Showing papers by "Primary Children's Hospital published in 1987"

Reduced Natural Killer Cell Activity in Autism

Abstract: Natural killer (NK) cells arc believed to afford protection against malignancy and viral infections. In addition, these cells may be involved in regulating the immune response because altered NK activity is often associated with autoimmune disorders. An investigation of the natural cytotoxic potential of peripheral blood mononuclear cells from 31 patients with autism has been carried out using K562 tumor cells as target cells. Cells of 12 of the patients induced significantly reduced levels of cytotoxicity; this was not correlated with a quantitative alteration in patient NK cells as determined by use of the Leu-11 monoclonal antibody. This observation of altered NK cell activity, and previously reported findings of other immune abnormalities in autism, suggest that immune changes may be directly related to underlying biological processes of autism or that these changes may be an indirect reflection of the actual pathological mechanism.

Elementary Schoolteachers' Understanding of Diabetes

Abstract: Even if parents of diabetic children are well-educated in the care of diabetes, there may be no one in the children’s classrooms informed enough to cope with diabetic emergencies. We distributed a questionnaire to elementary schoolteachers in the Salt Lake City area to determine their understanding of diabetes. The answers showed a poor understanding of basic physiology and little knowledge about how to recognize and treat hypoglycemia and hyperglycemia. Poor communication between parents and teachers was also revealed. We feel these results emphasize the need for diabetes educators to work closely with teachers to improve their understanding of children with diabetes.

Calcium and phosphate solubility in neonatal parenteral nutrient solutions containing Aminosyn PF

Abstract: Factors affecting the solubility of calcium and phosphate in neonatal total parenteral nutrient (TPN) solutions containing a new amino acid formulation were studied. Six TPN solutions containing various concentrations of Aminosyn PF, an amino acid solution for infants and children, were prepared in 10% dextrose injection. Some of the solutions also contained cysteine hydrochloride 40 mg per gram of protein. Various concentrations of calcium gluconate and monobasic and dibasic potassium phosphate were added to 20-mL samples of the TPN solutions. A total of 27 samples of each TPN solution was prepared. Samples were visually inspected after 18 hours at 25 degrees C and again after 30 minutes in a water bath at 37 degrees C. Clear samples at this time were also examined microscopically. Solubility curves were prepared by plotting the concentrations at which either visual or microscopic precipitation occurred. Solubility curves for TPN formulations containing Aminosyn PF revealed a decrease in calcium solubility of 5 to 15 meq/L and a decrease in phosphate solubility of 5 to 15 mmol/L compared with previously published calcium-phosphate solubility curves for another similar amino acid solution, TrophAmine. Calcium and phosphate solubilities were also influenced by temperature and the time after solution preparation. In these TPN formulations containing Aminosyn PF as the amino acid source, the solubilities of calcium and phosphate were substantially less than reported in a previous study of solutions containing TrophAmine.

Ceftazidime (ctz) clearance (cl) with congenital urinary tract obstruction (uto)

Abstract: Congenital UTO is the leading cause of childhood renal failure. Although these children receive complex drug therapy, the effects of UTO upon pharmacokinetics have not been adequately studied in immature humans or animals. Pseudomonas infections often complicate congenital UTO and may be treated with CTZ. To study the effects of UTO upon CTZ kinetics, we produced unilateral UTO in 3 fetal sheep at 75d/146d gestation. After spontaneous term birth, catheters were inserted to: drain the obstructed kidney; separately collect urine from the unobstructed kidney; and infuse drug and sample blood separately. Obstructed kidney glomerular filtration rates ranged from 0 to 28% of total by DTPA renal scans. CTZ was infused into 3 lambs for 3 hrs before 3 one hr urine collections to determine each kidney's: CTZ CL, creatinine CL (CR CL), and fractional sodium excretion (FENa). UTO decreased urine flow (0.05 to 0.01 ml/min-kg, p<.05); CR CL (2.16 to 0.44 ml/min-kg, p=.002); and increased FENa (0.35 to 7.94%, p<.05). UTO reduced urine [CTZ] to a low of 74.3±8.6 μg/ml. CTZ CL (y) correlated with CR CL (x) such that y=1.60 x −0.10 (r=.80, p<.001). UTO severely impairs renal function as well as CTZ excretion. Pseudomonas kidney infections in infants with bilateral UTO may require higher CTZ doses to reach therapeutic urine [CTZ] and longer dosing intervals which may be estimated from CR CL.

Experimental use of a new atrially passed, sutureless, ventricular apex to aorta conduit

Abstract: Ventricular outflow obstruction in the infant remains a surgical challenge with high operative mortality despite a variety of approaches. An apical to aortic conduit would be a direct approach but usually required cardiopulmonary bypass and removal or fixation of perhaps a critical amount of apical myocardium. Therefore, we developed a two component apical prosthesis consisting of a grommet, fixed internally by a flange, that can be placed via the atrium without bypass and an external female adapter. This transatrial ventricular access device (TAVAD) does not require removal of myocardial tissue or sutures. The TAVAD concept was acutely tested in 8 anesthesized dogs (mean wt. = 15 kg). Initially the TAVAD device was capped and acute stability in the myocardium was demonstrated in 5 dogs. Subsequently, in 3 dogs, the TAVAD method was used to achieve communication with a valved conduit to the thoracic aorta. Acute grommet stability in the myocardium was evident even with the conduit attached and ventricular pressures up to 250 mmHg. The ability to carry cardiac output was demonstrated by ascending aortic occlusion. Chronic implantation off bypass in 3 lambs (mean wt, = 8.5 kg) has shown continued myocardial fixation and conduit function. Angiography demonstrated unobstructed apical to aortic flow and normal ventricular wall motion. Since the lamb myocardium is similar in thickness to the human infant, we conclude that the TAVAD device and method may be useful in relieving ventricular outflow obstuction in infants while preserving myocardial tissue and function.

Use of T scores on the revised child behavior profile with inpatients.

Abstract: The assignment of T values to raw scores on the behavior problem scales of the Revised Child Behavior Profile (RCBP) was examined. RCBP T scores below 70T are normalized standard scores. Therefore, the T scores below 70T are comparable within each scale and from one scale to another. In contrast, RCBP T scores above 70T are not standard scores. Therefore, they cannot be compared appropriately to other scores. The lack of intrascale and interscale comparability of RCBP T scores above 70 is especially problematic for the study of inpatients whose scores tend to fall in the unscaled region above 70T. Therefore, it is recommended that for studies of inpatients, raw scores on the behavior problem scales should be transformed to standard scores by use of the mean and standard deviation of an appropriate comparison group. Then, for purposes of interpretation, scores that fall in the upper ranges of the inventory can be compared appropriately to other scores on the same scale or to scores on other scales of the RCBP.