Sudden infant death syndrome. A prospective study

One hundred twenty-five sudden infant death syndrome (SIDS) victims followed up since birth from a large prospective study were compared with matched controls. Some of the future SIDS victims showed evidences of neonatal brain dysfunction including abnormalities in respiration, feeding, temperature regulation, and specific neurologic tests. These abnormalities could not be ralated to events in labor or delivery. A greater proportion of the future victims were mildly underweight for gestational age. The gestations that produced the SIDS victims were characterized by a greater frequency of mothers who smoked cigarettes and had anemia. The demographic profile of SIDS families proved to be indentical to the profile for families with excessive perinatal mortality. Many of the SIDS victims showed a retardation in postnatal growth prior to death.     

Hemangioma of bladder

A twenty-nine-year-old woman had a history of recurring gross, total painless hematuria. The past history and urologic studies supported the diagnosis of hemangioma of the bladder. A partial cystectomy was performed. The pertinent literature is reviewed.     

The maternal and fetal levels of human chorionic gonadotropin, human placental lactogen and prolactin during the perinatal period (author's transl)

The levels of human chorionic gonadotropin (HCG), human placental lactogen (human choriosomatomamotropin HCS) and prolactin (PRL) were determined in the serum of 72 maternity patients and the serum of the newborn infants. The determinations were done with radioimmunologic tests (RIA). These three protein hormones were also determined in the amniotic fluid and in the maternal serum from 4-6 days prior to the delivery of the infant. The concentration of HCG or HCS in the serum of the newborn infants was a mean 0.43 or 0.37% of the level in the maternal serum. The concentration of PRL in the serum of the newborn was 118% and slightly higher than in the serum of the mothers. The concentration in the amniotic fluid was 1.5% for HCG, 5.8% for HCS, and 252% for PRL, compared to the corresponding levels in the maternal serum. The fact that the hormone concentrations in the amniotic fluid are significantly higher than in the serum of the newborn suggests excretion of the hormones from the fetal circulation via the fetal liver and the fetal kidney. The high levels of PRL in the maternal and the newborn serum may be caused by the high concentrations of estrogen or progesterone. Increased during the course of the pregnancy there was a significant sex linked difference in the level of HCG in the maternal serum correlated to the sex of the newborn infant.     

Sebaceous gland inhibition from combined glucocorticoid-estrogen treatment

Sebum production in seven hirsute women was found to be markedly inhibited by low-dosage glucocorticoid therapy, usually 5 to 10 mg of prednisone daily, combined with the cyclic administration of ethinyl estradiol, either 80mug or 100mug daily, in the form of oral contraceptive medication. The average reduction of sebum secretion was 85.7%, from a pretreatment mean value of 3.07 mg of sebum to an average treatment level of 0.44 mg.     

Incidence, technique of isolation, and treatment of group B streptococci in obstetric patients

A prospective study was performed to determine the incidence of group B streptococci cultured from the cervix in a series of obstetric clinic patients at St. Margaret's Hospital. Cultures were taken during each trimester and planted to both a blood agar plate and a selective broth medium. Of a total of 812 cultures, 18 were positive, an over-all incidence of 2.2 per cent. During the first, second, and third trimesters, 2.2 per cent, 2.5 per cent, and 1.9 per cent of cultures were positive, respectively. Women with positive cultures were treated with a 10 day course of oral penicillin or a suitable alternative; four of 16 had persistent positive cultures at the end of the first treatment period, three of these four responded to a second course of antibiotics, and the remaining patient responded after a third treatment course. The total number of positive cultures by selective broth was 24, compared to nine in blood agar, indicating a 2.7-fold increase in pickup by the selective broth.     

Propranolol therapy in patients undergoing myocardial revascularization

The records of 185 consecutive patients having myocardial revascularization were reviewed with regard to preoperative administration of propranolol and intraoperative or postoperative complications. Tachycardia and hypertension before cardiopulmonary bypass were slightly more common in patients never taking propranolol or those who had discontinued it for more than 48 hours before operation. There was no statistically significant difference in the incidence of postbypass hypotension among patients who took propranolol within 24 hours of operation, those who discontinued it more than 24 hours before operation, and those who never took the drug. Operative mortality was not significantly different among patients who received propranolol within 48 hours of operation (3%), those who never took it and those who discontinued it more than 48 hours before operation (4%). Early in the series, five patients had an acute myocardial infarction within 48 hours after routine preoperative withdrawal of propranolol. Because complete withdrawal of propranolol in patients with unstable angina pectoris may lead to acute myocardial infarction, we recommend gradual withdrawal of the drug during 48 hours before operation. If this is not possible because anginal pain recurs or intensifies, then reduced doses may be given safely up to 10 hours before revascularization, provided that the patient is a satisfactory candidate for bypass and that adequate myocardial revascularization can be accomplished.     

Hemodynamics in sleep-induced apnea. Studies during wakefulness and sleep

Twelve patients with predominantly obstructive type sleep apnea underwent cardiac catheterization, hemodynamic monitoring, and arterial blood gas analysis during wakefulness and sleep. Abnormalities during wakefulness included systemic hypertension in four of 12, exercise-induced mild pulmonary hypertension in five of 12, and alveolar hypoventilation in one. During sleep nine patients had cyclic elevations of arterial pressure with each apneic episode, exceeding 200 mm Hg systolic in three of 12. Pulmonary artery pressures increased in 10 of 12, exceeding 60 mm Hg systolic in five. Marked degrees of hypoxemia (arterial P02, less than 50 mm Hg in eight of 12) and moderate hypercapnia with respiratory acidosis were associated with these hemodynamic changes. Cyclic upper airway obstruction during sleep may result in hypercapnia, acidosis, and pronounced hypoxemia, which can lead to hemodynamic abnormalities during sleep. Sustained pulmonary hypertension and possibly systemic hypertension may follow. Tracheostomy is an effective therapy and is recommended to symptomatic patients who have predominantly obstructive apnea but no relievable anatomic cause of upper airway obstruction.     

Regulation of nitrogen catabolic enzymes in chick liver -- effects of amino acids

It is well-known that in the chick, dietary protein increases the levels of several hepatic enzymes that are involved in nitrogen metabolism and excretion. However, the biochemical mechanism of this response is essentially unknown. The experiments presented in this paper show that the chick is responding to alpha-amino nitrogen and not to any specific amino acid. Furthermore, it is shown that this system responds to endogenous sources of nitrogen as well as dietary protein and that the xanthine dehydrogenase response involves regulation of enzyme synthesis without changing the rate of degradation.     

Partial replacement of chicken semen by turkey semen in artificial insemination of chickens

Chicken semen undiluted, diluted with a diluent containing fructose and/or mixed with turkey semen was used to inseminate Leghorn hens. In two of three experiments there was an improvement in fertility from insemination by mixed semen as compared to semen diluted to the same extent with the diluent.