Search

The use of 99Tcm-mercapto acetyl triglycine (99Tcm-MAG3), a new hippuran substitute, has been reported widely in adults but not in children. Our experience of its use in 100 infants and children for renography and indirect micturating cystography (IMC) is reported. The average age was 5.6 years. 65 patients completed IMC studies and nine patients had 99Tcm-dimercaptosuccinic acid (99Tcm-DMSA) scans performed on the same day. The majority of patients were referred for the investigation of urinary tract infection. 32 kidneys were found to be scarred on 99Tcm-MAG3 scans, 17 kidneys and ureters refluxed on IMC and 14 kidneys were obstructed. The results of 99Tcm-MAG3 scans were compared with those of other urinary tract investigations including ultrasound, micturating cystography (MCUG), intravenous urography (IVU) and 99Tcm-DMSA scintigraphy. No kidney which was scarred had a normal 99Tcm-MAG3 scan. All significant degrees of dilatation or obstruction on IVU or ultrasound were also detected by 99Tcm-MAG3. 99Tcm-MAG3 gave more information than any other single imaging modality and we believe it represents an ideal initial screening test in the investigation of urinary tract infection in older toilet-trained children.

We report a case of portal and systemic venous gas detected in a neonate without clinical or radiographic evidence of necrotizing enterocolitis who then subsequently developed unequivocal clinical and radiographic signs of this condition. These findings are discussed in relation to previous reports in the literature.

It has been calculated that over one-third of the total number of cases receiving sickness benefit have some form of nervous disorder (1), and 1 of 22 persons has to be placed in a mental hospital at one time or another (Carrel, 2). Social prejudice, however, still bars adequate support of psychiatric research, and much scientific work is hampered through lack of financial help.

It is well known that injection of protein substance into the blood causes the appearance in the blood of antibodies to the protein. Injection of bacteria is followed by the appearance of several kinds of antibodies, and the substances which produce “clumping” constitute one, or rather two, of these antibodies. The appearance of agglutinins in the blood following vaccination or infection has been shown to occur regularly in such a large number of individuals, and in animals, that there can be no doubt that this production of antibodies is a natural phenomenon connected with successful resistance to the deleterious effects of the organisms. Non-production or abnormalities in the production of agglutinins following injection of bacteria represents a pathological process probably of the nature of sepsis.

The haemorespiratory system is subject to disease like any other tissue of the body. Degenerative changes of large arteries are known to have occurred thousands of years ago, and atherosclerosis is to be found throughout the world irrespective of race or geographical distribution. The first recorded observations of disease of the cerebral vessels appeared in the year 1700 (1). Perivascular softenings were noted in 1814 (2); a book on disease of the brain with clinical associations was published in 1836 (3). Atheroma was studied in 1844 (4), and periarteritis of the cerebral vessels in 1868 (5) and 1887 (6). Changes in the vessel walls and perivascular cells were noted in 1863 (7), and white cells and emboli seen in cerebral vessels in 1882 (8).

At the Annual Meeting of this Association held at Belfast last July, Sir Frederick Mott gave you an address on the thyroid gland and promised a further contribution with regard to the iodine content. This paper is an attempt to correlate the iodine content with histological structure and with the mental and bodily condition of the patient. I must apologize for the work being far from complete, as most of the time since then has been taken up with the examination of the published methods for the estimation of iodine in the gland, and owing to certain objections to these methods it has been necessary to invent a process without these objections, and which, at the same time, is carried out with a minimum expenditure of time and material.

Recent work upon mental disorders has shown that there are important changes in the endocrine organs as well as in the central and sympathetic nervous system. Changes have been especially studied in the sex glands and in the thyroid; and it seemed evident that the determination of the basal metabolic rate of mental hospital patients might do much to add to our knowledge of disorders of the working of these glands. The present research was undertaken under the direction of the late Sir Frederick Mott, who was Honorary Director to the Joint Board of Research for Mental Diseases, City and University of Birmingham. From the beginning it was evident that the usual Douglas bag or spirometer methods, involving mouth and nose pieces or a mask, were quite unsuitable for the work in hand, it being absolutely necessary that the disturbing factors of fear, anxiety and excitement should be eliminated. A chamber was, therefore, constructed similar to one which Prof. J. S. Haldane uses for various experimental purposes, in which the patient could sit, lie or sleep without disturbance for a period of two hours, the metabolism being measured by determining the changes in the air of the chamber at the end of this period. As, however, these changes are small, a special modification of the Haldane air analysis apparatus was required.

Geistesstorung kann auftreten infolge einer Funktionsbeeintrachtigung des Hirns, welche entweder auf einer langeren Einwirkung von Bakterientoxinen auf das Hirn beruht, oder auf Storungen der capillaren Blutzufuhr des Hirns aus gleichartiger toxischer Ursache. Da die arterielle Blutzufuhr des Hirns in nachster Nachbarschaft der Keilbeinhohle vorbeizieht, konnen bei chronischer Entzundung dieser toxische Produkte im Laufe der Zeit in ausreichender Menge absorbiert und zum Hirn weitergeleitet werden, um eine Funktionsbeeintrachtigung desselben hervorzurufen. Die Arbeit enthalt das Ergebnis 200 aufeinanderfolgender Sektionen, bei welchen die Nebenhohlen mittels einer besonderen Technik untersucht wurden, viele Nebenhohlen wurden auserdem histologisch auf Organismen untersucht. Die Vorgange, welche beim Vorliegen benachbarter Infektionszustande das Hirngewebe ergreifen, werden erklart und durch Originalpraparate und -zeichnungen veranschaulicht.

Failure of a kidney to grow satisfactorily in childhood is evidence of renal disease. Because kidneys may enlarge during an episode of acute pyelonephritis, concomitant renal length measurements cannot be used as baselines for growth assessment. This study was designed to determine the degree of renal enlargement in children with acute pyelonephritis and the time the enlargement takes to resolve after treatment is started to find the optimum time for obtaining baseline measurements.In a cohort study, 180 children younger than 5 years old with their first proven acute urinary tract infection, with or without pyelonephritis, had renal scintigraphy and sonography within 15 days of starting treatment. The presence of cortical defects on scintigrams indicated pyelonephritis. The lengths of kidneys with and without scintigraphic defects (i.e., with and without pyelonephritis) were compared, adjusting for age and sex, and the length of kidneys with defects was related to time elapsed between the start of treatment and sonography.Ninety-nine kidneys (28%) in 77 children (43%) had scintigraphic defects. Kidneys with defects were an average of 3.2 mm longer than kidneys without defects. Length and time interval between treatment and sonography in kidneys with defects correlated negatively, with mean length approaching that of kidneys without defects by 10-11 days.Kidneys with acute pyelonephritis initially increase in length but return to normal on average by the 11th day of treatment. If poor renal growth is used as an indication of renal disease, sonography should be delayed or repeated at least 2 weeks after the start of treatment to determine the length of the uninflamed kidney.