High-Sensitivity Dry Rehydratable Film Method for Enumeration of Coliforms in Dairy Products: Collaborative Study

A dry-film coliform count plate that is inoculated with 5 mL sample was compared with the Violet Red Bile Agar plate method in a collaborative study by 18 laboratories. Products analyzed were 2% milk, chocolate milk, cream, vanilla ice cream, cottage cheese, and cheese. Collaborators tested blind duplicate uninoculated samples and samples inoculated at low, medium, and high level. Significantly (P< 0.05) higher numbers of coliforms were recovered by the dry-film method from 2% milk samples at the 3 inoculum levels, the chocolate milk at the low- and high-inoculum levels, and the cream at the high-inoculum level. Significantly higher counts were obtained by the agar method for cottage cheese samples at the low-inoculum level. The repeatability standard deviation for the dry-film method was significantly higher for the high-inoculum level chocolate milk sample and the medium-inoculum level cottage cheese. The same statistic was significantly higher for the agar method at all 3 inoculum levels in the 2% milk and the medium-inoculum level cream. The high-sensitivity dry rehydratable film method for enumeration of coliforms in dairy products has been adopted first action by AOAC INTERNATIONAL.

[Fluoride and children]

Fluoride is considered as an essential carioprophylactic agent. However, its use raises problems related to the possible negative effects of excessive intake. Precautions are therefore necessary when prescribing fluoride to children. This includes: 1) evaluation of all sources of fluoride for each individual child and his/her family; 2) evaluation of the cariogenic risk for the child according to his/her environment; and 3) estimation of the family's ability to follow medical advice and prescriptions. The role of the practitioner is thus to adapt the fluoride prescription according to the age and particular cariogenic susceptibility of each child. Pediatricians, general practitioners and dentists need to be convinced of how important regular visits to the dentist are for all children, from an early age. Not only fluoride, but also nutrition and hygiene are essential factors in achieving good dental health in childhood.

Fos-immunoreactive responses in inferior colliculi of rats with experimental audiogenic seizure susceptibility

Audiogenic seizure (AGS) susceptibility is a reflex epilepsy of rodents in which acoustic stimulation evokes wild running attacks and subsequent convulsions. Susceptibility can be induced in non-susceptible strains by treatments causing transient or permanent hearing losses as long as these occur during the neonatal period. The defect which is the basis of susceptibility has been proposed to be a failure of developmental organization of inferior colliculus (IC) into frequency selective zones. That is, high frequency stimuli evoke responses in broader arrays of neurons in ICs of susceptible rats than in those of neonatally untreated (non-susceptible) controls. Nonetheless, this observation has been made only in rats in which susceptibility was induced by exposure to intense noise on postnatal day (PND) 14. By contrast, the present study examines whether unusually broad topographic responses are also characteristic in ICs of rats made susceptible by the neonatal administration of low doses of the ototoxic antibiotic, kanamycin (KM). Patterns of Fos-like immunoreactivity (Foslir) induced by seizures or pure tone stimuli were compared in ICs of adult Wistar rats which neonatally had been (a) sham-treated; (b) noise-exposed on PND 14; or (c) injected on PNDs 9-12 with 100 mg/kg KM. It was found that sound-triggered seizures in the two experimental groups resulted in induction of Foslir primarily within cortical areas of IC. By contrast, pure tones evoked unusually broad responses in the central nucleus of ICs of both susceptible groups but not in those of controls. Additionally, in the KM-treated rats, the range of frequencies evoking abnormal responses extended one octave lower than was characteristic of noise-exposed rats. The earlier schedule of treatments in the KM model may account for this inasmuch as low frequency response domains undergo development at younger ages. The similarity of results in the two models suggests failure of development of frequency selective fields in IC is indeed the common basis of experimentally induced susceptibility to sound-triggered seizures.

Cochlear integrity in rats with experimentally induced audiogenic seizure susceptibility

While chronic susceptibility of rodents to audiogenic seizures (AGSs) is often accompanied by cochlear lesions, it has not been demonstrated whether cochlear hair cell losses are essential to pathogenesis in this epileptic disorder. An alternative possibility is that the neonatal timing of hearing losses is what unites various models of chronic AGS susceptibility. In the latter case, either transient or permanent hearing losses might induce susceptibility as long as they concur with a critical period of development. To address this issue, it was examined whether lesions were universally present in cochleas of adult rats after having been made susceptible to sound-triggered seizures by different types and severities of neonatal auditory trauma. Neonatal treatments included: (1) an 8 min exposure of rat pups to intense noise (125 dB SPL) on postnatal day (PND) 14; (2) injections of low doses of kanamycin (KM: 100 mg/kg) on PNDs 9-12; or (3) injections of high doses of KM (500 mg/kg) on PNDs 9-12. As adults, rats in all experimental groups, but not in sham-treated groups, exhibited sound-triggerable seizure responses. Nonetheless, this outcome did not depend on integrity of cochleas. Hair cells were rarely missing in the cochleas of noise-exposed, low-dosage KM-treated, or sham-treated rats. By contrast, all inner and outer hair cells were missing from the basal 75% of cochleas of adult rats which had been treated with high-dose KM on PNDs 9-12. Results indicate that cochlear lesions are not requisite for the induction or expression of AGS susceptibility. At the same time, however, significant hair cell losses do not necessarily preclude susceptibility. It appears that the neonatal timing rather than the permanence of hearing losses may be what engenders chronic AGS susceptibility.

Autoimmune disease results from multiple interactive defects in apoptosis induction molecules and signaling pathways

Activation induced cell death (AICD) plays a critical role in eliminating autoimmune cells and limiting inflammation after activation. The two major signaling molecules for AICD are the Fas and TNF-R pathways of apoptosis. Defective Fas apoptosis in lpr/lpr mice results in a compensatory increase in TNF-R/TNF-mediated apoptosis. TNF/TNF-R has been shown to be a compensatory pathway of apoptosis in T cells and macrophages of lpr/lpr mice. Therefore, early production of TNF/TNF-R limit an immune response by inducing AICD in the absence of an intact Fas/Fas ligand apoptosis pathway. However, increased TNF production in lpr mice also lead to increased susceptibility to septic shock and autoimmune disease such as arthritis. Therefore TNF production during an inflammatory response can downmodulate this response, but this also results in the failure to downmodulate TNF production leading to septic shock and arthritis. A second pathway of AICD is mediated by Nur77 after T cell stimulation through the CD3 molecule. Mice with defective Nur77 signaling undergo AICD using the Fas-Fas ligand pathway to eliminate autoreactive T cells. A third defect of AICD is observed in HCP-mutant me/me (motheaten) mice which develop autoimmune disease related to defective Fas apoptosis signaling. Therefore, multiple interactive pathways play a role in limiting development of autoimmunity.

Development of frequency-selective domains in inferior colliculus of normal and neonatally noise-exposed rats

Topographic patterns of pure-tone responses in inferior colliculus (IC) of Wistar rats were mapped using immunohistochemical staining for the nuclear protein Fos, the translation product of the c-fos proto-oncogene. Patterns were compared in ICs of immature and mature rats and in mature rats which experienced auditory deprivation beginning on day 14, an age near the developmental onset of hearing. Neonatal hearing losses, caused here by exposure to potentially deafening noise, are known to result in audiogenic seizure susceptibility in neonatal rats. These seizures can be triggered only by high-frequency stimuli and are believed to be initiated in IC. Thus, it seemed possible that susceptibility might depend on derangements of topographic frequency representation due to neonatal auditory deprivation. The band-like frequency-response domains, characteristic of adult IC, were found to be poorly differentiated in ICs of immature rats. On day 12, only lower-frequency stimuli induced discrete bands of Fos immunoreactivity while responses to higher frequencies remained exceptionally diffuse within ventral portions of IC. Only after day 24 did responses to the highest frequencies also appear mature. Furthermore, most significantly, adult rats which were transiently deafened on day 14, retained the more voluminous response patterns which were characteristic of immature IC. Because frequency selectivity in cochlea also develops by a low-to-high frequency sequence, results are consistent with a hypothesis that topographic organization arises in IC by an activity-dependent process. Whereas neonatal noise exposure also conferred audiogenic seizure susceptibility, it appears the arrest of tonotopic organization of IC is the probable basis of this reflex epilepsy.

[Endocrinal sequela in bone marrow transplantations during childhood and adolescence]

Bone marrow transplants are being increasingly used to treat a broadening spectrum of serious pediatric conditions including hematologic, metabolic, and immune disorders. A common adverse effect is slowing of statural growth which, according to the author's experience, reaches 0.4 SD a year on average in the highest risk group with progressive graft-versus-host disease after whole body irradiation and transplantation of an allograft. Growth was normal in autograft recipients treated by moderate-intensity chemotherapy. High-dose chemotherapy, in particular with busulfan and cyclophosphamide, has been reported to cause growth retardation. The mechanism of failure to gain height is complex. Partial growth hormone deficiency is rare. Relative resistance of growth plates is the most likely mechanism. The role and efficacy of growth hormone replacement therapy is unclear. Conditioning regimens can affect ovarian and testicular function. Peripheral thyroid resistance can occur after whole body irradiation and transplantation of an allograft. The high rate of growth and endocrine disorders warrants close monitoring including full evaluations of growth and pubertal development as well as periodic endocrinologic investigations.

Noise exposure-induced audiogenic seizure susceptibility in Sprague-Dawley rats

Parameters were evaluated for the optimum induction of audiogenic seizure susceptibility in Sprague-Dawley (SD) rats by noise exposure. The effect of maturation on this susceptibility was also examined. It was found that SD rats are most inducible between neonatal days 13 and 15 and that susceptibility requires a minimum of 2 days to develop. Noise exposure on day 14 results in universal susceptibility by day 20, but seizure severity is not maximal until days 32-36. Although susceptibility persists at high levels into adulthood, seizures in older rats revert to the wild-running-only type. Seizure latency (from stimulus onset to onset of wild running) becomes increasingly shorter during the prepubescent period (days 16-24) but is stable at older ages. The mean shortness of latency in adult seizures depends somewhat on the age when initial noise exposure occurred; day-14 noise exposures result in seizures with shortest latencies. Ontogenetic comparisons were made of susceptibility in these noise exposure-induced rats, genetically epilepsy prone rats (GEPRs, which are SD substrains)29 and noise exposure-induced Wistar (WI) rats28. It appears that epileptogenesis begins at virtually the same age in all four groups of rats but that considerable differences characterize the absolute severity of seizures and the age dependence of maximum seizure severity among the strains.

Audiogenic seizures in unilaterally sensitized and monaurally stimulated Wistar rats

Results of previous studies (Pierson, M. and Swann, J., Epilepsia, 32 (1991) 1-9) have demonstrated that exposure of Wistar rats to noise on day 14 results in audiogenic seizure susceptibility. Experiments reported here examined whether unilateral susceptibility could be induced in rats by monaural restriction of this noise exposure. Behavioral attributes of seizures on day 28 were compared in groups that were: binaurally noise-exposed/binaurally tested, binaurally noise-exposed/monaurally tested, monaurally noise-exposed/binaurally tested and monaurally noise-exposed/monaurally tested. Effects of left- and right-ear exposures and tests were assessed separately. Unilateral susceptibility was evident since seizures could be elicited later only by stimulation of the originally noise-exposed ear. Seizures were behaviorally different in monaurally noise-exposed and binaurally noise-exposed animals. Convulsions, directional reversals during running episodes, and relatively short latencies occur only in binaurally noise-exposed rats. These behaviors occur with either monaural or binaural stimulation. Initial, running direction was random in binaurally stimulated/binaurally noise-exposed rats, but was fixed in all other groups depending on which ear was exposed in either sensitization (day 14) or testing (day 28). Right- and left-ear sensitizations or tests resulted in left-directed and right-directed running onsets respectively. Previous studies of the effect of selective CNS lesions in instances of unilateral or bilateral susceptibility have led to the understanding that seizure initiation in unilaterally susceptible animals is mediated by the crossed ascending auditory pathway.(ABSTRACT TRUNCATED AT 250 WORDS)

Sensitization to noise-mediated induction of seizure susceptibility by MK-801 and phencyclidine

The effect of single administrations of MK-801 (5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine) or PCP (phencyclidine) on the induction of audiogenic seizure susceptibility by noise in immature rats was examined. Treatments with these non-competitive N-methyl-D-aspartate (NMDA) receptor antagonists resulted in increases in noise exposure-dependent susceptibility. In neonatally drug-treated rats, seizures during adulthood were found to occur with significantly higher incidence and severity. Furthermore, drug treatments were found to lengthen what is normally a restricted developmental period within which susceptibility can be induced by noise exposure. The drugs, however, had no inherent ability to induce audiogenic seizure susceptibility if given alone. Moreover, in already-susceptible rats, MK-801 exhibited predictable anticonvulsant effects. These data suggest acute PCP or MK-801 exposures may transiently exacerbate risks inherent in certain forms of trauma. The mechanism underlying these effects is unknown although certain inferences are possible and may reveal much about epileptogenesis in this model.

Growth hormone response following growth hormone releasing hormone injection in thalassemia major: influence of pubertal development

Thirty-five patients with thalassemia major, aged 7 to 21 years, were studied to define the relationship between the pubertal development and the growth-hormone (GH) secretion during sleep, after administration of GH-releasing factor (hpGRF 1-44), and betaxolol-glucagon or arginin-insulin. Pubertal development was classified as being appropriate or delayed for chronological age. GH response to pharmacological stimuli and during sleep was not linked to the pubertal development according to the chronological age. The peak of GH secretion after GHRH injection was significantly delayed in thalassemic patients with retarded puberty. The integrated secretion of GH during the 120-min test was slightly but not significantly reduced in these patients. The prepubertal pattern of GHRH response was restored in the patients receiving substitutive therapy by HCG or testosterone. The alteration of GH response to GHRH in thalassemic patients is likely to be only due to delayed puberty and decreased endogeneous GHRH secretion since it is corrected by androgen or gonadotropin replacement.

Comparative study of biosynthetic human growth hormone immunogenicity in growth hormone deficient children

The immunogenicities of six recombinant human growth hormone (rhGH) preparations, from KABI (A rhGH191 and B rhGH192), Eli Lilly (C), Nordisk (D), Sanofi (E) and Serono (F), used to treat 260 GH-deficient children, have been compared using a common specific and sensitive procedure for antibody determination. For this purpose we developed two immunoassays: a competitive liquid radioimmunoassay using 125I-rhGH, and an immunometric solid enzymoimmunoassay in which the rhGHs were immobilized. Blood samples were collected from the GH-deficient children before treatment and after 3, 6, 9, 12, 18 and 24 months of therapy. Human GH antibodies were detected in children treated with 3 of the 6 rhGH preparations. Seven percent of the patients treated with hormone A, 14% with hormone B and 22% with hormone C formed antibodies against the respective rhGH. Differences in capacity and affinity of the hGH antibodies were observed between these anti-GH-positive groups. They could be divided into 2 groups according to their immunopotency. One group (7, 14 and 6% of the patients treated with hormones A, B and C, respectively) developed anti-hGH antibodies with very low binding capacities (30-100 fmol/ml). The other group (16% of the patients treated with hormone C) developed IgG-type antibodies to hGH with higher binding capacities (200-1,200 fmol/ml) and a measurable binding affinity (Ka = 10(8) M-1). These hGH antibodies partially inhibited the binding of labeled GH to its specific liver membrane receptor. However, because of their low titer, they did not inhibit growth in the treated children.(ABSTRACT TRUNCATED AT 250 WORDS)

[Adynamia episodica hereditaria: Gamstorp's disease or Eulenburg's paramyotonia?]

Over seven generations owing 71 identified and studied persons, 18 (12 males and 6 females) suffered paroxystically adynamic paralysis or myotonic accesses. A such association is rare and according to the proeminent symptoms is denominated as hyperkaliemic periodic paralysis or as congenital paramyotonia. In the both forms of the diseases: cold injury, fasting, long time resting, or efforts are able to provoke crisis and so does an oral potassium loading. Studies on Ka+Na membrane permeability suggest the responsibility of Na+ K+ pump and may explain the physiopathology of the alternative manifestations at the muscle cellular level but may be are rather a marker than a cause of permeability disturbances. In the present family, some clinical, biological and electrophysiological arguments suggest the unicity of the disease. A better way to confirm that would be the localisation of a unique gene in the patient. DNA samples of several members are in study for molecular biology in the hope to precise a identical location. Some informations from molecular biologists suggest a probable location near the myotonic dystrophy (M.D.) in the 19 q12 but not identical with it.

Peripheral nerve function in children with end-stage renal failure

Information on clinical and subclinical peripheral neuropathy in children with end-stage renal failure (ESRF) is scarce. We have studied the presence of clinical and subclinical peripheral neuropathy in children with ESRF comparing recently developed non-invasive methods with the measurement of nerve conduction velocities. Twelve children (7 boys, 5 girls; age range: 5-17 years; duration of haemodialysis: 0.5-60 months) participated. Thermal discrimination threshold (TDT) and vibration perception threshold (VPT) were determined twice before and after haemodialysis in each patient. Peroneal nerve conduction velocity was determined once before haemodialysis. No clinical or subclinical peripheral neuropathy was observed in any of the children. Except for two slightly increased TDT values after haemodialysis all results were within the normal range. No correlation was found with age or duration of haemodialysis and no association was found between the three methods. VPT values showed a significant improvement after haemodialysis treatment, although all VPT values were in the normal range. This suggests that haemodialysis has an influence on cutaneous sensation, but further study is needed to confirm this observation. Longitudinal investigations will be necessary to evaluate whether TDT and VPT determinations can be used for early screening of clinical and subclinical neuropathy in children with ESRF.

[Stature after 18 months of treatment with synthetic growth hormone in 12 patients with Turner's syndrome]

The increased availability of recombined human growth hormone (rhGH) allows its possible use in clinical situations not classically recognized as regular indications. Among these, the Turner's short stature is presently under experimental evaluation for its responsiveness to rhGH. Twelve patients, 10 with a 45, X karyotype, 1 46 XXiq, and 1 mosaicism, have been given rhGH at a dosage of 0.15 U/kg per injection six times a week. Mean age at onset of treatment was 12.8, mean growth retardation was 4.1 SDS according to Sempé. After 18 months of treatment mean growth catch-up was 0.9 SDS. Maximal velocity was reach during the first trimester of treatment and decreased thereafter but was above normal for bone age in all but 2 after 18 months. The bone age increased less than structural age. No side effects were reported. At the present time the efficacy of rhGH in increasing final height in Turner's patients is likely but not demonstrated by any studies. The exact place of ovarian substitution, even during the prepubertal period, is still matter of discussion. Since the velocity response to rhGH was maximal among the youngest patients an early diagnosis of the syndrome will likely be necessary to improve final stature.

[Clinical and biological studies of 14 cases of the Prader-Labhart-Willi syndrome]

Clinical and cytogenetic studies are performed on 14 patients with PWS including endocrinological investigations, as coagulation factor XI activity and pigmentation studies. Recent hypothesis from molecular analysis are discussed.

Interstitial deletion of chromosome 15: two cases

Two cases of interstitial deletion of chromosome 15 with similar clinical features are presented. In one case, assay of hexosaminidase A enabled us to confirm that the structural gene is located between 15q22 and 15q25 and that it is included in the deletion.

[Otologic signs and early diagnosis of Turner syndrome. Reevaluation of 30 cases]

In most occasions the Turner's syndrome is diagnosed on the basis of severe growth retardation. But the possibility of an effective treatment of short stature requires earlier a diagnosis. Among the other signs, the importance of ORL signs is underestimated. A group of 30 patients has been analysed to determine their precise extension. The external ears are frequently prominent, low-set and/or posteriorly rotated. Frequency and chronicity of otitis media is highlighted by hypoacousy of the transmission type. The perception pathology is far less common and seems being independent of middle ear pathology. A abnormal development of the 1st branchial arch is likely to explain the auricular pathology in view of the frequently associated anomalies of the palate and the dental articulation. One must clearly consider the diagnosis of Turner syndrome in the case of chronic auricular pathology associated with low linear velocity in a young girl allowing for earlier diagnosis.

The physical, psychological, educational and professional conditions of young adults given growth hormone for childhood growth hormone deficit

Twenty five of the 75 patients having been given human growth hormone in the Pediatric Nancy Endocrinological Division have reach final adult height. All have been treated the same way, 10 boys and 4 girls were diagnosed as isolated deficit, 7 boys and 4 girls as combined deficit. The physical, sexual, radiological, intellectual, professional and psychological characteristics have been defined either during the treatment follow-up or at a final interview. All results have been compared to the familial conditions if possible. Final adult statures are in the low range of the normal (-2 DS). The sexual development, normal for patients with isolated deficit, has not been achieved completely by regular protocol for patients with combined deficit. The intellectual and professional achievements are rather low but this has to be matched with below the normal familial conditions. Psychological determination is quite satisfactory but the personality is dominated by shyness and lack of responsibility. It is likely that an earlier onset of treatment and a better psychological guidance may lead to a better final results judged both on physical grounds but also on psychological and professional conditions.

[Treatment of neonatal hypothyroidism. Comparative effects of levothyroxine and thyroid extracts]

The authors compare the effects of treatment with thyroid extracts and levothyroxine on T3, T4 and TSH levels in 2 groups of 8 hypothyroid infants. Serum TSH levels were lower in infants receiving thyroid extracts on and after the 15th day. The interest of a treatment associating T4 and T3 and of adapted doses of LT4 is discussed.

[Genetic counseling and the caudal regression syndrome]

It has been published about 500 cases of caudal regression (sacral agenesis) of which 12 are undoubtly familial. In most of the non familial cases an aetiology is not demonstrable except the cases related to maternal diabetes and/or insulin treatment. A genetic control of the caudal regression is implicit in the familial transmission. Three sporadic new cases are reported and, at the occasion of the genetic counselling we analyse the 8 well reported genealogies. Among 133 subjects, 72 show some evidences of caudal regression. This is compatible with a pattern of autosomic dominant transmission. The analogy with the caudal regression anomaly of the mouse, in which the role of genes located closely to the histocompatibility system is demonstrated, evokes such a relation in the human with the major histocompatibility system. If true, this may be used as a genetic marker, especially for early antenatal diagnosis.

[Medical ethics in genetic counseling]

Genetic counselling gives the doctor a peculiar responsibility according to medical deontology and professional ethics rules. Originality and specificity of that kind of counselling requires intensive discussion of the geneticist's attitude in front of the diagnosis and specially prenatal diagnosis.

[Total testicular regression syndrome or anorchidism]

Ten cases of boys without testis are presented. Clinical and anatomical patterns of the disease are analysed. Total absence of testicular tissue is proven by the lack of plasma testosterone response to HCG stimulation and by cautious surgical investigation. Artificial virilization by prolonged androgen administration associated with silastic prothesis implantation is the only possibility of treatment. Anorchism does not represent a form of gonadal dysgenesis or sexual ambiguity since external genitalia are always non ambiguous, chromosomal constitution is XY without any structural anomaly of Y and H-Y histocompatibility antigen is present. Absence or destruction of the testis are caused by different mechanisms, according to the data obtained by individual case studies. The most likely is that foetal testes developped normally are destroyed in utero or in the perinatal period or even soon after birth. The most frequent mechanism with a genetic predisposition, seems to be bilateral pedicle twisting.

[Chromosome 11 and cancer]

Two cases with chromosome 11 anomaly related to cancer are reported. The first one has a pericentric inversion (inv. p14 q12) with sympathoblastoma and Ondine's curse. The second one has a deletion (11p13) with aniridia and catalase deficiency but without Wilms tumor at two year of age. Retinoblastoma, nephroblastoma and sympathoblastoma may be related to genome modification. The mechanism of oncogenesis are discussed.

[Symphalangism and multiple synostoses disease: a study of 2 families]

The more frequent practise of X-ray examination shows that symphalangism may be involved by other synostosis. Maroteaux described in 1972 "multiplex synostosis disease". Seven personal cases (all female) in two families are described with particular problem of deafness and vertebral fusion. Dominant autosomic inheritance.

[Parent-child correlations for stature]

A study on the relationship between a child's expected height and his parents' attained adult height was made from data obtained from 15,381 healthy children, age 4 to 18 years, and of French descent. The correlation between child's and parents' height was significant and important. Correlation coefficients increase with the ages of children. The theoretical height which a child might expect to attain in adulthood, based on his parents' heights, could be calculated by diagrams or program cards used in conjunction with a manual calculator. This information might be of importance for pediatric or medical care in school.

[Benign pheochromocytoma and metaphyseal bone lesions in childhood]

The authors report a 5 year-old child in whom lesions of the inferior metaphyses of the femur and superior metaphyses of the tibia were observed after successive pheochromocytomas. The aspect of the lesions, their improvement after surgical treatment of the tumors, the data in the literature and histologic findings suggest that a bone ischemia was induced by impaired microcirculation with infarction of the metaphyses.

[Puberty and adult height in congenital virilizing adrenal hyperplasia (author's transl)]

A study of 52 pubertal patients having been treated for virilizing adrenal hyperplasia (38 females and 14 males) leads to emphasize the importance of the precocity and accuracy of treatment. In patients with delayed treatment, mainly when they are girls, an advanced or true precocious puberty will increase the advance of bone age and reduce adult height. But, whatever be the time of onset of treatment and of pubertal achievement, no important or sustained sexual improvement was found in patients receiving a well-controlled treatment.

Cholesterol content of serum lipoprotein fractions in children maintained on chronic hemodialysis

Lipoprotein analyses were performed on serum samples from nine hemodialyzed children, 8 to 18 years old, and from nine pair-matched control children. Cholesterol was measured by gas-liquid chromatography in lipoprotein fractions separated by polyacrylamide gel electrophoresis. Total serum triglycerides and cholesterol levels were higher in the hemodialyzed group. Very low density lipoprotein cholesterol concentration was higher. The increase of low density lipoprotein cholesterol concentration and the decrease of high density lipoprotein cholesterol concentration were not significant, but the ratio of the low density lipoprotein cholesterol to the high density lipoprotein cholesterol was increased. These results outline the potential risk of premature atherosclerosis in uremic children on maintenance hemodialysis. In addition, lipoprotein cholesterol reference values are presented from a group of 113 healthy children.