Insulin-like growth factor binding protein 1 level in amniotic fluid: correlation with birth weight.

Insulin-like growth factor binding protein 1 is the predominant insulin-like growth factor binding protein in amniotic fluid. It is produced by the decidua and by fetal tissues, and it is thought to play an important role in fetal growth. We have measured this protein in 58 samples of amniotic fluid, from 13 to 19 gestational weeks, and found a highly significant negative correlation with fetal weight at birth. We conclude that the level of insulin-like growth factor binding protein 1 in amniotic fluid at midpregnancy is a good marker of fetal growth failure.

Cyanide assay: statistical comparison of a new gas chromatographic calibration method versus the classical spectrophotometric method.

This work compares two different methods for assaying hydrogen cyanide, a spectrophotometric method and a headspace gas chromatographic method, each with its own reference standard generation. In the first method, the reference standards are cyanide solutions. In the second method, the reference standards are based upon the in situ reduction of ethyl thiocyanate by dithiothreitol to produce hydrogen cyanide. Furthermore, hydrogen cyanide concentration in the blood of patients who were poisoned by smoke inhalation or who committed suicide by cyanide ingestion is determined using both methods. Results are discussed using statistical comparison.

[Cervical Castleman's disease in a 12 year-old child]. / Maladie de Castleman cervicale chez un enfant de 12 ans.

A case of unifocal cervical Castleman's disease without systemic manifestations occurring in a 12 year-old child is reported. Histological examination showed the characteristic features of angiofollicular lymph node hyperplasia. The results of immunological and in situ hybridization studies are also reported. A local IL6 secretion in the interfollicular areas was demonstrated.

[Somatosensory evoked potential of the lower extremity in the premature neonate]. / Potentiel évoqué somesthésique du membre inférieur chez le nouveau-né prématuré.

The morphology of SEP is a good index of cortical maturation. Cerebral SEP is elicited by stimulation of the posterior tibial nerve at 38 wk post-conceptional age in 37 neonates distributed in 3 groups: I = gestational age (GA) at birth less than 31 wk; II = GA 23-36 wk; III = full-term neonates (FTN). A somatosensory response was identified in only 21 cases (56.8%). The presence of SEP in 3 groups, ie I, II, III, was 45.5%, 53.8% and 69.2% respectively. The morphological characteristics studied (latencies, amplitude and rising time) in these neonates were different: the peak latencies of major positive wave (P1) and rising time were not significantly different between I and III. These parameters were statistically different between II and III. SEP development is linked to some morphological factors-height, and growth-but also to the maturation of the central nervous system (myelinisation and central pathway organization). These results indicate that until 38-39 wk post-conceptional age, the maturation of the central somatosensory pathway is variable at different birth periods; this suggest the possible role of extra-uterine factors of in the acceleration of neurological development.

[Renal tubular acidosis and perception deafness. Apropos of a familial form]. / Acidose tubulaire rénale et surdité de perception. A propos d'une forme familiale.

We report a case of primary distal tubular acidosis with sensorineural deafness in two children from the same family. Failure to thrive at age one month was the first manifestation. Administration of bicarbonates allowed rapid resumption of normal growth. Inheritance is recessive and autosomal, contrary to isolated distal tubular acidosis. Early detection of deafness, a common feature that can easily be treated by hearing aids, should avoid delays in development of speech.

[Treatment with sustained theophylline release. Monitoring by salivary assay in children]. / Traitement par théophylline à libération prolongée. Surveillance par dosage salivaire chez l'enfant.

We have tested the possibility of replacing plasma assays by salivary assays of theophylline for the monitoring of sustained-release theophylline therapy in asthmatic children. In a first group of 40 children aged 7.2 +/- 3.3 years (mean +/- SD) treated with sustained-release theophylline in mean daily doses of 18.8 +/- 5 mg/kg, 77 plasma and saliva samples were taken simultaneously 6 hours after the morning dose (6 H). Saliva was collected after mouth-wash and stimulation with 10 mg of citric acid. Assays were performed using the EMIT method. Theophylline plasma concentrations (P) and salivary concentrations (S), both expressed as mumol/l, were found to correlate: P = 1.58 S + 8.7 (P less than 0.0001). In a second group of 33 children, 39 simultaneous samples were taken at 6 H. From the equation previously obtained the plasma concentration corresponding to each salivary concentration was calculated, and the calculated value was compared with the measured value. The difference between the two values was 7.1 +/- 9 mumol/l. On this basis, and because the method is non-invasive and painless, were are now using salivary assays (under strict conditions of collection and measurement) to verify the patients' compliance and to maintain or adjust dosage in asthmatic children.

[Acute chorea revealing lupus erythematosus disseminatus]. / Chorée aiguë révélatrice d'un lupus érythémateux disséminé.

A case of systemic lupus erythematosus (SLE) is reported in a 12 year-old girl who presented with chorea. This rare manifestation of SLE was previously recorded as a mode of presentation in half of the 51 reported cases. In view of the relative rarity of rheumatic fever in economically advanced countries, SLE should be entertained as a manifestation of chorea. The possible pathophysiologic mechanisms of this central nervous system involvement are discussed.

[Epilepsy with bilateral cortical calcifications. Discussion of a durable post-critical deficit]. / Epilepsie avec calcifications corticales bilatérales. Discussion d'un deficit post-critique durable.

The epilepsy-bilateral cortical calcifications syndrome includes epilepsy with onset in childhood or adolescence and symmetrical calcifications of cerebral cortex with a predilection for the occipital cortex. The calcifications are sometimes visible on plain radiograph images but may be detected only by CT. Literature perusal revealed reports of 16 cases. We report a case with an aperceptive visual agnosia and marked but resolutive CT anomalies developed during a partial status epilepticus episode.

[Gastroesophageal reflux in infants. Value of orthostatism and ventral decubitus]. / Reflux gastro-oesophagien du nourrisson. Valeur de l'orthostatisme et du décubitus ventral.

Gastroesophageal reflux (GER) may induce severe complications in infants: besides esophagitis numerous authors have established a relationship between GER and relapsing respiratory infections, between GER and apnea, cyanosis or bradycardia. This required a more precise estimation of the postural treatment than the clinical data of vomiting or the weight curve. Esophageal pH studies are considered to be the most valuable investigational technique in case of GER. It allowed us to study the importance of acid reflux in 43 patients under 1 year of age in different postures: 45 degrees upright in an infant-seat, horizontal prone and 30 degrees prone positions.