NON-IgE-MEDIATED ASTHMA IN CHILDREN

ABSTRACT. Among 586 children with asthma, 484 (82 %) were found to have IgE-mediated ("extrinsic") asthma, and seventy-two (12 %) non-IgE ("intrinsic") asthma. The remaining 30 patients (6%) were classified as "intermediate", as they had serum IgE within or above serum IgE levels of healthy children but no allergy to common allergens. During a three-year study period, the seventy-two patients with intrinsic asthma as opposed to 84 patients with extrinsic asthma had significantly 1) more hyperinflation of the lungs, 2) more episodes of acute hospital admissions due to asthma and/or pneumonia, 3) more elevated serum IgG and IgM, and 4) more cultures from secretions of lower airways of Haemophilus influenzae and pneumococci. Further, although treated with corticosteroids, eleven of the children with intrinsic asthma showed progressive disease, judged from fixed and/or declining forced vital capacity followed by signs of lung fibrosis on repeated pulmonary X-rays. It is emphasized that children with intrinsic asthma may represent an entity of childhood asthma, in some cases with severe progression of disease within a few years.     

Complex fractures of the proximal humerus: role of CT in treatment

The authors reviewed the computed tomography (CT) scans, plain radiographs, and subsequent treatment of 17 patients with complex proximal humeral fractures. CT scans and radiographs were compared in the demonstration of fracture lines, displacement of fracture fragments, rotation of fragments relative to their normal positions, and status of the head and articular surface of the humerus. The impact of CT findings on the decision to treat with surgery versus closed reduction and on the choice of surgical procedure was assessed. Surgery was not performed in nine patients because CT scans showed no significant displacement of fragments previously judged displaced or "indeterminate" on radiographs. Surgery was performed in eight patients; CT demonstrated significant abnormalities not definitely shown with radiography. In six of these eight patients, CT scans demonstrated unsuspected abnormalities that directed the choice of surgical procedure. CT scans provide clinically useful information for the treatment of complex proximal humeral fractures when radiographs provide inadequate or indefinite information.     

FUNCTIONAL RESPONSES OF THE RAT ISOLATED SEMINAL VESICLE TO ELECTRICAL FIELD STIMULATION: A PHARMACOLOGICAL ANALYSIS

• 1 Electrical field stimulation (EFS) of the rat isolated seminal vesicle elicited frequency-dependent and tetrodotoxin sensitive contractions which were unaltered by hexamethonium or mecamylamine.
• 2 Prazosin alone was not sufficient to abolish these responses, but a combination of atropine and prazosin was fully effective, indicating involvement of both noradrenergic and cholinergic mechanisms.
• 3 Responses were predominantly cholinergic (blocked by atropine, potentiated by ecothiopate but not significantly altered by prazosin or guanethidine) at 1–8 Hz but became increasingly noradrenergic (blocked by prazosin or guanethidine but relatively unaltered by atropine or ecothiopate) with increasing frequencies of stimulation.
• 4 Electrical field stimulation of seminal vesicles removed from reserpine or 6-hydroxydopamine (6-OHDA)-pretreated rats produced contractions that were clearly cholinergic in nature.
• 5 After exposing the seminal vesicles to guanethidine, or after pretreatment of rats with 6-OHDA, responses to EFS remained, indicating that activation of discrete cholinergic and noradrenergic innervations seem to underlie the contractile responses observed.
• 6 Yohimbine and prazosin potentiated the predominantly cholinergic responses at 1,2 and 4 Hz in tissues from untreated rats, but not in those from animals pretreated with reserpine or 6-OHDA, indicating the possibility of an interaction between the two innervations.
• 7 No inhibitory responses to EFS could be demonstrated in tissues precontracted with KCI in the presence of a combination of atropine and prazosin suggesting the absence of a non-adrenergic, noncholinergic inhibitory innervation.

     

Genetic and physical mapping of the McKusick-Kaufman syndrome

McKusick-Kaufman syndrome is a human developmental anomaly syndrome comprising mesoaxial or postaxial polydactyly, congenital heart disease and hydrometrocolpos. This syndrome is diagnosed most frequently in the Old Order Amish population and is inherited in an autosomal recessive pattern with reduced penetrance and variable expressivity. Homozygosity mapping and linkage analyses were conducted using two pedigrees derived from a larger pedigree published in 1978. The PedHunter software query system was used on the Amish Genealogy Database to correct the previous pedigree, derive a minimal pedigree connecting those affected sibships that are in the database and determine the most recent common ancestors of the affected persons. Whole genome short tandem repeat polymorphism (STRP) screening showed homozygosity in 20p12, between D20S162 and D20S894 , an area that includes the Alagille syndrome critical region. The peak two-point LOD score was 3.33, and the peak three-point LOD score was 5.21. The physical map of this region has been defined, and additional polymorphic markers have been isolated. The region includes several genes and expressed sequence tags (ESTs), including the jagged1 gene that recently has been shown to be haploinsufficient in the Alagille syndrome. Sequencing of jagged1 in two unrelated individuals affected with McKusick-Kaufman syndrome has not revealed any disease- causing mutations.      

AN EPIDEMIOLOGICAL STUDY OF A DANISH SCHOOL POPULATION

ABSTRACT. A study was performed on a Danish school population to obtain reference values of the following serum lipids: total lipid, phospholipid, cholesterol, glycerol and triglyceride. 92 % of 630 children participated, but 23 were excluded following clinical examination. Thus values are given for 301 girls and 274 boys aged 8 to 17 years.     

AN EPIDEMIOLOGICAL STUDY OF A DANISH SCHOOL POPULATION I. Reference Values for Serum Lipids Based on a Clinical and Biochemical Study of 284 Girls and 268 Boys

Abstract. A study was performed on a Danish school population to obtain reference values of the following serum lipids: total lipid, phospholipid, cholesterol, glycerol and triglyceride. 92% of 630 children participated, but 23 were excluded following clinical examination. Thus values are given for 301 girls and 274 boys aged 8 to 17 years.