Fibromuscular dysplasia as a cause of stroke in infancy and childhood

Two children had abrupt onset of hemiplegia due to childhood fibromuscular dysplasia (FMD). Although FMD is a recognized cause of strokes in adults, the disorder has not, to our knowledge, been reported previously in children. Our report reviews the pathology and diagnosis of FMD and discusses the complexities of its treatment.

Phenylketonuria masked by low protein feeds

Two patients with phenylketonuria (PKU) requiring treatment were fed on low protein milks. Both had blood phenylalanine levels below 1200 micronmol/l (20mg/100 ml) until given a phenylalanine challenge. Phenylalanine content of mature breast milk may provide intakes similar to those used in treating PKU. Diagnosis of PKU is unlikely to be missed if screening is carried out on the sixth or seventh day of life because of higher phenylalanine in breast milk during the first week. Interpretation of screening tests requires knowledge of the infants' feeds and a blood phenylalanine above 360 micronmol/l (6 mg/100 ml) in the absence of tyrosinaemia requires careful investigation.

57-cobalt-bleomycin as a tumor scanning agent in primary hepatocellular cancer

57Co-bleomycin and 99mTc-sulfur colloid scans were performed in 13 southern African black patients with primary hepatocellular cancer (PHC) and 3 patients with other space-occupying hepatic lesions. Selective concentration of 57Co-bleomycin in the defect or defects seen on the 99mTc-sulfur colloid scan occurred in only 4 of the 13 (31%) patients with PHC. In the remaining PHC patients, as well as in the 2 patients with metastatic liver disease and the 1 patient with an amebic liver abscess, the 57 Co-bleomycin and 99mTc-sulfur colloid scans were identical. 57Co-bleomycin appears to have only a limited place as a tumor-seeking agent in the diagnosis of PHC in southern African blacks.

Correction of leukocyte function in Chediak-Higashi syndrome by ascorbate

Because ascorbate potentiates chemotaxis of normal leukocytes, we examined the effect of ascorbate on polymorphonuclear leukocytes from a patient with the Chediak-Higashi syndrome. Chemotactic migration was 104+/-16 leukocytes per 10 fields (mean+/-S.D.) initially and 258+/-44 (P less than 0.001) after ascorbate, as compared to 182+/-10 in controls. There was no bactericidal activity by 40 minutes in the patient's untreated leukocytes. After ascorbate bactericidal activity of patient and untreated control cells was the same. The addition of ascorbate reduced cAMP levels in the patient's cells from a mean of 34.5 pmoles per 10(7) polymorphonuclear leukocytes to 5.9, as compared to a control value of 3.1+/-1.4. The association of elevated cAMP and impaired function in the polymorphonuclear leukocytes of patients with the Chediak-Higashi syndrome may be related to abnormal microtubular assembly.

Alterations in plasma sialyltransferase associated with successful chemotherapy of a disseminated tumor. Case report

Levels of plasma sialyltransferase were measured in a patient with disseminated carcinoma of the testes. Initial enzyme values, elevated six fold above those in normal controls, were among the highest thus far encountered in a population of patients with various stages and types of malignancy. During a remarkable respose to chemotherapy with cis-diaminodichloroplatinum, plasma sialyltransferase levels fell markedly. Serial measurement of this enzyme may aid in evaluation of tumor responsiveness to therapy in patients whose disease is not readily measurable.

Anxiety, self-concept, and personal and social adjustments in children with sickle cell anemia

The psychologic effect of sickle cell anemia, a life-long chronic illness, on the self-concept, anxiety level, and personal and social adjustments of school-aged children was investigated by using a battery of standard psychologic tests. Two groups of children were evaluated: a study group of 29 children with sickle cell anemia (hemoglobin SS) and a comparison group of 26 black inner city schoolchildren without sickle cell disease or other known chronic illness. The youngsters with sickle cell anemia did not differ from a peer group of schoolchildren in personal, social, and total adjustments. The self-concept scores of the patient group were lower than those of the comparison group. An unexpected finding of the study was the observation that the anxiety scores (measuring acute anxiety) were significantly lower in the study group than those in the comparison group.

Feather pecking and cannibalism in a caged layer flock

1. The progress of feather pecking and cannibalism was recorded from hatching to end of lay in a flock of caged layers and the influence of group size, floor area allowance and cage tier upon the incidence of these activities during lay assessed. 2. The largest group suffered more cannibalism and feather pecking than smaller groups, floor area allowance and tier being less important factors. 3. A significant trend was found for one death from cannibalism to be followed by more in the same cage.4. It was concluded that feather pecking and cannibalism are separate phenomena, although the same cage conditions increased the incidence of both. 5. Cannibalism may be divided into vent pecking and cannibalism affecting other parts of the body, the former is independent of feather pecking and the latter, though usually preceded by feather pecking, is only indirectly associated with it.

Elevated plasma sialyltransferase in the cancer patient

Sialyltransferase activity was measured in plasma samples using desialated fetuin as the acceptor and cytidine 5'-phosphate-sialic acid as donor. The data show an increased enzyme level in 56 of 65 cancer patients studied, as compared with normal control values. The enzyme was not significantly elevated during lacation or in liver cirrhosis, but it was elevated in rheumtoid arthritis. Of the patients with cancer, 35 showed plasma enzyme levels above any value encountered in rheumatoid arthritis plasmas. The determinants of enzyme level in cancer appear to be complex: monitoring of plasma sialytransferase may be of value in measuring tumor progression, metatastatic involvement, or success of therapeutic programs.

The syndrome of systemic carnitine deficiency. Clinical, morphologic, biochemical, and pathophysiologic features

An 11-year old boy had had recurrent episodes of hepatic and cerebral dysfunction and underdeveloped musculature. Overt weakness developed at age 10. Lipid excess, especially in type I fibers, was found in muscle. Hypertrophied smooth endoplasmic reticulum and excessive microbodies were present in liver. Marked carnitine deficiency was shown in skeletal muscle, plasma, and liver. Ketogenesis was impaired on a high fat diet, but omega oxidation of fatty acids was enhanced. There was excessive glucose uptake and essentially no oxidation of labeled long-chain fatty acids by perfused forearm muscles in vivo. Oral replacement therapy restored plasma carnitine levels to normal, but not liver or muscle carnitine levels, and was accompanied by clinical improvement.

Supplying health care to nondelegates during 1972 national political conventions

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Labile inhibitor of lymphocyte transformation in plasma from a patient and subacute sclerosing panencephalitis

A thermolabile inhibitory factor of mitogen-induced lymphocyte transformation was observed in the fresh plasma of one patient in stage 3 of subacute sclerosing panencephalitis (SSPE) and not in three other patients in various stages of the disease. Thus, its relevance to SSPE is not clear. The plasma factor was removed by adsorption onto human and animal cells and polystyrene beads, and it was found in the 7S globulin fraction of the effluent from gel permeation chromatography.