in a child with a known affected parent, cord blood screening appears to be unreliable for the diagnosis of FH.     

EFFECT OF P-GLYCOPROTEIN EXPRESSION ON OUTCOME IN THE EWING FAMILY OF TUMORS

This study was designed to determine the prognostic significance of multidrug resistance, mediated by P-glycoprotein (Pgp) expression, in Ewing sarcoma. The clinical and laboratory features, treatment protocol, and outcome of 75 patients with Ewing sarcoma or peripheral neuroectodermal tumor treated between 1972 and 1997 were reviewed. Pgp expression was tested with the monoclonal antibody JSB-1. Thirty-four (64%) of the 53 tissue samples from untreated patients stained positive for Pgp. Progression-free and overall survival were 44 and 59%, respectively, in patients with negative findings, and 28 and 41% in those with positive findings; neither difference was significant. Of the 12 relapsed patients, 6 (50%) expressed more Pgp after chemotherapy than at diagnosis and 4 (33%) expressed less. Within these subgroups, 5 out of 6 and 3 out of 4 died from the disease. No correlation was found between Pgp and known prognostic factors of Ewing tumors. Pgp expression is probably an intrinsic factor of Ewing tumors but has no correlation to prognosis.     

PREDICTIVE VALUE OF HIGH IgE LEVELS IN CHILDREN

Abstract. A group of 207 healthy non-atopic children 0–14 years of age without any known family history of atopic disease was selected for a study of the relation between serum IgE levels and the occurrence of atopic manifestations during an observation period of 18 months; 206 fullfilled the study. Serum IgE was measured by a direct radioimmuno-logical sandwich technique (PRIST¹). At the follow-up 28 of 32 with an initial IgE level greater than one standard deviation above the mean for the age continued to show a high level (87.5%). The total concordance was 81.1%. Atopic or probable atopic diseases had developed in 75.0% of children 0–1 year of age with an initial IgE above +1 S.D., but in only 6.4 % of those from the same age group with a lower initial IgE. Even among children 2–14 years old, it was noticed that a high IgE level was predictive of the subsequent development of atopic disease. Otitis media was more frequent among children with an initially elevated IgE level than among the rest of the children. Determination of serum IgE with the PRIST-technique has been shown to provide a valuable means for predicting future atopic manifestations and may be used as a screening procedure especially in children of atopic parents.     

AN EXPERIMENTAL EVALUATION OF THE EFFECTS OF FIVE STYLES OF TEACHER CONVERSATION ON THE LANGUAGE OF HEARING-IMPAIRED CHILDREN

This study of conversation was undertaken to test experimentally conclusions reached in earlier work with deaf primary school children and pre-school hearing children. Both of these studies revealed significant negative correlations between a measure of teacher control of the conversations and measures of children's initiative and loquacity. This study was designed to investigate the direction of causality in these correlations. Teachers were asked to change their conversational styles in specific ways with the same pairs of children. On each of five occasions they were to bias their conversations towards one of five "levels of control"--enforced repetitions, two-choice questions, wh-type questions, personal contributions and phatics. The results show that as teachers change style, their children follow them with the predicted changes in initiative and mean length of turn.     

急性毛细支气管炎患儿血浆脂类炎性介质的变化

对３５例急性期和１５例恢复期毛细支气管炎（简称毛支）患儿用放射免疫法测定了血浆白细胞三烯Ｃ＿４（ＬＴＣ＿４）、血栓素Ｂ＿２（ＴＸＢ＿２）、６－酮－前列腺素Ｆ＿（１ａ）（６－Ｋｅｔｏ－ＰＧＦ＿（１ａ））浓度。结果表明：（１）急性期ＬＴＣ＿４明显增高，恢复期降至正常。（２）急性期和恢复期ＴＸＢ＿２、ＴＸＢ＿２／６－Ｋｅｔｏ－ＰＧＦ＿（１ａ）比值均显著增高；６－Ｋｅｔｏ－ＰＧＦ＿（１ａ）急性期明显降低，恢复期升至正常。提示毛支患儿存在ＴＸＡ＿２－ＰＧＩ＿２平衡失调，ＬＴＣ＿４、ＴＸＢ＿２在气道痉挛、阻塞中起了重要作用。同时对３５例急性期测血液ＩｇＥ，结果２０例增高，提示毛支患儿多数存在过敏素质和气道高反应性。     

LOCALIZATION OF PLASMA PROTEINS IN KIDNEYS OF CHILDREN WITH DIFFUSE NEPHROPATHIES, STUDIED BY AN INDIRECT IMMUNOFLUORESCENT TECHNIQUE

Preliminary report of the results obtained with an indirect immunofluorescent technique applied to the study of renal biopsy specimens. Depositions of IgG, IgA, IgM, complement, fibrinogen and albumin were investigated in glomeruli of children with diffuse nephropathies and in adult controls. The localization of the protein precipitates was confirmed by comparing the immunofluorescent picture with the results of the P.A.S.M./ H.E. staining of the same sections.     

RELIABLE DIAGNOSIS OF THE MAJOR TYPE OF CYSTIC FIBROSIS WITH FIBROBLAST CULTURES A Double Blind Study

ABSTRACT. A double blind study has been carried out to demonstrate that the most common type of cystic fibrosis (CF) can be reliably diagnosed with skin-derived fibroblast cultures. Alkaline phosphatase (AIP) activity has been measured in 6 normal controls, 12 CF-heterozygotes and 6 CF-homozygotes before and after stimulation with Tamm-Horsfall-glycoprotein (THP), isoproterenol and theophylline ("THP-induction test"). The mean AIP-activities after THP-induction were 8.8, 12.7 and 34.6 for the three different genotypes respectively. There was no overlap between the values of CF-homozygotes on the one hand, and the values of CF-heterozygotes and normal controls on the other hand. All 24 specimens were correctly diagnosed in the present double blind study, indicating the very high degree of reliability of the THP-induction test in the detection of the predominant type of cystic fibrosis with fibroblast cultures. Normal controls and CF-heterozygotes could not be discriminated on an individual basis, but as a group the CF-heterozygotes displayed higher AIP-values.     

叶酸缺乏的离乳大鼠模型建立和评价

初次探讨在国内尝试用RHAA配方建立离乳大鼠的FD模型 ,并对该模型进行评价 ,以期今后对叶酸缺乏 (FolatesDeficiency ,FD)影响离乳大鼠学习记忆的观察和可能机制的分析有一更可信的基础。选择 5 4只刚离乳的健康雄性SD大鼠 ,随机分成实验组、对饲组和对照组三组。实验组饲以去叶酸的RHAA配方饲料 ,另二组饲以添加了 8mg叶酸 /kg膳食的RHAA饲料 ,对饲组按实验组的进食量加以控制 ,对照组不控制进食。每周记录体重和摄食量两次。分别于饲养第 2和第 6周末测定血清叶酸浓度。结果 :实验第 2周除实验组血清叶酸浓度降低外 (P <0 .0 1) ,其余各指标在三组间无明显差异 (P >0 .0 5 )。实验组从第 3周、对饲组从第 4周开始摄食量减少 ,生长速度减慢 (P <0 .0 5 )。第 6周实验组的平均体重、血清叶酸浓度明显低于对照组和对饲组 (P <0 .0 1)。结论显示 :用RHAA配方饲料饲养 6周可建成较重的离乳大鼠的叶酸缺乏模型 ,并最大限度地促进其生长 ,是短期内建立离乳大鼠叶酸缺乏模型较理想的配方     

STIMULATION OF SODIUM AND WATER ABSORPTION BY SUCROSE IN THE RAT SMALL INTESTINE

ABSTRACT. This study describes the absorption of Na, K, CI, H₂O and sugars from an isosmotic sucrose electrolyte solution and compares it with the absorption of these substances from an isosmotic glucose electrolyte solution and a mannitol electrolyte solution, by an in vivo perfusion technique in the rat jejunum and ileum. The composition of the solutions was similar to the oral rehydrating solutions, currently in use for the treatment of acute diarrhoeal diseases. The study shows that an isosmotic sucrose containing electrolyte solution induces a significantly greater Na, CI, and K absorption compared to glucose electrolyte solution. Water absorption however, is significantly less from the former solution probably due to osmotic drag of water into the lumen by the slowly absorbed fructose released from sucrose hydrolysis. These findings underline the clinical importance of using hyposmotic sucrose electrolyte solution for oral rehydration.     

THE DEVELOPMENTAL STATUS OF A SAMPLE OF CHILDREN WITH PHENYLKETONURIA

Fourteen patients comprise the sample. Most of the children were older than the optimal age when treatment commenced but the study shows the individual differences in the ultimate behavioural and intellectual status achieved and poses a number of questions as to the reasons for variability. The study also shows some behavioural changes with treatment. It indicates that loco-motor progress, unless accompanied by the development of other skills, is not a reliable predictor of later progress. None of the children in the sample had defects of articulation but some showed delayed language. The quality of language function was shown to have prognostic significance.     

FOLLOW-UP STUDY OF PHOTOTREATED FULLTERM NEWBORNS

Abstract. Valkeakari, T., Anttolainen, I., Aurekoski, H. and Bjbrkqvist, S.-E. (Departments of Paediatrics, University of Oulu, Oulu, and Central Hospital, Lahti, and Department of Ophthalmology, Middle Ostrobothnian Central Hospital, Kokkola, Finland). Follow-up study of phototreated fullterm newborns. Acta Paediatr Scand, 70:21, 1981. A follow-up study including examinations made by a paediatrician, an ophthalmologist and a psychologist and complemented with EEG-recordings and a number of laboratory determinations was performed at the age of 3 years on 41 children who had received phototherapy during the first week of life and on 42 control children of the same age. No differences were found in growth, development, social maturity, neurological or ophthalmologic disorders, EEG-recordings or laboratory determinations between both groups. It seems unlikely that phototherapy causes any harmful longterm effects provided that the eyes are shielded.