摘要:

ABSTRACT.Gonadal and other types of leukemic “sanctuaries” are probably the main causes of hematological relapse in the treatment of acute leukemia. The introduction of high‐dose Metho‐trexate (HDM) in a consolidation phase is based on theoretical considerations and the use of HDM in malignant tumors. Three courses of Methotrexate, 500 mg/sq.m. at 3‐weekly intervals, has been used as part of a consolidation therapy in Norway during the last two years to 59 children with ALL and one with AML. One child died following HDM. Postmortem examination showed that she was not in complete remission at the time. Among 154 courses of HDM in the 60 patients were eight severe reactions, including six cases of allergic‐toxic skin reactions. Two patients developed a Stevens‐Johnson's like syndrome. Stomatitis was common in those with toxic reactions. The risk of HDM in patients who are not in complete remission is stressed and the use of rescue therapy with two doses of Leukovorin instead of one is recommended. Forty of forty‐two children in 1st complete remission have been in sustained primary remission for 4 to 28 months. Two of these 40 children died after about a year from infections. Only two patients so fa

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1978.tb16318.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Thirty‐four children with Hodgkin's disease were treated during the years 1969–75. After radiotherapy, 7–15 cycles of MVPP were given within 24–53 months. In order to avoid chronic leukopenia, leukocyte counts were made frequently during chemotherapy, and the drug doses adjusted accordingly. A complete remission was obtained in 32 of the 34 children. Two patients died because of progressive disease. Twelve of the 32 survivors have been followed for at least 5 years, and a further 12 for at least 3 years. Three children are still on chemotherapy, whereas the remaining 29 being followed are in continued complete re

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1978.tb16319.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.The presence of antibody‐coated bacteria in urine has been shown to be an indicator for renal bacteriuria in adults with chronic UTI. To evaluate this method (ABCU test) in pediatric patients, 128 infants and children with their first UTI were investigated. Twenty‐nine patients of the 78 who had a first clinically defined upper UTI had antibody‐coated bacteria in urine. The test was seldom (2/20) positive in the infants under six months. In the older patients (27/58 ABCU‐positive) the frequency of positive tests increased with the duration of symptoms. When the symptoms had lasted for over one week, 11 out of the 13 children with their first upper UTI showed antibody‐coated bacteria in urine. Four of the 36 first lower UTIs and 5 out of the 14 asymptomatic cases were ABCU‐positive. The patients were followed‐up for an average of 9 months. Those who were classified as having first upper UTI had in most cases a positive ABCU test in recurrences, independently of the clinical picture. The recurrences after the first lower UTIs showed antibody‐coated bacteria in urine only when the recurrence was classified as upper UTI on the grounds of the clinica

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1978.tb16320.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Blood volume was measured using125iodinated human serum albumin in 27 children with acute lymphoblastic leukemia, and in 7 children with various types of leukemia. Total blood volume was normal in patients without marked enlargement of spleen and liver, and increased progressively as spleen and liver size increased. The hypervoiemia was entirely due to expansion of plasma volume. In the children with marked hepatosplenomegaly, only hematocrit (but not red cell mass) was below the normal range in most cases. Both hematocrit and red cell mass were subnormal in the majority of patients without considerably enlarged spleen and liver. Therefore, anemia in children with marked hepatosplenomegaly may be partly caused by hemodilution of red blood cells in expanded plasma volume.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1978.tb16321.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Thirty girls, studied in 1961 after 2.5 years of intensive swimtraining, were the subject of a follow‐up for ten years. When last examined, seven and ten years after the original study, all the girls had given up swimtraining. The increased values for vital capacity observed in 1961 remained unchanged, but residual volume, functional residual capacity and total lung capacity showed small increases even after corrections for body growth. Such increases are, however, normal in these years. Heart volume which was high originally, was found to be lower ten years later, although mean values were still higher than normal. The decrease seen from 1961 to 1971 could mainly be ascribed to a decrease in the subjects with the largest hearts originally. Both total hemoglobin and blood volume decreased to normal values in relation to body size. Maximal oxygen uptake, though, fell from 2.80 1/min (51.4 ml/kg × min) to 2.18 1/min (36.4 ml/kg × min) ten years later. It is suggested that the functional capacity of the cardiovascular system declined more markedly than its dimensi

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1978.tb16322.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Two children with severe bronchial collapse secondary to bronchomalacia improved dramatically after institution of continuous positive airway pressure (CPAP). Treatment was discontinued after 14 weeks without reappearance of symptoms. Repeated bronchoscopy revealed a diminution in the bronchial collapsibility. It is suggested that CPAP should be given if generalised bronchomalacia is present to tide the children over a bad period while the bronchus is becoming more stable.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1978.tb16323.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Ten term and eleven preterm newborn infants with appropriate weights for their gestational age were infused for one minute with L‐alanine (150 mg/kg) at the age of 29 to 76 hours (mean 48 hours) and circulating levels of glucose, lactate, pyruvate,d‐betahydroxybutyrate (d‐BOHB), insulin and glucagon were monitored. Plasma glucose concentrations increased from 2.7±0.16 (mean±S.E.M.) to 3.7±0.2 mmol/1 after 50 min (p±0.01) in term infants. In preterm infants, after an initial decrease of the glucose level from 3.1±0.16 to 2.6±0.16 mmol/1 (p±0.05), it returned to the baseline level at 50 min: 3.0±0.2 mmol/1. The blood concentration ofd‐BOHB decreased in term infants from 192±37 to 112±6 μM/1 (p±0.01) after 40 min. In preterms, its decrease was not significant (p±0.05). Plasma glucagon levels rose from 53±5 to 70±8 pmol/1 after ten minutes (p±0.01) in term infants and from 61±6 to 75±9 after 20 min (p±0.01) in preterm infants. There were no significant changes in plasma insulin concentrations in either group. Forty minutes afterl‐alanine infusion, I/G ratios were lower in preterm infants (1.26±0.14) than in term infants (1.71±0.25) (p±0.01). There was no relationship between the glycemic responses tol‐alanine and the basal levels ofd‐BOHB.The data suggest that the glycemic effect ofl‐alanine infusion and circulating glucagon depends upon a specific stage in maturation. The antiketogenic effect ofl‐alanine infusion i

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1978.tb16324.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.A case of copper deficiency associated with hypocalcemia, radiological features of rickets and hyperparathyroidism is described in a small‐for‐date infant (gestational age 39 weeks, B.W. 1240 g). Neonatal serum copper (Cu) levels were found between 223 and 138 μmol/l. She was given daily 2 400 U of vitamin D2and a load dose of 80 000 IU at the age of 55 days. At the age of 79 days, X‐rays of the legs and wrist showed spread, cupped and frayed metaphyses. Serum Ca was 1.35 mmol/1, P=0.99 mmol/1 with high alkaline phosphatases (A.P.) 590 II/ml. But plasma level of 25 hydroxycholecalciferol (25‐OH‐CC) was normal = 10.8 ng/ml. Serum Cu was low=3.14 μmol/l and serum immunoreactive parathormone (iPTH) level was elevated: 520 μlEq/ml (N±100). Administration of vitamin D2(15 mg) induced an immediate normalization of serum Ca, normal serum iPTH (68 μlEq/ml) in one month, normal X‐rays in two months and normal A.P. in four months. Serum Cu and ceruloplasmin levels increased slowly without any supplementation to subnormal levels at the age of eight months (14.9 and 1.65 μmol/1. Serum Cu concentrations were found to be normal (16.0–33.7 μmol/1) in five children with hypocalcemic rickets. These results suggest a role of Cu deficiency in the occurrence of this transient vitamin

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1978.tb16325.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Previously described radiological signs of Turner's syndrome were evaluated in X‐rays of the left hand from 17 patients with Turner's syndrome (age 10.4–15.3 years) and 17 age‐matched girls with constitutional short stature. While none of the signs clearly distinguished between the two groups, ballooning of the tips of the terminal phalanges with a high ratio between the tip and mid‐shaft diameters seemed to be the most useful sign of Turner's syndrome. Disproportionately long phalanges in the 4th finger and the presence of a coarse reticular pattern in the carpal bones appeared to be the next most useful signs. The presence of a short 4th metacarpal or a narrow carpal angle, and assessment for Madelung's deformity were of little value in distinguishing between the two

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1978.tb16326.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Renal function was studied in 11 pre‐term infants with idiopathic respiratory distress syndrome (IRDS) grade 1 according to Prod'hom's criteria. As a reference 16 healthy pre‐term infants were studied. The groups did not differ with regard to mean gestational age (GA) and mean postnatal age (PNA). The studies were preformed twice, first at a PNA of 33–37 hours and then at 132–148 hours. GFR and CPAHwere determined with the single injection technique and the ability to excrete Na was determined following an oral Na+load. GFR was higher in IRDS infants at the first investigation and slightly lower in IRDS infants at the second investigation. The GFR correlated to the lowest recorded Pao2r=0.45) in IRDS infants. CPAHwas similar in IRDS and controls at the first, and lower in IRDS infants at the second investigation. The urinary Na+excretion was significantly higher in IRDS infants. Treatment with digitalis was in part responsible for the high urinary Na+excretion. The IRDS infants had a higher Na+and glucose intake than the control infants. It is suggested that this higher intake is in part responsible for the relatively high GFR and urinary Na+excretion in the IRDS

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1978.tb16327.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY