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1.
《European journal of pediatrics》1996,156(1):3-6
The purpose of this study was to investigate the incidence, outcome and prevention of thrombo-embolism in children with dilated
cardiomyopathy. From 130 patients with dilated cardiomyopathy, 17 (14%) showed evidence of thrombo-embolism. Seven had initial
cardiac thrombus, 7 exhibited initial embolus and in 3 thrombo-embolism was only diagnosed at autopsy. All 17 patients showed
seriously impaired systolic function of the left ventricle with fractional shortening (FS) of 10 ± 3%, range 5%–17%, as compared
to those without thrombo-embolism with FS of 17% ± 6%, range 5%–26% (P <; 0.0001). Seven patients were treated with oral anticoagulants once thrombo-embolism had been diagnosed; one of them experienced
a further embolic event as opposed to three out of four patients not treated with anticoagulants.
Conclusion All children with dilated cardiomyopathy and fractional shortening below 20% should be treated with prophylactic anticoagulative
agents
Received: 12 May 1996 / Accepted: 29 July 1996 相似文献
2.
J. L. Stéphan G. Deschênes Y. Pérel B. Bader-Meunier M. Brunat-Mentigny O. Lejars J. P. Lamagnères 《European journal of pediatrics》1997,156(3):239-242
This report documents the occurrence of a nephrotic syndrome in five children with Hodgkin disease. In two cases the nephrotic
syndrome predated the diagnosis of lymphoma by 6 months and 12 months respectively , while in the other three, the two disorders
occurred simultaneously. The nephrotic syndrome resolved in four cases during effective treatment for active Hodgkin disease,
while proteinuria remained unchanged in the fifth case with partial control of the lymphoma. The occurrence of a nephrotic
syndrome as a manifestation of active Hodgkin disease suggests that some immunological abnormalities play a role in the pathogenesis
of the association.
Conclusion The possibility of glomerular dysfunction although rare must be considered and actively looked for in all cases of Hodgkin
disease. Similarly, any unusual sign or symptom noted in patients with nephrotic syndrome, particularly receiving or having
received immunosuppressants, requires thorough investigation to determine the presence or absence of lymphoma.
Received: 5 December 1995 / Accepted: 4 July 1996 相似文献
3.
M. M. Uttenreuther-Fischer B. Vetter C. Hellmann U. Otting S. Ziemer G. Hausdorf G. Gaedicke A. E. Kulozik 《European journal of pediatrics》1997,156(4):277-281
In many children, the pathogenesis of thrombo-embolism remains unexplained. This study examines the role of non-genetic risk
factors in 37 children with venous or arterial thrombosis. Included were 17 patients with portal vein thrombosis following
umbilical vein catheterisation, 6 with portal vein thrombosis and an uneventful neonatal period, 4 with deep vein␣thrombosis,
4 with renal vein thrombosis after kidney transplantation, 1 haemodialysis patient with thromboses of arteriovenous shunts,
and 5 with arterial thromboses at various sites. In 25 of these 37 patients (68%) exogenic risk factors and particularly vascular
manipulations (24/37) were related to the thrombotic event. Resistance to activated protein C was identified in 5 patients
and protein C deficiency in 2 (7/37; 19%). This prevalence was significantly higher than that of the control group (14/243;
5.8%; χ2, P < 0.008).
Conclusion Our data show that non-genetic and particular iatrogenic risk factors can often be identified in children with thrombosis,
but activated protein C resistance and protein C deficiency are significant genetic risk factors in this age group.
Received: 23 April 1996 / Accepted: 1 August 1996 相似文献
4.
D. Bonnet V. Cormier E. Villain P. Bonhoeffer J. Kachaner 《European journal of pediatrics》1997,156(10):751-753
We report a 3-year-old child with Williams syndrome in whom the first vascular feature of the syndrome was a myocardial infarction
related to the occlusion of the left main coronary artery trunk. This coronary artery occlusion was not associated with supravalvular
aortic stenosis.
Conclusion This report emphazises that acute vascular events related to systemic artery anomalies may reveal Williams syndrome.
Received: 4 February 1997 / Received in revised form and accepted: 6 May 1997 相似文献
5.
The Marshall-Smith syndrome is characterised by a triad of facial dysmorphism, failure to thrive and accelerated osseous
maturation. We report a further case of this rare syndrome with the unusual but previously reported complication of laryngeal
hypoplasia and review the associated laryngeal anomalies that have been reported to date.
Conclusion Severe airway obstruction due to congenital anomalies must be excluded in any dysmorphic child presenting with respiratory
distress at birth. Rapid airway assessment will enable early and appropriate intervention and may be important when deciding
on the long-term plan for the infant.
Received: 28 March 1996 and in revised form: 13 November 1996 / Accepted: 13 November 1996 相似文献
6.
R. P. Beekman F. J. A. Beek M. G. Hazekamp E. J. Meijboom 《European journal of pediatrics》1997,156(7):516-520
In a 2 year period seven patients who presented with stridor, without respiratory compromise, and three patients without
obstructive symptoms were prospectively selected, and underwent MRI. In eight patients with a vascular ring and a pulmonary
sling, MRI delineated the vascular abnormality and normal great vessels were found in two patients.
Conclusion MRI successfully delineates the great vessels and demonstrates the presence of a vascular ring and pulmonary sling.
Received: 15 May 1996 / Accepted: 17 January 1997 相似文献
7.
Blood transfusion increases blood volume and blood viscosity of the neonate. Since both volume expansion and increase in
blood viscosity may be associated with increased pulmonary artery pressure, we studied effects of transfusion (10 ml of red
blood cells per kilogramme of body weight) on right ventricular output and right systolic time intervals by means of pulsed-Doppler
echocardiography in 38 preterm infants with a mean (SD) gestational age of 28 (5) weeks (range 25–34), birth weight 1060 (395)
g (range 480–1910), actual body weight 1875 (450) g (range 820–2790) and postnatal age of 44 (23) days (range 17–105). After
transfusion, packed cell volume and haemoglobin increased significantly from 0.26 (0.044) to 0.38 (0.046), and from 8.2 (1.6)
g/l to 12.8 (1.9), respectively. Blood viscosity increased from 1.78 (0.3) mPa to 2.68 (0.4) by 33%. Right ventricular output
decreased significantly from 320 (57) ml/kg/min to 290 (70) due to decrease in heart rate by 7%. Blood pressure and right
ventricular stroke volume did not change. There was a significant increase in pulmonary red cell transport (right ventricular
output times packed cell volume) of 21%. Right ventricular pre-ejection period (RPEP), right time peak velocity (RTPV), right
ventricular ejection time (RVET), and ratios of RTPV/RVET(c), RPEP:RVET did not change after transfusion.
Conclusion These results suggest that neither pulmonary artery pressure nor right ventricular function changed as a result of transfusion
in spite of rising blood volume and blood viscosity.
Received: 19 October 1996 / Accepted: 23 December 1996 相似文献
8.
Amrit S. Dhillon Stephen Chapman David V. Milford 《European journal of pediatrics》2001,160(6):372-374
We report the finding of an absent cerebellar hemisphere and partial absence of the cerebellar vermis in a child with dysmorphic
features, spondyloepiphyseal dysplasia, steroid resistant nephrotic syndrome secondary to focal segmental glomerulosclerosis
and T-cell lymphopenia (Schimke immuno-osseous dysplasia). These findings have not, to our knowledge, been described before
and are likely to represent the consequence of a vascular event either in-utero or in early infancy.
Conclusion Cerebral imaging should be performed early in the course of the disease and should be repeated if further neurological events
develop.
Received: 5 December 2000 / Accepted: 24 January 2001 相似文献
9.
《European journal of pediatrics》1996,156(1):65-68
Physiological parameters of infants and children with Prader-Willi syndrome were examined in order to clarify whether there
were indicators of disturbed respiratory control mechanisms in the pre-obesity stage of the syndrome. From January 1993 to
March 1995 in eight patients with Prader-Willi syndrome (five boys, three girls, aged 6 weeks – 12.5 years),␣polysomnography
was performed and compared with 28 children matched for gestational age, sex, birth weight and age at sleep study. The recordings
included thoracic and abdominal breathing movements, nasal airflow, tcPO2, tcPCO2, oxygen saturation, EEG, EOG and ECG. Respiratory responses to hypercapnia during quiet sleep were obtained from five Prader-Willi
patients and ten peers. The Prader-Willi group showed an increased number of apnoeas per hour of sleep, a decreased nadir
of oxygen saturation, increased maximum of the instantaneous heart rate and decreased respiratory responses to hypercapnia
during quiet sleep.
Conclusion These findings indicate a primary dis‐turbance of central respiratory control in patients with Prader-Willi syndrome which
may be worsened by the development of obesity.
Received: 26 January 1996 / Accepted: 21 July 1996 相似文献
10.
Lemierre syndrome used to be a complication of severe oropharyngeal infection with regional thrombophlebitis, septicaemia
and septic metastatic infections caused by Fusobacterium necrophorum in the pre-antibiotic era. A case of septic arthritis of the hip caused by F. necrophorum as a complication of tonsillectomy is reported in a 9-year-old boy.
Conclusion Lemierre syndrome, usually seen after an oropharyngeal infection, can also complicate ton-sillectomy.
Received: 24 September 1996 / Accepted: 14 January 1997 相似文献
11.
Antenatal ambroxol treatment does not prevent the respiratory distress syndrome in premature infants 总被引:2,自引:0,他引:2
C. Dani P. V. Grella L. Lazzarin F. F. Rubaltelli 《European journal of pediatrics》1997,156(5):392-393
The effectiveness of ambroxol in the prevention of neonatal respiratory distress syndrome and in reducing the need for intermittent
mandatory ventilation and oxygen therapy was studied in 88 mothers whose infants was born between 24 and 34 weeks of gestation
and who were randomized either for treatment with ambroxol (group A = 42) or served as control (group B = 46). There were
no significant differences in the mean gestational age, birth weight or Apgar score between the two groups. We found no significant
differences in occurrence of respiratory distress syndrome (55% vs 45%), in support by intermittent mandatory ventilation
(71% vs 72%) or oxygen therapy (74% vs 75%) at 12 h of age between groups A and B.
Conclusion This study does not suggest the efficacy of antenatal ambroxol treatment both for the prevention of neonatal respiratory
distress syndrome and for the reduction of its severity.
Received: 12 October 1995 and in revised form: 30 August 1996 / Accepted: 10 September 1996 相似文献
12.
M. Nistal J. A. Jimenez-Heffernan D. Hardisson J. M. Viguer J. Bueno P. Garcia-Miguel 《European journal of pediatrics》1997,156(2):107-109
We describe a 12-year-old patient with a primary pulmonary mass in the left upper lung. The diagnosis of inflammatory pseudotumour
was suspected preoperatively. After pathological examination and complete clinical evaluation, a diagnosis of malignant primary
pulmonary fibrous histiocytoma was established. This is a very uncommon primary neoplasm of the lung and to our knoweledge
only five paediatric cases have been reported. Because of the rarity of these sarcomas and histological similarities to benign
inflammatory pseudotumour, care must be taken to avoid confusion between the two disorders particularly in intra-operative
frozen sections.
Conclusion Primary malignant fibrous histiocytoma of the lung is an uncommon tumour that should be considered in the differential diagnosis
of pulmonary neoplasms of childhood. The histological diagnosis can be difficult due to the similarities with␣inflammatory
pseudotumour.
Received: 29 May 1996 / Accepted: 21 July 1996 相似文献
13.
A comparison of intratracheal and intravenous administration of gentamicin during liquid ventilation
M. A. Zelinka M. R. Wolfson I. Calligaro S. D. Rubenstein J. S. Greenspan T. H. Shaffer 《European journal of pediatrics》1997,156(5):401-404
Pulmonary absorption of aminoglycosides is poor with intravenous administration, but may be enhanced by direct intratracheal
administration of these drugs using perfluorochemical liquid ventilation (LV). To test this hypothesis, gentamicin sulfate
was administered to two groups of newborn lambs during LV. Serum and lung tissue levels of gentamicin were compared after
either pulmonary intratracheal (IT) or intravenous (IV) routes of administration. Serial serum levels of gentamicin were obtained
every 15 min for the 1st h, every 30 min for the 2nd h, and then hourly until sacrifice (maximum 6 h). At sacrifice, representative
samples of each lung lobe were homogenized and analyzed for tissue gentamicin content. At 1 h, serum gentamicin levels were
similar in both groups: IT administration levels were 3.7 ± 0.55 SE μg/ml and IV levels were 3.5 ± 0.85 SE μg/ml. The peak
serum gentamicin level of 4.8 ± 0.8 SE μg/ml for the pulmonary administration group occurred 1.5 h after administration. Lung
tissue levels of gentamicin for IT administration (4.04 ± 0.62 SE μg/g) were significantly greater than for IV administration
(1.75 ± 0.33 SE μg/g; P < 0.05). There were no significant differences in interlobar gentamicin distribution for either mode of administration.
Conclusion Perfluorochemical can be used as a vehicle for intratracheal delivery of antimicrobials. This route provides equivalent serum
levels at 1 h, higher lung tissue levels, and uniform interlobar distribution relative to intravenous administration of gentamicin.
We speculate that pulmonary administered gentamicin during LV may provide an effective alternative treatment modality in the
management of severe neonatal pneumonia.
Received: 12 April 1996 and in revised form: 24 July 1996 / Accepted 28 July 1996 相似文献
14.
U. Nowak-Göttl H. Vielhaber J. Grohmann R. Schneppenheim H. G. Koch 《European journal of pediatrics》1997,156(3):195-198
Resistance to activated protein C (APCR), in the majority of cases due to the arginine506 (Arg506) to glutamine (Gln) mutation in the factor V gene, has emerged as the most important hereditary cause of venous thrombo-embolism.
To determine to what extent this relatively common gene mutation influences the fibrinolytic system we investigated a population
of APC resistant children (n = 65) in comparison with a control group␣of sex- and age-matched healthy children (n = 100). Compared to the controls, plasma levels of tissue-type plasminogen activator (t-PA), urokinase-type plasminogen activator
(u-PA) and plasminogen activator inhibitor (PAI) 1 antigen, D-Dimer and enhanced thrombin generation were significantly (P < 0.0001) increased in children with the common factor V mutation. No difference was found between symptomatic and non-symptomatic
children. Whether high concentrations of t-PA, u-PA and PA1 antigen can predict future vascular occlusion in children with
APCR requires a more extensive multicentre study.
Conclusion Our data indicate that hypercoagulability in children with the Arg506 to Gln mutation in the factor V gene is mainly attributed to the genetic aetiology of the disease.
Received: 25 May 1996 / Accepted: 3 September 1996 相似文献
15.
A 4-month-old boy with prenatally diagnosed Wiskott-Aldrich syndrome became ill with a severe cytomegalovirus (CMV) infection,
the outcome of which was fatal. The parents had isolated the infant from other children and adhered to standards of hygiene
in order to avoid CMV infection because their first child had died of Wiskott-Aldrich syndrome and CMV infection. The mother
breast-fed her child although she was CMV IgG positive. The source of infection was most probably breast milk, which contained
CMV at the time the infant developed the generalized CMV infection.
Conclusion In infants with immunodeficiency syn‐dromes, CMV infection may have a fatal outcome. Since the virus can be transmitted by
breast milk, the advantages and disadvantages of breast-feeding should, therefore, be weighed in newborn infants with an immunodeficiency
syndrome whose mother is a CMV carrier.
Received 11 November 1996 / Accepted: 14 April 1997 相似文献
16.
N. Adachi M. Migita T. Ohta A. Higashi I. Matsuda 《European journal of pediatrics》1997,156(6):444-448
Natural Killer (NK) cell activity was examined in a 16-month-old Japanese boy with Shwachman syndrome associated with severe
vitamin E deficiency. As evaluated by 51Cr-release assay from K562 cells, NK cell activity was constantly decreased. After 8 weeks of oral α-tocopherol (α-Toc) supplementation
(100 mg/day), NK cell activity had normalised. When α-Toc supplementation was interrupted for 16 weeks, NK cell activity again
decreased. Flow cytometry of peripheral lymphocytes revealed a lowered number of CD16+ CD 56− fraction, which has the most potent NK cell activity. Single cell-in-agarose assay, to investigate the binding and cytolytic
activity of NK cell at the single cell level, revealed that the number of NK cells which bind to K562 cell was decreased,
but that the cytolytic activity of the individual binding cell was relatively unaffected. A second supplementation of α-Toc
for 8 weeks successfully restored NK cell activity, the number of cells expressing NK cell markers and the number of K562-binding
cells as compared to the age-matched normal range.
Conclusion These results indicate that severe vitamin E deficiency caused impaired NK cell activity due to a decrease in the number
of CD16+ CD56− NK cells and that this abnormality is reversible with α-Toc supple‐mentation.
Received: 30 January 1996 and in revised form: 19 November 1996 / Accepted: 22 November 1996 相似文献
17.
P. Labrune J. Zittoun I. Duvaltier P. Trioche J. Marquet P. Niaudet M. Odièvre 《European journal of pediatrics》1999,158(9):734-739
An 18-month-old girl presented with macrocytic megaloblastic anaemia followed by haemolytic uraemic syndrome. Metabolic investigations
led to the identification of an inborn error of cobalamin metabolism consisting of defective methylcobalamin biosynthesis,
probably cobalamin G, since methionine synthase activity was decreased under standard reducing conditions. Despite treatment,
pulmonary hypertension progressively developed and responded to oxygen therapy. Renal involvement evolved to terminal failure
and haemodialysis, while pulmonary hypertension was controlled by oxygen therapy. Such clinical manifestations have never
been reported in association with a defect of methylcobalamin and thus of methionine biosynthesis.
Conclusion A congenital abnormality of cobalamin metabolism was suspected then confirmed in the presence of typical haematological features
associated with unusual clinical manifestations such as progressive renal failure and pulmonary hypertension.
Received: 12 June 1998 and in revised form: 13 October 1998 and 21 December 1998 / Accepted: 10 January 1999 相似文献
18.
Ranjit Ranjan Roy Eliza Roy Mohammed Habibur Rahman Mohammed Moazzam Hossain 《World journal of pediatrics : WJP》2009,5(2):127-131
Background Nephrotic syndrome is an immune mediated disorder of the kidney associated with T cell dysfunction and secondary disturbance
of B cell with changes in levels of immunoglobulin and IgG:IgM ratio. These changes in immunoglobulin levels can be used as
a proxy marker to understand the clinical variety and prognosis of nephrotic syndrome.
Methods We studied 43 children with nephrotic syndrome during January 2003 to January 2005 in the Pediatric Nephrology Unit, Department
of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Blood samples were collected from the 43 patients,
and serum levels of IgG, IgM and IgG:IgM were measured by liquid phase immunoprecipitation assay. Another 20 healthy children
attending the laboratory for blood grouping and hepatitis B screening test were enrolled as controls.
Results In the 43 children with nephrotic syndrome, 24 had steroid sensitive nephrotic syndrome (SSNS) and 19 steroid resistant nephrotic
syndrome (SRNS). Compared with healthy children, the IgG level was low, IgM level was high, and IgG:IgM ratio was low (P<0.05). The serum IgG level and IgG:IgM ratio were significantly lower in children with SRNS and in children with frequent
relapse (FRNS) combined with steroid dependent nephrotic syndrome (SDNS) than in those with infrequent relapse nephrotic syndrome
(IFRNS) (P<0.05, respectively).
Conclusions Management of different nephrotic syndromes is based on the levels of immunoglobulins along with clinical and biochemical
parameters. The decrease of IgG level as a predictive marker for unfavorable prognosis of nephrotic syndrome in children needs
further evaluation in larger scale studies. 相似文献
19.
Sungur M Ocal B Oğuz D Karademir S Karakurt C Senocak F 《European journal of pediatrics》2009,168(5):593-597
Children with Down’s syndrome (DS)-associated complete atrioventricular septal defect (AVSD) have rapid and aggressive development
of pulmonary vascular disease when compared with non-Down’s syndrome (ND) children. We aimed to evaluate the role of plasma
endothelin-1 (ET-1) and nitrate levels in DS children with complete AVSD-associated pulmonary hypertension (PH) and compare
this to ND patients. The study included 20 patients (11 males, nine females) who had complete AVSD associated with PH. Comparisons
were made between DS patients (n = 12) aged 4 to 8 months (median 5 months) and ND patients (n = 8) aged 4 to 12 months (median 7 months). Blood samples were drawn from the inferior vena cava, pulmonary artery, pulmonary
vein, and aorta. The plasma ET-1 concentrations of the two groups were compared to the peripheral venous and arterial ET-1
levels, and pulmonary vein nitrate was compared to the peripheral arterial nitrate levels of ten healthy infants. The mean
pulmonary artery (PA) pressure and pulmonary vascular resistance (Rp) were significantly higher in the DS group than ND patients,
and the pulmonary blood flow (Qp) in ND patients was higher than DS patients. There were no differences between the two study
groups in regard to plasma ET-1 and nitrate levels obtained from matched sampling sites. The plasma ET-1 and nitrate levels
were significantly higher in both study groups compared to the control subjects. The plasma ET-1 and nitrate levels in DS
patients with PH were not different when compared to those of ND patients. 相似文献
20.
Nephrotic syndrome associated with X-linked recessive ichthyosis due to steroid sulfatase deficiency has rarely been reported
in English literature. We describe a 4 and a half-year-old boy presenting with steroid-resistant nephrotic syndrome (SRNS)
with an underlying ichthyotic skin present since birth. Renal biopsy revealed minimal change disease. As many of the male
members of the family also showed similar skin manifestations, genetic analysis was done on the patient, which revealed deletion
of the steroid sulfatase (STS) gene spanning both the 3′ as well as the 5′ends. The patient was thus diagnosed with SRNS associated
with X-linked recessive ichthyosis. He was started on cyclosporine regimen, and remission was achieved in 5 weeks. We speculate
that the deficiency of STS resulting in increased cholesterol sulfate accumulation interferes with the integrity of adherens
junctions present between glomerular epithelial cells of the slit diaphragm, and this results in proteinuria and nephrotic
syndrome. The nephrotic syndrome remitted with a calcineurin inhibitor medication. Conclusion: We suggest that the deficiency
of STS is another one in an increasing list of genetic causes of podocytopathy and nephrotic syndrome. Remission of proteinuria
in such a case may be achieved with immunosuppressive medication. 相似文献