Positive monospot tests preceding the diagnosis of acute monocytic leukemia in two adolescents.

The early detection and treatment of two cases of acute monocytic leukemia (AMoL) was hampered by the presence of positive slide tests for infectious mononucleosis (IM). This assumes great importance with the recent development of specific therapy, effective for certain subtypes of nonlymphocytic leukemia.     

Positive monospot tests preceding the diagnosis of acute monocytic leukemia in two adolescents

The early detection and treatment of two cases of acute monocytic leukemia (AMoL) was hampered by the presence of positive slide tests for infectious mononucleosis (IM). This assumes great importance with the recent development of specific therapy, effective for certain subtypes of nonlymphocytic leukemia.     

Estimation of annual height velocity based on short- versus long-term measurements

We assessed the relationships between annual height velocity, calculated from two measurements taken at intervals of 6, 12 and 24 months, in 69 healthy prepubertal children (34 male, 35 female) aged 6.5 years (range 6.25–6.75 yrs) who were followed for 2.5 years and measured biannually. Initial height values for age were within normal ranges except for one child with a height SDS of — 2.0. Mean annual velocities also conformed to British norms. Significant differences were observed between consecutive six-monthly velocities and these values failed to predict annual velocities calculated from measurements taken at 12– or 24-month intervals. Seasonal effects were thought to have some impact on the six-monthly velocity differences. Height velocity, based on measurements taken at intervals of 12 months, was essentially similar to two-year velocity values. The results indicate that in estimating annual height velocity, six-month intervals between measurements may be misleading while 12-monthly measurements are as reliable as height velocity values based on measurements taken at two-year intervals.     

The impact of hormone physiology on clinical practice with reference to two papers spanning 40 years of endocrinology.

Following the pioneering work of Roger Ekins in describing the methodology for radioimmunoassay of hormone concentrations in plasma a series of publications followed describing variation in plasma hormone concentrations in a number of diseases. Though fluctuations in hormonal concentrations had been suspected, it was not until Hunter and Rigal documented these for the GH axis that it became apparent that the preferred mode of signalling for many hormone systems and in particular the anterior-pituitary hormones was of a pulsatile nature.     

Editor's notes on preceding paper and invited commentary by I. Aaronson

Editor's notes on preceding paper and invited commentary by I. Aaronson     

Flow velocity waveforms in the fetal internal carotid artery relative to fetal blood gas and acid-base measurements in normal pregnancy

Flow velocity waveforms in the fetal internal carotid artery during fetal behavioural state 2F were compared with blood gas and acid-base data from fetal scalp blood samples immediately following artificial rupture of the membranes in 17 normal term pregnancies. The pulsatility index in the fetal internal carotid artery was positively related to PO2 and base excess suggesting that also under physiological conditions fetal cerebral vascular resistance may respond to changes in fetal oxygenation.     

The effect of varying arterial oxygen tension on neonatal acid-base balance.

Acute severe hypoxia, when the arterial partial pressure of O2 (PaO2) is sufficiently reduced, causes a shift from aerobic to anaerobic metabolism and can be fatal to neonates. The ability of the neonate to accommodate this shift, and prevent acidosis, could play a role in its ability to tolerate hypoxia. This study examines the effect of varying degrees of acute hypoxia on acid-base homeostasis in the neonate using a model of right to left shunting where PaO2 is decreased and, if severe, arterial partial pressure of CO2 is increased. Three-d-old swine were anesthetized, intubated, and mechanically ventilated. Ventilation with a gas mixture of medical air and 95% N2:5% CO2 resulted in four groups: 1) normoxia (n = 5); 2) mild hypoxia (n = 4); 3) moderate hypoxia (n = 3); and 4) severe hypoxia (n = 5), with PaO2 of 10.7, 8.0, 5.3, and 2.7 kPa (80, 60, 40, and 20 mm Hg), respectively. Acid-base status was evaluated via changes in arterial blood partial pressure of CO2, pH, HCO3-, and base excess at 0, 30, 60, and 120 min. Only the severe hypoxia group had significantly elevated (p less than 0.0001) arterial partial pressure of CO2 compared to the other groups at 60 and 120 min [8.7 +/- 0.5 and 8.0 +/- 0.5 kPa (65.5 +/- 3.7 and 60.0 +/- 3.7 mm Hg), respectively]. Base excess was unaltered in the normoxic and mild and moderate hypoxic groups, indicating no change in metabolic acid-base status. The severe hypoxic group had progressively decreased HCO3-, base excess, and pH at 60 and 120 min.(ABSTRACT TRUNCATED AT 250 WORDS)