Computed tomography of the head in the evaluation of microcephaly

Eighty-five infants and children found to have microcephaly had computed tomographic (CT) brain scans performed. A greater degree of microcephaly correlated with the finding of atrophy or ventricular dilation on CT scan. Patients who had known preceding destructive brain insults had the highest incidence of abnormal findings on scans (20/22). Patients who had CNS dysfunction of unknown etiology had the lowest frequency of abnormal findings (12/33); however, in three of these patients, a previously unsuspected brain malformation was found on CT scan. Patients who had other congenital anomalies had an intermediate proportion of abnormal findings on CT scans (20/30), and in 11 of these scans, a previously unsuspected or only partly suspected brain malformation was diagnosed. Discovering previously unsuspected information or finding supportive data regarding the basis for the underlying disease process, being able to provide a more specific developmental prognosis and accurate genetic counseling, justifies the inclusion of a CT scan of the head in the evaluation of the microcephalic child.     

Vitamin K1 content of maternal milk: influence of the stage of lactation, lipid composition, and vitamin K1 supplements given to the mother

Using a sensitive electrochemical assay for vitamin K1 and standardized techniques for breast-milk collection, we studied the vitamin K1 content of human milk during the first 5 wk of lactation with respect to 1) individual and interindividual differences, 2) the relationship of vitamin K1 to other lipids, and 3) the influence of oral supplements of vitamin K1 on breast milk concentrations. Comparison of fore and hind milk from the mothers revealed higher vitamin K1 concentrations in hindmilks, suggesting that the lipid content influences the vitamin K1 concentration in maternal milk. Samples of maternal milk from nine mothers collected from day 1 to day 36 of lactation showed significantly higher vitamin K1 concentrations in colostral milk than in mature milk. For colostral milk there was a significant correlation of vitamin K1 to cholesterol (r = 0.62) but not to total lipid or phospholipid suggesting a role for cholesterol in the secretion of vitamin K1 into colostral milk. For mature milk correlation coefficients of vitamin K1 with all lipids were low (r = 0.29-0.37) suggesting that at later stages of lactation dietary fluctuations of vitamin K1 may be a more important determinant of the vitamin K1 content of breast milk than the lipid composition. To test the influence of diet, mothers were given oral supplements of vitamin K1.(ABSTRACT TRUNCATED AT 250 WORDS)     

Epstein-Barr virus-transformed B-cell line (DV-1) derived from bone marrow of a patient with severe combined immunodeficiency and immunoblastic lymphoma

An Epstein-Barr virus-transformed B-cell line derived from a patient with severe combined immunodeficiency who died of a lymphoreticular malignancy has been characterized. The line derived from bone marrow cultures and designated DV-1 shows surface and cytoplasmic IgM and staining with fluorescent monoclonal antibodies against immunoglobulin heavy and light chains mu, delta, and kappa, Dr, and several other B-cell surface antigens. DV-1 secretes IgM kappa and demonstrates monoclonality on analysis of immunoglobulin heavy and light chain gene rearrangement patterns. Incubation with either phytohemagglutinin or pokeweed mitogen failed to cause significant stimulation of proliferation of DV-1 and another EBV-transformed B-cell line derived from an immunologically normal host (LA-350), whereas incubation with Staphylococcus aureus Cowan strain 1 led to significant inhibition of DV-1 and LA-350. Rabbit IgG antibody specific for human immunoglobulin mu-chains produced a dose dependent stimulation of both lines. The responses of DV-1 and LA-350 to mitogens and anti-mu were not as high as those of normal peripheral blood lymphocytes. This spontaneously derived Epstein-Barr virus-transformed B-cell line from a patient with severe combined immunodeficiency demonstrated functional characteristics similar to a B-cell line derived from an immune competent host. While these cells spontaneously incorporate 200 times more thymidine than normal resting peripheral blood lymphocytes, they retain their ability to be modulated by antiimmunoglobulin, and staphylococcal Cowan strain 1, but are unresponsive to the effects of B-cell growth factor.     

Immune function during space flight

It is very likely that the human immune system will be altered in astronauts exposed to the conditions of long-term space flight: isolation, containment, microgravity, radiation, microbial contamination, sleep disruption, and insufficient nutrition. In human and animal subjects flown in space, there is evidence of immune compromise, reactivation of latent virus infection, and possible development of a premalignant or malignant condition. Moreover, in ground-based space flight model investigations, there is evidence of immune compromise and reactivation of latent virus infection. All of these observations in space flight itself or in ground-based models of space flight have a strong resonance in a wealth of human pathologic conditions involving the immune system where reactivated virus infections and cancer appear as natural consequences. The clinical conditions of Epstein-Barr-driven lymphomas in transplant patients and Kaposi's sarcoma in patients with autoimmune deficiency virus come easily to mind in trying to identify these conditions. With these thoughts in mind, it is highly appropriate, indeed imperative, that careful investigations of human immunity, infection, and cancer be made by space flight researchers.     

Effect of indoleamine 2,3-dioxygenase on induction of experimental autoimmune encephalomyelitis

Experimental autoimmune encephalomyelitis (EAE) is a T cell-mediated demyelinating disease of the central nervous system (CNS). Indoleamine 2,3-dioxygenase (IDO) is an enzyme that catabolizes tryptophan, which can result in the death of T lymphocytes. This effect of IDO is inhibited by 1-methyl-tryptophan (1-MT). We used a murine model of EAE to demonstrate: (1) opposing patterns of spinal cord IDO and interferon-gamma (INF-gamma) mRNA expression through the preclinical, acute and remission I phases of EAE; (2) a change in the kynurenine-to-tryptophan (K/T) ratio during these same phases; and (3) 1-MT-induced exacerbation of clinical and histologic disease parameters during EAE. These results suggest that IDO may contribute to the regulation of T cell activity associated with the different phases of this animal model of multiple sclerosis (MS).     

Elevated Serum Alpha Fetoprotein and Normal Liquor Alpha Fetoprotein Values in Association with an Abdominal Pregnancy

Summary: A case report is described in which abdominal pregnancy was misdiagnosed by ultrasound scanning as a pregnancy within a horn of a bicornuate uterus. Two serum alpha fetoprotein (SAFP) results were greatly elevated and an amniocentesis was performed, the liquor alpha fetoprotein (LAFP) and karyotype were normal. Elective Caesarean section was performed at 38 weeks for a persistent transverse lie and an abdominal pregnancy was found. The outcome was excellent for both the mother and child.
This is the first reported case of amniocentesis and measurement of LAFP in an abdominal pregnancy and confirms abdominal pregnancy as a rare cause of an elevated SAFP.     

Screening for a raised rectal temperature in Africa

The main purpose of this study was to compare rectal and axillary temperature measurements in African children. Altogether 573 sick children were seen in an outpatient setting in rural West Africa. Rectal and axillary temperatures were measured and the parent or guardian was asked if they thought that the child had a raised body temperature. Normal ranges were defined from an age matched population of 203 healthy children. A raised axillary temperature predicted a raised rectal temperature with a sensitivity of 98% and a specificity of 88%. The parents' impression that their child had a fever was a less sensitive (89%) and less specific (59%) indicator of raised rectal temperature. A raised axillary temperature is a good screening test for a raised rectal temperature in African children.     

Fibromatosis of bone in children

Radiographs, computed tomograms, and radionuclide bone scans were obtained preoperatively in three children with fibromatosis involving the bones and soft tissues of the extremities. Two of the children had identical scar-like bone lesions of the proximal tibia, which, to the authors' knowledge, have not been reported before in this disease. The lesions recurred in two children.