Acta paediatrica Hungarica最新文献

Offsprings of parents who had acute myocardial infarction before age of 45 years were investigated. The aim of this examination was to obtain information whether the variation in the balance of prostacyclin/thromboxane ratio is a common cardiovascular risk factor in children. In children whose parents have had early myocardial infarction, a significant decrease was shown in 6-keto-prostaglandin F1 alpha level while the thromboxane B2/6-keto-prostaglandin F1 alpha ratio increased in these children. Plasma tromboxane B2 levels hardly differed from those of the control in that group of children whose one parent and at least one of the grandparents or uncles or aunts suffered from coronary heart disease. Plasma thromboxane concentration was lower in another group of children whose "only" one parent had myocardial infarction. It may be supposed that this is a compensatory mechanism in the offspring of parents suffering from early coronary heart disease.

The authors investigated the urinary N-acetyl-beta-D-glucosaminidase (NAG) activity in the case of 101 normal healthy and 20 polycythemic newborns and prematures, and 50 prematures suffering from hypoxia on the 1st, 2nd, 4th, 14th, and 28th day after birth. The obtained activities were referred to the creatinine concentrations of the urine samples and given as NAG index. There were no significant differences in the NAG indices either between fullterm and preterm babies or between appropriate for gestational age (AGA) and small for gestational age (SGA) neonates of the normal group. The NAG indices on the first day of life were significantly higher in the case of polycythemic newborn in comparison with the normal group (p less than 0.01). On the 14th day, after the partial plasma exchange, the NAG indices returned to the normal range. The premature babies suffering from IRDS received an average 10.1 days oxygen supplementation. Their NAG indices were significantly (p less than 0.01) higher on the 1st, 2nd, 4th days than those of the healthy prematures of the normal group and decreased considerably up to the 14th day. Finally the NAG indices reached the normal value on the 28th day. These results support the assumption that the urinary NAG index is a suitable indicator of the renal tubular damage during the newborn period.

In 12 very-low-birth-weight (VLBW) infants with intrauterine growth retardation and in 14 VLBW-infants appropriate for gestational age (AGA) fed a human milk (HM) formula (HM enriched with 6 g freeze dried HM per 100 ml) the renal excretion of urea and ammonia was studied on the 10th, 21st and 42nd days of life. The lowest excretion of urea was found in both groups on the 10th day of life. Up to the 42nd day of life the excretion raised significantly more in the AGA- than in the small for gestational age (SGA)-infants. In contrast to the urea excretion the excretion of ammonia was highest on the 10th day of life in both groups, but the excretion was significantly higher in the SGA-infants if compared to the AGA-infants. In the AGA-infants excretion of ammonia decreased with postnatal age whereas in the SGA-infants the high excretion remained up to the 42nd day of life. The data suggest that in VLBW-infants the urea synthesizing capacity is decreased and develops within the first weeks of postnatal life. The postnatal development is delayed in SGA-infants when compared to AGA-infants. The differences are more pronounced with increasing degree of intrauterine growth retardation.

In 78 patients with idiopathic growth hormone (GH) deficiency the effect of the fathers' educational level on the age and the extent of growth retardation at diagnosis was studied. There was a tendency for an increase of the age and the degree of growth retardation with the decrease of the fathers' completed grades. The occurrence of height SD scores less than -4.5 was conversely related to the number of grades completed by the father (chi 2 = 19.2 p less than 0.001). Eighteen of the 70 patients treated with growth hormone discontinued treatment after 0.3 to 6 years. Compliance was closely related to the grades completed by the father (chi 2 = 24.7 p less than 0.001). Six out of 7 patients with a height SDS less than -4.5 at diagnosis and with a father of low level of education (less than 8 grades) became non compliant. It is concluded that the degree of growth retardation at diagnosis and compliance at treatment in GH deficiency is related to the educational level of the father.

Unlabelled: The breast milk prolactin (PRL) has been claimed to play a role in the control of electrolyte composition of the milk. Since metoclopramide has been shown to increase milk production in humans, we have made an attempt to investigate the production, the PRL and sodium concentrations in milk with (group I) and without (group II) maternal metoclopramide treatment (5 days, 30 mg/day). Both groups consisted of 11 mothers and their full-term newborn infants. The daily milk production was significantly higher in the treated group (276.4 +/- 36.6 vs 150.9 +/- 25.3 ml/day, p less than 0.01). The PRL measured by RIA was similar in the milk samples of the metoclopramide treated and control groups (80.5 +/- 17.7 vs 90.7 +/- 27.3 ng/ml). The sodium concentration in the milk of mothers taking metoclopramide was 22.1 +/- 1.6 mmol/l and 24.3 +/- 3.2 mmol/l in the control group (p = 0.59). On the 5th postnatal day the plasma PRL of the newborns of mothers treated with metoclopramide does not differ from the values of the control babies (29.8 +/- 2.6 vs 30.7 +/- 2.4 ng/ml) indicating that the amount of metoclopramide transferred into the milk has no apparent influence on the hypothalamo-hypophyseal axis of the neonate.

In conclusion: the maternal metoclopramide treatment augments the milk production without having any effect on the PRL and sodium concentration of human "mature" milk.

Serum lipids and lipoproteins were investigated in the premature myocardial infarction (PMI) risk families before 45 years of age with the aid of screening for hyperlipemia and hyperlipoproteinemia (HLP): in the case of 174 persons from Csongrád County from the Departments of Internal Medicine I and II and of 42 patients (fathers) suffering from PMI and their 79 "high risk" children from Heves County. In the investigated three groups of "high risk" children the genetically determined antiatherogenic HDL-Ch level diminished in 34.8, 52.3, 40.5 per cent. Significant negative correlation was detected between the serum HDL-Ch and beta-lipoprotein; significant positive correlations were found between the HDL-Ch and the serum lipase activity; between the beta-lipoprotein and the phospholipid level; significant negative correlation was proved between the HDL-Ch and the phospholipid level in the group of PMI patients and their offsprings. The Ch/Tg, and the HDL-Ch ratios were significantly diminished in the PMI patients' group against the risk children' group, while the Ch/HDL-Ch rate was significantly elevated.

To test the hypothesis that prostaglandin (PG) E2 is a respiratory depressant in the newborn lamb, 12 chronically catheterized, unanesthetized lambs (age 2 to 6 days) were infused with progressively increasing doses of PGE2 (0.1, 0.5, 1.0 and 5.0 ug/kg/min: 30 min for each dose) into the ascending aorta. PGE2 caused significant, progressive decrease in ventilation (due to decreased tidal volume and breathing rate) heart rate, blood pressure and percent of the time spent in low voltage electrocortical activity (LVA). PGE2 also caused respiratory acidosis, hypoxemia and increased frequency and duration of apneic events (greater than 3 sec). During the infusion, there was a dose related increase in plasma concentration of PGE2. At 30 min post-infusion, all measured variables showed recovery, although arterial pH carbon dioxide tension and plasma PGE2 remained significantly different from control values and the percent time in LVA was even higher than during control. Infusion of the vehicle alone (n = 5) caused no significant changes in any of the measured variables. The results, taken in combination with previous fetal studies, indicate that PGE2 has marked inhibitory effects on breathing movements both before and after birth.

"In vitro" sensitivity of lectin (PHA, Con A)-stimulated lymphocytes to antitumor drugs (ARA-C, ADR, VM26, MTX, CP, VCR, Vepesid, ACLA) and the clinical efficiency of the complex therapy was compared in 7 patients with ALL and 2 patients with NHL. H3-thymidin incorporation of lymphocytes labelled prior to the drug exposure was used as "in vitro" method. A fairly good correlation was found between the "in vitro" test and the clinical response to the drug administered. These results suggest that this "in vitro" test is useful in choosing the drugs to be administered in case of malignancies of children.

We studied concentrations of thyroid hormones (T3, T4, FT4, rT3, TBG and TSH) in 62 type I diabetic children and adolescents. The patients were classified into group A (n = 27, good control, HbA1c less than 10%), group B (n = 19, poor control, HbA1c greater than 10%) and group C (n = 16, diabetic ketoacidosis, pH less than 7.1 and HCO3 less than 15 mmol/L. All patients were treated with two daily injections of purified monocomponent insulins. Thirty healthy subjects of the same age served as control group. Patients in group B and C had significantly lower T3 and higher rT3 levels (p less than 0.001) compared to the matched controls (1.5 vs 2.2; 0.9 vs 2.2; 0.58 vs 0.3 and 0.6 vs 0.3 nmol/L). Serum TBG levels were significantly lower (p less than 0.01) in the group A (19.5 +/- 4.3 mg/L), group B (20.3 +/- 3.3) and group C (18.0 +/- 3.4) compared with control group (24.2 +/- 3.1). There was significantly negative correlation between T3 and HbA1c in group B (r = 0.546; p less than 0.02). The results of this study confirm that euthyroid sick syndrome does exist in type I diabetic children and adolescents with poor metabolic control and ketoacidosis. The inverse relationship between T3 and HbA1c percentage (low T3 and high HbA1c) points to the poor diabetic control.