A changing pattern of cerebral palsy and its implications for the early detection of motor disorders in children

Hemiplegic cerebral palsy is appearing as the commonest cerebral palsy syndrome found at the Yorkshire Regional Child Development Centre, Leeds, and in the majority of cases does not follow a definable perinatal injury. As a practical consequence of this changing pattern of cerebral palsy a large proportion of these children will now be detected at 'well baby' clinics rather than at hospital neonatal 'at risk' clinics. As lack of awareness of the signs of cerebral palsy in the young infant lead to delay in detection and management, the early signs of congenital hemiplegia are discussed.     

EFFECT OF ACUTE MYOCARDIAL INFARCTION ON PITUITARY-TESTICULAR FUNCTION

The effect of acute myocardial infarction on the secretions of LH, FSH and testosterone was studied in thirteen male patients. Plasma testosterone fell transiently on the fourth day after acute myocardial infarction. This was accompanied by a rise in LH on the same day which persisted for a week after infarction. Serum FSH showed no significant change. The data suggest that following the medical stress of myocardial infarction, testosterone concentration was suppressed resulting in a compensatory rise in LH.     

Treatment of intermittent claudication

Our experience of twenty-eight patients with intermittent claudication treated by means of paravertebral lumbar somatic nerve block is presented. There was immediate demonstrable improvement in 92-5% of the twenty-six patients included in this follow up. At the end of 6 months the improvement was maintained in 72-7% of the patients and in about 70-0% of patients at 6 months and at 9 months. Six of the seven patients followed up for 1 year had a claudication distance at least twice that prior to the block. The results of this indicate that lumbar somatic nerve block is less disturbing and more effective than other forms of conservative treatment for intermittent claudication.     

DOWN'S SYNDROME WITH X0/XY MOSAICISM

Abstract. A 5-month-old Chinese infant with combined Down's syndrome and X0/XY mosaicism is presented. The phenotypical features of mongolism are classical and unmodified. The somatic effects of X0/XY mosaicism is that of incomplete masculinization with short phallus, hypospadias, bifid scrotum, urogenital sinus, and bilateral extra-abdominal infantile testicles. These features together with the absence of internal female organs and signs of Turner's syndrome in this patient are different from the previous reported cases of mixed gonadal dysgenesis.     

A new microparticle size calibration standard for use in measuring smaller microparticles using a new flow cytometer

Summary. Background: Microparticle size measurements are often calibrated on flow cytometers using polystyrene microspheres that forward scatter more light vs. particle diameter than cellular microparticles. Methods: We compared theoretical with measured forward angle light scattering on the LSRII, FC500 and Apogee A40 using polystyrene and silica microspheres vs. synthetic lipid vesicles and platelets, then compared plasma microparticle counts using different calibration strategies. Results: Polystyrene and silica microspheres with higher refractive indices forward scattered more light with a wavelength of 488 nm for a given size microparticle than did lipid vesicles or platelets. The LSRII and FC500 did not count many, and were unable to separate by size, polystyrene microspheres < 0.5 μm in diameter. On the Apogee A40, polystyrene microspheres could be separated by size down to 0.2 μm, and a polystyrene microsphere 0.4 μm in diameter produced the same forward scatter relative intensity as a 1‐μm lipid or cellular microparticle. Using the new calibrator, the Apogee A40 found 80 000–4 000 000 μL^?1 total microparticles, 11 000–350 000 μL^?1 annexin V positive microparticles and 6000–350 000 μL^?1 platelet microparticles < 1 μm in plasma samples. Conclusions: The Apogee A40 was able to resolve size differences in polystyrene microspheres down to 0.2 μm and microparticles down to 0.4 μm. On the Apogee A40 we propose using a 0.4‐μm polystyrene microsphere as equivalent to a 1‐μm cellular microparticle for size calibration. Using this calibrator, the Apogee A40 detected higher numbers of total, platelet and annexin V positive microparticles than were found using a Megamix gate.     

EFFECT OF SURGICAL STRESS ON PITUITARY-TESTICULAR FUNCTION

The effect of surgical stress on the secretions of LH, FSH, testosterone (T) and oestradiol (E2) were studied in twelve male patients. During surgery LH rose significantly; post-operatively, LH fell but remained persistently elevated a week after operation. However, T and E2 fell progressively to a nadir on the second and fifth post-operative day respectively and remained suppressed. Serum FSH showed no significant change. Despite a post-operative decrease in sex hormone binding globulin (SHBG) binding capacity, non-SHBG bound T showed a decrease parallel to T. Multiple sampling studies showed that the secretions of LH were increased and that of T were decreased post-operatively. Following surgery, LH responses to LHRH were magnified, FSH and T responses showed no significant change when compared with the pre-operative responses. These data suggest that secretions of LH were increased during surgery. Following surgical stress, T and E2 concentrations were suppressed resulting in a compensatory elevation of LH concentrations.