Effects of growth hormone therapy in prepubertal children with short stature secondary to intrauterine growth retardation

A total of 130 short children were included in a French multicentre study and randomized between a control group (group A) and two groups treated with daily subcutaneous injections of GH at doses of 0.7 IU/kg/week (group B) and 1.4 IU/kg/week (group C) for 2 years. Height velocity was significantly increased ( p <0.0005) in groups B and C, with a greater increase in group C than in group B ( p < 0.001). The benefit after 2 years compared with controls was 4.3 cm in group B and 5.9 cm in group C. The rate of bone maturation was not affected by GH therapy. These results led to the conclusion that 2 years of treatment with GH improves final height prognosis in children with short stature secondary to IUGR, and that this effect is dose dependent. The effect on final height has still to be demonstrated.     

Mseleni joint disease in 1981: decreased prevalence rates, wider geographical location than before, and socioeconomic impact of an endemic osteoarthrosis in an underdeveloped community in South Africa

Mseleni joint disease (MJD), an endemic osteoarthrosis, was first described in 1970, localized to Kwa Zulu, South Africa. In 1981 another survey was conducted (1) to see whether prevalence had changed, (2) to estimate the prevalence in areas not previously surveyed and (3) to estimate its socioeconomic impact. A 5% stratified random sample of homesteads was selected and five local interviewers surveyed 333 kraals, interviewing 333 individuals, obtaining information on 3368 live members of these homesteads. Overall prevalence rates were 7.4% in 1566 females and 3.0% in 1179 males (age or sex unknown in 623). The previously affected area still had the highest prevalence rates, but they were significantly lower than before, even if only residents of at least ten years' duration were considered. These consistently lower age-specific prevalence rates are compatible with a decline in incidence rate, possibly because of disappearance of an environmental causal agent. Prevalence rates for females in some areas not previously surveyed were between 5 and 10%, suggesting that a larger area than stated before is affected. The proportions of severely disabled individuals are the same as reported in 1973 but greater in number considering the larger area affected. Of these, an estimated 67% of males and 47% of females are not receiving disability grants. Fifty per cent of children (aged 6-25 years) of affected parents have had no schooling compared with 30% of children of unaffected parents. This study also highlighted several methodological problems unique to rural research. It is suggested that while aetiological research should continue, the existing prevalence of MJD has major social, economic and health care implications, for which solutions should be researched as a high priority.     

Colorectal hemangioma: radiologic findings

The authors correlated radiographs with the clinical and histologic data of 12 patients with colorectal hemangioma. All patients presented with rectal bleeding, which was chronic in seven. Phleboliths were also visible in seven cases, which correlated with chronic bleeding in five. On barium studies, three masses were soft and three produced rigid narrowing. The atypical features of rigid luminal narrowing, which might mimic a carcinoma, and hypovascularity correlated with chronic bleeding or visible phleboliths, which suggest the correct diagnosis of colorectal hemangioma.     

汉族志愿者阿米替林代谢与异喹呱羟化代谢的关系

8名男性健康志愿者po阿米替林100 mg后,以阿米替林及其3种代谢物的血浓度曲线下面积(AUC₀^∞)计算阿米替林的脱甲基化代谢及羟基化代谢能力。结果提示个体间阿米替林及其3种代谢物的AUC差异很大。其中7名志愿者测定异喹呱羟化代谢表型,6例为异喹呱强代谢者,1例为弱代谢者。尿中异喹呱的羟化代谢率与阿米替林的羟基化代谢率、阿米替林和10-羟基阿米替林的AUC₀^∞呈显著相关。阿米替林总血浆清除率与异喹呱羟化代谢率呈弱相关。此结果表明阿米替林和异喹呱的羟化代谢可能由同一酶控制,阿米替林的羟基化代谢和脱甲基化代谢可能为两个独立的代谢途径。     

Failure of ablation of a mediastinal parathyroid adenoma by repeated contrast staining

In a patient with primary hyperparathyroidism an attempt was made to ablate a middle mediastinal parathyroid gland by forceful staining with radiographic contrast material. The gland was stained on two separate occasions, two weeks apart. Both times the serum calcium level temporarily fell to the normal range but reverted to abnormal levels. The patient ultimately required surgery for correction of hypercalcemia. The mechanism of staining and possible reasons for failure as well as potential complications are discussed.     

The incidence of infections in compromised patients at Groote Schuur hospital. An autopsy study.

The results of a retrospective autopsy study of 115 adult patients with haematological or lymphoreticular malignancies or who had undergone transplantation procedures, are presented. The overall incidence of infection was 65%, 123 infections being detected in 75 patients. The bulk of the infections involved the gastro-intestinal and respiratory systems, other systems being considerably less frequently affected. Patients who had received allografts and subsequent immunosuppression had the highest incidence of viral inclusions, especially cytomegalovirus. Candida infections were more common than aspergillosis, and severe fungal infections were most frequent in patients with acute leukaemia who had been treated aggressively. The only other mycosis detected was cryptococcosis. Bacterial pneumonia was the most frequent infection over-all (36%). Tuberculosis, pyelonephritis and Pneumocystis pneumonitis were also encountered.