Congenital hyperinsulinism and the surgeon: lessons learned over 35 years.

Background/purpose: Congenital hyperinsulinism induces severe and unremitting hypoglycemia in newborns and infants. If poorly controlled, seizures and irreversible brain damage may result. Subtotal (<95%) or near-total (95% to 98%) pancreatectomy have been performed for glycemic control in babies who do not respond to aggressive medical therapy.

Prognostic value of quantitative pathologic features and DNA content in individual patients with stage I endometrial adenocarcinoma.

The prognostic value of clinical features, qualitative and quantitative pathologic characteristics and steroid receptor incidence was evaluated in 50 patients with Stage I endometrial adenocarcinoma. It turned out that many of these features were prognostically important. Estrogen receptor content was not significantly associated with prognosis in our material, but patients with progesterone receptor positive lesions had a better survival than those in which the tumors were progesterone receptor negative.

Protein/creatinine ratio in the assessment of proteinuria during pregnancy.

Since the nature and the level of urinary protein excretion have considerable clinical implications in the course of pregnancy, the early detection of even minor degrees of hyperproteinuria is important. Quantitation of 24-h urinary protein excretion is the only definite method of establishing the presence of hyperproteinuria, but this method shows practical failures particularly in an outpatient setting. Dipstick analysis as a screening for hyperproteinuria also lacks reliability, since the normal rate of protein excretion in primigravid pregnancy has recently been shown to be less that 150 mg per day.

The influence of spontaneous breech delivery on the integrity of the central nervous system of the newborn (a prospective study).

The effect of breech delivery on the condition of the newborn infant was studied in a population of 48 consecutive, mature, newborn infants delivered spontaneously and having birth weights between the 5th and 95th percentiles for gestational age. The integrity of the central nervous system of all infants was assessed semiquantitatively by Prechtl's method of neurological examination. The results were compared to those obtained in a previous study of a similar group of infants born in vertex presentation.

A quantitative structural model of the testis of fertile males with normal sperm counts.

The morphology of testicular biopsies of 8 healthy fertile men with proven normal sperm counts was studied using stereological techniques. Quantitative estimations were made of different cellular compartments in the testicular biopsies. The experimental errors of observation, homogeneity of the section, accuracy of the measurements and errors caused during the preparation of the sections were studied.

Postpartum resolution of glomerular changes in edema-proteinuria-hypertension gestosis.

Complete resolution of glomerular changes in toxemia of pregnancy has been reported to occur as early as 4 weeks postpartum, whereas their persistence for as long as 2 years in some instances has been noted. However, the mechanism of resolution remains obscure. Percutaneous renal biopsy was performed in 22 patients between 10 and 14 days after delivery.

Age at menarche and menopause of uterine cancer patients.

An investigation was undertaken of the ages at menarche and at menopause of cervical and endometrial cancer patients for the years 1950-55 and 1960-65. Analysis of the ages at menarche in relation to the year of birth did not show a difference between the uterine cancer groups, whereas the age at menopause did show such a difference. The menopause occurred later in the endometrial than in the cervical cancer group.

Quantitative morphology of the placenta. III. The growth of the placenta and its relationship to birth weight.

The relationship of placental components to birth weight was investigated by stereology. 37 placentas from nonpathological pregnancies delivered after a period of 224-303 days of amenorrhea were examined. The umbilical cord was clamped immediately after birth.

Fetal breathing movements in the normal and growth-retarded human fetus: a multiscan/M-mode echofetographic study.

52 women were examined, between the 25th and 40th wk of pregnancy, during the day-time, by the echographic multiscan/M-mode technique. Definitions of normal fetal breathing movements and singultus fetalis movements were determined. In normal pregnancies fetal breathing movements occurred during 12-19% of the total observation time before the 39th wk of pregnancy but only during 6-9% of the observation time in the 39th or 40th wk.

Quantitative morphology of the placenta. II. The growth of the placenta and the problem of postmaturity.

The morphological changes in the placenta concomitant with the transition from maturity to postmaturity were investigated by stereology under early clamping of the umbilical cord. 37 placentas from nonpathological pregnancies delivered after a period of 224-303 days of amenorrhea were examined. It appeared that after 267-288 days of amenorrhea, 8 out of 9 placental components showed no further growth and even showed regression.

The fetal autonomic nervous system, the fetal heart rate and the beat-to-beat irregularity.

In the exteriorized fetal lamb an experimental study on the influence of the fetal autonomic nervous system upon the heart rate pattern is described by means of blockage of the cholinergic, alpha-adrenergic and beta-adrenergic system. The alpha-adrenergic system proved to have no effect upon heart rate. The beta-adrenergic system had a positive chronotropic effect and the parasympathetic system had a negative chronotropic effect.

Marriage and childbearing in relation to cervical cancer.

In order to assess any correlation between cervical cancer and age at marriage and childbearing, matched control groups were formed. From the comparison it appears that cervical cancer patients are more likely to be married and to have married at an earlier age than control women. In the same age groups at marriage there was no difference in the number of children between the cervical cancer patients and the control women.