[Pseudo-Hirschsprung's disease (author's transl)]

Eight children with pseudo-Hirschsprung's disease are reported. They can be divided into three groups: alimentary ganglioneuromatosis, schwann cell hyperplasia and those with normal appearance by stantard histology. In view of the heterogeneity, histology cannot predict the extent or the prognosis of the disease. Several biopsies at various levels of the alimentary tract and the use of advanced techniques are necessary to assess fully the extent and the type of the lesion and whether it is congenital or acquired. The majority of pseudo-Hirschsprung's disease tend to affect most of alimentary tract, which may lead to the formation of stagnant loops with all their risks. Treatment includes ileostomy, continuous hypoallergenic oral feeding, and manual expression several times a day.

[Constant rate enteral feeding in the patient's home. Clinical experience in paediatrics (111 children) (author's transl)]

Constant rate enteral feeding in the patient's home considerably shortens the stay of children in a specialized pediatric unit. A study of 111 children treated by this method for the past 5 years shows that, provided close co-operation with the family is obtained, obvious psychological benefits can be expected with little risk of technical complications. From an economic point of view, the method provides an effective means of reducing costs.

A potent inhibitor of cell proliferation in "middle molecules" isolated from the urine of uremic patients

A potent inhibitor of cell proliferation was found in the urine of a patient with chronic renal failure. This substance included in "middle molecules" (MM) fraction, was obtained by chromatography. This factor was shown to inhibit noticeably the proliferation of various cells : lymphocytes stimulated by allogeneic cells, monolayer cell lines of normal or tumorous origin and leukemic cell lines derived from acute lymphoblastic leukemia. This effect was reversible and thus could not be related to a direct, rapid cytotoxic effect of MM. Such substances could play an important part in uremic symptoms, such as immunodeficiency, anemia, thrombopenia, gastrointestinal or skin manifestations.

Effect of inducers and inhibitors of monooxygenase on the hydroxylation of prostaglandins in the guinea pig. Evidence for several monooxygenases catalyzing omega- and omega-1-hydroxylation

The incubation of prostaglandins (PG's) with liver microsomes from guinea pigs treated with inducers of monooxygenase (1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT), benzo[alpha]pyrene (benzpyrene), or a mixture of chlorinated biphenyls (Aroclor 1254)) exhibited marked elevation of 19-hydroxylation of PGE1, PGE2, PGA1, and PGA2 without affecting significantly 20-hydroxylation. However, with respect to effects on hydroxylation of a variety of xenobiotics, benzpyrene and Aroclor treatments differed markedly; whereas Aroclor treatment elevated the demethylation of ethylmorphine, benzphetamine, and p-chloro-N-methylaniline (PCMA), benzpyrene treatment had no effect on demethylation of ethylmorphine and only a marginal effect on that of PCMA. Both inducers elevated benzpyrene hydroxylation. By contrast, treatment with phenobarbital did not affect the hepatic microsomal PG's hydroxylation, although the hydroxylation of benzpyrene and the demethylation of ethylmorphine, benzphetamine, and PCMA were enhanced. Also, the hydroxylation of PG's by kidney cortex microsomes was not affected by either benzpyrene or Aroclor treatment. Inhibitors of monooxygenase were used to help delineate the type of monooxygenases induced. At low levels of alpha-naphthoflavone (ANF), benzpyrene hydroxylation in control- and Aroclor-treated guinea pigs was only little affected; by contrast, the same concentration of ANF markedly inhibited benzpyrene hydroxylation in benzpyrene-treated guinea pigs. On the other hand, metyrapone was most inhibitory in control guinea pigs. Support for the conclusion that benzpyrene induces in the guinea pig a hepatic monooxygenase with different characteristics than that found in control animals was provided by the observation that ANF (10 MICROM) inhibited PGE1 hydroxylation more pronouncedly in liver microsomes from benzpyrene-treated than from Aroclor-treated guinea pigs or controls. In addition, in benzpyrene and Aroclor-treated guinea pigs, ANF inhibited the (omega-1)-hydroxylation more pronouncedly than that of omega-hydroxylation. By contrast, metyrapone appeared to inhibit omega-hydroxylation more effectively than (omega-1)-hydroxylation. These results indicate that in the guinea pig, hydroxylation of PG's at the omega (20-) and omega-1 (19-) positions is catalyzed by different monooxygenases and that the inducers tested affect several hepatic monooxygenases with different specificities toward xenobiotics; however, with respect to PG's only the enzyme(s) involved in the 19-hydroxylation is affected.

Anti-inflammatory and platelet anti-aggregant activity of phospholipase-A2 inhibitors

Mepacrine, papaverine, p-bromophenacyl bromide and 2,3-dibromo(4'-cyclohexyl-3'-chloro)-phenyl-4-oxo-butyric acid (CB 874) inhibit the hydrolysis of phospholipids induced by thrombin in dog platelets. They also exhibit anti-inflammatory and anti-aggregant properties. These biological activities may be explained by a direct or indirect inhibitory action on phospholipase A2. Phospholipase A2 inhibitors may block not only the release of arachidonic acid and its subsequent conversion into prostaglandins but also the formation of lysophospholipids involved in inflammation and/or platelet aggregation.

[Vitamin B2 deficiency and total parenteral nutrition]

A 15 year old adolescent with Crohn's disease who received total parenteral nutrition for three months developed riboflavin deficiency. The aetiology, the clinical picture and the method of diagnosis of this unusual deficiency are reviewed. The importance of an adequate intake of vitamin B2 and the other B group vitamins, particularly in the malnourished, is emphasied.

[Supply of vitamin A, E, C, B 12 and folates during total parenteral nutrition in pediatrics]

Serum vitamin A, vitamin E, vitamin B12, folate and leucocyte vitamin C were measured in 45 patients between the ages of one month and 2 1/2 years who were receiving total parenteral nutrition. After allowing for variations in intake the following recommendations are made: Vitamin A (central vein) 2,500 i.u./day (peripheral vein) 1,000 - 1,500 i.u./day. Vitamin E (peripheral vein) 0.8 mg/kg/day, Vitamin B12 (central vein) 0.8 - 1 microgram/day, Folate (central vein) 10 - 80 microgram/day, Vitamin C (central vein) 25 mg/day.