Upper calyx reno-vascular obstruction in children: Fraley's syndrome. Intrarenal vascular obstruction of the upper calyceal infundibulum has been distinguished by Fraley as an entity separate from an asymptomatic vascular impression. Clinically, this form of intrarenal vascular obstruction presents as nephralgia or hematuria. This infundibular obstruction is caused by normal renal vessels, usually the upper segmental artery: radiologically, the vessels produce a constant well-defined filling defect in the infundibulum at IVP, and, the upper calyx group is distended and shows delay in emptying. We found this condition in 14 children from 1968-1975. Control studies showed no progression in the radiological findings, even over a long period. In one of our cases angiography was indicated to exclude tumour or cyst; in another case, surgery was necessary. Complications are urinary tract infection or stone formation. Therefore, children with Fraley's syndrome require regular clinical examination.


Pelvis-shoulder dysplasia.

Pelvis-shoulder dysplasia. Pelvis-shoulder dysplasia is rare skeletal dysplasia characterised by symmetrical hypoplasia of the iliac wings and scapulae. It may be associated with unstable hips in infancy, a prominent lumbar lordosis and a waddling gait. Symptoms tend to lessen with increasing age. A child with this condition who has been followed up to the age of five years is described. Her pelvic dysplasia is milder than in previous cases and has caused no disability. Minor skeletal abnormalities are also present in the lumbar spine, femora and rib cage. Radiography of other members of the family was normal.


Dosimetric studies in the radiological examination of the hips in young infants with a special fenestration method of gonad protection. A special lead shield of 1,5 mm Pb, with a fenestration was used for gonad protection during X-Ray of the hips for detection of dysplasia. The window allows the delineation of all parts of the skeleton required to make a correct diagnosis and check the standardized position of the pelvis, while all other parts, especially the gonads are safely shielded. The scattered radiation for the testes was further reduced by a trough-shaped lead shield behind the scrotum. The effectiveness of this gonad protection was measured by direct dosimetric studies on the infant with LiF and CaF2: Dy dosimeters at different adjustments of the X-ray generator and with medium and ultra high speed screen-film combinations.


Peroral removal of a sewing needle and attached thread from the esophagus in an infant. The authors describe a simple Seldinger Catheter technique by which they removed a metallic sewing needle with attached thread from the esophagus of a 5 month old infant.


Multimodal approach to diagnosis of hamartoma of the spleen. Splenic hamartoma is a benign, primary neoplasm which usually causes a mass in the left upper quadrant of the abdomen. If radionuclide studies show a space-occupying lesion in the spleen that appears solid on the ultrasonogram, and selective abdominal arteriography reveals a richly vascular splenic tumor, hamartoma of the spleen should be the preoperative diagnosis.


Infantile hepatic hemangioendotheliomas associated with hemihypertrophy. An infant presented with congenital hemihypertrophy, hepatomegaly, and a low thoracic paraspinal mass. Liver scan showed multiple defects in the uptake of radioisotope. Surgical exploration revealed multiple infantile hemangioendotheliomas of the liver and a paraspinal hemangioendothelioma. In review of 69 reported cases of infantile hemangioendothelioma of the liver and viscera, there has been no previous note of hemihypertrophy associated with this abnormality.


Postinflammatory pseudotumor of lung in a child: diagnosis by angiography. A case of postinflammatory pseudotumor of the lung with unusual clinical features is presented. Radiological investigation, with particular emphasis on the angiographic diagnosis, is described.


[Incidence of congenital malformations among newborn infants in Poland in 1972. Preliminary report]. An analysis of frequency of congenital malformation observed among the neonates in 1972 in Poland has been performed on the basis of individual statistical cards filled in by medical personnel for each hospital delivery. Among 486.404 live- and stillborns, 7647 neonates with congenital malformations have been noted, which corresponds to the index of 15,72 per 1000 total births. The most frequently observed malformations were: congenital anomalies of limbs (755)-4,63/1000 total births, mostly congenital dislocation of hip; congenital malformations of the nervous system--2,11 degrees/00; of heart and circulatory system--1,89 degrees/00. Relatively low index of anencephaly has been noted--0,61/1000 total births. Among newborns of mothers from rural areas anencephaly and congenital hydrocephalus were more frequently noted. In urban areas congenital anomalies of limbs and congenital anomalies of skin, hair and nails were diagnosed more frequently. Frequency of congenital malformations among neonates of very young (less than 20 or less than or equal to 19 y.) and older (greater than equal to 35 y.) mothers was higher than in the intermediate age groups. Influence of mother's age on the frequency of particular malformations was analysed. Among neonates with congenital malformations born alive percentage of sexes was similar to the general population of live borns, whereas among stillbirths and prematures unable to live with congenital malformations--females were more frequent.


[Immunochemical properties and therapeutic usefulness of the preparation Igalina produced by Biomed]. In order to obtain higher concentration of IgA-antibodies in commercial gammaglobulin preparations, used for treatment of hipo - and dysimmunoglobulinemia states, there are produced two preparations: "Gamma-A- Konzentrat " of Behringwerke and " Igalina " of Biomed . The first one was examined and described by us previously (4, 12). Now we present our studies on Igalina . The examinations were performed using electrophoresis on cellulose acetate, double diffusion in agar gell using 15 specific antisera to plasma proteins and immunoelectrophoresis with anti-IgG, IgA and IgM. There were detected traces of albumin, transferin , alfa2 macroglobulin, haptoglobin fibrinogen and presence of IgA, IgG and IgM. We also observed the split of IgG line in immunoelectrophoresis at the cathode and to Fc and Fab fragments. The concentrations of IgA, IgG and IgM were evaluated using Mancini method (IgA--920 IU/ml, IgG--1640 IU/ml IgM 2500 IU/ml). Concentrations of chosen antibodies in Igalina were: ASO--1000 U/ml, anti- Staphylolisins 8 U/ml, agglutinins antistaphilococal 1 : 320, diphtheria antitoxins 42 U/ml, agglutinins antithyphi 1 : 20----1 : 640. They were 4 to 100 times higher than in plasma serum. Isohaemagglutinins were not detected. Igalina was used for preventive treatment of children contacted with viral infections or therapeutically for children who demonstrated first symptoms of viral infections of respiratory tracts. Preparation was given 48 times to 40 children. This group included 19 newborns and 10 children with I and IV type of dysimmunoglobulinemia or hipoimmunoglobulinemia . Doses ranged from 0,5 ml up to 1,0 ml/kg body weight. Estimations of IgA, IgG and IgM concentrations in serum and saliva of children (using Mancini method) were carried out before injection of Igalina and on the third and seventh day after injection. Results of studies were statistically evaluated, and besides the lack of significant differences we found some rise of IgA and IgG concentrations. We would like to underline also that in 6 children with hipo or dysimmunoglobulinemia the levels of IgA and IgG reached normal value on the third day after injection of Igalina . Investigations of secretory piece in saliva in the same period were carried out too. In three patients we could find the presence of secretory piece just after injection of Igalina . We did not found antibodies to IgA in patients' sera after treatment. The clinical results of treatment as well as toleration of the drug were good and very good.


[Metastases of retinoblastomas to the bones of children]. The authors present their own clinical material of retinoblastoma in children treated in the Clinical Department of Child Oncology of the National Research Institute of Mother and Child in Warsaw, in the years 1962-1976. Analyses of epidemiological and clinical data of 47 cases was done, and a four-stage classification was established. Case report of bone metastases of retinoblastoma from material is presented with some conclusions concerning treatment and prognosis in cases with bone metastases.


[Sacrococcygeal teratomas in children treated at the Oncological Clinic of the Mother and Child Institute in Warsaw]. During the years, 1962 through 1975, 27 children with sacrococcygeal teratomas were seen at the Oncological Department of the National Research Institute for Mother and Child in Warsaw. 13 teratomas were benign and 14 were malignant. Surgical removal through a sacral approach was the basis of the treatment. In the presacral tumors with great diameter two-phase method was performed (the first phase--trans-abdominal excision of the tumor and the second phase--excision of remnant tumor's pedicle with coccygeal bone resection). Monodrug chemotherapy (Cyclophosphamide, Actinomycin D) in malignant tumors was without effect. In the group of benign teratomas are alive 11 children, in the group of malignant teratomas only one child survived. Some profits are expected from the multidrug chemotherapy ( Methotrexate , Cyclophosphamide, Actinomycin D) associated with radiotherapy, this can make operable primarily inoperable tumors.


[Ovarian neoplasms in girls treated at the Oncological Clinic of the Mother and Child Institute in Warsaw 1970-1975]. Sixteen girls with ovarian tumors treated in the years 1970-1975 in the Oncological Department of the National Research Institute of Mother and Child were studied. 6 tumors were benign ( cystis dermoidalis --5 cases, cystadenoma mucinosum --1 case) and 9 tumors were malignant (dysgerminoma--6 cases, teratoma malignum --3 cases and neoplasma malignum epitheliale --1 case). Middle age of girls with ovarian tumors was 11 years. The commonest signs were abdominal pains, abdominal discomfort and presence of tumor in abdomen. Benign tumors were treated surgically by unilateral adnexectomy in 5 cases and bilateral adnexectomy in 1 case. Surgery and radiotherapy were basic treatment in malignant tumors in 6 cases, 3 cases of malignant tumors were treated by surgery, radiotherapy and chemotherapy, one case of malignant teratoma in stage Ia was treated only surgically. 6 girls with malignant tumors survived without evidence of the disease 33 months and longer. The best results were obtained in dysgerminomas even in stage III of disease. In teratoma malignum group survival were obtained only in the stage Ia of the disease.


[Inhibition of premature uterine contractions]. Various drugs used to stop premature uterine contractions are discussed in the paper. Particular attention is paid to beta-mimetic drugs. The results of ming Partusisten, one of beta-mimetic drugs, is presented on the material of 104 patients with threatening immature and premature labour. Partusisten was administered in the form of intravenous drip infusion or tablets. During treatment monitoring of the uterine contractility and of foetal heart rate took place. Inhibition of the uterine contraction activity was successful in 100 per cent of cases. In 60,9 per cent in the group of threatening immature labour and in 38,1 per cent in the group threatening premature labour, the delay of delivery was more then 28 days. The delay of delivery by 48 hours was 87 per cent and 84 per cent in both groups respectively. Tachycardia was one of the first side effects observed in 15,2 per cent of cases. There is also presented an example of pregnancy when delivery was delayed by 21 days in spite of premature outflow of amniotic fluid (at a high rupture of membrane). The authors are of the opinion that Partusisten is very effective and gives little side effects, preventing premature uterine contractions. Dosage should be individualized according to the case and labour advancement, and should be based on topographic evaluation of uterine contraction. Negative influence of the drug on foetuses was not observed.


[Prenatal monitoring of fetal heart activity and the course of labor and the state of the newborn infant]. In the paper practical importance of cardiotocographic interpretation of records carried out during pregnancy is discussed as well as the importance of antepartum monitoring of foetal heart rate. 1944 records of 663 pregnant women were analysed. Observations of basic frequency of foetal heart rate, oscillation and heart rate response to foetal movements and uterine contractions were made. Taking into consideration these criteria the records were classified as: reactive, nonreactive and combined (reactive and nonreactive) patterns. Among 663 cases there were 544 reactive patterns, 73 combined with predominance of reactive ones, 34 combined with predominance of nonreactive ones and 12 nonreactive patterns. Comparison of separate types of records with Apgar test in the 1 st, 3 rd, and 5 th minute shows that low Apgar score (below 7) is mainly related to the group of nonreactive and combined records with predominance of nonreactive patterns. Apgar score is above 7 in the group of reactive and combined patterns with predominance of reactive pattern. Comparison of the types of records to the kinds of delivery termination shows that in predominately nonreactive pattern there was 50-55% of operational deliveries in predominately reactive pattern groups however 24%. Therefore repeating reactive pattern in antepartum monitoring records is the evidence of good foetal state and this state most probably will not be disturbed during labour. Repeating nonreactive pattern with decreasing oscillation is the evidence of increased foetal distress.


[Fate of subsequent pregnancies in relation to the outcome of previous pregnancies]. Adverse outcome of the previous pregnancy as a risk factor for the next one has lately been given increased attention. Particular concern has been expressed as to the possible adverse effects of induced abortion on subsequent pregnancy outcome (1, 2, 3, 4, 5, 6). The purpose of the present report was to establish on the basis of population studies whether and to what extent, abnormal outcome of pregnancy increases the risk of abnormal outcome of the next or further pregnancies. Particular attempt was made to evaluate the increased risk of abnormal outcome of pregnancy following spontaneous and induced abortion. A sample of the studied population was originally collected in several Departments of Obstetrics for a study on epidemiology of low birth weight, and its selection was conditioned by that study. The sample included women whose present pregnancy resulted in the delivery of a live born child. This pregnancy was not taken into consideration in the present study except as a basis for selection of 2 study groups of women who previously had at at least 2 pregnancies (except the present one): Group A consisted of 1180 women who gave birth in the recent pregnancy to a full term child weighing over 3000 g and Group B of 1170 women who delivered a low birth weight infant in their previous pregnancy. Mothers of infants weighing between 2500 and 3000 g were also included in this group because the foetal growth tables for Polish newborn infants showed that weight limits at the 5th percentile for full term male infant ranged between 2500-2800 g and below 10th percentile between 2600 and 3000 g. The following outcomes of previous pregnancies were considered: Full term newborn infant (FT) Low birth weight infant (less than or equal to 2500 g) (Pr) Spontaneous abortion (SA) Induced abortion (IA) Other outcomes (O) Contingency tables containing information on the frequency of different outcomes of earlier and later pregnancies were prepared and the effects of the mode of termination of the earlier pregnancy on the later ones were demonstrated. Interrupted pregnancies were not included in the whole number of cases for the calculation of the percent value, as the decision to interrupt is usually arbitrary and very seldom related to the outcome of the previous pregnancy. The differences between the distribution of pregnancy outcomes in various categories of termination of earlier pregnancy were tested by standard Chi square test which was useful also for testing the dependence of the mode of outcome of the preceding and the following pregnancy. The relative risk coefficient was also calculated for two different combinations of outcomes.(ABSTRACT TRUNCATED AT 400 WORDS)


[Use of the control group selected by a method of matched samples in the evaluation of the health status of children from complicated pregnancies]. A method of matched samples consisting in selection of "a partner" for each examined individual according to the established criteria of similarities is one of the methods used owing to its apparent organizational ease in selecting of the control group. The control group selected in this way was used in the evaluation of the effect of bleeding during the first 16 weeks of pregnancy on the health status and physical development of children. The paper points out the advantages of using the control group selected by the method of matched samples. It also presents the difficulties encountered in practice. Typical of this study technical methods and statistical tests used in evaluation of the results were juxtaposed and discussed, then compared to those used when a group was randomly selected. Special attention was paid to 3 basic problems: Time stability is selection of criteria for matched samples. Adjustment of age differences within pairs. Two methods were used for comparison of the anthropometric measurements. The first one consisted in levelling of the differences by the method of regression, the second in the use of various available growth curves. The results obtained by both methods were compared by means of statistical tests. The third problem concerned adequacy of the tests used when the control group was selected by the method of matched samples. Results obtained by application of t-Student test for paired samples were compared to those obtained by t-Student test for independent variables. The merits of the method of matched samples were presented using some examples (table I, II, III). Eleven conclusions were drawn from evaluation of suitability of selecting the control group according to the method of paired samples. These can be put into three main groups: Showing in what kind of studies the control group selected by the method of matched samples is payable . Showing various inconveniences caused by selection of the control group by the method of matched samples, Conclusions concerning methodological or other benefits drawn from this method. It is clearly indicated in this paper that the control group selected by the method of matched samples is recommended only in certain investigations. Before the final decision is taken all pros and cons should be considered.


[Effect of increased motor activity on changes in posture during puberty]. The purpose of this longitudinal study was to investigate the dynamics of changes of anteroposterior curvatures and scoliosis during puberty in relation to the level of physical activity. The material consisted of 111 children. Their mean age was 11.5 years at the beginning of the study. One group (n = 53) was from a sport's class (athletics, rowing-- 2 hours training, 4-5 times a week), and the other (n = 58) from a control class. The anthropostereometric method, according to Jachowicz was used to determine the posture. Measurements were taken once a year for a period of 3 years. The analysis of the material showed a great individual variations in values and dynamics of changes of anteroposterior curvatures. Differences between trained and untrained children were observed. The results suggest a certain "stability" of stature in trained children (especially boys), probably due to increased muscular mass. During 3 years of study a lability of posture and appearance of structural defects (especially scoliosis) were observed. This indicates the need for regular control of posture and in some cases corrective exercises in the training programme. It was found, that the graphic method of evaluation of defects is more useful in practice than the descriptive one.


[Characteristics of sleep EEG abnormalities in children with phenylketonuria during the first year of life]. 350 sleep EEG recordings in PKU children in the first year of life were analysed in order to characterize the abnormal features. Recordings were taken from serial studies carried out during the last 8 years on early and late treated children. Only quiet sleep was evaluated due to its longer duration after the second month of life and its important developmental characteristics. The criteria of abnormality were the following: lack of bioelectric features of sleep, abnormal " trac é alternant ", and other criteria of defined range, character and morphology. The number of abnormal records was referred to the three periods of the first year of life: first and second trimester, and the second semester of the first year of life, and also to treatment. EEGs before treatment were considered as records of untreated children. Table 1 compares the number of normal and abnormal records according to age and treatment. Table 2 illustrates the character and the range of abnormalities with reference to age and treatment. Tables 3, 4, 5, give the characteristics of morphological features of abnormal records. Our previous papers describe EEGs of PKU children of different age during waking and sleeping, while the present study is the evaluation of EEGs in children of the same age recorded in sleep only. The choice of these criteria is justified by the greatest variability of EEG records in relation to developmental factors and activating role of sleep. Among all EEGs, 60% were recorded during treatment. The biggest number of EEGs recorded in untreated children was obtained in the first three months of life and became gradually less. About 70% of the records were normal. No difference was noted between the number of normal and abnormal EEG records in different periods of the first year of life. The number of normal records was considerably higher in treated children than the number of abnormal records in untreated ones. This relationship was not noted in the first three months of life. In the first half year of life, generalized abnormalities as well as abnormal " trac é alternant " predominated and localized abnormalities were exceptional. On the other hand, in the second half year of life nearly half of the abnormalities were as follows: general paroxysmal abnormalities not observed in the first half year of life, considerably higher amount of abnormalities localized only in the temporal region, less generalized non-paroxysmal abnormalities, and lack of bioelectrical features of sleep.(ABSTRACT TRUNCATED AT 400 WORDS)


[Clinical and biochemical diagnosis of galactosemia among our cases]. Clinical and biochemical diagnostic studies concerned 17 cases of galactosemia coming from 15 not consauguineous families. Galactosemia was diagnosed between 1-st day and 11-th month of life. Tentative diagnosis based on clinical picture was made in 12 infants, others were detected through family history of galactosemia and/or biochemical newborn screening carried out at the National Research Institute of Mother and Child since 1969. Clinical symptoms of galactosemia occurred in most patients in the first week of life. They were the following (tab. II): hepatomegaly (in 94%), jaundice (81%), splenomegaly (79%), vomitus (62%) and diarrhoea in 56% of patients. Cataract was found in 6 infants (38%). Biochemical diagnosis was based on the results of enzymatic estimation of galactose-1-phosphate uridyl transferase activity in blood, galactose-1-phosphate in red blood cells and galactose in blood and urine. No activity of galactose-1-phosphate uridyl transferase was found in all patients, and the concentration of galactose-1-phosphate was higher than 25 mg/100 ml of red blood cells. High galactose level was observed in blood and urine in all patients with typical clinical course of galactosemia. In 2 patients however without clinical symptoms of the disease only trace amounts of galactose was detected in blood and urine. All these patients were treated with galactose free diet.


[Centile charts of cephalometric characteristics of Warsaw's children from 1 month to 7 years of age]. The present study contains the centile charts and tables of the 5, 10, 25, 50, 75, 90 and 95 centiles values of the 5 fundamental head dimensions: head length (g-op), head breadth (eu-eu), face height (n-gn), face breadth ( zy - zy ), and cephalic index (formula see text). They are elaborated on the basis of Warsaw children sample in the age from 1 month to 7 years of life. They are a great value for pediatric clinical diagnosis.


[Galactosemia].

[Galactosemia]. This paper is a review of inborn errors in galactose metabolism with special attention being paid to practical aspects of this problem. The authors presented the history of experimental research on galactose metabolism in human body, patomechanisms of biochemical abnormalities and clinical course of the disease as well as the review of genetic papers regarding polymarphism of galactose-1-phosphate uridyl transferase, galactosemic variants in human population and the possibilities of early diagnosis and treatment of galactosemia.


[Neurological status and psychomotor development of children with phenylketonuria treated early]. Low phenylalanine diet treatment in children with phenylketonuria (PKU) started sufficiently early prevents mental retardation. But the question whether the treatment prevents all c n s damage is still open. This problem was evaluated on the basis of longitudinal neurological and psychological studies of 118 PKU children in whom treatment was started before the 6-th week of life. As a comparative group 90 children with untreated or late treated PKU were investigated. A detailed analysis of the results was carried out investigating each case in relation to the precision of dietary restrictions and the duration of treatment. The incidence and type of abnormal findings were compared with the abnormalities found in children with untreated or late treated PKU and with the incidence in the total child population. In 78 children (66,1%) there were no abnormalities in the neurological status and mental development was normal except for some retardation in the visual-motor maturation. In 35 children (29,7%) signs of hyperkinetic syndrome were present in 5 (4,2%) there was both mental retardation and signs of hyperkinetic syndrome. In the comparative group all 90 children had severe neurological abnormalities and mental retardation. The obtained results confirm that the essential effect of the diet on the development of PKU patients is during the first year of life. In order to obtain optimal results however, it is necessary to continue the diet for a sufficiently long period. But in spite of following the prescribed treatment in PKU children it is not always possible to prevent minimal c n s damage.


[Lipoprotein X (LP-X) in the differential diagnosis of cholestasis in children, with special reference to biliary atresia]. Lipoprotein-X (LP-X) in the serum of infants with persistent jaundice is indicative of cholestasis. In early infancy biliary atresia and biliary agenesis are the most common cause of cholestasis, whereas neonatal hepatitis is a less frequent cause of cholestasis. The authors introduced and described the qualitative and quantitative methods of LP-X determination for diagnostic purposes. LP-X estimations were carried out in 9 children with persistent jaundice. LP-X was found to be present in 4 infants-in 2 with complete absence of extrahepatic biliary tracts, in 1 with extrahepatic biliary atresia and in 1 with hypoplastic extrahepatic biliary tract. LP-X was also found in a 5 year old boy with mechanical occlusion of bile ducts caused by a malignant tumor ( rhabdomyoblastoma ), and in 3 year old girl with inborn enzymatic liver dysfunction. In this case LP-X concentration was estimated before and after 3 week course of cholestyramine, after which there was a 35% decrease in the LP-X concentration. In a 4 month old child LP-X was not found in spite of the absence of extra and intrahepatic biliary tracts. This finding may be explained by the far advanced hepatic cirrhosis. The authors stress the importance of introducing of LP-X estimation in the differential diagnosis of jaundice in early infancy.


[A new type of sweat test and its use in children]. Chloride concentration in sweat was determined by the method of Skine Chloride System of Orion's Model 417 in 100 healthy children and 42 CF children. Statistically significant differences were demonstrated in chloride concentration in sweat between the group of healthy children and CF children. The results of our investigations suggest, that this method is useful in the diagnosis of CF in childhood.


[Indicators of protein metabolism in infants with intrauterine dystrophy red various dietary mixtures]. In the previous work published in No 7 of "Development Period Medicine" ( Problemy Medycyny Wieku Rozwojowego ) the results of nitrogen balance studies in S-f-D infants fed different milk formulas were described. The present study concerns other protein metabolism indices in the same infants. The infants were divided into four groups according to the formula they were fed. The composition of formulas is shown in table I. In the infants besides the balance study, serum urea nitrogen, protein and albumin level, were estimated once a month. Also urea, creatine and creatinine, and hydroxyproline in 24-hours urine collections were examined. Excretion of creatine, creatinine and hydroxyproline was summarized in 5 boys from the group of 38 investigated infants in the first five months of life when meat-free diet was fed. The above mentioned indices permit for better assessment of the effect of the diet on protein metabolism and the requirement of protein for S-f-D infants. The results of protein metabolism indices were compared with the indices obtained in F.S. infants similarly fed. Group S of S-f-D infants was compared with group A of F.S. infants and the other groups of S-f-D infants were compared with each other. In S-f-D infants fed formula S, a lower level of serum urea nitrogen was observed in comparison with F.S. infants of group A in spite of greater protein intake in S-f-D infants. This should prove a greater protein requirement in S-f-D infants. Decreased protein content and cow's milk fat modification also had profitable influence on protein utilization because serum urea nitrogen and nitrogen in urine were low in S-f-D infants fed this formula. Urine urea nitrogen as a part of total urine nitrogen is bigger in group S and C infants, and the lowest in group G infants (formula with lower fat and total protein content). Serum protein and albumin level was generally higher in S-f-D infants than in FS ones. Particularly high level of these parameters was observed in group G infants. The most regular behaviour of age trend versus protein and albumin level was observed in S-f-D infants fed formula H and C, fast increase of values was observed in the first half of life. In the S-f-D infants which were given formulas with decreased content of protein H and C group lower excretion of creatine was noted. As in FS infants, a gradual increase of creatine with age and body weight was stated. In 24-hour urine collection creatine excretion was lower, particularly in the infants daily creatinine excretion was positively correlated with body weight, body length and age.(ABSTRACT TRUNCATED AT 400 WORDS)


[Calcium requirement in infants with intrauterine dystrophy. Report I. Indicators of calcium balance in infants with intrauterine dystrophy]. Observations of many investigators point at a lower amount of calcium in body composition of Small-for-Date infants (S-f-D). So far, only few investigations indicated that the calcium metabolism is disturbed in the postnatal life of S-f-D infants as well. Taking into consideration these data, the authors attempt to define calcium-requirement in S-f-D infants. In this report the cross-sectional observations of 30 infants are described . They were born after 37 weeks of gestation. The mean body weight was 2318 and it ranged between 1200-2760 g. Their body weight at birth was below 10 percentile according to Brzozowska . In these infants 3-days balance studies were carried out once a month. The calcium balance indices were compared with the indices of the Full-Size infants (FS) who were observed during the former years. The S-f-D and FS infants were fed similar diets based on unmodified cow's milk formulas. It was noted that the percentage absorption index in S-f-D infants was significantly lower than in the control group in 1-st and 2-nd trimester of life (table III, fig. 2). The S-f-D infants had a good appetite in first semester of life and they ate a big volume of milk formula and calcium in it. It seems that this is the reason that calcium retention in S-f-D infants in spite of lower ability of calcium retention, did not differ statistically from calcium retention in FS infants. The mean values were a little lower however. In the 2-nd half year of life statistically significant difference between any of the balance indices in S-f-D and FS infants was not found.(ABSTRACT TRUNCATED AT 250 WORDS)


[Longitudinal studies on the physical development of low birth weight children. Growth dynamics and sexual dimorphism during the first year of life]. Longitudinal studies of physical development in the first year of life were carried out in the group of children born with low body weight. Results were compared with those obtained in the control group. The examined group consisted of 73 children born from single pregnancies in hospitals from families living in Wola district of Warsaw. Out of 73 children, 35 were born t term as small-for-date children (DW). Remaining 38 children were prematurely born (W). The control group (K) consisted of 40 children born in hospital at term, from single pregnancy, with body-weight at birth corresponding to foetal age (25-75 centiles). They came also from families living in Wola district. Analysis of physical development was based on the results of anthropometric measurements carried out at monthly intervals through the first year of life, considering required age tolerance, using standardized measuring methods and instruments. The principles of feeding, nursing, prophylaxis of rickets and iron deficiency as well as preventive vaccinations were the same for all children. Variability with age as well as monthly and yearly gains and the index of sexual dimorphism of the following parameters were analysed: body-weight, body-length, head and chest circumference thorax and head length, shoulders width, hip width. Longitudinal observation of these children through evaluation of growth increments made the analysis of the dynamics of somatic development possible. The analysis showed differences in physical development in the first year of life in children under examination. These differences concerned both the variability of separate traits with age, and the dynamics of development, development of sexual dimorphism index in relation to the control group. The differences ere also observed between the small-to-date and prematurely born children. Developmental differences ere noted among the children born with low body-weight dependent on the achieved foetal age at birth. No tendency in small-for-date infants to decrease the differences as compared to the control group was noted. This tendency was typical of the prematurely born children. The highest developmental rate was observed in prematurely born infants.(ABSTRACT TRUNCATED AT 400 WORDS)


[Sacrococcygeal approach in the treatment of defects of the lower segment of the digestive tract]. The research investigations carried out for years revealed most details on embryology nd pathophysiology of anorectal malformations. They left still unsolved the problem how to obtain better functional results following their surgical treatment. It is well known, that in the group of high- supralevator deformities, the lower rectum, anal canal and internal sphincter are absent, and the terminal pouch lyes above the puborectalis sling. The purpose of the of the pull-through procedure is the reconstruction of proper relationship between bowel, the levator diaphragm and external sphincter, without damage to the muscles and pelvic plexus. The technics advocated by Stephens and Rehbein are apparently important steps forward in surgery of these defects. The sacrococcygeal route of Kraske, adapted by Stephens for operative treatment of anorectal malformations, gives approach from behind to the supralevator space for identification of puborectalis sling. The muscle is separated from urethra or vagina, and gradually the tunnel through the sling and external sphincter is created. The gentle and in proper plane pull of the bowel through an undamaged puborectalis muscle gives the possibility to save its function as rectal sphincter and receptor as well. This paper presents 76 children with anorectal malformations, treated in the Department of Pediatric Surgery during 1966 to 1975 yr. The "International" Classification, proposed in Melbourne was used to group the patients according to the level of the terminal bowel: in Supralevator , Intermediate and Translevator defects (tab. I-III). The surgical procedures in particular types of anomalies are presented in the tables IV-VII. The detailed clinical evaluation and roentgenological examination were the base to assess the type of malformation and to choose the method of treatment. To find other coincidental malformations, generally most frequently occurring in the genitourinary tract, the intravenous pyelography was the routine early investigation. Other tests, like cystography and endoscopy were done when indicted. The genitourinary tract abnormalities were found in 9 of 14 children with supralevator deformities, in 9 of 17 children with intermediate type and in 17 of 45 from the translevator group. Oesophageal atresia was present in 6 children, the congenital heart failure in 13 and skeletal malformations in 21 of the total. In neonates with supralevator anomalies the primary reconstructions were not very successful, so transversostomy became a routine preliminary procedure.(ABSTRACT TRUNCATED AT 400 WORDS)


[Effect of rehabilitation of the feeding function on the development of visual-motor coordination and speech in children with infantile cerebral palsy]. The aim of the study was to determine the effect of rehabilitation of feeding function on eye/hand coordination and speech development in cerebral palsied children. The analysis included 28 children with tetraplegic form of cerebral palsy. Age of these children was from 12 to 48 months (in one case 6 months, the other case 6 years). In the first examination, standard deviations in independent feeding function (according to "feeding test") were established as well as the level of eye/hand coordination and speech development (according to Denver Developmental Screening Test). All cerebral palsied children from examined group have had specific helping-exercises according to the method based on normal stages of feeding development. Second examination was performed from 7 to 24 months from the beginning of rehabilitation. The comparative group consisted of 14 children with tetraplegic form of cerebral palsy in this group there were no specific exercises. The parents took them home after short time of stay at the Rehabilitation Department on the basis of the above examinations both group were compared (results presented in the diagrams). It was found, that the method of rehabilitation of feeding function is very useful. Good oral feeding patterns are an essential basis for the skill of muscles and their speech sounds production. Correct position and feeding on self are important for the development of eye/hand coordination. Summing up, rehabilitation of the feeding function should be an integral part of the general problem of rehabilitation of cerebral palsied children.


[Results of the surgical treatment of children with residual developmental anomalies of the 1st and 2d branchial clefts and thyroglossal duct]. The purpose of this study was assessment of the results of surgical treatment of children with developmental anomalies derived from the first and second branchial clefts and thyroglossal duct. Normal and abnormal development of branchial arches and clefts, pharyngeal pouches and thyroglossal duct, as well as the anatomy nd topography of the resulting developmental anomalies are discussed. The observed developmental anomalies are classified into: cysts, cysts with sinuses developing as a result of inflammatory processes, puncture, incision, operation, dermal sinuses draining externally, dermal sinuses with external and internal orifices, the latter in the groove of the palatine tonsil or foramen caecum of the tongue, dermal sinus with external orifice and dermal fistula. Methods of diagnostic investigations and surgical treatment are described. The cysts derived from the first and second branchial arches were treated surgically by a transverse incision running across the peak of the bulging cyst. Removal of the cyst was started by dissection of the anterior and lateral surfaces of the wall, and then the posterior wall was dissected free from the deep structures in the neck. In cases of cysts with fistulae or dermal sinuses the operation was preceded by injection of 1% methylene blue into its external orifice. In this way it was possible to stain the walls of the cyst or sinus and to mark its end. The operation was started with elliptical excision of the external orifice of the lesion. In cases of dermal sinuses derived from the first branchial clefts an additional incision was made along the posteroinferior border of attachment of the auricule to the skull. In operations of dermal sinuses derived from the second branchial cleft after dissection of the wall at a distance of several centimeters a second incision was made transversely for easier dissection of the sinus wall lying in deeper parts of the neck. Removal of the cysts and sinuses derived from the thyroglossal duct required always resection of the middle part of the body of the hyoid bone. Upward elevation of the cut hyoid bone body visualized the upper part of the thyroglossal duct up to its end in the lingual foramen caecum, and made possible removal of this part. The cut hyoid bone body was left divided. In the years 1953-1976 56 children were treated surgically for these developmental anomalies. The material comprised 33 girls and 23 boys. Three groups of patients were isolated. Most children were operated upon between the 5th and the 9th year of life at the age of 12 years.(ABSTRACT TRUNCATED AT 400 WORDS)


[Surgical treatment of congenital defects of the jejunum and ileum in infants]. The examinations were based in the material of the Clinic of the Children's Surgery of the M.A. in Lublin of 16 newborns and babies operated because of the congenital defects of the jejunum and ileum. Among the patients there were 9 with the intestinal occlusion or with the stenosis, 5 with the diverticulum Meckel's or too long existing umbilical duct and 2 with the foramen of the mesentery. The results of the treatment of these defects dependent on the method of the operation. Good results of the operation were obtained by opening of the abdominal cavity with the medial incision, resection of the dilated intestine, funnel-shaped stenosis of the afferent ansa and anastomosis of one end to end or the end to back.


[Naloxone as a drug for improving anesthesia results in children]. In anaesthesiology of today, due to the increased use of strong analgetics, it is necessary to have an effective antagonist for mini- mizing the danger of respiratory depression in postoperative period. Naloxone, ( Narcan , R-Endo Laboratories Inc., Subsidiary of E. J. du Pont de Nemours and Co., (Inc.), USA), a new narcotic antagonist was investigated in this study. It has been applied to 58 patients in cases of respiratory depression at the end of anaesthesia in which fentanyl was given, (these cases constituted 14% of all anaesthesias). Fentanyl was given intravenously in fractional doses, (fig 1), during NLA, and other general anaesthesias, for operation and diagnostic examination ( exeption of cardiosurgery), in children and adolescents from two month-to nineteen years of age, (tab. 1.). Naloxone was given intravenously, in fractional doses from 1 microgram to 5 micrograms/kg body weight. As a criterium of an antidepressive effect of Naloxone--in addition to clinical evaluation, blood gases analyses and continuous capnographic recording has been accepted. In all 58 cases diminition of respiratory depression was observed 2-3 min. after injected each dose of Naloxone. Respiratory rate increased from 15 to 22/min. concentration of CO2 in expired gases decreased from 5-6% to 4,5%, (fig. 2 and 3), and regain of consciousness, and return of intensive reaction to endotracheal tube stimulation was observed. Naloxone produced neither changes in the cardiovascular system, nor side effects. Based on these results Naloxone has been suggested as an effective narcotic antagonist. It increase of the possibility of applying strong analgetics in children--allowing to keep a steady level of anaesthesia with easy elimination respiratory depression in the desired period of time.


[Angiocardiography in the diagnosis of congenital bulboventricular heart defects. Anatomopathological and angiocardiographic correlations]. Current surgical methods enable radical treatment of the most bulboventricular malformations (syn. conotruncal malformations, transposition complex). The defects, which were until now the field of embryologist and pathologist, require accurate and precise clinical diagnosis of the anomaly. The purpose of this analysis was to estimate the ability of angiocardiography for diagnosis of bulboventricular malformations considering the type of essential anomaly, its exact morphology and character of coexisting malformations. The report represents 49 cases with pathological diagnosis of bulboventricular malformations in children, in which during hospitalization angiocardiography has been performed. The cases were selected from 1918 angiocardiographies and also from 987 cases of pathological specimens with congenital heart diseases in the years 1970-1977. There were: 33 cases of TGA, in these 2 with corrected TGA, 3 cases of DORV, 1 case of DOLV , 12 cases of CV. All cases showed the broad spectrum of variants in position of the great arteries and kind of conus apart from type of basic anomaly. Septal defects, pulmonary orifice stenosis or atresia and anomalies of atrio-ventricular orifices particularly in common ventricle were mostly coexisting malformations. To recognize essential anomaly we estimated atrio-ventricular and ventriculo-arterial relation (connection), based on Kirklin classification. The conuses and position of the trunk of the great arteries were treated as pathomorphologic details, that had no influence on essential diagnosis of malformation. Arbitrary accepted definition and nomenclature was based on data from bibliography. Angiocardiography was made using full-size filmchanger AOT with maximal frequency 6 frames/sec. Contrast medium injected mainly into the ventricles. X-rays were performed usually immediately in two projections. Comparison of the angiocardiographic diagnosis with pathology of the hearts showed the correct diagnosis of the essential malformation, by means of angiocardiography, in more than 80% cases. But the diagnosis percentage in particular elements of malformation varied from 2/3 to 1/3 according to the type of malformation. The absence of the correct diagnosis of the essential anomaly, based on type of relations, was the lack of visualization of all heart cavities (in some cases), which was conditioned by the method. On the other hand the correct angiocardiographic diagnosis was sometimes impossible, because of very complicated anatomical situation in malformed hearts.(ABSTRACT TRUNCATED AT 400 WORDS)


[Effect of physical training on the somatic development and work capacity of boys aged 10-13 years]. Working capacity was assessed for 20 healthy boys aged 13, who had been intensively trained as football players for the last three years. The control group consisted of similar age group boys who, apart from physical training classes at school, did not take part in any organized sport. On the basis of standard work load measured on a bicycle ergometer and by the gradational step tests, a more economical reaction of the circulatory and respiratory systems was observed in the trained boys in comparison with the controls. In the course of submaximal as well as maximal loads, a significantly lower heart rate was noted not only during work but also in the period of recovery. The systolic pressure after tets obtained lower values and returned more speedily to the initial level. At the maximal load and at high heart frequency up to 210 min-1, the systolic pressure, contrary to the adults, did not exceed 170 mm Hg which may be linked with the anatomo-functional character of the circulatory system . During the ergometric tests lower VO2 uptake was observed in the sport group, especially when calculated for the lean body mass. That group also showed higher values for VO2 max. at lower heart frequency. Lactic acid blood concentration at the maximal load did not show significant differences in the sport boys in comparison with the controls, but it reached lower level in comparison with the adults. Moreover, it was also stated that in the trained boys albuminuria was lower after the maximal load than in the controls. Albuminuria was diagnosed in 50 per cent of the sport boys after 90 minutes of football game, which leads to the conclusion that training is a comparatively high physical effort and the child's body needs a supplement of protein for its normal development.


[IgE concentration in healthy children of various age groups]. Serum IgE was estimated in 181 healthy children aged 2 months-17 years. The concentration of IgE was measured by radioimmunosorbent technique (RIST). To eliminate serum interference the IgE levels were calculated using the correction factors: 0,96 and 0,91 (for the sera diluted respectively 1:10 and 1:5). Statistical calculations were made after logarithmic transformation of the particular results. On the base of the mean geometric values linear and parabolic regression lines have been made. On the grounds of the received regression equations it has been found that parabolic variant of the changes of the IgE concentration with respect to age, shows more accurately the real state. The index of the parabolic correlation (r = 0,98) shows a close and positive relations between IgE concentration and the age of children. The lowest concentrations of IgE were found in the youngest group of infants and then the level increased during childhood. The parabolic regression line and 95% confidence limits for the geometric mean values ar inserted in the paper.


[Caloric balance in infants with intrauterine dystrophy fed formulas containing unmodified fats]. The small-for-Date (S-f-D) infants are treated as high risk infants with regard to some metabolic disorders. Special attention should be paid to disorders of energy metabolism. The S-f-D infants already at birth showed the symptoms and results of intrauterine undernutrition, analogical to protein-calorie malnutrition in infants with postnatal dystrophy. The most important effect of intrauterine undernutrition influencing energy metabolism of S-f-D infants were discussed. Higher calorie requirement and higher calorie losses than in full-size (FS) infants were underlined. It was noted that proper feeding may, to a great extent, lessen the results of deficits in gestational age, as well as to increase the survival ability and assure the best possible physical and mental development. As the knowledge of energy metabolism in infants, particularly in those born with intrauterine undernutrition, is insufficient the studies of calorie balance were undertaken. The investigations were carried out in 26 infants observed longitudinally and crossectionally . All infants were fed ad libitum unmodified fat and protein cow's milk formulas containing glucose instead of saccharose in the first trimester and from second trimester gluten--free flour instead of wheat flour. Other meals were given according to obligatory scheme of infants' nutrition. The results of calorie balance studies were compared with the roper data of FS infants in I trimester and II semester of life, which were described in our previous paper. The results of fat an nitrogen balances were also taken into consideration. It was found, that the calorie intake in S-f-D infants is higher, particularly in first months of life, than in FS infants. It is closely related to the degree of intrauterine dystrophy. In this respect S-f-D infants behave similarly as the infants with postnatal dystrophy, which are capable to catch-up by increased calorie intake in answer to previous undernutrition. The calorie excretion in feces is significantly higher inthe first months of life in S-f-D infants.(ABSTRACT TRUNCATED AT 400 WORDS)


Further studies on BL-3912A: effects on avoidance behavior of rats with low baselines and on reaction thresholds to electric footshock. Rats selected for their low performance baselines in an active avoidance shuttle box task were given various doses of R-(-)-2-amino-1-(2,5-dimethoxy-4-methylphenyl) butane (BL-3912A), S-amphetamine or piracetam. BL-3912A at 1 mg/kg IP had no significant behavioral effects, while 5 and 10 mg/kg significantly increased the number of avoidance responses without affecting responses during the intertrial interval (ITI). Statistically reliable effects on behavior were not observed following 20 mg/kg of BL-3912A. S-Amphetamine at 0.5 and 1 mg/kg IP also facilitated avoidance responding, but could be differentiated from BL-3912A in that the S-amphetamine significantly increased shuttles during the ITI. S-Amphetamine at 0.1 mg/kg was not effective, while 2 mg/kg increased ITI activity. Piracetam (50 or 200 mg/kg) had no significant effects on avoidance or shuttles during ITI. Using an electric shock titration procedure, BL-3912A at 10 and 20 mg/kg IP had no significant effect on reaction thresholds. Animals receiving 100 mg/kg of p-chlorophenylalanine po for 3 days and tested 2 days later showed hyperalgesia to the electric shock. In summary, BL-3912A facilitated shuttle box avoidance responding of rats with low performance baselines. Behavioral facilitation occurred without concomitant increases in noncontingent activity or apparent changes in reactivity to electric footshock.


Comparison of the cycloheximide and food satiation effects on a discrimination task. The effects of intraventricular cycloheximide (CHX) pretreatment were examined on the ability of rats to recall a light position discrimination task. The CHX pretreatment used inhibited brain protein synthesis at the time of training by 71%. Following treatment with CHX the animals demonstrated no retention of the task 18 hr later. Free feeding for 24 hr prior to treatment with cerebro-spinal-like fluid (CSF) produced similar effects as CHX. It is proposed that the amnesic effect of CHX in this behavioral paradigm may be a nonspecific action resulting from decreased motivation. Both the CHX-treated and satiated animals exhibited low responding levels during training, despite comparable behavioral activity levels for the CHX- and CSF-treated groups.


Specificity of cholecystokinin satiety effect: reduction of food but not water intake. The C-terminal octapeptide of cholecystokinin (CCK) was injected into water-deprived rats to observe the effect on water and milk intake. The doses used were 0, 20, and 40 Ivy dog units/kg. The data indicated that milk intake was suppressed in a dose-related fashion within 2-4 min of injection but water intake was not suppressed. This satiety hormone is thus specific to food intake.


Discriminable effects of antimuscarinics: dose response and substitution test studies. In a shock escape T-maze task, rats were trained to turn right following one drug treatment and left following a second drug treatment. The specific drug and dose conditions were the only discriminative cues available to the animals. The number of training sessions before criterion performance indicated the discriminability of the two training conditions. Drug vs no drug training showed that discriminability was proportional to dosage for low doses, but was constant over a range of higher doses. Such an asymptote of discriminability was observed with scopolamine, atropine, benactyzine and Ditran (JB 329), and was shown not to result from tolerance. High dose vs low dose discriminations involving scopolamine were learned very slowly if both doses were within the asymptotic range; this indicates that similar discriminable effects were produced by high and low doses. To compare various drugs, substitution tests were administered to trained rats. The four antimuscarinic drugs generally substituted for one another but did not mimic and were not mimicked by drugs in other pharmacological classes. Some exceptions to this pattern were noted. The discriminable effects of scopolamine were partially antagonized by physostigmine. The results indicate that the antimuscarinic drugs share discriminable actions probably produced by their anticholinergic actions. The asymptote of action at high doses appears genuine, possibly reflecting receptor saturation.


Effect of GABA-transminase inhibition on rectal temperature in mice. gamma-Acetylenic GABA (amino-4-hex-5-ynoic acid) and gamma-vinyl GABA (amino-4-hex-5-enoic acid), two catalytic irreversible inhibitors of GABA-transaminase, produce marked sustained elevations in brain GABA concentrations. Associated with these biochemical changes is a decrease in the rectal temperature of mice. This hypothermia can be reversed by increasing ambient temperature. The results suggest GABA plays an important role in mammalian central thermoregulation.


Time-action and behavioral effects of amphetamine, ethanol, and acetylmethadol. As time increased between drug administration and the start of experimental sessions, effects of drugs on food-maintained responding in rhesus monkeys increased to a maximum and then decreased. d-Amphetamine, ethanol, and alpha-l-acetylmethadol (LAAM) generally decreased high response rates in one component of a chain schedule, while very low response rates in another component were increased reliably only by ethanol. The time of peak LAAM and ethanol concentrations in blood or plasma corresponded with or overlapped the time of maximal behavioral effect, while the time of maximal behavioral effect with d-amphetamine occurred somewhat prior to the time of peak plasma-amphetamine concentration. With d-amphetamine and perhaps with ethanol, effects on operant responding were greater after 30-min pretreatment intervals than after six-hr pretreatment intervals despite higher plasma or blood concentrations at six hours than at 30 min.


Characteristics of beta-phenethylamine self-administration by dog. Phenethylamine (PEA), a biologically active amine found in the brain, maintained intravenous self-administration behavior by dogs previously trained to respond for amphetamine. Systematic changes in the unit dose of PEA (1.5 to 6.0 mg/kg/infusion) were negatively related to the number of infusions (91.3 to 29.5, respectively) per 4hr session. The mean intake of PEA was 165 mg/kg/session. Pretreatment with chlorpromazine (0.5 to 2.0 mg/kg, IV, 30 min prior to the session) produced a dose-dependent increase in the number of self-administered PEA infusions. However, there were no changes in responding for PEA following pretreatment with either the dopaminergic antagonist pimozide (5 to 40 micrograms/kg, IV, 30 min prior to the session) or the adrenergic antagonist phenoxybenzamine (1 to 8 mg/kg, IV, 30 min prior to the session). These data suggest that the reinforcing properties of PEA are not dependent on either a dopaminergic or adrenergic system.


Amphetamine effects on brain slow potentials associated with discrimination in the rat. Slow potentials were recorded from the anterior cortex of rats during discrimination conditioning and the effects of various doses of d-amphetamine on these responses were examined. In the discrimination paradigm one tone (Sd) was followed at three see after the onset by food reinforcement while another tone (S delta) indicated that no reinforcement would follow. Slow potential (SP) responses were measured during the three-sec period following onset of the stimulus. For the first several training sessions the SP responses demonstrated a phase of generalization during which responses were the same to both stimuli. Thereafter, the responses to Sd were significantly greater than responses to S delta. d-Amphetamine produced a dose-related depression of SP responses to the reinforced stimulus in doses of 0.25 to 2.0 mg/kg. The effect of amphetamine on SP responses to S delta was biphasic; the lower doses (0.25 and 0.5 mg/kg) enhanced responses, no change was seen after 1.0 mg/kg and the high dose (2.0 mg/kg) depressed responses. This study demonstrates that the rat develops differential slow potential responses to reinforced and nonreinforced stimuli in a discrimination paradigm and that d-amphetamine produces a differential and dose-related alteration of these SP responses. It is suggested that the actions of amphetamine may be produced through interference with mechanisms of discrimination, by an effect on subcortical activating systems involving norepinephrine, and/or by activation of inhibitory dopamine receptors on cortical neurons.


Effects of angiotensin II on schedule dependent and induced behavior at recovered body weight. The effects of 4 doses of angiotensin II, 0.4, 0.8, 1.2 and 1.6 mg/kg, injected subcutaneously on schedule dependent lever pressing and schedule induced drinking and licking were studied in rats who had recovered body weight under ad lib eating conditions. Prior to this experiment rats had been maintained at 80% body weight and were tested under the usual conditions producing schedule induced drinking. Animals were then returned to the home cage and allowed to recover body weight. Results were analyzed for both the first 15 min of the 1 hr session and for the total 1 hr session. Data indicate that all four doses decreased lever pressing during the first 15 min and for the total 1 hr session. The three highest doses produced increased licking during the first 15 min. Only the highest dose augmented licking throughout the total 1 hr session. Water intakes were significantly increased by the three highest doses only during the first 15 min of the session. Peripheral effects of angiotensin II were discussed and a central pharmacological action on drinking was suggested.


Subcutaneous injections of apomorphine, stimulus generalization and conditioning: serious pitfalls for the examiner using apomorphine as a tool. This report shows that stimulus generalization occurs in rats conditioned by a single injection of apomorphine. The data suggest that apomorphine initially acts as an unconditioned stimulus (UCS) of an unconditioned response (UCR) that, in turn, produces stimuli which become conditioned stimuli (CS) of a conditioned response (CR) having a nature identical to that of the UCR. The study also shows that behaviour elicited by a subcutaneous injection of apomorphine depends on the part of the body selected for administration. The mentioned properties should be taken into account when apomorphine is used as a tool in studies on brain and behaviour.


Food deprivation-induced alcohol ingestion in the mouse: calories versus primary sensory preference. Random bred Swiss mice showed preference for water over 10% ethanol solution when unlimited food was available. When partially food deprived, the preference was reversed in 5 out of 8 animals. About half of the naive mice, however, ingested substantial amounts of this ethanol solution at the very first exposure when partially food deprived for 12 days. It is suggested that while the caloric value of ethanol is reinforcing, food deprivation might make the sensory effects of ethanol also reinforcing.


Genetic and evolutionary fitness.

Genetic and evolutionary fitness. The advantages and disadvantages of evolutionary fitness (probability that a single mutant line will not become extinct) and genetic fitness (mean fecundity) are compared. For deterministic processes the two are equivalent, but for stochastic branching processes they may be totally unrelated except that an absolute genetic fitness of unity or less implies an evolutionary fitness of zero. To know the variance as well as the mean family size does not in general uniquely determine the evolutionary fitness. Except where genetic fitness is close to unity, the impact of selection is shown to be rapid for the binomial, Poisson, negative binomial, and truncated negative binomial distributions. Evolutionary fitness, though somewhat cumbersome, has greater relevance to evolution, genetic counseling, and voluntary population control; but genetic fitness which is much easier to handle is the more appropriate measure where a large number of mutants is involved. Some empirical data on the transmission of various types of characters from parent to child are analyzed to allow comparison of genetic fitness, Crow's index, and a Malthusian parameter, with evolutionary fitness. There is a fair, but far from perfect, agreement among them. Multiple correlation of evolutionary fitness with mean and variance of family size taken jointly suggests a much more satisfactory approximation. It thus appears that, at the least, the population geneticist cannot afford to ignore the variance (which is not adequately represented in Crow's index). These relationships, based on two sets of data only may be accidental and should be invoked with caution. It seems more than likely that other aspects of the distribution of family size (eg, even higher moments) may contain relevant information in certain cases.


A goodness-of-fit test for the polygenic threshold model: application to pyloric stenosis. A new test of goodness of fit for the polygenic threshold model is proposed. This test, when applied to disorders showing different incidence rates in males and females, is designed to account for ascertainment in more detail than previously done by other investigators. This is accomplished by computing the expected distribution of nuclear families with more than one affected sib conditioned on several family-dependent variables, including whether each family was ascertained via only affected boys or via at least one affected girl. A direct measure of the probability of observing a data set is thereby derived. The test, when applied to data on pyloric stenosis, exposes the critical nature of the ascertainment procedures. Different levels of statistical significance are obtained when mode of ascertainment is taken into account than when the mode of ascertainment is ignored.


"ADAM complex" (amniotic deformity, adhesions, mutilations)--a pattern of craniofacial and limb defects. We report eight patients with the craniofacial defects and limb anomalies of the (amniotic deformity, adhesions, mutilations) ADAM complex. Facial abnormalities comprise clefts and distortion and dislocation of craniofacial structures; limbs show various combinations of amputation, secondary syndactyly, and constriction. From previous reports and our cases it is obvious that the clinical picture of the ADAM complex varies enormously; a less severe type combines cleft lip and palate with amputations or amniotic bands. Clinical and experimental data suggest that these malformations are of symptomatic (exogenous) origin. Nosologic differentiation from other conditions phenotypically similar but of genetic etiology is important for genetic counseling. Observation of the ADAM complex in two members of a family suggests that genetic factors might operate in some cases.


Cranial computed tomography of epidermoid and congenital fatty tumors of maldevelopmental origin. The computed tomographic and clinical findings in 17 patients with fatty intracranial tumors and in 10 patients with epidermoid tumors, all of maldevelopmental origin, are presented. Fat was found in lipomas (the most frequent), dermoids, and teratomas. Differentiation between these tumors is discussed on the basis of density, calcification, location, and symptomatology.


Hemodynamic studies using a CT scanner.

Hemodynamic studies using a CT scanner. New CT software programs allow rapid-sequence images to be obtained. During a period of 12 sec, multiple CT images can be produced, so that the progression of contrast flow at intervals of 1 sec or less can be followed. In addition, as many as 16 consecutive 3-sec scans can be performed, or arbitrary time intervals inserted between scans. The rapidity with which the contrast medium enters and leaves a specific tissue may be a valuable, non-invasive diagnostic tool in differentiating enhancing lesions. Other potential applications are mentioned.


Computed tomography in the evaluation of patients with bilateral retinoblastomas. Six patients with histologically proven retinoblastomas were examined by computed tomography, two at the time of initial diagnosis and four from 2 to 30 years following treatment, which consisted of radiation therapy alone or with surgery. The spectrum of computed tomographic findings includes: calcified retinal tumor, intracranial subarachnoid spread of tumor, radiation-induced tumors (papillary adenocarcinoma and undifferentiated sarcoma) in the field of prior radiation, and second, primary central nervous system tumor, a pineoblastoma.


[Aspirin-like defect - a hereditary thrombocytopathy due to impaired release of platelet adenosine diphosphate]. This report presents the case of a 36 year old woman with an inborn haemorrhagic syndrome, who exhibited a lifelong history of spontaneous bruising, nose bleeding, prolonged bleeding after tooth extraction, and menometrorrhagia. The routine tests of haemostasis were consistent with impaired platelet functions. The diagnosis of the "Aspirin-like defect" was made on the basis of the following findings: the bleeding time was prolonged, whereas the platelet count and morphology were normal; platelet retention in glass bead filters was unmeasurable. ADP-induced platelet aggregation was normal, while it was markedly reduced with collagen and epinephrine. The platelet ADP and ATP content, as well as the ATP/ADP ratio were within normal limits. Aggregation of platelets pre-incubated with aspirin was only slightly reduced when induced by ADP, collagen, or epinephrine. These findings suggest that the thrombocytopathy in our patient is due to an impaired ADP release from the platelet granules containing normal quantities of adenine nucleotides. A similar disorder is observed in normal subjects after aspirin ingestion, and therefore the defect described in this paper is referred to as the "Aspirin-like" defect.


[Liver injury during combined chemotherapy of acute leukemias]. The authors observed 70 patients with acute leukemia treated by polychemotherapy. In 2 patients the signs of severe liver damage were found. The occurrence, course and results of laboratory tests suggested Purinethol predominantly as the cause of development of these alterations. The complication did not occur frequently in our patients. The changes regressed in a satisfactory way after the withdrawal of the hepatotoxic cytostatic from the therapy.


Posterior fossa intra-axial tumors: a comparison of computed tomography with other imaging methods. Fifty patients with posterior fossa intra-axial tumors were evaluated by computed tomography and the results compared with routine skull films, radionuclide brain scanning vertebral angiography, and cerebral air studies. The routine skull series was found to be of little benefit. Computed tomography was more sensitive than the radionuclide brain scan in detecting all of the lesions except astrocytoma, for which sensitivity was comparable. Angiography was the most sensitive means of detecting hemangioblastoma, and was the only reliable radiographic method of differentiating hemangioblastoma from astrocytoma. Cerebral air studies were the most sensitive and specific means of evaluating brainstem gliomas.


Liquid diffraction analysis of the model membrane system. Egg lecithin + myelin protein (N-2). The scattering from the model membrane system, egg lecithin + myelin protein (N-2), has been analyzed by liquid diffraction methods. It is found that by manipulating the protein-lipid ratio, the scattering domains of the protein and lipid can be identified. The multilayer contribution can also be identified by its position and concentration behavior in both the intensity pattern and its Fourier transform. When the multilayer and protein components are subtracted, the phospholipid scattering and an interaction term are left: these two can be resolved by a reasonable assessment of their relative magnitude in the boundary region where they overlap. The interaction term can then be used to determine the most probably position of the protein in the membrane. The deconvoluted protein and lipid transforms can then be combined in the proper way to obtain the electron density profiles. The resolution of the interaction term is not yet complete, but a method for accomplishing this is discussed.


The effect of added protein on the interchain x-ray peak profile in egg lecithin. The effect of added protein on the phospholipid interchain peak profile has been measured. The results indicate that the basic organization of the bilayer is preserved, and that the added protein affects only the arrangement of the lipid hydrocarbon chains in the first few adjacent layers.


The model membrane system. Egg lecithin + myelin protein (N-2). Effect of solvent density variation on the X-ray scattering. The electron density contrast method has been applied to the membrane system egg lecithin + myelin protein (N-2). The case treated here is for a low protein concentration. As theory predicts, the scattering from the different regions of the membrane (protein, hydrocarbon, and polar head group regions) are modulated differently by changing the contrast. It is then possible to separate out the electron pair correlation functions for the different regions, and from these to determine the membrane election density distribution for an external electron density p0 = 0.


Structural studies of synthetic filaments prepared from column-purified myosin. Synthetic filaments prepared from column-purified rabbit skeletal myosin by slow dialysis exhibit characteristic bipolar organization and 14-nm axial subunit spacing. Backbone substructure can be discerned in high resolution micrographs in the form of striations of 3--4-nm width and slight angular tilt from the direction of the filament axis. Filament backbone diameters vary over the population, although remaining relatively constant for a single filament. Approximately 25% of the filaments appear poorly stained and frayed, which may be due to collapse on the electron microscope grid. Optical diffraction studies reveal a 43-nm axial repeat as well as the 14.3-nm subunit repeat, indicating a structural homology with natural filaments. A model for synthetic filament aggregation is presented that is consistent with observations of backbone diameter variation, absence of bare zones, and the presence of fraying filaments.


Mechanisms in the suppression of delayed hypersensitivity in the guinea pig by 6-mercaptopurine. II: Kinetic and morphologic studies on the monocyte-macrophage component. The effect of 6-mercaptopurine on the development and expression of delayed hypersensitivity was studied in the guinea pig. Results indicated that 6-MP produced its suppressive effects primarily by action on cells of the monocyte-macrophage series. Suppression could occur under conditions of both developing and pre-established delayed hypersensitivity. The defect primarily involved newly synthesized, bone marrow-derived monocytes. Marked alterations in monocyte macrophage generation and distribution, especially the T1/2 of circulating monocytes were demonstrated. Suppressive effects were associated with the appearance of a unique morphologic microscopy. Finally, the in vivo expression of delayed hypersensitivity correlated better with a variety of parameters relating to qualitative macrophage function and distribution rather than those relating to quantitative macrophage levels.


Complete neglect of differential overlap study of the binding of salts to N-methyl acetamide. The complete neglect of differential overlap method is used to investigate the binding of LiF, LiCl, NaF, and NaCl to N-methyl acetamide (NMA) as a model for these ions binding to a peptide moiety. The cation (formula: see text) anion interaction is shown to result in a net residual charge on NMA, which becomes less positive as the difference in electronegativity between the anion and cation of the salt present increases. A residual charge of smaller magnitude is also found on a water molecule in the analogous system cation (formula: see text) anion, which displays this same dependence.


The effects of subcutaneous injections of sodium selenate on blood composition and milk yield in dairy cows. Three groups of four lactating cows received a subcutaneous injection of 0 . 05, 0 . 10 and 0 . 15 mg Se/kg body weighty respectively administered as sodium selenate. A fourth group was injected with saline. In all the cows injected with sodium selenate, the concentration of Se in blood increased rapidly and was significantly higher than in control cows for two days in the group receiving the lowest dose and for 182 days (the duration of the experiment) in the two other groups. The activity of glutathione peroxidase in blood increased slowly in all cows injected with sodium selenate and was significantly greater than in control cows after 15, 22 and 29 days respectively, and remained significantly greater for 63, 91 and 182 days respectively. In a second experiment a single subcutaneous injection of 0 . 15 mg Se/kg body weight had no effect on the mean milk yield of 37 animals (19 . 1 kg/day) compared with the milk yield of a similar group of control animals (19 . 1 kg/day) during 70 days. The concentration of Se in milk was significantly higher on the first (168 microgram/litre) and second (69 microgram/litre) day after injection than in control animals (mean 26 microgram/litre).


Experimental staphylococcal mastitis in the mouse: the persistence of chronic infection from one lactation to the next. Chronic staphylococcal mastitis was established in 50 mammary glands of 25 mice. The mice were mated and in the subsequent lactation there was alveolar mastitis in one of 50 glands. A further five glands had abscesses that contained staphylococci but there was no alveolar mastitis. The results are discussed in relation to the large number of infections that persist from one lactation to the next in cows not subjected to mastitis control measures.


Multivariate behavioral genetic analysis of twin data on scholastic abilities. Multivariate behavioral genetic analyses may employ either genetic and environmental correlations or phenotypically standardized covariances to assess the structure of genetic and environmental influences. Correlations and phenotypically standardized covariances answer different questions--correlations are appropriate for understanding the nature of genetic and environmental influences, whereas covariances are appropriate for determining the etiology of phenotypic correlations. The ratio of the genetic and environmental covariances to the phenotypic correlation yields estimates of bivariate heritability and environmentality, measures of the extent to which observed phenotypic covariance is due to genetic and environmental influences. Multivariate analyses of genetic and environmental correlations and covariances are illustrated with twin data on scholastic abilities. Factor analyses of correlations suggest that the same set of genes affects the major areas of academic achievement and that the environmental influences are similarly structured. Analyses of phenotypically standardized covariances indicate that the structures of genetic and environmental influences as they contribute to phenotypic resemblance among scholastic abilities are both similar and simple: there are one general genetic factor and one general environmental factor. Bivariate heritabilities and environmentalities are similar in magnitude, indicating that the strong phenotypic relationship among scholastic abilities is due roughly equally o genetic and environmental influences.


A multivariate twin analysis of within-family environmental influences in infants' social responsiveness. Observational measures of social responsiveness were obtained for twin infants. The structure of within-family environmental influences was assessed by correlating identical twin pair differences for 13 behaviors in seven social settings. Factor analysis of the difference score matrix yielded one interpretable factor. This factor indicated that within-family environmental influences were not completely random but may exert a systematic effect on social behavior in several situations.


Twin method: defense of a critical assumption. Since Galton's time, critics of the twin method have rejected the evidence of genetic differences in human behavior, because the twin method assumes that identical and fraternal pairs have equally similar environments. Twins whose genetic similarity is misperceived by themselves and others provide a critical test of the adequacy of this assumption. The relative effects of perceived and actual genetic similarity on cotwin differences in cognitive, personality, and physical development were assessed in a sample of young, adolescent twins whose genetic similarity was often misperceived. Twins' responses to questions about their own and others' judgments about their zygosity and physical similarity, and the ratings of similarity by eight judges, were used to estimate the perceived similarity of the twins. Actual zygosity was established by matching cotwins on 12 or more blood group loci. Perceived zygosity and perceived similarity by self and others were found to be insignificant biases in the twin study method.


Correlated characters in selection for aggressiveness in female mice. II. Maternal aggressiveness. The present study investigated whether maternal aggression has shown a correlated response in a program of artificial selection for isolation-induced interfemale aggression in housemice. Females from the first replicate of lines (H1, C1, L1) and the second replicate of lines (H2, C2, L2) from generation S5 were given daily aggression tests for 20 consecutive days following the birth of their first litter. Evidence of a correlated response was found for replicate 2, but results for replicate 1 provided no evidence of a correlated response. In generation S10, when better separation of the lines on isolation-induced aggression had occurred, the study was repeated. In S10 there was clear evidence of a correlated response in both of the replicates.


The role of recanalization in tubal pregnancy after sterilization. Recanalzation at the site of tubal ligation is one of the causes of the failure of such a procedure. The underlying factor could be a pre-existing proliferative disease of the tube, i.e. salpingitis isthmica nodosa. The plexiform type of re-canalization that resulted in the presented case might the cause of the tubal pregnancy. The presence of amenorrhea and /or irregular uterine bleeding in a patient with tubal sterilization requires meticulous investigations to avoid the high morbidity rate associated with missed ectopic gestation. The use of HCG assays and laparoscopic evaluation could improve diagnostic ability in similar cases.


Age, thymic involution, and circulating thymic hormone activity. Circulating thymic hormone activity and thymic histology were studied in patients undergoing open heart surgery. Plasma thymic hormone activity was measured using a bioassay based upon thymocyte antigen induction on null mouse lymphocytes. Activity was highest at 15-30 yr of age and declined thereafter, being negligible after the sixth age decade. The age-related decline of circulating thymic hormone activity correlated, in general, with progressive thymic involution. However, hormone activity was detected in plasma from some cases with advanced involution, suggesting that the normal young thymus may have considerable functional reserve.


Increased aldosterone plasma protein binding in women on combined oral contraceptives throughout the menstrual cycle. Plasma aldosterone concentration and the percentage of the fraction bound to a specific plasma aldosterone-binding globulin (ABG) were measured throughout the menstrual cycle in 26 healthy women aged between 19 and 38 yr who were receiving estrogen-containing oral contraceptives (OC), Midafternoon upright levels of total plasma aldosterone were similar in control and OC subjects and showed normal cyclic fluctuation in both groups. The percentage of ABG-bound aldosterone was markedly higher in OC subjects than in controls at all stages of the cycle and showed a positive correlation with the mean blood pressure when all OC subjects studied were considered. In addition, when the plasma ABG levels were measured 6 months or more after the start of medication, they appeared to be related to the dose of estrogen in the OC, but not to the length of time of its administration. The identity of plasma ABG in OC subjects with that in control subjects was also established.


Cortisol production and inactivation by the human lung during gestation and infancy. The enzyme which interconverts the active hormone cortisol (F) and its biologically inactive analog cortisone (E), viz. 11 beta-hydroxysteroid dehydrogenase, is known to be present in many tissues. In this study, its possible role as a regulator of cortisol concentration in the human lung was investigated. Small amounts of minced tissue were incubated for 2 h at 37 C in the presence of tracer F or E. After extraction, the steroids were chromatographed using Sephadex LH-20 column chromatography. From 11-21 weeks of gestation, inactivation of F to E occurred (54.7 +/- 8.0%), while in 11 premature infants there was no conversion in either direction and in 9 infants (4 months to 2 yr of age) there was slight conversion of E to F (7.0 +/- 3.4%). Activity in children was negligible. Lung tissue from 4 anencephalics (35-40 + weeks) retained the ability to inactivate F to E (21.3 +/- 4.3%), though to a lesser extent (P less than 0.01) than fetuses up to 21 weeks. The validity of these in vitro studies was borne out by assays of the endogenous steroids in lung tissue and serum. These results suggest that there is an alteration from rapid inactivation of F to E in early fetal life to slight F production in infancy and that this change is advanced by pituitary or other factors which are decreased in anencephaly. This decreasing inactivation by the lung during late gestation results in higher intracellular F levels which probably act to promote lung maturation in preparation for birth.


[Production of soy bean inoculants. Behavior of supports based on peat from Tierra del Fuego sterilized by vapor and ethylene oxide]. The survival of Rhizobium japonicum was studied in neutralized and sterilized peats from Ushuaia and Rio Grande. The carriers were sterilized by ethylene oxide and by autoclaving. Similar counts for Rhizobium (5 x 10(8) cel/g) were obtained in peat-cultures sterilized by both methods, after eight months. A good nodulation and nitrogen fixation capacity was observed with inoculated soybean plants. Using the strain Rhizobium japonicum E-45, no appreciable difference in symbiotic effectiveness was found between the inoculants prepared with the two peats.


Serum immunoreactive somatomedin-C is elevated late in pregnancy. The concentrations of immunoreactive somatomedin-C (Sm-C) in the sera of women with uncomplicated pregnancies were found to be progressively higher as the duration of gestation increased. Between 19 and 42 weeks of gestation, there was a significant correlation between serum Sm-C concentration and duration of gestation. A striking decline in Sm-C was observed following delivery. While the data are too preliminary to elucide the mechanisms for the raised Sm-C, the concurrent increase in Sm-C and human placental lactogen (hPL) raises the possibility that hPL may mediate the increment in Sm-C.


Comparison of [125I]somatomedin A and [125I]somatomedin C radioreceptor assays for somatomedin peptide content in whole and acid-chromatographed plasma. The placental membrane radioreceptor assay was used to measure the levels of somatomedin (SM) peptides in plasma. Displacement of both [125I]somatomedin A ([125I]SM-A) and [125I]somatomedin C ([125I]SM-C) by normal whole plasma, the peptide fraction of acid-chromatographed plasma, and a partially purified, insulin-free SM preparation were compared. The peptide fraction of plasma was isolated by acid chromatography over Sephadex G-50 in 0.25 M formic acid with a yield of greater than or equal to 90%, as determined by bioassay and [125I]SM. In the case of [125I]SM-A, the dose-response curves for whole plasma, acid-chromatographed plasma, and the standard SM preparation were parallel (P less than 0.2). In contrast, for [125I]SM-C, the dose-response curves for acid-chromatographed plasma and the purified SM preparation were parallel (P less than 0.2), but both differed significantly from that of whole plasma (P less than 0.001). In addition, there was less variability in the assay of acid-chromatographed plasma compared to whole plasma. The results indicate that radioreceptor assay of unextracted normal plasma using [125I]SM-A is a valid measure of SM peptide concentration, while radioreceptor assay of unextracted normal plasma using [125I]SM-C, in our hands, is not. Acid chromatography of plasma before its assay is an uncomplicated procedure which allows valid and precise measurement of SM peptide content using either [125I]SM-A or [125I]SM-C.


Neurogenic galactorrhea-amenorrhea.

Neurogenic galactorrhea-amenorrhea. Neuroendocrine function in two women with galactorrhea-amenorrhea arising from abnormalities in the PRL reflex arc was compared to that of normal women. Basal gonadotropins were lower than normal, and one patient lacked episodic secretion of LH; however, the serum gonadotropin rise after iv LRH was in the normal range in both patients. Mean basal PRL levels were slightly elevated in one patient and were normal in the other, and the PRL levels after TRH, chlorpromazine, and levodopa testing were similar to those seen in normal women. Breast stimulation did not increase PRL levels in either patient. PRL levels fell with bromergocryptine therapy, galactorrhea ceased, and normal menses resumed. These studies indicate that chronic afferent impulses originating in the PRL reflex arc can result in galactorrhea and amenorrhea and that bromergocryptine therapy in such patients can restore normal menses.


The Dubowitz syndrome.

The Dubowitz syndrome. The Dubowitz syndrome is an autosomal recessive condition of intrauterine growth retardation, postnatal growth retardation, microcephaly, characteristic facial appearance, high-pitched hoarse voice, and borderline intelligence or mild mental retardation. Cleft palate may occur as well as hypospadias, cryptorchidism in affected males, and mild limb defects. The 13 cases reported in the European literature and eight personally examined patients are reviewed.


Sex hormone-binding globulin and estrogen receptor in breast cancer: technique and preliminary clinical results. The binding capacities of SHBG (sex hormone-binding globulin) and ER (estrogen receptor) were measured by agar gel electrophoresis with dextran-coated charcoal treatment and also by sucrose density gradient ultracentrifugation in the sera from 19 women with breast cancer to assay the correlation between SHBG and ER in breast cancer. SHBG levels were also measured by agar gel electrophoresis with dextran-coated charcoal treatment in control sera from 20 normal women. Two kinds of 17 beta-estradiol-binding substances were recognized in the cytosol of breast cancer cells and they were confirmed to be ER and SHBG. Out of 13 postmenopausal patients with breast cancer, the SHBG levels in 6 ER-positive cases (66 +/- 13 pmol/ml plasma, mean +/- SD) were significantly higher than the levels of 10 controls (35 +/- 7.6 pmol/ml; P less than 0.005). SHBG levels in 7 ER-negative patients (34 +/- 7.9 pmol/ml plasma) did not significantly differ from the levels of the controls, but differed significantly from the levels of ER-positive patients (P less than 0.005). Out of 6 premenopausal breast cancer patients, the SHBG levels in 5 ER-positive cases (63 +/- 7.5 pmol/ml plasma) tended to be higher than the levels in 10 controls (55 +/- 4.7 pmol/ml plasma), but did not achieve statistical significance (P greater than 0.05). The findings suggest that correlation between SHBG and ER in postmenopausal breast cancer is possible, but no significant difference was noted between the SHBG levels in ER-positive premenopausal breast cancer patients and premenopausal normal women.


[Early detection and observation of the evolution of congenital malformations of the aorta in newborn infants, infants and young children]. 57 infants and small children (42 boys and 15 girls) with congenital aortic malformations were investigated. Clinical, ecg and X-ray follow-up was carried out. Following 4 groups of patients were separated: 1) neonates and infants with supraductal (preductal) aortic hypoplasia or atresia, with hypoplastic left ventricle of the heart (5 boys and 2 girls), 2) infants with supraductal coarctation of the aorta, without underdevelopment of the left heart cavities (2 boys and 2 girls), 3) infants and children with postductal coarctation of the aorta (17 boys and 3 girls) and 4) infants and children with valvular or/and subvalvular, or supravalvular aortic stenosis (18 boys and 8 girls). Congenital malformations of the aorta and of the left side of the heart should be suspected in all neonates and infants displaying early symptoms of cardiorespiratory failure, resembling frequently the symptoms of severe "pneumonia". Proper measurement and thorough analysis of arterial pulses and pressures in upper and lower extremities is of great importance in detection and differential diagnosis of congenital aortic malformations in infants, even when features of other cardiovascular lesions (e.g. ventricular septal defect, endocardial cushion defect, transposition of the great arteries) dominated in the clinical picture of complex malformations. Small amplitudes of peripheral arterial pulses, with considerably--prolonged upstroke time, small amplitude of arterial pressure measured in upper and lower extremities, co-existing with electrocardiographic patterns of the right ventricular hypertrophy--suggested an aortic malformation complicated by hypoplasia of the left ventricle. Distinctly lower systolic and mean arterial pressure in legs, than in arms was typical for coarctation of the aorta. Significant differences in diastolic pressure values in arms and legs with coexisting ecg patterns of dominating right ventricular hypertrophy should rise a suspicion of abnormal, separate communication of the ascending aorta, and the descending aorta, separately from the left and from the right ventricles of the heart. The electrocardiogram seems to be of great help in differentiation between aortic lesions with or without hypoplastic left ventricle, those with or without systemic right and left ventricle, and those with systemic left ventricle only. Early detection, diagnosis, prompt and proper medical and surgical treatment may be lifesaving for the majority of infants with congenital malformations of the aorta not complicated by left ventricular hypoplasia.


[Absorption and elimination of fats in infants with fetal growth retardation depending on the method of feeding]. Fat excretion and absorption in 38 healthy S-f-D born infants fed on 4 kinds of diet, differentiated with regard to fat quantity and quality as well as protein quality, were examined by means of three 24 hour fat balances. Higher fat intake, higher fat excretion in feces and lower index of its absorption, typical of these infants, were observed. Differences in relation to the infants born with normal body-weight were particularly distinct in the first six months of life. It was noted that the quantity of fat excretion in feces was influenced by the degree of fetal malnutrition. An advantageous influence of fat modification, which consisted in partial replacement of cow-milk fat with vegetable oil (soya oil) on fat excretion and absorption, was shown. Feeding higher fat formulas--3 g/100 ml and modified protein were also considered advantageous. It was noted that S-f-D infants, even in cases of feeding with modified fat formulas, at the end of the first year of life did not reach such values of the absorption index as infants born with normal body-weight. The conception that the triglyceride structure differing from that in the breast milk is the factor deteriorating cow-milk fat absorption in the infants was suggested and discussed.