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Dermineralization and disorganized bone growth may result in children treated with diphosphonates.

A pedigree with a new form of hereditary sensory neuropathy is described. Ataxia and scoliosis rather than loss of pain and ulcerating acropathy are the principal clinical feature. Analysis of the pedigree suggests a dominant mode of transmission with variable age of onset and perhaps reduced penetrance.

Four children had optic nerve hypoplasia with hypopituitarism, and their clinical picture varied with age. The newborn had apnea, hypotonia, seizures, hyopglycemia, and prolong jaundice. The young infant had defective vision, behavioral delay, hypotonia, and seizures. Except for a mildly receding lower jaw and a high-arched palate, the appearance of the patients was not unusual. The fasting blood glucose level was mildly depressed. In two cases the liver was palpable and results of liver function tests were abnormal. The older child, who was blind and mentally retarded, had growth failure. The extent of the pituitary hormone deficiencies was variable, including diabetes insipidus. The septum pellucidum was not invariably absent. Clinical and pathological findings indicate that the brain lesion might be more diffuse than hitherto recognized. Early recognition of this syndrome and timely intervention might diminish serious sequels.

A retrospective study of children with head injuries and head lacerations in an active emergency department (Vancouver General Hospital) revealed differences in incidence with age and sex, as well as relationships between the frequency of visits and the season, the day of the week and the time of day. Radiographs were taken of a large number of the patients with head injuries and a significant proportion of these children were admitted to hospital.A prospective study is proposed which would examine the natural history of accidental head injuries in children.

In hearts showing auricular fibrillation mechanical stimulation of the right vagus nerve causes, as a rule, marked slowing or stoppage of ventricular rhythm, without producing any appreciable effect in the electrocardiographic record of the auricular fibrillation. The ventricular pauses are apparently due to the blocking of stimuli from the auricles. The force of ventricular systole is distinctly weakened for several beats after vagus stimulation, and ectopic ventricular systoles have been seen in several instances, apparently the result of the vagus action. There may, in some cases, be lowered excitability of the ventricles, while no constant change is seen in the size of the electrical complexes representing ventricular systole.

The records of visits of children and adolescents to the emergency department of the Vancouver General Hospital were reviewed during the period July 1, 1965, to June 30, 1966, and the diagnostic and disposal data recorded. One-quarter of all visits were made by children and adolescents. Three-quarters of the visits were made for surgical conditions. There were more males than females in both surgical and medical groups, and the peaks in attendance were of those in the early preschool and late adolescent age groups. Three-quarters of the patients were referred to the family doctor and approximately one-sixth were admitted to the hospital. These findings suggested that while prompt medical attention was usually indicated, the majority of problems were not urgent and that the emergency department was becoming a substitute for the office of the family physician.

A multidisciplinary team is described which was developed for dealing with the complex problems of the visually handicapped child in British Columbia. One hundred blind children were studied. Optic atrophy was the most frequent type of ocular pathology, followed by cataracts and retinopathy of prematurity. The most common etiological basis of blindness was genetic followed by unknown, infective and due to excessive neonatal oxygen. Seventy-seven percent of the patients had one to seven additional disabilities. The role of the physician in the handling of blind children and the need for him to be increasingly exposed to the chronically handicapped in his training are emphasized.