Cesko-Slovenska Pediatrie最新文献

Elevated alpha-amylase activity in serum was thought for a long time to be a laboratory standard in diagnosis of acute pancreatic disease. The purpose of this study was to evaluate the clinical usefulness of routine measurement of total serum amylase (using the Boehringer Mannheim EPS method) and pancreatic isoamylase (using Boehringer Mannheim EPS method) and lipase (Kodak Eastman) in children. Authors examined the group of 93 children with abdominal pain whose age ranged from 5 to 17 years. In previous laboratory measurements using Spofa test (Slovakofarma) they were found to have elevated alpha-amylase in serum, thus the pancreatic disorder was put in question. A pancreatic disorder was proven in 9 children (9.7%) from this group. The authors consider the measurements given above to be the markers significantly improving the specificity of routine biochemistry in children with pancreatic diseases.

The authors describe the case-history of a boy with secondary myelodysplastic syndrome (MDS) which developed into acute leukaemia. The latter was quite resistant to treatment. The disease was preceded by treatment of NH lymphoma with a high grade of malignity by radiotherapy and chemotherapy. The authors give the total doses of all cytostatics which were administered to the patient. One year prior to diagnosis of MDS cytogenetic examination of peripheral blood revealed a highly pathological karyotype, from the numerical and structural aspect. Among others monosomy of chromosome no. 5 was found which is typical for MDS and these changes indicate as a rule a poor prognosis and relatively early transformation to acute leukaemia.

The authors describe three patients with episodes of abdominal pain where despite a negative finding in the urine sonography revealed dilatation of the hollow system. Urography proved stenosis of the pyeloureteral junction. The authors discuss the cause of abdominal pain. Consistent with data in the literature, the authors draw attention to pitfalls in the diagnosis of hydronephrosis. They recommend sonographic examination of children with abdominal pain, as a negative urinary finding does not rule out hydronephrosis. In this respect screening of hydronephrosis and other obstructive anomalies during the neonatal period is an advantage.

In the submitted case-history the authors describe the clinical course of haemolytic-uraemic syndrome (HUS) during Campylobacter infection in a two-year-old boy. On the described case the authors wish to confirm that in the manifestation of HUS in childhood not only infections caused by the usual microbial agents can participate but also Campylobacter jejuni.

At the Paediatric Clinic of the Institute for Postgraduate Medical Training in the University Thomayer Hospital in Prague an extensive archive of rare X-ray findings from the field of child pneumology was assembled which is used for postgraduate medical training. To facilitate physical manipulation of the documents the X-ray pictures were transferred to a computer data base. For storage the Thorax programme was used which is distributed on CD-ROM. The authors discuss the use of this programme in practice. At present the data base comprises 529 digitalized X-ray pictures of 149 case-histories of pulmonary diseases of child patients.

The authors investigated in detail the sorption and desorption of oxygen and carbon dioxide in a solution of perfluorocarbons (solution RM 101, Miteni, Italy). From the results of the investigation ensues that maximal oxygen saturation of 77.3 vol.% can be achieved at 8 degrees C. With rising temperature the oxygen concentration in the solution declines (67.6 vol.% at 37 degrees). The saturation of the RM 101 solution corresponds to a linear equation of seventh order (fig. 2). Desorption of the RM 101 solution fully saturated with carbon dioxide, is on the other hand, most rapid at 37 degrees C (after the 13th minute the RM 101 solution contains less than 2% carbon dioxide as compared with 25 vol.% at 8 degrees C during the same period. In general the kinetics of desorption of carbon dioxide in solution correspond to a linear equation of fifth order (fig. 4). From the practical aspect it is not expedient to saturate the RM 101 solution with oxygen longer than 15-20 minutes. The mentioned kinetic parameters are important for the construction of a special liquid membrane or bubble oxygenator. In particular the latter is useful as with its use the authors achieved a 1.9 x higher oxygen concentration in the RM 101 solution than declared by the manufacturer.

A single kidney in patients with agenesis or after nephrectomy is regarded as a risk factor. Primarily, the role of glomerular hyperfiltration and later possible glomerular sclerosis are emphasised. Complex treatment of Wilms tumour patients includes previous chemotherapy and radiotherapy. The aim of our study was to investigate late sequelae of this aggressive treatment on the morphology and function of a single kidney and to compare these results with a group of single kidney patients, where the diagnosis of Wilms tumour was excluded.

The Vth nation-wide survey of children and adolescents which was conducted in autumn 1991 under new conditions comprised again, similarly as the four previous ones, a representative sample selected by random sampling. As compared with the 1981 survey, the anthropometric parameters were extended by the circumference of the relaxed left arm and the hip circumference. A questionnaire for parents was elaborated where by a quite new approach was used. The still positive action of the secular trend of increasing height was confirmed. The action of the trend shifts to younger age groups, as compared with former surveys. The present survey confirmed also a tendency towards slimness in both sexes, however, in particular in girls a shift of this tendency to younger age groups was apparent. It will be certainly necessary to evaluate in future whether this trend reflects also a more favourable ratio of body composition. With regard to these changes the authors submit new percentile charts for evaluation of height, proportionality, and for children under three years, also head circumference.