摘要:

Chorionic gonadotrophin is produced primarily by some part of the fertilized ovum, after it becomes embedded in the uterine wall, subsequently from the corresponding part of the placenta. The hormone production continues until detachment of the placenta. The hormone is excreted in the urine. In animal experiments it has the same effect as the pituitary gonadotrophin ICSH (interstitial cell stimulating hormone): in the ovary maturation of follicles and luteinization, in the testis stimulation of the interstitial cells but also – probably indirectly through stimulation of the hormone secretion of the interstitial cells – of the tubuli seminiferae (literature: see FEVOLD 1939, ENGLE and LEVIN 1941). Chorionic gonadotrophin has got some use in the therapy of metrorrhagia (Eeiprich 1934, Novak 1938, Jacoby and Der Briicke 1940). It is, however, emphasized in «The Report of the Council on Pharmacy and Chemistry» 1940, that the hormone itself is of little therapeutical value in gynecology (see also Davis and Hellbaum

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1946.tb16927.x

出版商:Blackwell Publishing Ltd    

年代:1946

数据来源: WILEY

摘要:

Summary.Account of 24 cases of acute leukemia in children.The acute leukemia in children as a rule is a myeloblast‐leuke‐mia (in at least 21 of 24 cases).The initial symptoms are diffuse, – fatigue, fever, lack of appetite and pallor. In most cases (23 of 24) there is found either splenic or glandular enlargement and besides, in 13 cases also enlargement of the liver. These symptoms are considered as specially valuable in an early diagnosis.3/4 of the cases commence in the first 5 years of life.Anemia is a frequent symptom in an early stage of the disease, but in some cases it may be absent for weeks.The red blood corpuscles show no characteristics. Index varies between 0.7 and 1.8. In 20 out of 23 cases index lies between 0.8 and 1.2.Clinical bleeding‐tendency is found in 50 % of the patients in the more advanced stages of the disease. No connection between the bleeding‐tendency and the number of thrombocytes has been demonstrated.The number of white blood cells varies within wide limits, from 1300 to 185 000 per mm3of blood. It also varies highly from time to time in the individual patient. On admission to the department, 21 of 24 patients show values below 20 000 white blood cells per mm3of blood, 17 below 10 000. 2 patients showed above 30 000 white blood cells per mm3of blood.Eoentgen picture of the bones have been taken in 17 patients. 5 show certain changes similar to those that sometimes are found in acute leukemia.In 18 cases it has been made successful sternal puncture with findings of bone marrow rich in cells, with up to 99.4 % of myeloblasts. The pathological cellular type has in all cases been demonstrated in blood‐smear preparations, in 17 of 18 cases however, they have been recognised as myeloblasts only after successful sternal puncture having ascertained th

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1946.tb16928.x

出版商:Blackwell Publishing Ltd    

年代:1946

数据来源: WILEY

摘要:

Zusammenfassung.Es wird ein Fall von typischer Schonlein‐Henochscher Purpura bei einem 3jährigen Mädchen beschrieben, bei dem die Er‐krankung 2 Tage nach der Diphtherie‐Schutzimpfung ausgelöst wurde. Neben Hautblutungen traten Ödeme an den Gliederen‐den, Gelenkbeschwerden, Kolikschmerzen mit okkulter Darm‐blutung und Hämaturie auf. Die Hautblutungen erschienen in mehreren (8) Schüben im Laufe von 5 Monaten, worauf das Kind gesund wurde. Die Läppchenprobe mit Anatoxin fiel negativ aus, aber nach intrakutaner Injektion einer Verdünnung des‐selben, 0,001 ml Anatoxin entsprechend, erfolgte eine prompte Eeaktion seitens des Darms in Form einer Blutung. Damit wird die Eolle des Diphtherieanatoxins als auslösendes Allergen be‐kräftigt. Der Fall stellt einen Beleg für die Anschauung dar, dass die Krankheit anaphylaktisch bedingt ist, und rechtfertigt die Bezeichnung anaphylaktische Purpura an Stelle der alten Benennung anaphylaktoide Purpura. Er bestätigt hierdurch die Erkenntnisse, zu denen Li auf anderem Wege (durch die inverse Anaphylaxie) gelangt war.Der dargestellte Fall diirfte der erste von Schönlein‐Henoch‐scher Purpura sein, der nach Diphtherie‐Schutzimpfung beobach‐tet – oder

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1946.tb16929.x

出版商:Blackwell Publishing Ltd    

年代:1946

数据来源: WILEY

摘要:

Summary.The author gives a resume of the symptomatologi of gargoy‐lism. 6 cases are reported. 5 of them belong to the same family. All of these are boys and none of them had cloudy cor‐neae. A pedigree shows that the affection is inherited from a healthy mother and is probably sex‐linked. The author therefore believes that it is justified to set up a special sex‐linked type of gargoylism where the corneae are

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1946.tb16930.x

出版商:Blackwell Publishing Ltd    

年代:1946

数据来源: WILEY

摘要:

Zusammenfassung.1Auf Grund von Nachfragen wurden die späteren Schicksale von insgesamt 460 Patienten verfolgt, die mit den Diagnosen Idiotia, Imbecillitas, Debilitas mentis, Microcephalus, Idiotia mongoloidea, Idiotia amaurotica und Hydrocephalus behandelt worden waren. Die Anzahl macht, wenn man die Hydrocephalen weglässt, 2,59 % aller behandelten Patienten aus, deren Alter von 1 Tag bis 13 Jahre variiert, und wenn man sie mitzählt, 3,79 %.2Bei den eigentlichen Schwachsinnigen war das Verhältnis. der Knaben zu den Mädchen ca. 4: 3 und bei den Hydrocephalen 5: 4. Bei den übrigen kamen etwas mehr Mädchen vor als Knaben.3Die Sterblichkeit in den ersten Lebensjahren ist in alien Gruppen gross gewesen, und sie nahm ab, je älter die Patienten zur Behandlung get ommen waren. Die gemeinsame Sterblichkeit macht bis jetzt 57,8 % aus. – Hinsichtlich der geistigen Entwicklung stand der weitaus grösste Teil beim Tode auf ausserst niedriger Stufe.4Die Todesursache war bei dem grössten Teil eine Infektions‐krankheit. Besonders von den Mongoloiden starb der grösste Teil gerade an Lungenentzündung. – Von den Hydrocephalen starb der grösste Teil ohne eine besondere Komplikation. Zehn von ihnen wurden operiert, und davon kamen zwei mit dem Leben davon. Der eine war imstande, die Volksschule durchzumachen, aber der andere ist immer noch unfähig sich zu bewegen. Alle diejenigen, welche ausser dem Wasserkopf noch andere Miss‐bildungen in den Gehirnhäuten hatten, starben im Verlauf der ersten Lebensjahre, ohne sich weiter zu entwickeln.5In je jüngerem Alter bei den gegenwärtig lebenden Fällen der geistige Defekt festgestellt wurde, umso schlechter war im all‐gemeinen die Entwicklung. Von den eigentlichen Schwachsinnigen war keiner von den unter 1 Jahr diagnostizierten später imstande, die Volksschule zu besuchen. Von dem im Alter von 1–7 Jahren behandelten Fällen waren 12 oder 13,3 % imstande, mindestens das Pensum der Volksschule zu absolvieren. Fünf von diesen, die alle unter 3‐jährig in Behandlung waren, hatten gleichzeitig eine Infektionskrankheit. Zwei davon bekamen Krämpfe, die später verschwanden, einer hatte schwere Eachitis, einer war ein Bett‐nässer und einer taubstumm. Nur drei, deren Entwicklung immer noch langsam weitergegangen ist, waren nur aus diesem Grunde in Behandlung. Die erwähnten Befunde hatten ohne Zweifel schwächenden Einfluss auf die allgemeine Entwicklung. – Von den mit der Diagnose Idiotia, Imbecillitas und Debilitas behandelten Fällen haben sich spater aus jeder Gruppe solche entwickelt, die verschiedene Entwicklungsstufen erreichten. Es durfte angebracht sein, die Differentialdi

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1946.tb16931.x

出版商:Blackwell Publishing Ltd    

年代:1946

数据来源: WILEY

摘要:

Summary.After a brief account of the disorders in which pneumothorax and mediastinal and cutaneous emphysema may occur the author gives a survey of the theoretically possible mechanisms which may operate in the production of these conditions after tracheotomy. He divides the complications into two groups:Direct tracheotomy complications, due to the operation itself, andindirect tracheotomy complications, the ultimate cause of which must be sought for in the existing primary disease, but in which the tracheotomy must be assumed to play a contributory rôle.Three cases observed by the author himself are described, in each of which a patient with diphtheria got tension‐pneumo‐thorax, mediastinal emphysema and cutaneous emphysema in the course of the first hours following the operation, after an interval of relatively good condition.While the diagnosis in the first case was established only on post‐mortem examination, in the two last cases the condition was diagnosed intra vitam by direct measurement of the pressure in the pleural cavity, as radiographic examination could not be carried out. The two last patients were treated by exsufflation, and one of them recovered. The other had diffused diphtheric changes right down in the finer branches of the bronchi.The author discusses the frequency of the complications and, in common with other authors, he is inclined to think that the condition is of more frequent occurrence than would seem to be suggested by the reports to be found in the literature.As regards the age distribution it is pointed out that the complications seem in marked degree to belong to the years of childhood, seeing that there have not been reported any cases of mediastinal emphysema and pneumothorax after tracheotomy in patients over 8 years old. Of 36 patients 27 were under the age of 4 years.The prognosis in cases of pneumothorax seems to depend upon the mechanism of production, since all patients with pneumothorax due to direct injury to the pleura during the operation are seen to have recovered, whereas the prognosis in pneumothorax occurring as a so‐called indirect tracheotomy complication is very unfavourable, at any rate in the absence of treatment.In conclusion the different pathogenetic possibilities are discussed.The author believes that the direct tracheotomy complications may generally speaking, be regarded as less dangerous. The only possibility for the occurrence of pneumothorax in this group is deemed to lie in a direct injury to the pleura during the operation.In the indirect tracheotomy complications the cutaneous emphysema is merely to be regarded as an incidental phenomenon in an existing mediastinal and interstitial emphysema. Here the conditions are favourable for the development of pneumothorax, a valvular and, perhaps, tension‐pneumothorax, which may rapidly lead to death.Repeated exsufflations is presumed to be the only method of treatment which is practically feasible in case of these unruly little patients, where continuous drainage presents great difficulties.In the cases here described there seems to have existed a combination of both mechanisms: cutaneous emphysema occasioned by the forcing out of air from the tracheotomy‐opening when the cannula had fallen out or become choked up, and afterwards mediastinal emphysema arising through further transmission of an interstitial emphysema, and pneumothorax due to rupture of subpleural emphysematous vesicles.In conclusion the author seeks to give an explanation of the apparently more frequent occurrence of pneumothorax and mediastinal emphysema in tracheotomized than in non‐tracheo‐tomized patients with diphtheric or other stenotic processes in the tr

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1946.tb16932.x

出版商:Blackwell Publishing Ltd    

年代:1946

数据来源: WILEY

摘要:

Summary.The investigation comprised a study of 239 cases of nephritis, of which 96 % of those still aliye 10 to 20 years after the first hospital treatment, were followed up. In addition to the ordinary tests, quantitative sediment counts by ADDIS method were made. 90 % of the acute cases of nephritis, most of whom had had a hemorrhagic onset, had recovered, slightly more than5 % had permanent renal damage, and somewhat less then 5 % were border‐line cases, where further investigation would have been necessary for definite classification.The form of the onset seems to be of the utmost importance for prognosis. An unnoticed insidious onset was combined with bad prognosis. This form of the disease, termed «primary chro‐nic«, led relatively quickly, in all cases within five years, to death. This type of onset is not common, only 11 cases in the total material. The «secondary chronic», on the other hand, influenced the general state of health surprisingly little over a long period (10–20 years). Acute convulsive uremia and the extent of the initial albumin did not influence the prognosis, neither did tonsillectomy.(We should like to take the opportunity to thank chief doctors Med. Dr. FAXIÉN and ÅKRRÉN, Gothenburg, whose valuable help rendered possible the technical side of the investigation, and to express our gratitude to colleagues throughout Sweden for their kindness in answering our qu

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1946.tb16933.x

出版商:Blackwell Publishing Ltd    

年代:1946

数据来源: WILEY

摘要:

Summary.An account is given of a family in which 3 normal parturitions with normal children were followed by 5 unsuccessful pregnancies, partly with abortions, partly with extreme anemia in the newborn within the first days of life. The parents did not have syphilis. The anemia was of macrocytic character, and in 2 of the 3 cases it terminated fatally, while in one case there was complete clinical and hematological restitution. One of the cases is described in detail, with autopsy findings. Clinically and serologically (the mother is Eh‐negative, but with a very strong anti‐Eh agglutinin) this case reminded of erythroblastosis foe‐talis, but the hematological and histological findings spoke decisively against this diagnosis. On this account the case is taken to be an instance of acute macrocytic anemia.The relation between the two diagnoses is disc

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1946.tb16934.x

出版商:Blackwell Publishing Ltd    

年代:1946

数据来源: WILEY

摘要:

Summary.One case of paroxysmal tachycardia at a 3 weeks old boy is described.Symptoms: Pronounced tachycardia, bad general state, cyanosis, dyspnoea, enlargement of the liver. The diagnosis is made with the help of electrocardiogram. The therapy has been neo‐stigmin injections, and during the free intervals, neostigmin per os as far as could be seen with good effect. The prognosis for this specific case seemed to be good with this treatment, but the danger of relapse makes the therapy a bit uncertain. CHRISTENSEN in 1944 had made a synthesis from the literature of 37 cases. The prognosis seems also in these cases to be good, when it has not been the question of organic heart diseases. The very bad general state makes it plausible that some cases of death of infants with uncertain diagnosis would be blamed on non‐diagnosticated attacks of paroxysmal tachycardia. The treatment has earlier consisted of digitalis or strophanticus. However, the effect has not been reliable. Mecholyl also was used. This drug seems to have sure effect but to give more toxic effect than the neostigmin, which was used in this c

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1946.tb16935.x

出版商:Blackwell Publishing Ltd    

年代:1946

数据来源: WILEY

摘要:

Zusammenfassung.Der somatische Status des bescbriebenen Zwillingspaars weist wesentlich darauf bin, dass es sich urn identische, eineiige Zwil‐linge handelt: Gesicbtszüge, Haarfarbe und Wirbel, Farbe der Iris, Blutgrappe. In den Körpermassen besteben Unterscbiede, die mit dem Unterschied des Geburtsgewicbts im Verhaltnis steben. Die Masse des Eopfes sind normal. Die Spuren der Rachitis am Brustkorb sind bei beiden Patienten gleich.Der Status psychicus ist bei beiden so gleich, dass sicb im Grad der Intelligenz oder dem Ausdruck der verschiedenen see‐lischen Funktionen keine nennenswerten Unterscbiede wahr‐nebmen lassen. Irgendein exogenes, mit der Geburt verbundenes Trauma ist ätiologisch nicbt festzustellen. Hereditär ist Oligophrenic (Debilitas) des Bruders der Mutter zu berücksichtigen, was zu der Schlussfolgerung berechtigt, dass unsere Zwillinge auf endogenem Boden entstandene OUgophrene (Imbezillen) sind. Der hier beschriebene Fall ist als ein gutes Beispiel für erbhcbe endogene Oligophrenic zu betrachten, aus deren Ätio‐logie die exogenen Faktoren eliminiert

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1946.tb16936.x

出版商:Blackwell Publishing Ltd    

年代:1946

数据来源: WILEY