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Head Trauma in football players with mononucleosis
ABSTRACTS
deficiency of certain amino acids (specifically arginine) contributed to the reduction of urea cycle intermediates resulting in hyperammonemia. Toxicity, such as metabolic acidosis, m a y have resulted due to an excess infusion of other amino acids (specifically methionine) in the E.A.A. solutions. These conditions were corrected with the infusion of a C.A.A. hyperalimentation solution.--Jane F. Goldthorn
695
A 7-mo-old male infant with diencephalic emaciation (Russell syndrome) is reported. In this patient, the rostral part of the floor of the third ventricle was elevated by a tumor. Irradiation and operative treatment are discussed and the published literature of 62 cases has been collected and evaluated.--Karl Ludwig Waag
Lymphocyte Response After Surgery in the Neonate.
Wiademann-Beckwith Syndrome. Comment on Hereditary Pattern. J. A. Tovar, J. Arena, and P. Zubigalla. Chir
P. Puri, D. J. Reen, Orla Browns, et al. Arch Dis Child 54:599-603, (August), 1979.
P6diatr 20:187-189, ( M a y - J u n e ) , 1979.
The cellular immune systems of 14 neonates undergoing surgery for a variety of congenital anomalies were studied 2 hr preoperatively and 18 hr postoperatively. The total leucocyte and lymphocyte counts, the percentages and total numbers of T- and B- lymphocytes and the response of lymphocytes to P.H.A. stimulation were each measured. No significant change was found in any of these measurements of cellular immune response though anesthesia and surgical t r a u m a are known to cause depression of the response in older children and adults. The active bone marrow generation and lymphocytosis in the neonate m a y explain the differences from the findings in older patients.--Peter A. M. Raine Recall Antigen Response in Pediatric Cancer Patients Receiving Parenteral Hyperalimentation. B. C. Teitell,
J. Herson, and J. Van J Parent Ent Nutr 4:9-11, (JanuaryFebruary), 1980. Skin test antigens as a predictive indicator of nutritional status and disease status for children with cancer were evaluated in 41 of 55 pediatric tumor patients between the ages of 2 and 17 yr who received intravenous hyperalimentation (IVH). Each child received a m u m p s antigen skin test and a Candida antigen skin test prior to receiving IVH. Twenty-four patients received a second battery of skin tests on completion of the course of IVH. The frequency of positive skin tests on completion of the course of IVH, The frequency of positive skin tests among well-nourished patients was 61% (11/18) and in malnourished patients was 0% (06). Response to chemotherapy occurred in patients with either positive or negative skin test results. This is in direct contrast to the data on adult oncology patients receiving chemotherapy in which there were positive skin test results seen only when there was response to chemotherapy. The relationship of change in nutritional status, tumor response, and skin tests found in adult patients are applicable only to malnourished pediatric patients. The immaturity of a child's immune system, the difference in pediatric tumors in contrast to adult tumors, the aggressive chemotherapy used in treating pediatric tumors and the nonstandardized time intervals of re-applying a second skin test battery all appear to influence response to skin test antigens not influenced by improvement of nutrition through IVH. Because of this, skin testing in pediatric oncology patients does not appear to be a decisive parameter to evaluate the contribution of IVH in response to therapy.--Jane F. Goldthorn Diencephalic Syndrome of Emaciation Combined With Disturbance of Growth Hormone Secretion. H. Sirang,
IV. Andler, W. J. Bock et al. A. Kinderchir 27:31-36, (May), 1979.
The authors report a family with four siblings affected by characteristics of the Wiedemann-Beckwith syndrome; that is, exomphalos, macroglossia, gigantism and usually omphalocoele, hypoglycemia, and increased incidence of tumors. Previously, this disease was thought to be inherited as an autosomal recessive. As there was no consanguinity and no previous cases in this family, an autosomal dominant form of inheritance must be considered.--J. Deevey Head Trauma in Football Players With Mononucleosis. J. S.
Torg, C. Beer, L. A. Bruno, et al. The Physician and Sportsmedicine 8 ( 1): 107-110, (January), 1980. Three case reports of minor head trauma resulting in C N S Pathology occurred in football players subsequently found to have positive Monospot test and comparable symtomatology. In each case, the blow to the head was not unusually severe, but resulted in definite neurologic symptoms. Although complicating neurologic damage is reported in less than 1% of mono cases, it is second only to spleen injuries as a cause of death. Individuals who manifest symptoms and findings of a cerebral disorder in the absence of observed head trauma should alert the team physician of the possibility of this condition.--Harry F. Laws II, Use of Suture Material in Intestinal Anastomosis. F. N~-
thiger, W. J. Ziegler, J. Finger, et al. Heir Chit Acta 14(supp[):l~3, 1980. In a randomized study the authors compare four of the common suture materials using a single layer colon anastomosis in rats. After a short discussion of the history of the development of suture material the chemical and physical properties of the used suture material are described. Methods and results are reported in a preliminary series. The histology demonstrated in all anastomoses the well known pattern of healing. Dexon and Vicryl, however, had less inflammatory reaction than silk or chromic catgut, which often have microabscesses. Measurement of the tensile strength of the anastomosis were carried out on the second, fourth, seventh and 14th day postoperatively and showed significant variability in the different materials. Chromic catgut demonstrated the least tensile strength, Dexon was, however, as strong or stronger on all days than the tested other sutures. There was no statistic significant difference observed between Vicryl and Dexon. In a second series the activity of the alkaline phosphatase was measured on days 4 and 14, giving an indication of the fibroblast activity and the collagen content in the anastomosis. There were no differences among the four suture materials tested. The authors conclude that chromic catgut should no longer be used because it is too quickly absorbed and gives significant inflammatory reaction. Silk is an excellent suture
deficiency of certain amino acids (specifically arginine) contributed to the reduction of urea cycle intermediates resulting in hyperammonemia. Toxicity, such as metabolic acidosis, m a y have resulted due to an excess infusion of other amino acids (specifically methionine) in the E.A.A. solutions. These conditions were corrected with the infusion of a C.A.A. hyperalimentation solution.--Jane F. Goldthorn
695
A 7-mo-old male infant with diencephalic emaciation (Russell syndrome) is reported. In this patient, the rostral part of the floor of the third ventricle was elevated by a tumor. Irradiation and operative treatment are discussed and the published literature of 62 cases has been collected and evaluated.--Karl Ludwig Waag
Lymphocyte Response After Surgery in the Neonate.
Wiademann-Beckwith Syndrome. Comment on Hereditary Pattern. J. A. Tovar, J. Arena, and P. Zubigalla. Chir
P. Puri, D. J. Reen, Orla Browns, et al. Arch Dis Child 54:599-603, (August), 1979.
P6diatr 20:187-189, ( M a y - J u n e ) , 1979.
The cellular immune systems of 14 neonates undergoing surgery for a variety of congenital anomalies were studied 2 hr preoperatively and 18 hr postoperatively. The total leucocyte and lymphocyte counts, the percentages and total numbers of T- and B- lymphocytes and the response of lymphocytes to P.H.A. stimulation were each measured. No significant change was found in any of these measurements of cellular immune response though anesthesia and surgical t r a u m a are known to cause depression of the response in older children and adults. The active bone marrow generation and lymphocytosis in the neonate m a y explain the differences from the findings in older patients.--Peter A. M. Raine Recall Antigen Response in Pediatric Cancer Patients Receiving Parenteral Hyperalimentation. B. C. Teitell,
J. Herson, and J. Van J Parent Ent Nutr 4:9-11, (JanuaryFebruary), 1980. Skin test antigens as a predictive indicator of nutritional status and disease status for children with cancer were evaluated in 41 of 55 pediatric tumor patients between the ages of 2 and 17 yr who received intravenous hyperalimentation (IVH). Each child received a m u m p s antigen skin test and a Candida antigen skin test prior to receiving IVH. Twenty-four patients received a second battery of skin tests on completion of the course of IVH. The frequency of positive skin tests on completion of the course of IVH, The frequency of positive skin tests among well-nourished patients was 61% (11/18) and in malnourished patients was 0% (06). Response to chemotherapy occurred in patients with either positive or negative skin test results. This is in direct contrast to the data on adult oncology patients receiving chemotherapy in which there were positive skin test results seen only when there was response to chemotherapy. The relationship of change in nutritional status, tumor response, and skin tests found in adult patients are applicable only to malnourished pediatric patients. The immaturity of a child's immune system, the difference in pediatric tumors in contrast to adult tumors, the aggressive chemotherapy used in treating pediatric tumors and the nonstandardized time intervals of re-applying a second skin test battery all appear to influence response to skin test antigens not influenced by improvement of nutrition through IVH. Because of this, skin testing in pediatric oncology patients does not appear to be a decisive parameter to evaluate the contribution of IVH in response to therapy.--Jane F. Goldthorn Diencephalic Syndrome of Emaciation Combined With Disturbance of Growth Hormone Secretion. H. Sirang,
IV. Andler, W. J. Bock et al. A. Kinderchir 27:31-36, (May), 1979.
The authors report a family with four siblings affected by characteristics of the Wiedemann-Beckwith syndrome; that is, exomphalos, macroglossia, gigantism and usually omphalocoele, hypoglycemia, and increased incidence of tumors. Previously, this disease was thought to be inherited as an autosomal recessive. As there was no consanguinity and no previous cases in this family, an autosomal dominant form of inheritance must be considered.--J. Deevey Head Trauma in Football Players With Mononucleosis. J. S.
Torg, C. Beer, L. A. Bruno, et al. The Physician and Sportsmedicine 8 ( 1): 107-110, (January), 1980. Three case reports of minor head trauma resulting in C N S Pathology occurred in football players subsequently found to have positive Monospot test and comparable symtomatology. In each case, the blow to the head was not unusually severe, but resulted in definite neurologic symptoms. Although complicating neurologic damage is reported in less than 1% of mono cases, it is second only to spleen injuries as a cause of death. Individuals who manifest symptoms and findings of a cerebral disorder in the absence of observed head trauma should alert the team physician of the possibility of this condition.--Harry F. Laws II, Use of Suture Material in Intestinal Anastomosis. F. N~-
thiger, W. J. Ziegler, J. Finger, et al. Heir Chit Acta 14(supp[):l~3, 1980. In a randomized study the authors compare four of the common suture materials using a single layer colon anastomosis in rats. After a short discussion of the history of the development of suture material the chemical and physical properties of the used suture material are described. Methods and results are reported in a preliminary series. The histology demonstrated in all anastomoses the well known pattern of healing. Dexon and Vicryl, however, had less inflammatory reaction than silk or chromic catgut, which often have microabscesses. Measurement of the tensile strength of the anastomosis were carried out on the second, fourth, seventh and 14th day postoperatively and showed significant variability in the different materials. Chromic catgut demonstrated the least tensile strength, Dexon was, however, as strong or stronger on all days than the tested other sutures. There was no statistic significant difference observed between Vicryl and Dexon. In a second series the activity of the alkaline phosphatase was measured on days 4 and 14, giving an indication of the fibroblast activity and the collagen content in the anastomosis. There were no differences among the four suture materials tested. The authors conclude that chromic catgut should no longer be used because it is too quickly absorbed and gives significant inflammatory reaction. Silk is an excellent suture