Jørgen Vesterdal

Studies on the Kidney Function in Premature and Full‐Term Infants by Estimation of the Inulin and Paraamino‐Hippurate Clearances1

Only a few reports of investigations into the kidney function in newborn premature and full-term infants have been published. The estimation of the filtration rate and the effective renal blood flow (i.e. the volume of blood passing through the active parts of the kidneys per minute) is most important. The filtration rate is considered to be identical with the inulin clearance. Mannitol clearance has also been used, but the results are not identical with those obtained with inulin clearance, the ratio mannitol clearance / inulin clearance being 0.902. The effective renal blood flow is measured by estimation of diodone (diodrast) clearance or paraaniino-hippurate (PAH) clearance, which give identical results. The normal values for adults are: inulin clearance 124 ml, and PAR clearance 648 ml per minute for 8 surface are8 of 1.73 sq. m. ( 7 ) . The filtration fraction ( L e . the ratio inulin clearance / PAH clearance) is 0.192. The first investigations on the kidney function in infants (1, 5 , 13) showed that the clearances for inulin, urea, Na, I( and C1 are very low. Recently, a few thorough studies have been reported.

The Maximal Tubular Transfer of Glucose and Para‐amino‐hippurate in Premature Infants1,2

The maximal tubular excretion of para‐amino‐hippurate (TmpAH) and the maximal tubular reabsorption of glucose (Tmc) have been determined in 7 premature infants aged 19–135 days. An infusion technique was used by which it was possible to change the water administration during the experiment.

A Simple Method of Estimating the Inulin and Paraamino-hippurate Clearances in Newborn Infants1

The inulin clearance in infants was first measured on patients with inoperable meningomyeloceles (8, 12, 13). Using an intravenous drip, inulin was injected into the tubing and afterwards estimated in samples of urine and of blood from the anterior fontanelle. The same technique was later used for the estimation of diodone and inulin clearances (4). Recently, studies on these clearances in normal infants have been published by BARNETT & al. (l), who used paraaminohippurate (PAH) and inulin but do not describe their technique, and by WEST, SMITH & CHASIS (11) who gave PAH and mannitol by intravenous infusion and measured their concentrations in samples of catheter urine and venous blood. Since it may be difficult t o draw four-five blood samples from the veins of a newborn infant during the experiment, a micromethod for the estimation of the agents in capillary blood was desirable. Preliminary experiments (10) showed that intravenous infusion should be avoided, as the increased diuresis may influence the kidney function. I have therefore used a simple method in which inulin and PAH are injected subcutaneously and estimated in capillary blood and in urine by a microtechnique. Intravenous fluid may be given in varying doses independent of the administration of PAH and inulin. The method is not

Radiological findings in congenital cystic pancreatic fibrosis.

The authors review the radiological findings in 18 oases of fibrocystic disease of the pancreas. In five cases of meconium ileus the radiological picture was very suggestive as to the diagnosis. Later in life, the combination of a diffuse net‐like pattern in the lungs and an irregular intestinal pattern with segmentation was very characteristic of this disease, although each of these findings, taken separately, was inconclusive, as it might be caused by other diseases.

Misleading Results of Pneumoencephalography in an Infant with Severe Hypoglycemic Attacks

In a five months old infant with a severe non‐pancreatogenic hypoglycemia of unknown pathogenesis, an encephalogram through suboccipital puncture showed wide areas of air over the left hemisphere.

Plasma glutamine and glutamic acid in children with brain diseases as compared with normal children.

With the method of KREBS, the plasma glutamine and glutamic acid have been determined in 12 children without cerebral disorders, and in 25 children with cerebral diseases, particularly cerebral palsy and epilepsy, and also in 5 children with neuroses. Very great variations occur in the same individual at different times. The children with cerebral disorders show the same glutamic acid level as the controls, but their glutamine level was lower. However, the method is of no diagnostic value. Further studies in this field will be carried out.

Traumatic heart disease in a 6-year old girl.

The author reports a case of ventricular paroxysmal tachycardia combined with atrio‐ventricular block, arising after a fist‐blow in the chest in a girl of six. Sinus rhythm was obtained with quinidine. ACTH had no demonstrable effect on the scar presumably present in the right ventricle.

Collection of Urine in Infancy by Means of Plastic Colostomy Bandage

A simple method is described for collection of urine from infants of both sexes by means of a plastic colostomy bag.

Congenital Malformations of the Urinary Tract. I. Diagnosis

In this and the following paper (by Dr. Winkel Smith) we will present a case material, consisting of the urological patients admitted to the University Clinic of Pediatrics, Copenhagen, during the years 1949--1958. This series comprises 183 cases submitted to urological examination. In this number there are not included cases of simple hypospadia, pseudohermaphroditism and enuresis. The indications for urological examination were: 1) recurrent or persisting pyuria (a single attack of pyuria does not, in our opinion, necessitate a thorough examination). 2) retention of urine, frequency, dribbling or incontinence. In common enuresis we have only in part of the cases taken urograms; these were all normal and have therefore not been included in the present series. 3) hematuria (except in acute nephritis and hemorrhagic diathesis). 4) abdominal colic, with a localization suggesting a urinary disorder or

Total and extracellular body water in children during AGTH treatment

In his interesting paper Dr. Tallquist mentioned that the pyruvic acid values in the blood do not always show a correlation to the infant’s development, as judged by the birth weight. I t may be of interest to note that in a different context there is reason to assume that the true degree of fetal development at birth is better reflected in certain chemical data than in the birth weight. Dr. Berfenstam, of Uppsala, has shown that the carbonic anhydrase values in the red blood cells are strikingly correlated to the fetal development as evaluated on menstrual data.