C. Thomas Kisker

Clinical and occult testicular leukemia in long-term survivors of acute lymphoblastic leukemia

Twenty-nine of 60 boys with acute lymphoblastic leukemia survived for more than 30 months and were potential candidates for discontinuation of therapy. Six patients developed overt clinical testicular leukemia: one at 34 months from diagnosis while receiving therapy and five at three to 17 months after therapy was stopped. Elective wedge biopsy of the testes has become part of the evaluation prior to discontinuation of therapy since 1977. Six of 18 boys had microscopic evidence of leukemic infiltration of the testes: four with diffuse involvement and two with focal clusters of leukemic cells. Testicular biopsy is recommended at the time of discontinuation of therapy and perhaps early in the course of the disease, although a negative biopsy does not exclude some focal lesions. The eventual outcome of those with occult testicular leukemia remains to be determined.

Intrauterine fetal transfusion, 1965–1976, with an assessment of the surviving children ☆

The need for IUT in the management of Rh hemolytic disease is likely to continue in the foreseeable future. Recent reports have been skeptical about the success of this procedure and the quality of the surviving infants. Of 84 fetuses who received 134 IUTs, over all, 35.7 per cent survived; 48.3 per cent of the nonhydropic group survived. Fifteen of the 23 survivors between 3 and 11 years of age received intellectual, academic, behavioral, health, and developmental evaluations. When compared to sibling and high-risk control groups, the study children showed no significant differences in intelligence quotients, arithmetic achievements, or reading achievements; their school performance is acceptable and none is presenting significant behavioral problems. Except for an excessive number of umbilical and inguinal hernias, there were no physical abnormalities that could be directly related to IUT.

School behavior and attendance during the first year of treatment for childhood cancer

The school behavior of children with cancer and hemophilia is a relatively new area of interest and investigation. Children with cancer have been described as having increased school absenteeism and a self-protecting posture. The school behavior and achievement of children with cancer and hemophilia were rated by their teachers before and after first being seen in a large pediatric center. No pre-vs-post diagnosis differences were noted on academic and behavior ratings with either the cancer or hemophilia children. School absenteeism for the children with cancer was four times greater than that of healthy children, and absenteeism of children with hemophilia was twice normal. A substantial percentage of children with cancer was rated as having academic performance affected to at least a moderate degree. The school performance and behavior of children with cancer and hemophilia need to be monitored and appropriate educational adjustment made to accommodate the limitations imposed by these medical conditions.

Rectosigmoidal colitis in common variable immunodeficiency disease

SummaryA patient with common variable immuno-deficiency disease is described with severe colitis confined to the rectosigmoid region. Inflammation was extensive in the regions involved and exhibited a character that we believe is most unusual. Inflammation was transmural in the regions involved. Macrophages were the major inflammatory cells, and no granulomas or giant cells were seen. Although the disorder seemed distinct from either ulcerative colitis or Crohns disease, the colitis responded favorably to oral azulfidine, prednisone, and to steroid enemas.

Coagulation changes following vasectomy: A study in primates * †

Thirty vasectomized rhesus monkeys were tested for changes in coagulation factors that might reflect an increased incidence of thrombosis. The results of tests on these monkeys were compared with results of tests on 18 control rhesus monkeys; there were no significant differences between control and vasectomized animals for any of the parameters tested. One vasectomized animal had increased levels of fibrin monomer in his plasma on repeated samples, but no evidence of thrombosis on postmortem examination.