Stenosis of individual pulmonary veins: radiologic findings.

Congenital stenosis of individual pulmonary veins is uncommon. Of the 49 cases reported, four were seen at the IWK Hospital for Children and are reported here. Plain radiographs show a shift of the heart toward the side of major involvement, Kerley B lines, fluid in the fissures, and interstitial edema of the affected lobes. These findings, while subtle, should nevertheless suggest stenosis. Technetium-99m macro-aggregate lung perfusion scans show absence of or diminished perfusion of the affected lobes. The diagnosis can usually be confirmed with angiography. Congenital stenosis of individual pulmonary veins should be considered in children with repeated pulmonary infections, dyspnea, failure to thrive, hemoptysis, or unexplained pulmonary hypertension.

Restriction endonuclease digestion analysis of DNA from viruses isolated from different sites of two fatal cases of herpes simplex virus type-1 infection.

Herpes simplex virus (HSV) type-1 was isolated from a fatal case of herpes simplex encephalitis (case 1) and from a fatal case of disseminated herpes simplex (case 2). The virus was isolated from the lip lesion, the frontal lobe and the temporal lobe of the brain in case 1 and from a mesenteric node, myocardium and salivary gland in case 2. Restriction endonuclease digestion analysis showed that each case was infected with different substrains of HSV. The changes in band pattern in isolates from case 1 occurred in the "variable" region of the genome, showing that viruses with such variations can be isolated simultaneously from different tissues. The changes in band patterns in isolates from case 2 indicated the presence of two virus substrains, one in the mesenteric node and salivary gland and a second in the myocardium.

Mycoplasma hominis: a placental pathogen?

Current information on the role played by Mycoplasma hominis in placental inflammation was reviewed. M. hominis is associated with chorioamnionitis and funisitis, but the clinical significance of this association in not clear. Further research on the role of the organism in perinatal disease is needed. Meanwhile, in a gravely ill infant with a history of prolonged rupture of the placental membranes, chorioamnionitis, and funisitis, M. hominis should probably be considered a potential pathogen, cultures for this organism should be performed, and therapy with an antibiotic regimen effective against M. hominis should be instituted.

Early infantile variant of Krabbe globoid cell leucodystrophy with lung involvement.

An 8-week-old boy presented with a history of irritability, progressive feeding difficulty, generalised weakness, tachypnoea, and minor motor seizures. The clinical course was characterised by rapidly progressive respiratory failure, and neurological deterioration culminating in death at age 15 weeks. Electron microscopical examination and histological studies of the lung showed the presence of numerous intra-alveolar and a few interstitial macrophages. Enzyme studies and subsequent histopathological studies on brain confirmed the diagnosis of an unusual variant of Krabbe globoid cell leucodystrophy.

Placental infection with Mycoplasma homonis and Ureaplasma urealyticum: clinical correlation.

Placentas from a clinical study group of 446 high-risk pregnancies and 108 normal pregnancies were cultured for Mycoplasma hominis and Ureaplasma urealyticum and examined histologically. Results were compared and correlated with the clinical history. The recovery rate of U urealyticum, but not of M hominis, was significantly higher in the clinical study than in the control group. Isolation of both mycoplasmas was associated with polymorphonuclear leukocyte infiltration of placental membranes, fetal surface, and umbilical cord. Recovery of mycoplasma was significantly higher with prolonged membrane rupture, spontaneous abortion, stillbirth, and early neonatal death. Isolation of U urealyticum, but not of M hominis, was associated with prematurity, lower birth weight, and intrauterine growth retardation.

Prevention of group-B beta-haemolytic streptococcal septicaemia in low-birth-weight neonates by penicillin administered within two hours of birth.

Between January, 1969, and May, 1974, 11 of 1208 low-birth-weight infants had early onset group-B streptococcal septicaemia. All 11 infants were of less than 35 weeks gestational age and 9 presented with the clinical and radiological signs of idiopathic respiratory distress syndrome. 10 died. Antibotics were given to 3 infants only, but not before the age of 12 h. From June, 1974, infants less than 35 weeks gestational age, and from January, 1977, infants less than 2500 g, received systemic penicillin by 2 h of age after throat, ear, umbilical, rectal, and blood cultures. Penicillin was continued for 10 days if group-B streptococci were isolated but was stopped at 48 h of age if all cultures were negative. Between June, 1974, and November, 1977, there was 1 case of septicaemia and no death from group-B streptococal infection in the 983 low-birth-weight infants born during this period. These data suggest that systemic penicillin from birth prevents low-birth-weight infants from dying of group-B streptococcal infection.

[Therapeutic effects on disorders of spermatogenesis in hyperprolactinemia without pituitary adenoma]. / Therapeutische Beeinflussbarkeit von Spermatogenese-Störungen bei Hyperprolaktinämie ohne Hypophysenadenom.

As in patients with high pituitary prolactin secretion disturbances of the spermatogenesis are observed, we picked out from our patients with low sperm count those showing hyperprolactinemia without pituitary adenoma. They were treated for 50 days with 2-brom-alpha-ergocryptin (Pravidel, Sandoz AG, Nürnberg), which selectively inhibits prolactin release. Following treatment, in 7 cases an increase in sperm count was observed, while in 2 cases a decrease occurred. 4 cases with azoospermia showed no alteration. No explanation for the possible stimulation of spermatogenesis can be given today.

Scabies masquerading as Letterer-Siwe's disease.

Letterer-Siwe's disease was diagnosed from clinical appearance and initial assessment of a skin biopsy in a child with a 2-month history of skin rash. Fine erythematous papules were scattered on the trunk. The biopsy showed epidermal thickening and an inflammatory infiltrate chiefly in the upper layers of the dermis; deeper in the dermis the infiltrate was perivascular and periappendicular, histiocytes predominating in some areas and lymphocytes in others. A diagnosis of scabies was made after burrows were demonstrated on palms and soles and the mite of scabies was isolated from them.

Fatal cerebral embolus - a complication of left ventricular venting.

A 3-year-old child died following a routine tetralogy of Fallot repair. Death was caused by a cerebral embolus. Injury to the left ventricle during left ventricular venting resulted in an apical myocardial infarct. The embolic source was a mural thrombus covering the area of infarction. A technique is described whereby left ventricular venting can be avoided during open-heart surgery in small patients.

[The significance of continuous fetal monitoring for further lowering of perinatal morbidity. Pilot study]. / Die Bedeutung der continuous fetal monitoring fur die weitere Senkung der perinatalen Morbiditat

By means of a pilot study we tried to calculate the perinatal morbidity after continuous fetal monitoring. From 810 electronical and biochemical monitored high-risk babies in the period from 1971 to 1973 we checked and/or have investigated 685 risk-newborns. Thereby 87 (=12,7%) were premature newborns. From this 685 risk-newborns 14 (=2,04%) appeared conspicuous. Only by 7 of them (=1,02%) we found mental and/or physical retardation. 2 of this children have a cerebral palsy. Causes of retardation with and without cerebral palsy we could lead back in the perinatal period. The causes are discussed. We point to the urgency of comprehensive follow-up studies.

[Teratogenic effect of busulfan on testis cells of the rat (postnatal development)]. / Zur teratogenen Wirkung von Busulfan auf die Hodenzellen der Ratte (die postnatale Entwicklung)

10-mg/kg of 1,4-bis-(methanesulfonyloxy)-butane (busulfan) are administered on various days of gestation to Wistar rats. The testes of the male pubs of these litters are examined histologically. Depending on the time of application of busulfan the cells of spermiogenesis are dimished and the meiosis is delayed. The Leydig cells are unchanged. In a second experiment, the weight of the seminal vesicles, LH and FSH in the serum show no differences versus the control group.

Congenital cytomegalovirus infection: clinical, pathological and virological studies of two fatal cases.

Two infants severely ill at birth as a result of congenital cytomegalovirus infection were born in Halifax, Nova Scotia, in April and July 1968. Both died within seven weeks. Clinical, pathological and virological studies including serology and electron microscopy were made both before and after death. Cytomegalovirus was isolated in tissue culture from urine specimens from both infants during life and from organ tissues, blood and ascitic fluid after death. Large inclusion-bearing cells mixed with the erythrocytes and leukocytes were seen within the lumina of pulmonary blood vessels. A brief general discussion is presented of the various clinical manifestations of congenital cytomegalovirus infection and of the different serum antibody patterns found in these two pairs of mothers and infants.