Diffuse xanthogranulomatous pyelonephritis in children: an unrecognized variant

Xanthogranulomatous pyelonephritis in childhood has been thought to exist only in focal form. We encountered 2 cases of diffuse xanthogranulomatous pyelonephritis in children and have found 3 others reported in the literature, making it necessary to change this concept. The essential radiologic and pathologic differences between focal and diffuse xanthogranulomatous pyelonephritis are reviewed.

Congenital oesophageal stenosis

A case of congenital oesophageal stenosis presenting shortly after birth is reported. Treatment by daily dilatation with a bead on a continuous thread loop was carried on at home over several months. This proved to be a simple, safe, and effective treatment.

Mantel-Haenszel analysis of Oxford data. II. Independent effects of fetal irradiation subfactors

A Mantel-Haenszel analysis of fetal irradiation subfactors indicated that most of the "extra" X-rayed cases in the Oxford Survey of Childhood Cancers were radiation induced. First trimester exposures were rare but probably ten times more dangerous than later exposures. Ratios of observed: expected numbers of cancer deaths were lower for children with abnormal X-rays than for other X-rayed children, and lower for recent than remote exposures. The first of these differences was probably due to several antenatal conditions having positive associations with obstetric radiography and several causes of early (noncancer) deaths; the second one was probably due to a progressive lowering of film doses between 1940 and the present time. A rare cause of fetal irradiation (hydramnios), whose associations with congenital defects are well documented, led to the discovery that two faults in the International Classification of Diseases and Causes of Death have contributed to mistaken ideas about the etiology of childhood cancers: Neoplasms were not listed among the official causes of stillbirths, and cystic tumors of the kidneys and lungs of infants were not listed as neoplasms.

Mantel-Haenszel analysis of Oxford data. I. Independent effects of several birth factors including fetal irradiation

Data from the Oxford Survey of Childhood Cancers were subjected to the Mantel-Haenszel procedures to recognize independent effects of associated factors in retrospective data. Our results showed that several birth factors, including fetal irradiation, social class, maternal age, and sibship position, exerted separate effects on childhood cancers in general, and reticuloendothelial system neoplasms in particular.

Pre-natal irradiation and childhood malignancy: a review of British data from the Oxford Survey

This paper reviews data relating to obstetric radiography from the Oxford Survey of Childhood Cancers, i.e. for deaths in Britain from 1953 to 1967. Some 8513 cases were traced and used in the analyses, together with an equal number of matched controls. The relative risk estimate (1-47 overall) does not vary significantly between different tumour groups, for different ages at death, nor between sexes. Other epidemiological factors-sibship position, maternal age, social class, region of residence and maternal morbidity-are analysed and show varying degrees of association, but not sufficient to "explain" the observed risk in terms of a selection effect. The dependence of the risk on the number of films exposed is highly significant and adequately described by a linear relationship. The timing of and reason for the exposure are also examined. Analysis of the risk by year of birth shows a pattern of steadily declining risk for both solid and haematopoietic tumours; this may be partly attributable to lower radiation doses per film exposed but is also due to the smaller numbers of films used. A consequence may well be that the risk-always of small clinical significance-would become virtually undetectable in future investigations.

Ferromagnetism of SmCd

Measurements have been made of the magnetizations and resistivities of polycrystalline specimens of SmCd and LaCd. SmCd is found to be ferromagnetic with a Curie temperature of 194 K and a spontaneous moment of 0�05 PH per samarium ion at 77 K. Above this

Group characteristics of children with cerebral and spinal cord tumours

A study of 2072 children who developed cerebral or spinal cord tumours of varying degrees of malignancy before 15 years of age has shown that there is equally good representation of fatal and non-fatal cases in official registrations. Attack rates are higher for boys than girls and the prognosis is better for girls than boys. The risk of an early death is negatively correlated with age at diagnosis, and the risk of a late death shows the opposite relationship. These observations and a relatively high incidence of hindbrain tumours are suggestive of an embryonic origin for most of the cases.

Cancer as a cause of abortions and stillbirths: the effect of these early deaths on the recognition of radiogenic leukaemias

Data from the Oxford Survey have shown that childhood cancers are causes of in utero deaths which affect leukaemias more than solid tumours and difficult deliveries more than easy ones. As a result of these biases singletons give the impression of being more leukaemia-sensitive than twins. This is a false impression which affects other situations and makes it more difficult to detect the leukaemogenic effects of obstetric radiography in a prospective survey than in a case-history survey, and essential to look for these effects beyond the period affected by the in utero deaths.

Illness as subjective experience

This is a patient's autobiographical account of her illness while hospitalized at the place of her employment. She discusses her emotional reactions to her illness experience–her anxiety and depression over seizure activity and concomitant debilitation, her frustration over her failure to communicate with the staff, her request for psychiatric consultation, and her eventual rehabilitation. She raises such issues as the reluctance of physicians to recommend psychiatric consultation, the obstacles to effective communication and patient care posed by medical territorialism, and the complications that arise when a health worker must assume the role of patient, cared for by fellow staff members.

Vibration syndrome

Stewart, Alice M., and Goda, D. F. (1970).Brit. J. industr. Med.,27, 19-27. Vibration syndrome. Raynaud's phenomenon, or the finger blanching of men who work with vibrating tools, is undoubtedly due to vasospasm. Nevertheless the abnormal element in the situation is not a series of traumatized nerve endings but a deposition of callus under the palmar surfaces of fingers and thumbs. This deposition is a late consequence of the most distinctive, but not necessarily the most painful, of the numerous effects incurred as a result of the tool speed being completely out of the control of the operator and of the tool/component rebound being only partially under his control. The replacement of soft finger pads by rigid callus is also the only consequence of hard manual work to show how necessary it is for a structure like a finger–which is largely composed of bones, joints, tendons, and skin–to have a reservoir, the equivalent of a blood-filled sponge, between every joint to accommodate any sudden reduction in blood volume, or indeed any sudden increase in the volume of blood held in the arteries and veins relative to the amount held in the capillaries. It is still a moot point whether users of vibrating tools have more arm complaints of a serious nature than other manual workers. They do, however, have a multiplicity of aches and pains, ascribable to various causes including tool speed and tool/component rebound, which are in toto very sensitive to such things as blunt impacts, hard components, heavy tools, awkward jobs, and inept handling of tools, whether the ineptness be due to inexperience or to advancing age. Users of vibrating tools have more pain in the hands and wrists than in the elbows and shoulders, but the pain tends to persist longer in the latter sites than in the former sites.

Seasonal fluctuations in wool growth in south Western Australia

The growth rate of wool was measured at monthly intervals for a period of two years in four groups totalling forty Merino sheep, maintained under typical farm conditions in a Mediterranean climatic environment. Marked seasonal fluctuation in wool growth was found in all sheep. The highest level of clean wool production, 85 attained in the spring months, was nearly three times that of the lowest level, which occurred in the autumn. The rate of wool growth fluctuated independently of body weight. Wool growth fell steep4 while bob weight was maintained; wool growth subsequently rose sharply while body weight increased relatively slowly. The factors responsible for the observed fluctuation in the rate of wool growth are discussed and the conclusion reached that lack of useful energy and protein, in the summer and autumn grazing is probably the principal cause of the decline in rate of wool growth in these months.