Phenobarbital and phenytoin in neonatal seizures: metabolism and tissue distribution.

Loading doses of 15 to 20 mg per kilogram of both phenobarbital and phenytoin, administered intravenously, are necessary in the newborn to achieve rapid therapeutic plasma anticonvulsant levels. Maintenance doses of 3 to 4 mg per kilogram of both agents will maintain therapeutic levels. Phenytoin is, however, not predictably absorbed by the oral route.

Pontosubicular necrosis and hyperoxemia.

Pontosubicular necrosis (PSN) is confined to a short perinatal developmental period and is apparently related to asphyxia at birth. Neuronal necrosis with karyorrhexis and proliferative changes in astrocytes are most prominent in the pontine gray matter and subiculum of the hippocampus. We have observed a striking association of PSN in neonates with high arterial blood oxygen (PO2) levels during the first week of life.

Streptomycin-specific antibody coincident with a developing warm autoantibody.

The presence of an antibody with specificity against streptomycin-sensitized red blood cells in the serum of a patient with tuberculous pericarditis is reported. Hemolysis and significant anemia were absent. The antibody appeared to develop together with an evolving warm autoantibody, but was clearly separable from the latter.

Neonatal asphyxia. II. Neonatal mortality and long-term sequelae.

Neonatal asphyxia, defined in this study as delay of greater than 1 minute in onset of spontaneous respiration at birth, occurred in 1% of 13,221 live-born infants of birth weight greater than 500 gm between 1970 and 1971. Seventy-five (56%) of 133 asphyxiated infants survived the neonatal period. Survival was directly related to gestational age.

The frequency of bleeding and height of adolescent haemophiliacs.

The relation between the height of adolescent haemophiliacs and their bleeding frequency has been studied. 45 haemophiliacs aged 10--19 years were divided into 3 groups: small, medium and tall, using a Height Standard Deviation Score. The average bleeding frequency per 100 days in the group of small haemophiliacs was 8.

Patterns of bleeding in adolescents with severe haemophilia A.

Eighty-two boys with severe haemophilia A who spent some time at Lord Mayor Treloar College during 1973-7 were studied. All episodes of bleeding that occurred during term time were recorded, along with the number of transfusions. The bleeding frequency among these boys, most of them aged 10-17 years, increased steadily from 8,31 episodes/100 days in 1973 to 12,63 episodes/100 days in 1977.

Implantation of an endocardial tined lead to prevent early dislodgment.

Early electrode dislodgment from the ventricular apex is a major complication associated with transvenous cardiac pacing. A new lead with flexible tines proximal to the tip electrode has been developed to minimize acute dislodgment incidence. The bipolar tined lead was implanted in 79 patients.

Computed tomography in white-matter disease.

CT scans of 11 patients with proved white-matter disease were reviewed and divided into three categories. The demyelinating (secondary) and diffuse sclerosis groups frequently exhibited abnormal intravenous enhancement and mass shift. This made differentiation from inflammatory and neoplastic processes difficult.

Multiple bleeds in haemophilia A.

One hundred and eighty-one bleeding episodes involving two sites simultaneously were noted during a survey of 4935 bleeding episodes, an incidence of 3.7%. Elbows, knees and ankles were the commonest sites involved in double bleeds, while the thigh, upper arm and elbow were the commonest sites involved in the double bleeds needing most transfusions.

Fetal heart rate patterns and development in the first year of life.

The development of 50 high-risk infants who were provided intrauterine monitoring during labor was prospectively evaluated. Twelve infants had normal fetal heart rate patterns, 16 moderate-severe variable patterns, and 22 severe variable or late deceleration patterns. The parity, socioeconomic status, race of the mothers, and sex of the infants were similar in each group.

Phenobarbital pharmacokinetics in neonates.

Phenobarbital pharmacokinetics after intravenous injection were studied in 8 neonates with seizures. Subjects ranged in gestational age from 30 to 40 wk. Plasma concentrations of phenobarbital were measured by enzyme-multiplied immunoassay (EMIT).

Phenobarbital and diphenylhydantoin levels in neonates with seizures.

Little information is available regarding appropriate plasma levels of anticonvulsant drugs in neonates. We determined the plasma levels of phenobarbital and diphenylhydantoin following initial administration and during maintenance therapy in 59 neonates with seizures. Following intravenous administration of 15 to 20 mg/kg, levels of 20.

The nature of the phosphorus linkage in component I, a phosphoprotein isolated from the blood serum of DES-treated cockerels.

The nature of the phosphorus linkage in electrophoretic component I of the blood serum of DES-treated cockerels was investigated by enzymatic and partial acid and alkali dephosphorylation. The C-P bond was excluded because this bond is stable to 6 N HCl at 110 degrees C. for 20 hours, and all the phosphorus was released under these conditions.

Cerebrovasculopathy following irradiation in childhood.

Symptomatic intracranial vasculopathy developed in four patients following irradiation for central nervous system tumors. All the patients presented with a stroke-like picture from 2 to 22 years after the completion of radiotherapy. Two of the patients showed abnormalities on arteriography consisting of narrowing of the supraclinoid portion of the internal carotid artery and the adjacent proximal anterior and middle cerebral arteries.