[Aortopexy as a surgical treatment method in infantile congenital tracheo-chondrohypoplasia and tracheomalacia]. / Aortopexia, mint a csecsemökori congenitalis tracheo-chondrohypoplasia és a tracheomalatia mütéti kezelése.

Congenital tracheal chondrohypoplasia and tracheomalacia have come to present a significant challenge in recent paediatric surgery. Authors shortly describe their pathology, pathophysiology, symptoms, diagnostic evaluation and outline the most frequency surgical procedures for them. The first three aortopexies in the authors' departments are described in this paper, with particular attention paid to the clinical problems of congenital tracheal chondrohypoplasia and tracheomalacia and the role of this method in surgical treatment, respectively. Aortopexy is quick, easy to carry out and atraumatic for the growing trachea. Authors want to draw attention to the fact that not every form of congenital tracheal chondrohypoplasia and tracheomalacia may be treated by conservative therapy, and that surgical treatment is recommended not only for life threatening forms, but for other severe forms as well.

[Androgen-producing adrenocortical adenoma in childhood. Pitfalls of differential diagnosis]. / Androgént termeló mellékvesekéreg adenoma gyermekkorban. A differenciáldiagnosztika buktatói.

A two-year-old girl presented with clitoromegaly and an abdominal mass. Diagnostic procedures including sonography, computerized tomography, scintigraphy and measurement of catecholamines in urine excluded neuroblastoma, but suspected Wilms-tumor. Before completing the steroid measurements therapy was initiated according to Wilms-tumor (preoperative cytostatic therapy followed by surgical removal of the tumor). Morphology of the tumor, the serum and urinary steroid profile proved a benign adrenocortical adenoma producing mainly delta 5-steroids including the weak androgen, dehydroepiandrosterone.

[17 beta-hydroxysteroid dehydrogenase defect: female phenotype with 46,XY karyotype]. / 17 beta-hidroxiszteroid dehidrogenáz defektus: nöi fenotípus 46,XY karyotípussal.

Deficiency of the 17 beta-hydroxysteroid dehydrogenase (17b-HSD-d) causes female external genital phenotype in spite of 46,XY karyotype and presence of testes due to disorder in biosynthesis of testosterone. However, marked somatic and genital virilization occurs during puberty. Clinical and laboratory investigation of three cases are presented with typical elevation of the precursor steroid androstenedione, and decrease of product steroid testosterone. All the three patients were reared as girls. During puberty orchidectomy was performed in two cases and vaginoplasty in one case. Estrogen replacement therapy contributed to development of female secondary sex characteristics.

Characteristics of cholinergic neuroeffector transmission of ganglionic and aganglionic colon in Hirschsprung's disease.

Differences in the release and content of acetylcholine and the alpha 2 adrenoceptor mediated interaction between noradrenergic and cholinergic neurons were investigated by neurochemical and pharmacological methods in aganglionic and ganglionic segments of isolated human colon taken from children suffering from Hirschsprung's disease. Both at rest and during transmural stimulation the release of acetylcholine was significantly higher in the spastic (aganglionic) segment than in the proximal dilated bowel. Significant differences were found in the tissue concentration of acetylcholine between ganglionic and aganglionic specimens. The pattern of response to transmural stimulation was also different in the spastic and dilated bowel. Transmural stimulation induced relaxation and contraction in ganglionic specimens but only contractions in aganglionic specimens. The sensitivity of the smooth muscle in the aganglionic portion to exogenous acetylcholine and to field stimulation was found to be higher than in the ganglionic portion. While noradrenaline added to the organ bath reduced the stimulation-evoked release of acetylcholine from spastic segments, via an alpha 2 adrenoceptor mediated process, yohimbine did not enhance the release. It is suggested that in Hirschsprung's disease the increased acetylcholine release, the enhanced sensitivity of smooth muscle cells to acetylcholine, and the lack of alpha 2 adrenoceptor mediated noradrenergic modulation of acetylcholine release from cholinergic interneurons might be responsible for the spasm of aganglionic segments.

Canine infectious tracheobronchitis: effects of an intranasal live canine parainfluenza-Bordetella bronchiseptica vaccine on viral shedding and clinical tracheobronchitis (kennel cough).

A modified-live intranasal (IN) canine parainfluenza (CPI)-virus Bordetella bronchiseptica vaccine was evaluated in dogs for efficacy against laboratory-induced canine infectious tracheobronchitis. The comparative efficacies of IN and parenteral administrations of the CPI virus fraction were also evaluated. The frequency and duration of clinical tracheobronchitis, blood serum agglutination titer, humoral antibody response, and duration of CPI virus and B bronchiseptica shedding were measured. Group A dogs were vaccinated subcutaneously or IM with an experimental CPI vaccine and challenge exposed with CPI virus. Group B dogs were vaccinated IN with avirulent CPI virus-B bronchiseptica live antigens and challenge exposed with virulent CPI virus and virulent B bronchiseptica. The IN vaccination (group B) significantly reduced (P less than or equal to 0.001) the occurrence of clinical tracheobronchitis by 96%. The combined challenge exposure of virulent CPI and virulent B bronchiseptica produced a synergistic enhancement of the clinical signs of kennel cough. The percentage of days after challenge exposure that virus shedding was detected for controls equaled 70% as compared with 50% and only 1% for parenterally and IN vaccinated dogs, respectively. Isolation of virulent B bronchiseptica microorganisms was reduced 89% in dogs vaccinated IN compared to controls. The geometric mean humoral antibody titers to CPI virus after 2 parenteral vaccinations and 1 IN vaccination were 1:43 and 1:34, respectively.

Appendicitis in premature babies.

From 1st January, 1973, to 30th September, 1977, 11 cases of appendicitis were observed in premature babies. All patients were subjected to operation. One patient was lost. For the diagnosis, anamnestic data concerning infections, the general and localized symptoms, laboratory data and X-ray findings should be taken into consideration. Close observation of the patient is necessary for determining the optimum time for surgery. This and rational antibiotic and postoperative therapy are essential in the treatment of the condition.

[Possibilities of early orthodontic treatment in patients with cleft lip and cleft palate]. / Möglichkeiten der kieferorthopädischen Frühbehandlung bei Lippen-Kiefer-Gaumen-Spaltpatienten.

Prior to lip operations upon children with cleft lip and palate, the authors make use of denture-like acrylate plates and external elastic rubber bands. Occurring anomalies are treated already in the deciduous dentition. In this way, the very marked jaw deformity in cleft children may be reduced to a minimum.

Characterisation of an epizootic haemorrhagic disease virus.

A high titre of epizootic haemorrhagic disease (EHD) virus was obtained from roller bottles of African green monkey kidney (Vero) cells. Cell associated EHD virus was purified by use of Genetron-113 and sonication. Purified viral particles were probably icosahedral with a diameter of 58 nm and contained capsomeres which appeared to be composed of five and six subunit structures. Phenol extracted nucleic acid from purified EHD virus when treated with orcinol or diphenylamine gave colour reactions and ultraviolet absorption spectrums characteristic for ribonucleic acid (RNA). EHD viral RNA had a melting temperature of 86 degrees C in 0.015 M NaCl-0.0015 M sodium citrate. RNA from EHD virus did not react with formaldehyde, but after it was heated at 102 degrees C for 10 min hyperchromicity was observed. Electrophoresis of EHD-RNA in 5 per cent polyacrylamide gels showed the genome to be composed of at least five different segments.