HEREDITARY SYNDROME CONSISTING IN RECURRENT ATTACKS RESEMBLING BRACHIAL PLEXUS NEURITIS, SPECIAL FACIAL FEATURES, AND CLEFT PALATE

ABSTRACT. Erikson, Anders (Department of Paediatrics, Centrallasarettet, Boden, Sweden). Hereditary syndrome consisting in recurrent attacks resembling brachial plexus neuritis, special facial features, and cleft palate. Acta Paediatr Scand, 63: 885, 1974.—A father and his two daughters with recurrent reversible attacks resembling brachial plexus neuritis are presented. In this family cleft palate and a previously described characteristic facial appearance accompanied the disorder. No other abnormalities nor any specific cause of the attacks were found. EMG of shoulder, arm and hand muscles revealed signs of partial denervation. Physiotherapy seemed to accelerate the spontaneous recovery. The condition has a better prognosis than some similar disorders for which it is easily mistaken.     

Medial Histocompatibility Antigens

Medial histocompatibility (H) antigens are weak H antigens, recognized by unrestricted T cells; they differ thus from both major and minor H antigens. An example, Qed-1, is described in detail, and other known medial H antigens of the mouse are reviewed. The structural and genetic relationships of major and medial H antigens and their role in T cell recognition are discussed.     

INFLUENCE OF PREMEDICATION ON PLASMA ACTH AND CORTISOL CONCENTRATIONS IN CHILDREN DURING ADENOIDECTOMY

The endocrine response to stress, as reflected by the plasmaconcentrations of ACTH and cortisol, was investigated in 14children receiving two different premedications during halothaneanaesthesia for adenoidectomy. Seven children (group A) werepremedicated with diazepam 5mg rectally and atropine 0.3–0.4mgsublingually and seven (group B) received a rectal combinationof diazepam O.5mgkg^–1, morphine 0 15mgkg^–1 and hyoscine0.01 mg kg^–1. Before and after surgery plasma concentrationsof ACTH and cortisol were lower in group B than in group A.In group A mean values for ACTH increased from 4O.7nglitre^–1before adenoidectomy to 352.9 nglitre^–1 (P<0.001) afteradenoidectomy. The corresponding increase in group B was from12.1 nglitre^–1 to 82.1 nglitre^–1 (P<0.01). Ingroup A mean cortisol concentrations increased from 235.7 nmollitre^–1 to 655.7 nmol litre^–1 after adenoidectomy(P< 0.001) and in group B from 121.4 nmol litre^–1 to427.9nmol litre^–1 (P<0.01). End-tidal carbon dioxidetension was approximately the same in both groups. It was concludedthat the combination of diazepam, morphine and hyoscine decreasedthe endocrine response to stress     

FATAL ACCIDENTAL HYPOTHERMIA AND ALCOHOL

A series of 51 fatal cases of accidental hypothermia in northernSweden has been reviewed. The cases conform well to previousinvestigations with respect to the mean age of the victims (48years) and a predominance of males. The cases occurred mainlyduring the winter months and on Saturdays. Most cases succumbedat temperatures below –10°C. The most frequent necropsyfindings were areas of frostbite with purple discoloration ofthe skin, reddish lividity and superficial erosions of the gastricmucosa. Paradoxical undressing was present in more than halfof the cases. About two thirds of the cases were under the influenceof alcohol with a mean blood alcohol concentration of 1.6 g/l.Furthermore, at least half of the cases could be consideredhabitual drunkards. In condusion, the present series shows twomain groups of fatal hypothermia victims: one group of elderlypersons, mostly chronic abusers and under the influence of alcohol(approximately two-thirds of the series), and another of youngerand sober persons, performing recognised sporting activities(approximately one-fourth of the series).     

Platelet Counts in Myocardial Infarction,Angina Pectoris and Peripheral Artery Disease

ABSTRACT Serial determinations of peripheral venous platelet counts were performed in 43 consecutive patients with acute chest pain. On admission, patients with acute myocardial infarction (AMI) had a significantly lower mean platelet count (p<0.05) than patients without AMI, whereas hematocrit was higher (p<0.025). Thereafter a further reduction was seen with steadily reduced platelet counts by about 20%, both in comparison with healthy controls (p<0.001) (n=113) and patients with peripheral artery disease (PAD) without heart symptoms (p<0.005) (n=54). The platelet number increased one week after admission and even thrombocytosis was observed. The changes in platelet number during AMI seem to parallel the changes in platelet function. Patients with PAD had normal mean platelet counts. Female patients as well as healthy subjects had significantly higher values than men (p<0.01).     

Long-term Effects of Captopril and Atenolol in Essential Hypertension

ABSTRACT Fifty patients with mild or moderate essential hypertension were randomized (double-blindly) to treatment with either captopril (n=26) or atenolol (n=24). Their mean supine diastolic blood pressure after placebo was 100–125 mmHg. The study included an initial dose finding phase (12 weeks) during which the dosages of captopril and atenolol were increased stepwise every second week in order to obtain normotension (supine diastolic blood pressure <95 mmHg). Hydrochlorothiazide was added when necessary. During the second phase of the study the patients were followed on active treatment for 2 years. After the initial 12 weeks of active treatment, recumbent and standing blood pressures had fallen significantly both in the captopril group (by 31/20 and 33/19 mmHg, p<0.001) and in the atenolol group (by 24/18 and 30/20 mmHg, p<0.01 (systolic), p<0.001 (diastolic)). The antihypertensive effect was maintained in both groups during long-term treatment. The antihypertensive effect of both agents was potentiated to the same extent by addition of hydrochlorothiazide. Side-effects were few and mild. It can be concluded that both captopril and atenolol are safe and effective antihypertensive drugs.     

Out-patient antihypertensive drug utilization and stroke mortality: An ecological study

Directly age-standardized rates of out-patient utilization ofantihypertensive drugs (antihypertensives, diuretics and beta-blockers)and stroke mortality in men and women (40–79 years ofage) were compared over 4 years (1987–1990) in a midwestern(Värmland) and a southern (Skäne) province of Swedenand in their 49 (16 + 33) municipalities. In both genders, thestroke mortality and utilization rates of the 3 antihypertensivedrug groups, both combined and separate, were higher in Värmlandand there were positive correlations between these rates whenall 49 municipalities were compared. On the other hand, foreach province and each drug group there were municipalitieswith every possible combination of stroke mortality and antihypertensivedrug utilization rates. In addition, antihypertensive drug utilizationrates were similar in men and women even though the stroke mortalityrates were much lower among the latter. The findings cast doubton the effectiveness of antihypertensive drug treatment in commonpractice.     

Mouse Alpha-fetoprotein: Genetic Studies

The genetic control of alpha-fetoprotein (AFP) synthesis in the mouse is studied. Structural variants of mouse AFP have not yet been found, although 22 inbred strains have been tested for the presence of such variants. In constrast, a mouse strain has been found, in which the regulation of AFP synthesis is altered. In this mouse strain the rate at which AFP synthesis is turned off after birth is decreased, as compared to other inbred mouse strains. This property is controlled by a single recessive Mendelian gene, which has been called Raf (for regulation of a lpha- f etoprotein synthesis). The conclusion that Raf is a single recessive Mendelian gene is supported both by genetic data published previously and by new genetic data presented in this paper. The Raf gene not only controls the rate at which AFP synthesis is turned off after birth, but also controls the amount of AFP produced under conditions of liver regeneration. Thus, characterization of the Raf gene can shed light both on the mechanism that turns off AFP synthesis after birth and on the mechanisms that control regeneration of the liver.