中性粒细胞明胶酶相关脂质运载蛋白、肾损伤分子1和白介素18在诊断心肺分流术后急性肾损伤中的意义

目的探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子1(KIM-1)和白介素18(IL-18)在儿童心肺分流术(CPB)后急性肾损伤(AKI)临床诊断中的价值。方法随机收集2013年3月至2013年6月住院行CPB的先天性心脏病患儿67例,按照pRIFLE标准分为AKI组及非AKI组;观察术前,术后30 min、2 h、4 h、24 h、48 h和72 h血清肌酐(Scr)、尿NGAL、尿KIM-1、尿肌酐(Ucr)及尿IL-18水平。采用受试者工作特征曲线(ROC)及曲线下面积(AUC)评价NGAL、KIM-1及IL-18早期预测AKI的价值。结果 67例CPB儿童中23例(34.3%)发生AKI。按pRIFLE标准分期:危险期15例,损伤期4例,衰竭期3例,丧失期1例。AKI组术后4 h、48 h和72 h尿NGAL/Ucr高于非AKI组,差异有统计学意义(P0.05);术后4 h尿NGAL/Ucr为1.20时,预测AKI的灵敏度和特异度为0.864和0.561,AUC为0.671(95%CI:0.537~0.804)。术后48 h和72 h AKI组尿KIM-1/Ucr高于非AKI组,差异有统计学意义(P0.05);CPB术后24 h尿KIM-1/Ucr为1.16时,预测AKI的灵敏度和特异度分别为0.773和0.512,AUC为0.698(95%CI:0.563~0.834)。术后4 h AKI组尿IL-18/Ucr高于非AKI组,差异有统计学意义(P0.05);CPB术后4 h尿IL-18/Ucr为0.04时,预测AKI的灵敏度和特异度为0.773和0.561,AUC为0.655(95%CI:0.510~0.800)。结论联合检测尿NGAL、尿KIM-1及尿IL-18水平对儿童CPB术后早期预测AKI的发生可能具有重要的临床价值。     

尿胱抑素C和白细胞介素-18对危重新生儿急性肾损伤的预测价值

目的 探讨尿胱抑素C(Cys C)和尿白细胞介素-18 (IL-18)对危重新生儿急性肾损伤(AKI)的早期预测价值.方法 选择2010年9月至2011年2月生后6h内入住本院新生儿重症监护病房的新生儿为研究对象进行前瞻性研究,根据入院1周内是否发生AKI,分为AKI组和非AKI组(对照组).检测患儿入院当日尿Cys C、IL-18、微量白蛋白(MA)、α1微球蛋白(α1-MG)水平,并于入院24 h内进行新生儿急性生理学评分(SNAP).以多因素Logistic回归分析评估在校正混杂因素后尿Cys C、IL-18与AKI的关系,用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价尿Cys C、IL-18对新生儿AKI的预测价值.结果 研究期间共纳入57例新生儿,11例(19.3％)在入院1周内发生AKI.AKI组出生体重、胎龄、Apagr评分均低于对照组,尿Cys C、IL-18、α1-MG、MA水平及SNAP评分均高于对照组,差异有统计学意义(P＜0.05).Logistic回归分析显示,在校正胎龄、出生体重、尿MA、α1-MG水平及SNAP评分等因素后,尿Cys C、IL-18浓度与AKI显著相关.尿Cys C和IL-18预测新生儿AKI的AUC值分别为0.91 (95％ CI0.82 ～0.99,P＜0.001)和0.74(95％ CI0.53～0.95,P=0.015).结论 尿Cys C、IL-18是新生儿AKI的独立预测指标,尿Cys C具有更好的早期预测价值.     

盐酸氨溴索对体外循环患儿术后肾功能的影响

目的：有研究表明盐酸氨溴索可减轻体外循环所致的肺损伤,但其对体外循环患者术后肾功能损害的作用尚不十分清楚。该研究拟探讨盐酸氨溴索对体外循环下室间隔缺损修补术患儿肾功能的影响,为临床应用提供参考。方法：选择在体外循环下择期行室间隔缺损修补术患儿40例,年龄3～8岁,心功能I或II级,随机分为对照组和盐酸氨溴索组,每组20例。盐酸氨溴索组切皮后缓慢静脉注射4.5 mg/kg盐酸氨溴索 (生理盐水稀释至10 mL),对照组静脉输注等容量生理盐水。分别于术前、术后2 h、12 h、24 h及48 h取静脉血及新鲜尿液,检测尿中视黄醇结合蛋白(RBP)、N-乙酰-β-D-氨基葡萄糖酐酶(NAG)、β2-微球蛋白(β2-MG)水平及血清β2-MG、肌酐(Cr)、尿素氮(BUN)浓度。结果：与术前相比,两组术后2 h血清Cr、尿β2-MG,术后2 h及12 h血清β2-MG,术后2 h,12 h,24 h,48 h尿RBP,及术后2 h,12 h,24 h尿NAG水平升高（P<0.05）。氨溴索组术后2 h时血清Cr,术后2 h及12 h血清β2-MG、尿β2-MG,术后2 h,12 h,24 h,48 h尿RBP,以及术后12 h和24 h尿NAG的水平明显低于对照组（P<0.05）。结论：盐酸氨溴索可减轻体外循环所致患儿的肾损伤,其作用机制有待进一步研究。［中国当代儿科杂志,2009,11（8）：656-658］     

婴儿先天性心脏病体外循环术后肾损伤分析

目的：探讨婴儿先天性心脏病（简称先心病）体外循环（CPB）术后肾损伤情况。方法：选取我院2009年10月至2010年7月期间CPB下行先心病手术的婴儿40 例，分别于转流前、手术结束时、术后2 h、术后6 h、术后24 h用酶联免疫吸附法（ELISA）检测血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、半胱氨酸蛋白酶抑制剂C (CysC)和尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)浓度。常规生化方法检测术前及术后血清肌酐（Cr）及尿素氮（BUN）浓度。结果：术前与术后血清Cr及BUN均在正常范围内；血清TNF-α、IL-6和尿NAG浓度在CPB后均有显著性升高（P<0.05）。相关性分析提示血清TNF-α分别与尿NAG、血清CysC呈正相关（r分别为0.195，0.190，均P<0.05），血清IL-6与尿NAG亦呈正相关（r=0.278，P<0.01）；血清CysC和尿NAG检测出肾损伤的阳性率显著高于血清Cr或BUN(均P<0.01)。结论：CPB能引起婴儿急性肾损伤，可能与血清中TNF-α和IL-6的浓度增高相关。血清CysC和尿NAG可作为反映肾功能变化较敏感的指标。     

尿L-FABP与尿NGAL联合应用在儿童心脏术后急性肾损伤早期诊断中的价值

目的探讨尿肝型脂肪酸结合蛋白(L-FABP)与尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)联合应用在儿童心脏术后急性肾损伤(AKI)早期诊断中的价值。方法以需建立体外循环(CPB)的97例先天性心脏病儿童为研究对象,收集其心脏手术前及术后不同时间点的血尿标本,分别测定血清肌酐(Scr)、尿L-FABP和尿NGAL水平,并比较AKI组(n=18)和非AKI组(n=79)患儿术后各标志物的动态变化。应用受试者工作特征(ROC)曲线及曲线下面积(AUC)评估标志物单独及其联合应用在预测术后AKI发生中的作用。结果 AKI组患儿尿L-FABP和尿NGAL水平在术后2 h、6 h均显著高于非AKI组,其浓度变化明显早于Scr的升高。尿L-FABP在术后2 h、6 h单独预测AKI发生的AUC分别为0.921和0.896;尿NGAL在术后2 h、6 h单独预测AKI发生的AUC分别为0.908和0.928。术后2 h及6 h尿L-FABP及NGAL联合应用预测术后AKI发生的AUC分别为0.942和0.929。结论尿L-FABP和尿NGAL在儿童心脏术后AKI早期即显著升高,明显早于Scr的改变,可早期预测AKI的发生,而两者联合应用可使诊断的精确性进一步提高。     

尿表皮生长因子和尿微量清蛋白及β2微球蛋白与过敏性紫癜患儿早期肾损伤的相关性

目的探讨尿表皮生长因子(EGF)、尿微量清蛋白(MA)及β2-微球蛋白(β2-MG)与过敏性紫癜(HSP)及过敏性紫癜性肾炎(HSPN)发病的关系与相关性;探寻HSP早期肾损伤敏感的实验室指标。方法HSP患儿73例,分为HSP组(皮肤型组、混合型组、HSPN型组);健康对照组;治疗前组、治疗后组。采用酶联免疫吸附双抗体夹心法(ABC-ELISA)测定各组尿EGF,采用放射免疫分析法测定尿MA及β2-MG水平。结果1.HSPN型组尿EGF水平为(173.90±112.53)μg/L,高于皮肤型组(89.22±40.21)μg/L和混合型组(132.96±56.41)μg/L;HSPN型组尿MA水平为(46.34±18.49)mg/L,高于皮肤型组(12.30±6.73)mg/L和混合型组(24.31±12.66)mg/L;HSPN型组尿β2-MG水平为(0.52±0.39)mg/L,高于皮肤型组(0.26±0.18)mg/L及混合型组(0.35±0.25)mg/L,其差异均有统计学意义(Pa<0.05)。2.尿EGF水平治疗前组[(122.16±63.71)μg/L]高于治疗后组[(59.13±11.60)μg/L]及健康对照组[(24.74±8.75)μg/L];MA水平治疗前组[(43.09±10.46)mg/L]高于治疗后组[(12.94±5.73)mg/L]及健康对照组[(6.12±3.91)mg/L];尿β2-MG水平治疗前组[(0.45±0.25)mg/L]高于治疗后组[(0.29±0.16)mg/L]及健康对照组[(0.19±0.12)mg/L](Pa<0.05),且治疗后组与健康对照组比较差异有统计学意义(P<0.05)。3.HSP患儿肾损害中BUN/Cr阳性13例(阳性率17.81%),尿检阳性22例(阳性率30.14%),BUN/Cr加尿检阳性35例(阳性率47.95%),β2-MG阳性49例(阳性率67.12%),MA阳性53例(阳性率72.60%),EGF阳性67例(阳性率91.78%)。EGF、MA和β2-MG分别与BUN/Cr、尿检、BUN/Cr加尿检阳性率比较,差异均有统计学意义(Pa<0.05)。4.尿EGF与尿MA和β2-MG水平均呈正相关(r=0.444,0.426Pa<0.05)。结论EGF参与了HSPN的发病过程,尿EGF、MA及β2-MG可作为反映早期HSP患儿肾损伤的指标之一。     

新生儿尿中TNF-α与Apgar评分之间的关系

目的：探讨新生儿尿中TNF-α与Apgar评分之间的关系。方法：28例新生儿,生后Apgar评分1 min<3分者18例,4～6分者10例;评分正常组9例。采用ELISA法检测新生儿尿中TNF-α水平,并同时测定尿中反应肾损伤的指标β2-微球蛋白(β2-MG)的水平。结果：尿TNF-α,β2-MG正常对照组为(25.35±5.76) pg/ml,(0.09±0.01) mg/L;在生后Apgar评分1 min 4～6分者为(32.50±6.55) pg/ml,(3.67±2.00) mg/L;Apgar评分1 min<3分者为(44.03±12.41) pg/ml,(4.66±1.85) mg/L。评分低者与正常组比较,尿TNF-α和β2-MG均显著升高(P<0.05)。直线相关分析显示：尿中TNF-α和β2-MG水平呈显著正相关关系(r=0.51,P<0.05)。结论：尿中TNF-α水平与生后Apgar评分高低有密切关系,可作为新生儿窒息后肾损伤的一个重要指标。     

血、尿β_2-MG及尿NAG测定与新生儿窒息后肾功能评价

目的：新生儿窒息可引起全身多脏器功能损害,该文通过观察窒息新生儿血、尿β2微球蛋白(β2-MG)及尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)含量的变化以评价新生儿窒息后肾功能的改变。方法：采用放射免疫法和对硝基酚比色法对28例窒息新生儿(又分为重度窒息组13例和轻度窒息组15例)和16例正常新生儿血、尿β2-MG及尿NAG同时进行检测。结果：窒息组血、尿β2-MG及尿NAG值［(4.46±1.42) mg/L,(2.69±1.80) mg/L,(13.68±2.01) U/mmol.Cr］明显高于正常组［(2.97±1.24) mg/L,(0.96±0.82) mg/L,(6.12±1.16) U/mmol.Cr］(P<0.01)。重度窒息组血、尿β2-MG及尿NAG值［(4.99±1.28) mg/L,(3.86±1.14) mg/L,(13.94±3.82) U/mmol.Cr］高于轻度窒息组［(4.30±1.21) mg/L,(2.93±0.87) mg/L,(9.68±1.27) U/mmol.Cr］(P<0.05)。窒息新生儿尿β2-MG较血β2-MG升高更明显(P<0.01)。结论：血、尿β2-MG及尿NAG测定对早期评价新生儿窒息后肾功能损害,尤其是对肾小球或肾小管的损害定位、预测损伤程度具有重要意义。     

IL-18抗体对小鼠微小病变型阿霉素肾病的治疗作用

目的 探讨应用抗白细胞介素18抗体(IL-18Ab)中和内源性IL-18活性对阿霉素(ADR)小鼠微小病变型肾病综合征(MCNS)的治疗作用.方法 雄性昆明种小鼠,一次性尾静脉注射ADR 7.5 mg/kg建立MCNS模型,对照组注射同等容量的生理盐水.给予ADR后第5、7、12及21大模型组小鼠分别注射IL-18Ab(10μg/只,IL-18Ab组)或等容量PBS(非治疗组).于实验第1、14、28及42天检测尿蛋白水平,第42天处死小鼠,常规方法测血清总蛋白(TP)、白蛋白(Alb)、总胆固醇(TC)、甘油三酯(TG)及IL-4、IL-18、IFN-γ和TNF-α水平,电镜观察肾脏组织病理改变.结果 注射阿霉素后,小鼠均出现肾病综合征表现,以大量蛋白尿、低蛋白血症、高胆固醇血症为特征.大量蛋白尿于实验第2周出现,第4周达到高峰.对照组、非治疗组及IL-18Ab组分别为(3.13±0.82)mg/24 h、(34.27±5.16)mg/24 h及(27.51±3.34)mg/24 h(P＜0.01),第7周非治疗组尿蛋白水平为(30.45±2.13)mg/24 h,IL-18Ab治疗组尿蛋白水平明显降低为(21.83 ±2.67)mg/24 h(P＜0.01).非治疗组及IL-18Ab组TC分别为(6.51±0.23)mmol/L及(5.15±0.9)mmol/L(P＜0.01),TG为(3.31±0.32)mmol/L及(1.67±0.17)mmol/L(P＜0.01),Alb分别为(15.99±0.89)g/L及(19.23±1.53)g/L(P＜0.05).电镜显示:非治疗组肾脏上皮细胞足突广泛融合,而IL-18Ab组肾脏组织学改变显著减轻,仅有部分足突融合.与正常对照组相比,非治疗组血清IL-18、IFN-γ和TNF-α显著增高.而IL-18Ab治疗后上述细胞因子均明显降低(P＜0.01).结论 IL-18Ab对ADR诱导的MCNS的治疗作用可能与中和内源性IL-18活性、抑制Th1细胞介导的免疫反应有关,抑制或中和内源性IL-18的释放及活性,有可能成为MCNS治疗的新途径.     

KIM-1及NGAL在婴幼儿复杂先心病术后早期肾功能损伤中的预测作用

目的探讨尿中肾脏损伤分子-1(Kidney injury molecule-1,KIM-1)及中性粒细胞明胶酶相关脂质运载蛋白(reutrophil gelatinase-associated lipocalin,NGAL)在复杂先心病根治术后急性肾功能损伤评估中(acute kidney injury,AKI)的敏感性及临床价值。方法回顾性分析本院2011年12月年至2014年12月收治的复杂先心病术后急性肾功能衰竭患儿临床资料,共23例,其中男性15例,女性8例,年龄4~18个月,平均年龄(8.38±1.75)个月,体重3~14kg,平均体重(5.15±3.82)kg,观察术前、术后2 h、4 h、6h内尿中NGAL、KIM-1及血肌酐、尿素氮、K~+、平均动脉压及尿量的变化。结果术后2 h尿液中NGAL开始上升,为(1.28±0.63)ng/L,术后4 h尿液中KIM-1上升,为(1.14±0.16)ng/L,与手术前比较,差异有统计学意义。经积极干预治疗后,23例患儿中,19例存活,4例因多器官功能衰竭而死亡。结论尿中KIM-1及NGAL有助于复杂先心病术后急性肾功能损伤的早期检测,可为临床治疗提供重要线索。     

Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomised, placebo-controlled trial: First results of ETA®

There is a common progression known as the allergic march from atopic dermatitis to allergic asthma. Cetirizine has several antiallergic properties that suggest a potential effect on the development of airway inflammation and asthma in infants with atopic dermatitis. Methods. Over a two year period, 817 infants aged one to two years who suffered from atopic dermatitis and with a history of atopic disease in a parent or sibling were included in the ETAC^® (Early Treatment of the Atopic Child) trial, a multi-country, double-blind, randomised, placebo-controlled trial. The infants were treated for 18 months with either cetirizine (0.25mg/ kg b.i.d.) or placebo. The number of infants who developed asthma was compared between the two groups. Clinical and biological assessments including analysis of total and specific IgE antibodies were performed. Results. In the placebo group, the relative risk (RR) for developing asthma was elevated in patients with a raised level of total IgE (≥ 30 kU/I) or specific IgE (≥ 0.35 kUA/I) for grass pollen, house dust mite or cat dander (RR between 1.4 and 1.7). Compared to placebo, cetirizine significantly reduced the incidence of asthma for patients sensitised to grass pollen (RR = 0.5) or to house dust mite (RR = 0.6). However, in the population that included all infants with normal and elevated total or specific IgE (intention-to-treat - ITT), there was no difference between the numbers of infants developing asthma while receiving cetirizine or placebo. The adverse events profile was similar in the two treatment groups. Discussion. Raised total IgE level and raised specific IgE levels to grass pollen, house dust mite or cat dander were predictive of subsequent asthma. Cetirizine halved the number of patients developing asthma in the subgroups sensitised to grass pollen or house dust mite (i.e. 20% of the study population). In view of the proven safety of the drug, we propose this treatment as a primary pharmacological intervention strategy to prevent the development of asthma in specifically sensitised infants with atopic dermatitis.     

Resurgence of measles in Singapore: profile of hospital cases

OBJECTIVE: To ascertain the profile of cases of measles seen at a general hospital during a recent outbreak that occurred despite a measles vaccination program. METHODOLOGY: A retrospective study from January 1991 to March 1998. All patients with measles (ICD code 055. 9) seen at the emergency unit or as inpatients were included. RESULTS: There were 87 cases identified. The diagnosis was clinical in all and proven serologically in 71%. Eighty-five per cent of the cases occurred between January 1997 and March 1998. There was a bi-modal age distribution with peaks in the very young (相似文献   

�¶�֢��ϵ�ϰ���ע��ȱ�ݶද�ϰ������ڵ�ת��

孤独症谱系障碍(autistic-spectrum disorders,ASDs)近年来患病率逐年攀升至1%左右,其症状往往伴随终生,成为严重威胁儿童健康和发展的神经发育性疾患;注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是儿童期最常见的精神障碍,国内报道患病率为4.13%～5.83%,其症状可延续至青少年期,甚至到成年期[1]。这两类精神障碍在成年期的临床表现、共患病、治疗策略和预后与儿童期有哪些不同呢?本文通过回顾相     

EXCITING NEW TREATMENT APPROACHES FOR PATHYPHYSIOLOGIC MECHANISMS OF SICKLE CELL DISEASE

During the past several decades, our understanding of the complex pathophysiology of vasoocclusion associated with sickle cell disease has improved greatly. Interaction of genes, hemoglobin molecules, red cell membrane and metabolic changes, cell-cell interactions and cell-plasma interactions, red cell adhesion to vascular endothelium, activation of coagulation, and vascular reactivity play a role in vaso occlusion. Penicillin prophylaxis of pneumococcal infections and appropriate use of blood transfusions and other supportive measures improved survival of sickle cell patients. Hydroxyurea made a major impact on sickle cell therapy when it was shown to decrease acute painful episodes, acute chest syndrome, and the need for blood transfusion in adults. Significant experience in the use of hydroxyurea has been accumulated in older children. The benefits and risks of hydroxyurea for younger children and long-term risks in all patients will be evaluated in future investigations. Other promising therapies include butyrate compounds, clotrimazole, magnesium supplementation, poloxamer 188, antiadhesion agents, anticoagulant approaches, and nitric oxide. Hemopoietic transplantation remains the only curative therapy. However, several transgenic mouse models are available for studies of gene therapy or other treatment approaches on biochemical, cellular, and pathologic effects of mutant genes.     

Infiltrations of Epstein-Barr virus-carrying cells in granular lymphocyte-proliferative disorders corresponding to chronic active Epstein-Barr virus infection

A 21-year-old man with granular lymphocyte-proliferative disorders (GLPD) associated with chronic active Epstein-Barr virus (EBV) infection is described. Chromosomal analyses revealed several clonal abnormalities and two of them were mainly repetitious. High copy numbers of monoclonal EBV genome were also detected in the proliferative large granular lymphocytes (LGLs), indicating the monoclonal expansion of EBV-infected LGLs. The patient had an indolent course for several years, and there was no evidence of infiltrations of his bone marrow until the end stage. At autopsy, microscopic studies revealed marked infiltrations of LGL in the liver and spleen, and the infiltrating cells were NK-cell immunophenotype. The infiltrated LGLs showed latency I.     

LUTEINIZING HORMONE RECEPTOR MUTATIONS IN DISORDERS OF SEXUAL DEVELOPMENT AND CANCER

Human male sexual development is regulated by chorionic gonadotropin (CG) and luteinizing hormone (LH). Aberrant sexual development caused by both activating and inactivating mutations of the human luteinizing hormone receptor (LHR) have been described. All known activating mutations of the LHR are missense mutations caused by single base substitution. The most common activating mutation is the replacement of Asp-578 by Gly due to the substitution of A by G at nucleotide position 1733. All activating mutations are present in exon 11 which encodes the transmembrane domain of the receptor. Constitutive activity of the LHR causes LH releasing hormone-independent precocious puberty in boys and the autosomal dominant disorder familial male-limited precocious puberty (FMPP). Both germline and somatic activating mutations of the LHR have been found in patients with testicular tumors. Activating mutations have no effect on females. The molecular genetics of the inactivating mutations of the LHR are more variable and include single base substitution, partial gene deletion, and insertion. These mutations are not localized and are present in both the extracellular and transmembrane domain of the receptor. Inactivation of the LHR gives rise to the autosomal recessive disorder Leydig cell hypoplasia (LCH) and male hypogonadism or male pseudohermaphroditism. Severity of the clinical phenotype in LCH patients correlates with the amount of residual activity of the mutated receptor. Females are less affected by inactivating mutation of the LHR. Symptoms caused by homozygous inactivating mutation of the LHR include polycystic ovaries and primary amenorrhea.     

A profile of respiratory symptoms in urban and rural South Australian school children

This report describes the cross-sectional analyses of data from the first year of a longitudinal study using questionnaire and respiratory function data over a 5 year period from a sample of rural South Australian school children. The cumulative or lifetime prevalences of respiratory symptoms were estimated in 825 rural and 1261 urban school children aged between 5 and 15 years in order to determine if the prevalence rates differed between rural and urban school children. The study found the overall cumulative prevalence of asthma and/or wheezy breathing (AWB) to be 24.1% in the rural school children compared to 27.6% in the urban school children. Most children developed AWB symptoms before the age of 7 years, with 20% reporting moderately severe symptoms and 10% having more than one attack per fortnight. The cumulative prevalence of bronchitis, loose/rattly cough (BLRC) differed significantly between the rural school children (34.1%) and urban school children (47.9%). The BLRC symptoms preceded the development of AWB in many cases. Urban school children also reported a higher prevalence of atopic conditions.     

Personality profiles and heart rate variability (vagal tone) in children with recurrent abdominal pain

The aim of the study was to explore psychological factors and autonomic activity in children with recurrent abdominal pain and to compare them with those in a control group of healthy children. The Personality Inventory for Children was used for assessment of developmental, emotional and psychosocial factors in 25 children with recurrent abdominal pain (age, 7-15 y). Parasympathetic and sympathetic functions in these children and in 23 healthy control subjects (age, 7-13 y) were also investigated, non-invasively using a computerized polygraph. Vagal tone (parasympathetic function) was indexed by calculation of respiratory sinus arrhythmia in beats/min. Skin conductance (sympathetic function) was recorded by the constant current method. On the Personality Inventory for Children, 16 patients had high scores on somatic concern. Several patients had scores in the clinical range for depression, withdrawal and anxiety, but the mean scores for these personality profile scales were well within the normal range of healthy children. Interestingly, there was a spike on the L (Lie)-scale for most of the patients and 15 patients had scores above or close to the clinical cut-off value. As compared with the scores in healthy children, vagal tone and sympathetic tone were normal. Conclusion: Many children with recurrent abdominal pain have scores in the clinical range for depression, withdrawal, anxiety and L-scale indicating coping problems, denial and a trend towards somatic concern that may contribute to the evolution of abdominal pain. Autonomic nerve activity was not disturbed in these children.     

Hauttemperaturen verschiedener Körperoberflächenareale des Rumpfes bei Säuglingen

Summary In two groups of infants (3–53 weeks old) skin temperatures were controlled in different areas of the trunk—i.e.: regions of sternum, lungs, heart, liver, spleen, kidneys—at different room-temperatures (group I: 21–25°C; group II: 29–32°C). Rectal temperatures of some probands in both groups also had been controlled simultaneously. A definite change in the reaction to heat was proofed in different periods of the first year of life. In higher environmental temperatures the skin temperature was almost constant at every controll-point of the skin, even in older infants. In lower environmental temperatures the skin temperatures lowered continuously with age till 7. to 9. moth. From 10. to 12. month the lowering of skin temperature discontinued. The rectal temperatures were relatively constant in all infants. Only in infants from 7. to 12. month, whose skin temperatures were controlled in lower as well as in higher environmental temperatures, a tendency to higher rectal temperatures was proofed in warmer environmental temperatures.The significance of these results is discussed.

---

---

Untersuchungen mit Unterstützung durch die Deutsche Forschungsgemeinschaft.