Primary Bone Tumours of the Pelvis in Childhood—Ewing's Sarcoma of the Ilium,Pubis and Ischium. (Report of 30 cases) (Part I)

30 children with Ewing's sarcoma, the most common malignant pelvic tumour in childhood, were analysed. The diagnosis of Ewing's sarcoma is relatively easy and can be established in most of the cases on plain radiography. The diagnostic radiographic features of the tumour are discussed. The two most important conditions in differential diagnosis are eosinophilic granuloma and the rare primary bone lymphoma. Osteomyelitis should rarely cause confusion unless the clinico-radiographic findings are not properly evaluated.     

COMPARISON OF ATRACURIUM-INDUCED NEUROMUSCULAR BLOCKADE IN NEONATES, INFANTS AND CHILDREN

The potency of atracurium was determined in neonates, infantsand children during thiopentone–fentanyl–nitrousoxide in oxygen anaesthesia using single dose–responsecurves. The effective doses producing 50% depression of thefirst twitch of the train-of-four were significantly lower inneonates and infants than in children (82 and 112 v. 135 µgkg^–1). Following a standard dose of atracurium 0.5 mgkg^–1, 95% depression of the first twitch occurred morerapidly in neonates than in children (0.9 v. 1.4 min), whilerecovery to 10% of the control twitch height occurred more rapidlyin neonates than in the other two groups (22.7 v. 29.7 and 28.6min). It is concluded that neonates and infants require lessatracurium to produce a given degree of neuromuscular blockadecompared with older children. However, prompt recovery can beexpected in all healthy paediatric patients following a standardintubating dose of atracurium 0.5 mg kg^–1.     

ALCOHOL ENHANCES VITAMIN C EXCRETION IN THE URINE

Urinary ascorbic acid excretion was measured on four consecutivedays in 9 normal male volunteers for 4 hr before and after drinkingnothing (control), 0.58 g alcohol/kg body wt as whisky or lageror water (11./70 kg body wt). The normal reduction in ascorbicacid excretion under control conditions was abolished by drinkingwater. Alcohol in either form produced a 47% increase in urinaryascorbic acid excretion. A similar ascorbiuresis in chronicalcoholics would be an additional factor in the causation ofvitamin C deficiency in these patients.     

A Study of the Menopause, Smoking, and Contraception in Women with Crohn's Disease

One hundred and ninety-six women with Crohn's disease from south-eastWales were asked to provide details of their menstrual cycles,age at menopause, history of surgery, smoking habits and useof oral contraceptives. One hundred and forty-six provided theinformation (response rate 77 per cent). Eighty-four were stillmenstruating, three were pregnant, 10 had undergone hysterectomy,one had a pharmacologically-induced menopause and 48 had hada physiological menopause. Of these 48 women, 33 were diagnosedas having Crohn's disease before the menopause. Twenty-fiveof these were smokers. The mean age at menopause was similarin smokers and non-smokers and in those diagnosed before andafter the menopause. The mean age at menopause was between 46and 47. A logistic analysis using the ‘status quo’method showed that 50 per cent of women with Crohn's diseasehad the menopause at 47.6 years compared with 49.6 years ina group of healthy women from the same area. The two groupshad similar smoking habits and it would seem that a prematuremenopause is associated with Crohn's disease.     

RADIOLOGICAL EROSIONS IN FROZEN SHOULDER

Erosions of the humeral head can occur in the frozen shoulder,with or without other radiological features. True erosions needto be distinguished from radiographic projectional artefacts.The presence of an erosion does not affect the prognosis adversely KEY WORDS: Humeral head erosion, X-rays, Capsulitis     

PLASMA INHIBIN LEVELS IN MEN WITH CHEMOTHERAPY-INDUCED SEVERE DAMAGE TO THE SEMINIFEROUS EPITHELIUM

Immunoreactive plasma inhibin levels and free testosterone index (FTI) were estimated in 17 patients who had previously received combination chemotherapy for Hodgkin's disease and in 16 age-matched controls. In the same patients we had previously found significantly raised FSH and LH levels in the presence of normal basal and HCG-stimulated total testosterone levels. Mean plasma inhibin levels were not different between the patients (601 +/- 321 U/l) and controls (530 +/- 174 U/l) nor were FTI values (81.5 +/- 35 vs 91 +/- 47 respectively). There was a positive correlation (r = 0.53, P less than 0.05) between FSH and inhibin levels and a negative correlation between FSH and FTI (r = -0.51, P less than 0.05) in the patients but not in the controls. No such correlations with inhibin or FTI existed for LH but there was a positive correlation between LH and FSH levels in the patients. In four patients inhibin levels were pathologically raised and in this group mean FSH values (21.7 +/- 4.7 IU/l) were higher (P less than 0.001) and mean FTI (59.1 +/- 22.6) lower (P less than 0.001) than respective values (13.6 +/- 5.3 IU/l and 88.4 +/- 35) for the remainder of the patients. These data are not compatible with the hypothesis that inhibin is the major negative feedback signal for the control of FSH secretion.     

Exhaled nitric oxide concentration and amniotic fluid nitrite concentration during pregnancy

Abstract. We have assessed fetal and maternal nitric oxide (NO) production in pregnancy. Exhaled NO and amniotic fluid nitrite concentrations were measured by chemiluminescence between 10 and 42 weeks of pregnancy. Exhaled NO concentrations did not alter significantly during gestation. In contrast, there was a significant change in mean amniotic fluid nitrite concentration in late pregnancy ( P < 0.001). The finding of decreased amniotic nitrite concentrations after 37 weeks of gestation support the hypothesis that reduced NO production may contribute to increased uterine activity in late pregnancy.     

Synthesis and in vitro activities of new tryptophan-modified and thiomethylene-containing pseudopeptide antagonists of the neurokinins

A series of pseudopeptide analogs of the substance P-like hexapeptide Ava-Phe-Phe-Gly-Leu-Met-NH₂ was produced by N_α-protection, introduction of the thiomethylene bond, of d - and non-proteinogenic amino acids, and alteration of the side chain of tryptophan. Synthesis of the pseudopeptides on a solid phase was successfully improved by direct formation of the CH₂—S bond on the resin. However, while thiomethylene formation between leucine and norleucine led to the expected SS diastereoisomer, the major product of the similar coupling between two phenylalanines was the SR isomer. An improved resistance of the analogs to proteolysis was observed, which could be related to the structural changes. Interestingly, these modifications led to three water-soluble and potent neurokinin antagonists on classical in vitro bioassays.