[1988 Nobel prize for medicine and physiology].
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Biomedical subjects
Publications and source records attributed to Y Rotem.
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A four-year-old boy developed oliguria, proteinuria and hypocomplementemia, without hematuria, in the course of proven infectious mononucleosis. A chest radiograph revealed a mild cardiomegaly, prominent pulmonary vasculature and pleural fluid. These abnormalities were compatible with acute glomerulonephritis and were in support of this clinical diagnosis in spite of the absence of hematuria.
This is a report of a case of Sandifer's syndrome following surgery. It occurred after a partial thoracic stomach (Gavriliu's operation) and was created following a repair of esophageal atresia.
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The case of an 18-month-old child poisoned by her mother with chlorpromazine is described. Fifteen other cases of child poisoning have been previously reported. In all of these cases the assailant was the mother (who in 11 cases was described as mentally disturbed); in 14 cases the presenting sign was a change in the level of the child's consciousness; and in ten cases the agent was a psychotropic drug. These poisonings were always well planned and manipulative, usually of long duration (1 1/2 to 48 months), and often continued during hospitalization, but lacked homicidal intent. Three children died. It is suggested that this subgroup of child abuse be more rigidly defined and possibly be named "the chemically abused child." A higher degree of suspicion and alertness to this problem would increase the number of cases identified and the number of children who receive professional care.
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A brother and sister who suffered from pruritus since infancy developed hepatic cirrhosis early in life. Although this clinical picture has never been seen in Wilson's disease, Kayser-Fleischer rings in the boy made further studies necessary. Oral radiocopper loading tests administered to both children and to their parents served to exclude Wilson's disease conclusively. Determinations of the concentrations and patterns of bile acids in the serum indicated that the abnormalities observed in these children are not related to errors in bile acid synthesis. Although a defect in bile acid transport is present, it appears to have occurred as a consequence of the liver disease.
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