[Articular scintigraphic changes in infantile rheumatoid arthritis].
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Biomedical subjects
Publications and source records attributed to G Bona.
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Plasma growth hormone values in newborns subjected to exsanguinotransfusion for haemolytic disease were compared with those in a sample group of neonates with physiological icterus. Basal HGH values in infants with EF were significantly higher than those noted in the controls, whereas blood sugar values were within the limits of normal. These results suggest that enhanced HGH secretion attributable to the stress of exsanguinotransfusion is accompanied by direct stimulation of hypothalamic cells producing GH releasing factor on the part of bilirubin.
Hyaline membrane disease is an important factor in the postnatal mortality of prematures. Its pathogenesis is examined. Prematurity, maternal diabetes, and caesarean section are seen as predisposing causes. Delayed biochemical maturation of the lung (shown by a low lecithin-sphyngomyelin ration in the amniotic fluid and probably caused by hypophyseal-adrenal insufficiency) results in an absence of surfactant. Labour stimulates its production by massive release of endogenous cortisol. The part played by betamethasone and other substances in prophylaxis is discussed. It is felt that, at present, the availability of preformed tensioactive factors alone can achieve the decidedly improved prognosis required in so serious a disease.
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Lymphatic scintigraphy has proved a useful addition to radiological lymphography in oncological diagnosis in paediatrics. In cases studied comparatively with the two techniques, scintigraphy has been found to offer good resolution capacity also. The radioisotope method demonstrated its greatest value as a control examination for judging results obtained after surgery or radiation. In doubtful cases it was possibile to repeat the examination after a short time in order to evaluate the development of the lymph node lesion. The technique is easy to carry out in paediatric age: 0.5 ml of colloidal Tc with specific activity from 0.3 to 0.5 mCix are injected subcutaneously, mixed with 75 U of hyaluronidase between the Ist and IInd interdigital space to highlight iliac and para-aortic lymph nodes. The useof 99mTc is of special interest because it has made irradiation of these small patients negligible.
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The availability of short-life, low energy isotopes has enabled scinti-scanning to be usefully applied in paediatrics. A personal series relating to its employment in the diagnosis of tumours in young infants is presented. Illustrative cases in which the technique gave better indication of the site and extent of neoplasia in the brain, lung, kidneys, liver, spleen and skeleton are described. The advantages of the techinque are explained. The amount of radiation absorbed by the part examined and other radiosensitive areas is so small that there is a complete absence of danger, even in small children.
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