A case of cow's milk allergy in the neonatal period-evidence for intrauterine sensitization?

Clinical manifestations of cow's milk allergy rarely occur in the first days after birth. We report on a newborn presenting with hemorrhagic mecon-ium in the first hour of life followed by bloody diarrhea in the next few days. At day 14, an elevaled total IgE, specific IgE to cow's milk and an eosinophilia in peripheral blood were found. Symptoms disappeared when the milk feed was changed to an extensively hydrolyzed casein formula. Two challenges with cow's milk formula (on day 30 and at 7 months of age) were followed by recurrence of vomiting, watery diarrhea and failure to thrive. At the age of 17 months cow's milk was tolerated well. Although other pathogenetic mechanisms cannot completely be ruled out, there is strong evidence that cow's milk allergy— induced by intrauterine sensiti-zation—explains the symptoms in our patient. In conclusion, cow's milk allergy can occur even in the first days of life, and our clinical observation supports the concept of intra-uterine sensitization to allergens.     

Akuter VestibularisausfallEine seltene Differentialdiagnose im Kindesalter

Bei einem 10j?hrigen Jungen bestand nach einer Luftweginfektion wegen Nüchternerbrechens, Schwindels und Spontannystagmus der Verdacht auf erh?hten Hirndruck. Bei kalorischer Unerregbarkeit eines Vestibularorgans und normalem Liquor- und Kernspintomographiebefund des Sch?dels stellten wir jedoch die Diagnose eines akuten Vestibularisausfalls, der sich rasch spontan zurückbildete. Das Pr?dilektionsalter dieser Erkrankung liegt bei 40–50 Jahren, nur 5% der Patienten (Inzidenz 4:100000) sind Kinder. Sie gilt als vestibulares ?quivalent des H?rsturzes. Charakteristisch sind akute Schwindelattacken, kalorische Unter- bzw. Unerregbarkeit eines Vestibularorgans ohne kochle?re Symptome, und die Abwesenheit einer zentralnerv?sen St?rung. Urs?chlich sind infekti?se und ferner vaskul?re, metabolische und toxische Affektionen, die im Kindesalter keine Rolle spielen. Hier geht der Erkrankung in der Regel eine virale Luftweginfektion voraus. Im Gegensatz zum Erwachsenenalter ist im Kindesalter die Prognose exzellent.     

Immunohistochemically Determined Estrogen and Progesterone Receptor Levels: A Comparison of Three Antibodies with the Ligand-Binding Assay

Abstract: Traditionally, estrogen and progesterone receptor levels have been determined by biochemical ligandbinding assays, but more recently immunohistochemical techniques have become available. They have gained popularity due to their low cost, smaller sample size requirements, and direct visualization capability of reaction location. Several antibody clones are commercially available and antibodies directed against the estrogen receptor (ER) are supplied by Ventana Medical Systems (Tucson, AZ), Abbott Laboratories (Abbott Park, IL), and lmmunotech Westbrook, ME). Antibodies directed against the progesterone receptor (PgR) are supplied by Ventana Medical Systems (Tucson, AZ), lmmunotech (Westbrook, ME), and Becton-DickinsonKelI Analysis Systems (San Jose, CA). Computer-assisted image analysis using the CAS ZOOTM (Becton-DickinsonKIS, San Jose, CA) allows quantitation of immunohistochemically determined receptor levels. Correlation of quantitated immunohistochemical ER levels with values determined by ligand-binding assay revealed the Ventana antibody to most closely predict the ligand-binding results (wk = .667). The Ventana anti-progesterone antibody quantitation most closely correlated with the ligand-binding results (wk = 435) for determination of PgR. Progesterone receptor level as determined by any of the tested methods did not stratify patients into favorable and unfavorable prognostic groups. Estrogen receptor level as determined by the Ventana antibody was the most predictive of patient outcome but this relationship did not reach statistical significance (p = .09). Most discrepancies between the ligand-binding assay and the immunohistochemical assays were associated with one of three factors: (a) low volume of neoplastic cells present due either to small sample size or high stromal content, (b) premenopausal status with circulating endogenous estrogens potentially occupying receptor sites, (c) presence of benign breast epithelium resulting in a false-positive ligand-binding assay.     

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槲寄生化学成分的研究——Ⅷ.2,3-丁二醇单葡萄糖甙的分离和结构

From the ethanol extract of Viscum coloratum (Kom.) Nakai , a giucoside ofaliphatic diol and three other glucosides were isolated. Based on chemical and spectroscopic analysis,the structures have been elucidated as 2-β-D- glucosyl-3- methylpropanol (Ⅷ), syringin (Ⅸ),eleatheroside E(Ⅹ) and syringenin-4'-O-D-apiosylglucoside (Ⅺ). Ⅷ is a new glucoside of aliphaticdiol and named 3-β-D-glucopyranosyloxy-butanol-2. Three other compounds (Ⅸ～-Ⅺ) were foundfor the first time in this plant.     

Inter- and intrasensory modality matching in children with hand-eye coordination problems: exploring the developmental lag hypothesis

This study set out to explore the suggestion that the problems experienced by 8-year-old children diagnosed as clumsy in the area of hand-eye coordination (HECP) might be attributed to a developmental lag. The performances of this group of HECP children were compared with those of groups of 5-year-old and 8-year-old controls without such deficits, when required to carry out a task involving pointing, without vision, to targets located, visually, visually/proprioceptively, or proprioceptively, the dependent variable being the distance error score from the centre of the target. The performances of the HECP children, when vision or vision/proprioception was used to locate the targets, were shown to be inferior to those of the two control groups of children thereby supporting a visual deficit hypothesis. When the targets had to be located proprioceptively, the performance of the HECP children was shown to be similar to that of the 5-year-olds, while both groups were inferior to the 8-year-olds, thereby supporting a developmental lag hypothesis in proprioceptive terms. However, when the scores for the preferred and non-preferred hands were analysed separately a marked deterioration in the performances of both the 5-year-old controls and the HECP children was observed while the 8Jyear-old controls were unaffected. While this finding supports a developmental lag explanation of the inferior performances of the HECP children, it was necessary to qualify such an explanation when the within-group performances using the preferred and non-preferred hands were compared. Only the HECP children, under the visual/proprioceptive or proprioceptive conditions, showed significant performance differences, in. favour of the preferred hand. This finding was taken as a suggestion that the developmental lag exhibited by the HECP children might have pathological overtones possibly related to the development of the corpus callosum.     

Skin surface PCO2 monitoring in newborn infants in shock: effect of hypotension and electrode temperature

We studied the effect of hypotension and of electrode temperature (41 degrees C to 44 degrees C) on the relation of skin surface PCO2 (Roche prototype) to arterial PCO2 in 24 sick neonates of 690 to 3,500 gm with systolic blood pressures of 5 to 70 mm Hg. PsCO2 closely correlated with PaCO2. The standard error of estimating PaCO2 from PsCO2 was 3.02 torr at 44 degrees C, 3.20 torr at 43 degrees C, and 3.57 torr at 41 degrees C. The pH (6.89 to 7.61), body temperature (33.5 to 38.1 degrees C), hematocrit (0.28 to 0.65), scleredema, or treatment with tolazoline did not affect the relation of PsCO2 to PaCO2. PsCO2 grossly exceeded the predicted value at systolic blood pressures below 15 mm Hg, irrespective of electrode temperature.