[Strictly forbidden fruit?].
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Biomedical subjects
Publications and source records attributed to C G Bergstrand.
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Fourty-two consecutive patients with craniopharyngioma were treated by "stereotactic approach", i.e. preferentially stereotactic puncture and installation of colloid isotope into cystic tumours and external stereotactic single dose irradiation to solid tumour parts. In a minority of cases, such treatment was less suitable, and surgical removal and/or radiotherapy was used. There was no peroperative mortality. A long-term follow up (observation time 10-23 years) of the 31 patients alive indicated that they were socially well adapted with a high rate of fulltime work and a low rate of intercurrent disease. In spite of substitution therapy for pituitary insufficiency in most cases, the patients were subjectively seldom disturbed by their disease. Our results support a change in the choice of therapy for craniopharyngioma patients, from open neurosurgery to the less invasive stereotactic techniques.
A multi-modality treatment programme, where stereotactic methods were used preferentially, gave results in a consecutive series of craniopharyngiomas, not inferior to those reported after microsurgical removal. Fourty-two patients with a follow-up range of 10-23 years are reported.
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Infectious mononucleosis is often complicated by haematological abnormalities but agranulocytosis is so rare that a causal relationship has been questioned. We here describe 2 sisters, 3 and 5 years old, who both developed agranulocytosis or profound granulocytopenia 4-5 weeks after the acute onset of mononucleosis. No contributory cause could be found and we conclude that a constitutional disposition may be responsible for this complication.
In 1976 a survey was made of all children with a diagnosis of suspected or verified child abuse registered at the Department of Paediatrics in Malmö from 1967 through 1974. Some of the results have been compared with more recent data collected during the years 1975 through 1978. Registered incidents of child abuse were found to have increased markedly during the later period, to a great extent due to the increased number of older children being registered in 1975--1978. A steep increase in cases was observed in 1976 coinciding with intensified efforts to inform and educate personnel responsible for the care or welfare of children. The larger number of incidents registered during the later period is thus considered to most likely have been caused by greater vigilance on the part of personnel responsible for children and not due to an increase in the real incidence of child abuse. A comparison between the two periods regarding the type of injuries recorded shows a five-fold increase in the yearly rate of less severe lesions, as contrasted with a two-fold increase in more severe lesions. During both periods, slight injuries represented a majority of all cases.
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Girls with adolescent idiopathic scoliosis are taller than nonscoliotic girls of the same age. This observation may be related to factors regulating longitudinal growth. Plasma growth hormone was determined in a group of scoliotic girls by double antibody radioimmunoassay under the following conditions: 1) Insulin induced hypoglycemia, 2) glucose tolerance test, 3) exercise. Somatomedin A was determined by a method based on the ability of serum to stimulate the incorporation of radioactive sulphate in embryonic chick cartilage. The results were compared with those obtained in a control group of healthy nonscoliotic girls of comparable age. After overnight fasting and after at least one hour's rest the basal growth hormone level was 9.8+/-11.1 (+/-S.D.) ng/ml in the scoliotic girls (n=48) and 2.2+/-1.1 ng/ml in the controls (n=15). This difference is significant. In the hypoglycemia test the peak growth hormone level tended to be higher in the scoliotic girls but the difference is not significant. In the exercise test the maximal value was reached at different times in the two groups: at 20 min after start of the exercise in the scoliotic girls (n=14, 17.3+/-11.8 ng/ml) and at 40 min in the controls (n=9, 16.0+/-6.6 ng/ml). In the glucose tolerance test the growth hormone level was suppressed in both groups but the mean values tended to be higher during the first 120 min in the scoliotic girls. The serum somatomedin levels were higher in the group of scoliotic girls (n=19, 1.13+/-0.17 U/ml) than in the controls (n=14, 0.88+/-0.16 U/ml) and the difference is significant. The results obtained are difficult to interpret but suggest that growth hormone secretion is higher in girls with adolescent idiopathic scoliosis than in healthy girls of comparable age.
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