[Viscous human collagen IV. Physical properties and experimental tolerance]

Viscous solutions of collagen IV have been used experimentally on rabbits and monkeys. The physical properties of the solution allow a first class visco-surgery. Tolerance is studied: degradation and absorption in the anterior chamber, intraocular pressure, endothelial effects, biological sensitivity. Good tolerance and mechanical properties are said excellent and use during human surgery has started.

[Nutritional copper deficiency. Apropos of a case]

Copper deficiency developed in a five-month-old prematurely born infant with an abdominal wall closure defect and a small bowel fistula under long-term parenteral nutrition. The first manifestations were typical bone changes including diffuse osteoporosis, delayed bone age, widened cupped metaphyses with beaks and a fracture, subperiosteal hematomas and ossifications in the shafts of long bones, and a diaphyseal fracture. Other findings that confirmed the diagnosis included edema of the limbs with pseudoparalysis, neurologic abnormalities, anemia, leukoneutropenia, and very low serum levels of copper and ceruloplasmin. Following initiation of copper supplementation, clinical, hematological and biological disorders resolved within a few days and roentgenologic bone abnormalities within four months. Copper deficiency develops only in the presence of specific risk factors, that are often combined in a single patient: inadequate stores due to prematurity, excessive loss due to chronic diarrhea, exudative enteropathy, a proximal stoma, or a biliodigestive fistula; and inadequate intake due to malabsorption or long-term exclusive parenteral nutrition (EPN). Appropriate copper supplementation is needed in all these high risk situations. Early, continuous copper supplementation is required for young children under EPN. Serum copper assays should be included among the periodically monitored biochemical parameters.

Multiple dental extractions in a child with Glanzmann's thrombasthenia: report of case

Patients with Glanzmann's thrombasthenia have a tendency to hemorrhage. This report shows evidence, however, that extractions in children with the disease can be accomplished without supplemental therapy.

[Neonatal bilateral renal venous thrombosis and Salmonella ibadan infection. Cure with thrombolytic agents]

An 11 day-old neonate presented with bilateral renal venous thrombosis in the course of Salmonella Ibadan infection. 36 hours thrombolytic treatment with urokinase was associated with an immediate favorable outcome. Heparin and antibiotic treatment were pursued for 3 weeks. A 6 month follow-up and results of renal ultrasonography, urography and renal scanning allow to assess recovery, with restoration ad integrum for both kidneys.

[Influence of caudal anesthesia on the secretion of catecholamines in children]

Eighty-two children, class ASA I, between four months and 14 years of age, all undergoing elective subumbilical surgery, were randomly assigned to two groups: a control "halothane anesthesia" group (n = 35) and a 0.25% bupivacaine "caudal anaesthesia" group (n = 47). In the control group, there was a significant peroperative increase in heart rate, respiratory rate, systolic blood pressure and plasma adrenaline levels (p less than 0.05). There was no significant difference in the noradrenaline levels. In the "caudal anaesthesia" group, the haemodynamic response was less pronounced, this being concomitant with a decrease in adrenaline and noradrenaline levels (p less than 0.05 and p less than 0.001, respectively). During surgery, there were significant differences between the groups in heart rate, respiratory rate, noradrenaline levels (3 +/- 0,30 nmol X l-1 vs 1.68 +/- 0.18 nmol X l-1; p less than 0.001) and adrenaline levels (1.67 +/- 0,28 nmol X l-1 vs 0.78 +/- 0.08 nmol X l-1; p less than 0.01). It is concluded that the catecholamine response in children undergoing minor abdominal surgery has been blocked by caudal anaesthesia.

[Retrospective diagnosis of a coma in an infant]

A four month old baby presented one morning a quiet, hypotonic, areflexive coma without any signs of localization, which vanished without any sequelae. Hepatic cytolysis and an isolated proteinuria with a maximum at about three days after the initial neurological problems completed the picture. A new interview with the parents looking for a toxic cause revealed without any doubt poisoning by tetrachloro-ethylene. Following this particular case, the main signs of poisoning by halogenated aliphatic hydrocarbons are recalled. One should always have in mind the possibility of poisoning at all ages, even with young babies.

[Neonatal listeriosis and postnatal contamination. A new case]

Four cases of neonatal listeriosis issued from the same maternity during the period of ten days are reported in this paper. Three newborns suffered from a delayed listeriosis meningitic form with complete recovery. The fourth newborn suffered from early septicemic form and died. This is a new observation of post-natal cross infection with listeria monocytogenes in the same maternity. The reported cases remain rare up to now, although this is a classic notion.

[Coma and necrotizing enteritis in Schönlein-Henoch syndrome]

Authors report one case of HENOCH-SCHONLEIN syndrome particular by the association of two serious complications of good prognosis: neurological signs with coma and necrosing enteritis necessitating an intestinal resection of 60 cm of small bowel.

[Nutritional rehabilitation and evaluation of the nutritional state. Validity of anthropometric measures for following, in hospitalized patients, the course of nutritional status and of body compartments during nutritional recovery]

A population suffering from a serious form of malnutrition was examined. The effectiveness of nutritional rehabilitation is demonstrated by the statistically significant changes observed in clinical and laboratory indicators. Several anthropometric measurements related to nutritional status are also compared with total body potassium (TBK) in patients with a positive nitrogen balance during the process of nutritional rehabilitation. It is concluded that weight (W), arm circumference (AC), middle arm muscle circumference (MAMC) and skinfold thickness (ST) measures are useful, and sufficiently accurate and precise to follow the evolution of nutritional status and body compartments.

Carbamazepine in the treatment of aggressive behavior in schizophrenic patients: a case report

Carbamazepine has been used in the treatment of temporal lobe epilepsy since 1963. It has also been found effective in the treatment of psychiatric disorders accompanying epilepsy. Patients with nonspecific EEG abnormalities without overt epilepsy but with behavioral problems, including gross psychopathology and violent behavior, improve on carbamazepine. These findings prompted us to use it in the treatment of aggressive behavior in a schizophrenic patient. Due to the frequency and severity of aggressive behavior in this patient, maintenance ECT was given. However, when carbamazepine was instituted, ECT was discontinued and the patient has been virtually free from aggressive behavior since this medication has been instituted. The authors conclude that carbamazepine may be used in the treatment of aggressive behavior in schizophrenic patients.

Capgras syndrome in siblings

The hallmark of the Capgras Syndrome is delusional misidentification of persons, objects or animals. It can occur in organic syndromes and in functional disorders. Hence there are adherents of organic as well as dynamic factors in the genesis of this disorder. The authors report the occurrence of the Capgras Syndrome in a brother and sister and elaborate on the interplay of both genetic and dynamic factors in the etiology.

Phase I clinical trial and pharmacology of 2,4-diamino-5-(3',4'-dichlorophenyl)-6-methylpyrimidine (metoprine) (DDMP) and folinic acid (CF)

Escalating doses of DDMP (metoprine) (15-280 mg/m2) were administered as single oral doses 24 h before a fixed leucovorin (CF) rescue (15 mg IM every 6 h for 72 h). CNS toxicity was dose-limiting and cumulative when the drug was given more frequently than at 3-week intervals. DDMP has a very long half-life (150 h) and is extensively bound to serum proteins (88%). It diffuses into the CSF and concentrates in brain tumours and normal brain tissue (brainserum ratio 3.8-5.3). DDMP is a potentially useful drug against brain tumors. Tumor regressions were seen in two patients with epidermoid carcinomas.

[Henoch-Schoentein syndrome following duodenitis with severe denutrition from distal ileum lesions. One case (author's transl)]

A case of Henoch-Schoenlein syndrome in an 8-year old child is described. The cutaneous symptoms appeared 10 days after duodenitis with ulceration of the duodenal bulb. Severe denutrition resulting from lesions of the distal ileum total required parenteral nutrition for 38 days. The anatomo-radiological signs of gastrointestinal manifestations of the syndrome are discussed.