Biomedical subjects
Publications and source records attributed to H Jorulf.
A method for assessment of the kidney size in infants and children is described based on measurement of the renal parenchymal area determined planimetrically, using for reference the height of the column of the upper three lumbar vertebrae or the body weight. The kidney size is expressed in standard deviation in the appropriate nomograms.
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Various radiodiagnostic procedures expose the eye lens of the diagnostic technician to radiations. With the aid of lead glasses with an attenuation of radiation equivalent to 0.25 mm of lead, the dose can be reduced by 90%.
During the years 1965--1974, 125 cases of posterolateral diaphragmatic hernia have been operated at five departments of pediatric surgery in Sweden. The overall operative mortality was 50%. A follow-up investigation included 19 cases, where in 12 cases spirometry and in 11 cases studies of the mobility of the diaphragm were included. Physical examination revealed excellent results in most cases. Lung function studies, however, show a moderate (20--30%) reduction, which is not surprising with regard to lung hypoplasia and impaired movement of the diaphragm on the operated side. In adolescence and younger age, these patients are mostly in excellent condition; but later, when lung function is also reduced by the age factor, their neonatal condition may be of importance.
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During a 4 1/2-year period a special study of 207 consecutive perinatal deaths, including clinical, genetical, roentgenological and autopsy investigations, was undertaken with the aim of identifying inherited malformations with a high risk of recurrence to subsequent sibs. Fifty-three of the children dying perinatally were malformed. In 13 cases the cause of the malformation was purely genetic; 11 were caused by mutant genes of large effect, and two by chromosomal aberrations. Information from such a study provides a good basis for genetic counselling of the family.
An account is given of results of the radiologic examination of 29 infants and children with bone tuberculosis caused by the Bacilli Calmette-Guérin (BCG) as a complication to intradermal vaccination. The diagnosis is based on radiologic appearances, microscopy and bacteriologic examination of specimens obtained from the bone lesions. The radiologic appearance of the bone lesions is in most cases characteristic and differs decisively from that of pyogenic osteomyelitis and malignant disease.
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Up to 1970 only13 fully verified and successfully treated cases of neonatal adrenal haemorrhage were on record. As uniform diagnostic and therapeutic guiding principles are still lacking, our experience of 24 consecutive cases appears worth presentation.--The most frequent clinical signs were a palpable mass in 21 cases, jaundice in 14 patients and urinary infection or sepsis in 10 neonates.--Intravenous urography revealed the diagnosis with a reasonable degree of reliability in all our cases. No additional information of significance was obtained at aortography, employed in 2 of our cases.--Surgical exploration with drainage of the haematoma or adrenalectomy was performed in 18 cases, 6 were treated conservatively.--Recovery was uneventful in all but for one conservatively treated patient. In this case death was caused by a second profuse bleeding, which proved fatal in spite of all life saving efforts.
The Cronqvist cranial index with the normal values for different age groups according to Austin & Gooding is compared with the ventricular index estimated by ultrasound in a series of 166 neuropaediatric subjects aged 0 to 5 years. A large number of hydrocephalic patients has a normal cranial index. The cranial index alone is thus an unreliable method for the screening of hydrocephalus.
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Among 14816 consecutive live births there were 7 cases of osteochondrodysplasia (incidence 1:2117). In addition there was 1 case of stippled epiphyses, possibly induced by anticonvulsive drugs taken by the mother during the pregnancy, and one case of cerebro-hepato-renal syndrome of Zellweger with roentgenological features similar to those of hypochondrodysplasia. None of 102 stillborns seen at the same time had osteochondrodysplasia. For genetic counselling an exact diagnosis is mandatory, radiological examination of the skeleton is often of decisive importance.
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