The Ask-Upmark kidney in a premature infant.

A premature infant with segmental hypoplasia of one kidney is reported. Since 1929 when Ask-Upmark first reported this renal anomaly and its association with hypertension, the nature of the lesion has remained in doubt. The question whether it is acquired post-natally or whether it is a developmental mal-formation has not been resolved. The case which we now report clearly documents the prenatal development of the lesion as well as its association with arrested nephrogenesis and the presence of abnormal vasculature. The cause of these changes is not clear, but it is suggested that ureteral reflux was present.     

Professional responsibility: Confronting sexual abuse of people with disabilities

Confronting sexual abuse of people with disabilities has recently become a challenge for health professionals. This paper discusses issues of professional responsibility in three areas; clinical, management, and personal issues. Prevention of sexual assault is seen as a primary professional obligation. An outline is offered for development of a systematic approach to deal with the problems of sexual abuse within an institutional setting.     

Effect of D- and/or L-aspartic acids on feeding,drinking, urine outflow and core temperature

Rats were given D- and/or L-aspartic acids (Asp) in saccharine solution for one week. Body weight gain, daily food and fluid intake, weight of faeces, urine outflow and osmolality, and rectal temperature were compared with those of the pretreatment period. After the rats had been sacrificed the weights of liver, spleen and kidney were estimated and compared with those of the control. The long-term oral administration of D-Asp caused a significant decrease in the weights of total body, liver and kidney, in the daily food and fluid intake, in the weight of faeces and in the volume of urine. The osmolaiity of urine of the rats administered D-Asp was significantly higher than that of the control. The concomitant oral administration of L-Asp seemed to antagonize the effects of D-Asp.     

Effect of systemic and intracortical administration of phenytoin in two genetic models of absence epilepsy

1. Spontaneous 7-10 Hz spike-wave discharges (SWDs) are the electroencephalographic hallmark of absence seizures, as can be observed in WAG/Rij as well as in GAERS, two commonly used well-validated genetic rat models of absence epilepsy. A local upregulation of sodium channels within the perioral region of the primary somatosensory cortex indicated an initiation site for SWDs in WAG/Rij rats, in line with a new theory that assumes that SWDs have a cortical focal origin in the perioral region of the somatosensory cortex. We tested whether bilateral microinfusion at this focal site of the sodium channel blocker phenytoin, which is known to aggravate SWDs after systemic administration, reduces SWDs in both models. 2. WAG/Rij rats and GAERS, chronically provided with cortical EEG electrodes and bilateral cortical cannula's, were used. The EEGs were recorded before and after or systemic or bilateral infusion of phenytoin. 3. Microinfusion of phenytoin at the perioral region of the somatosensory cortex produced an immediate cessation of seizure activity in WAG/Rij rats, while systemic injection produced an increase in both genetic models. Microinfusion of the same and higher concentrations of phenytoin in GAERS at the same stereotactic coordinates showed no effect. Phenytoin was effective in GAERS 2 mm more posteriorly.4. The data suggest that both genetic models have a cortical area at which diametrically opposite effects of phenytoin can be found compared to systemic injections: a decrease after local microinfusion and aggravation after systemic administration, although the exact cortical location may be different. Moreover, a deficit in sodium channels might be an ethiological factor underlying an increased probability for the initiation of SWDs in the somatosensory cortex.     

Unilateral nodular diabetic glomerulosclerosis (Kimmelstiel-Wilson): report of a case

A unique case of unilateral nodular diabetic glomerulosclerosis is described. It occurred in a patient with arteriosclerotic occlusion of the main renal artery and ischemic atrophy of the uninvolved kidney. The purpose of reporting this case is to draw attention to some factors that seem to be important in the pathogenesis of diabetic glomerulosclerosis.     

Altered blood group expression in a patient with congenital rubella infection

An infant with probable congenital rubella infection developed altered blood group expression. This was noted at 4 months of age. The child's blood was typed on seven separate occasions during the first 8 weeks of life as type A, but on repeat testing, her cells failed to agglutinate with anti-A and anti-A,B typing serum. The A antigen was present, however, because an eluate made after incubating her red cells with anti-A contained anti-A, and A antigen was demonstrated on buccal mucosa cells. Altered expression of blood group A (loss of agglutinability) has occurred previously only in association with hematologic malignancy.