A contribution to the problem of atypical polymyositis in children.

The diagnostics of polymyositis has frequent difficulties, first af all in atypical forms. These can be presented under different names, which lead clinicians to an erroneous way. For example, "climacteric myopathy" (Kaeser) is considered an endocrinous myopathy, "late onset myopathy" a disease joined with old age (as well as "Werner's disease") or "benign children myopathies" (Walton Natrass). In the last years, a distinctive clinical picture is, due to almost causal therapy by cytostatics and immunosuppressives, worn out and therefore these diseases are called "near states" or "overlap syndrome". In our patients, the correctness of the diagnose was confirmed, apart from electromyographic and histopathological findings, primarily by treatment response and the course of the disease.

[Attitudes towards child rearing in mothers of children with congenital heart defects]. / Výchovné postoje matek detí s vrozenou srdecní vadou.

By means of a questionnaire addressed to parents the authors investigated training attitudes of 18 mothers of children aged 6-14 years (8 boys and 10 girls) operated during preschool age for congenital cardiac disease. They compared their attitudes with those of healthy children and children suffering from juvenile chronic arthritis. All mothers preferred democratic training with stimulation of the children's activities. They refused authoritative and restricting attitudes. Mothers of children with congenital heart disease did not display excessively centered relations to the child, as compared with other mothers nor exaggerated protectiveness. A problem remains, however, the feeling of self-sacrifice for the child which, contrary to the two other groups, was manifested by 33% of the mothers.

The effect of lung resection on some blood circulation factors in children.

Eighteen children (8 boys, 10 girls) aged 6-16 years were examined. In all of them the basic diagnosis was bronchiectasia. Catheterization of the lesser circulation global spirometric examination, and perfusion lung scintigraphy with 99mTc both before and 2--4 years after lung resection were performed. Operations performed: 14 cases of lobectomy, one of bilobectomy, three of pneumonectomy. In all of the 14 children after lobectomy the pulmonary arterial pressure remained normal even during exercise. In contrast to this, in the three children after pneumonectomy and in the one boy after bilobectomy the mean pulmonary arterial pressure exceeded 20 mmHg at rest or after exercise. The total pulmonary resistance, converted per square metre of body surface, was--with a single exception [4.7 units before surgery]--within normal limits; after minor resections it rather tended to decrease, whereas in two of four children after major resections it slightly increased. Postoperative perfusion lung scintigram revealed a worsening in comparison with the preoperative finding in practically all of the children. This worsening can be ascribed not only to the restriction of lung tissue, but also to a compensatory emphysema of the remaining parenchyma. In patients with bronchiectasia, extensive resections have uncertain long-term prognosis.