INTENSIVE CARE OF SMALL PREMATURE INFANTS: I. Clinical findings and results of treatment

Clinical findings and results of treatment in a series of 49 premature infants with birth weights between 850 and 1250 g are presented. The “intensive care” included nursing in incubators with high environmental humidity maintaining skin temperature at 36.5°C, umbilical catheterisation (both arterial and venous), intravenous glucose infusions, correction of metabolic acidosis by rapid sodium bicarbonate infusions, oxygen therapy and finally endotracheal intubation and mechanical ventilation. The series was divided into 3 categories according to the severity of respiratory symptoms. There was only one survivor out of 12 cases in the category of severe RD, whereas 14 of 21 with moderate RD and 9 of 16 with slight or no RD survived. The overall survival rate was 45%. The correlation between clinical findings, arterial blood gases and pH, chest X-rays, response to treatment and outcome in each of the 3 categories is discussed. The preliminary data from our follow-up studies indicate that there are only a few cases showing signs of permanent brain injury at the age of two years.     

Children in Sauna: Electrocardiographic Abnormalities

ABSTRACT. We studied changes in ECG in 81 children and 20 adolescents and young adults when they were exposed to heat stress in a climatic chamber, which resembled an ordinary Finnish sauna. Changes were similar to those caused by increased sympathetic activity in 57% of the subjects during the bath and in 23% during the recovery period. Three children had extrasystoles during and four after sauna. One previously healthy 5-year-old girl with wandering pacemaker sacred a 3.3 sec sinus arrest and had reversible junctional rhythm during the heat exposure. We conclude that, although these changes were transient and benign, the sinus arrest suggest that heat stress in sauna is considerable and may be risky for those children who have disorders of the sinoatrial node.     

Results of surgery for chronic otitis media in patients with a cleft palate

The long-term results of surgical treatment of 19 chronic ears in 16 patients with a cleft palate were analysed. The mean follow-up period was 6.5 years. The patients were found to be significantly younger than other patients with chronic otitis media. Granulating otitis media was the indication for surgery in 11 ears and cholesteatoma in 7 ears. A successful outcome after the primary operation was found in 68% of the patients. Four patients required a revision operation which was successful in all of them. Hearing results of patients with cleft palate did not differ significantly from those obtained in other patients. It is concluded that middle ear surgery should be offered to patients with a cleft palate with the same indications as in other patients with chronic otitis media.     

Abnormal craniofacial growth and early mandibular osteoarthritis in mice harbouring a mutant type II collagen transgene

Skull morphology and histology in the heterozygous offspring of a transgenic founder mouse Del1, harbouring 6 copies of deletion mutation in Col2a1 gene, were compared with those in normal siblings. On visual observation and roentgenocephalometric examination the heads of heterozygous Del1 mice were smaller than normal. Histologically the sizes of cartilaginous structures of the cranial base were reduced. Severe defects were seen in the temporomandibular joint as progressive osteoarthritic lesions. These observations elucidate the relationship between the genotype and phenotype and demonstrate that heterozygous Del1 mice are a useful model for studies on a genetic disturbance where 'clinical' manifestations are not evident until adult age.     

Ultrastructure of a novel anaerobic Gram- positive nonsporing rod from dental root canal

Abstract — A novel anaerobic Gram-positive rod, strain ES4C, was isolated from a dental root canal infection. The isolate did not produce acids from carbohydrates and showed no glycosidase activity. Most biochemical reactions were identical to Clostridium malenominatum with the exception of the production of three aminopeptidases. In addition, no spores were detected. A tetragonally arranged surface layer was consistently found by electron microscopy. The ultrastructure of closely related Eubacterium spp. was also studied, but no crystalline surface structures were found. The physiologic and ultrastructural characteristics of ES4C did not allow identification as any known species. The periapical lesion responded to routine root canal therapy, but after 18 months observation the radiologic signs indicated partial healing only.     

Ultrastructural relationship of cell envelope layers in Wolinella recta

Abstract – The cell envelope of Wolinella recta was studied by electron microscopy. In thin sections the surface layer (S-layer) seemed to be in close contact to the outer membrane (OM). A hexagonally arranged pattern of the S-layer was revealed by freeze-etching. Unlike in other oral bacteria with an S-layer, the cleavage occurred along the S-layer by freeze-fracture, suggesting an exceptionally tight relationship between the two outermost layers. The convex surface of the S-layer was usually revealed by this technique. When cleavage occurred through the outer membrane, no periodicity was seen in the arrangement of the intramembranous particles.     

Hydrophobicities of human polymorphonuclear leukocytes and oral Bacteroides and Porphyromonas spp., Wolinella recta, and Eubacterium yurii with special reference to bacterial surface structures

Abstract – The hydrophobicities of human polymorphonuclear leukocytes (PMNLs) and Bacteroides buccae, B. oris, B. oralis, B.veroralis, B. buccalis, B. heparinolyticus, B. intermedius, B. denticola, B. loescheii, B. melaninogenicus, Porphyromonas gingivalis, P. endodontalis, Wolinella recta , and Eubacterium yurii were studied by the hexadecane method. The majority of the strains were equally or less hydrophobic than the PMNLs. Only in the case of E. yurii and the only strain of B. buccalis were all strains more hydrophobic than the PMNLs. However, some strains of B. intermedius , B. oris , B. denticola , and P. gingivalis were also more hydrophobic than the PMNLs. With the exception of B. intermedius and species with a crystalline surface protein layer (S-layer), the strains of all other species with a thick capsule were more hydrophilic than the strains with little or no extracellular polymeric material. All strains of the S-layer species were either quite hydrophilic or hydrophobic depending on the species, totally irrespective of the presence of the capsule. The results suggest that the S-layers of oral anaerobic bacteria may be important determinants of cell surface hydrophobicity.     

Influence of Age on Cardiovascular Effects of Increased Dietary Sodium and Angiotensin-converting Enzyme Inhibiton in Normotensive Wistar Rats

Recent studies have shown that increased intake of dietary sodium chloride produces blood pressure-independent increase in cardiac and renal mass even in young normotensive rats. With advancing age the harmful cardiovascular effects of increased dietary sodium are not so well known. In the present study the influence of advancing age on the cardiovascular effects of increased intake of sodium (control diet, 0.3% and high-sodium diet, 2.6% sodium in the chow) were examined in young and aged (3 and 18 months old, respectively, at the beginning of the experiment) male normotensive Wistar rats in a six-week study. Moreover, the potential role of renin-angiotensin system in ageing during normal and a high-sodium intake was studied using a pharmacological tool, angiotensin converting enzyme (ACE) inhibitor ramipril. Ageing did not significantly modify basal systolic blood pressure measured by the tail cuff method. A high intake of sodium chloride increased blood pressure significantly only in aged rats, while in young rats it increased renal weight. Left ventricular weight was not affected by high-sodium diet in either age group. The ACE inhibition during control diet lowered blood pressure and decreased left ventricular weight in young rats only and these effects were completely blocked by a high-sodium diet. The maximal vascular contraction force of mesenteric arterial rings to noradrenaline was decreased with ageing while endothelium-dependent and -independent relaxation responses were unaltered with ageing. The sensitivity to sodium nitroprusside was impaired by the high-sodium diet in young rats. In both age groups the urinary excretion of calcium was increased during the high-sodium diet. In conclusion, the increased intake of sodium produced different changes in cardiovascular function in normotensive rats depending on age. With advancing age, the sensitivity to sodium-induced increase in blood pressure was increased. In aged rats a high intake of dietary sodium elevated blood pressure, while in young rats it increased renal mass without increase in blood pressure. In both age groups sodium did not affect left ventricular hypertrophy. Both high-sodium intake and ageing attenuated or even abolished the cardiovascular effects of ACE inhibition.