Nutrition of the fetus and premature infant

Nutrition in the fetus and the premature infant is a rapidly changing field, not solely due to the acquisition of new knowledge but also because there have been major conceptual advances that have altered our approach to nutrition during early stages of development. This special report will highlight some of these conceptual advances in this area.     

Topographic diagnosis of hearing loss in patients with ischemic heart disease. Use of high-rate brain stem evoked response audiometry

Hearing loss in patients with ischemic heart disease traditionally has been attributed to atheromatous cerebral vascular disease. In this study, the site of the auditory lesion was sought in patients with ischemic heart disease and perceptive hearing loss. Standard brainstem evoked response audiometry (BSER) with increased stimulation rate (ISR) were performed. Sixty-seven patients admitted for coronary artery disease were examined. Fifty-seven recordings were complete and evaluable. All the cases of hearing loss were endocochlear. In 4 patients. BSER and ISR detected subclinical retrocochlear lesions that were compatible with ischemic disease. The results suggest that selective early cochlear ischemia can occur in young persons with heart disease. The sensitivity of BSER with ISR for detecting ischemic brainstem lesions was confirmed.     

Factors associated with child mental health service use in the community

OBJECTIVE: To determine the association of parent, family, and child factors with mental health services need and utilization. METHOD: Possible determinants of services need and utilization were assessed in a general population sample of 2,227 children aged 4 to 18 years. RESULTS: 3.5% of the total sample had been referred for mental health services within the past year. The most potent factors associated with service need and utilization were the child's problem behaviors (both internalizing and externalizing) and academic problems and family stress. Socioeconomic factors and the child's sex were not in itself associated with help-seeking factors. Parental psychopathology, life events, and family psychopathology lowered the parents' threshold for evaluating the child's behavior as problematic but did not increase the likelihood of referral. CONCLUSION: Referred children are more likely to live in families under stress than are children with the same level of problems who live in well-functioning families. Clinicians and researchers who make inferences from findings in clinical samples should realize, therefore, that children from problem families are overrepresented in their samples.     

Acquired tracheomalacia--a case report

Divalproex sodium is an effective drug for the treatment of migraine. Most adverse drug events are transient and not of great clinical concern. Although rare, well-documented examples of liver toxicity have been reported in children under 2 years of age on polypharmacy. Additional cases occur in children under 10 who are receiving polypharmacy, particularly those who have intractable seizures and degenerative central nervous system disease. Clinicians who treat migraineurs with divalproex sodium do not need to be overly preoccupied with monitoring of drug levels and liver function tests. The most valuable test is clinical observation of the patient.     

Genetics in hypertension research. What can we learn from it regarding common essential hypertension?

Essential hypertension is a polygenic disease. Various genes responsible for rare monogenic forms of hypertension have been identified in the recent years. These are glucocorticoid remediable aldosteronism (GRA), Liddle's syndrome and apparent mineralocorticoid excess (AME). A fourth form, the Bilginturan syndrome is associated with brachydactyly and resembles essential hypertension. The investigations of the pathomechanisms in these rare diseases can help us to understand common hypertension.     

Microtopography of the skin and scar formation

The surface microtopography of normal human skin varies from one anatomical region to another. The patterns at different sites are considered to reflect different orientations of dermal fibers. A simple technique is described that enables such orientations to be accurately delineated. Various scars resulting from lacerations, surgical incisions, and steroid-induced striae were examined in the manner described.     

Cocaine cue in rats as it relates to subjective drug effects: a preliminary report

Using a food-reinforced two-lever operant method, rats (n=5) could be trained to discriminate 10 mg/kg cocaine from saline. Stimulus generalization experiments with lower doses (0.31-5.0 mg/kg) revealed that the cocaine cue is a dose-related phenomenon. Neuroleptic drugs were found relatively ineffective as possible antagonists of the cocaine cue, and no antagonistic effect whatsoever was obtained with dibenamine, propranolol, cyproheptadine and methysergide. iamphetamine (1.25 mg/kg) and apomorphine (0.31 mg/kg) were generalized with cocaine, and a dopaminergic involvement is discussed.     

Antimicrobial peptides of the brevinin-2 family isolated from gastric tissue of the frog, Rana esculenta

Four structurally related peptides with potent growth-inhibitory activity towards Escherichia coli were isolated from an extract of the stomach of the European green frog Rana esculenta, and were identified as members of the brevinin-2 family. Two peptides, termed brevinin-2Eg (GIMDTLKNLA10 KTAGKGALQS20 LLNHASCK LS30GQC) and brevinin-2Eh (GIMDTLKNLA10 KTAGKGALQS20 LLNHASCKL S30 KQC) have not been described previously. One peptide is identical to brevinin-2Ec, previously isolated from R. esculenta skin secretions, and one peptide is identical to brevinin-2Ef whose structure has been deduced from a cloned cDNA prepared from a R. esculenta skin cDNA library. The data demonstrate that certain peptides of the brevinin-2 family, like the magainins in the toad, Xenopus laevis, may play an important role in protecting the gastrointestinal tract of Ranid frogs against microbial invasion.