Growth in early treated congenital hypothyroidism

The growth of 361 children with congenital hypothyroidism diagnosed by screening was assessed by estimating mean values for height, weight, body mass index (BMI), and head circumference on each birthday up to the age of 4 years. In the group of children with severe congenital hypothyroidism (pretreatment plasma thyroxine < or = 30 nmol/l), the mean heights at 1 and 2 years were less than standards for healthy children, but this may be due to technical factors related to difficulties in measuring young infants and the method used to estimate height on each birthday. By the age of 3-4 years the values for mean height in the children with either severe or less severe congenital hypothyroidism were equal to or greater than those for healthy children. At all ages mean head circumference in boys and girls with severe congenital hypothyroidism was greater than standards for healthy children, but this only reached statistical significance in girls at 1 year. With the exception of the results for boys at 1 year, mean values for BMI were slightly greater in the children with severe congenital hypothyroidism. The mean BMI results for children with either severe or less severe congenital hypothyroidism were significantly greater than those for healthy French children at all ages, but they showed the same trends with increasing age. It is concluded that by the age of 3-4 years stature is essentially normal in children with early treated congenital hypothyroidism but that the increased head size reported before screening may still be evident in early infancy.     

Diabetes insipidus with impaired osmotic regulation in septo-optic dysplasia and agenesis of the corpus callosum

The clinical and endocrinological findings in 24 children with septo-optic dysplasia and/or agenesis of the corpus callosum are described with particular reference to posterior pituitary function. Nine had diabetes insipidus. The prevalence of diabetes insipidus was similar in children with complete and incomplete forms of septo-optic dysplasia. Maintenance of normal osmotic balance was very difficult in six of these children, even after the introduction of treatment with vasopressin, either as desmopressin, or lysine vasopressin spray in one of the early cases.     

OBJECTIVE VERIFICATION OF TETANUS IMMUNE STATUS IN AN APPARENTLY NON-IMMUNE POPULATION

SUMMARY Patients who are not known to be immunised to tetanus are considered to be non-immune. The appropriate treatment is the commencement of active immunisation with a course of three tetanus toxoid inoculations; if the wound is considered to be tetanus-prone, 250 IU of human anti-tetanus immunoglobulin is given concurrently. This study determined the true immune status of 166 patients who were considered to be non-immune on the basis of the available history. The majority (90 of 166) had protective levels of immunoglobulin (greater than 0.06 IU/ml) and further treatment was not indicated. Only two patients were non-immune. The remainder had protective levels (between 0.01 and 0.06 IU/ml) and required a tetanus toxoid booster.     

T lymphocytes specific for immunoglobulin allotype. II. Cloned Igh-1(b)- specific cytotoxic T cells

This study describes long-term-cultured lines and clones of cytotoxic T cells (Tc) with specificity for determinants of the Igh-1(b) immunoglobulin allotype. These Tc clones were initiated by repeated stimulation of immune spleen cells from BALB/c mice with an Igh-1(b)-producing myeloma, and then they were maintained in medium supplemented with mitogen-induced growth factors in the absence offurther antigenic stimulation . The lytic potency of these clones was 30-100-fold greater than the primary cultures from which they were derived, and specificity studies showed them to be lytic for Igh-1(b) targets and not for targets expressing Igh-1(a) or Igh-4(b), nor the lipopolysaccharide blasts . Finally, soluble preparations of Ig were tested for their ability to block lysis of labeled Igh-1(b)-expressing targets. The results showed that Igh-1(b) and not other immunoglobulin allotypes or isotypes could block lysis, and that the mechanism of lytic inhibition is due to Igh-1(b)-induced autolysis of the killer cells.     

Clinical significance of white cell antibodies in febrile nonhemolytic transfusion reactions

Febrile nonhemolytic transfusion reactions (FNHTRs) are associated with white cell (WBC) antibodies. The purposes of this study were to determine the frequency of WBC antibodies, to associate the severity of reactions with antibody specificity, and to distinguish FNHTRs from infection and postoperative fever. By using the granulocyte indirect immunofluorescence test in conjunction with lymphocytotoxicity testing, it was found that 70 percent of FNHTRs in 24 patients involved WBC antibodies. The remaining 30 percent of apparent FNHTRs were associated with infections and postoperative fever. Granulocyte-specific antibodies were as prevalent as HLA antibodies and were associated with the severest reactions. Because FNHTRs occur with granulocyte-specific antibodies, HLA antibodies, and possible monocyte-specific antibodies (untested in this and other studies), these reactions could be grouped together as WBC-associated reactions.     

应用无支架Medtronic生物瓣行主动脉瓣替换

评估无支架Ｍｅｄｔｒｏｎｉｃ生物瓣作主动脉瓣替换的安全性和临床效果。方法以冠状动脉开口下方植入技术用无支架Ｍｅｄｔｒｏｎｉｃ生物瓣作主动脉瓣替换共８５例。易除左、右冠状动脉空运保留完整的无冠窦,全部采用连续缝合方法。结论无支架Ｍｅｄｔｒｏｎｉｃ生物瓣作主动脉瓣替换效果良好,适用于年龄超过７５岁以及伴有狭小动脉根部的病人。